EHR and Health IT Consulting
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Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Amazing Steps To Encrypt Your Patient Data

Amazing Steps To Encrypt Your Patient Data | EHR and Health IT Consulting | Scoop.it


Think your practice is too small for a data breach to occur? Think again. It’s vital to stay on the right side of HIPAA requirements for data security. This isn’t always easy and can cost a 
significant amount, but in general, locking down data is less expensive than damage control after a breach.

Breaches of patient information are on the rise—138% from 2012 to 2013, according to breach data reported to the Department of Health and Human Services (HHS). And no system is completely theft-proof. However, there are steps you can take to make your privacy harder to invade. That’s important because many data thieves are opportunists who will bypass difficult targets in search of easier quarry.

  1. Consider hiring a security expert and conducting a thorough vulnerability assessment. It isn’t cheap, but there are payoffs for practices that consider this an investment.
  2. Partner with strong IT vendors and services. Is your EHR as theft-proof as possible?
  3. Encrypt all transmission of electronic private health information, including texts and emails.
  4. The biggest threat to data security in your office could be your most loyal employees. Train your staff to be vigilant about email and web use, and develop a policy for BYOD (bring your own device). Many patients and employees now use their own mobile devices—everything from smart phones, laptops and tabletsto wearables—in the workplace. BYOD policies must ensure patient data remains secure.
  5. At the other end of the technology spectrum, paper-based data breaches still account for substantial amounts of data loss. In 2012, for example, there were 50 reports of data loss to HHS involving paper documents, representing information for 386,065 individuals. If your office still has file cabinets full of paper folders, consider scanning then shredding or removal to a secure storage site.
  6. Many small and midsized medical practices are weighing the pros and cons of purchasing cyber or data breach insurance to mitigate the financial risks of a breach. This might be a good option for your office.
  7. Lead by example. HHS offers CME-eligible online educational programs that can help physicians understand what’s required to comply with HIPAA privacy and security rules.

 

If a data breach does occur, inform those affected as soon as possible, and identify the information that has potentially been compromised. Keep in mind you won’t be able to do this if you don’t know what data resides in your practice or what systems are networked.

Technical Dr. Inc.'s insight:

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CywareCo's curator insight, August 26, 2016 6:32 AM
Healthcare security can no longer be ignored. The details of your entire life in the hands of a hacker who is willing to sell it for money will lead to identity theft - https://cyware.com/journal/healthcare-security-ignored/
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How Health IT Enables Safer Medical Travel & Tourism 

How Health IT Enables Safer Medical Travel & Tourism  | EHR and Health IT Consulting | Scoop.it

IT innovation, global medicine and frustrated medical patients drive the demand for medical travel. But telemedicine also improves patient care and the customer experience of medical travelers. Once again, we welcome medical IT entrepreneur, Agha Ahmed, Managing Partner of GHIMBA, as we explore how IT innovations help patients get high-quality healthcare outside of the USA.

 

How do IT innovations help provide services that medical travelers can benefit from?

 

IT helps deliver safe medical care and a pleasant trip to facilities overseas. For more than 20 years, IT innovations have improved patient care worldwide. Now, these innovations are helping medical travelers, too.

 

How so?

 

In telemedicine and m-health, telecommunications, mobile devices and information technologies provide clinical health care at a distance. (M-health is the practice of using mobile technology in healthcare.) There are three important devices and software capabilities that help deliver the promise of medical travel:

 

  • First, there are electronic media records. With an EMR system, it’s easy to gather patient clinical notes, diagnostic scans, medical administrator records, and discharge summaries in digital form. By automating and streamlining clinical workflow, IT cuts the time and effort needed to maintain information and create the data trail needed for medical audits and QA procedures.

 

  • Then, there are smartphones. Our familiar hand-held computers are becoming an important enabler in the cloud-based healthcare infrastructure. An EMR system deployed in the cloud can make a smartphone a virtual healthcare wallet. Patients can access their medical records from a smartphone and share the information with overseas healthcare providers.

 

  • Finally, data mining and analytics. Data mining and analytics technologies combine, prepare and search massive data stores gathered from many sources. Combined with analytics software, a cloud-based EMR system provides easy access to the knowledge and insight that overseas doctors can use to identify medical problems. And, patients can learn about cost-effective treatment for specific diseases and conditions without leaving home.

 

These innovations work with participants in the medical travel industry to deliver value to patients and business opportunities to entrepreneurs.

 

What’s the most important thing that IT provides patients and entrepreneurs?

