Mission Health Selects PeraHealth To Enhance Clinical Surveillance, Patient Safety

Asheville, N.C.-based Mission will integrate PeraHealth’s suite of clinical surveillance solutions into its existing enterprise data warehouse and its Cerner electronic medical record (EMR) system, helping care teams visualize a full picture of patient condition. The software will also be used at the 763-bed Mission Hospital to remotely monitor patients and support bed management across the health system’s five other hospitals located throughout western North Carolina.

“Our partnership with PeraHealth further demonstrates our commitment to providing fully integrated patient care that improves the health of the people and communities we serve,” said Ronald A. Paulus, M.D., president and CEO at Mission, the only health system in the nation named to Truven Health Analytics’ Top 15 Health Systems list four years in a row (2012-2015).

Powered by the Rothman Index, a disease-agnostic measure of patient condition used to predict patient readmission and mortality risk, PeraHealth software pulls data from all major EMR systems. The data is automatically translated into an Index score that’s presented in color-coded graphs computed upon admission and trended across the entire episode of care. The Rothman Index is validated by 18 peer-reviewed publications, including a recent article detailing how its use by a nurse rapid response team was linked to a 30 percent mortality reduction.

“Providing clinicians with innovative, analytics-driven resources to help deliver the right care, in the right place, at the right time is essential in today’s healthcare environment,” said Dr. Chris DeRienzo, Chief Patient Safety Officer at Mission Health. “We believe our partnership with PeraHealth will enhance communication among caregivers, especially during care transitions, and deliver new methods of reducing preventable harm to our patients through machine learning and predictive analytics.”

Patients frequently exhibit subtle warning signs in the hours and days before experiencing life-threatening health problems. Considering the average five-day hospital stay includes at least 24 patient handoffs, these signs can easily be missed during department transfers and shift changes, increasing the potential for unnecessary patient harm and costs.

“Detecting potential patient deterioration is extremely challenging for any care team,” said PeraHealth CEO Stephanie Alexander. “By clearly trending a full picture of patient condition in real-time, PeraHealth solutions alert clinicians earlier to subtle health issues, which can increase the likelihood of successful intervention. We are honored to partner with Mission Health to support their use of innovative analytics to provide high value patient care.”

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BayCare Health System Recognized for Achievement in Electronic Medical Record Adoption by Leading Global Organization

BayCare Health System's progress in adopting an electronic medical records (EMR) system was recognized by the Healthcare Information and Management Systems Society (HIMSS), a global organization known for thought leadership on improving health care through information technology (IT).

Electronic medical record systems can improve patient care, increase patient safety, enhance medication safety and increase efficiency. BayCare Health System reached Stage 6 of 7 in the EMR Adoption Model developed by HIMSS Analytics, a non-profit subsidiary of HIMSS, that collects and analyzes health care data. The adoption model identifies and scores hospitals using an eight-step scale (0-7) that charts the path to a fully paperless environment. Less than 20 percent of U.S. hospitals and health systems tracked by HIMSS Analytics have reached Stage 6 as they convert to a fully automated/paperless medical records system. The ten BayCare hospitals recognized join only three others in the Tampa Bay area that have achieved this milestone.

BayCare Vice President and Chief Information Officer Timothy Thompson commented, "BayCare's IT strategy has been focused on providing a better care environment for our patients through meaningful information. This recognition by HIMSS validates our leadership position in information technology, not just in Florida but across the U.S. Our achievement enables us to offer health care providers better access to important health information. It also puts relevant information at our patients' fingertips through the MyBayCare.org portal."

Stage 6 hospitals have achieved a significant advancement in their IT capabilities that positions them to successfully address many of the current industry transformations, such as meaningful use criteria in the American Recovery and Reinvestment Act; claims attachments for the Health Insurance Portability and Accountability Act; pay for performance; and government quality reporting programs.

The BayCare facilities recognized for reaching Stage 6 are Mease Countryside, Mease Dunedin, Morton Plant, Morton Plant North Bay, St. Anthony's, St. Joseph's, St. Joseph's Children's, St. Joseph's Hospital-North, St. Joseph's Women's and South Florida Baptist.

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A Proposal To Increase EHR Satisfaction Using Education

A recent study presented at the 2013 HIMSS conference revealed through the survey of 4,279 clinicians that EHR satisfaction has declined from 39% in 2010 to 27% in 2012.

