tag:blogger.com,1999:blog-65685392768857920232024-02-20T07:45:48.415-06:00Health InformaticsPatient Care. Quality. Outcomes. Coverage. Cost. Technologies.Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.comBlogger19125tag:blogger.com,1999:blog-6568539276885792023.post-79130464139651738322010-06-05T20:08:00.005-05:002011-01-09T20:00:20.602-06:00Drivers of MD reimbursement cutsCongress may soon pass a bill that cuts physician reimbursement from Medicare by as much as 21%<br /><br />What's driving the cuts?<br /><br />* High federal budget deficit is putting pressure on federal government to cut MD reimbursement (<span class="blsp-spelling-corrected" id="SPELLING_ERROR_0">Remember</span>: Government is THE largest <span class="blsp-spelling-error" id="SPELLING_ERROR_1">healthcare</span> payer)<br />* <span class="blsp-spelling-corrected" id="SPELLING_ERROR_2">Inclination</span> of state governments to regulate (limit) insurance premium increases on individuals will likely drive lower payment by state government to hospitals and doctors<br />* Private <span class="blsp-spelling-corrected" id="SPELLING_ERROR_3">insurers</span> will likely renegotiate contracts with providers to cut reimbursement rates if both federal and state governments cut MD reimbursement rates<br /><br />Are there other drivers?Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-16203991859806402942010-06-05T08:24:00.003-05:002010-06-05T08:31:35.296-05:00John Wooden is no more"Learn as if you were to live forever; live as if you were to die tomorrow"<br /><br />"Don't give up on your dreams, or your dreams will give up on you"<br /><br />John Wooden will always remain a guiding light.Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-89335371887478909882010-02-14T17:16:00.002-06:002010-02-14T17:20:41.528-06:00Human BehaviorFound a great quote on Health Care Informatics blog related to following "checklists" within ICU and surgery:<br /><br />"Human beings, who are almost unique in having the ability to learn from the experience of others, are also remarkable for their apparent disinclination to do so." Douglas AdamsGirish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-11954517354028612352010-02-06T11:12:00.006-06:002010-02-07T06:53:16.452-06:00Privacy or Security - what's more important?While the standards are shaping up, and there is monumental work to be done in a relatively short amount of time. How do you choose which one to do first. It is clear that a reasonable prioritization is needed, some things are relatively more important than others. <div><br /></div><div>Same argument applies to establishing a privacy and security policy. That begs the question - What's more important? Should an organization establish and implement a privacy policy first or should it ensure that a consistent standards-based security policy is implemented so no breach happens in the first place. If you answered "Both", you are on the right track as potentially judged by any reasonable person. However, an organization with limited resources can have the right intent but some things do need to take precedence over others so the implementation goal can be realized.</div><div><br /></div><div>Establishing and implementing a consistent privacy policy takes precedence and requires unwavering support in any health care organization. Security policy is highly important but it need not be standards-based right for the get-go. You might have heard the saying "Security implementation is a function of the size of your wallet". You can build elaborate checks, audits, disk/server-space, authentication and authorization and make them consistent across the organization if you have the right kind of money to throw at it. With limited funds, you can still uphold the goal of data security by adopting security policies that allow for individual businesses within the organization to have their respective security policies which meet the data security aims. For instance, to fulfill the goal of role-based security, individual businesses can implement an elaborate suite of roles and implement a sophisticated and highly automated mechanism OR can decide a maintain a combination of spreadsheets and manual tracking to fulfill the goal. Either way, the security goal will be fulfilled. </div><div><br /></div><div><br /></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-9970509938241069562010-01-13T22:49:00.005-06:002010-01-13T23:23:03.976-06:00Running national security is like executing a Business Intelligence programSaw this <a href="http://www.foxnews.com/static/managed/img/Politics/Obama_WarCouncil_doomsday_604x341.jpg">picture</a> of Obama surrounded by the security team.<div><br /></div><div>Looks a lot like a BI program initiative:</div><div><br /></div><div>* <b>Interconnected</b>: Multiple inter-connected functional groups in a business unit</div><div>* <b>Collaboration</b>: Each group has its own agenda, but must collaborate with other groups to achieve the goal </div><div>* <b>Vision</b>: Each group has its own view of the "world", yet select few see the complete picture</div><div>* <b>Leadership</b>: Someone must make the call when there is a stalemate</div><div>* <b>Prioritization</b>: Constantly reprioritize as new information comes in</div><div>* <b>Impact</b>: Doing nothing has a disastrous impact </div><div>* <b>Behavior</b>: </div><div>>> Some treat it like a project and have an end in mind, others know that this is a continuous program</div><div>>> Some are overly optimistic, many are pessimistic. Realistic people are needed instead. </div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com1tag:blogger.com,1999:blog-6568539276885792023.post-25742812585111990012009-11-22T15:10:00.004-06:002009-12-13T17:36:15.219-06:00HIT - naysayers & skepticsAnyone who has engaged in Information Technology business for some time knows that most IT investments do not generate significant benefits until sufficient years have passed. In most cases, even 5-year ROI models are flawed since it may take a decade before significant gains from the investment are seen. That is what we know. Then, why would we treat HIT differently? I would challenge anyone who dismisses investing in EHR/HIT technologies solely because evidence of its positive impact on quality of care cannot be visualized over the short-term horizon. <div><br /></div><div>Do not dismiss before you explore. The inclination to "do nothing" in face of mounting challenges and insistence on availability of absolute evidence prior to investment could be disastrous. <div><br /></div></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-68817151405636389852009-10-31T08:31:00.005-05:002009-10-31T09:21:49.344-05:00A case for modular EHR<p class="MsoNormal"><span class="apple-style-span"><span style=" ;font-family:Georgia;color:black;">Came across a great <span style="text-decoration:none;text-underline:nonecolor:black;"><a href="http://www.aafp.org/online/etc/medialib/aafp_org/documents/news_pubs/fpm/access/20090700-8towa.Par.0001.File.tmp/20090700-8towa.pdf">article</a><a href="http://www.aafp.org/online/etc/medialib/aafp_org/documents/news_pubs/fpm/access/20090700-8towa.Par.0001.File.tmp/20090700-8towa.pdf"> </a></span> on plug-and-play modular EHR by David C. Kibbe, MD, MBA, senior advisor to the AAFP’s Center for Health Information Technology. The author questions the push for adoption of comprehensive EHRs when in fact that the needs of a practice (market) might be for some its components such as e-prescribing or a registry function. He proposes a shift from vendor-centric approach to platform-centric one where the practices are able to purchase and adopt EHR "modules" that follow industry standards.<o:p></o:p></span></span></p> <p class="MsoNormal"><span class="Apple-style-span" style=" ;font-family:Georgia;">This idea is certainly not new, consider this <span style="text-decoration:none;text-underline:nonecolor:black;"><a href="http://geekdoctor.blogspot.com/2009/10/project-and-product-certification.html">blog</a> </span>post by John Halamka where he states that Partners Healthcare and Beth Israel Deaconess are using a platform-centric approach for EHR and quality reporting, and are on their way to meet the meaningful use criteria. </span></p> <p class="MsoNormal"><span class="Apple-style-span" style=" ;font-family:Georgia;">Interoperable plug-and-play modules make sense to me. Buy components (modules) you need, connect new components with ones you already have on the platform.</span></p> <p class="MsoNormal"><span class="apple-style-span"><span style=" ;font-family:Georgia;color:black;"><o:p> </o:p></span></span></p>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com1tag:blogger.com,1999:blog-6568539276885792023.post-25407690100692392222009-09-27T11:28:00.005-05:002009-09-27T11:41:24.997-05:00Ethical use of data for Clinical Decision Support<span style=" ;font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;">Noticed this ethics-related question on </span><span style=" ;font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;">LOINC website</span><span class="apple-converted-space"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span style="color:#123879;"><a href="http://loinc.org/articles/Bonney2009"><span class="Apple-style-span" style="font-size:medium;">http://loinc.org/articles/Bonney2009</span></a><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><div><span class="Apple-style-span" style="font-family:Arial;color:#123879;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></div><div><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;"><b>“Is it appropriate, or ethical , to use health data collected for the purpose of direct patient care to develop computerized predictive decision support tools?” </b></span></span></div><div><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></div><div><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">I do not have access to the complete article, but the question itself triggered some thoughts in my mind. I guess the first question to ask is – does the end justify the means? Since use of CDSS (Clinical Decision Support Systems) has been shown on average to lead to better clinical decision-making for providers and hence impact patient care, is it okay to use patient care data for development of such tools?</span></span></div> <p><span style=" ;font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;">I will attempt to answer this question using the ethical framework governing the research on human subjects to see if it may apply to this situation (</span><i><span class="Apple-style-span" style="font-size:medium;">source of framework: Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical? JAMA. 2000;283:2701-11. [PMID: 10819955])</span></i><span class="Apple-style-span" style="font-size:medium;">.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p><span style=" ;font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;">Here is the list of 7 framework requirements and their applicability to CDSS development as assessed by me –</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <ol start="1" type="1"> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Social or scientific value</span>: Benefits from CDSS should justify the resources spent and risks imposed on patients whose data has been used</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></li> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Scientific validity</span>: Predictive decision-making methodology used by CDSS should be properly structured to meet its objectives</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></li> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Fair participant selection</span>: Participant data should be selected to achieve a fair distribution of the burdens and benefits of CDSS.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></li> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Favorable risk-benefit ratio</span>: CDSS should be designed to ensure that the risks to an individual human participant are balanced by expected benefits to the same participant</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></li> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Respect for participants</span>: Privacy of participant should be protected and confidentiality of their data should be maintained. This can be achieved by using de-identified data and obtaining patient consent for collection, use, and sharing of data</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></li> <li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Informed consent</span>: Participant consent to include data in development of CDSS </span><span class="Apple-style-span" style="text-decoration: underline;"><span class="Apple-style-span" style="font-size:medium;">must</span></span><span class="Apple-style-span" style="font-size:medium;"> be obtained. The risk to participant should be measured relative to risk associated with receiving care without use of CDSS. This risk should be communicated to the participant when obtaining informed consent.</span></span></li><li class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt: auto;mso-list:l0 level1 lfo1;tab-stops:list .5incolor:black;"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="text-decoration: underline;">Independent review</span>: CDSS development should receive independent ethical review that is appropriate to the level of potential risk it poses to participants.</span></span></li></ol><div><div><span class="Apple-style-span" style="font-family:Arial;font-size:130%;"><span class="Apple-style-span" style="font-size:14px;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></span></div></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-90894939091616357192009-09-20T18:07:00.005-05:002009-09-20T18:12:44.313-05:00Medical vs. Nursing Informatics - Part 3 (final)<p class="MsoNormal"><span><span class="Apple-style-span" style="font-size: medium;">Here is the final part of the comparison between medical and nursing informatics. </span><a href="http://geekinformatics.blogspot.com/2009/09/medical-vs-nursing-informatics-part-1.html"><span class="Apple-style-span" style="font-size: medium;">Part 1</span></a><span class="Apple-style-span" style="font-size: medium;"> and </span><a href="http://geekinformatics.blogspot.com/2009/09/medical-vs-nursing-informatics-part-2.html"><span class="Apple-style-span" style="font-size: medium;">Part 2</span></a><span class="Apple-style-span" style="font-size: medium;"> can be found here.</span><span class="Apple-style-span" style="font-size: medium;"><o:p></o:p></span></span></p><p class="MsoNormal"><u><span class="Apple-style-span" style="font-size: medium;">Medical and Nursing Vocabularies</span></u><span class="Apple-style-span" style="font-size: medium;">: </span></p> <p class="MsoNormal"><span><span class="Apple-style-span" style="font-size: medium;">Number of medical vocabularies such as MeSH, SNOMED, LOINC have been developed over the years. 100+ separate controlled vocabularies were conceptually linked in 1986 to form a meta-thesaurus called the UMLS (Unified Medical Language System).</span></span></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;">Some nursing products such as CINAHL (Cumulative Index of Nursing and Allied Health Literature) use a medical vocabulary MeSH as an underlying vocabulary for diseases, drugs, anatomy, and physiology, and have expanded the vocabulary to include unique nursing terms in the vocabulary </span><a href="http://www.universityhealthsystem.com/Research/docs/Searching%20sEBSCO%20CINAHL.pdf"><span class="Apple-style-span" style="font-size: medium;">http://www.universityhealthsystem.com/Research/docs/Searching%20sEBSCO%20CINAHL.pdf</span></a></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size: medium;"> </span></o:p></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size: medium;"> </span><u><span class="Apple-style-span" style="font-size: medium;">Growth opportunities</span></u><span class="Apple-style-span" style="font-size: medium;">: Lastly, both medical and nursing informatics domains are ripe for </span><b><span class="Apple-style-span" style="font-size: medium;">innovation and improvement</span></b><span class="Apple-style-span" style="font-size: medium;">. Consider the emerging health care models such as Patient Centered Medical Home that are likely to impact the physicians and nursing professions, in addition to impacting the related informatics domains as well.</span></o:p></p><p class="MsoNormal"><br /></p>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-26142830925976209812009-09-17T23:05:00.005-05:002009-09-20T18:16:27.854-05:00Medical vs. Nursing Informatics - Part 2<span class="Apple-style-span" style="font-size:medium;">Here is the second part of the comparison between medical and nursing informatics that highlights the similarities and differences between their information needs. First part can be found </span><a href="http://geekinformatics.blogspot.com/2009/09/medical-vs-nursing-informatics-part-1.html"><span class="Apple-style-span" style="font-size:medium;">here</span></a><span class="Apple-style-span" style="font-size:medium;">.</span><div><span class="Apple-style-span" style="font-size:medium;"><br /></span></div><div><p class="MsoNormal"><u><span class="Apple-style-span" style="font-size:medium;">Physician vs. Nursing Information needs</span></u><span class="Apple-style-span" style="font-size:medium;">: </span></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">It is important to </span><b><span class="Apple-style-span" style="font-size:medium;">compare and contrast physicians’ and nurses’ information needs</span></b><span class="Apple-style-span" style="font-size:medium;"> to appreciate why we need to two separate informatics disciplines.</span></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">There is </span><b><span class="Apple-style-span" style="font-size:medium;">significant overlap</span></b><span class="Apple-style-span" style="font-size:medium;"> between nurses’ and physicians’ needs for information – drug-drug interaction, pill identification, etc. However, there are certain information needs that are very specific to nurses’ needs – </span><b><span class="Apple-style-span" style="font-size:medium;">nursing procedures, nursing care plans,</span></b><span class="Apple-style-span" style="font-size:medium;"> etc. Arguably, a nurse may need access to </span><b><span class="Apple-style-span" style="font-size:medium;">both information sources</span></b><span class="Apple-style-span" style="font-size:medium;"> created for physicians (such as MD Consult, UpToDate, VisualDx, MediSpan, Micromedex, EMBASE, etc.) as well as those created specifically for nurses (CINAHL, NursingConsult, etc.) in order to do his/her job. For instance, a nurse administrator </span><b><span class="Apple-style-span" style="font-size:medium;">creating or updating a training program</span></b><span class="Apple-style-span" style="font-size:medium;"> for practicing nurses may need current educational materials. Or, when a patient is being discharged and nurse wants to provide </span><b><span class="Apple-style-span" style="font-size:medium;">educational or instructional material for patient’s care</span></b><span class="Apple-style-span" style="font-size:medium;"> at home.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">Similary, there is an overlap on </span><b><span class="Apple-style-span" style="font-size:medium;">evidence-based information needs</span></b><span class="Apple-style-span" style="font-size:medium;"> but some of the needs for evidence are unique to nursing. For instance, each Evidence-Based Nursing monograph available on Mosby’s Nursing Consult (</span><a href="http://www.nursingconsult.com/"><span class="Apple-style-span" style="font-size:medium;">www.nursingconsult.com</span></a><span class="Apple-style-span" style="font-size:medium;">) contains a concise review of the current evidence available on a clinical problem and presents specific recommendations for nursing care. Another such example is </span><st1:place st="on"><st1:placename st="on"><span class="Apple-style-span" style="font-size:medium;">Nursing</span></st1:placename><span class="Apple-style-span" style="font-size:medium;"> </span><st1:placename st="on"><span class="Apple-style-span" style="font-size:medium;">Reference</span></st1:placename><span class="Apple-style-span" style="font-size:medium;"> </span><st1:placetype st="on"><span class="Apple-style-span" style="font-size:medium;">Center</span></st1:placetype></st1:place><span class="Apple-style-span" style="font-size:medium;"> by EBSCO. See the related press release </span><a href="http://www.ebscohost.com/uploads/thisTopic-dbTopic-871.pdf"><span class="Apple-style-span" style="font-size:medium;">http://www.ebscohost.com/uploads/thisTopic-dbTopic-871.pdf</span></a></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">In clinical settings, physician and nursing </span><b><span class="Apple-style-span" style="font-size:medium;">workflows</span></b><span class="Apple-style-span" style="font-size:medium;"> are quite different, so their information needs at the </span><b><span class="Apple-style-span" style="font-size:medium;">point-of-care</span></b><span class="Apple-style-span" style="font-size:medium;"> differ. For instance, a nurse may enter patient symptoms and signs in a nursing information product that returns what other observations should be made, not for diagnosis, but to know what to report to physician. In </span><b><span class="Apple-style-span" style="font-size:medium;">research</span></b><span class="Apple-style-span" style="font-size:medium;"> settings, information needs of nurses and physicians may differ as well. These differences impact the </span><b><span class="Apple-style-span" style="font-size:medium;">human-computer interaction (HCI) concepts</span></b><span class="Apple-style-span" style="font-size:medium;"> that are used to design and implement systems built for physicians and nurses within these settings.</span></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">From </span><b><span class="Apple-style-span" style="font-size:medium;">administrative perspective</span></b><span class="Apple-style-span" style="font-size:medium;">, information needs of CNIO and CMIO would be different. For instance, in a hospital different policies may be created by CNIO and CMIO for nurses and physicians respectively to impact their productivity.</span></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">Lastly, </span><b><span class="Apple-style-span" style="font-size:medium;">education needs</span></b><span class="Apple-style-span" style="font-size:medium;"> of a nurse and a physician would differ based on certifications they would like to pursue, specialty-specific training required for a floor nurse, etc. For instance, a nurse administrator creating or updating training program for practicing nurses may retrieve information related to procedures, processes, general discussion information that is usable for nurse education.</span></p> <p class="MsoNormal"><o:p><span class="Apple-style-span" style="font-size:medium;">In the third and final part, I will discuss medical and nursing vocabularies as well as growth opportunities.</span></o:p></p></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-18993251340702599012009-09-14T22:20:00.006-05:002009-09-15T08:30:02.138-05:00Medical vs. Nursing Informatics - Part 1<div><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:medium;">Here are a series of articles contrasting Medical informatics with Nursing informatics. I present the first part below - </span></span></div><div><p class="MsoNormal"><span><span class="Apple-style-span" style="font-size:medium;">Medical Informatics deals with the storage, retrieval, and optimal use of biomedical information, data, and knowledge for problem solving and decision making (as defined by </span><a href="http://en.wikipedia.org/wiki/Edward_H._Shortliffe"><span class="Apple-style-span" style="font-size:medium;">Dr. Shortliffe</span></a><span class="Apple-style-span" style="font-size:medium;">). Nursing Informatics is defined as a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge into nursing practice. (source: American Nurses Association)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal"><span><span class="Apple-style-span" style="font-size:medium;">Both definitions sound very similar. In fact, both medical and nursing informatics fields are similar in many respects:</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Support for </span><b><span class="Apple-style-span" style="font-size:medium;">improvement in quality of care</span></b><span class="Apple-style-span" style="font-size:medium;"> and patient outcomes</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Availability of </span><b><span class="Apple-style-span" style="font-size:medium;">contextual</span></b><span class="Apple-style-span" style="font-size:medium;"> information – right information to right person at right time</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Support for </span><b><span class="Apple-style-span" style="font-size:medium;">security and privacy</span></b><span class="Apple-style-span" style="font-size:medium;"> of data</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><b><span><span class="Apple-style-span" style="font-size:medium;">Inter-relation to other health informatics</span></span></b><span><span class="Apple-style-span" style="font-size:medium;"> specialties – public health informatics, bioinformatics, pharmacy informatics</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo2; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Inclusion of both </span><b><span class="Apple-style-span" style="font-size:medium;">clinical and non-clinical</span></b><span class="Apple-style-span" style="font-size:medium;"> areas (such as medical research, nursing research)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal"><u><span class="Apple-style-span" style="font-size:medium;">History</span></u><span class="Apple-style-span" style="font-size:medium;">:</span></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">Medical Informatics has a rich and long history. Some of the </span><b><span class="Apple-style-span" style="font-size:medium;">significant m</span></b><b><span><span class="Apple-style-span" style="font-size:medium;">ilestones</span></span></b><span><span class="Apple-style-span" style="font-size:medium;"> in development of this practice include the following:</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l1 level1 lfo1; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span class="Apple-style-span" style="font-size:medium;">Establishment of </span><span><span class="Apple-style-span" style="font-size:medium;">NLM and Index Medicus by John Shaw Billings (1890)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l1 level1 lfo1; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Development of MEDLINE (1966)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l1 level1 lfo1; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Development of Mycin, first CDSS by Dr. Shortliffe (1970)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="margin-left:.5in;text-indent:-.25in;mso-list:l1 level1 lfo1; tab-stops:list .5in"><span style=" font-family:Wingdings;mso-fareast-font-family:Wingdings;mso-bidi-font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">Ø</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span><span class="Apple-style-span" style="font-size:medium;">Development of MUMPS, the first programming language designed specifically to deal with medical data (1986)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal"><span><span class="Apple-style-span" style="font-size:medium;">In contrast, as a formal specialty practice, Nursing Informatics is fairly recent. In fact, for many years before a dedicated and concerted effort to Nursing Informatics was established, nurses relied on retrieval of information using same systems that were developed primarily for physician users. However, </span><b><span class="Apple-style-span" style="font-size:medium;">nurses have significant unique information needs</span></b><span class="Apple-style-span" style="font-size:medium;"> that are not met by physician-focused information systems. Consider the number of </span><b><span class="Apple-style-span" style="font-size:medium;">print journals</span></b><span class="Apple-style-span" style="font-size:medium;"> that have been developed uniquely for nurses – Nurse Leader, Journal of the Association of Nurses in AIDS Care, Newborn & Infant Nursing Reviews, Journal of Radiology Nursing, Journal of Pediatric Nursing, Applied Nursing Research, etc. Large subscriber base and high usage of these journals amongst nurses suggests the uniqueness of nurses’ needs. Over the past few years, the number of </span><b><span class="Apple-style-span" style="font-size:medium;">nursing-focused CDSS</span></b><span class="Apple-style-span" style="font-size:medium;"> (Clinical Decision Support Systems) such as Nursing Consult (</span><a href="http://www.nursingconsult.com/"><span class="Apple-style-span" style="font-size:medium;">http://www.NursingConsult.com</span></a><span class="Apple-style-span" style="font-size:medium;">) with </span><b><span class="Apple-style-span" style="font-size:medium;">support for nursing point-of-care and research needs</span></b><span class="Apple-style-span" style="font-size:medium;"> has been steadily increasing over the years. </span></span></p><p class="MsoNormal"><span class="Apple-style-span" style="font-size:medium;">In part 2, I will discuss physician vs. nursing information needs. Stay tuned.</span></p></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-20491227212363711002009-09-07T19:10:00.006-05:002009-09-10T06:07:49.166-05:00PowerPoint 2010 - sneak preview<div><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">According to Microsoft PowerPoint team's </span></span><a href="http://blogs.msdn.com/powerpoint/archive/2009/07/29/the-new-powerpoint-media-experience.aspx"><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">blog</span></span></a><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">, new features include: </span></span></div><div><ul><li><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">C</span></span><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">ompletely revamped their media playback technology</span></span></li><li><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">Improved the media workflow: insertion, editing, presenting and distribution</span></span></li><li><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">Added features to help trim media, integrate with the animation timeline, and export PowerPoint presentation to video</span></span></li></ul></div><div><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></div><div><span class="Apple-style-span" style="font-family:arial;"><span class="Apple-style-span" style="font-size:medium;">Here is a sneak peek at PowerPoint 2010. Looks good!</span></span></div><div><div><br /></div></div><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/U9uWOYK0Pjk&rel=0&color1=0xb1b1b1&color2=0xcfcfcf&hl=en&feature=player_embedded&fs=1"><param name="allowFullScreen" value="true"><param name="allowScriptAccess" value="always"><embed src="http://www.youtube.com/v/U9uWOYK0Pjk&rel=0&color1=0xb1b1b1&color2=0xcfcfcf&hl=en&feature=player_embedded&fs=1" type="application/x-shockwave-flash" allowfullscreen="true" allowscriptaccess="always" width="425" height="344"></embed></object>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-30711047861281214922009-08-30T21:30:00.006-05:002009-08-30T22:12:09.719-05:00Choosing health care in MN based on best quality and cost<div>Want to compare health care providers in Minnesota for the quality of care they provide and total health care cost? Use <a href="http://www.MNHealthScores.org">Minnesota HealthScores,</a> a non-profit Web site that helps consumers <span class="Apple-style-span" style="color:#FF0000;">choose the best MN health care providers</span> for them and their family based on cost and quality of health care they provide.</div><div><br /></div><div>MNHealthScores.org <span class="Apple-style-span" style="color:#FF0000;">compares cost and quality of care</span> provided by medical groups and clincs for the following conditions:</div><div>* Asthma</div><div>* Breast cancer screening</div><div>* Cancer screening</div><div>* Cervical Cancer Screening</div><div>* Chlamydia screening</div><div>* Colorectal cancer screening</div><div>* Depression</div><div>* Diabetes</div><div>* High blood pressure</div><div>* Vascular disease</div><div><br /></div><div><a href="http://www.MNHealthScores.org">MNHealthScores.org</a> also provides<span class="Apple-style-span" style="color:#FF0000;"> cost reports</span> that display payment amount for physician services, including amount a health plan pays for a procedure such as colonoscopy or office visit plus the amount a health plan tells the physician to collect as a copayment from the patient.</div><div><br /></div><div><a href="http://www.MNHealthScores.org">MNHealthScores.org</a> uses data provided by MN health plans and data submitted by more than 300 medical clinics statewide.</div><div><br /></div><div>Here are some ways consumers can use MNHealthScores.org:</div><div>* determine <span class="Apple-style-span" style="color:#FF0000;">how well care is being delivered by your clinic</span></div><div>* learn about what type of care or<span class="Apple-style-span" style="color:#FF0000;"> "standard of care"</span> consumers should expect from the health care system, so that they can discuss it with their health care team</div><div>* <span class="Apple-style-span" style="color:#FF0000;">search</span> for a new medical group or clinic</div><div>* If you have a specific condition, such as diabetes, review the scores for the diabetes measure to determine<span class="Apple-style-span" style="color:#FF0000;"> which medical groups in your area had the highest scores</span>. Groups with the highest scores performed better in giving patients the right care for this health condition.</div><div>* determine <span class="Apple-style-span" style="color:#FF0000;">payment amount for physician services</span></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-60229380483395125352009-08-30T12:31:00.007-05:002009-08-30T14:06:36.359-05:00MN HIE<span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">Being a Minnesota resident, I decided to learn about the state's HIE efforts. </span><a href="http://www.mnhie.org/"><span class="Apple-style-span" style="font-size:medium;">MN HIE</span></a><span class="Apple-style-span" style="font-size:medium;"> is operational and has ~3 million residents (or 58% of MN population) in its patient directory. It provides medication history for past 12 months via provider's </span><span class="blsp-spelling-error" id="SPELLING_ERROR_0"><span class="Apple-style-span" style="font-size:medium;">EMR</span></span><span class="Apple-style-span" style="font-size:medium;"> or via a secure web application, and will provide following additional services starting this fall:</span></span></span><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;"><br /><br /></span></span><span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">* patient eligibility</span></span></span><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span><span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">* lab results</span></span></span><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span><span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">* immunization history</span></span></span><span class="apple-converted-space"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span><span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">* exchange of medical record information</span></span></span><span style="font-family:Arial;color:black;"><span class="Apple-style-span" style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span><span class="Apple-style-span" style="font-size:medium;"><br /></span></span><span class="apple-style-span"><span style="font-family:'Times New Roman';color:black;"><span class="Apple-style-span" style="font-size:medium;">Since medication history is based on pharmacy claims data, clinical data exchange will be possible starting this fall when medical record information exchange is offered as a service by MN HIE.</span></span></span><div><span class="Apple-style-span" style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></div><div><span class="Apple-style-span" style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:medium;">Do you know the "state" of your state's HIE?</span></span></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-49528860507374165402009-08-24T23:37:00.012-05:002009-08-25T00:22:49.008-05:00Disease registry: "Chronic disease tracking system" for those who cannot afford an EMR<span class="Apple-style-span" style="font-size: medium;">For practices that do not plan to purchase an </span><span class="blsp-spelling-error" id="SPELLING_ERROR_0"><span class="Apple-style-span" style="font-size: medium;">EMR</span></span><span class="Apple-style-span" style="font-size: medium;"> and want to </span><span class="blsp-spelling-corrected" id="SPELLING_ERROR_1"><span class="Apple-style-span" style="font-size: medium;">proactively</span></span><span class="Apple-style-span" style="font-size: medium;"> manage the health of population, a registry can be used instead. This registry can be used to </span><span class="Apple-style-span" style="line-height: 16px; "><span class="Apple-style-span" style="font-size: medium;">track a practice's diabetes patients, including their required labs and preventive services. This information can then be used to manage population health proactively.</span></span><div><span class="Apple-style-span" style="line-height: 16px;"><span class="Apple-style-span" style="font-size: medium;"><br /></span></span></div><div><span class="Apple-style-span" style="line-height: 16px;"><span class="Apple-style-span" style="line-height: normal; "><span class="Apple-style-span" style="font-size: medium;">A simple MS-Excel based Disease registry can be found </span><a href="http://www.aafp.org/fpm/20060400/47usin.html"><span class="Apple-style-span" style="font-size: medium;">here</span></a><span class="Apple-style-span" style="font-size: medium;"> at </span><span class="blsp-spelling-error" id="SPELLING_ERROR_2"><span class="Apple-style-span" style="font-size: medium;">AAFP</span></span><span class="Apple-style-span" style="font-size: medium;">.org. This file </span></span><span class="Apple-style-span" style="font-size: medium;">tracks interventions and clinical parameters that are important in diabetes management. In case problems are encountered, an alert is displayed. For instance, if the date of a </span><span class="blsp-spelling-error" id="SPELLING_ERROR_3"><span class="Apple-style-span" style="font-size: medium;">patient's</span></span><span class="Apple-style-span" style="font-size: medium;"> last A1C was more than 90 days ago, that date cell turns yellow as a warning; and turns red if more than 180 days ago.<br /></span></span><div><span class="Apple-style-span" style="line-height: 16px;"><span class="Apple-style-span" style="font-size: medium;"><br /></span></span></div><div><div><div><span class="Apple-style-span" style="font-size: medium;">Identifying all patients in the practice with a chronic disease such as Diabetes type 2 and initial data entry of this registry excel sheet are identified as major challenges to achieving a complete and functional disease registry. However, once the registry is complete, it provides many advantages:</span></div><div><span class="Apple-style-span" style="font-size: medium;"><br /></span></div><div><ul><li><span class="Apple-style-span" style="font-size: medium;">Proactive management of chronic diseases</span></li><li><span class="Apple-style-span" style="font-size: medium;">Use for preventive services and screenings such as Pap smears, mammograms, colon cancer screening etc. for general patient population</span></li><li><span class="Apple-style-span" style="font-size: medium;">Increased compliance with recommended services</span></li><li><span class="Apple-style-span" style="font-size: medium;">Improved patient care</span></li><li><span class="Apple-style-span" style="font-size: medium;">Document performance as part of p4p activities</span></li></ul></div><div><span class="Apple-style-span" style="font-size: medium;"><br /></span></div><div><span class="Apple-style-span" style="font-size: medium;">Dr. David Ortiz who created this registry worksheet recommends:</span></div><div><ul><li><span class="Apple-style-span" style="font-size: medium;">Start small, pick a chronic condition that you want to improve</span></li><li><span class="Apple-style-span" style="font-size: medium;">Involve your practice staff. Get their buy-in and agreement before </span><span class="blsp-spelling-error" id="SPELLING_ERROR_4"><span class="Apple-style-span" style="font-size: medium;">operationalizing</span></span><span class="Apple-style-span" style="font-size: medium;"> the plan</span></li></ul></div><div><br /></div></div></div></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com1tag:blogger.com,1999:blog-6568539276885792023.post-5928917747473550932009-08-21T16:59:00.015-05:002009-08-22T08:32:35.693-05:00IT critical to improving care of patients with chronic diseases<div><div><p class="MsoNormal"><span style="font-family:Georgia;color:black;"><span class="Apple-style-span" style="font-size: medium;">There are those who suspect the power of health IT to significantly improve cost and quality of care. Quite likely they may also consider funneling multi-billion stimulus funding to HIT a colossal waste. Here is</span><span class="apple-converted-space"><span class="Apple-style-span" style="font-size: medium;"> </span></span><a href="http://www.healthcareitnews.com/news/demo-shows-it-critical-improving-care-patients-chronic-diseases"><span class="Apple-style-span" style="font-size: medium;">evidence</span></a><span class="Apple-style-span" style="font-size: medium;"> that proves otherwise and might even force such detractors to rethink their opinion. </span></span></p><p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;">Results of a </span><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: medium;">5-year</span></span><span class="apple-converted-space"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span><a href="http://www.healthcareitnews.com/news/demo-shows-it-critical-improving-care-patients-chronic-diseases"><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size: medium;">Medicare Physician Group Practice Demonstration</span></span></a><span class="apple-converted-space"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: medium;">study involving 10 large MD practices were published that attributed improved quality of care </span></span><span class="apple-style-span"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: medium;">for patients with chronic diseases to use of HIT. This </span><a href="http://www.healthcareitnews.com/news/demo-shows-it-critical-improving-care-patients-chronic-diseases"><span class="Apple-style-span" style="font-size: medium;">Medicare Physician Group Practice Demonstration</span></a><span class="Apple-style-span" style="font-size: medium;"> study is also mentioned as the </span><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size: medium;">"first" P4P project to work directly with physician practices</span></span><span class="Apple-style-span" style="font-size: medium;">. Here are some impressive figures from this study</span><span class="apple-style-span"><span class="Apple-style-span" style="font-size: medium;">.