ENTRIES TAGGED "electronic health records"

Visualizing Health IT: A holistic overview

O'Reilly report covers major trends and tries to connect the neurons

If visualization is key to comprehending data, the field of health IT calls for better visualization. I am not talking here of pretty charts and animations. I am talking, rather, of a holistic, unified understanding of the bustle taking place in different corners of health: the collection and analysis of genetic data, the design of slim medical devices that replace refrigerator-sized pieces of equipment, the data crunching at hospitals delving into demographic data to identify at-risk patients.

There is no dearth of health reformers offering their visions for patient engagement, information exchange, better public health, and disruptive change to health industries. But they often accept too freely the promise of technology, without grasping how difficult the technical implementations of their reforms would be. Furthermore, no document I have found pulls together the various trends in technology and explores their interrelationships.

I have tried to fill this gap with a recently released report: The Information Technology Fix for Health: Barriers and Pathways to the Use of Information Technology for Better Health Care. This posting describes some of the issues it covers.

Read more…

Comment |

Where are the chances for change in health care – top-down or bottom-up?

Impressions from Strata Rx bolster different philosophies

Everyone seems to agree that health care is the next big industry waiting to be disrupted. But who will force that change on a massive system full of conservative players? Three possibilities present themselves:

Read more…

Comment: 1 |

Ticking all the boxes for a health care upgrade at Strata Rx

What is needed for successful reform of the health care system?

Here’s what we all know: that a data-rich health care future is coming our way. And what it will look like, in large outlines. Health care reformers have learned that no single practice will improve the system. All of the following, which were discussed at O’Reilly’s recent Strata Rx conference, must fall in place.

Read more…

Comment: 1 |

Bringing the knowledge of best practices to the doctor’s point of care

Workflows, EHRS, and social networking

Impatience is said to be the stance of modern technology users, but a doctor sitting with a patient has good reason to be impatient. The afflicted person may be suffering from a condition where lost minutes could mean death, an amputated limb, or severe brain disfunction. Even if the patient’s condition is not so dire, there are probably a half dozen other people with painful complaints twiddling their thumbs in the waiting room while the doctor tries to guess at a course of treatment. And in the US today, guessing is often the only option.

Somewhere in the country, an expert has probably learned all about the medical condition at hand and even presented the solution at a conference. Relatively few medical crises are really new discoveries. But the current system of disseminating information through conferences, journals, and rotations, or even through newer media such as blogs and webinars, cannot reach the beleaguered doctor and patient at the point of care.

I got a glimpse of a solution in the book #SOCIALQI (which has an associate web site) by the multi-disciplinary biomedical researcher Brian McGowan. His first challenge to us is an assertion that the central problem holding back improvements in health care quality is the inadequate dissemination of knowledge. I could match this claim with several other urgent needs in the health care field: inconsistent and distorted recording of patient data, lack of standards for storage and data exchange, and resistance by doctors to patient engagement, to name a few. But McGowan’s first chapter makes a very persuasive argument: if the best practices of each site were instituted throughout the health care system, we’d save thousands of lives and drastically lower costs. Read more…

Comment |

Open source developers combine efforts in the health care field

A report from an Open Health Tools meeting

I had a chance to listen in a recent meeting of Open Health Tools, a trade association bringing together companies, academics, and standards bodies who create open source software tools for all stages of the health care field. Open Health Tools has been around since 2007 and is attracting some impressive new members. The achievements of this “ecosystem” (as they call it) may soon put to rest the dismissive attitude many people in health care have toward open source.

A Tough Location for a Procedure

Free and open source software has lots of barriers yet to overcome in health care, similar to but in a somewhat different configuration from the barriers in other fields where it has triumphed (government, finance, commerce). Liability is at the top of everyone’s mind in health care. They have to be assured that J. Random Hacker has not just checked in a poorly tested update to the program they’re installing on their ICU monitoring station. There are many responsible stewards of open source EHRs (several packagers of the VA’s VistA project, as just one example, have spoken at our Open Source Convention) but the buyers have to understand better what is entailed in vetting and maintaining open source software.

Health care providers, outside of research institutions with technically adventurous staff, also prefer turn-key solutions. These to some extent are deceiving, because every institution needs to customize the software heavily for its own needs, and many regret the proprietary solutions they’ve tied themselves to when they find out how hard (sometimes beyond anyone’s definition of feasibility) or costly the customizations are. They are still afraid of open source’s fluidity, however. Read more…

Comments: 2 |

Challenge to Meaningful Use by House leaders highlights difficulty of asking incumbents to be innovators

Working too closely with an industry can undercut innovation

Four leading members of the House Ways and Means Committee tore away last Thursday at the polite, cautious, incremental approach that the Department of Health and Human Service has been taking toward key goals of HITECH act that was meant to drag health care into the 21st century.

Specifically, the House leaders signaled their disappointment at the Stage 2 Meaningful Use rules, promulgated last August by the Office of the National Coordinator and the Center for Medicare & Medicaid Services. The Congressmen isolate certain rules that appear to be less stringent than Stage 1, point out that the key goals of interoperability and data exchange are weak, and most notably ask for a total stop to payments made to health care providers under Meaningful Use.

Read more…

Comment |

Growth of SMART health care apps may be slow, but inevitable

Harvard Medical School conference lays out uses for a health data platform

This week has been teeming with health care conferences, particularly in Boston, and was declared by President Obama to be National Health IT Week as well. I chose to spend my time at the second ITdotHealth conference, where I enjoyed many intense conversations with some of the leaders in the health care field, along with news about the SMART Platform at the center of the conference, the excitement of a Clayton Christensen talk, and the general panache of hanging out at the Harvard Medical School.

SMART, funded by the Office of the National Coordinator in Health and Human Services, is an attempt to slice through the Babel of EHR formats that prevent useful applications from being developed for patient data. Imagine if something like the wealth of mash-ups built on Google Maps (crime sites, disaster markers, restaurant locations) existed for your own health data. This is what SMART hopes to do. They can already showcase some working apps, such as overviews of patient data for doctors, and a real-life implementation of the heart disease user interface proposed by David McCandless in WIRED magazine.

Read more…

Comment |

Report from HIMSS: health care tries to leap the chasm from the average to the superb

HIMSS has promoted good causes, but only recently has it addressed cost, interoperability, and open source issues that can allow health IT to break out of the elite of institutions large or sophisticated enough to adopt the right practices.

Comments: 4 |

David Blumenthal lauds incrementalism at forum on electronic health records

The former National Coordinator spoke at a health care forum in Boston yesterday. The biggest plea from the audience was for more time with patients–a focus not on meaningful use but on meaningful contact.

Comment: 1 |

What I like about the health care technology track at the Open Source convention

The health care technology track at the Open Source convention
touches on core areas for improvement: patient-centered care, the use of
mobile devices, administrative efficiencies, and the collection,
processing, and display of statistics to improve health care

Comment: 1 |