While many organizations and publications have speculated about what has caused the decrease in satisfaction, I’d like to suggest we dedicate our resources to solving the problem instead of simply discussing the causes. Like so many transitions in the past, I wonder if the solution could simply be a matter of education? The study cited that the number of clinicians using EHRs who claimed to be “very dissatisfied” increased by 10% during those two years. This begs the question, are all users dissatisfied with their specific program, or may the dissatisfaction be caused by change itself? After all, physicians and nurses are being forced to change a long standing practice of paper charting.

According to the Pew Research Center’s Internet and American Life Project 20% of Americans did not use the internet and 13% did not have access to a computer in 2010. Outside of those numbers there are many medical professionals who are simply uncomfortable with computers or do not have strong typing skills. If a nurse is learning how to navigate a keyboard while simultaneously having to learn a system, it’s not surprising that he or she may be dissatisfied with the change. The disruption in workflow could be greatly improved by teaching nurses and doctors how to integrate EHRs into their daily tasks while still in the classroom.

Academic electronic health records programs, like EHR Tutor, allow students to gain exposure to EHRs before entering the workplace. Learning how to use electronic charting while still learning how to do the basics of their job, teaches students to be just as comfortable with a computer as they would be with a pen and piece of paper. This is something that may help ease the transition to electronic charting in the future.

In addition to being generally dissatisfied, the number of users dissatisfied with the “features and functionality” of their EHR system increased from 51% to 61%. One pain point seemed to be the fact that the features and functionality in many EHRs do not align well enough with clinicians’ workflow. Workflow can be determined by meetings with key stakeholders, shadowing medical personnel during their workday and conversations with designated doctor or nurse champions. The process works best when input from the people who will be using the system is carefully considered and fully utilized. However, improving workflows will not solve the entire problem.

For example, let us examine a problem like “alert fatigue”. In many systems, alerts pop up with warnings about drugs that may be unnecessary or elementary for a prescribing physician, or with a warning that a field is missing data that may not be relevant to the patient. An alert may also appear after a particular issue has been handled. While the alerts may seem logical to a programmer, they don’t necessarily make sense in the field. Thankfully, there are more and more schools offering courses on healthcare technology, which provide a foundation of knowledge for future developers and analysts.

Centers like the Training Hub for Operative Technologies in Healthcare at Imperial College in London offer full programs dedicated to healthcare technology. For current developers, Coursera.org offers free courses including “Health Informatics in the Cloud”, “Interprofessional Healthcare Informatics” and “Healthcare Innovation and Entrepreneurship”, all of which examine the real life work of medical professionals in relation to the technology they use. This is a knowledge set that is absolutely necessary for a programmer trying to design a system for those very people. By having companies sponsor those classes or conversations, we would open the lines of communication and enhance the education of program developers.

Along with a decrease in satisfaction regarding features and functionality, the amount of clinicians who said they would not purchase their current EHR system again if given the chance increased from 25% to 38%. This cannot be solely the fault of developers; some of the onus must fall on consumers themselves. Instead of hearing the lament, “If only I would have known…” after an EHR implementation, we can begin by making sure medical offices do know what they are getting with any particular system and what they should expect when shopping for an EHR. Educating consumers is imperative. For example, the level of computer skills and familiarity with technology needed when using different programs may be a huge factor for a practice with less computer savvy practitioners.

Reading the reviews on EHRCompare.com quickly revealed that AdvancedEMR can be difficult to set up and implement for less technologically inclined staff, whereas Practice Fusion seems to be less customizable, but easier to use (based on user reviews alone). Using EHRCompare to research multiple EHRs, a user can search by specialty, setting, and hosting preference. Then, all applicable EHRs will appear with an overview of features along with user reviews. That information not only gives consumers a great place to start, it teaches them what questions to ask and what to look for. What are some pain points a consumer may not have thought of? How do the program specs translate to office usage?

Another great resource is the Health IT government website which has a full list of all certified EHR systems: http://oncchpl.force.com/ehrcert/CHPLHome. It has a large checklist of features for each product, allowing consumers to see, at a glance, what is available and what is missing. That way, consumers know all the details even if the EHR sales rep did not disclose them all. Knowing what to look for can help buyers purchase the best system for their particular practice.

Overall, any change in procedure involves a long, arduous education process. While there are technical problems to overcome in the present, many problems can be prevented with simple education in the future. Using the resources available we can make sure new medical professionals, EHR programmers and consumers all have access to the best resources and knowledge base possible. This is something that can only lead to improvement.

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CMS:Electronic Health Records Empower Patients And Equip Doctors

 CMS:Electronic Health Records Empower Patients And Equip Doctors

The Centers for Medicare & Medicaid Services (CMS) have released new data that demonstrate that doctors and hospitals are using electronic health records (EHRs) to provide more information securely to patients and are using that information to help manage their patients’ care. Doctors, hospitals, and other eligible health care providers that have adopted or meaningfully used certified EHRs can receive incentive payments through the Medicare and Medicaid EHR Incentive Programs.

Already, approximately 80 percent of eligible hospitals and more than 50 percent of eligible professionals have adopted EHRs and received incentive payments from Medicare or Medicaid. By meaningfully using EHRs, doctors and other health care providers prove they have been able to increase efficiency while safeguarding privacy and improving care for millions of patients nationwide.

Since the EHR Incentive Programs began in 2011:

  • More than 190 million electronic prescriptions have been sent by doctors, physician’s assistants and other health care providers using EHRs, reducing the chances of medication errors.
  • Health care professionals sent 4.6 million patients an electronic copy of their health information from their EHRs.
  • More than 13 million reminders about appointments, required tests, or check-ups were sent to patients using EHRs.
  • Providers have checked drug and medication interactions to ensure patient safety more than 40 million times through the use of EHRs.
  • Providers shared more than 4.3 million care summaries with other providers when patients moved between care settings resulting in better outcomes for their patients.

Now, more than ever, EHRs are enabling more patients to access their health information, and allowing health care providers across a variety of settings to share patient medical records and information securely, while still protecting patient privacy. “Electronic health records are transforming relationships between patients and their health care providers,” said CMS Administrator Marilyn Tavenner.

“EHRs improve care coordination, reduce duplicative tests and procedures, help patients take more control of their health and result in better overall health outcomes.“

“More patients than ever before are seeing the benefits of their providers using electronic health records to help better coordinate and manage their care,” said Farzad Mostashari, M.D., national coordinator for health information technology. “These data show that health care professionals are not only adopting electronic health records rapidly, they’re also using them to improve care.”

The Obama administration has encouraged the adoption of health information technology starting with the passage of the Recovery Act in 2009. The Act has been a critical factor in improving the quality of health care and lowering costs, and ultimately transforming our health care delivery system.

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Orion Health Chooses HP to Support Managed Health Services

Orion Health Chooses HP to Support Managed Health Services

HP (NYSE: HPQ) have announced that Orion Health, a New Zealand-based leader in health information exchange (HIE), electronic health records (EHR) and healthcare integration solutions, has selected HP Converged Cloud to support its global managed health services. Health technology solutions enable providers to quickly and securely access critical patient data in order to coordinate patient health and improve population health.

These solutions need to be standardized to meet both compliance and regulatory requirements. Orion Health has implemented products and solutions that are used by hundreds of thousands of clinicians to help facilitate care for tens of millions of patients across more than 35 countries. Clinicians, provider facilities and original equipment manufacturing (OEM) partners rely on Orion Health to facilitate data exchange between hospitals, health systems, HIEs, EHRs, and affiliated providers and medical devices.

This results in improved care coordination and enhanced quality of care. HP is providing Orion Health with a scalable and secure virtual infrastructure that is based on HP CloudSystem Matrix, an Infrastructure as a Service (IaaS) for private and hybrid cloud environments. This enables customers to quickly provision their infrastructure for physical and virtual environments. By implementing HP CloudSystem Solutions and HP Cloud Maps Solutions, Orion Health will have the flexibility to deliver cloud services that are tailored for each of its customers.

"Through a combination of HP Cloud Maps and Orion Health Managed Services, we will be able to quickly build a comprehensive catalogue of applications for simple deployment, reducing the time to deliver a new application," said Paul Cunningham, chief technical architect, Orion Health.

"By selecting HP, Orion Health will have the flexibility to deliver cloud services that are tailored for each customer on demand, and will be more agile and efficient while maintaining industry compliance and security standards."

The implementation of HP CloudSystem Matrix will enable Orion Health to:

  • Increase performance through a scalable IaaS model that rapidly adjusts to dynamic business demands in minutes.
  • Increase availability through a system enclosure that adds redundancy to each server so there is no single point of failure.
  • Maintain compliance and regulatory requirements by hosting sensitive and private data on-site in a secure environment.
  • Lower administration costs by enabling individual administrators to manage both virtual and physical resources using the same set of tools.

