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EMR, HIE Use Up Sharply In U.S.

A new survey by Accenture has concluded that the number of U.S. doctors using EMRs — either in their practice or at a hospital — has climbed to over 90 percent, and that almost half are using HIEs. More than half of doctors surveyed (60%) report using an EMR in their own medical practice.

The Accenture survey reached out to 3,700 doctors in eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.  Data showed a spike in healthcare IT usage across all of the countries surveyed.

In the U.S., doctors had the biggest increase in adoption demonstrated in the survey, up 32 percent in routine use of health IT capabilities, as opposed to an average increase of 15 percent among non-U.S. clinicians, reports HealthcareIT News.

Other standout activities were e-prescribing (65 percent using) and entering patient notes into EMRs (78 percent), a 34 percent annual increase between 2011 and 2012. Forty-five percent of physicians also use IT for basic clinical tasks such as getting alerts while seeing patients (45 percent), according to Healthcare IT News.

Healthcare IT News also caught an interesting detail around lab orders. The magazine notes that 57 percent of U.S. doctors said they regularly use electronic lab orders  (a 21 percent annual increase) the volume of physicians doing so internationally dropped 6 percent.

Globally, the number of doctors who “routinely” access clinical data on patients seen by different health organizations has climbed by 42 percent, from 33 percent of doctors in 2011 to 47 percent in 2012. Spain was the leader by a significant margin, with 69 percent of doctors routinely accessing such data.

The study also concluded that internationally, almost 60 percent of doctors customarily enter patient notes electronically either during or after consults.

On the other hand, so-called “digital doctors” are still unlikely to connect or transact electronically with outside organizations. Accenture found that only 10 percent of physicians communicate electronically to support remote consults/diagnostics, and that roughly 20 percent e-prescribe, receive notifications of patients’ interactions with other health organizations and communicate electronically with clinicians in other organizations.

May 10, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

NY Hospital Links DNA Profiles With EMR

New York’s Mount Sinai Medical Center has launched a new program designed to link patient DNA to optimal treatments, in which patients consent to DNA sequencing, contact with researchers and longitudinal studies related to data within their EMR.

To date, 25,000 people have signed up to participate in the biobank program, BioMe. BioMe is designed to access a broad range of clinical and environmental information stored in the EMR and link it with genetic information provided by patients.  BioMe also offers doctors the opportunity to give patients more targeted care based on their DNA profile. The program is funded by The Charles Bronfman Institute for Personalized Medicine at Mount Sinai.

As part of this effort, a team of doctors, genetic scientists and IT experts at Mount Sinai are gradually implementing a new program called CLIPMERGE (Clinical Implementation of Personalized Medicine through Electronic Health Records and Genomics).  CLIPMERGE is using a new tool, developed at Mount Sinai, which gives doctors real-time therapeutic suggestions based on patient genetic profiles. The idea behind these technologies is to link CLIPMERGE and BioMe, bringing up to the moment information on genetic responses to certain medication to the patient bedside.

Right now, real-time feedback on ideal medications based on DNA profiles is available for three conditions related to cardiovascular disease, blood clots and high cholesterol. The idea is that as scientists discover other DNA-specific responses to therapeutics, CLIPMERGE and BioMe will help bring them to practicing physicians quickly.

According to Healthcare IT News, the BioMe databank will include diverse human ancestry, with self-reported 25 percent of African ancestry, 30 percent of European ancestry, 36 percent of Hispanic Latino, and 9 percent of other ancestry.

May 6, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

The Sneaky Healthcare Cloud

Folks, I’ve read countless reports about the growing emergence of the cloud in healthcare. The thing is, many are studies summarizing broad trends in the industry, rather than news about specific providers who are willing to stand up and say that they actually implemented a cloud solution to house their healthcare data.

If hospitals and health systems are indeed adopting cloud solutions, why aren’t we hearing more about their experiences?  I have a few theories:

*  Migration:  Organizations that move from a legacy data management system to a cloud-based infrastructure have a lot of work to do. These folks probably don’t want to discuss what they’re doing until they’re pretty sure they’ve gotten the job done right.

