E.H.R Standards for India : GOI Report

Electronic health records are a summary of the various electronic medical records that get generated during any clinical encounter. Without standards, a lifelong summary is not possible as different records from different sources spread across ~80+ years will potentially need to be brought into one summary. To achieve this, a set of pre-defined standards for information exchange that includes images, clinical codes and a minimum data set is imperative.

Foreword to ‘ E.H.R Standards for India ’ by the GOI.

The Government of India, as it goes for the unveiling of National Health Portal, comes out with a definitive guidelines for E.H.R standards in India. The document takes a look at E.H.R standards to be followed throughout different medical provider institutions in India, so that medical data becomes portable and easily transferable. Its amazing to see how many ehealth companies have been stumped because of lack of such a document earlier. This might be good news for a number of companies which foolishly wait for standards to be finalized, instead of simply building the most Flexible, Secure, Doctor & Patient-friendly E.H.R they can.

More importantly , It takes a look at Data ownership.

It says “The health data is owned by the patient while the actual records are owned by the care providers who act as the custodians of the data. Adequate safeguards to ensure data privacy and security must strictly be adhered to at all times. Patients must have the privilege to verify the accuracy of their health data and gain access whenever they wish to do so.

Thankfully, Patients have earned their spot in our policy making. We know that products which do not have the patient interactions in mind will just not succeed. Now that we have a roadmap ahead, It’s a race to the finish for the nascent ehealth industry in our country.

You can download a copy of the document here.

Top 10 Health Technology Hazards For 2013

The evolution of healthcare information technology systems such as electronic health records (EHRs) has definitely helped improve quality and efficiency in healthcare. At the same time, there’s a growing level of complexity and opportunity for error. With increasing use of technology in healthcare, healthcare providers need to be wary of the associated risks with its use.

Now in its sixth year, ECRI Institute publishes an annual list of top hazards of technology in healthcare. The Top 10 Health Technology Hazards list is updated each year based upon the prevalence and severity of incidents reported to ECRI Institute by healthcare facilities nationwide; information found in the Institute’s medical device problem reporting databases; and the judgment, analysis, and expertise of the organization’s multidisciplinary staff. Here are the group’s estimation of the most probable hazards which might crop up in 2013 because of use of technology in healthcare.

1.  Alarm hazards

2.  Medication administration errors using infusion pump

3.  Unnecessary radiation exposures and radiation burns during diagnostic radiology procedures

4.  Patient/data mismatches in EHRs and other health IT (HIT) systems

5.  Interoperability failures with medical devices and health IT systems

6. Air embolism hazards

7. Inattention to the needs of pediatric patients when using “adult” technologies

8. Inadequate reprocessing of endoscopic devices and surgical instruments

9. Caregiver distractions from smartphones and other mobile devices

10. Surgical fires

You can download the original report by registering here.

Here are the lists of Top hazards for 2010. for 2011 and for 2012

Photo credit: @Jacobsons on Flickr (CC BY-NC-SA 2.0)

Why Doctors Love To Hate Electronic Health Records

Doctors love to hate electronic health records. Over the years, many surveys have tried to pinpoint the physicians who are more likely to be satisfied by their EHRs. Surveys have found that those in primary care or Internal medicine are generally more satisfied with their EHRs than their colleagues in Oncology or Ophthalmology. Also, solo physicians were the most satisfied and that satisfaction decreased as the practice size grew to 50 physicians. Physicians in 100% productivity-based practices were more satisfied than salaried physicians. 

So what are the top reasons doctors love electronic health records?

1) An electronic record forces documentation of many steps which might be otherwise missed. More thorough documentation of clinical visits leads to less leakage of revenue.

2) In medicine, patient data is the source of all decisions. EHRs make data retrieval easier and thus quality of patient service is enhanced

3) Doctors are no longer tied to their desks and can work from anywhere anytime.

As many doctors will be quick to point out, EHR adoption also comes with a lot of pain-points.

1) There is no guaranteed improvement in productivity. In fact, there could be a loss of productivity in the short term.

2) Some EHRs are badly designed and require too many steps/ clicks for relatively simple documentation procedure, for eg. CPOE.. Sometimes, important data maybe difficult to find.

3) The omnipresent computer monitor and keyboard is not a very likeable third party in the examination room. It is an obstacle to one-to-one relationship building between doctors and patients.

Nevertheless, electronic health records are used widely and are here to stay. Insights into the reasons some EHRs are preferred over others can be an important advantage for many companies in this multi-billion-dollar industry.
You can read the original AMA article here.

Also see:
-How Poor Health IT Implementation Can Hurt Patients : Electronic health records can improve care, but doctors should also be mindful of some health IT obstacles that can be detrimental to patients.
-How To Ease EHR Frustration : EHRs can slow physicians' practices to a crawl, but evidence suggests they ultimately pay off.

