Copy-paste in the EHR

Should physicians use the “copy-paste” function to document in the EHR?  In his latest blog post, 3M HIS blogger Jeremy Zasowski uses a whiteboard to sketch out the pros and cons, and offers two case studies that get to the heart of the copy-paste issue.

Watch the video here.

 

Better Living—and Documentation—Through Computer Assistance

Have you ever driven a car without power-steering? It’s quite a workout. We used to all drive without power-steering and for “entertainment” you had to spend ten minutes twisting a small dial back-and-forth trying to get a radio station to come in clearly, only to drive under a bridge and completely lose it. Now we’re on the verge of self-driving cars and I can stream an entire album saved in the cloud into my car just about anywhere and anytime I want. No more fine-tuning that pesky radio dial.

Who’s After Your Healthcare Data?

It has been impossible to ignore the number of data breaches in the news lately. Whether you have been directly affected or not, one thing is certain: data security should be a top priority, especially in the healthcare industry. This eye-opening article talks about the new focus of hackers: targeting healthcare data. Healthcare data is extremely valuable when compared to the current value of Social Security numbers or credit card numbers on the black market. John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston, sums it up:

While a stolen Social Security number might sell for 25 cents in the underground market, and a credit card number might fetch $1, “A comprehensive medical record for me to get free surgery might be $1,000,” Halamka says. “It is a commodity that is hot on the black Internet [market].”

Will you pass Meaningful Use Stage 1 for Natural Language Processing?

The MU of NLP. Haven’t heard of that yet? Well, it’s a new concept and I think it’s going to become as standard and important as Meaningful Use of EHRs. As important as MU is for EHR adoption and in fully evolving healthcare from the paper era, the true revolutionary advances are going to come from making sense of all of the digital data being collected in an electronic health record.

So, what are the Stage 1 requirements for meeting Meaningful Use of Natural Language Processing? The criteria are twofold. The first part is the criteria for establishing a fully integrated NLP platform with your clinical workflows. The second part is meeting two key use cases.

Is Value-Based Purchasing Working? Should We Make it a Game?

Value-based purchasing (VBP), a program authorized by the Patient Protection and Accountable Care Act of 2010, authorizes the Centers for Medicare & Medicaid Services (CMS) to base a portion of hospital reimbursement payments on how well hospitals perform in 25 core measures.  The goal of the VBP program is to incentivize hospitals to improve care by starting to base reimbursement on quality of care delivered. This program focused on how patients rate their hospital experience, and how well hospitals follow certain standards of care. Some of the VBP core measures ask the following:

• Were blood cultures performed in emergency department prior to initial antibiotic?
• Were prophylactic antibiotics discontinued within 24 hrs after surgery end?
• How often was pain well controlled?

Health Care is Getting IT-Entrepreneurial

An interesting FierceHealthIT article just announced that New York Presbyterian Hospital (NYP) is renting space at a New York City-based technology “accelerator” called Blueprint Health, LLC.  Blueprint Health focuses on helping new companies or IT startups connect with healthcare organizations to aid them in developing products and bringing them to market. According to the article, NYP will run computer systems out of Blueprint’s offices and have an “innovation space.” NYP’s goal is to create closer collaboration between healthcare-IT focused startups and the hospital, ultimately resulting in new technologies being used at NYP.

Healthcare’s Efficiency Challenge

I’ve started reading a book by William Baumol called The Cost Disease, which raises an interesting question. Why in 2014 can I buy a laptop computer that is smaller, more powerful, and most of all, much cheaper than one I could have bought just ten years ago, but healthcare costs have risen from ten years ago? Why are some industries able to become more efficient, and produce more of their goods or services, faster and cheaper, while other industries are stuck in a spiral or are continually raising costs with stagnant efficiency?

I won’t give a full, in-depth review of the book, but in short, the analysis lays out the premise that in some industries, such as with computers or automobiles, manufacturers are able to continually improve on both their manufacturing processes and the quality of the goods they are manufacturing. This enables these manufacturers to produce better goods at lower costs. These lower costs then enable them to pass some of these savings on to their customers, as well as to pay their employees more money.

Delivering on the Promise of an “E-Health” Revolution

As more and more hospitals and healthcare organizations convert more and more of their paper medical records to electronic health records (EHRs), an interesting dynamic has begun to emerge, as well as an interesting challenge.

The dynamic is that while the conversion from paper to electronic records was promised to provide time and cost savings for healthcare, the adoption of EHR systems by physicians has led to a number of perhaps unforeseen consequences. One of the chief consequences, which could also be considered a chief complaint, is that physicians who document on their patients electronically make less eye contact with their patients and have lower patient satisfaction ratings, vs. physicians who document on paper.

Making Use of Data

In his book Blink, Malcolm Gladwell writes about Dr. Brendan Reilly’s work at Cook County Hospital in Chicago from back in the late 1990s. At that time, the hospital was stretched thin, running low on resources and struggling to deal with roughly 250,000 patients coming through the Emergency Department every year. Patients routinely waited hours to be seen. One of the hospital’s key struggles was determining which patients coming into the Emergency Department with complaints of chest pain were actually having a heart attack and thus required expensive, resource-intensive care.

It’s an interesting case study if you get a chance to read it, but I’ll just give a brief summary here. Dr. Reilly used work that had been done from back in the 1970s by a cardiologist named Lee Goldman. Goldman took the data from hundreds of cases and ran it all through a computer program to identify what kinds of symptoms and clinical findings actually predicted a heart attack.

AHIMA 2013: Observations from the convention floor

Years ago when I was about to head off to college, my grandfather took me aside and gave me some advice he thought would help me as I adjusted while at school. What he told me back then that has stuck with me ever since: “Like waters rise together.” He meant that when you enter a new situation with people you don’t know, you will eventually find the people most like you and settle into that new situation.

Walking around at AHIMA this year and viewing all of the vendors, their booths, their offerings, and marketing messages, I find that my grandfather’s quote may apply here as well, just in a slightly altered format: “All vendors blend together.”