In Canada the forward thinking of our Governments, put Canada Health Infoway in place close to 10yrs ago, with the goal that patient information could be shared with providers, as required, first locally or regionally and ultimately pan-Canadian.

The two countries may use different terms, but the goals are the same. Improve the delivery of care by securely sharing required patient with care providers and/or physicians.

Based on surveys down by HIMSS Analytics, the chart below shows that we in Canada are behind the US, but making progress.

Contrary to what many would believe the best progress in Canada is happening in the Maritimes. New Brunswick is leading the country. Why? This province is smaller both in geography and population which allows them to collaborate and work together differently than some of the larger provinces.

The researchers themselves in the full article, indicate that there are 6 major limitations to their study. The key points being:

1)      The USA should ‘temper expectations for the pace and magnitude of the effects” of the governments incentive programs.

2)      Work needs to be done on how to measure the return on investment and quality

So we should not discredit the article, but should go beyond the headline to understand what the real issues are.

Observations from someone who has worked at implementing Hospital Electronic Patient Records:

1)      There are 3 key components to implementing these large systems: Technology, Process Change and Culture Change. The technology is the easy part. In the 1^st 3 or 4 stages of the ENRAM model, we are providing the clinicians with tools and they are generally receptive (example PACS). These stages can be lead or directed by IT.

But as you move into Clinical Documentation, CPOE and Clinical Decision Support the baton must be handed to the clinicians to lead. This is their work that will change. Paper processes need to be redesigned to take advantage of what computers can do. Automating the paper process for the sake of automating is general a recipe for disaster.

Process Re-design and Culture Change are not areas where clinicians/physicians have expertise, experience and in some cases interest. It is not what they were trained to do. But to be successful going forward they need to be the champions.

2)      HIMSS has published in a number of articles that they have not seen significant ROI (quality or dollars) until Hospitals move to stage 5 on the ENRAM scale. The first 4 stages are about building the infrastructure.

3)      Understanding and articulating benefits is an area that needs significant work. The return in many cases does not come back to the organization that is investing, but to the system as a whole. Small organizations, at least in Ontario, have been criticized for making the investments.

4)      The small remote hospitals may see the most benefit as their patients often must be transported to larger centres for care or physicians come on a rotating bases to provide care.

In today’s world where time is of the essence and short fast communication is valued, take the time to read past the headline… the message is often much different than the few words used to capture our attention.

Resources:
Find the original online at the WSJ Health Blog HERE!
Find the full study at the American Journal of Managed Care HERE!

When most people think of Bluetooth, they think of headsets for their mobiles however this technology can be adapted for a number of uses in Healthcare. Basically take any two devices in relatively close proximity that do, could or should exchange information and Bluetooth can provide the solution.

A brief walk through any ward in any hospital around the world would be all that is required to complete a business case for evaluation or adoption. Take note of all of the hardwired devices and imagine the benefit of removing the tangle of integrated wires from the environment; then consider the medical and other equipment that could transmit patient data directly to a nursing station, a handheld or even an EHR without all the hassles, expense and power requirements of WiFi. It’s probably a good size list.

There have been limits to the Bluetooth technology that have made it’s integration into Healthcare technology somewhat limited to date, namely battery life. The average mobile headset can last a day or maybe two on standby but drains very quickly when in active use. A four hour charge just won’t work for for a nurse on a 12 hour shift so overcoming this hurdle seems to be the key to the technologies future success.

Enter Bluetook 4. iMedicalApps has a great article on the future of this technology which outlines why Bluetooth 4 is going to be a game changer for healthcare and one of the key components is a set of standards that will see battery charges last for weeks or possibly months.

Resources:
Check out the iMedicalApps article online here,
Or for more technical details try the Bluetooth Directory here.

Leveraging the acquisition of MedPlexus, GE today announced the launch of Centricity Advanced, a SaaS EMR including physician office management with an integrated patient portal. This is an interesting release in that rather than porting an EMR from the client server world, Centricity Advance has been designed and built as a native web application and is therefore created with the web in mind, not as an afterthought.

The advantages of an EMR SaaS are wide-ranging. Rather than building, managing, upgrading and supporting their own in-house system, Physicians can leverage the new platform to offload the majority of their IT needs in exchange for a single monthly fee. The cost advantages of a $4,000 to $9,000 start up fee with monthly payments averaging $500 per month versus $20,000 upfront for in-house self-managed system provide a compelling business case. The real return on investment however is driven by freeing up time, resources and possibly office space allowing clinicians to focus on providing patient care rather than providing IT care.

Generally when things are less expensive, the price is paid in lost features or performance however GE is adamant that the system will not disappoint.  One of the main innovations worth a look is the integrated Patient Portal that will allow patients to securely access their personal medical records, schedule their own appointments, request refills, access billing statements, lab results and communicate privately with authorized clinicians.

For Physicians looking to modernize their offices or perhaps provide better means of connecting their practice with their patients but who do not want to spend a great deal of time or money upfront, SaaS may be a leverage point that offers the best possible value for money.

Resources:
Read the full news release on GE’s site here,
And an excellent summary artical on Computer World here.

The study found that monthly mortality rates dropped by 20% to .7 from 1 per 100 discharges. While this seems a small factor, it is estimated that 36 fewer deaths occurred over the 18 months that the CPOE system was studied after being launched which is quite material.

Resources:
Read the WSJ article here,
Access the study on the Journal of American Academy of Pediatrics site here.

Data sets released include information on: smoking rates, obesity rates, access to healthy food, and utilization of medical services and a host of other health related data stores, all available in open and downloadable formats.

The result of the data being released has become evident almost immediately. Within the 12 weeks that HHS posted on an interim site, citizens took up the challenge and began writing apps and mashups including the following examples:

An interactive community health dashboard that allows civic leaders and citizens to see a “report card” of health performance in their county and learn about the latest best practices that other communities have implemented to improve their performance;

Integration of patient satisfaction ratings from Medicare’s Hospital Compare database into web search results for hospitals – bringing this information to your fingertips

Amazing new health mapping tools that help consumers, providers, and policymakers focus on the right questions and make better informed choices

A brilliant new combination of GPS device and app that allows asthmatics to have their inhalers automatically transmit the location and time of each use – producing an anonymized, real-time map of asthma incidence that can provide crucial guidance regarding how to target interventions to reduce the burden of asthma

A (highly addictive) new online card game that engages you in a discovery of your community’s health and well-being status and how it compares to other communities in a head-to-head clash

And more!

HHS plans to capitalize on this early success by continuing to expand the supply and release of data over the coming months.

Resources:
Read the formal White House release here,
Read the formal HHS release here,
Watch the video of the event here,
Directly access the data here.

Furthermore the plan is focused on enabling collaboration among the armed services, Tricare the services’ health plan organization, the Joint Chiefs of Staff, the MHS Chief Information Officer, and other Department of Defense health-related offices.

This release clearly validates the importance of an EHR to the US Government when even the Military is recognizing it as a strategic priority.

The level of overall political visibility and the importance of the stakeholders involved in implementing this specific plan makes it success much more likely and presents both immediate opportunities for private sector engagement and overall positive externalities for the EHR market long term.

Resources:

Read more about the release at Government Health IT,
Download the Military Health System Strategic Plan.



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