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AMIA17 – There’s Gold in Them EHRs!

Posted on November 13, 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.

If even 10% of the research presented at the 2017 American Medical Informatics Association conference (AMIA17) is adopted by mainstream healthcare, the impact on costs, quality and patient outcomes will be astounding. Real-time analysis of EHR data to determine the unique risk profile of each patient, customized remote monitoring based on patient + disease profiles, electronic progress notes using voice recognition and secondary uses of patient electronic records were all discussed at AMIA17.

Attending AMIA17 was an experience like no other. I understood less than half of the information being presented and I loved it. It felt like I was back in university – which is the only other time I have been around so many people with advanced degrees. By the time I left AMIA17, I found myself wishing I had paid more attention during my STATS302 classes.

It was especially interesting to be at AMIA17 right after attending the 3-day CHIME17 event for Hospital CIOs. CHIME17 was all about optimizing investments made in HealthIT over the past several years, especially EHRs (see this post for more details). AMIA17 was very much an expansion on the CHIME17 theme. AMIA17 was all about leveraging and getting value from the data collected by HealthIT systems over the past several years.

A prime example of this was the work presented by Michael Rothman, Ph.D of Pera Health. Rothman created a way to analyze key vital signs RELATIVE to a patient’s unique starting condition to determine whether they are in danger. Dubbed the Rothman Index, this algorithm presents clinicians and caregivers with more accurate alarms and notifications. With all the devices and systems in hospitals today, alarm fatigue is a very real and potentially deadly situation.

Missed ventilator alarms was #3 on ECRI Institute’s 2017 Top 10 Health Technology Hazards. It was #2 on the 2016 Top 10 list. According to ECRI: “Failure to recognize and respond to an actionable clinical alarm condition in a timely manner can result in serious patient injury or death”. The challenge is not the response but rather how to determine which alarms are informational and which are truly an indicator of a clinical condition that needs attention.

Comments from RNs in adverse-event reports shared in a 2016 presentation to the Association for the Advancement of Medical Instrumentation (AAMI) sums up this challenge nicely:

“Alarm fatigue is leading to significant incidents because there are so many nuisance alarms and no one even looks up when a high-priority alarm sounds. Failure to rescue should be a never event but it isn’t.”

“Too many nuisance alarms, too many patients inappropriately monitored. Continuous pulse oximetry is way overused and accounts for most of the alarms. Having everyone’s phone ring to one patient’s alarm makes you not respond to them most of the time.”

This is exactly what Rothman is trying to address with his work. Instead of using a traditional absolute-value approach to setting alarms – which are based on the mythical “average patient” – Rothman’s method uses the patient’s actual data to determine their unique baseline and sets alarms relative to that. According to Rothman, this could eliminate as much as 80% of the unnecessary alarms in hospitals.

Other notable presentations at AMIA17 included:

  • MedStartr Pitch IT winner, FHIR HIEDrant, on how to mine and aggregate clinically relevant data from HIEs and present it to clinicians within their EHRs
  • FHIR guru Joshua C Mandel’s presentation on the latest news regarding CDS Hooks and the amazing Sync-for-Science EHR data sharing for research initiative
  • Tianxi Cai of Harvard School of Public Health sharing her research on how EHR data can be used to determine the efficacy of treatments on an individual patient
  • Eric Dishman’s keynote about the open and collaborative approach to research he is championing within the NIH
  • Carol Friedman’s pioneering work in Natural Language Processing (NLP). Not only did she overcome being a woman scientist but also applying NLP to healthcare something her contemporaries viewed as a complete waste of time

The most impressive thing about AMIA17? The number of students attending the event – from high schoolers to undergraduates to PhD candidates. There were hundreds of them at the event. It was very encouraging to see so many young bright minds using their big brains to improve healthcare.

I left AMIA17 excited about the future of HealthIT.

Looking Forward to #AHIMACon16 – HIM Scene

Posted on October 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.

This post is part of the HIM Series of blog posts. If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

As we prepare to head to the 2016 AHIMA Annual convention (see our full list of conferences we attend), we’re excited to talk about how we’re planning to expand HIM Scene to include as many HIM voices and perspectives as possible. HIM Scene will still be hosted here on Hospital EMR and EHR and will still have its own email list where HIM professionals can receive great HIM related content from thought leaders across the industry. However, we’ll be using HIM Scene to share a wide variety of people and perspectives.

The HIM industry is an amazing group of devoted people and that really comes through at every AHIMA annual convention I attend. Plus, HIM has a lot more influence than many people realize. So, we’re happy to do what we can to raise the voices and perspectives of HIM professionals here at HIM Scene.

Looking forward to the AHIMA Annual convention next week in Baltimore, we’re excited to learn about a number of important topics. Here are a few we’ll be sure to report on in future HIM Scene posts:

ICD-10 – A year after implementation, I’m really interested to hear the real stories of how ICD-10 has impacted healthcare organizations for good and bad. I bet there will be a lot of stories that haven’t been shared. I’ll also asking the HIM professionals I meet what they think the impact of the end of the ICD-10 grace period will have on healthcare. I wonder how many will have stories of ICD-10 improving care versus stories of ICD-10 for reimbursement.

Information Governance – This is an eternally hot topic in HIM, but it always continues to evolve. This is particularly true as records have gone electronic. This year I wonder how many people have been involved in some sort of health data sharing project. Information governance can get pretty tricky as healthcare organizations start to share data with each other electronically.

HIPAA Privacy and Security – A really hot topic given all the HIPAA breaches and ransomware incidents in healthcare. I’m sure I’ll find a number of HIPAA privacy officers that will share some good insights into how they’re dealing with these security and privacy challenges. I’m afraid many of them will give me exasperated responses about how their leadership isn’t taking it serious enough.

Informatics – I’ve been really intrigued with HIM’s role in healthcare informatics. Once you dive in, it makes since why HIM would be involved, but I don’t think most people saw that at first. What’s also been interesting to watch is many HIM professionals who’ve kind of shunned their involvement in healthcare informatics. We’ll see if many are still in that position or if most HIM professionals are starting to embrace and participate in the informatics efforts of their organizations.

What hot topics will you be looking for at the 2016 AHIMA Annual Convention? The AHIMA 2016 theme is to “Inspire Big Thinking to Launch Our Future.” We’ll be sure to report back any big thinking we hear from people we meet.

ahima-2016

If you’d like to receive future HIM posts in your inbox, you can subscribe to future HIM Scene posts here.

What Does Health Informatics Mean to You?

Posted on March 23, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin’s latest HIM Scene posts here.

A couple of weeks ago, I was involved in a great discussion about health informatics and what it actually entails. This wasn’t the first time I have been involved in this type of discussion as informatics has been a buzzword in healthcare for several years now. Since no two organizations are structured exactly the same, Informatics can mean different things to different people.

For me, I have seen informatics in practice as those roles involved in building and optimizing the electronic medical record (EMR) and clinical workflows. Informatics professionals ensure data is being collected appropriately so that it can be used for further healthcare decision making and operations. This was a daunting new task several years ago when Meaningful Use first came into play. I remember many articles and statistical reports stating there was a major shortage of IT professionals who were going to be needed to help organizations meet Meaningful Use criteria and perform the role of health informatics.

I do not see informaticists as being confined to any particular department of a healthcare organization but rather they are professionals that are skilled in applying technological and data science techniques to healthcare practices. I have seen many roles such as IT, HIM, and licensed clinical professionals take on informatics responsibilities to address the needs of the changing healthcare environment. Informatics needs the collaboration of these different skillsets to bridge the gap between the technology and healthcare consumer outcomes using data and research.

When we start to look at informatics as it relates to healthcare research methodologies, I believe this is where informatics starts to split off into a more refined usage of data. This goes beyond the EMR workflow optimization and into the realm of using the data to build registries, look at cause and effect relationships, and review patterns and trends in healthcare treatment and outcomes. Since most of us healthcare professionals are at different stages of EMR implementation and optimization, there are some early adopters testing the waters and beginning to understand the value of all of the healthcare data that has become readily available. I am excited to see what the future holds for health informatics and how these tasks will be aligned with the HIM professional’s skillset.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Arkansas Health System Uses eICU Tech to Boost ICU Care

Posted on February 10, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s an example of a form of telemedicine which is becoming highly popular in hospital ICUs.  eICU technology, in which critical care experts provide expertise remotely through a central hub, allowing hospitals to have 24 hour a day support in their ICU whether it’s down the street or across the country.

In Arkansas, Baptist Medical Health Center-Little Rock, eICU technology is in place within a building on the campus, reports Healthcare Informatics magazine.

The eICU acts as an air traffic control center, giving the ICU staff extra set of eyes and ears to monitor patients, according Vicki Norman, R.N., director of eICU care at Baptist Health, which includes eight Arkansas medical centers.

Not only does the eICU support the ICUs within the Baptist Health system, it also has eICU care contracts with 20 hospitals and 223 beds across two states; seven of the 20 hospitals are part of the Baptist Health system.

With patients being monitored by two-way video and “cockpit like sensors,” eICU staff can detect even the slightest change in the patient’s condition, and let the bedside staff know very quickly when the problems arise.

According to Norman, the eICU center includes a staff of 15 critical care physicians and 25 critical care nurses in the control center, whom, Norman says, has an average of 20 to 25 years of experience, reports Healthcare Informatics.

The central element to the eICU control center is software from Phillips which allow doctor and nurse teams to monitor every critical care patients simultaneously. The software’s Smart Alert automated monitoring and notification system constantly analyzes data on patients to pick up problems long before they might be noticed by local personnel on the ground in the ICU.

According to Baptist health leaders, studies of healthcare systems that have implemented an eICU control center short 27 percent reduction in mortality rates in a 17 percent cut in length of stay, largely because eICU monitoring allows clinical staff to intervene with patience as needed far more quickly. Other data suggests that patient time spent on ventilators also falls when the eICU is used.

Baptist’s experience aside, it looks like the eICU has a bright future, as it seems to be able to achieve positive clinical results that lessen the sting of the expense. For example, a recent study published  in CHEST Journal concluded that hospitals can boost patient survival rates and speed ICU and discharge rates if they use tele-ICU technologies.

Which Health IT Is Poised For Hospital Growth?

Posted on January 21, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Wondering which hospital applications are likely to be popular in the near future?  According to HIMSS Analytics, contenders include patient portals, clinical data warehousing/mining, and radiology barcoding software are poised for faster uptake in hospitals.

To gather this information, HIMSS Analytics did an analysis of the current market penetration and projected five-year sales trajectory each application considered in its Electronic Medical Record Adoption Model (EMRAM) report.  Researchers found that first-time purchases of these advanced EMR applications should grow dramatically in hospitals across the U.S.

According to Healthcare Informatics, there are good reasons why each of these three technology should be on the upswing in hospitals.  For example, the patient portal market is growing because it’s tied to Meaningful Use Stage 2 requirements.  Expected growth in sales of clinical data warehousing/mining technology is tied to the need to leverage data held in EMRs, and it’s that that sales increases in and radiology barcoding are probably associated with patient safety initiatives.

Meanwhile, the report also noted that several basic applications which have already saturated the hospital market will be responsible for a high-volume IT replacement sales, including laboratory barcoding, pharmacy management systems and information systems for radiology and laboratorydepartments.

The report from HIMSS seemingly doesn’t take mobile applications and systems into account — I’d argue because they are not yet seen as enterprise-level tools — but I think hospitals will be spending more on mobile technology than anticipate over the next few years, as tablets and smartphones become a permanent part of their infrastructure.  Just how fast that will happen remains to be seen, but it will happen.

Big Data Could Generate $450 Billion For Healthcare System

Posted on April 16, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 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. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s some information that should give all of us something to chew on  this week, courtesy of the always-interesting Jane Sarasohn-Kahn at the HealthPopuli blog.  In a recent piece, Sarasohn-Kahn pulls data from McKinsey & Company suggesting that if big data is properly harnessed, it can produce nearly — wait for it — $450 billion in value for the healthcare system.

As always, however, there’s a catch. This value explosion can’t happen, McKinsey says, unless big data is leveraged across five dimensions of care. These dimensions, which McKinsey calls “new value pathways,” offer opportunities for better efficiencies and economies of scale for the health system, HealthPopuli notes.

The five dimensions include:

Right living, in which big data is used to help patients take an  active role in staying healthy, by such mechanisms as daily health reminders and getting patients to seek care early when problems do arise.

Right care, in which big data tools, particularly coordination of data across providers and settings, make sure that patients get the right care at the right time.

*  Right provider, in which data analytics matches patients with the ideal provider for their situation, sometimes to lower-cost providers that can provide appropriate care.

*  Right value, which uses big data analysis to reward providers who produce the best outcomes.

*  Right innovation, a pathway in which big data is mined to promote continuous improvement and productivity in healthcare processes as well as R&D.

Sounds great, doesn’t it?  Well, maybe not so much given what has to change. To travel down these pathways, McKinsey notes, it will take re-aligning several key forces in the healthcare system, including privacy and data security, a shift to  value-based reimbursement, partnerships across industry segments currently found in deep silos (such as payors and providers), and data analysis capabilities current lacking in the health IT workforce. Sigh. And  I was feeling hopeful there for a bit.

As Sarasohn-Kahn notes, one way McKinsey sees to meet some of these goals more quickly would be to promote transparency as a cultural norm. But honestly, the silos we see today exist for important institutional and competitive reasons. If we want key partners in the big data effort to cooperate, it’ll probably take a governmental club to that head. Hey, ONC, are you ready to get rough with those who don’t want to play in the same data sandbox?