 

Powerful data sharing and analysis, anywhere in the world. Cloud computing and modern IT devices make it easy to transfer, analyze and share massive amounts of medical data, quickly and safely. IT contributes medical services that patients and overseas healthcare providers can be confident in. There are three notable capabilities.

 

  • IT makes comprehensive medical information accessible. All patient-related data is stored in a single, authoritative source in a cloud computing center. Centralized data management makes it easier for qualified medical travel solution providers to identify gaps in information and synchronize the data and people involved at each step in patient care.

 

  • IT helps patients get the best care available. By hosting medical records, cloud computing centers become part of an ecosystem, which includes globally accredited hospitals and clinics. Healthcare providers anywhere in the world get easy access to medical information before patients arrive. Or, patients can use their smartphones to download information when they arrive. When highly qualified practitioners analyze and share medical information, patients benefit.

 

  • IT provides patients with a smoother, more pleasant trip. Internet data searches and medical travel solution facilitators reduce the time, effort and worry of finding, traveling to and engaging medical facilities overseas.

 

Cloud computing and other IT innovations can help make offshore treatment a safe, cost-effective alternatives to U.S. healthcare. These innovations can be used with medical travel facilitators and solution providers to deliver world-class medical services.

 

Where can we find out more about IT and medical travel?

 

Telemedicine is a major topic in an upcoming conference, the Medical Travel and Global Healthcare Business Summit in Tampa, Florida. If you’re wondering about medical travel business opportunities, you’ll want to check out the conference, which will be held on June 14th through 17th. The summit is designed for healthcare and wellness providers, IT services business leaders, and hospital and clinic administrators.

 

The conference discusses business and technical aspects of medical travel, including how IT, telemedicine and m-health support travel logistics and patient care. The emphasis is on finding and making the most of the many business opportunities available to entrepreneurs and healthcare industry professionals.

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Richard Stern's curator insight, July 8, 2016 9:15 AM

Safety and Health are priority issues when travelers have business travel needs on a regular basis. Technology innovations contribute to the likelihood of a better outcome. 

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Should You Test Your EHR Data Backup and Restore Process?

Should You Test Your EHR Data Backup and Restore Process? | EHR and Health IT Consulting | Scoop.it

It’s common knowledge that backing up data for your medical practice is critical forprotecting against devastating losses of patient data in the event of a natural disaster, system glitch, or hardware failure. But practices should go further than simply backing their data up; testing these backup and restoration processes is just as important for ensuring data safety as the initial backup itself.

 

Why Backups are Important

 

For practices that utilize EHRs, having backups is critical for a number of reasons. While the first scenario that many imagine is a catastrophic loss of data resulting from a server malfunction or local event, this is not the only reason to have a data backup.

Experts recommend backups to protect againstsecurity breaches or viruses, to provide continuity of care across multiple providers or in the event of an outage, andthe protection ofvaluable assets for research and analytics.

Medical practices should establish scheduled, automatic backups as well as perform manual backups after making any system changes.

 

Your Backup is Only as Good as its Restore

 

When preparing an EHR data backup procedure, it’s important to remember that the value of your backup is congruous to the quality of the restore. A backup is no good if the restore is incompatible with current hardware or software, which is just one example of what can go wrong.

 

Particularly for practices using an EHR vendor, it’s essential to confirm compatibility of the restore with current systems. This restore must also be promptly accessible, and establishing synchronization with an EHR vendor is importantfor this timeliness. Checking post-restore integrity as a routine part of testing can ensure that once your restore is complete, your data will be accessible and useable.

 

How Will You Know if Your Backup is Good?

 

One of the most effective ways to know if your backup is good is to run a test. The test should exercise the system using common work processes that access multiple types of data.  The worst case is when a practice believes they have beensuccessfully backing up their data, only to find out that the backups are incomplete.

 

Other restore fail scenarios include practices that have discovered that theyhave only been backing up their software (URL: http://www.americanehr.com/blog/2011/12/data-backup-information-protection/), not their data. This kind of loss can be devastating for patients and providers alike, and regularly running tests can protect against these situations.

 

Scheduling Your Backups

 

Aside from testing the functionality of backups,strategically determining the times that these systems will run will prevent interference with staff or clinic activities. Frequency also depends on how much data the practice can afford to lose. If a backup runs weekly, this means that a worst-case scenario could result in the loss of six days’ worth of data.

 

Depending on practice volume, agenda, and other factors, setting goals and quantifiable standards for backups ensures alignment with best practices.

