Hospitals’ Electronic Wasteland. Stimulus funds aim to change a system largely devoid of in-depth electronic record keeping.

I personally find the title of this article – well written.

Less than 2 percent of U.S. hospitals today use comprehensive electronic health records, according to a new survey of 3,000 hospitals that highlights just how far the health-care system has to go to meet President Obama’s goal of providing every American with access to electronic records by 2014.

Experts involved in the study, headed by David Blumenthal, Obama’s newly appointed national coordinator for health information technology, say that the $19 billion in funding for health-care information technology and other provisions outlined in the new stimulus bill will directly address the two major hurdles to adoption–the cost to implement and maintain the records, and the difficulty of exchanging information among various health-care providers’ differing computer systems.

“Those provisions try as directly as possible to address some of the barriers highlighted in the research,” said Blumenthal, a physician who currently serves as the director of the Institute for Health Policy at Massachusetts General Hospital (MGH) in Boston, at a press conference this week. He will assume his new post in April, leading an office within the Department of Health and Human Services–the Office of the National Coordinator of Health Information Technology–which was made permanent by the stimulus legislation.

According to the findings, published Wednesday in the Journal of the American Medical Association, about 8 percent of U.S. hospitals use basic EHR systems–which include patient demographics, medical complaints, medications, and some test results–in at least one department. Only about a quarter of those are using comprehensive EHR systems, including so-called decision support systems, which assist physicians and other health-care providers in making treatment decisions, for example, reminding them to prescribe pre-operative antibiotics.

“If the goal of [electronic record] adoption is to improve quality of care, then this kind of decision support can help clinicians provide the right care more often,” said Cait DesRoches, a public health expert at the Institute for Health Policy at MGH and one of the authors of the study, at the press conference.

Individual electronic functions are more common–about 16 percent of hospitals use electronic ordering systems for medications, while more than three-quarters of respondents reported using electronic systems for the results of laboratory and radiology tests.

The original article can be accessed here.

IHE seeks comment on new imaging, IT standards

Some updates on IHE,

The Integrating the Healthcare Enterprise (IHE) Radiology Technical Committee has released new supplements to the IHE Radiology Technical Framework, which define specific implementations of established standards to achieve effective systems integration and facilitate appropriate sharing of medical information.

The new upplements available for public viewing are:
• Cross-enterprise Document Sharing for Imaging (XDS-I.b)
• Basic Image Review (BIR)
• Extensions to the Portable Data for Imaging (PDI) Integration Profile
• MR Diffusion Imaging (MDI)
• CT/MR Perfusion Imaging with Contrast (PIC)

The IHE Technical Frameworks are a resource for users, developers and implementers of healthcare imaging and information systems. The Technical Frameworks are expanded annually, after a period of public comment, and maintained regularly by the IHE Technical Committees through the identification and correction of errata.

The public comment is open until May 1, 2009. All comments submitted will be considered by the Technical Committee in refining the Trial Implementation versions, to be published in June 2009.

The original article can be found here.

JAMA: Why aren’t health IT makers liable for product-related medical errors?

Now this is an interesting article.

“Even when their products are implicated in harm to patients, manufacturers of health IT have wide contractual and legal protection that renders them virtually “liability-free,” according to a March 25 commentary in the Journal of the American Medical Association.”

I’m not going to argue on either side of the coin but I believe all healthcare informatics practitioner ill know (deep in their hearts), the number of human errors made versus the amount of machine (one that is programmed to repeatedly perform the same function with accuracy) is far higher (and a machine error that results from a human’s action is still a human error).

However, before I get abused by supporter of the other side of the coin, I do concur with the original article on the whole.

Take a read, its food for thought

KLAS: Providers still searching for a complete CVIS

A complete, truly integrated cardiovascular information system (CVIS) does not exist today, based on the opinion of most healthcare providers, according to a new report by healthcare market research firm KLAS.

KLAS said it examined the fragmented market for cardiology systems. Among the findings, the report stated that healthcare providers are still seeking a total cardiology solution that can efficiently distribute images, offer intuitive physician reporting tools and handle operational tasks throughout the cardiology department.

Some vendors, such as GE Healthcare and Philips Healthcare, come close to the vision of a total solution in terms of the functionality of the modules they offer, but integration of those modules is lacking, based on the respondents.

KLAS found that other vendors, such as Lumedx and McKesson, have integrated solutions, but lack proven adoption of some key functional areas to be called a complete CVIS. Among the cardiology IT vendors rated in the KLAS report, Digisonics was ranked number one with an overall performance score of 78.8 out of 100. ScImage (76.9) and Emageon (76.8) were ranked second and third, respectively.

“Cardiology IT is a market with no clear winner, and no vendor is safe from replacement,” said author Ben Brown, director of imaging informatics research for KLAS. “Unlike the market for clinical systems, where the decision to pursue a single-vendor strategy is common, cardiology vendors should expect to see a number of clients come and go over the next two years as the market continues to experience a significant amount of churn.”

The report identified reasons for the high rate of replacement among cardiology solutions, including physician frustration, rapidly advancing technology and the need to unify an organization’s imaging and IT infrastructure, generally as part of an enterprise imaging strategy. A steady stream of acquisitions in the space–such as Amicas’ acquisition of Emageon and the recent purchase of ProSolv by Fujifilm–has also been a factor as product lines are consolidated.

KLAS found that the most satisfied CVIS customers were those with dedicated, internal cardiology IT support resources. Maintaining specialized onsite support aids in both training and business continuity, which contribute to physician satisfaction and adoption.