</span></span></span></span></p> <p class="MsoNormal"><span class="apple-style-span"><span style=" font-family:Georgia;mso-bidi-font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size: medium;">* Geisenger improved care on all 32 categories that include continuing programs for diabetes and coronary artery disease, adult preventative care, and hypertension</span></span></span><span style="font-family:Georgia;color:black;"><span class="Apple-style-span" style="font-size: medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span class="apple-style-span"><span style=" font-family:Georgia;mso-bidi-font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size: medium;">* </span><st1:place st="on"><st1:placetype st="on"><span class="Apple-style-span" style="font-size: medium;">University</span></st1:placetype><span class="Apple-style-span" style="font-size: medium;"> of </span><st1:placename st="on"><span class="Apple-style-span" style="font-size: medium;">Michigan (UM) Family</span></st1:placename></st1:place><span class="Apple-style-span" style="font-size: medium;"> practice group improved care on 29 categories. Care improvements were made in areas that included diabetes, congestive heart failure, coronary artery disease, hypertension, and breast and colorectal cancer screenings.</span></span></span><span style="font-family:Georgia;color:black;"><span class="Apple-style-span" style="font-size: medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span class="apple-style-span"><span style=" font-family:Georgia;mso-bidi-font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size: medium;">* UM Family Practice group claims $2.9M in Medicare savings surpassing the CMS target</span></span></span></p> <p class="MsoNormal"><span style="font-family:Georgia;color:black;"><o:p><span class="Apple-style-span" style="font-size: medium;"> </span></o:p></span></p> <p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;"><br /></span></p><p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;">How did they get this done?</span></p><p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;">* Provided clinical decision support through alerts/reminders within the EHR</span></p> <p class="MsoNormal"><span class="apple-style-span"><span style=" font-family:Georgia;mso-bidi-font-family:Arial;color:black;"><span class="Apple-style-span" style="font-size: medium;">* Start small and then expand the program - First year focus on Diabetes. Congestive heart failure and coronary artery disease were included in second year. Hypertension in year three.</span></span></span></p><p class="MsoNormal"><span class="Apple-style-span" style="font-size: medium;">* Commitment of physicians and administrators within the practices</span></p> <p> </p> <p class="MsoNormal"><span style="font-family:Georgia;color:black;"><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size: medium;">Reducing costs while improving care -- who says it can't be done!!</span></span><span class="Apple-style-span" style="font-size: medium;"> Studies such as the one cited above have far-reaching consequences considering chronic diseases account for ~60% of the deaths worldwide and half of them can be prevented!</span></span></p></div></div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-3868013034545952512009-08-18T08:47:00.003-05:002009-08-18T17:29:17.806-05:00EHR video tutorialHere is an EHR tutorial from The Forbes.com Video Network.<br /><br /><iframe marginwidth="0" marginheight="0" src="http://www.forbes.com/video/embed/embed.html?format=frame&height=496&mode=render&show=5&video=fvn/business/healthcare-goes-electronic&width=336" frameborder="0" width="336" scrolling="no" height="496"></iframe>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-2578371025395787882009-08-17T17:04:00.006-05:002009-08-17T17:46:32.158-05:00EMR | EHR | PHR | HIE | RHIO defined<span class="blsp-spelling-error" id="SPELLING_ERROR_0">NAHIT</span> (National Association for Health Information Technology) is shutting down Sep 30<span class="blsp-spelling-error" id="SPELLING_ERROR_1">th</span>. It published HIT terminology definitions, including those for <a href="http://www.nahit.org/pandc/press/pr5_20_2008_1_33_49.asp"><span class="blsp-spelling-error" id="SPELLING_ERROR_2">EMR</span> <span class="blsp-spelling-error" id="SPELLING_ERROR_3">EHR</span> HIE and <span class="blsp-spelling-error" id="SPELLING_ERROR_4">RHIO</span></a>. Complete report can be found <a href="http://www.nahit.org/images/pdfs/NAHIT_Key_HIT_Terms_Report.pdf">here</a>.Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0tag:blogger.com,1999:blog-6568539276885792023.post-23942579344552338332009-08-16T23:26:00.002-05:002009-08-17T17:43:40.586-05:00HIEs and their statusHere is a <a href="http://www.ehealthinitiative.org/HIESurvey/2009Directory.mspx">directory </a>of HIEs compiled by eHealth initiative. HIEs in <a href="http://www.ehealthinitiative.org/HIESurvey/2009StateOfTheField.mspx">Stage 5, 6, and 7</a> are operational HIEs. This is one of the most comprehensive and updated HIE directory I have come across.<div><br /></div><div>If you find your HIE is not included, please use the link on the directory page to submit your HIE informaiton.</div>Girish Pathriahttp://www.blogger.com/profile/16667130956863701087noreply@blogger.com0