Posts Tagged ‘EMR’
Models of Care: Can They be Copied?
January 28, 2010
Can good models of efficient care be emulated in other hospitals. Much has be touted about the Mayo Clinic, Cleveland Clinic and others. The lower costs of these models has been documented. See the Dartmouth Health Atlas report on chronic care (see table on page 9).
In a video on Huffington Post Video last month, the interview at the Cleveland Clinic about the successful EMR still questions whether this success can occur elsewhere. Yes, the implementation was expensive and expensive to maintain but the benefits over paper are quantifiable in terms of quality of care and improved outcomes. Maybe the lessons of successful EMRs have paved the way for others.
Finally, Dr. Cosgrove, CEO at the Cleveland Clinic is interviewed by Fox Business News at the Davos World Economic Forum. He again repeats his contention about the need to address obesity and health care costs. Again, a model or approach to care and costs which others can emulate.
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Our Pen-and-Paper Doctors
June 25, 2008
The New York Times has an editorial today on the need for physicians to adopt EMRs. It is in reaction to a report in the New England Journal of Medicine. The slow pace of fast change is happening in healthcare IT. Not devoting enough resources to health IT continues the short sited path of the past. The advantages are clear – get on board and devote the resources. Improved government incentives will help.
Share this:Video on Paper Free Healthcare
February 29, 2008
AllScripts has posted a video on YouTube and invites discussion of this topic on their website:
www.allscripts.com/paperfree/
3-D visualization tool for electronic health records
January 16, 2008
Another announcement about IBM innovation, this time in a 3-D image of the body to be integrated into EMRs. It is called the Anatomic and Symbolic Mapper Engine. How it works:
“A doctor first clicks the computer mouse on a particular part of the image, which triggers a search of the patient’s eHR to retrieve the relevant information. The patient’s information corresponding to that part of the image is then displayed, including text entries, lab results, and medical images, such as magnetic resource imaging. The doctor can zoom in on the image to retrieve selective information or narrow the search parameters by time or other factors.”
Can’t wait to see a demo.
A fascinating concept. Why not make it available to PHRs as well?
Eye Movement and EHRs
September 11, 2007
In this report from the Boston Globe, titled “Eyes shift from patient to keyboard, the writers bring to light an important issue in implementation of an EMR – its affect on the physician-patient relationship. One study quoted in the articled noted that “about a quarter of patients felt as though computers reduced the amount of time their doctors spent talking with, looking at, and examining them. But just 8 percent felt that the computer actually interfered with the doctor-patient relationship.” On suggested approach is to “apologizing to her patients for turning away from them.” It also notes that using an EMR can add time to the visit. Part of this can be the tendency to review old notes (although one must wonder the amount of time it took to review paper records, especially for patients with chronic illnesses, or did the doctor just not bother because the information was too difficult to extract?). Is the trade-off here, less personal but perhaps safer medical care? Or at least better documented?
Related to this is a study reported in the Journal of the American Medical Informatics Association titled, “Electronic Health Records in Specialty Care: A Time-Motion Study”. This study of 15 physicians and 157 patients concluded that, “Following EHR implementation, the average adjusted total time spent per patient across all specialties increased slightly but not significantly.”
Both of these reports contribute to the ongoing attention needed to the social impacts of EMRs on provider-patient relationships.
Share this:Kaiser Survey on Health Records
May 3, 2007
According to a study released today at a Kaiser Healthcare Summit in DC, while most of the survey respondents stated that their provider uses electronic records, and that they are more efficient, the were slightly more trusting of papers records by 47 to 42%. 46% had visited a health information website, and were slightly more interested in these type of sites as opposed to insuror websites. 51% said they would prefer a doctor who uses an EMR all other qualifications being equal. 73% thought that the benefits of EMRs outweighed the risks.
Overall, these results are encouraging, but they still show a low level of familiarity with EMRs.
Share this:PracticeFusion and Google – the real story
March 21, 2007
The big announcement by PracticeFusion, a startup offering a free EMR in exchange for using the patient data to sell ads, is reported as a partnership with Google. Is this Google Health or something else. Reading the fine print, “Practice Fusion’s deal with Google is what makes a free medical records system possible. Google’s AdSense program will generate ads that will be displayed as the records system is used.” according to SaukValley.com. Doesn’t sound like Google is moving into the EMR business with this program. Besides, if it was a high level Google partnership, won’t Google announce it simultaneously?
Share this:New EHR Business Model
December 12, 2006
In a report from HealthcareIT News, titled, “Vendor to offer web-based EHRs to docs in exchange for data“, a company called Practice Fusion is announcing an new business model for community physicians. It is a hosted model for EHRs where the company will discount their services and then sell “de-identified data to insurance groups, clinical researchers and pharmaceutical companies.” Can this business model work? Small practices might welcome a lower cost solution, however, they and their patients might be concerned about whether the data is fully deidentified and their privacy protected. Will the host vendor be covered by HIPAA?
Share this:Consumer attitudes toward PHR, EHR
December 6, 2006
In a new study release by Price, Waterhouse, Coopers, Top Seven Health Care Trends in ’07, there an indication of low confidence that EHRs will improve care (34% yes) but a larger group who are undecided or need more information (42%). I don’t agree with the report title in Healthcare IT News which says, “Consumers don’t believe EHRs will improve care, report says”. I think the lesson from the report is the need more information. The failure here is not communicating the importance of EHRs and PHRs and the value they provide to the consumer.
Also in the report is the trends toward “Consumers taking the wheel” (consumer driven health plans success will depend on word of mouth reports) and “Private equity investors will fund the next generation of innovation in services and treatments, challenging larger competitors that lack market agility.” This will be true not only in minute clinics but other new practice venues.
New York Times on Privacy and EHRs
December 4, 2006
In the December 3rd edition of the New York Times, a story titled “Health Hazard: Computers Spilling Your History” examines privacy of electronic medical records. In addition to finding how hospitals can successfully defeat attempts of employees to sneak a peak at medical records of the rich and famous (including President Clinton), the author cites concerns in Congress, e.g., “But the toughest challenge may be a human one: acute public concern about security breaches and identity theft.” This is cited as the major barrier to adoption of EMRs by physicians in the U.S. while other western countries have up to 89% use. One observation of a policy analyst: “If you don’t have the trust of patients, they will withhold information and won’t take advantage of the new system.”
Well said, but much of the task of protecting privacy is proper planning and implementation of systems. One of the biggest threats appears to be health care workers who store patient data on laptops. With all the methods of securing laptops or better yet, accessing centralized systems through secure channels, why should this continue to be a risk.
One note on PHRs: “EVEN without new federal laws to guide them, some companies have begun
to encourage their employees to embrace electronic medical records. At Pitney Bowes, employees are paid a bonus if they store a copy of their personal health records on WebMD.com, the medical Web site.” An encouraging sign and a new way to use incentives.
