Diagnostic Reading #8: Five Must-Read Articles From the Past Week

This week’s articles include: a study examining healthcare IT technology adoption in rural areas; the need for additional training on correct interpretation of digital breast tomosynthesis scans; a study showing remote patient monitoring does not reduce readmissions or mortality for patients with heart failure; a Q&A with radiologist Stamatia Destounis, Healthcare ITMD; and news that more than 100 health industry stakeholder organizations have agreed to push the industry and policymakers to take six steps—many supported by information technology—which they say can immediately improve the nation’s healthcare system.

A study entitled “Variation In Rural Health Information Technology Adoption and Use,” recently published in Health Affairs, noted that while initial health IT adoption and meaningful use achievement were higher among rural providers and hospitals than those in urban areas, these populations were less likely to return in Continue reading

HIMSS 2016: Finding the Latest Trends in HealthIT

Carestream is attending the industry-leading HIMSS health IT conference next week

HIMSS 2016logo

 

Carestream is gearing up for the 2016 Healthcare Information and Management Systems Society (HIMSS) Conference  Feb. 29 to March 4, joining more than 40,000 health IT professionals, clinicians, executives and vendors from around the world. Each year, this conference brings together educational events, world-class speakers and a showcase for the best health IT products.

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Top Five Health IT Blogs of 2015 from Everything Rad

As we near the end of 2015, it is a popular time of year to take a look back at the blogs that generated the highest interest throughout the year. In this summary, we look at some of the most popular Everything Rad healthcare IT blogs of 2015 covering value based healthcare, radiology reporting, meaningful use and clinical collaboration.

  1. Four Reasons Multimedia is the Future of Radiology Reporting – We have been touting the power of multimedia-enhanced radiology reporting for some time. We have shown the history of reporting in our industry, as well as showcased the important business cases multimedia reporting provides to departments via referrals from physicians. In brief—multimedia-enhanced radiology reporting is the future.
  1. What Does Clinical Collaboration Really Mean? – Clinical collaboration was born out the use of our vendor-neutral archive (VNA). The VNA served as a housing mechanism for medical images across a variety of –ologies, not just limited to DICOM images. With the VNA, the images remain safe and accessible when necessary, however, to enable intelligent, user-based sharing, more than just storage is needed.
  1. Imaging’s Place in Value-Based Healthcare – The answer to a question asked in a SIIM 2015 Friday morning session was clear–medical imaging needs to make further progress to be in a position to provide value-based care.
  1. White Paper: Metadata – Creating Meaningful Access to Clinical Images & Data – Metadata is explored in greater depth in an effort to truly uncover its value and importance not only medical imaging, but also in all patient clinical data.
  1. Video: The Value of Imaging Sharing in Clinical Collaboration – See how image sharing on the Clinical Collaboration Platform is able to give clinicians real time, on-demand access to imaging results, as well as how it can empower patients to share their images between facilities, physicians, and specialists. 

eBook: Radiology as an Enterprise Model for Collaboration

Collaboration has become a key component of today’s healthcare system. Department silos are breaking down and fading away, and from the rubble is born multidisciplinary teams with a focus on interoperability across departments.

Meaningful Use (MU) has served as a great incentive to make patient information universally available to clinicians through the EHR, but too often the collaborative benefits of the technology fail to become available to the “-ologies” in the health system.

But there are examples of successful collaboration delivering real benefits to the medical community and patients.  One of the best is the University of Virginia (UVA), where the EHR-driven radiology workflow not only provides full clinical information to radiologists, but the collaborative workflow adopted by UVA has also helped the UVA Physicians’ Group attest to MU Stage 1 and receive nearly $1.5 million.

Cree Gaskin, MD, Vice Chair, Informatics at UVA outlines their process in a recent chapter of our CIO eBook. The key to this EHR-driven radiology workflow was the life-cycle of the PACS. Specifically, the fact that it has reached a maturity level that is the third and final phase of the evolution, as seen in Dr. Gaskin’s graphic below.

EHR-driven radiology workflow

This third stage involves the PACS becoming integrated and interoperable with the EHR. This allows workflow to become optimized, and images and reports to become accessible via the EHR. From this, collaboration among clinicians and other stakeholders is supported in full and information can be accessed immediately. This ongoing gathering of data informs clinical decision support and big data analysis.

From within the EHR, the radiologist can identify what would be useful, depending on the case. That information can then be served up to radiologists so they do not have to spend time searching for it. If the information is identified in advance, then it can be made accessible, as almost all of the necessary data is housed in UVA’s EHR.

The key is to establish an EHR-driven workflow, as demonstrated here in Dr. Gaskin’s graphic.

