Archive for January, 2011
Do EMRs Improve the Quality of Healthcare?
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.
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Using Social Media to Promote Evidence-Based Practice
January 17, 2011
This concept is unique in health care social media. It goes beyond marketing or even engaging customers and on to the real impact on practice. It happens that this may more of a Canadian approach to social media. Freed of much of the health care marketing in the US, tying evidence-based practice to social media goes to the heart of the value of these tools. Perhaps it is also the influence of Cochrane on evidenced based practice in Canada and the UK and EU.
On a side note, check out Spigit, a new company all about innovation. Not specific to health care but if you look toward Canada again to the Innovation Cell. See also this post from TechCrunch on visualization in innovation. More on innovation soon for a book review on The Myths of Innovation.
Share this:A year in Review Perspective from Higher Education
January 6, 2011
Lev Gonick, CIO of Case Western Reserve University, has written 2011: The Year Ahead in IT, a fresh perspective looking forward instead of back. There are many parallels to healthcare.
1. The Big Picture: The State of the Global Economy and What It Means for IT on U.S. College Campuses (or, globalization and localization). He says that universities are tied to the cities they live in and community partnerships are crucial for global competitiveness. The same could be said for urban and academic medical centers.
2. How do you spell opportunity? A-U-S-T-E-R-I-T-Y (shared services and entrepreneurship). With greater austerity in health care, shared services and making IT a profit center through entrepreneurship are key to IT survival in healthcare as well.
3. Operational Excellence Is Good Enough (leveraging the cloud for strategic reengagement). Instead of a focus on operational excellence, moving toward cloud-based services and software/platform as a service. Healthcare continues to be skittish about the cloud but with the appropriate SLAs and security, may provide appropriate solutions.
4. We Go to University to Learn (mobility, simulations, gaming, and unified communications). Best quote: “While the rhetorical debates will continue, blended learning models based on hybrid pedagogies of face-to-face interactions with online exploration, discovery, reflection and mentoring are emergent realities.” This is emerging in education of health professionals and more experimentation should be welcomed.
5. Content is King… No, No, Platform Is King … No, No (learning management, publishing, and learning middleware). Another quote: “Given the maturity of the traditional course management platforms, the lethargic character of the academic publishing industry satisfied with its annuities in traditional textbooks, and the early state of e-books for learning, a new set of players in the area of student engagement, assessment, and support is likely to offer to stitch together the layers between the content and platform providers.”
6. I Used to Walk 10 Miles in Snowshoes to School (rich media and 21st-century learning). The move from text-centric learning to video conference, multimedia learning and more. The possibilities in healthcare are apparent and some are being utilized with YouTube and 3D anatomical models. Will holograms be next?
7. If We Hang In There We Will See an ROI on Our 8- and 9-Figure ERP Implementations (new models for administrative systems). Expensive enterprise systems moving to SaaS platforms changing the legacy of large implementations into short cycles of outsourced applications.
8. Consumer Sovereignty Can Be Stopped at the Gates of the Campus (governance and enterprise program management]. Sounds alot like centralized healthcare IT departments. “Frustration with the lack of agility, available resources and talents has led to a growing position that IT needs to get out of the way other than provisioning reliable network access, limited security and related regulatory and risk-mitigation roles.”
9. Overcoming the Myth of the University as Open. Global research endeavors requiring data sharing free faculty to go beyond the walls of the institution. Healthcare may be moving faster than the rest of the university community by translational research efforts and health information exchange as facilitators.
10. American Global Competitiveness and Research and Education Networks (IT and its contribution to reducing the town-gown divide).
Another quote true for healthcare: “IT and network engineering, and a commitment to supporting evaluation and at the same time catalyzing innovation, attracting investment and supporting the value of quality of life.”
With all the hype about mobile and clouds, it is refreshing to have a more thoughtful analysis of what is ahead.
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