The Healthcare Knowledge Exchange

Inclusive Healthcare – Taking charge of our own healthcare

2012-09-23T01:17:00.001-07:00

Inclusive Healthcare – Taking charge of our own healthcare

How often are you aware about cost and quality before attending a care provider? Does your provider involve you in your healthcare decisions?

For most of us, these questions wouldn’t elicit a positive response. Historically we have been used to unidirectional doctor patient communications wherein the individual patient has been passive, underutilized, or excluded from choices about care in a system that overcomplicates and sometimes hides useful data about safety, price, and quality.

However, in the face of mounting economic pressure in public and private systems, no one can afford to ignore the transformative potential of informed, empowered consumers. Patients are morphing into health care consumers with growing use of technology for medical shopping and health engagement

According to a survey conducted by Altarum , the health services research organization, virtually all (99%) of U.S. health citizens want to play a role in medical decisions about their care. However, consumers vary in just how much of that responsibility they want to assume:

-35% want to make the final decision with some input from doctors and other experts

-29% want to be completely in charge of their decisions

-28% want to make a joint decision with equal input from their doctor

-7% want their doctor to make the decisions, providing some input themselves

Just 1% wants the doctor to be completely in charge of treatment decisions.

The cost of care is an issue consumers are keen to know more of in health care. Altarum asked consumers about two health behaviors when receiving advice or services from a health provider — looking for information about doctor quality ratings before choosing where to go, and asking before a visit how much the cost would be. Overall, fewer than half of consumers asked about prices (42%) or investigated quality before receiving the health service (39%).

Importantly, engaging in these two health behaviors was less likely among folks who were in poor/fair health than those in excellent health, with 29% looking for quality information on providers and 34% asking about cost — compared with 62% of people in excellent health asking about quality and 60% asking about cost.

The survey found, consistent with other polls that most consumers trust and like their doctor. Furthermore, 76% of consumers also believe that their doctor would “never” recommend a test or procedure unless it was necessary.

Role of technology

Many patients would engage more fully in the management of their own health, but they face barriers caused by information asymmetry and a tradition of paternalism in provider-patient relationships. Communications technology plays a prominent role in erasing barriers and enabling consumerism in health care.

Consumerism is about giving every person the information and tools they need to choose safe, high- quality, affordable health care. When safety, quality, and cost metrics are widely available, all consumers benefit. When actively involved in making choices about care, patients experience fewer errors, fewer unnecessary procedures, and higher satisfaction.

Altarum looked into peoples’ use of computers and smartphones for everyday life tasks, such as playing games, locating stores and theatres, comparing gas prices, and conducting health care activities.

The findings: 35% of computer and smartphone users have used these tech’s for finding a doctor, 19% have downloaded a health app, 18% have compared prices of medicines, and 16% have compared prices for medical services. It is early days for comparative shopping in health, but this aspect of health-shopping is poised to substantially grow toward 2014 as health insurance exchanges and consumer-driven health plans put health citizens into the role of health shoppers.

What’s concerning in Altarum’s findings is that the poorer health the consumer perceives, the less consumer-empowered that individual feels. While 75% of those in excellent health say they’re confident they can reduce costs of care by shopping for better prices, only 30% of those in poor/fair health are confident in doing so. Thus, 70% of those in poor/fair health are uncertain/not at all confident that they’ll be competent health shoppers, able to reduce their health costs.

Yet it’s those in poorer health who tend to be higher cost patients.

Key Initiatives

The Internet has changed both the way we live and the way that companies operate. The past decade has seen several entrepreneurial companies are positioning themselves to play starring roles in shedding light on prices and quality in health care — such as Castlighthealth , Changehealthcare, Clearhealthcosts Consumers have been empowered by more information on price and quality, more choices in products and services, and more voice through review sites and online self-help options

New platforms have harnessed the “power of the crowd” by tapping into a broader base of intellectual capacity. Many of the services are giving patients new tools to understand and manage their own medical conditions and interact with peers. A good example is Patientslikeme , an online community of patients united by shared experience.

The large and growing “quantified self” movement, in which people measure and track the metrics that are important to them, is another facet of this. The Fitbit , and other such devices that let measure workouts and track them, are not just a fad. They’re an indication of the way people want to take charge of their health and decisions surrounding it

Finally, organizations from the public and private sectors are using digital innovations to target specific populations, promote broad-based campaigns across sectors, and facilitate interactive communications to prevent disease and promote health. These are digital initiatives for social impact. A prominent example is Michelle Obama’s Lets Move campaign, a multi-year, multichannel initiative to reduce childhood obesity.

With these digital innovations having a cascading impact on the healthcare consumers, it’s evident that the health-care ecosystem is heading towards a participatory and inclusive model, away from the authoritarian, paternalistic practices of yesteryear.

2012-07-17T04:18:00.000-07:00

Clinical Research Informatics

I. The need for Clinical Research Informatics:

Healthcare providers having a ‘Research Centre/Institute’ tag suffixed to their display name has been a widespread phenomenon in our country. But in reality only a handful of them actually engage in active clinical research while the others often mistakenly use this to reap commercial benefits. The fact that clinical research is the lynchpin that connects innovative technologies from basic discovery research to their application as breakthroughs in patient care is deeply undervalued by healthcare centers. Most care providers treat clinical research as a byproduct of clinical care and the former is more of an afterthought / add on to the later.

The flow of research from bench to bedside and back again, through review in practice, necessitates a comprehensive research strategy aligned to the organizational vision. Many organizations falter with their research programs in absence of an appropriate strategy and leadership commitment.

Developing the right informatics infrastructure through provisioning relevant IT solutions is a vital cog to a comprehensive research strategy. Moreover, with the correct business model healthcare institutions derive additional research value from a sophisticated IT infrastructure.

But improvements through the use of electronic information exchange have been slow in clinical research studies for many reasons, including the lack of informatics infrastructure, exemplified by low EMR adoption, inconsistent data standards and database architecture, and insufficient analytic tools. Even though our healthcare leaders are being increasingly aware of the need for digitizing the hospital operations, potential efficiencies available through IT solutions for clinical research are largely undermined.

Studies indicated that over 75 percent of information obtained for support of clinical trials was entered on paper [1]. Use of electronic solutions can reduce the cost of data collection by 55% over paper [2]. Furthermore, the information once collected is typically entered for various needs from four to seven times by clinicians

Additionally, three main fields in science and medicine that are currently disconnected: 1) basic research, which tries to understand the fundamental principles and phenomena that drive cells, organisms and systems in both normal and pathological conditions (such as cancer); 2) translational research and applied medicine, which represent the application of basic research to solve specific problems, aid in diseases and help society at different levels and 3) EMRs or “Electronic Health Records” that have been developed as a new technology to facilitate both patient care and research by collecting and archiving patients’ history. The key bottleneck is how to efficiently integrate these three independent “parts” of medical and scientific areas in a single solution to improve patient care.

A robust clinical research informatics platform would enable:

· Integration of patient and research data

· Sponsors to understand the progress of their research projects

· Institutions to ensure ethical and regulatory compliance

· Robust data collection, processing and reporting

· Capturing and leveraging Intellectual Property generated

· Enable collaboration among partners and others in research fraternity

II. The Clinical Research Workflow

Clinical Research Study might be stated as an overarching terminology which envisages sponsored or investigator initiated clinical trials or other survey oriented non interventional studies. A typical clinical research study lifecycle comprises of the following steps. The study originates from a hypothesis, and then is detailed in a study protocol. The protocol documentation includes study design and operational details such as the duration of the study, type of participants, inclusion and exclusion criteria for subjects, patients’ schedule for assessment and interventions, medications and dosages. Following this, the protocol is assessed by an Institutional Ethics Committee (IEC) or Institutional Review Board (IRB) to ensure the appropriateness of the clinical trial protocol as well as weigh the risks and benefits to study participants. It also reviews all study-related materials before and during the trial.

After the study is approved and site selection done, patient/subject are screened and recruited based on pre determined inclusions and exclusion criteria. Thereafter all enrolled study subjects/patients undergo series of assessment, investigations/interventions in compliance to the protocol schedule. The clinical research staff ensures appropriate documentation, deidentification of data per relevant standards and archiving of data. Collected data are analyzed and interpreted by researchers to derive inferences which form the basis for biomedical discoveries.

At the heart of clinical research is the immense data collection and analysis that determines the efficacy and safety of medical therapies. Currently, the processes for identifying subjects eligible for research, collecting study parameters, assembling information from multiple study sites, conducting oversight of study protocols, and analyzing results involve manual operations which are time consuming, labor intensive, and expensive

III. Capabilities of an Integrated Clinical Research Informatics Model:

Historically, research and healthcare information technology systems have been disconnected, supporting separate, but sometimes redundant, processes and workflows. Unfortunately, the use of disparate systems can result in patient safety concerns, inefficient processes, data quality issues and challenges

Most Clinical Research Organizations (CROs’) and pharmaceutical companies engaged in clinical trials rely on commercial off the shelf Clinical Trial Management System (CTMS) solutions for digitizing the trial process. A CTMS package is an integrated suite of applications sharing a common database designed to help manage clinical trails acitivies at different levels. But for a hospital based clinical research presents unique informatics requirements that are amenable to solutions supported by EMR systems which might be already deployed. Such scenarios solicit an EMR integrated comprehensive informatics solution which extends beyond the scope of a traditional CTMS solution. The solution should enable:

· Proactive identification of potential research subjects from the EMR database

· Help screen and recruit research participants

· Research data collection through electronic data capture methods (EDC) from the EMR including Web, Hand held devices, and Phone based Interactive Voice recognition (IVR)

· IRB Document management, amendment and milestone tracking

· Randomization and blinding of participants in a randomized control trial

· De-identification of data according to HIPAA standards

· Trail reporting and identify data queries that needs to be addressed

· Adverse events reporting

· Easily move valid data from EMR into research registries

· Facilitate secure EMR access for research auditors/ monitors

· Appropriately billing for Research visits to the sponsor unlike the normal visit

· Tagging hospital patients enrolled in a research study for easy identification

· Capture rich structured data from the EMR (phenotypic) and combine with bio-informatics data (genotypic)

· Enable export data in format ( for eg: CDISC )for initial statistical purposes or downstream integration with other tools

· Provide coding methods for fields such as pathology or medication data.

IV. The Clinical Research Informatics Model

The desired capabilities of an EMR integrated Clinical Research Informatics solution, as discussed in the previous section, has been mapped to the enabling core IT systems functionalities .The following schematic represents a Reference Model which intends to aid decision makers make an informed choice while implementing IT systems for clinical research areas of the hospital. More often all of these functionalities might not be met by a single software solution but an integration of multiple systems might be necessary to achieve the desired research outcomes. This model also might form a basis for negotiations with the EMR vendor to include additional functionalities in the solution package to support clinical research

Moreover, this lays a longer-term foundation for accelerated discovery, extensive outcomes research, and ultimately a “learning health system” in which a “bench-to-bedside-to-bench” cycle of information will support continual improvement in knowledge, care and health

The model is split in two distinct zones meant for Patient Care and Clinical Research intersected by a Pseudonymisation wall

Research Specific Functionalities within EMR

The Electronic Medical Record (EMR) is the centerpiece to all patient care activities in the hospital. It is capable of capturing and archiving all information (for eg: charts, orders, results, medications, diagnosis, interventions etc) generated during patient care. For a hospital engaged in clinical research, the EMR can be optimized to envisage pro research functionalities such as:

• Study Feasibility & Screening – The EMR has potential to be an ideal system to search for patients that are eligible for an ongoing or potential study. All patient records from the EMR is maintained in a EMR Data Warehouse (EMR-DW), a system that enables the patient records to be stored and used for analytical purposes. With advanced search capabilities, it’s also possible to retrieve a series or records to retrospective chart reviews.

• Recruitment Alerting –Inclusion criteria for clinical research studies can be programmed into the EMR, which can the proactively alert the attending physician that a patient is eligible for enrolment into a study when they are in the clinic. Failure to recruit a sufficient number of eligible subjects presents a major impediment to the success of clinical trials. This can be addressed if the EMR has the capability of a real time Clinical Trial Alert (CTA). Without the assistance of IT solutions, recruitment is extremely slow, expensive, and low-yield.

• Patient Tagging & Participant Tracking – Identification of hospital patients involved in a research is crucial to protecting the safety and rights of participants. The EMR should be capable of flagging (a sort of identification on the patient’s record) the patient enrolled in a clinical research strudy with information about clinical trials/studies in which he/she is participating. This would help clinical staff, investigators, study coordinators, clinicians, and oversight bodies such as the IRB to follow participants throughout the research process and ensure that their safety and rights are protected. An Integrated participant tracking enables better management and eliminates need for multiple data entry

• Protocol Document Management – The system should have document management capabilities for support grants, peer review, IRB continuing review, ethics approval, adverse event reporting, etc and support the informed consent and re-consenting processes. Organizations of a larger scale prefer dedicated Enterprise Content Management systems to fulfill this need.

Research Study Management System: Core Functionalities.

1. eCRF & Electronic Data Capture

Traditionally paper based Case Report Forms (CRF) have been used to transcribe relevant data manually from the medical record of a clinical research study subject. In a paper system, data are entered first on the clinical report form and second by the data entry group into an electronic system. An eCRF is a pre configured electronic form that eliminates manual data entry/re entry and fetches the data from the medical records through electronic data capture.

The Electronic Data Capture (EDC) is a system that electronically transcribes clinical data from the EMR into the electronic case report form (eCRF). EDC replaces the traditional paper-based data collection methodology to streamline data collection and management.

Since data are entered into a data collection tool only once, processing time for data entry is reduced, and transcription errors are less likely. EDC can help clean and lock data faster than traditional paper CRF systems.

2. Pseudonymisation

Research studies must use de-identified patient data according to relevant standards (for eg: HIPAA). This is not only a legal requirement but is essential for protecting patients’ rights. With that in effect, the patient data flow from clinical to research domain should channel through a data pseudonymisation system. This system will enable de-identification of patient identifiable data to accepted standards such as HIPPA, assign codes to the data as well as support re-identification of patients in case of medical emergencies. Following pseudonymisation the de-identified data is expected to reside in a separate research domain where is can be used by researchers who cannot identify which patient the data is particular to. This includes having the capability to handle cases of very small populations

The De-identification system needs to integrate with any system where Personal Health Information (PHI) is collected and will then be used for research purposes

3. Randomization and Blinding

Randomization capability enables locally sponsored interventional clinical studies for systematic assigning patients to different study arms in a statistically robust fashion. It needs to interface with clinical systems including, but not limited to EMR, the Pharmacy System, and the research systems and its associated electronic data management systems.

For blinded clinical trial that involves providing a blinded drug based intervention the hospital pharmacy system needs to capabilities to un-blind in an emergency the study treatments and to manage the resupply to the patient on the behalf of the study

4. Data Management

Accurate, reliable, usable data — it's the lifeblood of clinical research. The method an investigator chooses for collecting, storing and analyzing data can mean the difference between a study that advances the science and improves patient care, or a study with inconclusive results and no publications. Typically the Data Management functionality will capture all of the structured and unstructured data that is captured in study documents. This can be used to provide a warehouse of all research data that has been captured from the research activities. Also there should be a role and site level access which allows users from other institutions to contribute data to the studies

The system should not only be able to support studies requiring low to medium data collection complexity but also should be able to manage regulatory compliance (for eg: 21 CFR Part 11), sophisticated data management and quality control, for multi-site trials.

5. Data Marts and Knowledge Management

A project data mart is typically project specific collection of data that enables clinical and research data to be extracted from their primary data management systems and combines and curates the study data into a system that enables researchers to explore and analyze their data according to the study design.

A Knowledge Management System is a searchable repository of research results (or Facts") that capture the published and published findings of research activities. This includes statistical relationships between patients and their biology and integrates entities across patients, literature, markers and drugs. Data collected from across the research activates needs to be analyzed to make inferences about the specific research hypothesis.

V. The way ahead

India is being touted as one of the fastest growing market globally for clinical trials with more than 15% of global clinical trials expected to be carried out in the country [3]. With increasing market size and complexity there is a need of better ways to transfer and access patient information electronically. A clinical research enterprise that is configured around such electronic information systems will yield more rapid scientific discovery and will provide significant support of related activities including Comparative effectiveness of clinical trials and other outcomes-related research; Quality of care measurement; public health and safety monitoring, and post-marketing surveillance.

With a widespread EMR adoption, the interface between “bench and bedside” is gradually becoming more porous and productive, while providing the required oversight. These improvements will positively affect patients, physicians, researchers, entities which invest in clinical research, and ultimately all who look to scientific discovery to propel medical advancement

References:

[1] Alschuler L, Bain L, Kush RD. Improving data collection for patient care and clinical trials. Sci Career Mag Mar 26 2004

[2] Pavlovic I, Kern T, Miklavcic D. Comparison of paper-based and electronic data collection process in clinical trials: Costs simulation study. Contemp Clin Trials 2009; 30: 300-16.

[3] http://www.outsourcing-pharma.com/Clinical-Development/India-tipped-for-15-share-of-clinical-sector-by-2011

Literature Review:

http://www.indianexpress.com/news/crackdown-two-hospitals-lose-research-institute-tag/842869/1

http://ctri.nic.in/Clinicaltrials/login.php

www.epic.com

www.cerner.com

America's Richest Hospitals

2011-11-06T02:52:00.000-08:00

Healthy & Wealthy

Here are the 10 top grossing short-term acute-care hospitals in the United States listed by gross revenue, according to CMS cost report data analyzed by American Hospital Directory. Note: The hospital total patient revenues and bed counts reported here are reported to CMS by the hospitals in their most recent cost reports and, in some cases, may include patient revenue and beds from other facilities that share a provider number with the main hospital.

1. University of Pittsburgh Medical Center Presbyterian — $9.8 billion. University of Pittsburgh Medical Center Presbyterian is a 1,600-bed medical-surgical referral hospital and works in conjunction with the University of Pittsburgh School of Medicine. The hospital is a renowned center for organ transplantation, and a distinguished leader in cardiology and cardiothoracic surgery, critical care medicine and trauma services and neurosurgery.
2. The Cleveland Clinic — $9.1 billion. The Cleveland Clinic located in Cleveland, Ohio, is a non-profit multispecialty academic medical center with more than 1,200 beds. The clinic maintains an outstanding reputation for quality care. The Sydell and Arnold Miller Family Heart & Vascular Institute heart program has been ranked number one in America for 15 years in a row by US News & World Report, and the programs in urology, rheumatology and gastrointestinal disorders all rank among America's top two, also according to U.S. News & World Report.
3. Cedars-Sinai Medical Center (Los Angeles) — $7.2 billion. Cedars-Sinai Medical Center opened in 1902, and is the largest academic medical center in the western United States with 947 beds. The hospital is affiliated with more than 2,000 physicians and is home to 10,000 employees. In Aug. 2010, the Cedars-Sinai Heart Institute opened California's first 30-bed in-patient unit devoted to providing advanced heart failure patients with an intensive, multidisciplinary approach to inpatient care.
4. Florida Hospital Orlando (Fla.) — $7.1 billion. Florida Hospital Orlando opened its doors as the Florida Sanitarium and Benevolent Association in October 1908. Today the full-service, acute-care hospital features 2,000 patient beds. In March of the year, the hospital has launched the only heart transplant program in Central Florida by adding Cardiologist Barbara Czerska, MD, and Transplant Surgeon Lawrence McBride, MD, to the Florida Hospital Transplant Center.
5. New York-Presbyterian Hospital/Weill Cornell Medical Center (New York City) — $6.8 billion. New York-Presbyterian Hospital/Weill Cornell Medical Center is a 2,200-bed academic medical center which includes, New York-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Payne Whitney Westchester and Morgan Stanley Children's Hospital. The hospital employs more than 18,000 people and was recently ranked for the tenth year in a row to U.S. News & World Report's Honor Roll of America's Best Hospitals, ranking in 15 adult and 10 pediatric specialties.

6. Stanford (Calif.) Hospital — $6.0 billion. Stanford Hospital is known for pioneering medical advances. The first successful adult human heart transplant in the country and the first combined heart-lung transplant in the world were performed at this facility. Continuing in its cutting-edge style, in June 2010, 466-bed Stanford debuted a hybrid medicine room in which the patient can stay in one place to be treated or diagnosed. The hospital has 1,910 physicians on staff and is home to more than 850 medical residents and interns.
7. University of California San Francisco Medical Center at Parnassus — $5.6 billion. The Parnassus campus of the University of California San Francisco Medical Center opened in 1898 after the 13-acre site overlooking Golden Gate Park was donated by San Francisco Major Adolph Sutro. Today, the hospital features 660 beds and features top programs in cancer care, cardiac care, neurosurgery and orthopedics. The UCSF Children's Hospital, which includes the Center for Mothers and Newborns, a pediatric intensive care unit, a neonatal intensive care nursery linked to a birth center and a pediatric surgical suite, is located on the sixth, seventh and 15th floors of Parnassus
8. Temple University Hospital (Philadelphia) — $5.5 billion. Temple University Hospital opened as Samaritan Hospital in Jan. 1892. The facility is the chief clinical training site for the Temple University School of Medicine and it is located on the University's Health Sciences Center Campus. As one of the most recognized academic medical centers in the country, the hospital offers comprehensive inpatient and outpatient services to the surrounding community and highly specialized tertiary services to the entire region.
9. Hospital of the University of Pennsylvania (Philadelphia) — $5.4 billion. The Hospital of the University of Pennsylvania opened in 1765 as the nation's first medical school, and its top quality patient care has continued for more than two centuries. The facility was named one of the 30 Best Hospitals in America by Becker's Hospital Review in March 2010. Additionally, the 728-bed hospital is ranked as one of the top 10 hospitals in the United States by U.S. News & World Report, for the third consecutive year.
10. Montefiore Medical Center – Moses Division Hospital (New York City) — $5.4 billion. Montefiore Medical Center was founded by leaders of New York's Jewish community in 1884, and today it serves nearly two million individuals from the Bronx and nearby Westchester County. Montefiore serves as the University Hospital for Albert Einstein College of Medicine. The hospital is home to centers of excellence in cancer care, cardiovascular services, pediatrics, transplantation and neurosciences. The hospital receives more than 93,000 inpatient visits per year.