 

Conclusion

 

Protection against disaster-borne data loss, along with the convenience of external management,has led many practices to choose third parties or their EHR vendor to administrate backups.  Don’t rely on external entities to validate your backups.  Internally test and verify your systems restore process too.

 

At ZH Healthcare, our BlueEHS services offer complete peace of mind with multiple layers of protection, including automated backups and “snapshot” components which can be used to restore your systems quickly. In addition, we offer on-demand download access from the cloud, and in-house data storage. 

 

 

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How To Measure What We Cannot See In Healthcare

How To Measure What We Cannot See In Healthcare | EHR and Health IT Consulting | Scoop.it

These days it seems that everyone in healthcare is buzzing about big data and analytics, and no wonder. Transforming, if not reimagining, healthcare is going to take everything we’ve got. Achieving the triple aim of higher quality, better access and lower cost of care cannot be done without being able to measure what we do. As the old adage says, “if you can’t measure it, you can’t improve it”. To that I might add, “if you can’t see it, you can’t improve it”.

 

Anyone who has walked the halls of a hospital or clinic knows there is no shortage of data. We just aren’t very good at knowing exactly how to get our arms around it. Data is only meaningful if it is organized in ways that we can truly comprehend what it is telling us. Today, the smart money is on technologies that help us visualize and therefore understand data without the need of a PhD in advanced analytics.

 

One such tool is something we call Power Map for Excel. This 3D visualization add-in is now a centerpiece (along with Power View, Power Query, and Power Pivot,) within the business intelligence capabilities ofMicrosoft Power BI in Excel.

 

Information workers with their data in Excel have realized the potential of Power Map to identify insights in geospatial and time-based data that traditional 2D charts cannot communicate. For instance, digital marketers can better target and time their campaigns while environmentally-conscious companies can fine-tune energy-saving programs across peak usage times. These are just a few of the examples of how location-based data is coming alive for customers using Power Map and distancing them from their competitors who are still staring blankly at a flat table, chart, or map.

 

Please take a look at the video below. Then ask yourself, what if instead of mapping U.S. Power Production we were looking at:

 

  • Syndromic surveillance of the geospatial distribution and severity of an infectious disease

 

  • A real-time map of a hospital system’s nosocomial infection rate

 

  • A representation of the incidence of chronic disease plotted against the geographic distribution of toxins in air, soil and water

 

  • A facilities, capabilities and occupancy map of a region’s readiness for accountable care
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American EHR Call For Submissions.

American EHR Call For Submissions. | EHR and Health IT Consulting | Scoop.it

Do you have a story to tell or experiences using health information technology? How would you like to share those experiences with American EHR’s 26,000+ members who represent all 52 states and territories and 152 medical specialties?

 

Whether positive or negative, shared experiences surrounding the usage of EHR’s or other technologies such as mobile apps or web-based tools are extremely valuable to clinicians, ancillary caregivers, and staff who work in clinical patient settings.

 

Whether you’re a primary care clinician, a practice administrator, or a technology expert, please take a few moments to share your experiences and insights.

 

What are we looking for?

 

500–700 word articles on topics such as the following:

  • Interopability
  • Connected Health
  • E-Prescribing
  • Data exchange (or the lack thereof)
  • Clinical decision support
  • Clinical mobile apps
  • Tips on time-saving
  • Areas in which technology use is challenging
  • Interacting with patients using portals or personal health records
  • MACRA and Meaningful Use

 

All submissions are reviewed by our editorial team prior to publication, and must be educational in nature. Open to clinicians, practice managers, consultants, CIO’s, or other health IT professionals.

 

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What is Big Data for Healthcare IT?

What is Big Data for Healthcare IT? | EHR and Health IT Consulting | Scoop.it

Big data is a term commonly used by the press and analysts yet few people really understand what it means or how it might affect them. At it’s core, Big Data represents a very tangible pattern for IT workers and demands a plan of action. For those who understand it, the ability to create an actionable plan to use the knowledge tied up in the data can provide new opportunities and rewards.

 

Let’s first solidify our understanding of Big Data. Big Data is not about larger ones and zeros nor is it a tangible measurement of the overall size of data under your stewardship. Simply stated, one does not suddenly have “big data” when a database grows past a certain size. Big Data is a pattern in IT. The pattern captures the fact a lot of data collections that contain information related to an enterprise’s primary business are now accessible and actionable for that enterprise. The data is often distributed and in a variety of formats which makes it hard to curate or use, hence Big Data represents a problem as much as it does a situation. In many cases, just knowing that data even exists is a preliminary problem that many IT workers are finding hard to solve. The peripheral data is often available from governments, sensor readouts, in the public domain or simply made available from API’s into other organizations data. How do we know it is there, how can we get at it and how can we get the interesting parts out are all first class worries with respect to the big data problem.

