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Has Amazon Brought Something New To Healthcare Data Analytics?

Posted on November 29, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Amazon’s announcement that it was getting into healthcare data analytics didn’t come as a major surprise. It was just a matter of time.

After all, the retail giant has been making noises about its health IT ambitions for a while now, and its super-sneaky 1492 team’s healthcare feints have become common knowledge.

Now, news has broken that its massive hosting division, Amazon Web Services, is offering its Comprehend Medical platform to the healthcare world. And at the risk of being a bit too flip, my reaction is “so?” I think we should all take a breath before we look at this in apocalyptic terms.

First, what does Amazon say we’re looking at here?

Like similar products targeting niches like travel booking and supply-chain management, the company reports, Comprehend Medical uses natural language processing and machine learning to pull together relevant information from unstructured text.

Amazon says Comprehend Medical can pull needed information from physician notes, patient health records and clinical trial reports, tapping into data on patient conditions and medication dosage, strength and frequency.

The e-retailer says that users can access the platform through a straightforward API call, accessing Amazon’s machine learning expertise without having to do their own development or train models of their own. Use cases it suggests include medical cohort analysis, clinical decision support and improving medical coding to tighten up revenue cycle management.

Comprehend Medical customers will be charged a fee each month based on the amount of text they process each month, either $0.01 per 100-character unit for the NERe API, which extracts entities, entity relationships, entity traits and PHI, or $0.0014 per unit if they use its PHId API, which only supports identifying PHI for data protection.

All good. All fine. Making machine learning capabilities available in a one-off hosting deal — with a vendor many providers already use — can’t be wrong.

Now, let’s look coldly at what Amazon can realistically deliver.

Make no mistake, I understand why people are excited about this announcement. As with Microsoft, Google, Apple and other top tech influencers, Amazon is potentially in the position to change the way things work in the health IT sector. It has all-star brainpower, the experience with diving into new industries and enough capital to buy a second planet for its headquarters. In other words, it could in theory change the healthcare world.

On the other hand, there’s a reason why even IBM’s Watson Health stumbled when it attempted to solve the data analytics puzzle for oncologist. Remember, we’re talking IBM here, the last bastion of corporate power. Also, bear in mind that other insanely well-capitalized, globally-recognized Silicon Valley firms are still biding their time when it comes to this stuff.

Finally, consider that many researchers think NLP is only just beginning to find its place in healthcare, and an uncertain one at that, and that machine learning models are still in their early stages, and you see where I’m headed.

Bottom line, if Google or Microsoft or Epic or Salesforce or Cerner haven’t been able to pull this off yet, I’m skeptical that Amazon has somehow pole-vaulted to the front of the line when it comes to NLP-based mining of medical text. My guess is that this product launch announcement is genuine, but was really issued more as a stake in the ground. Definitely something I would do if I worked there.

Does NLP Deserve To Be The New Hotness In Healthcare?

Posted on August 30, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Lately, I’ve been seeing a lot more talk about the benefits of using natural language processing technology in healthcare. In fact, when I Googled the topic, I turned up a number of articles on the subject published over the last several weeks. Clearly, something is afoot here.

What’s driving the happy talk? One case in point is a new report from health IT industry analyst firm Chilmark Research laying out 12 possible use cases for NLP in healthcare.

According to Chilmark, some of the most compelling options include speech recognition, clinical documentation improvement, data mining research, computer-assisted coding and automated registry reporting. Its researchers also seem to be fans of clinical trial matching, prior authorization, clinical decision support and risk adjustment and hierarchical condition categories, approaches it labels “emerging.”

From what I can see, the highest profile application of NLP in healthcare is using it to dig through unstructured data and text. For example, a recent article describes how Intermountain Healthcare has begun identifying heart failure patients by reading data from 25 different free text documents stored in the EHR. Clearly, exercises like these can have an immediate impact on patient health.

