healthcare technology

Healthcare providers who access clinical decision support through mHealth platforms are finding a world of information at their fingertips – and they could be saving lives.

Digital technologies are changing the way medical information is gathered and exchanged.  Physicians of all ages and medical subspecialties from across the globe are utilizing tools to discuss potential diagnoses and obtain second opinions.

That’s the takeaway from researchers at the Scripps Research Translational Institute who took a closer look at online crowdsourced consult platforms.

Their conclusion is that these platforms, which include social media networks like SERMO, Medscape and HealthTap, are giving providers quick access to information that’s helping them reduce serious, costly and potentially deadly medical errors.

The study, focusing on an analysis of more than 37,000 active users on the MedScape Consult network between 2015 and 2017, appears in a recent issue of NPJ Digital Medicine.

The research points to the value of a mobile health resource for clinical decision support, giving providers a real-time portal for physician-to-physician engagement. Billed as a source for “the second to hundredth opinion in medicine,” these portals allow providers to gather best practices and apply them quickly, reducing the chances of a clinical error.

The study also points to the changing nature of clinical decision support.The study noted that providers can’t necessarily rely on informal face-to-face consults with colleagues – commonly known as curbside consults – because they’re “frequently inaccurate and incomplete.” Yet they can’t just call up a nearby specialist at a moment’s notice.

The study found that : "At a time when we’re turning to artificial intelligence to help improve diagnostic accuracy, there’s still plenty of room for tapping into human intelligence via such medical consulting platforms, Artificial intelligence has been advocated as the definitive pathway for reducing misdiagnosis, But the study's findings suggest the potential for collective human intelligence, which is algorithm-free and performed rapidly on a voluntary basis, to emerge as a competitive or complementary strategy."

A study to correlate EHR Communication with patient outcomes for diabetes patients reported that "EHR team communication flow patterns may be an important avenue to explore in raising quality of care and lowering costs for patients with diabetes in primary care." The study found that Primary care teams whose EHR communication reached more team members indirectly (ie, via message forwarding) had worse outcomes and higher medical costs for their patients with diabetes.

The study was carried out to determine how changes in electronic health record (EHR) communication patterns in primary care teams relate to quality of care and costs for patients with diabetes.

The Study Design: EHR-extracted longitudinal observational study.

A total of 83 health professionals in 19 care teams at 4 primary care clinics associated with a large Midwestern university participated in the study.

Counts of messages routed between any 2 team members in the EHR in the past 18 months were extracted. Flow-betweenness, defined as the proportion of information passed indirectly within the team, was calculated.

The analysis related changes in team flow-betweenness to changes in emergency department visits, hospital stays, and associated medical costs for the teams’ patients with diabetes, while adjusting for team face-to-face communication, patient-level covariates, comorbidities, team size, and clinic fixed effects.

Results: Patient hospital visits increased by 13% (standard error [SE] = 6%) for every increase of 1 percentage point in team EHR message forwarding (ie, higher team flow-betweenness). Medical costs increased by $223 (SE = $105) per patient with diabetes in the past 6 months for every increase of 1 percentage point in team flow-betweenness.

Conclusions: Primary care teams whose EHR communication reached more team members indirectly (ie, via message forwarding) had worse outcomes and higher medical costs for their patients with diabetes.

EHR team communication flow patterns may be an important avenue to explore in raising quality of care and lowering costs for patients with diabetes in primary care.

read the whole study details at  https://www.ajmc.com/journals/issue/2018/2018-vol24-n10/putting-the-pieces-together-ehr-communication-and-diabetes-patient-outcomes