To help illustrate the concepts involved in Big Data, we will use a hospital as an example. A hospital may need to plan for future capacity and needs to understand the aging patterns from demographics data that is available from a national census organization in the country they operate in. It also knows that supplementary data is available in terms of finding out how many people search for terms on search engines related to diseases and the percentage of the population that smokes, is not living healthy lifestyles and participates in certain activities.  This may have to be compared to current client lists and the ability to predict health outcomes for known patients of a specific hospital, augmented with the demographic data from the larger surrounding population.

 

The ability to plan for future capacity at a health institute may require that all of this data plus numerous other data repositories are searched for data to support or disprove the hypothesis that more people will require more healthcare from the hospital in ten years.

 

Another situation juxtaposed to illustrate other aspects to Big Data could be the situation whereby a single patient arrives at the hospital with an unknown disease or infection. Hospital workers may benefit from knowing the patients background yet may be unaware of where that data is. Such data may reside in that patients social media accounts such as FourSquare, a website that gamifies visits to businesses. The hospital IT workers in this scenario need to find a proverbial needle in a haystack. By searching across all known data sources, the IT workers might be able to scrape together a past history of the patient’s social media declarations which might provide valuable information about a person’s alcohol drinking patterns (scraped from FourSquare visits to licensed establishments), exercise data (from a site like socialcyclist.com) and data about their general lifestyle (stripped from Facebook, Twitter and other such sites). When this data is retrieved and combined with data from LinkedIn (data about the patients business life), a fairly accurate history can be established.

 

 By combining photos from Flickr and Facebook, Doctors could actually see the physical changes in the way a patient looks over time.

 

The last example illustrates that the Big Data pattern is not always about using large amounts of data. Sometimes it involves finding the smaller atoms of data from large data collections and finding intersections with other data. Together, these two hospital examples show how Big Data patterns can provide benefits to an enterprise and help them carry out their primary objectives.

 

To gain access to the data is one matter. Just knowing the data is available and how to get at it is a primary problem. Knowing how the data relates to other data and being able to tease out knowledge from each data repository is a secondary problem that many organizations are faced with.

 

Some of our staff members recently worked on a big data project for the United States Department of Energy related to Geothermal prospecting. The Big Data problem there involved finding areas that may be promising in terms of being able to support a commercially viable geothermal energy plant that must operate for ten or more years to provide a valid ROI for investors. Once the rough locations are listed, a huge amount of other data needs to be collected to help determine the viability of a location.

Some examples of the other questions that need to be answered with Big Data were:

 

  1. What is the permeability of the materials near the hot spot and what are the heat flow capabilities?
  2. How much water or other fluids are available on a year round basis to help collect thermal energy and turn it into kinetic energy?
  3. How close is the point of energy production to the energy consumption?
  4. Is the location accessible by current roads or other methods of transportation?
  5. How close is the location to transmission lines?
  6. Is the property currently under any moratoriums?
  7. Is the property parkland or other special use planning?
  8. Does the geothermal potential overlap with existing gas and oil claims or other mineral rights or leases?
  9. Etc…

 

All of this data is available, some of it in prime structured digital formats and some of it not even in digital format. An example of non-digital format might be a drill casing stored in a drawer in the basement of a University that represents the underground materials near the heat dome. By studying its’ structure, the rate of heat exchange through the material can provide clues about the potential rate of thermal energy available to the primary exchange core.

 

In order to keep track of all the data that exists and how to get at it, many IT shops are starting to use graphs and graph database technologies to represent the data. The graph databases might not store the actual data itself, but they may store the knowledge of what protocols and credentials to use to connect to the data, what format the data is in, where the data is located and how much data is available. Additionally, the power of a graph database is that the database structure is very good at tracking the relationships between clusters of data in the form of relationships that capture how the data is related to other data. This is a very important piece of the puzzle.

 

The conclusion of the introduction post to Big Data is that Big Data exists already. It is not something that will be created. The new Big Data IT movement is about implementing systems to track and understand what data exists, how it can be retrieved, how it can be ingested and used and how it related (semantically) to other data.

 

The real wins will be when systems can be built that can automatically find and use the data that is required for a specific endeavor in a real time manner. To be truly Big Data ready is going to require some planning and major architecture work in the next 3-5 years.