However, stories like the above are actually pretty unusual. Yes, healthcare organizations have been working to use NLP to mine text for some time, and it seems like a very logical way to filter out critical information. But is there a reason that NLP use even for this purpose isn’t as widespread as one might think? According to one critic, the answer is yes.

In a recent piece, Dale Sanders, president of technology at HealthCatalyst, goes after the use of comparative data, predictive analytics and NLP in healthcare, arguing that their benefits to healthcare organizations have been oversold.

Sanders, who says he came to healthcare with a deep understanding of NLP and predictive analytics, contends that NLP has had ”essentially no impact” on healthcare. ”We’ve made incremental progress, but there are fundamental gaps in our industry’s data ecosystem– missing pieces of the data puzzle– that inherently limit what we can achieve with NLP,” Sanders argues.

He doesn’t seem to see this changing in the near future either. Given how much money has already been sunk in the existing generation of EMRs, vendors have no incentive to improve their capacity for indexing information, Sanders says.

“In today’s EMRs, we have little more than expensive word processors,” he writes. “I keep hoping that the Googles, Facebooks and Amazons of the world will quietly build a new generation EMR.” He’s not the only one, though that’s a topic for another article.

I wish I could say that I side with researchers like Chilmark that see a bright near-term future for NLP in healthcare. After all, part of why I love doing what I do is exploring and getting excited about emerging technologies with high potential for improving healthcare, and I’d be happy to wave the NLP flag too.

Unfortunately, my guess is that Sanders is right about the obstacles that stand in the way of widespread NLP use in our industry. Until we have a more robust way of categorizing healthcare data and text, searching through it for value can only go so far. In other words, it may be a little too soon to pitch NLP’s benefits to providers.

Healthcare CIOs Focused On Patient Experience And Innovation

Posted on August 2, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Not long ago, 22 healthcare CIOs had a sit-down to discuss their CEOs’ top IT-related priorities. At the meeting, which took place during the 2018 Scottsdale Institute Annual Conference, the participants found that they were largely on the same page, according to researchers that followed the conversation.

Impact Advisors, which co-sponsored the research, found that improving patient experiences was priority number one. More than 80% of CIOs said patient engagement and better patient experiences were critical, and that deploying digital health strategies could get the job done.

The technologies they cited included patient-facing options like wearables, mobile apps and self-service tools. They also said they were looking at a number of provider-facing solutions which could streamline transitions of care and improve patient flow, including care coordination apps and tools and next-generation decision support technologies such as predictive analytics.

Another issue near the top of the list was controlling IT costs and/or increasing IT value, which was cited by more than 60% of CIOs at the meeting. They noted that in the past, their organizations had invested large amounts of money to purchase, implement and upgrade enterprise EHRs, in an effort to capture Meaningful Use incentive payments, but that things were different now.

Specifically, as their organizations are still recovering from such investments, CIOs said they now need to stretch their IT budgets, They also said that they were being asked to prove that their organization’s existing infrastructure investments, especially their enterprise EHR, continue to demonstrate value. Many said that they are under pressure to prove that IT spending keeps offering a defined return on investment.

Yet another important item on their to-do list was to foster innovation, which was cited by almost 60% of CIOs present. To address this need, some CIOs are launching pilots focused on machine learning and AI, while others are forming partnerships with large employers and influential tech firms. Others are looking into establishing dedicated innovation centers within their organization. Regardless of their approach, the CIOs said, innovation efforts will only work if innovation efforts are structured and governed in a way that helps them meet their organization’s broad strategic goals.

In addition, almost 60% said that they were expected to support their organization’s growth. The CIOs noted that given the constant changes in the industry, they needed to support initiatives such as expansion of service lines or building out new ones, as well as strategic partnerships and acquisitions.

Last, but by no means least, more than half of the CIOs said cybersecurity was important. On the one hand, the participants at the roundtable said, it’s important to be proactive in defending their organization. At the same time, they emphasized that defending their organization involves having the right policies, processes, governance structure and culture.