The Top 20 EMR Software Solutions

A very useful infographic provided by Capterra, the website which specializes in comparing business software. This infographic takes a look at the most popular EMR solutions in the market ( eClinicalWorks is number one) and grades them by total number of users, target audience, followers on social media etc.

© 2011 Capterra, Inc.
You can read about their reasoning and data analysis methods here.

Related articles

• Infographic: The 25 Most Important Online Project Management Solutions (readwriteweb.com)
• EHR Adoption To Reach 80% By 2016 (informationweek.com)
• Top 12 Mashable Infographics (mashable.com)

Using EMRs to improve Efficiency : Video

Using Electronic Medical records in managing medical practices provides a number of benefits, especially in smaller practices where it is much easier to introduce. A few of these benefits include efficient and portable patient care management, lesser errors and improved patient safety.

See how one private practice made the change to electronic medical records and hear how the new technology has changed the office's workflow and staffing levels.

Though this video has been created by Intel, it is a generic video describing the benefits of EMRs to physician practices and does NOT sell anything.

Related articles

• Electronic medical record (EMR) - review of pros and cons in Cleveland Clinic medical journal (casesblog.blogspot.com)
• Using the EMR to reduce ventilator associated lung injury (doctorrw.blogspot.com)
• A Family Physician's EMR Experience (thehealthcareblog.com)

Virtual Healthcare Center in Second Life

Image via Wikipedia

IBM Virtual Healthcare Island. 


The island is a unique, three-dimensional representation of the challenges facing today's healthcare industry and the role information technology will play in transforming global healthcare-delivery to meet patient needs.

The IBM Virtual Healthcare Island is designed with a futuristic atmosphere and provides visitors with an interactive demonstration of IBM’s open-standards-based Health Information Exchange (HIE) architecture. Working with project leads in the U.S., the island was designed and built by an all-IBM-India team.

Starting from the patient’s home, they create their own Personal Health Records (PHRs) in a secure and private environment and watch as it is incorporated into an array of Electronic Medical Record (EMR) systems that can be used at various medical facilities. As they move from one island station to the next, they experience how the development of a totally integrated and interoperable longitudinal Electronic Health Record (EHR) is used within a highly secured network that allows access only by patient-authorized providers and family members.

IBM’s Healthcare & Life Sciences (HCLS) Industry will continue to develop the new island in months to come.  The island can perform as a virtually “always on” demonstration tool for IBM’s sales personnel.  A video version of the island is also under production.

Related articles

• EHR Spending To Hit $3.8 Billion In 2015 (informationweek.com)
• Autonomy Announces Meaning Based Healthcare for Healthcare Delivery Organizations (prnewswire.com)

Health IT Initiatives at USF Health

University of South Floria Health Center has made good use of the health IT stimulus money to push the campaign to go completely Paperless. And then some more.

So now work is done with touchscreen pads and electronic prescribing systems. You can play, view, and download lectures, news, seminars, music and other USF Health-related media on your iPod, Mac, PC or MP3 player. New talent is recruited online via the Center for Transformation and Innovation

A video report on Tampa Bays leadership in Health IT with the Paperfree initiative

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• USF Health News Center

• USF- Health on Social Media

                    

Medical Error Rates Reduce Seven Fold with Electronic Prescribing !

There is a growing consensus that the implementation of health information technology should lead to more efficient, safer, and higher quality of care. The ever increasing burden of record keeping, to comply with the numerous regulations, makes shifting to Electronic prescribing a very attractive option. 

The benefits of shifting to EMRs and CPOEs are enormous.

• Less Paperwork
• Better Evidence based care
• Better Data collection
• and of course LESS ERRORS.

An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a study of 37 million patient records by HealthGrades

"For e-prescribing adopters, error rates decreased nearly sevenfold, from 42.5 per 100 prescriptions at baseline to 6.6 per 100 prescriptions one year after adoption. For non-adopters, error rates remained high at 37 per 100 prescriptions at baseline and 38 per 100 prescriptions at one year.


Illegibility errors were very high at baseline, and not surprisingly, were completely eliminated by e-prescribing (87.6 per 100 prescriptions at baseline for e-prescribing adopters, 0 at one year). Prescribing errors may occur much more frequently in community-based practices than previously reported. This study findings suggest that stand-alone e-prescribing with clinical decision support may significantly improve ambulatory medication safety.

 References:

 Electronic Prescribing Improves Medication Safety in Community-Based Office Practices. Journal of General Internal Medicine, 2010.

(via)Electronic Prescribing Decreases Prescribing Errors Seven Fold:

Also read-

Electronic Medical Records Help Reduce Medical Errors