Outsourcing:  Some healthcare leaders are outsourcing their cloud operations, but they’re not ready to scream to the rooftops that they’ve done so. My feeling is that they want to feel more confident about the relationship before they broadcast what they’re doing.

Security:  If a healthcare facility goes with the cloud, IT leaders there are probably pretty comfortable with cloud security, but I’m sure they don’t want to invite cybercriminals to put them to the test.

Politics:  Implementing the cloud for clinical data management may be a perfectly fine solution, but perhaps those facilities who have gone that way would rather not face criticism from outsiders who don’t agree with them.

Ultimately, the debates over cloud security may die.  As David Linthicum of HealthDataManagement notes, studies suggesting that even the public cloud can be secure are rolling in. (A recent study cited by Linthicum concludes that anything that can be accessed from outside, be it enterprise or cloud infrastructure, has an equal chance of being attacked.)

But for the time being, it seems pretty clear that hospitals aren’t going to hang out banners on their campus boasting about their cloud data infrastructure. Let’s see what happens over the next year or two.

April 11, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

EHR and mHealth Successes and Fails: Around Healthcare Scene

Patients are somewhat taught to fear sharing medical data. While privacy is important, especially when it comes to health, being more willing to share medical data can yield great results. The key is knowing who to share information with, and who to avoid. 

EHR vendors can be tricky when it comes to keeping clients around. Sometimes, they don’t really have a choice because the EHR holds client information “hostage” when the client says they are switching EHRs. However, this is a sneaky tactic, and there are many other ways to keep an EHR client longer — most importantly, providing a great product.

While many aspects of HIT have come to a halt, mHealth continues to flourish. There are many things that other parts of HIT can learn from mHealth’s success. First, mHealth doesn’t focus on every patient at once. Next, it is an unregulated industry. And finally, the projects are marketed directly to consumers and paid for by them as well. 

Are you a hospital leader and curious about what technologies you should be watching out for? Well, the ECRI Institute has compiled a list of technologies they feel executives should be looking at this next year. This list includes Electronic Health Records, mHealth, imaging and surgery, and more. 

When an EHR fails to work correctly, how do physicians deal with it? Researchers have observed clinical workflows to answer just that question. The observations concluded that while there was no correct answer, many use paper to record information. Hopefully, this study will show EHRs where their gaps are, and help them to correct them.

There are so many consumer medical devices out there. What makes one stand out from the best? And which one has the best form factor? Wrist bands or chest straps…hand held or pocket stored? Chime in over at Smart Phone Healthcare.

March 31, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

100% Interoperability, Quantified Self Data, and Data Liquidity – #HITsm Chat Highlights

Topic 1: Do you think the healthcare system WANTS 100% interoperability & data liquidity? Why/why not?

 

Topic 2: As consumer, what are YOUR fears about your health data being shared across providers/payers/government?

 

Topic 3: What do you think payers will do with #quantifiedself data if integrated into EHR? Actuarial/underwriting?

 

Topic 4: Could there be a correlation between your fear of data liquidity and your health?

 

Topic 5: What could assuage your fears? Education? Legislation? Regulation? Healthcare system withdrawal?

March 30, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

One Doctor’s EMR Usability Wish List

In this space, we talk a lot in the abstract about how physicians feel about EMR usability. Today, though, I wanted to share with you some great observations from a KevinMD.com piece by an angry anesthesiologist who lays out her own usability wishlist for EMRs and health IT generally.

In the piece, Dr. Shirie Leng fumes over the sheer work it takes for her to negotiate the systems she uses at her hospital. She notes that over the course of doing eight cases during a day, she’ll a) sign something electronically 32 times, b) type her user name and password into three different systems a total of 24 times and c) generate about 50 pages of paper given that the the computer record must be printed out twice.