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Use of electronic health record documentation by healthcare workers in an acute care hospital system.

Acute care clinicians spend significant time documenting patient care information in electronic health records (EHRs). The documentation is required for many reasons, the most important being to ensure continuity of care. This study examined what information is used by clinicians, how this information is used for patient care, and the amount of time clinicians perceive they review and document information in the EHR. A survey administered at a large, multisite healthcare system was used to gather this information. Findings show that diagnostic results and physician documents are viewed more often than documentation by nurses and ancillary caregivers. Most clinicians use the information in the EHR to understand the patient's overall condition, make clinical decisions, and communicate with other caregivers. The majority of respondents reported they spend 1 to 2 hours per day reviewing information and 2 to 4 hours documenting in the EHR. Bedside nurses spend 4 hours per day documenting, with much of this time spent completing detailed forms seldom viewed by others. Various flow sheets and forms within the EHR are rarely viewed. Organizations should provide ongoing education and awareness training for hospital clinical staff on available forms and best practices for effective and efficient documentation. New forms and input fields should be added sparingly and in collaboration with informatics staff and clinical team members to determine the most useful information when developing documentation systems.

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How social media changed this oncologist's life

How social media changed this oncologist's life | EHR and Health IT Consulting | Scoop.it

I have been drawn to social media (SM) both personally and professionally for many years now, but I still feel like an outlier in using it professionally. There have been ASCO education sessions on this topic, educational book articles, publications, and the like, but many of these take the approach that people don’t really understand SM and what it offers.

 

 

I fear that there is a different issue, that perhaps many health care professionals do think that they understand SM and that they have consciously decided not to use it professionally. Maybe they signed up for Twitter with their children’s help and found their feeds rapidly filled with tweets about Kim Kardashian, or they got Facebook friend requests from patients and quailed at the potential conflict of interest. Perhaps they mentioned it to colleagues or their chairperson and discovered that SM was dismissed or perhaps actively discouraged as something that had little benefit to a professional career. Instead of another lecture on how to sign up for SM, I thought I would share my experience, along with specific examples of how SM has directly led to professional benefits.

 

 

There is nothing inherently good or bad about SM. To put it simply, social media is media that is social; e.g., you can use it to interact with other people. Normal media is one direction only, to be received by you. You can yell at your television during the presidential debates, but Hillary, Bernie, Ted, and Donald can’t hear you. Social media allows you to interact with whoever is providing the information. If you disagree, please let me know in the comments below.

 

 

I first saw the potential of SM about 8 years ago, when I met Dr. Jack West, who was looking for oncologists to help provide content for his patient education website. I found that I could write blogs on lung cancer trials and get immediate feedback from patients and other doctors on my thoughts. More importantly, I could interact on the discussion boards with patients with lung cancer from all over the globe who wanted to understand their disease better, and I could help them make sense of a world turned upside down.

 

I was amazed at both the profound reach and the immediacy of it, and I was able to build somewhat of a professional reputation in lung cancer very early in my career by talking about issues in real time without being constrained by publication paywalls and schedules. I distinctly remember one reception at the ASCO Annual Meeting, where a senior investigator I barely knew walked up to me out of the blue and told me that she liked my take on her research, leading to a (small) role for me in a grant application she was submitting.

 

I have always been a news junkie, but joining Twitter in 2010 opened up a whole new dimension. At first I simply “followed” the few early-adopting oncology experts but didn’t think much of it. Over time, however, I realized that just about everything I was interested in was out there to be discovered in almost real time. I followed the beat reporters for my favorite sports teams and reporters from the New York Times and Washington Post, and was able to get (free) news around the clock while other people were waiting for the morning paper to learn anything new.

 

 

first saw the potential of SM about 8 years ago, when I met Dr. Jack West, who was looking for oncologists to help provide content for his patient education website. I found that I could write blogs on lung cancer trials and get immediate feedback from patients and other doctors on my thoughts. More importantly, I could interact on the discussion boards with patients with lung cancer from all over the globe who wanted to understand their disease better, and I could help them make sense of a world turned upside down.

 

I was amazed at both the profound reach and the immediacy of it, and I was able to build somewhat of a professional reputation in lung cancer very early in my career by talking about issues in real time without being constrained by publication paywalls and schedules. I distinctly remember one reception at the ASCO Annual Meeting, where a senior investigator I barely knew walked up to me out of the blue and told me that she liked my take on her research, leading to a (small) role for me in a grant application she was submitting.