EHR-driven workflow

How it works at UVA is that one central login at a workstation allows access to:

  • Protocoling
  • Reading Studies
  • Chart reviews/search
  • MU
  • Teaching file
  • Tech work lists
  • Manager referrals
  • Audit trail
  • Report creation and signing
  • MD performance metrics
  • Administrative reports
  • Peer review (prior while reading)
  • Charting—orders, notes
  • “Watch patients; results tracking
  • Communication with providers

The interoperability between UVA’s Epic EHR and Carestream PACS permits the EHR-driven workflow or the EHR-enslaved workflow which is PACS-driven. In the PACS-driven workflow, the doctor selects a study from the PACS integrated worklist, and the corresponding patient record will be opened in Epic.

UVA reports that the results of such capability have included improved report turnaround time (RTAT), and more important, with stratification by level of priority, and nearly $1.5 million MU Stage 1 incentives for the UVA Physicians’ Group.

For a more detailed look at UVA’s story, you can read the interactive eBook, “Clinical Workflow in an Era of Interoperability,” which contains interviews and soundbites from Dr. Gaskin, as well as Dan O’Malley, MS, UVA’s director, informatics and business services.

Julia, Weidman, Marketing Manager, Healthcare Information Solutions, CarestreamJulia Weidman is the Healthcare Information Solutions Marketing Manager for the US and Canada at Carestream.

 

Diagnostic Reading #51: Five Must-Read Articles From the Past Week

Carestream LogoIn this week’s Diagnostic Reading, we’re looking at the Meaningful Use HIT program, ultrasound mammography, redefining the role of the CISO, patient communication, and patient satisfaction.

Medical Groups Rebel Against Meaningful Use HIT Program – AuntMinnie

The American Medical Association (AMA) and 110 other medical associations have asked U.S. lawmakers to intervene in the meaningful use (MU) program before physicians decide to no longer participate in the initiative, designed to spur the adoption of healthcare IT. In a November 2 letter to leaders of the Senate and House of Representatives, the associations detailed their concerns over the administration’s plans to move ahead with implementing stage 3 of the meaningful use program, “despite the widespread failure” of stage 2.

Breast Ultrasound Mammography Find More Cancer – AuntMinnie

Adding ultrasound to mammography screening detects more early invasive breast cancer and probably reduces mortality, according to a 4 November study in the journal Lancet. The Japanese trial is thought to be the first of its kind in a large randomized multicenter population, and that focused on younger women at average risk with dense breast tissue.

Increased Cyber Risks Redefining the CISO – Healthcare IT News

Increased cyber risks and a recent string of major breaches have changed the game for chief information security officers, making cybersecurity a top priority for board members and helping CISOs more effectively make the case for bigger budgets. A recent IBM-sponsored research project performed by the Darwin Deason Institute for Cyber Security at Southern Methodist University in Dallas sought to explain this new shift. The results concluded there were three types of CISOs effectively innovating the way their firms handle cybersecurity.

Patients Lack Access to Digital Health Communication Tools – Healthcare Informatics

Many Americans lack access to or awareness of digital health tools, such as text appointment reminders and patient portals that can increase communication with their healthcare providers, according to a survey by The Council of Accountable Physician Practices (CAPP) and Bipartisan Policy Center (BPC). The survey also found most physicians don’t recommend using these digital tools, according to the consumer respondents. Just 29 percent receive electronic reminders for appointments, medication refills or suggested care and 14 percent report having the ability to check medications online. In addition, only 15 percent receive communication via online messaging platform and 9 percent get text reminders, and that digital interaction is growing very slowly, such as only 4 percent growth for email correspondence about patient health.

Online Review Show Technologists, Receptionists Impact Patient Satisfaction More Than Radiologists – Radiology Business

Patient reviews are becoming increasingly popular and influential throughout the healthcare industry, but that momentum doesn’t always carry over to radiologists. For example, in a study  published back in August by the Journal of the American College of Radiology,  researchers searched five popular physician-rating websites and only found reviews for 197 of 1,000 randomly selected radiologists.

Diagnostic Reading #47: Five Must-Read Articles From the Past Week

Carestream LogoA new week means a new Diagnostic Reading, This week we are looking at health record security, meaningful use, a CT use study, ICD-10, and patient engagement in hospitals.

Report: 45 % of Americans Have Had Records Compromised – Clinical Innovation + Technology

According to a white paper from iSheriff, a provider of cloud-based enterprise device security, almost 45 percent of Americans have had their sensitive health information compromised via a cyberattack. The New Healthcare Crisis: Cybercrime, Data Breaches and the Risks to Patient Records highlights the largest breaches and points out that the five-year total is more than 143 million compromised patient records which is more than one-third of the 319 million Americans.