In general, CVIS technologies are years behind the sophistication and proliferation of RIS and PACS software, which are generally supported by specialized personnel like a PACS administrator, according to the respondents. The cardiology departments that have begun to develop equivalent resources–either through training existing staff or shared support with other departments-have tended to be happier about their deployments.

Original article can be read here

Ramblings: My Next Speaking Engagement

My next speaking engagement would be at the first edition of Hospital Build Asia Exhibition and Congress 2009, held from 1st to 3rd April 2009 at the Suntec International Conference and Exhibition Centre, Singapore.

Hospital Build Asia 2009 is a  premier event for private and public organizations involved in healthcare facilities including;

  • Investment
  • Finance
  • Construction
  • Design & planning,
  • Building, renovation
  • Quality
  • Regulatory
  • IT infrastructure & technologies
  • Systems management
  • Facilities specifying and facilities management

The theme of my presentation is PACS related and since I was recommended to speak by a friend (Dr Sumer), I’d be touching on vendor neutral issues, however, for formality purposes, I had to put in my job title for my day job 🙂 I am also very please to find several old friends speaking at the event (across the different tracks), I reckon it will be a grreat event to hang out.

In addition, I have just been informed by the Events Manager that I am given 10 complimentary conference passes so if you are interested in attending, do drop me a mail. The catch is, you’ll have to do it fast as the closing date for registration is the 24th March so surf on to www.hospitalbuildasia.com for the conference brochure.

Apologies: I accidentally deleted some user comments.

Dear readers,

For those who left comments on my blog posts, I do sincerely apologize if you do not see them appearing because some of the comments got into my “spam queue” and I accidentally deleted it.

If possible, please re-send those comments.

Again, my sincere apologies (I’ll be more careful from now on).

Thanks

Ramblings: PACS Curriculum Survey

A friend of mine (an academian) is in the process of evaluating an upcoming PACS curriculum offered at her college (Clarkson College, USA) and would appreciate if you can spend 3 to 4 minutes on this survey.

There are only 10 questions and your feedback would be greatly appreciated.

Please forward this link to any of your colleges or professionals in the field, the survey is completely confidential.

VirtualPACS allows remote image data access

Ladies and Gentlemen,

Allow me to present to you – VirtualPACS, a framework and toolkit for secure, efficient and standards-based access to remote imaging data has the potential to enhance multi-institutional collaborations in biomedical imaging studies, according to the developers of an open-source application.

The framework consists of

  1. Presentation layer
  2. Middleware layer
  3. Mediation layer

VirtualPACS and all its software components (and instructions on how to download and use them) are made publicly available at www.virtualpacs.org

For those interested in reading the entire (original) article, click here.

Computerized order entry system trims imaging utilization

According to the results of a seven-year, time-series analysis published online in the journal Radiology, the introduction of a computerized radiology order entry (CROE) system with decision support capabilities into an integrated multispecialty group practice may substantially reduce the growth rate of high-cost outpatient imaging volume.

Conducted by researchers at the University of Florida Health Center in Gainesville, Fla., and Massachusetts General Hospital in Boston, the study demonstrates the clear benefit of using appropriateness criteria to help curb growth rates in advanced imaging utilization.

“No other branch of medical technology has experienced the explosive growth in volume and variety of available services that radiology has during the past two decades,” the authors wrote. “The medical care industry in the United States has purchased and installed advanced radiology equipment at an astounding rate, outpacing all other countries.”

The original article can be read here.

Peer-to-peer heart monitoring

Spreading the computational load to monitor heart patients remotely

The possibility of remote monitoring for chronically ill patients will soon become a reality. Now, researchers in South Africa and Australia have devised a decentralized system to avoid medical data overload. They describe the peer-to-peer system in a forthcoming issue of the International Journal of Computer Applications in Technology.

People with a range of chronic illnesses, including diabetes, high blood pressure, and heart problems can benefit from advances in monitoring technology. Such devices could send data on a person’s symptoms directly to a centralized computer server at their health center. This would allow healthcare workers to take appropriate action, whether in an emergency or simply to boost or reduce medication in response to changes in the patient’s symptoms.

However, as tele-monitoring is set to become widespread, there will inevitably be an issue of data overload with which a centralized computer will not be able to cope. Computer scientists Hanh Le, Nina Schiff, and Johan du Plessis at the University of Cape Town, working with Doan Hoang at the University of Technology, Sydney, suggest a decentralized approach.

Computer users are familiar with the concept of peer-to-peer (P2P) networks in which individual users share the workload across equivalent personal computers on a network. This avoids overloading any single server or swamping bandwidth on individual connections. The P2P approach is commonly employed by software companies and others to distribute large digital files, such as operating system updates, and high-definition movies.

A P2P network overlays a network on the individual peers, known as nodes, without a central control point and uses their idle processing cycles, storage, and bandwidth via the internet.

Le and colleagues have developed an application to demonstrate proof of principle of how a P2P network could incorporate patient sensors including thermometers, blood-pressure units and electrocardiograms (ECG). It is the latter on which the team has focused to build a P2P heart-monitoring network.

The system builds on the team’s concept of a physically-aware reference model (a PARM). Their PARM acts as a small-scale, but scalable model of the kind of network overlay that could be built on the internet. Tests have already demonstrated that a continual and unintrusive heart monitoring application could be developed into a working e-health system quickly and simply at low cost using P2P.

Original article here