 

I have always been a news junkie, but joining Twitter in 2010 opened up a whole new dimension. At first I simply “followed” the few early-adopting oncology experts but didn’t think much of it. Over time, however, I realized that just about everything I was interested in was out there to be discovered in almost real time. I followed the beat reporters for my favorite sports teams and reporters from the New York Times and Washington Post, and was able to get (free) news around the clock while other people were waiting for the morning paper to learn anything new.

 

In the past year, my latest SM endeavor has been blogging on ASCO Connection. A blog post is just an essay on a topic you feel strongly about, and ASCO Connection is nice enough to put the words up for colleagues to read. It is a wonderful feeling to have something to say and to be able to write it down and put it out there for others to see and comment on, and — given the size of ASCO’s membership — this platform reaches quite a few people.

 

So why get involved in SM as an oncology professional? Aside from the benefits of gathering information, it gets your name out there, especially early in your career. Many senior oncologists don’t think they need to be on SM, leaving a huge void that still is very open for junior people to fill. While professionals might not be on SM, patients, organizations, and traditional media are. When you are one of only a dozen experts in your field active on Twitter, you have a disproportionate influence. My involvement in GRACE led to numerous opportunities and connections, including an invitation to join ASCO’s Integrated Media and Technology Committee and opportunities to work with ASCO University online. In one interesting twist, a blog post I wrote on the stigma of tobacco and lung cancer led to an invitation to participate in a Congressional Briefing on Capitol Hill.

These are just a few examples from my own experience that I hope allow you to see some of the potential of SM to benefit your life and career. The full potential of oncology social media can’t be realized until a critical mass of professionals is actively participating, but many continue to resist. I strongly encourage you, especially junior professionals, to set up a Twitter account and start to follow some people you know. If you gave up on it in the past, try again, and don’t be afraid to ask for help if you feel you aren’t getting what you want out of it. Try it, and I think you’ll see the potential just as I did.

 

 

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Electronic Health Record Solutions Don’t Make Errors, People Do It

Electronic Health Record Solutions Don’t Make Errors, People Do It | EHR and Health IT Consulting | Scoop.it

HealthITNews reports that the Centers for Disease Control and Prevention is expressing increased alarm about patient care errors that are being introduced as a result of poorly designed or poorly implemented electronic health record solutions. The US Food and Drug Administration has also be weighing in lately on whether Health IT solutions should be more tightly regulated.

 

Whether or not more regulatory oversight of Health IT is needed, I suspect many of us have experienced instances where health information about us is found to be in error. I recall when my mother was hospitalized for chest pain that doctors were treating her as though she had been a life-long smoker. In fact she had never, ever been a smoker. At some point in time, information about smoking history had been erroneously entered into the electronic record. Now, the doctors treating her for chest pain were making decisions about the likelihood of heart disease based in part on that information about smoking history. In my own medical records I have also found, and had to correct, occasional errors in medication history, allergies, and immunizations over the years.

 

Despite this, I would tend to put the blame not on the computer or the software. It is not generally these systems making the errors, but rather the people using them. Sometimes the wrong information has been entered into the system, as in the case of my mother. Sometimes, errors are made because the information being displayed is in the wrong chronological order or is buried in a user interface that is out of synch with real-world, clinical workflow. In both instances, the problem is with people—those who designed the software and those who use it, but not with the software itself or the machines running it. How can we improve on this situation? Here are four ideas:

 

 

Involve the Patient Right from the Start

 

In gathering the information that becomes the foundation of our medical records, we are putting too much burden on caregivers. How much of the complete medical history or SOAP note is information that comes directly from the patient? Chief complaint, history of present illness, past medical history, social, family and occupational history, medications, allergies, review of systems? All of this information is retrieved by “interviewing” the patient. Perhaps it would be more efficient and more accurate if the patient himself entered all that information into a kiosk, or some other kind of fully automated, information intake solution. Surely with today’s technology we could design systems that would do a more consistent and comprehensive patient interview and subsequent documentation of information without taking even a minute of clinical staff time. Patients could then review the information captured about them for accuracy before it was officially entered into their record. 

 

 

Ease the Documentation Burden on Clinicians 

 

We need to ease up on documentation requirements for clinical staff. The patient-centered machine capture solution mentioned above would help remove a lot of the documentation burden. The remaining documentation of the exam, differential diagnosis, and treatment plan could be better facilitated by free text, medical dictation solutions with natural language processing and coding technology on the back end. Nothing is more important that freeing our clinicians of the time currently being spent doing data entry.