U.S. Government Finalizes Meaningful Use Regulations – AuntMinnie

The announcement by the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) and the U.S. Centers for Medicare and Medicaid Services (CMS) featured the final rule for stage 3 in addition to modifications to current stages of the MU program. The reporting period for providers to attest to meaningful use of IT in 2015 has been dropped from 365 days to 90 days. New participants in the MU program can take advantage of a 90-day reporting period in 2016 and 2017.

6 Glaring and Disruptive ICD-10 Glitches – Healthcare IT News

Linda Girgis, MD, Family Physician, South River, NJ, shares her experiencing using ICD-10 in its first week. The glitches she experienced are outline in her article and include: the CMS grace period, clearninghouses, referrals, eligibility checks, wait times and personnel.

Study: Skip CT in Most Blunt Emergency Trauma Cases – AuntMinnie

According to a study of more than 11,000 patients that was published October 6 in PLOS Medicine, doctors can safely forego CT imaging in more than one-third of emergency blunt trauma cases by using clinical criteria to assess patients rather than automatically sending them to imaging. The researchers hypothesized that two validated clinical tools could be used to avoid unnecessary radiation-bearing exams and also save money. They showed that nearly all injuries can be found using the two sets of clinical criteria, which they called “decision instruments,” comprising either six or seven elements. Both deliver at most a small fraction of the radiation dose of CT, the group reported.

ONC: Patient Engagement Capabilities Increasing in Hospitals – Healthcare Informatics

According to ONC data, which includes data from the American Hospital Association (AHA) Information Technology (IT) Supplement to the AHA Annual Survey, this is a significant increase from 2013, where 1 out of 10 (10 percent) hospitals provided the capability. Further, most hospitals allowed patients to transmit (66 percent) and download (82 percent) health information; however nearly all hospitals (91 percent) allowed patients to view their health information electronically.

Diagnostic Reading #31: Five Must-Read Articles from the Past Week

Carestream LogoAnother week and another issue of Diagnostic Reading. This week’s topics are focused on population health, Meaningful Use and the “Digital Divide,” clinical and claims data, radiology decision support, and radiology’s role in enterprise imaging.

1) Population Health: The Path Forward – Healthcare Informatics

Mixed sentiments were on display among the industry leaders participating in the 15th annual Population Health Colloquium, held on March 23 at the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia, and chaired by David Nash, M.D., dean of the Jefferson School of Population Health.

2) Did Meaningful Use Create a ‘Digital Divide’? – Healthcare IT News

A new study from Weill Cornell Medical College, published this week inHealth Affairs, points to the emergence of “systematic differences” between physicians who participated in the Medicare and Medicaid EHR Incentive Programs and those who didn’t. Docs’ participation in the Medicaid incentive program rose from 6.1 percent to 8.5 percent between those two years, researchers say, while participation in the Medicare incentive program rose from 8.1 percent to 23.9 percent.

3) Infographic: Clinical and Claims Data – What Lies Beneath? – Healthcare IT News

“This infographic draws upon the unified clinical and claims data warehouse of Arcadia Healthcare Solutions to show the quantity of data available for 500 patients. Claims records are represented by the “above-ground” green bars – but they’re dwarfed by the vast amount underlying electronic health record data, represented by the brown bars underneath.”

4) Radiologist Decision Support May Cut Unnecessary Studies – AuntMinnie

According to researchers at NYU Langone Medical Center, a decision-support tool that is readily available to radiologists when reading medical images can help them order more-appropriate follow-up exams. After adopting the tool the research team found that radiologists’ adherence to clinical guidelines improved from 50% to 80%.

5) Big Picture: Radiology’s Role in Enterprise Imaging – Radiology Today

“As medical imaging has risen from a radiology-specific concern to an enterprisewide need, hospitals and medical centers have responded to the increasing and broadening demand for images. Making that adjustment is no easy feat, however. Clinicians desire image availability and accessibility wherever they work; making it happen requires scrupulous planning and plenty of hard work.”

Diagnostic Reading #30: Five Must Read Articles from the Past Week

Carestream LogoAnother week means another edition of Diagnostic Reading where we highlight five must-read articles published in the last seven days. This week’s articles focus on Stage 3 Meaningful Use, dense breast tissue, VNAs, breast cancer screening, and mobile app adoption among radiologists.

1) Proposed Rules for Stage 3 Meaningful Use – Imaging Technology News (ITN)

Dave Fornell of ITN goes into details for each of the eight objectives for Stage 3 Meaningful Use set in place by the Centers for Medicare and Medicaid Services (CMS). The eight objectives include: 1. Protect Patient Electronic Health Information; 2. Electronic Prescribing; 3. Clinical Decision Support (CDS); 4. Computerized Provider Order Entry (CPOE); 5. Patient Electronic Access to Health Information; 6. Coordination of Care Through Patient Engagement; 7. Health Information Exchange (HIE); and, 8. Public Health Reporting.

