Health Informatics 7430

From Clinical Guideline to Order Set to Patient Harm: JAMA published a case and editorial regarding the well-intentioned but flawed application of clinical guidelines to order sets and the perverse incentives that can lead to patient harm. Here is the reference: JAMA. 2018;319(12):1207-1208. doi:10.1001/jama.2018.1666 In this particular case a patient was treated for an MI with a coronary artery stent and developed a complete heart block after the procedure. Medications that were not indicated to treat this complication were in the order set and the physician, when interviewed about his choice of medications, chose a beta-blocker (contraindicated based on robust data of use after a STEMI) that lead to worsening of the patient. He stated that he chose this medication as per the alert in the CDS that this was a "quality metric". I think it is interesting that providers are swayed against their better judgement to choose a medication from a set of orders that was incomp...

Can our VA help us with Telehealth? Yes they can..... VA Telehealth Services uses health informatics, disease management and telehealth technologies to target care and case management to improve access to care, improving the health of veterans.  Telehealth changes the location where health care services are routinely provided. The value VA derives from telehealth is not in implementing telehealth technologies alone, but how VA uses health informatics, disease management and telehealth technologies to target care/case management thereby facilitating access to care and improving the health of veterans. Technology Newsletters Videos Technology New technologies such as telehealth help improve health care services. For technology to work it must work for the people it is meant to help - patients and the professionals providing care. Telehealth in VA helps ensure veteran patients get the right care in the right place at the right time and aims to make the home in...

I have just recently begun studying this web site:  https://www.amia.org/about-amia/mission-and-history Others may find it helpful. AMIA aims to lead the way in transforming health care through trusted science, education, and the practice of informatics. AMIA connects a broad community of professionals and students interested in informatics. AMIA is the bridge for knowledge and collaboration across a continuum, from basic and applied research to the consumer and public health arenas. AMIA actively supports five domains: Translational Bioinformatics Clinical Research Informatics Clinical Informatics Consumer Health Informatics Public Health Informatics They show strong support for collaboration across regions and networks. AMIA Supports Goals of ONC Trusted Exchange Framework, New Data Policy Wednesday, February 21, 2018 Informatics Professionals See Potential for New Paradigm for Our National Health IT Infrastructure (BETHESDA, MD) – In a pa...

  HIMSS 2018 Link

When I took my pre-self assessment for Health Informatics, I felt like some of the terminology was a complete foreign language. As we have found out thought out the course in class or online discussions, and from our book we have found it covers integrating health, computer, and information sciences to manage and communicate data, information, knowledge and wisdom of health care for patients and communities. I have found over the discussions and readings there are some things that I did actually have experience with. We are using this blog to post some resources that have been helpful to our education in health informatics. Besides our book which classmates have called our "Bible" and learning from classmates knowledge and experience; I found in my online quick searches a website that has been helpful. The National Health Institutes, National Library of Medicine has a section on health informatics. It gives links for data, tools, statistics, guidelines, journals and other pub...

Integration Across Company's Improving Patient Outcomes with Informatics In January of 2018, I begun studying Healthcare Informatics for the first time.  It became very clear to me, early in the process, that the study of computer information, technology, and electronic health record keeping, would require me to learn a whole new language.  One of the first terms I encountered that needed a deeper dive was HL7.  I have found this web site quite helpful. HL7 Site http://www.hl7.org/ As we look to integrate a 3rd party platform into our EHR, the information related to CDA Release 2 was helpful as we organized our strategic plan. CDA® Release 2 DESCRIPTION The HL7 Version 3 Clinical Document Architecture (CDA®) is a document markup standard that specifies the structure and semantics of "clinical documents" for the purpose of exchange between healthcare providers and patients. It defines a clinical document as having the following six characteristics: 1) Persi...

Resources for providers by local physician: My good friend and EMR usability expert/evangelist Jeff Belden, MD, family physician and MU faculty member who divides his time between clinical responsibilities and the Tiger Institute,  has shared some good resources: The first one is his blog, toomanyclicks.com. Here he expounds on his work making the EMR more user friendly. As an example he posted recently (December 2017) on a dynamic note, how to collapse and expand across a dashboard to call on information as needed during clinical encounters. The next one is his book, available online, at inspiredEHRs.org. The focus of this book is on ambulatory adult clinical care and EHR functionality. The chapters of the book focus on medication lists and reconciliation as well as e-prescribing, drug alerts and allergy lists. Each chapter starts with a clinical scenario to illustrate a point and it is all tied together in the last few chapters where principles of design and human factors ...

APPLE’S MOVE TO SHARE HEALTH CARE RECORDS IS A GAME-CHANGER Imagine if Apple further opens up Apple Health so it no longer serves as the destination, but a conduit that can help guide patients through decisions to better manage their health. Hotlittlepotato In late January,  Apple previewed an iOS feature that would allow consumers to access their electronic health records on their phones. Skeptics  said  the move was a decade too late given a similar (and failed) effort from Google. Optimists  argued  that Apple was capable of translating health data into something meaningful for consumers. WIRED OPINION ABOUT Aneesh Chopra ( @aneeshchopra ) is president of CareJourney and former chief technology officer of the United States. Shafiq Rab ( @cioshafiq ) is senior vice president and chief information officer of the Rush University Medical Center. But the announcement portends great things for consumers and the app developers seeking to serve t...

I heard a story from a friend at another firm in another city that I thought highlighted the impact of interoperability on patient safety and, in this instance, the defense of medical negligence cases. I fudged things a little so as not to reveal the actual (pending) case. The plaintiff/patient underwent an operation at a hospital. Over the next few weeks she returned twice for signs/symptoms of a surgical site infection, and underwent multiple clean-out procedures. There was evidence that the infection had become systemic, including possible endocarditis. Her condition worsened to the point where she was discharged to a long-term care facility instead of home. The LTC facility received a very limited set of medical records from the hospital, and essentially only knew that the woman was being admitted for a post-op infection, and was suffering from some measure of motor dysfunction and altered mental status. Her condition was variable at the LTC facility with no clear baseline. ...

At MOI, we are about to introduce a new data platform that integrates research with clinical care called Patient IQ. This platform will allow us to administer surveys, allow physicians to utilize this information in their clinical decision making, and will allow coordination of research studies. https://patientiq.io/ We are excited and hopeful for how this will allow us to improve clinical care and completion of research studies.  I was heavily involved with our previous system (OBERD), and will be very involved with this as well. Overall, I'm hopeful that it will decrease the extent of work "clicks" I have to do in my current workflow and give us better outcomes. We shall see!