healthcare technology

Electronic health records are overloading outpatient docs with info in "disparate files and folders rather than presenting comprehensive, actionable data in a context that gives meaning," say researchers in a VA-funded study

 

A primary care physician may care for 2,500 or more patients in a given year, and many of their patient encounters may last only 20 minutes – much of which is often spent at a computer with a back turned to the patient.

 

It's become a truism by now that electronic health records are often viewed askance by primary care docs, many of whom see them as detrimental to the patient encounter.

 

A new report from U.S. Department of Veterans Affairs, Regenstrief Institute and Indiana University details just how outpatient EHRs are often failing the physicians who use them.

 

Why it matters

EHRs "are not rising to the challenges faced by primary care physicians because EHRs have not been designed or tailored to their specific needs,"

 

The report draws on eight years of close study of EHR use patterns to argue for wider acceptance of "human factor approach for the design or redesign of EHR user interfaces."

 

many EHRs as currently configured make it too difficult for primary care docs to do their job in a streamlined and efficacious manner

 

– requiring navigation through multiple screens and tabs to find basic information, increasing redundancy and decreasing efficiency.

 

Something as simple as auto-save – a default capability for most online shopping, for instance – is missing from many EHR systems.

 

Roots of the problem

The study traces the roots of the challenge to the fact that many EHRs were initially designed for specialists and hospitals – without much attention to the specific needs of primary care physicians.

For Primary care physicians, effective decision-making is grounded in perception and comprehension of a patient's dynamic situation."

 

For example, they note, an outpatient doc's choice to stop a patient's use of a particular medication will usually be informed by trends in that patient's blood pressure or cholesterol numbers, or other medications taken over the course of a month – all holistic information with implications for the patient's future health trajectory, but data that isn't always readily seen on a single EHR screen.

 

Technology needs to adapt to humans' needs, abilities, and limitations in healthcare delivery as it has in other domains.

 

EHRs should be redesigned to improve situational awareness for busy primary care physicians and support their tasks including reviewing patient information, care coordination, and shared decision-making."

 

read more at https://www.healthcareitnews.com/news/regenstrief-study-shows-ehrs-underperforming-primary-care

 

 

Boston Medical Center reduced the number of patients who received unnecessary diagnostic testing after implementing new recommendations into its electronic medical record (EMR) system.

 

The study, published in the Joint Commission Journal on Quality and Patient Safety, looked at the effectiveness of implementing electronic health record (EHR)-based interventions to promote high-value care.

 

The hospital saw significant decreases in pre-admission chest x-rays and labs ordered at routine times six months after the implementation. The proportion of patients that received pre-admission chest x-rays significantly decreased 3.1 percent; the proportion of labs ordered at routine times decreased 4 percent; and total lab utilization declined 1,009 orders per month.

 

The proportion of postoperative patients who received appropriate pain and pneumonia prevention orders increased 20 percent, the results revealed. However, there was no significant difference in the estimated red blood cell transfusion utilization rate or number of non-ICU urinary catheter days following the implementation.

 

While the interventions reduced diagnostic testing, they did not have a significant effect on clinical interventions. 

 

more at https://www.clinical-innovation.com/topics/ehr-emr/emr-solutions-decrease-unnecessary-lab-testing

 

Suki, the artificial intelligence (AI) voice assistant for healthcare professionals, launched in May to praise from health-tech innovators who hoped “Alexa for doctors” might slash electronic health record (EHR) documentation time.

If the company’s early numbers are any indication, that wish might come true.

Suki said recently that doctors who use the digital assistant have seen a 70 percent drop in time spent writing and filing medical notes.

 

That figure is 10 percentage points better than the preliminary results of Suki’s pilot. The finding could prove powerful, as research has suggested that physicians burn almost two hours in the EHR for every hour of patient interaction.

 

Suki has processed more than 12,000 patient encounters in the real world, handling 1,000 per week, according to the company. This steady stream of real-world data is poised to strengthen the technology’s machine-learning algorithm, which was trained on 250,000 patient encounters before it went live.

So far, Suki has integrated with three EHR systems. The company said that number is slated to rise.

Using voice commands, the technology pens a “clinically accurate” note that it then sends to a doctor’s EHR system.