HIMSS Davies Awards Winners: Leading Quality, Improved Patient Care

2011-10-12T03:03:00.000-07:00

The HIMSS Davies Awards of Excellence recognize excellence in the implementation of and value from health information technology

CHICAGO (September 13, 2011) – The six winners of the 2011 HIMSS Davies Awards deliver quality and consistent care to the patients and populations they serve with information technology – specifically the electronic health record. These healthcare leaders, winners of the HIMSS Davies Awards of Excellence, appear below in the four award categories: organizational, ambulatory, community health organization and public health.

HIMSS Organizational Davies Award - Kaiser Permanente: Headquartered in Oakland, Calif., Kaiser Permanente is one of the nation’s largest not-for-profit health plans, serving more than 8.8 million members with its 36 hospitals and 454 medical offices and more than 15,000 physicians in all specialties. Founded in 1945, the organization followed a 10-year plan beginning in 2002 to implement KP Health Connect, its system-wide E-H-R now used by all hospitals throughout the Kaiser Permanente system to allow clinicians to focus on delivering quality care to patients.

“Congratulations to Kaiser Permanente, the winner of the 2011 Davies Organization Award, for achieving the goals of safer, high quality and patient-centered care. The innovative, comprehensive and consistent use of information technology across the Kaiser healthcare system represents a new standard all of us will strive to achieve,” said C. Eric Hartz, MD, Chair of the HIMSS Organizational Davies Award committee and Chief Medical Information Officer at Eastern Maine Medical Center in Bangor, Maine. The medical center is the 2008 winner of the Organizational Davies Award.

HIMSS Ambulatory Davies Award: With quality patient care at the forefront of their achievements, the two winners in the ambulatory category are:

Fallon Clinic in Worcester, Mass., is a physician-owned and run not-for-profit multispecialty group practice with 357 providers representing 30 specialties located in 23 sites throughout central Massachusetts. With a thorough needs assessment, vendor selection and EHR implementation, Fallon Clinic achieved measurable improvements in the quality, safety, efficiency and satisfaction of healthcare delivery.

James F. Holsinger, MD, FC, opened his solo family medicine practice in Keokuk, Iowa, a rural community of 20,000 in a county with the highest unemployment rate in the state. The practice started in 2003 with no patients and two part-time visiting specialists renting space in the same building. Now, Dr. Holsinger has 1,400 active patients and is the first fully automated clinic in the area. Profitable in its first 20 months, the practice implemented, and uses in its day-to-day operation, nearly every EHR function and interface available.

"This cycle of evaluating practices for the prestigious Davies Award for excellence in implementation of electronic records has again resulted in the recognition of two outstanding examples of how computerization is leading to improved patient care and outcomes. We congratulate this year’s winners for their hard work, innovation and dedication to improving patient care," said Daniel Griffin, MD, Chair of the HIMSS Ambulatory Davies Award committee and founder of Alpenglow Medical, PLLC, in Fort Collins, Colo., a winner of the 2006 Davies Award of Excellence in Ambulatory Care.

Community Health Organization Davies Award: The HIMSS Community Health Organization Davies Award Committee selected Hudson River HealthCare (HRHCare), in Peekskill, NY. Since its founding as the Peekskill Area Ambulatory Health Center in 1975, this healthcare organization has continued its ongoing commitment to improving the quality of care, patient experience and health outcomes for its underserved, uninsured and underinsured patient populations. The health center’s 16 primary care sites serve 64,000 patients, with over 275,000 annual visits, representing a diverse, low income population in rural, urban, migrant, homeless and public housing settings.

