Posts Tagged ‘Health Care IT’
February 6, 2012
I recently read two books on EHR/EMRs: one was published in 2007 but still has relevance, the other published in 2010 and focused on implementation.
Electronic Health Records: A Guide for Clinicians and Administrators by Jerome Carter is published by the American College of Physicians is a 500+ page volume written primarily for physicians. The first part of the book is a comprehensive review of EHRs including infrastructure, perspectives on the the use of EHRs for things like outcomes, clinical decision support and quality improvement and legal and privacy issues. The second half of the book is devoted selection and implementation of EHRs with a comprehensive workbook on product features and vendor selection. The majority of the book is still highly relevant with the only exception being some of the information on infrastructure which seems outdated and the lack of discussion of mobile uses of EHRs which is definitely a future goal.
The second book, Keys to EMR/EHR Success: Selecting and Implementing an Electronic Medical Record is also in its second edition. This work by Ronald Sterling begins by walking the reader through the initial questions of why invest in an EMR and how to transition from a practice management system to a full-functioning EMR and how to evaluated the potential legal risks, all common issues for medical practices considering this transition. The author then moves on to product selection and making a decision and negotiating a contract. These implementation details can easily be lost in the selection process and this kind of systematic approach is essential. Finally, the book addresses implementation, activation and support. Again, ongoing support is a common issue for those from the health IT world but not always considered by physicians or practice managers.
Both books provide helpful advice and background for EMR implementation. For those considering an EMR or who want to become familiar with one, these are helpful resources. The book from ACP could also be considered as a textbook in a health informatics curriculum.Share this:
January 11, 2012
This is the topic of my new blog post on HealthWorks Collective. Already received lots of traffic on Twitter and lots of views. Would like to see more about mobile standards in health care from Motorcycle Guy and others.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:
March 24, 2011
One addition to my post on this book is the final chapter on trends – 20 in all.
- Hospitals are no longer buildings
- Patient Safety Focus
- Information is everywhere
- Evidenced-based Management
- Healthcare can’t keep up with the rate of scientific discovery
- “Not being sick” to “Being Well”
- Shortage of Professionals
- The information hight gains more and more influence
- Concepts such as P2P and Web 2.0 arrive at the health sector
- Social entrepreneurs take the lead
- Consumer-driven healthcare
- Electronic medical records
- Cost containment will become more and more critical in healthcare
- New actors will appear in the healthcare value chain
- Healthcare will become more and more “vertical”
- Personalize medicine drives the agenda
- Bioinformatics emerge
- Bioconnectivity is the next big thing
- Electronic signature is everywhere
- The triple helix is becoming real – administration, hospitals and universities, venture capital.
Some of these are obvious, others provocative. Are there more to add to the list?Share this:
November 4, 2010
One of the advantages of having a personal blog is not only expressing one’s opinions but also promoting accomplishments. I have been fortunate to have three in recent months:
- coauthorship on a major article on a disease registry from EMR data - Development and Validation of an Electronic Health Record–Based Chronic Kidney Disease Registry, Clinical Journal of the American Society of Nephrology, Nov. 2010. Press Release:Health Registry Could Transform Chronic Kidney Disease Care
- named in an NIH grant: Refinement and Enhancement of a Web-Based Risk Calculator Deployment System
- named a Fellow in the Health Information and Management Systems Society (HIMSS)
Also, I became a fellow in the Group for Information Resources of the American Association of Medical Colleges this summer and reviewed a grant for a Dutch organization. Great opportunities and challenges keep coming. A great year.Share this:
April 6, 2010
I have been invited to attend this leadership institute of the American Association of Medical Colleges. This “provides IT leaders the information and tools to understand how to excel at the nexus of academic, research, and clinical systems to support organizations as they move to more integrated and data driven models.” The five day institute in July is limited to 30 through a competitive process; I was nominated by my department chairman. I am looking forward to this interactive program. If anyone has participated or will be attending this summer, I’d like to hear from you.Share this:
March 26, 2010
Some new exposure for my blog is on MedicExchange.com which puts me in good company withJane Sarasohn-Kahn and others. The site has a broad range of information including blogs, news, white papers, webinars, etc.
Also, my profile is now on the J. Boye Conference in Philadelphia. This includes some introduction to my presentation and my twitter feed.
My profile is now up as an advisor for Within3.com, the social networking app for physicians and advisory boards.
As you may know, my blog is also fed to Medpedia in the health technology section.Share this:
January 21, 2010
In the New England Journal of Medicine this week there is a health care reform piece titled, “Cottage Industry to Postindustrial Care — The Revolution in Health Care Delivery.” The article, by leaders in health care quality, raises significant questions about the problems in health care delivery and a path to a solution through “standardization of value-generating processes, performance measurement, and transparent reporting of quality.”
The authors address concerns about “cookbook medicine” but rightly describe medicine as a cottage industry: “Services are often highly variable, performance is largely unmeasured, care is customized to individual patients, and standardized processes are regarded skeptically. Autonomy is hardwired into the system, because most physicians practice in small groups with limited oversight or coordination.”
How do we move to post-industrial care or even better, 21st century, technology-enabled, patient-focused care. Does that mean that small practices should join large practices, academic medical centers? The authors don’t propose that solution, but do propose following clinical practice guidelines which are flexible enough to manage individual differences in presentation. If medicine is trending toward broad implementation of clinical practice guidelines and a stronger focus on outcomes (value-based medicine), technology-centered particularly around the electronic medical record and a focus on efficiency, can small practices survive? Are will moving toward industry consolidation much like what has been experienced in banking?
The cottage industry of medicine with fee-for-service as a funding model, continues to drive up cost without adding value. While I am no economist, I believe medicine is changing and models of practice which focus on efficiency, technology and patient experience are taking the lead.
One final quote from the article: the authors characterize this cottage industry as chaos – “Chaos confounds constructive action, whereas wise standardization is a foundation for effective variation, efficiency, reliability, and rapid innovation.” Let’s hope that wise standardization through guidelines can promote the kind of rapid innovation needed to transform healthcare and that policy and funding decisions follow this direction.Share this:
January 28, 2009
A major summit begins tomorrow in Florida on health care reform. With Donna Shalala moderating, this summit. There will be a dedicated topic on Health Information Technology with one of the key speakers C. Martin Harris of the Cleveland Clinic. The conference website notes the recent Rand Corporation study stating,
“that properly implemented and widely adopted, HIT would save money and significantly improve health care quality. Annual savings from efficiency alone could be $77 billion or more, and health and safety benefits could double savings while reducing illness and prolonging life.”
Will this conference result in a general consensus on health care reform which can be implemented by the new administration?
A webcast will be available at 630pm EST.Share this:
December 10, 2008
The post on ZDNet calls for healthcare standards to improve adoption in health IT. One argument is that “vendors lose control of customers when they adhere to standards. This makes them reluctant to adopt standards” and therefore oppose standards or at least drag their feet. He also argues that “Hospitals and insurers gain bottom line benefits, while doctors do not.”
But the most important statement is “So long as hospital computing systems remain proprietary islands of
information, with proprietary drivers and minimum interoperability, the big winners here are going to be vendors, no one else.”
So what is the golden rule: build for standardization and interoperability or “He who has the gold must make the rules.”Share this: