Posts Tagged ‘EMR’
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:
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.Share this:
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.Share this:
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.
Conclusion: Why shouldn’t this be done more broadly, even nationally. Perhaps through Meaningful Use it will permeate more broadly.Share this:
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).Share this:
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.Share this:
March 7, 2011
Heading to San Francisco for this AMIA meeting. Looking forward to the opportunity to present from the podium and poster session. Topics include:
- Development and Sustainability of an EHR-based Chronic Kidney Disease Registry
- REDCap – Characterizing the Rapid Adoption at a large Academic Health Center
- Design of a Registry Management Tool for EMR Data
- Research Recruitment in Anesthesia Using EMR Data
There will be many opportunities for networking. Hope to come home with lots of ideas.
Hash tag is #TBICRI11Share this:
March 6, 2011
A nice interview with Dr. Harris, CIO of the Cleveland Clinic and President of the HIMSS board on following the spirit of meaningful use, not just the letter of the regulation to create a real sea change in health care.
From Hospital and Health Networks Daily blog.
February 13, 2011
While I read The Myths of Innovation as an eBook, my next three are all paperbacks:
- Reading in the Brain: The New Science of How We Read by Stanislas Dehaene
- Innovation and Entrepreneurship in the Healthcare Sector: From Idea to Funding to Launch by Luis G. Pareras, MD
- Keys to EMR/EHR Success: Selecting and Implementing an Electronic Medical Record by Ronald B. Sterling.
The last two are Greenbranch Publishing.
Watch for book reviews in the near future.Share this:
January 25, 2011
In a new study in the Archives of Internal Medicine, the hypothesis that electronic medical records would improve quality was not borne out. However, what was not picked up by most news stories about the article was that the data was from 2005-2007, 4 years old during a period of rapid adoption of EMRs. An accompanying editorial titled “Clinical Decision Support and Rich Clinical Repositories: A Symbiotic Relationship“, is critical of the report stating, “This lack of effect of CDS [clinical decision support] on provider behavior was surprising given the strong effects previously reported in randomized controlled trials of these systems.” These critics note that most of the guidelines which are more likely to be followed are immunizations rather than medication use which the study focused on. In conclusion, the editorial writers from the National Library of Medicine state, “Only when EHRs carry rich repositories can we expect EHRs to reach their promise and CDS to have measurable effects on a broad range of quality measures at the national level.”
My conclusion is that the use of clinical decision support within EMRs can impact quality on a national level but that early implementation of EMRs may take time to demonstrate this impact.Share this: