Big data continues to be a growing topic in healthcare IT. To find out more, we recently caught up with Justin Barnes, Vice President at Greenway Medical Technologies, who spoke about how big data is influencing healthcare and how practices should be thinking about how to capture, store and move data from electronic health records into reporting mechanisms.

 

Watch the below video and let us know what questions you have about big data.

 

The best medicine is collaborative. Particularly with specialization and increasingly complex and powerful therapeutic technologies, providers have to work with each other and with patients and families to get the best outcomes.

 

And the lifeblood to any effective healthcare collaboration is information.

 

A number of organizations, like Kaiser or Mayo, with healthcare IT systems crossing both ambulatory and inpatient environments, do a pretty good job of moving information between members of the care team—making collaboration efficient and useful.

 

However, for the majority of our currently fragmented healthcare system, the state of art of provider collaboration is surprisingly 20th century with a touch of 19th century thrown in. The most common collaboration methods are face to face and phone. For routine communications and reporting between providers, fax still remains prominent. E-mail, which is ubiquitous in the business world, is relatively rare in healthcare, particularly when it comes to provider to patient discussions.

 

Why the lag? There are a couple of good reasons; personal health information (PHI) is both sensitive and highly regulated and therefore requires careful handling (hence the reluctance to use unsecured email).

 

Secondly, healthcare information is locked into disparate computer systems or on paper, making it labor intensive and inefficient to share with other providers that don’t work at your shop.

 

Fortunately, we are starting to see some of this change. The technology is generally ready. Encrypted, secure email systems are now available and designed for both provider to provider and provider to patient communication. Standards for healthcare data communication have been established that cover lab data, images, patient summaries, and prescriptions. Health information exchanges (HIEs), which would provide a pipe for all of this data to be moved between separate organizations within a community are being built across the country.

 

Since technology is no good if no one uses it, the government is providing incentives through the Meaningful Use program for providers to actively use these information sharing tools. Examples: in the latest draft of the Stage 2 Meaningful Use guidelines, providers are required to electronically submit summaries of care for >10 percent of their patients when they are referred to another provider. There is a requirement that practices are able to electronically communicate with their state immunization registry. Sixty five percent of prescriptions have to be sent electronically. Providers are required to provide tools (i.e. patient portals) so that 10 percent of their patients can communicate with them electronically.

 

This is great start. Stage 3 Meaningful Use requirements (which have not yet been defined) will continue to up the ante, with additional requirements designed to incentivize electronic communication and collaboration.  Improvements in hardware and infrastructure will help make powerful tools such a video-conferencing more practical and widespread.

 

The way we pay for health care will also drive collaboration. The recent flurry of activity around accountable care organizations (ACO) provides a model that rewards provider groups that carefully managing patient welfare throughout the care process. ACOs can’t succeed without collaborative tools.   

 

At a certain point, the network effect kicks in, and information rich collaboration becomes the standard of care. Although it has been a painfully slow process that has been 20 years in the making, we are getting much, much closer.

 

What do you think?


Bruce Kleaveland is President of Kleaveland Consulting and a sponsored health IT correspondent for Intel.

Cloud computing and big data were certainly hot topics at this year's HIMSS12 event. We caught up with EMC to find out more about cloud and big data in healthcare IT and what both mean to health IT CIOs.

 

Watch the below video and let us know what questions you have.

 

One of the most important decisions that a doctor will make when in transitioning to an electronic health record (EHR) is their personal computing device. By personal computing device, I simply mean piece of hardware they use to enter data, review patient charts, run reports and all the other IT stuff that they will need perform in the era of Meaningful Use.

 

The good news: there are lots of choices.
The bad news: there are lots of choices.

 

Let’s break it down into two simple paths: tablets and PCs (such as laptops or “convertibles” that can be used as tablet but offer a keyboard too).

 

Here’s a simple checklist that you can use in making your choice.

 

Data entry flexibility: Are you comfortable with the data entry method of the device? Does it offer you options of different ways of entering data (i.e. real keyboard, virtual keyboard, digital pen, mouse, voice recognition, and handwriting recognition)? Flexibility not only gives you the ability to determine the method that you feel most comfortable with, but also allows you to mix and match in a given encounter (i.e. use digital pen for  a drop down problem list and voice recognition to record the subjective portion of the note). Tablets are very sexy, but in terms of sheer flexibility, PCs have the advantage.

 

Versatility: Is the device that you are using to go mobile from exam room to exam room equally useful when you are wrapping up at the end of the day in your office?  Or when you go home? Note: tablets are great mobile devices, but tend to less optimized when you aren’t mobile for routine tasks like printing that PCs do well.

 

EHR compatibility: There are very few applications that are built specifically or “native” to the tablet environment. That doesn’t mean that client server or web based EHRs won’t work on a tablet, but it may mean that it doesn’t work quite as well as a PC; it is worth checking before you commit.

 

Battery life/Battery management: Keeping your mobile devices fully charged is critical to smooth operation at the clinic; battery life of the device is important (the longer the better), but  having the flexibility to swap out the old for a fresh battery (so you don’t have to wait for the recharge) is also a plus. This is standard feature for most PCs—and not for tablets.

 

Screen size/display: Is your device the right size for you? Is it the right size for your patients? Providers need to balance size vs. weight. There is a right answer here—just what ergonomically works for you.

 

Final thoughts: For any practice that exceeds one physician, hardware decisions have a group element as well, which means that there has to be some compromises and trade-offs to meet the greater good of the practice as a whole. In this context, flexibility is king, since physicians are highly variable in their data entry preferences. In the flexibility argument, PCs always win.

 

Watch the below video for more information on selecting the right healthcare device. What questions do you have?


Bruce Kleaveland is President of Kleaveland Consulting and a sponsored health IT correspondent for Intel


Mobile devices are fostering greater collaboration at the point of care and helping to drive down health care costs. But as the ACO model takes hold—shifting the provision of care from acute care settings into the patient’s home—health IT professionals and providers alike are discovering that synchronous communication is the lynchpin that holds together all of the major parties comprising the health care ecosystem.

 

By enabling synchronous content streams—information shared and perhaps clarified in real-time—healthcare organizations are improving care, saving money, and empowering mid-level health care workers to help ensure continuity of high quality care.

 

For example, a patient in rural Kentucky who is struggling with medication management may not have access to a doctor, or an advanced practice nurse. Without the proper IT tool to enable synchronous communication—and the right health care worker to escalate that communication to the appropriate provider, as needed—often times the result is summoning  an ambulance and sending the patient to an acute care facility.

 

But with the technology currently available—and by leveraging community health workers, health navigators, PAs, visiting nurses, and others in a position to funnel patient information to the right provider in real-time—that same medication management issue could be addressed without the need for a hospital visit.

 

Yes, a similar approach is being implemented through various telemedicine projects, but it’s not widespread yet.

 

Patricia Abbott, Ph.D., RN, FACMI, FAAN, Johns Hopkins University Schools of Nursing and Medicine, thinks the hold-up is partly cultural and partly technical, with legal and financial components adding to the challenges.

 

But she’s hopeful, noting that cultures at acute care settings are, in fact, slowly evolving.

 

“Part of it is recognizing that, just as we don’t need an astronaut to fly a crop duster, we don’t need a physician to diagnose an earache,” Abbott says. “We can leverage synchronous communications by empowering others in the ecosystem, such as nurse practitioners, physician assistants, and others, with the right IT tools.”

 

For Abbott, the proliferation of smart phones, virtual desktops, consumer media pads, VPN connectivity, and shifting attitudes in healthcare settings that increasingly are allowing health care professionals to bring their own devices to work—provided they meet regulatory and security requirements—signals an industry moving in the right direction.

 

“What I think is in the process of happening is a transition to real-time, live communication and information exchange that goes well beyond just sending an email or text, or making a phone call,” Abbott says. “Geography and the type of device you use is irrelevant when the data coming from all the various sources is integrated. Being able to use technology to support a very rich view of everything that’s going on is the goal; almost like being physically present at the bedside, even though you are not.”

 

What questions do you have?

 

As a B2B journalist, John Farrell has covered healthcare IT since 1997 and is Intel’s sponsored correspondent.

At HIMSS12, Doug Cusick, vice president and general manager of Health and Life Sciences at HP, spoke about information technology and how it supports the delivery of healthcare. In particular, he summarized how big data is the essence of where healthcare will be going forward in the next few years, and how data is gathered, exchanged and disseminated so clinicians can make informed decisions.

 

As you can see in the below video, he covers how patients are being more active in the decision making process, are at the center of the healthcare ecosystem, both in the hospital and in the community, and how technology enables them to be a part of the system.

 

What questions do you have?

 

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