2) Making Sense of Dense Breasts – Imaging Technology News (ITN)

Jeff Zagoudis of ITN discusses how as states continue to mandate patient notification of dense breast tissue, the technology for analyzing and reporting continues to evolve. A big issue today is how almost all in the medical community know about the impact of breast density, but that knowledge has not been passed down to patients. The article dives into the how many states in the U.S. are working to notify patients about dense breast tissue, and other modalities to get a second read of the exam.

3) NEJM: Breast Cancer Screening Reduces Mortality by 40% – AuntMinnie

“Researchers from the World Health Organization’s International Agency for Research on Cancer (IARC) found that women ages 50 to 69 who regularly receive mammography screening reduce their risk of dying from breast cancer by 40%, compared with women who are not screened. This translates into about eight deaths prevented per 1,000 women regularly screened, according to the group.”

4) SIIM 2015: VNA Adoption Yields Workflow, Cost Benefits – AuntMinnie

In this session from SIIM 2015, Wake Radiology was able to realize the benefits of a vendor-neutral archive (VNA) such as improved workflow, better management of digital breast tomosynthesis (DBT) images, and reduced storage costs.

5) Q&A: Radiologists at the Forefront of Mobile App Use – Diagnostic Imaging

The Q&A is with David Hirschorn, MD, director of radiology informatics at Staten Island University Hospital, in which he discusses a panel he participated on at ACR 2015 called, “Reshaping Radiology Through Mobile: Apps, Technologies, and FDA Regulations.”

Video: Meaningful Use and Clinical Decision Support Dominated HIMSS15

Dave Fornell, editor for Imaging Technology News (ITN) and Diagnostic and Interventional Cardiology (DAIC) Magazine, stopped by the Carestream booth at HIMSS15 to discuss the biggest trends he saw at the conference.

Meaningful Use (MU) was the biggest trend Fornell saw, and he noted the different stages being focused on by vendors and hospitals. VNA, PACS, and EMR vendors he spoke with are focused on complying with Stage 3, but they are seeing that the hospitals are focused on consolidation.

Fornell also touched on clinical decision support, and how its part of Stage 2, but a much more important part of Stage 3 MU. As imaging exams are ordered, patient history is going to be ask for, and used as an integral component of the process.

The complete interview from HIMSS15 can be veiwed below.

Diagnostic Reading #19: Five Must Read Articles from the Past Week

Carestream logoIt’s the end of the week, which means it’s time for five more articles in the newest Diagnostic Reading. This weeks articles include an update from CMS, preparation for Meaningful Use Statge 2 attestation, the benefits of following up, insurance and the affordable care act, and a study about the perspective of patients on the benefits and harms of medical testing.

1) CMS Announces ‘Next Generation’ Accountable Care Organization Model – FierceHealthcare

The Centers for Medicaid and Medicare have announced a new ACO model that will encourage healthcare providers to take more financial risks. This new system will offer more predictable financial targets as well. The goal of the ‘next generation’ model is to offer strong financial incentives by focusing on quality rather than quantity of care.

2) A Health IT Auditor on the Two Big Obstacles in MU Stage 2 – Healthcare Informatics

This article discusses the difficulty that healthcare organizations have when it comes to deciding if they are ready to attest for Meaningful Use Stage 2. There are two main issues: 1) Providing a summary of care documents electronically, and 2) effectively implementing patient portals.

3) Early Follow-Up Reduces Readmissions of High-Risk Patients – FierceHealthcare

A study conducted by the Annals of Family Medicine found that following up with patients reduces the rates of readmission. The study found that follow up is particularly important for patients with a high-risk of readmission. If followed up with within a week, the rate of readmission for these patients dropped by a significant margin.

4) Exchange Enrollment Sees Limited Progress with Youth, Minorities – Modern Healthcare

Over 11 million people have enrolled in state-based or federal insurance programs. However, this year, the number of enrollees under the age of 35 has only increased one percentage point. Likewise, minority groups did not see improvement in percentage. While the Asian and Latino populations remained at the same percentage, the percentage of African American enrollees dropped 3%.

5) Patients Overestimate Benefits, Underestimate Harms of Medical Testing – Radiology Business

Researchers at Bond University in Brisbane, Australia, conducted a study that found patients overestimate the benefits of medical testing by a substantial amount. In the same manner, the study found that about 50% of patients underestimate the potential harm of medical testing. This is said to be important because these phenomena cause over diagnoses, unnecessary testing, and reduce the true value of radiology or other medical procedures.