Over the past several years, innovators across healthcare have advocated for a clinical voice assistant. But the challenges are many, from precise listening and documentation to satisfying cybersecurity concerns.

Although a clinical AI assistant might be far off for many providers and health systems, Suki and similar technologies could help solve a mounting problem in medicine: physician burnout.

Time spent in the EHR has been linked to physician burnout. On the conference circuit and in the opinion pages, doctor after doctor describes the stresses of medical note documentation — and how these demands eat up time and detract from care delivery.

Can Suki help improve workflows? It seems so. But can it go a step beyond and help physicians overcome burnout? Maybe. The answer to that question will depend on adoption rates and how Suki performs at scale.

 

Will Suki become a part of the clinic of tomorrow? Lets wait and see

 

read the unedited story at https://www.hcanews.com/news/alexa-for-doctors-claims-70-percent-reduction-in-ehr-time

 

 

“Universal EHR” structures, in which every citizen’s electronic health record is connected to a single national system, are tied to higher trust in the healthcare system and higher value for patients, 

 

Unified electronic records have also prompted national governments to address issues of privacy and security, data integrity, and health information exchange that are left up to the private sector in other countries – with varying degrees of success.

 

Half of the 16 countries included in the index have universal EHRs, while the other half have let a combination of free market forces and regulatory guidance dictate the course of health IT adoption.

 

The eight countries with universal EHRs saw an average overall “Value Measure” of 47.29, the report says.  The Value Measure is a combined score based on access to care, patient satisfaction, and an efficiency ratio score.

 

Now, Healthcare providers in the United States generally don’t harbor very warm feelings for their electronic health records (EHRs).

 

Despite efforts from vendors and regulators to improve the experience of interacting with these foundational health IT systems, dissatisfaction and frustration with usability issues and fragmented information are still causing users’ blood to boil.

 

It may seem counterintuitive, therefore, to suggest that expanding the industry’s reliance on EHRs is actually the key to making EHR use less stressful and more useful – but that is exactly what the 2018 Future Health Index, commissioned by Philips, seems to indicate.

Microsoft says care coordination and secure messaging tools are coming to its Teams platform

 

Microsoft is holding its Ignite conference this week, and the company teased a forthcoming care coordination tool that is in early stages of development – as well two secure messaging features it's creating as part of an effort to tailor Teams for specific industries.

 

 

"As an example of how Teams can enable secure workflows for regulated industries, we're delivering a new care coordination solution, now available in private preview, that gives healthcare teams a secure hub for coordinating care across multiple patients," Ron Markezich, Corporate Vice President for Microsoft 365, wrote on the company's blog. "It provides for integration with electronic health record systems and enables care providers to communicate about patient care in real-time within Teams' secure platform.”

 

Markezich said Microsoft is also releasing two new secure message capabilities for Teams: one for for image annotation and the other for priority notifications. While the image function is already generally available, the priority notifications feature is scheduled to be available for companies that use the commercial version of Teams by year's end.

 

"These capabilities support HIPAA compliance and enable doctors, nurses, and other clinicians to communicate about patients while avoiding the privacy risks that arise when healthcare professionals use consumer chat apps," Markezich added.

 

Microsoft said the new care coordination tools will integrate with EHR systems so clinicians and caregivers can communicate via the Teams platform. Considering that the average hospital has 16 different EMR vendors across all its affiliated practices, that integration won't be as easy as it might sound.

 

That said, the tech is in "private preview" mode, so it's a bit early to tell what shape it will take by the time it reaches the open market.

 

read the original story at https://www.healthcareitnews.com/news/microsoft-says-care-coordination-and-secure-messaging-tools-are-coming-its-teams-platform

 

Clinical documentation improvement (CDI) ensures that health services are accurately documented and helps healthcare coders and physicians work toward improved patient care while also streamlining productivity.

 

When meaningful clinical data is captured, organizations can ensure improved quality reporting, clinician productivity, and even better clinical information delivered at the point of care.

 

Phoenix Children’s Hospital recently opted for CDI at its outpatient clinics with Medicomp Systems.

 

It’s important to help physicians make patient care faster, safer, and more efficient.

 

Every single symptom, sign, medication, surgery, drug, operation procedure, almost a repository of more than 360,000 terms, they have structured and coded with every possible common coding schema, such as ICD-10,” he continued.

