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Twitter Highlights from AMIA17

Posted on November 15, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Last week I had the privilege of attending the 2017 American Medical Informatics Association (AMIA17) annual conference in Washington DC. I thoroughly enjoyed the experience and came away with new appreciation for the work informaticists do. Check out this blog for key AMIA17 takeaways.

One of the most enjoyable aspects of AMIA17 was the quantity and quality of the live-tweeting. My twitter feed hadn’t been that active at a healthcare conference since HIMSS17. There were no less than 20 attendees actively tweeting throughout the conference.

Below is a selection of memorable AMIA17 tweets.

I wasn’t familiar with Carol Friedman’s work, but her lovely tribute video was riveting – almost Hidden Figures-esque. Friedman not only had to overcome being a female data scientist, she was one of the few in her field to believe Natural Language Processing could be applied to healthcare. Her acceptance speech was filled with humor and funny stories.

One of the major announcements at AMIA17 was the creation of a new open access journal – called JAMIA Open. This new publication will be AMIA’s attempt to break down one of the biggest barriers to innovation – a lack of access to research papers. It will be interesting to track the progress of JAMIA Open in the months and years to come.

A very interesting concept discussed at AMIA17 was the use of EHR audit logs as way to identify areas for improvement. This included finding opportunities where retraining might be needed and where bottlenecks exist in clinical workflows. Suddenly it’s not so bad that EHRs record every action…or maybe it is if you are a bottleneck.

Genomics is very exciting. Carolyn Petersen, an Editor at Mayo Clinic, tweeted one out an interesting use case during AMIA17 – using genomic info to prevent adverse drug reactions. Amazing.

This was an extremely interesting question posed by Dr. Danny Sands. In the OpenNotes session he attended the presenters found that physicians were more honest in their documentation notes than they were with the patients they were seeing face-to-face. This makes for an intriguing scenario when patients gain access to those notes after a visit.

One of the more prolific live-tweeters at AMIA17 was Dr Wayne Liang. I enjoyed reading his tweets from sessions that I was unable to attend. This tweet stood out for me. He expertly summarized the 5 ways HealthIT systems could be improved to allow for better data analytics.

Another active live-tweeter was Pritika Dasgupta, PhD student at University of Pittsburgh Department of Biomedical Informatics. This tweet nicely summed up how sensitive the issue of decision support tools has become. Patients and clinicians both want the latest and greatest tools that will lead to the best outcomes. From that perspective, evidenced-based decision support tools can be very effective. However, medicine is more than simply a set of if/and/or statements. It is truly a craft and there is a concern that we lose something when we try to reduce patients to a set of input parameters.

It is always a special treat to listen to a Ross D Martin live performance. At AMIA17 he performed his latest creation – a theme song for #digituRN, an initiative to transform nursing through digital innovation. You can listen to the song on YouTube.

Shout out to Pritika Dasgupta, Dr Wayne Liang, Carolyn Petersen, Rebecca Goodwin, Dr Paul Fu Jr, Dr Arlene Chung, Jenn Novesky, Scott McGrath, Dr Danny Sands, Ross Martin, Alex Fair and Michael Rothman. It was fun to live-tweet with you at AMIA17.

In What Seems Like An Effort To Make Nice, eClinicalWorks Joins OpenNotes Initiative

Posted on October 12, 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.

eClinicalWorks has decided to try something new. The health IT vendor has announced that it will support the OpenNotes project, an initiative in which doctors share their notes with patients.

As most readers will know, it recently came to light that eClinicalWorks had gotten itself into some very hot water with the feds. eCW was forced to pay a $155 million settlement when the U.S. Department of Justice concluded that it had faked compliance with EMR certification standards.

Now, perhaps in an effort to make nice, eCW is making it possible for its customers to share visit notes using its patient portal. Actually, to be precise, the patient portal already had the ability to offer visit summaries to patients, but OpenNotes capabilities enhance these summaries with additional information.

OpenNotes, for its part, got its start in 2010, when Beth Israel Deaconess Medical Center, Geisinger Health System and Seattle’s Harborview Medical Center decided to study the effects of letting patients read their medical notes via a portal.

The study, the results of which were published in the Annals of Internal Medicine in 2012, concluded that patients approved of note-sharing wholeheartedly, felt more in control of their care and had an easier time with medication adherence. Also, while some doctors reported changing documentation during this process, the study also found that doctors saw no significant changes in workload.

Perhaps most telling, at the end of the process 99% of patients wanted OpenNotes to continue, and none of the participating doctors opted out. A movement had been launched.