 

 

Prohibit Templates, Cut and Paste

 

Templates simply don’t work because it is impossible to template the “patient story” and all of the other nuances of a good clinical exam. Likewise, cut and paste solutions are probably responsible for more medical misinformation and errors than anything else. EHRs should ban “cut and paste” capabilities altogether.

 

 

Share Information with Patients

 

At the end of the day, I believe all information in the medical record should be shared with the patient. The patient is an extra set of eyes, an extra check point if you will, against medical errors. Giving patients complete and full access to the information about them is not only a better way to engage patients in their care, but also a way to help make sure everyone is on the same page about their care. As eHealth advocates proclaim, “Nothing about me, without me!” I think this is sage advice for preventing misinformation and the introduction of errors in our medical records.

 

I would also be the first to admit that many, if not most of today’s electronic health record solutions are still too hard to use. They have been poorly designed in our attempt to replicate a clinical workflow previously based on paper records. As I have stated many times before, there is a unique opportunity to design solutions that really take full advantage of today’s technology

 

 

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Techniques For Matching Patient Record Data Across Disparate EHRs & Other Systems 

Techniques For Matching Patient Record Data Across Disparate EHRs & Other Systems  | EHR and Health IT Consulting | Scoop.it

Some of the most frequent questions I receive these days surround data interoperability and integrating multiple health IT systems. One of the biggest problems in connectivity is matching patient record data and ensuring that the same patient data in different systems is linked properly. Given how many times this topic comes up, I reached out to Cameron Thompson, Acxiom Healthcare Group Managing Director. Acxiom has an interesting method of patient data matching, called persistent links, and when I saw what they were doing for matching consumer records in non-healthcare settings (e.g. marketing) I thought some of you might want to learn about it. Here’s what Cameron had to say about the various techniques for matching patient data:

 

The promise of secure and seamless exchange of patient healthcare information is powerful. As payers, providers, Health Information Exchanges (HIXs) and Accountable Care Organizations (ACOs) move rapidly toward the full deployment of electronic medical records, healthcare IT professionals are grappling with a fragmented network of systems and data silos. These disparate systems and databases often house redundant copies of patient medical data in multiple formats, which limits the ability to see a true 360-degree view of the patient. The benefits from connected patient data are many, including:

 

  • Reductions in inaccurate coverage determinations.
  • Intelligent information sharing for clinical decision making.
  • Honoring patient consents and preferences consistently and accurately.
  • Minimizing risks of data breach with a unique health identifier that allows the transfer of patient information but NOT personally identifiable information such as name and address.
  • Reduction in time and effort in administrative processes including billing or claims inaccuracies.
  • Avoiding costly duplication or unnecessary testing.

 

To reduce these inefficiencies and solve the underlying problem, the new healthcare ecosystem needs an accurate means of identifying and matching patient record data to the correct individual across internal and external healthcare systems, including collaborative care delivery models.

 

Multiple systems across the healthcare enterprise produce duplicate patient records that are not easily recognizable as matches. Recognizing that Mary Jane Smith at 123 Elm Road in the 2009 clinical laboratory system is also Mary Collins of 78 Oak Street in the 2011 patient registration system is a challenge for any organization. Identifying a solid method for distinguishing patient information across multiple data systems and combining the data accurately will be pivotal to the effective adoption of Electronic Health Records (EHRs) and successful implementation of Health Information Exchange (HIE).

 

As organizations take on this challenge, several methods have been identified and considered to recognize an individual. Three leading methods can to be explored to achieve your business goals of continuity and cost reduction. These are:

 

1. Algorithm or String-Based Matching

 

An organization can develop an algorithm with string-based matching using identifiers in the existing data to uniquely identify individuals. The benefits of string-based matching include:

  • Recognizable practice – This is a well-known practice and resources capable of creating these programs are plentiful.
  • Options for processing – Algorithms can be created internally and run without sending data outside the organization or an external organization can be identified to conduct the match on the organization’s behalf.

Some of the challenges with this strategy include:

  • Inherent challenges in string-based matching – String-based matching relies on consistencies in reported names and addresses, which tend to change often.
  • Ensuring the accuracy of the data used in the algorithm – Manually entered names and addresses are often laden with inexactness. This makes string-based matching more difficult.
  • Absorbing the costs to develop and enable this identifier across systems – Costs would need to be incurred to develop, maintain and put the identifier into use across systems.