“This year’s Community Health Organization Davies recipient, Hudson River Healthcare, has raised the bar for others with the use of health information technology to improve healthcare delivery and increase clinical outcomes for their patients,” said Greg L. Wolverton, FHIMSS, Chief Information Officer, ARcare, in Augusta, Ark., and a 2008 HIMSS Community Health Organization Davies winner. “Congratulations to Hudson River Healthcare for its demonstration of best practice in action and being part of a very prestigious group of recipients that have excelled in implementation of electronic health records and shown sustainability in the use.”

Public Health Davies Award: Recognized in Atlanta at the Public Health Informatics 2011 Conference, sponsored by the Department of Health and Human Services Centers for Disease Control and Prevention, two winners of the HIMSS Public Health Davies Award of Excellence now join 14 past public health Davies award winners, all honored for positively impacting population health by optimizing health information technology. The winners are:

•Florida Department of Health, Bureau of Epidemiology, Electronic Surveillance System for the Early Notification of Community-based Epidemics, Florida (ESSENCE-FL), and
•The New York City Department of Health & Mental Hygiene, Primary Care Information Project.

Telemedicine for Peanuts !!

2011-06-20T22:37:00.000-07:00

In our strive towards the utopian Affordable and Accessible Healthcare for the Indian populace, innovation is no longer a choice. The country has been abounding in ‘jugaad’ fixes which has impacted the life of many. One of such examples is the content of this post. This article has been contributed by Himadri Mukherjee on behalf of R C Aggarwal Memorial Hospital & Research Center. Himadri can be reached at himadri.mukherjee3@gmail.com

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Hospital Performance Indicators

2011-05-30T22:50:00.000-07:00

Globally, are hospitals are being confronted with multiple pressures to increase operational efficiency as well as curb operating costs.Performance Indicators provide all healthcare executives with a baseline for their hospital's performance before they delve deep into root causes.This powerpoint takes a closer look at such metrics for hospital perf5ormance along with their defintions and impact in hospital operations

Hospital Performance Indicators

Consulting in Healthcare

2011-05-22T22:01:00.000-07:00

Healthcare consulting is what I do and , thus was a natural choice for my first blog post !

While many believe that healthcare centers around the most important entity, the Patient, it is also a business and is subject to the same concerns as any other industry. The synthesis of business and healthcare can be a hard one to combine. This is why healthcare consulting has assumed unmatched importance.

Moreover, major global phenomenon including aging populations, rising affluence in emerging markets (and the accompanying “diseases of wealth”), and advances in medical techniques and technology have buoyed healthcare consulting through the recessionary period—and will continue to do so over the long term.

Putting numbers to its size, the current global healthcare consulting marketplace amounts to more than US$ 18 billion ( Source: Kennedy Healthcare Consulting Marketplace Report) with an unprecedented growth rate in following years.

Given the fragmented nature of the mammoth healthcare industry, its important to understand the structure of consulting practice in healthcare.

As depicted in the adjoining schematic, the
healthcare industry can be broadly categorized into 4 segments. Healthcare consulting firms typically work with clients based out of any of these segments. A closer look would help better understanding.PAYERS comprise of any entity/organization who pays/finances for the healthcare services rendered. They include insurance companies, TPAs', claims clearing houses etc. This is especially relevant in health systems having a third party payment system such as the United States.All MNC consulting firms ( Mckinsey, Accenture, Deloitte etc) have a dedicated payer practice for serving such clients. PROVIDERS are organizations and individuals providing healthcare services. It could be anything ranging from a physician to multi specialty networked hospitals. All homegrown healthcare consultancies ( Apollo Global Projects, Hosmac MedicaSynergie ) primarily work for clients in the provider space with different capabilities.GOVT/REGULATORY BODIES envisage all government machineries involved in public health policy planning, strategy formulation and other regulatory activities. Public health consulting falls under this domain.LIFE SCIENCES include the bio pharmaceutical industry and medical devices.

Within each of the industry segments, consultants have different engagements with their clients. The India healthcare consulting market is dominated by Providers and Government segments followed by Lifesciences and an insignificant Payer share while globally there are equal opportunities in all segments

While deciding upon a career path in healthcare consulting its important we realize which segment do we intend to focus !