Since then, a long list of organizations has come on board to drive implementation of open notes, including Kaiser Permanente Northwest, Providence Health System, Salem Health and Oregon Health and Science University. This year, OpenNotes announced that 16 million Americans now had access to their medical notes online.

Back in 2012, I asked readers whether OpenNotes would eventually influence EMR design. Today, I would suggest that the answer is both “yes” and “no.”

On the one hand, I have little doubt that the project helped to advance the notion that patients should have on-demand access to their healthcare information, and moreover, to use it in managing their care. While some doubted this approach would work, OpenNotes can now be said to have sold the idea that health data transparency is a good idea. While the initiative had its doubters at its outset, today patient record access is far better accepted.

On the other hand, eClinicalWorks is the first EMR vendor I’m aware of to explicitly announce its support for OpenNotes. While it’s hard to tell what this means, my guess is that its competitors don’t see a need to take a position on the matter. While vendors are certainly being forced to take patient-facing data access into account, we clearly have a long way to go.

Patients Want Access To Physician Notes Despite Privacy Concerns

Posted on October 4, 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. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While privacy concerns remain, patients’ desire to access their medical records online seems to outweigh those concerns, according to a study reported in iHealthBeat.

The study, which was published in the Journal of Medical Internet Research, included 3,874 primary care patients at Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center. Each of these institutions implemented OpenNotes, a portal which allows patients to read the notes written by their doctors following office visits, e-mail correspondence and phone calls. The patients were able to view the notes via the portals where other parts of their medical records are stored.

Researchers interviewed patients at baseline, prior to their using the OpenNotes portal. They were interviewed again after a one year period during which they were able to use the OpenNotes portal to review the notes doctors made during their visits.

Privacy remained a concern throughout the study period, iHealthBeat noted. At the study’s outset, about 33 percent of OpenNotes project participants reported having concerns about privacy;  meanwhile, almost 37 percent said they were concerned about privacy after the one year period of using the portal.

After using the portal  for a year, 15.5 percent of patients said they were more concerned about privacy, while 12.7 percent said they were less concerned about privacy.

That being said, study participants were still very enthusiastic about having access to the notes. In fact, at the study’s end, 99 percent of participants said they wanted continued access physician notes, despite their initial privacy concerns.

In April of last year, when I first wrote about this project, I  predicted that patients would become very attached to the level of intimacy OpenNotes would offer with their providers.  It seems that this has come to pass. If 99 percent of patients want to continue with the project despite having privacy concerns, that’s a ringing endorsement of the concept. Now, I’m curious as to whether other institutions will get on board.

Will “Open Notes” Change EMR Design?

Posted on April 26, 2012 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.

Today I read about a very interesting project focused on improving relationships between physicians and patients. I suspect the concept would make some doctors’ skin crawl — anytime you’re asked to give up over control of information, it smarts a bit — but I suspect we’re seeing a glimpse of the future.

The  OpenNotes project, which is being conducted at Beth Israel Deaconess Medical Center, Geisinger Health System and Seattle’s Harborview Medical Center, lets patients review the notes, e-mails and phone calls primary care doctors make after their medical appointment. Patients access the information via a secure Web interface.

In July 2010, researchers published baseline findings prior to the OpenNotes kickoff in the Annals of Internal Medicine. Since then, the project seems to have attracted a lot of interest, with more than 100 doctors and 20,000 patients participating.   It’s also gotten a lot of support from foundations;  the group has received grants from the Robert Wood Johnson Foundation Pioneer portfolio, the Drane Family Fund, the Koplow Family Foundation and the Katz Family Foundation.

Wondering how participants feel about this level of medical intimacy? Check out the OpenNotes site, where you’ll find a video  offering impressions from patients and doctors on how they feel about their level of communication.  As you’ll see, OpenNotes volunteer patients seem to enjoy having a closer relationship with their doctor, and more importantly, feel empowered to comment or even contradict the doctor if they see something that seems to be out of line.

“You can look at the comments that Bob writes down and sometimes you agree with him and sometimes you don’t,” says one patient. “Sometimes we clash on it, but then we work things out.” (Note the familiar title “Bob” the patient uses to address his doctor, which I doubt he would have otherwise.) Sounds like a better working relationship than I have with most of my providers!

Of course, there’s always questions as to whether approaches like these would work outside the confines of a grant-funded, academically-minded group of institutions and doctors.  Certainly that’s hard to tell. But it seems clear that at minimum, something worthwhile is going on here that might force vendors to think about patient facing data more deeply.  I’m impressed by what I see here and hope that we continue to learn from these efforts.