To Dr. Leng, there’s ten steps institutions can take to eliminate much of the hassle and waste:

1. Eliminate user names and passwords:   She suggests using biometric sign-in technology.

2. Eliminate the paper:  Why print data that’s already entered into the system, she asks?

3. Make data systems compatible and 4. Make everyone statewide use the same system:  Dr. Leng says it’s crazy that we don’t have interoperability within hospitals or between different institutions.

5. Don’t make her turn the page:  “All the important information about a patient should be on the first page you open when you look at a patient,” she says. “I shouldn’t have to click six different tabs.”

6. Don’t make her repeat herself: If she does several cases the same way, with the same documentation each case, don’t make her re-enter it every single time.

7. Invest in voice-recognition software:  During patient interviews, Dr. Leng notes, she wants to look at patients and talk, not hunt and peck at the keyboard or worse, spend hours later typing in data or clicking checkboxes.

8. Go completely wireless:  Not an EMR point, but a good one nonetheless: why make doctors untangle cords and monitoring wires?

9. Hire a typist if you need one:  Don’t turn nurses into data entry clerks, she argues. Right now they have massive amounts of data entry piled onto their plate.

10. Triple back-up the system:  Paper doesn’t crash but computers do, she notes.

So there you have it, a list of EMR and health IT concerns straight from a practicing physician. I think all her points deserve attention.

March 18, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Post-HIMSS13 Discussion — #HITsm Chat Highlights

#HITsm T1: What takeaways from #HIMSS13 can we apply to the challenge of improving #patientengagement?

 

 

#HITsm T2. Best chance at driving #interoperability: A vendor initiative like CommonWell or a community initiative like TheCUREProject?

 

 

#HITsm T3: The recent eHI report notes that most advanced HIEs get revenue from a single source. How can this model be changed?

 

 

#HITsm T4: Now that #HIMSSanity is over, what’s the next major #healthIT conference on your calendar? Why?

 

March 16, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

ONC Encourages Emergence Of E-Patients

Throughout the Meaningful Use rollout, there’s been discussion of how to best use all of these new health IT toys to get patients more engaged in their care.  But as far as I know, the following is the first time ONC has officially launched an initiative to cultivate the emergence of health IT-smart e-patients.

In a new article in Health Affairs, ONC national coordinator for  health IT Farzad Mostashari has shared plans to use health IT to reach patients and encourage their involvement with their care. The ONC is already working with 17 Beacon communities to test ideas such as text-messaging for diabetes risk assessment, but the idea now is to expand things to much higher level.

ONC now hopes to encourage patients to participate in e-patient activities such as secure e-mail messaging with doctors, use of EMRs that patients can add to and transmit, as well as use of mobile health apps for chronic disease monitoring and wellness promotion, reports Politico.com.

I’m excited to see ONC jump on this bandwagon enthusiastically. While there is an e-patient movement afoot, and a growing list of doctors interested in “participatory medicine,” it’s unlikely that the run-of-the-mill patient with few self-advocacy or technical skills would get involved on their own.

And the truth is, if ONC truly wants to build a nation of engaged patients, Meaningful Use requirements are too modest by far. Sure, there’s new requirements afoot that will make it easier for patients to e-mail doctors and transmit their health information, and that’s fine. But the truth is that few patients will take advantage of these features without a great degree of encouragement.

As something of an e-patient myself, I’m eager to see the movement blossom, as I believe it’s good for both the clinician and ordinary citizens receiving medical care. Let’s see how much effort Dr. Mostashari and his team put into cultivating patient engagement.

February 15, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

The Patient Medical Record, Usable Health IT, and Return of Blackberry — Around Healthcare Scene

EMR, EHR, and HIPAA

EHR Benefit — Space Savings

This is the next installment of EHR Benefits. Some clinics claim that the space saving that comes with having an EHR is definitely a benefit. It’s usually more of a benefit for smaller practices, but can also benefit larger ones. One way is that the elimination of a document room could make room for another office.