Investors Competing For Health IT Opportunities

Posted on June 28, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that investors are hungry for health IT investment opportunities, in some cases battling competitors for particularly attractive companies. The report concluded that investment firms see health IT as a lower-risk way to get a cut of the healthcare market than other possible targets.

The analysis by Bain & Company, which looks at 2017 numbers, said that the number of health IT investment deals completed last year rose to 32 from 23 in 2016.

The value of disclosed deals fell from $15.5 billion in 2016 to $1.9 billion in 2017. This is not a sign of weakness in the sector, however. The 2016 deals volume was pumped up by two megadeals (acquisitions of MultiPlan and Press Ganey), which were valued collectively at $9.9 billion. Meanwhile, in 2017 only one deal exceeded $800 million.

Deal counts and volume aside, there’s no question that investors are still very interested in acquiring or taking a stake in health IT companies, Bain reports. According to its study, there are many good reasons for their excitement.

“Investors find HCIT target attractive not only because HCIT companies play a vital role in promoting technology adoption in healthcare but also because they bear less of the direct reimbursement and regulatory risk that affect other healthcare sectors,” the report says. “With a limited set of scale assets on the market and corporate buyers willing to pay premiums for those that do become available, valuations remain high and competition intense.”

The report notes that most of the health IT buyouts in 2017 involved biopharma investments, particularly among companies using IT solutions and advanced analytics to streamline development a testing of drugs. Such deals include the buyout of Certara, which offers decision support technology for optimizing drug development, and Bracket, which sells technology for managing clinical trials.

However, investors were also interested in EMR and practice management vendors. Given that just a handful of big vendors block of the market for hospital IT, they looked elsewhere.

In particular, investment firms were interested in consolidating some of the many vendors selling ambulatory care EMRs platforms supporting specialties like gastroenterology. For example, investors picked up a $230 million stake in Modernizing Medicine, which offers EMR and practice management systems for specialties such as dermatology and ophthalmology, Bain said.

In the future, investors will gain interest in revenue cycle management software. In addition to investing in or acquiring RCM tools for providers, investors may target RCM software helping patients pay their bills. For example, private equity firm Frontier Capital bought a majority stake in medical card company AccessOne last year.

Bain also predicts that Investors will pay growing attention to clinical decision support platforms, driven in part by legislation requiring doctors to use clinical decision support tools before ordering complex diagnostic imaging of Medicare patients.

In addition, investment firms are keeping their eye on population health management software vendors. It’s not clear yet which companies will dominate the sector, and how these platforms will evolve, so dealmakers are hanging back. Still, within a few years they may well begin to throw money at PHM companies.

CMS Wants Interoperability. Should Patient Data Access Champions Cheer – or Not? – #HITsm Chat Topic

Posted on June 12, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 6/15 at Noon ET (9 AM PT). This week’s chat will be hosted by Janice McCallum (@janicemccallum) on the topic of “CMS Wants Interoperability. Should Patient Data Access Champions Cheer – or Not?.”

Earlier this year at HIMSS18 and HealthDataPalooza, Seema Verma, CMS Administrator, announced the MyHealthEData initiative that places a priority on interoperability of EHRs, a long desired objective of health data enthusiasts.

The MyHealthEData initiative proposes open APIs with common data standards that will facilitate access to EHR data for software developers, although the business terms for accessing the data aren’t yet clear. In today’s #HITsm chat, I’d like to focus on how the MyHealthEData initiative will—or will not– benefit patients directly. I have more questions than answers and look forward to input from a range of healthIT and data management experts, patient data access advocates, innovation enthusiasts, and more.

First, some background materials:

This is the official announcement of MyHealthEData: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-03-06.html.  Note, the initiative is not intended to give consumers direct access to their data from their healthcare providers; rather, it gives them the ability to choose a “provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs. ” In this case, “provider” means a technology provider that will likely charge an initial fee and an ongoing fee for data management.

From ONC director, Don Rucker on interoperability, transparency and an API ecosystem: https://www.healthit.gov/buzz-blog/interoperability/apis-path-putting-patients-center/

Adrian Gropper, MD, in a comment on Rucker’s post on the Health Care Blog, questions whether patient-friendly and cost-effective developers will have full access to APIs:

The issue is fairly simple and was well documented by the API Task Force: Can a small, independent startup serving patients or physicians have access to the FHIR API if the patient says it should – period? http://thehealthcareblog.com/blog/2018/04/24/apis-a-path-to-putting-patients-at-the-center/

Finally, some insights from the current state of the Apple Health app that may give us reason to question how quickly something close to full data access and ongoing data liquidity will occur: https://corepointhealth.com/apple-health-fhir

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1 : Does anyone see any downside to the latest data and API standards? Is anything missing from CMS announcements and fact sheets? Or, should we all be cheering? #HITsm

T2: Health IT vendors that focus on patient engagement and patient data management should be happy about MyHealthEData. Who among the existing patient data app developers do you think will benefit most from an API ecosystem? Who might be hurt? #HITsm

T3: Do you think patient access to full health records will be more affordable due to MyHealthEData? #HITsm

T4: How long do you think it will take to make the apps useful to patients with complex conditions, given the current state of data availability via Apple Health app and early patient portals? #HITsm

T5: What’s the likely business model for the app developers? #HITsm
Here are some possibilities to discuss:
(1) app developers charge low price to patients; revenue will come from businesses that want to buy access to aggregate data.
2) Full fee paid by patients.
3) An advertising model?
4) Access to app is given as a benefit to existing customers, e.g., Google can afford to offer app for free/low cost to existing customers, because it sells other services; health insurers can subsidize costs to incentivize patients to better manage their health status via health data apps.
5) Other revenue/business models?

Bonus: How do you think healthcare providers will react to the requirement that they “ensure data sharing”? How will it affect small physician practices v. hospitals? #HITsm

Upcoming #HITsm Chat Schedule
6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – How Nursing Informatics is Changing the Healthcare Landscape
Hosted by Cathy Turner (@MEDITECH_Nurses) and Ashley Dauwer (@amariedauwer) from @MEDITECH

7/6 – What’s the Future of Patient Communication?
Hosted by Lea Chatham (@LeaChatham)

7/13 – TBD
Hosted by TBD

7/20 – TBD
Hosted by Jared Jeffery (@Jk_Jeffery)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Stanford Survey Generates Predictable Result: Doctors Want EHR Changes

Posted on June 11, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I know you’re going to have trouble believing this, but many PCPs think EHRs need substantial changes.

Such is the unsurprising conclusion drawn by a survey conducted by The Harris Poll on behalf of Stanford Medicine. The poll, which took place between March 2 and March 27 of this year, surveyed 521 PCPs licensed to practice in the U.S. who have been using their current EHR system for at least one month.

The physicians were recruited via snail mail from the American Medical Association Masterfile. Figures for years in practice by gender, region and primary medical specialty were weighted where necessary to bring them into line with their actual proportions in the population of PCPs in the U.S.

According to the survey, about two-thirds of PCPs think EHRs have generally improved care (63%). Two-thirds said they were at least somewhat satisfied with their current systems, though only 18% were very satisfied.

Meanwhile, a total of 34% were somewhat or very dissatisfied with their system, and 40% of PCPs said that EHRs create more challenges than benefits. Also, 49% of office-based PCPs reported that using an EHR detracts from their clinical effectiveness.  Forty-four percent of PCPs said that primary value of EHRs is data storage, while just 8% said that the biggest benefits were clinically-related.

To improve EHRs’ clinical value, it will take a lot of effort, with 51% saying they think EHRs need a complete overhaul.  Seventy-two percent of PCPs said that improving user interfaces could best address their needs in the immediate future.

Meanwhile, 67% of respondents said that solving interoperability problems should be the top priority for EHR development over the next decade, and 43% reported wanting improved predictive analytics capabilities.

Nearly all (99%) of PCPs said that EHR capabilities should include maintaining a high-quality record of patient data over time, followed closely by providing an intuitive user experience. Also, 88% said that providing clinical decision support at the moment of care was important, followed by identifying high-risk patients in their patient panel (86%).

When asked what EHR features they found most satisfying, they cited maintaining a high-quality patient record (73%), offering patients access to medical records (71%), sharing information with providers across the care continuum (65%) and supporting practice/revenue cycle management needs (60%).

However, EHRs still have a long way to go in offering other preferred capabilities, including changing and adapting in response to user feedback, improving patient-provider interaction, coordinating care for patients with complex conditions and engaging patients in prescribed care plans through mobile technologies. Vendors, you have been warned.

How Technology and Healthcare Should Gracefully Collide to Provide the Best Patient Experience – #HITsm Chat Topic

Posted on June 5, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 6/8 at Noon ET (9 AM PT). This week’s chat will be hosted by Jeanne Bliss (@jeannebliss) and Michelle Chaffee (@mdchaffee) on the topic of “How Technology and Healthcare Should Gracefully Collide to Provide the Best Patient Experience.”

Enhancing patient engagement and improving patient experience are priorities for many hospitals and health systems. And customer experience in healthcare must be a balance of human care and technical care – only when it enhances and improved human care. In this chat we’ll discuss the critical balance of the two and how high tech must enable and support high human touch, as well as best practices and the companies who are enabling technology support for human care delivery.

Reference Materials:

What Is Patient Experience?

Association of Patient Experience

Healthcare Systems Should Start Thinking “Would You Do That to Your Mother?”

Next-gen patient engagement: Applied intelligence and omni-channel messaging

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1: What strategies can healthcare patients, caregivers, clinical service providers, and payers employ to leverage technology to enhance the patient experience? #HITsm

T2: What are the touchpoints that can impact patient experience and what do you think are some of the best ways to utilize technology at each touchpoint? #HITsm

T3: What are some non-medical needs and opportunities for enhancing health outcomes and how can technology support these opportunities? #HITsm

T4: What are some examples how other industries outside of healthcare have used technology to support a good customer experience? #HITsm

T5: How can social media and the ‘sharing & collaboration’ tools that have grown so rapidly over the last 6-8 years enhance the patient experience? #HITsm

Bonus: What are some examples of the worst patient experience involving technology that you or someone you know has ever experienced? #HITsm

Upcoming #HITsm Chat Schedule
6/15 – TBD
Hosted by Janice McCallum (@janicemccallum)

6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – TBD
Hosted by Cathy Turner (@MEDITECH_Nurses) from @MEDITECH

7/6 – TBD
Hosted by Lea Chatham (@LeaChatham)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

How Health IT Helps and Hurts Patients – #HITsm Chat Topic

Posted on May 23, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/25 at Noon ET (9 AM PT). This week’s chat will be hosted by Amanda (@LALupusLady) on the topic of “How Health IT Helps and Hurts Patients (Especially Those with Chronic Conditions).”

Health IT is a powerful tool. It has changed the way patients, especially people with chronic illnesses live with and manage their care. As a woman living with multiple autoimmune illnesses for over three decades, my perspective is unique as I have seen the shift and how providers have been eager to adopt technology into their practice and recently experienced a doctor’s office where the fax machine is still the primary means of communication.

In my patient experience, I have chosen to adopt and use Health IT to assist me in managing my chronic care. Whether I am tracking my symptoms, keeping a food diary, or putting on a VR headset to help me relieve my pain, Health IT has improved my patient experience. While at the same time, the fact that with all the advances in Health IT that not every advance is a step forward for healthcare. There is frustration by patients that (in 2018) EHR developers have not yet developed a way for various platforms and institutions to connect to create one complete healthcare record for one patient.

Next week, I am proud that I will be at #HITExpo to share my patient experience at Healthcare Scene’s inaugural event in New Orleans. Understanding the value and insight that patients have can build an empathy, which I feel will directly improve the way Health IT collaborations work together.

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1: How is Health IT (Apps, Devices and New Technology) helping streamline the patient experience (especially for people living with chronic conditions)? #HITsm

T2: How is Health IT hindering (hurting) the patient experience (especially for people living with chronic conditions)? #HITsm

T3: What Health IT companies/developers have made a positive impact on your life? How? If you are a patient, what Health IT has directly improved your patient experience? #HITsm

T4: How can Health IT work together with patient communities to improve outcomes and engagement? #HITsm

T5: What can you do to support Health IT “collaborations that work” with patients, especially those living with chronic conditions? #HITsm

Bonus: What are you most looking forward to at #HITExpo? #HITsm

Wishing you a Healthy and Happy Lupus Awareness Month. Can’t wait to chat together.

Upcoming #HITsm Chat Schedule
6/1 – #HITExpo Hiatus
The #HITsm chat will be on hiatus this week with the Health IT Expo happening in New Orleans. Please join in on the conversation happening on the #HITExpo conference hashtag.

6/8 – How Technology and Healthcare Should Gracefully Collide to Provide the Best Patient Experience
Hosted by Jeanne Bliss (@jeannebliss) and Michelle Chaffee (@mdchaffee)

6/15 – TBD
Hosted by Janice McCallum (@janicemccallum)

6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – TBD
Hosted by Cathy Turner (@MEDITECH_Nurses) from @MEDITECH

7/6 – TBD
Hosted by Lea Chatham (@LeaChatham)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Practical Applications of EMR Optimization Through Clinical Decision Support – #HITsm Chat Topic

Posted on May 15, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 5/18 at Noon ET (9 AM PT). This week’s chat will be hosted by Justin Campbell (@tjustincampbell) from @GalenHealthcare on the topic of “Practical Applications of EMR Optimization Through Clinical Decision Support”


As a primer for the upcoming Health IT Expo, we will be discussing practical applications of EMR optimization through clinical decision support. Optimization dominates Health IT leaders’ list of priorities as they seek to rationalize EMR investment and harness its capabilities for improving efficiency, care and outcomes. However, boil-the-ocean approaches to EMR optimization can be counterproductive and stifle progress. Instead, Health IT leaders would be best served to focus on practical applications of optimization – specifically through clinical decision support, which serves as a lynchpin to clinical quality improvement initiatives.

Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care.

CDS has a number of important benefits, including:

  • Increased quality of care and enhanced health outcomes
  • Avoidance of errors and adverse events
  • Improved efficiency, cost-benefit, and provider and patient satisfaction

CDS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include:

  • Computerized alerts and reminders to care providers and patients
  • Clinical guidelines
  • Condition-specific order sets
  • Focused patient data reports and summaries
  • Documentation templates
  • Diagnostic support, and contextually relevant reference information

The majority of CDS applications operate as components of comprehensive EHR systems, although stand-alone CDS systems are also used. Many modern EMRs contain CDS capabilities such as rule engines, predictive modeling languages, and alert and order set authoring. However, the development and use of effective CDS within the EMR requires significant clinical, IT, and knowledge management resources that many organizations do not possess. This has led an increasing number of organizations to use compartmentalized decision support platforms other than EMR to drive portions of their CDS programs.

Ideally, CDS tools will be readily accessible to a wide array of caregivers where and when they need them, irrespective of what electronic health record they’re using. One such initiative emerging to share CDS resources is the AHRQ-funded CDS Consortium Project, which has demonstrated successfully that CDS from Partners Healthcare could be delivered to disparate EMRs across the country.