Orion Health will leverage HP's global reach to provide its integrated solution around the world, enabling it to generate new revenue streams by enhancing its managed services IaaS offering.

"As the health technology market evolves and grows, healthcare technology providers need to quickly and easily access information while complying with global regulatory requirements," said Saar Gillai, senior vice president and general manager, Converged Cloud, HP. "With a global understanding of the healthcare regulatory environment coupled with its expertise and portfolio, HP is uniquely positioned to provide complete HP Converged Cloud solutions that reduce deployment times and enable integrated health services worldwide."

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Report on Survey of Physician Adoption of Electronic Health Records

Health information technology (HIT) has the potential to revolutionize the delivery of health care. This report considers in particular the growth of electronic health records—a common example of HIT—and how it might affect the cost and quality of health care. Health information technology (HIT) refers to a variety of electronic methods used to manage information about people's health and health care.

This report expands on the findings of an earlier report—Health Information Technology in the United States—from 2006 that examined the barriers to widespread HIT adoption and the challenges faced in accurately measuring it. The authors provide new survey data from general physicians and from those serving vulnerable populations, while exploring methods to evaluate the effects of HIT on cost and quality of health care. The chapters of the report focus on a range of topics that include an economic analysis of HIT, the state of HIT internationally, and patients' experiences with electronic health records (EHR) and personal health records.

Key Findings:

  • 13 percent more physicians are using EHR since 2006;
  • there is no significant association between EHR use and quality of care;
  • providers who serve vulnerable populations are no less likely to provide HIT enhanced care than other providers;
  • and several developed nations are approaching universal implementation of EHR systems.

The type of data generated by HIT and EHR can help providers better understand disparities in health care quality and may improve the patient experience and medical outcomes.

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Final HHS Health IT Safety Plan issued

  • The Joint Commission to expand capacity to investigate Health IT-related events

A plan to guide health information technology (IT) activities across the Department of Health and Human Services (HHS) to eliminate medical errors, protect patients, and improve the quality and efficiency of health care was issued today by HHS. The final Health IT Patient Safety Action and Surveillance Plan addresses the role of health IT within HHS’ commitment to patient safety.

The Plan builds on recommendations from the 2011 Institute of Medicine report, titled Health IT and Patient Safety: Building Safer Systems for Better Care, and from public comments. “When implemented and used properly, health IT is an important tool in finding and avoiding medical errors and protecting patients,” said National Coordinator for Health IT Farzad Mostashari, M.D. “This Plan will help us make sure that these new technologies are used to make health care safer.”

  • The Plan, implemented by the Office of National Coordinator for Health IT (ONC), outlines the responsibilities to be shared across HHS and details significant participation from the private sector.
  • Through the Plan: ONC will make it easier for clinicians to report health IT-related incidents and hazards through the use of certified electronic health record technology (CEHRT).
  • The Agency for Healthcare Research and Quality will encourage reporting to Patient Safety Organizations and will update its standardized reporting forms to enable ambulatory reporting of health IT events.
  • The Centers for Medicare & Medicaid Services (CMS) will encourage the use of the standardized reporting forms in hospital incident reporting systems, and train surveyors to identify safe and unsafe practices associated with health IT.
  • Working through a public-private process, ONC will develop priorities for improving the safety of health IT.
  • ONC and CMS will consider adopting safety-related objectives, measures, and capabilities for CEHRTs through the Medicare and Medicaid EHR Incentive Programs and ONC’s standards and certification criteria.

To accompany the Plan’s surveillance of safety-related capabilities in CEHRT, ONC today issued guidance clarifying that ONC-Authorized Certification Bodies will be expected to verify whether safety-related capabilities work properly in live clinical settings in which they are implemented. In addition to the Plan, today Dr. Mostashari announced ONC has contracted with The Joint Commission to better detect and proactively address potential health IT-related safety issues across a variety of health care settings.

The Joint Commission will expand its capacity to investigate the role of health IT as a contributing cause of adverse events and will identify high priority areas for expected types of health IT-related events.

