Posts Tagged ‘EMR’
Presentation on Meaningful Use and EMR in Research
January 25, 2012
Last week I was invited to present to a medical school class on bioinformatics. My topic included EMR data standards, meaningful use and the use of EMR data in research. The session was very interactive and not totally captured in the slides. The challenge was presenting to medical students who are used to group activities, case studies and a research-based curriculum.
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Year in Review – Travel
December 26, 2011
It was a big year for traveling to conferences:
- February – HIMSS Annual Conference in Orlando – spoke at the Social Media center twice and presented on a panel on social media
- March – AMIA Clinical Research Informatics Summit in San Francisco. Two podium presentations (CKD Registry and REDCap business model) and two posters
- April – attended TEDx Maastricht in the Netherlands and a side trip to UMC Radboud in Nimegen.
- April – ACRT meeting (Association for Clinical Research Training) in Washington, DC – panel presentation on REDCap.
- May – Patient Experience Summit at Cleveland Clinic with Enoch Choi presenting
- June – consulting at a hospital in Michigan on data warehousing
- September – Medicine 2.0 Congress in Palo Alto, CA. Poster presentation
- October – American Association of Medical Colleges meeting on Big Data in Washington, DC
- October – Clinical and Translational Science Awards Informatics meeting at the National Institutes of Health. Bethesda, MD – poster presentation
- October – Panel at Case Medical School, Cleveland on Social Media in Clinical Trials
- November – Senior Workers Conference in Minneapolis, MN – presentation on Social Media and Electronic Medical Records
- December – Center for Health Services Research and Policy at MetroHealth Medical Center, Cleveland, on Disease Registries using EMR Data
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Distracted Doctors – Living in an App World
December 19, 2011
The NY Times article on how devices are distracting doctors certainly rings true as hospitals push patient safety and preventing data breaches. New devices, specifically smart phones and tablets (especially the iPad) are becoming pervasive in hospitals and outpatient settings often outside of the control of hospital IT departments. Medical schools as well attempt to increase awareness of the risks while evaluating the advantages of these devices.
One aspect of smart devices yet to be addressed is, does the app model in iOS and Android devices fit with medical practice. Part of the purpose of integrated EMRs is to bring all of the information to the user in one place. This increasingly includes CPOE and embedded clinical decision support tools. But an app model requires the user to jump from one app to another to acquire the information needed. This is a classic dilemma of an integrated application/portal (EMR) versus a better user experience (apps). Which works best for physician workflow? When will EMRs look more like apps?
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Presentation on Disease Registries using EMR data
December 10, 2011
On Dec. 2, I presented at the Center for Health Care Research and Policy at MetroHealth Medical Center on “Registry Using EMR Data: Chronic Kidney Disease Case Study.” This has been a successful registry which I am a coinvestigator on for the past 2 years. Some of the success factors include: a well-functioning interdisciplinary team, a systematic approach to the data, and a step-wise approach to publication and grant writing. It fits well into the IMO model of the Learning Healthcare System.
Slides are available here: http://www.chrp.org/seminars_past.asp
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The Next Wave of Technology: Social Media and Electronic Health Records
November 12, 2011
This Thursday I presented at the Senior Workers of the Twin Cities annual conference on this topic. It was helpful to discuss the value and trends in EHRs, PHRs, Social Media, and Mobile Apps. The group was receptive and had excellent questions on privacy and the digital divide. I started the talk by telling Regina Holliday’s story. The slides are below:
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Guest Blog Post on e-Patients.net
September 10, 2011
I was invited to write a guest post on the ONC Query Health initiate for e-Patients.net.
You can read it here.
Thanks to @ePateintDave for the enthusiastic invitation.
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Government Health IT Gets Boost with Two New Websites
September 8, 2011
HealthIT.gov redesign was rolled out this week with seperate paths for providers and patients. It makes a great case for EHRs on the provider side including examples of successful implementations in small practices. On the Patient/Family side it explains the value of health IT in lay language and has great videos by some well known ePatients – ePatient Dave and Regina Holiday.
The other announcement is the new Query Health project from ONC which “aims to define and deliver the standards and services for distributed population health queries from certified EHRs and community records, originating in the routine course of patient care.” Excellent goal with some tough technical challenges ahead. Includes implementation, clinical, technical and business. Already many companies and institutions have joined. This has great potential in research for chronic disease and epidemics.
It is a great week for government efforts to enhance healthcare through information technology.