In an age of overwhelming data access and rapid technological development, ensuring clinicians have the clinical decision support tools to sift through a sea of information to find what is most relevant to their patient’s needs is vital to optimizing health outcomes.

In this tweetchat, we will discuss types of CDS (including sepsis surveillance, risk calculators, drug interaction, among others), mechanisms to deliver CDS to the point of care, workflow and alert fatigue implications, and methods for sharing proven CDS libraries.

Resources and Other EMR Optimization & CDS Reading:

  1. EMR Optimization Whitepaper
  2. EMR Optimization Infographic
  3. HealthIT.gov Clinical Decision Support
  4. CDS in the Cloud: Deploying a CDC Guideline for National Use
  5. Almost 20 Percent of CDS Alert Dismissals May Be Inappropriate
  6. EHR vendors, AHIMA push use of clinical decision support to prevent patient falls
  7. EMR Sepsis Surveillance – Achieving Optimal Sepsis Sensitivity & Specificity
  8. Integrated Health Calculators Whitepaper

Join us for this week’s #HITsm chat where we’ll discuss the following:

T1: What experiences do you have with CDS implementation? What impacts (positive and negative) did it have? #HITsm

T2: How can CDS best be deployed to the point of care without exacerbating alert fatigue? #HITsm

T3: How are different types of CDS initiatives (VTE, sepsis detection & prevention; clinical pathways implementation; risk calculation) prioritized? #HITsm

T4: Is CDS best suited to be managed by EMR vendors or can CDS be shared across vendors? How? #HITsm

T5: What are strategies to manage to CDS code and clinical peer review and rating? #HITsm

Bonus: What are mechanisms for making knowledge artifacts for CDS shareable? #HITsm

Upcoming #HITsm Chat Schedule
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More Ways AI Can Transform Healthcare

Posted on April 25, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

You’ve probably already heard a lot about how AI will change healthcare. Me too. Still, given its potential, I’m always interested in hearing more, and the following article struck me as offering some worthwhile ideas.

The article, which was written by Humberto Alexander Lee of Tesser Health, looks at ways in which AI tools can reduce data complexity and detect patterns which would be difficult or even impossible for humans to detect.

His list of AI’s transformative powers includes the following:

  • Identifying diseases and providing diagnoses

AI algorithms can predict when people are likely to develop heart disease far more accurately than humans. For example, at Google healthcare technology subsidiary Verily, scientists created an algorithm that can predict heart disease by looking at the back of a person’s eyes and pinpoint early signs of specific heart conditions.

  • Crowdsourcing treatment options and monitoring drug response

As wearable devices and mobile applications mature, and data interoperability improves thanks to standards such as FHIR, data scientists and clinicians are beginning to generate new insights using machine learning. This is leading to customizable treatments that can provide better results than existing approaches.

  • Monitoring health epidemics

While performing such a task would be virtually impossible for humans, AI and AI-related technologies can sift through staggering pools of data, including government intelligence and millions of social media posts, and combine them with ecological, biogeographical and public health information, to track epidemics. In some cases, this process will predict health threats before they blossom.

  • Virtual assistance helping patients and physicians communicate clearly

AI technology can improve communication between patients and physicians, including by creating software that simplifies patient communication, in part by transforming complex medical terminology into digestible information. This helps patients and physicians engage in a meaningful two-way conversation using mobile devices and portals.

  • Developing better care management by improving clinical documentation

Machine learning technology can improve documentation, including user-written patient notes, by analyzing millions of rows of data and letting doctors know if any data is missing or clarification is needed on any procedures. Also, Deep Neural Network algorithms can sift through information in written clinical documentation. These processes can improve outcomes by identifying patterns almost invisible to human eyes.

Lee is so bullish on AI that he believes we can do even more than he has described in his piece. And generally speaking, it’s hard to disagree with him that there’s a great deal of untapped potential here.

That being said, Lee cautions that there are pitfalls we should be aware of when we implement AI. What risks do you see in widespread AI implementation in healthcare?