Redesigning The Patient Medical Record, the Healthcare Challenge’s Results

This is a guest post by Carl Bergman from EHR Selector. The post dicusses the results of the Healthcare Design Challenge put on by by the VA and the ONC. First place went to Nightingale and second place StudioTACK. There were also a few other rewards given out. Bergman also talks about several problems with this challenge.

Hospital EMR and EHR

Patients Question Clinical Decision Support Use

A new study published in Medical Decision Making found that patients aren’t as thrilled about computer-assisted decision making. The study revealed some interesting findings, like patients don’t trust physicians who use CDS. For those that use this, the study may be a bit unnerving, but it’s interesting nonetheless.

One Vendor’s Take On Building Usable Health IT

This post contains the views of Joe Condurso, president of CEO of health IT vendor PatientSafe, on building usable health IT. He offers several recommendations. They include responding to context, being mobile, and starting from a mobile design.

Smart Phone Healthcare

BlackBerry’s “Hail Mary” Pass for mHealth

Although BlackBerry used to be the device of choice among physicians, it has been crowded out with the introduction of newer devices. However, BlackBerry is trying to get back in the game with the release of some new devices which they believe offer something unique. Will doctors switch back, or is BlackBerry grasping at straws?

Track Infants Growth With BeCuddle iPhone App

A new iPhone app has been released to help parents keep track of their infants growth. BeCuddle has a variety of features, including the ability to track medication, record milestones, and just help a parent make sure their child’s health is right on track.

February 3, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Digital Signage Expo in Las Vegas – Healthcare Learning from Other Industries

In my recent post about the Presidential Inauguration and Healthcare, I commented how many times healthcare stays in its closed environment and doesn’t learn from the other industries. This is true in many parts of healthcare IT and that needs to change. While healthcare certainly has special needs and requirements, the attitude that healthcare can’t learn from other industries needs to be corrected if we want to improve healthcare as we know it.

I saw an example of this when I watched this video that talks about the Digital Signage Expo in Las Vegas. Look at some of the amazing digital signage technology they show in this video and think about how often you’ve seen them in healthcare.

The sad thing is that many people in healthcare have ignored these technologies with the excuse that they’ve been distracted by ICD-10, meaningful use, ACOs, etc. Certainly each of these items are big priorities, but many of the digital signage technologies mentioned in the video above could help a hospital or healthcare organization achieve their goals.

For example, one of the crazy ACO changes we’re going to see has to do with patient satisfaction. Yes, I know it’s crazy, but it’s coming. The more satisfied your patients are, the more you’re going to get paid. Could a virtual assistant video wall help to increase patient satisfaction? Could an interactive video wall that recognizes gestures provide the wow factor for the patients that visit your hospital? I think it could, but too many people in healthcare don’t get out of their office to learn about these technologies.

Near the end of the above video they say, “mobile is the action, the signage is the call to action.”

Think about this concept in healthcare. Imagine a video wall in your hospital that takes your hospital’s healthcare data and illustrates the challenges and costs of obesity to your health system. Then, alongside that digital illustration you have a call for patients to sign up for your weight loss program. Of course, this same concept could be applied to all of the healthcare initiatives your hospital is working on already.

There are a number of ways digital signage can be used in healthcare. Take a look at Leveraging Digital Signage in Hospitals for a number of examples and a post by Shahid Shah about using digital signage to create real service improvement. It would just be unfortunate if those in healthcare were “too busy” to take advantage of the technology options that are available out there.

I hope that many in healthcare will take part in the Digital Signage Expo (click image below for more details) so we can get some good cross pollination of ideas from what’s being done in other industries in healthcare.

At the recent Consumer Electronics Show (CES), I would walk up to a booth that I thought had no relation to healthcare. They’d see the words healthcare on my badge and almost every single time they’d say, “Oh, you’re in healthcare, this is how our technology applies to healthcare.” I expect the same thing will be true at the Digital Signage Expo.

I look forward to the day when healthcare is filled with amazing digital signage that engages patients and healthcare staff well beyond a static ad on the wall. The beautiful part is that the technology is already there. We just need to apply what’s being done in other industries to healthcare.

January 22, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.