 

Having 360,000 terms can be overwhelming, but they were built along disease patterns. If a physician entered that a patient had asthma, or tried to research asthma in the database, it went out to all related items that were related to asthma and it brought them together in a manner of an automatic template that was a quick, rapid initial draft.

 

There is no magic formula with clinical documentation and finding an applicable system for an organization.

“You cannot take shortcuts. You cannot not capture things that are critical and essential,”

 

The EHR interoperability challenge is what stands between a physician's ability to look up, extract, and track a patient's medical activities and records at medical sites other than their own. This could be at a laboratory where a patient's specialty blood work is being analyzed or they're having surgery on an inpatient or outpatient basis.

 

When it comes to tracking these patients, it's literally as they move about in the sphere of the healthcare world. The interoperability challenge occurs because you need your EHR to talk to systems outside your practice.

 

Solving this challenge means maintaining continuity of care for patients, minimizing or eliminating the duplicity of services, and helping physicians share patient information so they can gain insight from specialists that would complement their diagnoses.

 

Many EHR companies aren't willing to share access to their systems unless a physician is part of their overall user base. If you work in a particular hospital or practice that has their product, these particular companies will share information with physicians. The problem is they won't work with peripheral players, or physicians who are unaffiliated with the hospital or practice where their EHR is installed.

 

Why is it in the hospital's interest to provide access to patients via their EHR?

 

Sharing access to patients via the hospital's EHR creates a win-win situation where the hospital can keep the patient in their system.

 

these are excerpts from an interview David Wasserman, an advisor with the practice solutions and medical economics group at the Massachusetts Medical Society.

 

read more at the original  http://www.diagnosticimaging.com/ehr/solving-ehr-interoperability-challenge

 

Scribes have the potential to address several causes of physician burnout at primary care practices

 

High-quality scribes generate high-level gains in primary care practices.

 

That's the conclusion of recent research published in JAMA Internal Medicine, which found scribes decreased physician EHR documentation burden, boosted work efficiency, and improved patient visit interactions.

 

Scribes can have a significant impact on a prominent factor for physician burnout, the researchers wrote.

 

"Emerging evidence indicates that EHRs, as currently implemented, increase clerical workload and physician stress and interfere with direct physician-patient interaction, thereby diminishing professional satisfaction and contributing to professional burnout," the researchers wrote

 

more at https://www.healthleadersmedia.com/clinical-care/scribes-slash-physician-ehr-burden-boost-efficiency-improve-patient-visits

 

At the World Medical Innovation Forum this week, participants were polled with a loaded question:

“Do you think healthcare will become better or worse from the use of AI?”

Across the respondents, 98 percent said it would be either “Better” or “Much Better” and not a single one thought it would become “Much Worse.” This is an interesting statistic, and the results were not entirely surprising, especially given that artificial intelligence was the theme for the meeting.

This continual stream of adoption of new technologies in both clinical and post clinical settings is remarkable. Today, healthcare is a technology operation. As a case in point, outside of the array of MDs and medical professionals presenting at the forum, there was clearly a strong, advanced technology thread weaved throughout the conversations of the traditional topics of pathology, radiology, bioinformatics, electronic medical records (EMR), and standard healthcare provider issues.

As an example, a panel of senior technology experts from Microsoft, Cisco Systems, Dell EMC, Qualcomm, and Google joined research and information officers from Partners Healthcare and Massachusetts General Hospital to discuss the challenges in what they called “Data Engineering in Healthcare: Liberating Value.” That is a serious title for a panel.

Data portability was clearly a key topic, as was security and the public cloud.

The underlying issue with the cloud is that the EMR was never really designed to be portable.

Health records existed with institutional walls, and were not originally intended for real time care, but more as a means of tracking costs and transactions as the patient traveled through the various systems. As the EMR has not only become more feature rich, the ability to mine that data inside of them with ML and AI methods is clearly at the forefront of everyone’s mind right now.

There was discussion of episodic systems wrapped in policy and technology – this really isn’t quite how we can gain the maximum knowledge from the healthcare version of a Digital Me. A digital object containing all of our many and varied health related attributes. The challenges of discussing how to best build a “marketplace” and healthcare data exchanges and how to integrate “data marts” with existing EMR systems was obvious.