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NetPulse, HIEs, and The Importance of Reliable EMRs — Around Healthcare Scene

Posted on March 24, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Have you ever wished that all your fitness and food trackers were in one place? Well, look no further. NetPulse is trying to do just that. The new platform is working with some of the hottest apps, as well as fitness equipment makers, to make taking control of your health easier and more convenient.

A group of researchers recently published an opinion in the Journal of the American Medical Association regarding cloud-based health records versus HIEs. The verdict? They feel that the cloud-based health records might be a better way of sharing health records. What they had to say was rather interesting, so don’t miss the recap of it over at EMR and EHR.

Still looking to use HIEs, rather than Cloud-based health records? The ONC has recently released a toolkit to help different healthcare professionals use them more efficiently. This toolkit includes several guides and a spreadsheet to help determine costs and savings that are associated with implementing an EHR.

For those that missed HIMSS, check out the video that John filmed of the Metro point of care solutions. It gives you a first person perspective of what you could have seen demoed at HIMSS if you were able to attend. Plus, it’s pretty cool to see the point of care and BCMA technologies in action.

It’s important for an EMR to be usable. However, this isn’t always the case, and it can be extremely frustrating. Dr. Shirie Leng, an anesthesiologist, is someone who feels that way. In a recent piece over at, Dr. Leng discusses her EMR usability wish list. Be sure to check it out, and see if you agree. What is your usability wish list?

And, how smart is your current EMR? According to John, it might just be stupid. While they may have value, most EHR software is just full of dumb data repositories. Despite the negativity of this perspective, the future of EHRs does have hope. With the help of entrepreneurs innovators, current EHRs will be turned smart.

Finally, in order for EMRs to make the changes needed, to improve usability and become more “smart,” the vendors need to get it together.  KLAS recently put several popular EMRs head-to-head, reviewing their usability and efficiency. Although names weren’t listed, they found that some EMRs were very difficult to learn, and it’s not necessarily the physician who is using its fault. Perhaps it’s time that physicians and hospitals demand higher quality products.

Study Shows Value of NLP in Pinpointing Quality Defects

Posted on August 25, 2011 I Written By

For years, we’ve heard about how much clinical information is locked away in payer databases. Payers have offered to provide clinical summaries, electronic and otherwise, The problem is, it’s potentially inaccurate clinical information because it’s all based on billing claims. (Don’t believe me? Just ask “E-Patient” Dave de Bronkart.) It is for this reason that I don’t much trust “quality” ratings based on claims data.

Just how much of a difference there was between claims data and true clinical data hasn’t been so clear, though. Until today.

A paper just published online in the Journal of the American Medical Association found that searching EMRs with natural-language processing identified up to 12 times the number of pneumonia cases and twice the rate of kidney failure and sepsis as did searches based on billing codes—ironically called “patient safety indicators” in the study—for patients admitted for surgery at six VA hospitals. That means that hundreds of the nearly 3,000 patients whose were reviewed had postoperative complications that didn’t show up in quality and performance reports.

Just think of the implications of that as we move toward Accountable Care Organizations and outcomes-based reimbursement. If healthcare continues to rely on claims data for “quality” measurement, facilities that don’t take steps to prevent complications and reduce hospital-acquired infections could score just as high—and earn just as much bonus money—as those hospitals truly committed to patient safety. If so, quality rankings will remain false, subjective measures of true performance.

So how do we remedy this? It may not be so easy. As Cerner’s Dr. David McCallie told Bloomberg News, it will take a lot of reprogramming to embed natural-language search into existing EMRs, and doing so could, according to the Bloomberg story, “destabilize software systems” and necessitate a lot more training for physicians.

I’m no technical expert, so I don’t know how NLP could destabilize software. From a layman’s perspective, it almost sounds as if vendors don’t want to put the time and effort into redesigning their products. Could it be?

I suppose there is still a chance that HHS could require NLP in Stage 3 of meaningful use—it’s not gonna happen for Stage 2—but I’m sure vendors and providers alike will say it’s too difficult. They may even say there just isn’t enough evidence; this JAMA study certainly would have to be replicated and corroborated. But are you willing to take the chance that the hospital you visit for surgery doesn’t have any real incentive to take steps to prevent complications?