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Advanced research instrumentation pioneer Oxford Optronix launches next-generation tissue oxygenation and blood flow monitoring systems

Oxford Optronix, the leading provider of advanced research instrumentation for the clinical medicine and life science industries, today announces the formal launch of its next-generation OxyLite™ Pro and OxyFlo™ Pro systems for tissue oxygenation and blood flow monitoring – delivering the most advanced tissue vitality monitoring platform on the market today. This latest release marks the third generation of the company’s OxyLite™ and OxyFlo™ brand systems, first launched in 1991. The OxyLite and OxyFlo systems are unique modular instruments that utilise fibre-optic micro-sensors to provide real-time measurements of local tissue oxygenation (ptiO2), tissue blood perfusion (blood flow) and tissue temperature.

These instruments, which are designed to be used either individually or ‘in-tandem’ for simultaneous measurements of tissue oxygenation, blood flow and temperature, are widely used across the globe in areas of biomedical research concerned with hypoxia and ischaemia. With oxygen sensors based on state-of-the-art optical fluorescence technology – pioneered at Oxford Optronix – OxyLite™ Pro is a two- or four-channel oxygen and temperature monitoring instrument that provides continuous, quantitative and high-sensitivity monitoring of oxygen availability to cells and tissue.

This touch-screen based system is remarkably easy to use and is specifically targeted at oxygen measurements in the physiological range, as well as under conditions of hypoxia, offering application in research areas including tumour oxygen monitoring/angiogenesis; cerebral oxygen monitoring in models of stroke and brain injury; vital organ and muscle tissue monitoring; flap monitoring; ophthalmology; wound healing, fMRI-validation techniques; and in-vitro dissolved oxygen monitoring in cell culture and bioreactors.

OxyFlo™ Pro is the company’s third-generation, two- or four-channel laser-Doppler tissue blood flow monitoring instrument. Oxford Optronix is a pioneer in the development of laser-Doppler based blood flow monitoring (LDF) technology and its latest touch-screen, high-performance system sets a new standard in sensitivity and ease of use. An ideal system for measuring changing tissue blood flow in acute experimental models, OxyFlo™ Pro offers applications in peripheral vascular disorders; cerebral perfusion monitoring in models of stroke and brain injury; tumour perfusion monitoring/angiogenesis; blood flow in free flaps and pedicle flaps; wound healing; and gastroenterology.

Commenting on the combined system, Dr Hai-Ling Margaret Cheng of University of Toronto, Hospital for Sick Children in Canada said: “In our studies on the response to gas inhalation in abdominal organs, OxyLite and OxyFlo allowed us to monitor tissue pO2 and perfusion response simultaneously in the liver and kidney. No other minimally invasive system could capture dynamic changes with such fine temporal resolution, and no other system could provide concurrent pO2 and perfusion measurement in multiple tissue regions. Oxford Optronix enabled us to understand the physiological phenomena underlying our magnetic resonance imaging measurements. It is truly a powerful, must-have technology.”

Andy Obeid PhD, CEO of Oxford Optronix added: “The release of our new OxyLite™ Pro and OxyFlo™ Pro systems is the culmination of 5 years of continued product development in this area for us.” He added: “We work closely with our customers to develop targeted solutions that offer unmatched sensitivity, stability and accuracy coupled with total ease-of-use. The introduction of our third-generation platform, enables us to continue providing the ‘gold-standard’ in tissue vitality monitoring that our customers have come to expect.”

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Specialty Practices Find Smoother Path to EHR Adoption and Meaningful Use Certification with Digital Writing Technology from Anoto

Anoto, the world leader in digital writing technology, today announced that its solutions are being increasingly adopted by specialty practices as a result of its ease of use and streamlined approach in the transition to electronic health records (EHR). It is critical for specialty physicians adopting EHR technologies to have as little disruption in day to day activities as possible.

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Avita Health System Establishes Enterprise-Wide Meaningful Use Attestation Strategy Leveraging QuadraMed

QuadraMed® Corporation announced that Avita Health System has established QuadraMed’s electronic health record (EHR) as a critical component of its Stage 1 Meaningful Use attestation blueprint for its hospitals. To launch this strategy, Avita Health System leveraged best practices from Galion Community Hospital, the first hospital in its network to achieve Stage 1, as it attested while also streamlining administrative processes, better tracking performance measures, and setting more targeted quality care and reporting goals for the future. Galion Community Hospital rolled out QuadraMed’s Computerized-Patient Record (QCPR) EHR last year to support its Stage 1 efforts.

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