RHIOs, Health Information Exchange & Telemedicine

Mobile App to discover more about our food

2012-04-02T18:02:00.005-07:00

Have you wondered where your food came from? Is there "pink slime" in tonight's dinner?
Perhaps you don't eat eggs or gelatin and have your eyes set on a flavor of ice cream. How hard is it to get accurate information on the contents of this food item?

Well, there appears to be good news. There is a new mobility food traceability app that helps consumers learn more about he food they wish to eat. See this article by Derek Singleton.

Attesting for Meaningful Use

2011-11-09T18:39:00.000-08:00

A good blog post on Meaningful Use (MU) attestation by Houston Neal.

Dr. Kevin Spencer, a physician that recently attested to meaningful use, provides three tips to make successfully attesting easier for other practices. According to Dr. Spencer, the key components to successfully attesting were:

Choosing the right EHR software company;
Undergoing meaningful use training; and,
Changing documentation processes to fit meaningful use guidelines.

iPad EMR Apps

2011-06-06T20:38:00.000-07:00

Good information on iPad EMR apps by Houston Neal:
"...more and more electronic medical record (EMR) vendors are releasing iPad-specific versions of their EMRs. Some offer native iPad EMRs; others offer web-browser access through the iPad. However, there is no perfect iPad EMR solution"

I'm personally using RDP to log into my Win Apps, which we have designed to iPad friendly.

Read more:iPad EMR Apps | A Guide to Electronic Medical Records

Essential Communication Tools for Entrepreneurs

2011-05-21T19:57:00.000-07:00

Essential Communication Tools for Entrepreneurs

View more presentations from MaRS Discovery District

Care Coordination Measures

2011-04-08T20:06:00.003-07:00

Care Coordination Measures Atlas - March 2011

Care Coordination Measures

2011-04-08T20:06:00.001-07:00

Care Coordination Measures Atlas - March 2011

EMRs and iPAD strategy

2011-01-26T18:19:00.000-08:00

Austin Merritt, Chief Operating Officer of Software Advice, feels that EMR companies are slow to develop an iPad strategy:

"The medical software industry is far from supporting the iPad on a meaningful scale."
"... only a handful of other vendors (most notably AllScripts and Quest) have released iPad apps to supplement existing EHR systems".

I personally have been using RDP on my iPhone and have found it to work great for my Windows applications. In fact, we've been developing our internal Windows based applications with iPhone and iPad in mind, using these applications via RDP is similar in ease of use as native iPhone/iPad apps.

Neat Medical Apps for the iPhone

2011-01-08T16:20:00.001-08:00

This iPhone App determines your pulse rate and even displays a tracing. even better, its free!

This App, not yet released, will actually give a single lead EKG tracing. It's the invention of an Oklahoma physician, Dr David Albert, and is currently in process of getting FDA approval.

commercialize your healthcare IT

2011-01-08T11:54:00.000-08:00

Good points raised here.

Skype for Telemedicine

2011-01-08T11:49:00.000-08:00

This could open up new possibilities, Skype for Telemedicine. I see charging patients a flat monthly fee as a better option than charging per visit.

Telemedicine in Pediatric ICU care

2010-05-27T14:56:00.000-07:00

Mass General Hospital for Childern in partnership with Partner's Healthcare Center for Connected Health is using video conferencing technology in caring for pediatric ICU patients. Senior physicians are available to evaluate patients at the bedside remotely using video conferencing technology. The on site clinical team which includes nurses, resident physicians and interns, are all able to be join the senior physician in the bedside evaluation of the patient. They have plans to expand this model of care to the other wards and to use it for adult inpatient care as well. Read more...

EHR Market Share

2010-05-18T19:38:00.000-07:00

Great article on market share in the EMR industry. EPIC is listed as having the largest market share, with eClinicalWorks and Allscripts as close seconds. I was surprised to see how much eClinicalWorks has grown in a short time. According to these numbers, it has pulled ahead of traditional EHR powerhouses such as GE Centricity and NextGen. Another surprise was seeing Practice fusion ranking 6th on the list. Impressive growth for this SaaS, Free EHR product. In a way, I see Practice fusion as the future for EHR technology and business model. EHR may move away from the classic client-server model to SaaS, and may in fact become more of a commodity service. A compelling case for achieving meaning full use with Practice Fusion's free EHR, is the fact that physicians will actually be ahead financially with receipt of the stimulus dollars for EHR adoption.

Benefits of Paperless Record Systems in Hospitals

2010-04-08T18:28:00.000-07:00

This following guest article was written by Richard Hemby who regularly writes about online health care degrees and other college related topics for Online College Guru, an online college degree guide

The Benefits of Paperless Record Systems in Hospitals

Bulky charts full of hand-written scribbles, test results and medication history are becoming a thing of the past in hospitals across the nation. Medical charting is undergoing an exciting transformation to digital record keeping that will change patient care for good.

Until now, finding critical medical documents could take several minutes or more thumbing through pages and pages of records. During an emergency, those precious minutes could mean the difference between life and death. Thanks to electronic paperless record systems, a physician can pull up information about a patient in just seconds. The ability to do so can drastically improve the quality of patient care and save lives.

With traditional paper charting, it can take several days for physicians, laboratories and hospitals to transcribe and exchange exam notes and test results. This can cause a serious delay in proper medical care for patients. Paperless record systems allow all of the professionals treating a patient to quickly and efficiently exchange information.

Laptop and desktop computers hosting electronic record keeping software will soon replace overstuffed patient charts. Not only is this move fantastic for the future of healthcare, it makes great business sense for hospitals as well. Providing a higher level of patient care and faster service translates to happier patients and fewer medical errors and malpractice lawsuits. Having electronic medical records also frees up much needed space that has traditionally been devoted to storing an ever-growing library of paper charts.

President Barack Obama hopes to convert all paper charting to digital by the year 2014. In an effort to make this happen, the U.S. Government is offering $19 billion in stimulus money to help hospitals with the cost of transitioning to digital record systems. President Obama believes that the transition to paperless record systems will make the U.S. health care system safer, more efficient and will reduce overall health care costs.

While the initial cost of implementing a paperless system can be very steep, electronic record keeping is more cost effective than paper records in the long run. When all new records are written electronically and all old records have been scanned into the system, the cost of storing paper records and paying workers to organize, file and maintain them will be eliminated. This equals huge long-term savings for hospitals. Electronic record keeping can be intimidating at first, but the benefits that paperless record systems offer greatly outweigh the upfront cost.

The Benefits of Paperless Record Systems in Hospitals

Video conferencing for Mental Health

2010-02-10T09:38:00.000-08:00

Here's Video conferencing being used for Mental Health. As many of us know, obtaining mental health services can be a challenge, especially for people in remote areas. There is a tremendous need for mental health services among the veteran population, especially those returning from Iraq and Afghanistan. Veterans sometime forgo mental health services due to lack of availability of these services. Telemedicine has made it possible for these veterans to obtain this crucial services in a convenient manner. As a result, veterans who did not seek help earlier, are now getting care.

Facebook's Data Model

2010-02-09T19:30:00.000-08:00

I find data models and scalability design for popular applications, such as facebook and Linkedin to be quite fascinating.
Here is the data model of facebook, which has been reverse engineered.

Here is the Data API documentation.

Some thoughts on the data model, and the power using associations.

Telemedicine in the Pediatric ICU

2010-02-09T09:16:00.000-08:00

Video conferencing is being used in treating Pediatric patient at the Mass General Pediatric ICU:

"The attending physician can then see the patient, talk with clinicians on-site, personally evaluate the child's condition and make treatment decisions."

"The attending physician can then see the patient, talk with clinicians on-site, personally evaluate the child's condition and make treatment decisions. Special cameras and scopes can also be attached to the hospital-based unit to allow for closer evaluation of the patient."

"Because the attending physician can remotely examine the patient and communicate with the on-site staff directly, decision making can be enhanced and the quality of care improved."

Partners Connected Health is using Video conferencing telemedicine technology to deliver physician resources example how this technology can used to improve access to high value services. Nursing homes are another health care setting that can benefit from delivering remotely located physician resources on as demand basis. Nursing homes typically struggle to have adequate physician coverage on site and can certainly benefit fromthis technology

Top 50 Healthcare IT blogs

2010-02-03T19:42:00.000-08:00

Health Sensei has released its list of the 50 Healthcare IT blogs. I'm honored to be included in this list among some highly distinguished blogs.

Telemedicine for Diabetic Teaching

2010-01-28T20:04:00.000-08:00

This study demonstrated that diabetic teaching using via video conferencing based telemedicine was as effective as in-person teaching in improving control and patient satisfaction.

The advantage that diabetic teaching via telemedicine offers over the traditional face to face encounter, is the ability to deploy essential diabetic teaching across a wider region, thus solving the problem of access that many patients face.

Ideally, I envision that a patient should be able to visit their physician , and then from the same office visit, access the diabetic trainer via the video conferencing. Toward the end of the session, the patient and the remotely located diabetic educator would do a recap with the physician in order to insure the everyone is on the same page. This would be a way to decrease the level of fragmentation that can exist in diabetic care when multiple providers are involved.

The results of the study are listed below:

RESULTS—Patient satisfaction was high in the telemedicine group. Problem Areas in Diabetes scale scores improved significantly with diabetes education (adjusted P <>_1c improved from 8.6 ± 1.8% at baseline to 7.8 ± 1.5% immediately after education and 7.8 ± 1.8% 3 months after the third educational visit (unadjusted P <>P = 0.089 adjusted for BMI and age), with similar changes observed in the telemedicine and in-person groups.

Telemedicine results in few tests and greater patient satisfaction

2010-01-13T15:27:00.000-08:00

http://news.bio-medicine.org/medicine-news-2/Telemedicine-could-offer-fewer-follow-up-tests-and-greater-satisfaction-for-patients-7867-1/

How to Achieve Meaningful Use

2010-01-08T18:57:00.000-08:00

See this easy to understand article summarizing meaningful use.

Telemedicine for Orthopedics

2009-12-10T20:34:00.000-08:00

Orthopedics may be an opportunity for telemedicine. It may be especially useful in the correctional center setting where travel time for an orthopedic physician mY be an inefficient use of a valuable resource. See the abstract below:

Outpatient Orthopedics and the Impact of Telemedicine Upon Costs and Patient Care
Richard M. Garden, MD

Utah Department of Corrections, P.O. Box 250, Draper, UT 84020. Phone: (801) 576-7100.rgarden@utah.gov

In an effort to investigate and evaluate a start-up telemedicine program, the first two years of conducting orthopedic clinics via telemedicine were analyzed. These years were compared to the last full year during which all such clinics were conducted off site. The numbers of off-site visits, surgeries, total visits, grievances (patient complaints), and costs associated with on-site telemedicine (telecasts) were compared for years 1997, 1999, and 2000. A major reduction in the need for off-site visits, a small change in costs, a small increase in total utilization, a decrease in orthopedic-related grievances, and minimal changes in the number of surgeries were found. It was concluded that telemedicine is a fruitful endeavor and also offers a few less tangible benefits and lessons learned.

Journal of Correctional Health Care, Vol. 9, No. 1, 53-61 (2002)
DOI: 10.1177/107834580200900106

Providers skeptical of meaningful use reimbursement process

2009-11-02T07:05:00.000-08:00

Providers skeptical of meaningful use reimbursement process"Under a draft of potential measures released in September by the HIT Policy Committee, eligible providers would have to use CPOE (computerized physician order entry) for all orders, implement drug-drug, drug allergy and drug-formulary checks and maintain an up-to-date problem list of current and active diagnoses based on ICD-9 or SNOMED.
"

The issue of interoperability with hospitals in the local community is essential:
"...physicians from small practices often interact with more than five community hospitals and several labs, each with a different system. Doctors need to know that whatever electronic health record they buy will work with the systems the labs and hospitals have."

WSJ: Video conferencing in Medicine

2009-11-01T19:10:00.000-08:00

Guest Post: Clinical Process in Pain Management

2009-10-06T09:28:00.000-07:00

Clinical Process in Pain Management
It’s definitely not easy when you know you have a terminal disease like cancer. What’s worse is the fact that you know you’re going to suffer a painful death, one that will not come quickly but is drawn out and excruciating. Pain management is thus a very important part of palliative care, the kind that is provided to people who have been given just a few months to live at best, people who have lost all hope and for whom chemo and other treatment options are no longer effective. Even those patients who see a sliver of hope in the form of radiation and chemotherapy are in pain, because for this dreaded disease, even the treatment is a form of unbearable pain.
The clinical process in pain management includes the following steps:
• Assessing the pain and documenting its aspects – like how bearable it is and where it originates, if it is radiating or localized, if it is continuous or sporadic, and so on.
• Recognizing the triggers of pain – identifying the factors that cause the pain to flare up or intensify is important because it helps minimize trauma.
• Finding the cause of the pain – the triggers for the pain may be different from the cause. The cause may be a broken bone, but the trigger may be someone touching the injured area or moving it. It is imperative that the cause is identified and treated if the pain must be stopped for good.
• Assessing the risk in the situation – some treatment methods fail to take into account the risks involved. It’s important to assess all the risks, especially when treating people with prior medical conditions.
• Devising a care plan to manage the symptoms of pain – this is especially important when you’re looking after terminally ill patients who need long term pain management plans if they are to live out their last days in relative comfort.
• Treating the cause of the pain – the cause of the pain must be treated if possible, like in the case of broken bones or torn ligaments.
• Considering alternative action when the patient is unresponsive to one method of management – people respond differently to different drugs, so each person’s care plan has to be formulated with precision.
• Dealing with adverse drug reactions – some patients may be allergic to certain drugs, so you must ask the right questions before you begin treatment or pain management therapy.
• Continuously monitoring the situation to see if there has been any improvement – the patient has to be watched for signs, both of improvement and relapse. It’s important that non-verbal cues like grimaces and frowns be taken into consideration as well when caring for patients who are very ill.
Pain management is important in not just cancer but also in post-surgery situations and in acute care conditions. And when the clinical process is efficient, it makes it that much more bearable for the patient.

This guest article was written by Adrienne Carlson, who regularly writes on the topic of nurse practitioner schools . Adrienne welcomes your comments and questions at her email address: adrienne.carlson1@gmail.com

EHR Killer App

2009-07-28T12:19:00.001-07:00

Great, insightful article on the need for a EHR Killer App:

"...So where is the EHR 'killer app'? Unfortunately, it doesn't yet exist, and instead providers find themselves courted by innumerous EHR vendors, each offering their own, proprietary methods for accomplishing familiar tasks. If providers aren't careful, they might find themselves locked into vendor-specific software systems and siloed IT universes."

RHIOs, Health Information Exchange & Telemedicine

Mobile App to discover more about our food

Attesting for Meaningful Use

iPad EMR Apps

Essential Communication Tools for Entrepreneurs

Care Coordination Measures

Care Coordination Measures

EMRs and iPAD strategy

Neat Medical Apps for the iPhone

commercialize your healthcare IT

Skype for Telemedicine

Telemedicine in Pediatric ICU care

EHR Market Share

Benefits of Paperless Record Systems in Hospitals

The Benefits of Paperless Record Systems in Hospitals

Video conferencing for Mental Health

Facebook's Data Model

Telemedicine in the Pediatric ICU

Top 50 Healthcare IT blogs

Telemedicine for Diabetic Teaching

Telemedicine results in few tests and greater patient satisfaction

How to Achieve Meaningful Use

Telemedicine for Orthopedics

Providers skeptical of meaningful use reimbursement process

WSJ: Video conferencing in Medicine

More Hospitals Are Using Video to Connect Patients With Specialists Far Away, Speeding Treatment

Guest Post: Clinical Process in Pain Management

EHR Killer App