November 11th, 2010 by KevinMD in Better Health Network, Health Policy, News
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Hospitals nationwide are racing against the clock to ensure their health IT systems meet meaningful use guidelines. The incentive? Money, of course. Systems that meet certain criteria make doctors eligible for up to $44,000 in bonus money from the government.
As mentioned on this blog previously, implementing an electronic health system is difficult. The usability of the current generation of electronic health records (EHRs) is still relatively primitive, especially when compared to other industries, and the disruption in workflow is undeniable. Worse, there seems to be a lack of trained IT professionals to do the job.
In a recent piece from American Medical News:
60% of hospital IT executives believe tech staffing shortages, which some estimate to be a shortfall of 50,000 qualified IT professionals, will definitely or possibly affect their chances to achieve meaningful use.
It’s a problem. Read more »
*This blog post was originally published at KevinMD.com*
October 12th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.
But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.
Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:
Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.
This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.
*This blog post was originally published at KevinMD.com*
August 30th, 2010 by Nicholas Genes, M.D., Ph.D. in Better Health Network, Health Policy, News, Opinion, Research
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Here’s a confession: Despite my steadfast advocacy of medical blogging as a means to promote understanding and education, I continue worry a lot about professional liability. Not just whether the things I write could hurt my career, but, in terms of academic output, is blogging a waste of time? What view does my department’s leadership take on blogging?
Still, I’ve continued to support medical blogging as a useful academic endeavor, hoping that someday this support would be borne out. When sites like Sermo and Facebook came along, I despaired that more physician opinions were going to be hidden behind walled gardens, available only to select colleagues or friends.
Then, last week, some revelations — I discovered a member of my department’s leadership was blogging, or at least, had commented on a blog. How about that! The other revelation? Facebook may be the last great hope for academic discussions to flourish on blogs.
This all arose from a pretty academic question about emergency department implementation of electronic medical records. Does the degree of implementation (full, partial, or none) impact patient wait times in the emergency department? Read more »
*This blog post was originally published at Blogborygmi*
June 15th, 2010 by DrRob in Better Health Network, Health Policy, Opinion
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Quiz: What does the term “meaningful use” mean?
A. Using something in a way that gives life purpose and leads to carefree days of glee.
B. It depends on your definition of the word “term.”
C. It’s not mean. It’s really nice.
D. A large number of rules created by the government to assess a practice’s use of electronic medical records (EMRs) so that they can spur adoption, give criteria for incentive rewards, and have physicians in a place where care can be measured.
E. Job security for those making money off of health IT.
The answer, of course, is D and E. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
April 29th, 2010 by Felasfa Wodajo, M.D. in Better Health Network, Health Policy, Opinion, Research
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Check out John Halamka’s post on some of the excellent work one of the workgroups convened by the feds is doing. Here’s the complete quote:
Imagine if every EHR could send data to every other EHR using a simple addressing mechanism like email, a consistent REST implementation or a well described SOAP WSDL. Interoperability would follow rapidly because novel packages of data will be sent to support real business needs without any barriers of how to get the data from endpoint to endpoint.
The “addressing” part of the NHIN (Nationwide Health Information Network) Direct specifications is almost complete. The “implementation” workgroup is part of the fast moving NHIN Direct project which is developing lightweight standards for machine-to-machine communication of medical information. Read more »
*This blog post was originally published at a few thoughts from a tumor surgeon*