The Cleveland Clinic is deploying a telemedicine service tapping mobile devices to provide patients a virtual consultation within minutes.The MyCare Online offering by Cleveland Clinic costs $49 per care interaction and requires either a smartphone, iPad or PC and a free app, according to the Cleveland Plain Dealer. The service, which connects patients with a physician or nurse, is focused on helping users dealing with minor health issues such as rashes, the cold or the flu.Such mHealth services increasingly are being embraced by providers for a slew of reasons, from cost savings to improved care quality. For instance, as FierceMobileHealthcare has reported, UnitedHealthcare is partnering with Doctor On Demand, American Well and Optum to expand virtual healthcare services to a network of care physicians that will be accessible 24/7 via mobile devices atablets.
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When the HITECH Act was passed and meaningful use regulations were established under the Medicare and Medicaid EHR Incentive Programs, the steep rise of EHR adoption and implementation brought hope for patient care advocates. After more providers increased their use of certified EHR technology, questions still remained as to whether the quality of patient care had actually changed. Many physicians still find issues with utilizing EHR systems and the lack of EHR interoperability is causing problems for effective healthcare data exchange across multiple medical facilities.
Providers continually find the usability of certified EHR technology unsatisfactory, which led researchers from the Georgetown University School of Medicine to analyze 11 different EHR vendors and study their user-centered design process, according to a paper published in the Journal of the American Medical Informatics Association (JAMIA).
A survey conducted by the American College of Physicians in 2012 showed that nearly two out of five physicians were dissatisfied with their use of certified EHR technology. Essentially, EHR systems have lacked easy-to-read interfaces and an overall user-friendly platform.
The researchers from Georgetown University assessed the challenges vendors had to overcome when they attempted to incorporate user-centered design (UCD) in their certified EHR technology. The researchers uncovered that vendors either have well-developed UCD, basic UCD, or completely misunderstand how to incorporate UCD into their EHR development.
Those with well-developed UCD still lacked “contextually rich studies of workflow” among a variety of specialized healthcare providers. Those found to include basic UCD processes did not have the resources or knowledge for leveraging their ideas and insight of user-centered EHR development. Vendors who have misconceptions on UCD will need greater education on the importance of safety and usability of their EHR products.
The researchers essentially conducted interviews with vendor staff to better understand some of the difficulties they’re having with EHR design. Some of the problems surrounding integrating UCD and ensuring physician EHR use is satisfactory include lacking leadership support throughout a vendor establishment, missing strong studies of clinical workflow, and difficulties with recruiting subjects for these kind of usability studies.
Usability, however, is critical to ongoing EHR adoption and patient safety within a clinic or hospital. The Office of the National Coordinator for Health IT (ONC) even included “Safety Enhanced Design” in last year’s certification criteria stipulations, which include usability process requirements.
“There are increasing pressures on health IT vendors to improve the usability of EHRs and other health IT systems,” the researchers wrote in their report. “The ONC has UCD certification requirements in place to promote improved usability. Although the health IT vendors themselves are the end users of these regulations, no data are available to describe the current usability processes of health IT vendors.”
“Our results reveal variability in the UCD practices of EHR vendors, despite the ONC’s certification requirements that all EHR vendors attest to employing a UCD process in order to certify their EHR product. Given that UCD is an important factor that contributes to the usability and safety of the EHR, the variability in UCD practices may partially account for the poor usability of some vendors’ EHR products.”
Mercy Health's new telemedicine center, expected to open in 2015, offers a glimpse of things to come in telemedicine specialties such as telesepsis, tele-ICU, telecardiology (8 telemedicine specialty areas Mercy Healths upcoming including Telesepsis.
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