Health IT systems shift from record keeping to access that enables clinical collaboration
Julia Weidman, Carestream Health
Until the middle of the last decade, the primary goal of the EMR/EHR was actually to capture information, not to provide access to it – impeding clinical collaboration. It was a reference for doctors—a way to capture patient notes. It has since evolved from an archival role to an active collaborative role, providing access to reports, records, and images for all stakeholders involved in patient care.
Availability of a useful, problem-focused medical record
The idea for a comprehensive, organized medical record was pioneered by Dr. Larry Weed in 1956, but it didn’t become well accepted in the U.S. until after 1968. Dr. Weed—known as the father of the Problem-Oriented Medical Record (PMD)—described the concept in his often cited NEJM articles.
Throughout the U.S. and worldwide, equipment decision criteria are not so different
Bob Green, HIMSS member and writer
There are clear advantages to having new, up-to-date medical devices; including gains in productivity and efficiency. Medical equipment can support the movement to reduce healthcare costs and increase its efficiency and effectiveness. This movement is worldwide, and nothing new, as a McKinsey report stated a few years ago. “Today, medical device companies operate in a different world. In developed countries, healthcare systems are under acute financial pressure…. Developing economies are transforming the environment, too…. Success in emerging markets requires a deep understanding of stakeholders’ needs.”
New stakeholders influence purchase decisions
And new stakeholders are changing the way organizations look at the purchase of medical equipment. “In the developed world, decisions that used to be the sole preserve of doctors are now also made by regulators, hospital administrators, and other non-clinicians…. The result of this phenomenon is a shift from individual outcomes to a focus on population-level effectiveness.” Also, big data is beginning to offer a new level of evidence-based data that helps us evaluate the true advantages of technology.
The challenges and pathways to creating a unified framework for capturing, distributing and accessing clinical information
Cristine Kao, Carestream Health
What is interoperability in healthcare? Interoperability can be described as a well-functioning central nervous system, coordinating the enterprise’s many roles and tasks toward a common end: the well-being of each patient.
But when communications are slow, incomplete, or missing between any two entities — patients and providers, primary-care physicians and specialists, central and remote locations, and so on — the timeliness and quality of patient care can suffer. Many other parts of the total healthcare ecosystem can be affected as well: costs can rise, resources can be allocated inefficiently, and opportunities for constructive collaboration can be lost.
Information generated by different systems, on different networks and for different purposes becomes far more useful when a unified framework is in place for capturing, distributing and using the information. Ideally, with the appropriate security credentials, any individual user or collaborative team should be able to interact with the information they need, in the format they prefer, on their choice of device.
Why is interoperability important to healthcare?
Every stakeholder in the healthcare delivery process stands to benefit from interoperable systems built on interoperability standards that deliver collaborative transparency and efficiency. These stakeholders include patients who want to take more active responsibility for their own health; primary care physicians and specialists who are seeking meaningful collaboration, without information gaps, delays, or redundancies that could compromise quality; and providers in remote and rural areas who need the ability to share clinical images and data with centrally located specialists. Continue reading
Preparing for the next-generation of medical imaging data and analytics
Cristine Kao, Carestream Health
Today, the cloud is a grownup with a seat at the IT table. The major issues around the cloud (security, access and speed) have been satisfactorily resolved by industries outside of healthcare: technology, software, financial services, and retail have been using the cloud for years.
Of course, healthcare does have its own unique issues of privacy, security and access that make it slow to adopt any new technology, and the cloud has been no exception. But progress has been made. In a recent annual study of 125 large and small cloud users, for the first time in 2016, security was not the first concern mentioned. Technology has jumped ahead to meet the challenges of healthcare’s journey to value.
The cloud is an essential part of the healthcare industry’s IT structure/restructure to reduce costs, increase clinical collaboration and speed up clinicians’ access to information. As larger study files boost storage requirements, Intel and Carestream have partnered in Intel’s Storage Builder Program. The purpose of the collaboration is to blend Carestream’s expertise in healthcare information systems with Intel’s technological prowess to increase the performance of Carestream’s PACS and RIS systems and to make them more useful to clinicians. For example, Carestream recently deployed the new Intel® Solid-State Drive (SSD) Data Center (DC) Family for PCle® P3700 featuring Non-Volatile Memory Express™ (NVMe™) and observed a threefold increase in throughput in that portion of the Carestream Vue workflow.
Articles include an imaging technique that helps with cancer research; and survey shows large practices are increasingly more satisfied with their EHR vendors
A study reduces fears that use of clinical decision support systems could result in imaging exams being referred to other locations; an article reports telemedicine has the potential to dramatically transform the delivery of healthcare for millions of Americans; researchers report that observing eye-movement patterns in radiologists interpreting scans indicates each radiologist’s expertise and level of experience; new research through imaging shows a specific calcium molecule (TRPV6) is linked to aggressive cancers when it stops regulating itself properly; and a new survey shows large practices are increasingly more satisfied with their EHR vendors.
How to evaluate, use imaging clinical decision support
A study conducted by physicians at Massachusetts General Hospital reduces fears that using clinical decision support (CDS) systems for imaging exams could lead to referring physicians sending their imaging orders to other locations. After reviewing 4,866 studies that had been initially flagged as low value by CDS software and were subsequently canceled by the referring provider, the team found that 111 were ultimately performed within 60 days. Continue reading
Top news includes clinical decision making, EHRs and personalized recommendations in healthcare
This week’s articles include: radiologists playing a more active role in clinical decision making; use of EHR and CPOE systems create added clerical work for doctors; new systems can deliver a doctor’s personalized recommendations to patients to enhance compliance; a color-coded, user-friendly dashboard that tracks ER exams allows medical staff to better monitor patients; and companies are experimenting with ways to reach lower-income patients through apps, text messaging and video conferencing.
