From Yahoo Finance: AMSTERDAM and DURHAM, N.C., Feb. 3, 2016 /PRNewswire/ -- Royal Philips (NYSE: PHG; AEX: PHIA) today announced it is further enabling connected health by signing an agreement with Validic , a U.S.-based ...
By a News Reporter-Staff News Editor at Cardiovascular Week -- Royal Philips announced its collaboration with UCHealth, an integrated delivery network of five hospitals in Colorado and more than 100... | November 25, 2015
Paul Epping's insight:
Integration of (image) data in healthcare and sharing with all stakeholders (including the patient) in the healthcare ecosystem is one of the big foci of Philips
nt, lightweight, and precise system to interpret body movements could be suitable to control next-generation games. There is also a need in healthcare for a system to accurately measure body movement in people reco
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.
One-quarter of U.S. physicians are not prepared to effectively manage and coordinate care for patients with multiple chronic conditions, and 84 percent are not prepared for managing care of patients with severe mental health problems, according to a Commonwealth Fund study published in Health Affairs.
Paul Epping's insight:
A consequence of "knowing more and more about less and less".... shocking figure for the the Netherlands
A global survey focusing on mobile health apps shows the majority of those companies and developers who produce them are dissatisfied with the reception their apps receive on the market, and say performance falls short of their goals. The report by German market research company research2guidance also indicated a changing profile of the developers and businesses behind these apps, along with their priorities.The survey also sought to explore some of the distinguishing characteristics of successful mobile health app
Colistin antibiotic overused in farm animals in China apparently caused E-coli bacteria to become completely resistant to treatment; E-coli strain has already
Paul Epping's insight:
A serious thread for mankind is the increase of resistant bacteria to antibiotics. Why are pharmaceutical companies not collaboration to solve this? Or should our hop be on startups, using new techniques incl crowd sourcing?
EHR interoperability has been brought to the forefront lately as various health organizations and government agencies push for nationwide health information exchange. Furthermore, as integrated healthcare and care coordination become fixtures in the healthcare delivery industry, interoperability of systems between different kinds of practitioners shows itself to be critical.
A recent study by Maribel Cifuentes, RN, BSN, Melinda Davis, PhD, Doug Fernald, MA, Rose Gunn, MA, Perry Dickinson, MD, and Deborah J. Cohen, PhD, discussed how EHRs operated in 11 practices that were integrating the delivery of primary and behavioral healthcare. The researchers found that when behavioral health and primary care begins to integrate, the two kinds of practitioners brought separate EHR systems with them. This caused challenges and subsequent workarounds and solutions associated with EHR interoperability.
The study took 11 integrated practices in the Colorado area and gathered data regarding how EHRs worked for their needs, the challenges practices faced, what kinds of workaround strategies practices developed, and what kinds of long-term solutions the practices identified in order to promote care coordination over an EHR.
One of the challenges many of the integrated practices faced was that the EHRs were not necessarily designed to collect a certain kind of data. For example, in a primary care facility that hired several behavioral health counselors (BHCs), the facility’s EHR may not have been conducive to collective behavioral health data.
Second, EHRs generally lacked templates for primary care physicians and BHCs to develop coordinated care plans.
Third, many EHRs were not interoperable with each other, hindering primary care physicians and BHCs from working together in delivering coordinated care. The EHRs were also not compatible with tablet devices that were used to collect behavior health information in the waiting room prior to appointments. These tablets were used to present questionnaires that would provide behavioral health data. However, the lack of interoperability between these devices and EHRs made it so the data collected in the questionnaire could not easily be uploaded into the EHR.
The study reports four workarounds that were developed in the face of these challenges. First, as stated above, when the primary care and behavioral health practices first integrated, the physicians often had their own separate EHR systems. In order to make sure both systems had patient information, physicians had to manually enter the data into both EHRs. While this method may have been effective in ensuring patient information was stored in both EHRs, it was not particularly time or financially effective.
Second, medical assistants had to manually scan printed documents into EHRs. While this method may have also been effective, it presented several time and financial issues. Furthermore, the scanned documents were often harder to find in the EHR, hindering the physician from delivering care to patients in a timely manner.
Third, practitioners relied on patients and other physicians to recall patient information. This workaround was not effective because patient and physician memory was neither reliable nor accurate. One physician reported having to recall patient information that was told to him several weeks before meeting with the patient. Due to the amount of time that had passed since he had last discussed this patient, he was unable to determine what kinds of services the patient needed. This resulted in the patient taking tests that had already been administered.
Fourth, practitioners employed “freestanding tracking systems,” such as spreadsheets, that were not a part of the EHR. For example, one practice stored information regarding adolescents taking selective serotonin reuptake inhibitor medications in an Excel spreadsheet. Although this was widely used amongst the practice, it took enormous effort from practitioners to maintain, and the information on the spreadsheet was not easily integrated into the EHR.
By the end of the study, researchers observed that practices began moving past workarounds and toward more long-term solutions to their challenges in order to make their integrated practices more sustainable in the future. The researchers noted that these solutions were created by each practice’s own HIT teams and required their own funding. Three key solutions amongst the participating practices emerged.
First, many practices created their own customized EHR templates. These templates existed within their pre-existing EHR systems, and simply added more fields for data entry that would be more suitable for practitioners’ needs. However, developing these templates was an arduous task.
“Creating customized EHR templates was time consuming and required dedicated HIT staff working collaboratively with BHCs and primary care providers,” the researchers reported. “Practices that did not have access to these resources were not able to create customized templates as readily, or had to pay EHR vendors to do so.”
Second, some practices purchased EHR upgrades and reported several improvements from doing so, including increased interoperability, enhanced reporting templates, and more interfaces for integrating primary and behavioral health care.
However, EHR upgrades were considerable financial investments for practices. Practices were not allowed to upgrade their EHRs using the money allocated to them by participating in the study, so the upgrade needed to be a part of the individual practice’s investments. This financial burden made it so only five of the 11 participating practices were able to upgrade their EHRs.
The final emerging solution was the union of two EHRs. At the start of the study, four of the 11 participating practices were using two different EHRs -- one for behavioral health care and one for primary care. By the end of the practice, three of them were in the midst of merging those two EHRs, and one had built an interface that extracted data from multiple EHRs and stored the data in one place. While these solutions were quite complicated and costly, they were the most effective in overcoming interoperability challenges.
Despite the advances these practices made, the researchers maintained that integrated providers may still face hurdles in the future.
“EHR systems are not yet optimally designed to meet the needs of practices integrating behavioral health and primary care,” the researchers stated. “Our study found that EHRs generally lack features essential to support key integration functions such as documenting and tracking longitudinal data, working from shared care plans, and template-driven documentation for common behavioral health conditions such as depression.”
The researchers provided guidance on how to improve EHR use in integrated care situations, stating that perhaps systems need to start being designed for integrated care, as should different incentive programs.
“In the future, HIT systems should be intentionally designed, in cooperation with clinicians; to support and enable these integrated care functions, as well as the different modes of communication and care coordination tasks that occur between multi-professional members of integrated teams,” the researchers maintained.
Furthermore, the researchers stated that more financial incentives should be provided to allow practices to make these kinds of changes. Although several EHR and interoperability incentive programs exist, none of them provide incentives that would help practices change their EHR systems to make it more usable in an integrated practice.
Philips brengt zorgaanbieders bij elkaar om te praten over slimme, technologische oplossingen voor mensen met chronische aandoeningen. Hiertoe opent het bedrijf het zogeheten HealthSuite Labs co-creation center bij de High Tech Campus Eindhoven op 10 september.
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.”
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