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EHR Data Allows Hospital To Find C. Diff Source

Posted on October 26, 2017 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. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Here’s a kind of story that makes you feel better about your EHR investment. A new journal article is reporting that researchers were able to find a source of Clostridium difficile within a hospital, not with elaborate big data analytics but simply by using basic EHR data.

According to the item, which appeared in JAMA Internal Medicine, a group of researchers examined EHR data on time and location to map roughly 435,000 patient location changes at the University of California San Francisco Medical Center. The effort was led by Russ Cucina, chief health information officer at UCSF.

After analyzing overall data, the researchers found a total of 1,152 cases of laboratory-documented CDI. The data indicated that CDI-positive patients moved through an average of four locations during their hospitalization, but that the CDI events came from a single location.

Researchers concluded that when patients were exposed to C. diff infections in the emergency department’s CT scanner, it was associated with a 4% incidence of CDI. They also noted that the association between CT exposure and CDI was still significant even after adjusting other influences such as antibiotic use and patients’ length of hospital stay. The association also remained significant when their sensitivity analysis extended the incubation period from 24 to 72 hours.

Having identified the CT as a potential vector of infection, the hospital next looked at how the that happened. It found that cleaning practices for the device didn’t meet the standards set for other radiology suites, and took steps to address the problem.

While healthcare leaders will ultimately use EHR data to make broad process changes, addressing day-to-day problems that impact care is also valuable. After all, finding the source of CDI is no trivial manner.

For example, a study recently concluded that ambulatory care organizations can do a pretty good job of analyzing their workflow by using EHR timestamp data.

Researchers had developed the study, a write up of which appeared in the Journal of the American Medical Informatics Association, to look at how such data be could be used in outpatient settings. Aware that many outpatient organizations don’t have the resources to conduct workflow studies, the researchers looked for alternatives.

During the research process, the team began by studying the workflow at four outpatient ophthalmology clinics associated with the Oregon Health and Science University, timing each workflow step. They then mapped the EHR timestamps to the workflow timings to see how they compared.

As it turned out, the workflow times generated by analyzing EHR timestamps were within three minutes of observed times for more than 80% of the clinics’ appointments. The study offers evidence that outpatient organizations can examine their workflow without spending a fortune, using data they already collect automatically.

Of course, hospitals will continue to do more in-depth workflow analyses using higher-end tools like big data analytics software. These efforts will provide a multidimensional picture that wouldn’t be available using only timestamp analysis.  But for hospitals and clinics with fewer resources, timestamp analysis may be a starting point for some useful research.

#HIMSS16 Exhibitors with Great Workflow Stories

Posted on February 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

UPDATE: You can see the recorded video of this discussion in the YouTube video embedded below:

HIMSS16 Exhibitors with Great Workflow Stories-blog

Chuck Webster, MD, or as most people know him, @wareflo, is famous for always talking about healthcare workflow. You can talk about EHR and he’ll bring up workflow. You can talk about population health and he’ll discuss the workflow aspects of it. You can talk about buying a cheeseburger at McDonalds and he’ll talk about workflow. You can talk about your tweeting strategy and he’ll talk about workflow. He should really consider changing his name to Mr. Workflow.

One thing I’ve always found interesting is that each year Chuck goes through the list of HIMSS exhibitors (yes, all ~1300 of them…he’s insane like that!) and identifies which ones are using workflow technology to solve the problems of healthcare. With that in mind, I thought a blab with Chuck and other HIMSS16 vendors who include some aspect of workflow in their solutions would be a great intro to #HIMSS16. So, on Wednesday, February 17, 2016 at Noon ET (9 AM PT), I’ll be sitting down with Charles Webster and some #HIMSS16 vendors that are interested in workflow.

You can join my live conversation with Chuck Webster and even add your own comments to the discussion or ask Chuck questions. All you need to do to watch live is visit this blog post on Wednesday, February 17, 2016 at Noon ET (9 AM PT) and watch the video embed at the bottom of the post or you can subscribe to the blab directly. We’re hoping to include as many people in the conversation as possible. The discussion will be recorded as well and available on this post after the interview.

If you’re a healthcare IT vendor that has a solution that helps with healthcare workflows, we’d love to have you join us on the blab (video, chat, or just viewing). If you want to hop on video, you’ll probably want to visit the blab directly. Otherwise, if you just want to watch us chat, the video below will go live on the day of the blab.

If you’d like to see the archives of Healthcare Scene’s past interviews, you can find and subscribe to all of Healthcare Scene’s interviews on YouTube.