Radiologists Take On Bigger Role in Diagnosis – Wall Street Journal
At one of the top radiology departments in the country radiologists are now playing an active role in helping clinicians make medical decisions for their patients. Radiologists at NYU Langone Medical Center provide their analysis of imaging studies (via computer screen) as medical staff make their rounds in pediatric intensive care units, where frail patients are imaged daily to monitor their progress. The initiative to involve radiologists in making treatment decisions is led by Michael Recht, chairman of the radiology department, who oversees more than 200 physicians
EHRs are making things harder for physicians – DotMed Healthcare Business News
Physicians who used an EHR and CPOE were 30 percent less likely to be satisfied with clerical burden, according to a Mayo Clinic physician who was the lead author of a study. Doctors spend hours placing orders for patient procedures such as imaging exams and lab tests and are also spending more than 10 hours a week using the EHR on nights and weekends, according to the study. Continue reading
Alzheimer’s detection and the NFL are in the news
This week’s articles include: Almost every U.S. hospital is using EHRs to manage care at the point of delivery; U.S. cancer survivors will reach 20 million by 2026; contrast-enhanced MR images revealed that people with early Alzheimer’s disease have leakages in their blood-brain barrier; researcher says head CT radiation can be reduced by 90 percent; and stolen laptop could mean compromised health records for NFL.
ONC and CMS: We’re at a critical inflection point for EHRs, interoperability – Healthcare IT News
Now that almost all U.S. hospitals are using electronic health records, the industry is ready for the next phase of information sharing, improved outcomes and collecting the digital dividend. Patrick Conway, MD, chief medical officer at the Centers for Medicare and Medicaid Services, said the nation is moving into the next stage where patients consistently and reliably have access to their own data that drives better outcomes.
U.S. cancer survivors will number 20 million by 2026 – Auntminnie.com
A study by the American Cancer Society found that there will be 20 million cancer survivors in the U.S. by 2026, an increase of almost 5 million compared with the number of survivors alive today. The group found that more than 15.5 million Americans with a history of cancer were alive on Jan. 1, 2016, and this number is projected to reach more than 20 million by Jan. 1, 2026.
Imaging volumes and analytics make the news
This week’s articles include: providers need to leverage social media to target women; most physicians don’t know the costs of tests and procedures; many EHRs are missing data for inpatient and outpatient events; continued increases in patient visits to the ED has boosted imaging volumes; and a University of Texas professor contends that it might be a long time before healthcare analytics change the way providers deliver care.
Providers need to embrace social media for patient engagement – Health Data Management
If physicians want to reach today’s consumers, they need to leverage social media to target women who are making the healthcare decisions for their families and households. “Fifty-nine percent of women are making healthcare decisions for others in the United States, and that number shoots up to 94 percent among working moms with kids under 18,” said Dr. Geeta Nayyar, a practicing physician and mother who was one of the keynote speakers at a recent conference. Mothers who are 25 to 45 years old are the ones who are hiring and firing doctors, and using social networking to post online testimonials—both positive and negative.
Integrating clinical information supports the needs of the community
Neil R. Kudler, MD, Baystate Health
Baystate Health is an integrated delivery network (IDN) that includes five hospitals and more than 90 primary and specialty care practices serving a region of western Massachusetts with 800,000 residents. We know that patients who are coming to our facilities are also visiting other facilities outside of our network. As a result, they might be at risk of receiving duplicate procedures and imaging exams.
To address these concerns and to enhance patient care, we spent several million dollars to expand our electronic health record (EHR) into a regional health information exchange (HIE). We then invited hospitals and physician groups outside our network to participate at no cost to make our HIE both attractive and more effective.
Starting with an electronic medical record (EMR) and associated applications that provide demographic, claim and coding data, we built a clinical data repository that integrates and aggregates clinical information from Baystate entities and facilitates interfaces with disparate data sources from other organizations and their EMRs. Our platform addresses the challenge of standardizing the proprietary code language and data sets from the various EMR platforms to create a comprehensive view of patient health information.
Healthcare financing experts offer insights for small and rural hospitals
Jonah Michael and Michael Gsellmeier, First American Healthcare Finance
All hospitals face the challenge of financing and implementing the latest, ever-changing medical equipment while carefully managing budget dollars, but this challenge is amplified for small and rural hospitals. With higher demands from patients and an increased focus on improving the patient experience, rural hospitals must find new ways to keep up with their larger, urban counterparts when it comes to technology.
First, it helps to understand exactly why rural hospitals have a different set of challenges. Research from the American Hospital Association reveals that rural populations tend to have lower incomes and are, on average, older than urban populations. This combination translates to a high percentage of patients with Medicaid and Medicare. Furthermore, the research shows that there is a higher rate of chronic diseases in rural populations, meaning that more treatment is required with less hospital resources.
Hospitals, then, must deliver high-level, ongoing care to a population that may or may not be able to pay for their services. Beyond that, rural areas are also typically not high growth areas, so hospitals struggle to bring in new patients.
Another important element that can create both challenges and opportunities is a renewed focus on the whole patient experience. Simply put, patients have higher expectations than ever before. They are aware of emerging technologies—through the Internet, social media, TV and movies—and expect their hospital to have these technologies on hand. This puts an enormous amount of pressure on hospitals to obtain state-of-the-art equipment and technologies to maintain and attract patients.