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Quality and EHRs – What Works
September 6, 2011
A groundbreaking article in the New England Journal of Medicine, Electronic Health Records and Quality of Diabetes Care, by my colleagues in Cleveland, demonstrates several points:
- Healthcare quality can be effectively measured using EHR data
- Quality of diabetes care can be improved through the use of EHRs
- This can be done on a regional basis, beyond the scope of one hospital or health system
- EHRs are superior to paper records in improving quality care, demonstrating the Meaningful Use Concept
- This is true over different insurance types.
More background on the initiative, Better Health Greater Cleveland is available Brian Ahier’s blog and on the BHGC website. It is supported by a grant from the Robert Wood Johnson Foundation.
Conclusion: Why shouldn’t this be done more broadly, even nationally. Perhaps through Meaningful Use it will permeate more broadly.
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Adoption of PHRs – Where are we going?
April 22, 2011
Two recent articles on PHR adoption caught my attention this week:
- From ComputerWorld -Consumers remain wary of personal health records – reporting on the IDC survey which shows that 23.4% reported that they were somewhat comfortable or very comfortable with Google or Microsoft collecting their health information. 28% of the respondents indicated that they would use a PHR system if their physician recommended doing so. 10% indicated that they did not use one because of infrequent need for medical care and 10% indicated they did not trust the security of Internet sites.
- Can genomics encourage use of personal health records? An extended report from a presentation by John Halamka about PHRs and genomics. He notes two things that will drive PHR adoption:
1) health plans that require more patient interaction and shared decision-making with the provider
2) features such as the ability to securely email physicians, pay bills, refill prescriptions, get specialist referrals and make appointments, that is PHRs tethered to EHRs will be the consumer’s preference. He also sees a future opportunity to integrate personal genomics into PHRs. He talks about his own experience with personal genomics.
Based on these two articles, there is reason for optimism about growth in adoption of PHRs but may be conservative growth. Drivers of that growth will be: recommendation by providers (participatory medicine), tethered to an EHR so much of the data is already there, and being future rich.
Two additional features I think will be useful for patients are: connection with social media (such as, sharing one’s data selectively with private disease and condition communities, such as, organizedwisdom.com or patientslikeme.com) and connection with wellness apps and mobile devices both of which are offered by Google Health and Microsoft HealthVault).
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Report from AMIA – All Diseases will become Orphan
March 12, 2011
The first speaker I heard at the American Medical Informatics Joint Summit was Kenneth Buetow from the National Cancer Institute. In his typical provocative manner, he challenged the audience on the transition day from the Translational Bioinformatics to the Clinical Research Informatics Summits. He began with promoting the P4 Medicine as the new model for healthcare: personalized, predictive, preemptive, participatory. Although throughout the conference little was articulated on the participatory aspects with one exception. More on that later.
Buetow talked about defining cancer on the molecular level and the challenge of the exponential number of patients required to do genetic screening for a single disease. He referred to Pharma 3.0 from the Ernst and Young report on Progressions 2011 where patient engagement through social media as necessary in this new age of medicine. It is here that he stated, “All diseases will become orphans” meaning that as we understand more about genomics and are able to combine these findings with clinical data, we will understand each disease process on a truly personalized level and hopefully treat it as such.
As part of Pharma 3.0 and a new model for medicine, he did note some encouraging trends in volunteers for clinical trials, true patient activism in a full participatory sense. Specifically, he reported some recent statistics from Army of Women, a joint project of Avon and Susan Love to recruit an army of those willing to volunteer for research studies. Rapid recruitment occurred consistently for studies through this resource while traditional clinical trials continue to suffer from lack of full enrollment. He also referred to adaptive clinical trials as part of this new model. Finally, he discussed the Translatable Informatics Ecosystem as a way of describing how informatics will be key in this new paradigm using Services-Aware Interoperability Framework (SAIF) as one technology to reach that goal.
Many of the presentations at this year’s conference were focussed on data warehouses of clinical and genomic data and ontology development and application include many efforts in the semantic space.
Several speakers referred to Evidence Based Medicine, Personalized Medicine and the Learning Healthcare System implying if not explicitly stating that there is a convergence of the future of medicine and that medical informatics and clinical research informatics are at the center of this convergence. Bill Hersch, noting the explosion of data both in journals and through EHRs and others sources, citing Stead on the need for “Systems of Brains” to manage the amount of information now available
All agreed that Medical Informatics is at a crossroads and has the opportunity to take leadership in the future of medicine, managing the data explosion and making it managable in the personalized medicine era we are entering.