 

2. State-Issued Number

An organization can use another state-Issued number such as a state of issuance and birth certificate number. Benefits of this method include:

 

  • Development cost savings – using existing assigned identifiers would save costs on development of a new identifier.
  • Availability – an organization could select an identifier that is already available in many systems.

Some challenges with this strategy include:

  • Inconsistent data fields and record lengths – if state issued numbers are of different lengths this could create difficulty for the programmer creating the data field.
  • Protecting personal information from fraudsters – using a state-issued number could raise concern over identity theft with the proliferation of stolen Social Security numbers. Whether real or perceived, this information being made available opens the door for fraudsters to invade an individual’s privacy.

 

3. Persistent Links

Healthcare organizations should consider the use of highly accurate match technology that delivers knowledge-based persistent linking. This match technology delivers a set of persistent links a company uses to recognize their patients across a fragmented network of systems and data silos. Persistent Link match technology is regarded as the most precise match technology available to accurately resolve patient identity (such as AbiliTec, the linking technology offered by my company, Acxiom). The link provides a consistent, client-specific ID, across data variations, and it can be applied at all touch points and databases within an organization.

 

The use of persistent links, created from knowledge-based match technology, can provide:

 

  • More accurate patient recognition and identity resolution.
  • Greater control and governance around the patient data because each healthcare entity receives a dedicated set of encoded links, specific to their enterprise. This facilitates link transactions, minimizing the amount of personal identifiable information exchanged, aligning with the need for HIPAA compliance. Further, when multiple entities interact (e.g. an Accountable Care Organization between provider and payer) a unique link reconciliation can be processed by the provider in batch or real time.
  • A minimized amount of personal information that a healthcare entity needs to store as they use encoded links to integrate data and recognize patients.
  • Eliminate an upfront investment to develop and maintain identifiers. The first two options I mentioned – algorithms/string-based matching and state-issued numbers – require healthcare entities to develop and maintain the identifiers.
  • · Creation of a refresh cadence based on specific business needs, say monthly or quarterly, reducing non-matching exposure to the cadence latency.

 

There are also some challenges related to using persistent links:

  • Persistent link application and maintenance will be more costly and an organization needs to be willing to look at the investment in higher quality.
  • The healthcare organization needs to be willing and able to transmit records with personally identifiable information in a privacy compliant manner, such as encryption.

 

As healthcare organizations move forward by adopting technology to improve patient experience they will find that the accuracy of the data will drive their success. Organizations should consider each of these methods for recognizing patients, each have their benefits and select the method that best meets specific organizations needs.

 

 

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Who Owns The Data In Your EHR ?

Who Owns The Data In Your EHR ? | EHR and Health IT Consulting | Scoop.it

The concept of healthcare and EHR data ownership carries many implications for patients, providers, and medical practices. While experts agree that EHR vendors do not own the data, this has not prevented vendors from winning court disputes that resulted in serious financial losses for medical providers.

 

These considerations make the discussion of data ownership critical for any physician or medical practice that utilizes electronic health records.

 

Defining Data and Data Ownership

 

Healthcare data comes from a variety of sources. One is the patient themselves, who individually provide data to platforms such as patient portals. Another is the physician or healthcare team in the form of examination findings and clinical observations. Results from laboratory studies or radiology, along with data from other external healthcare providers or practices, also contribute to EHRs.

 

The number of parties who lay claim to healthcare data makes grappling with EHR data ownership even more complicated. Patients, providers, vendors, and the medical practice itself all have aninvestment in healthcare data, and there is often uncertainty over EHR data ownership. Amazingly both of these groups report that 20% simply don’t know who owns the data.

 

Establishing Data Ownership

 

The best method of minimizing disputes over EHR data ownership is prevention. Measures such as establishing data ownership early, defining terms, and enforcing guidelines are critical to minimizing trouble down the road. With EHR vendors, defining conditions of data exportation in the event the practice wishes to end a business relationship is critical.

 

For all parties, the concept of access must also be clearly defined. Terms include practice or provider access to data from the vendor’s servers, as well as patient access to healthcare data via portals or other mechanisms. The most common source of disputes is when a party wishes to leave the relationship; either the practice decides to select a different EHR vendor, or a patient wishes to port their data to a new provider.

 

Vendor Red Flags

 

For a medical practice, establishing terms of EHR data ownership must begin at the time of vendor selection. Identifying warning signs during this process can help providers avoid much larger issues in the future.

 

When choosing an EHR, keep an eye out for red flags such as unstructured data formatting (i.e. PDF instead of CCDA), an inability to meet the National Coordinator for Health Information Technology’s certification requirements,or restrictive contracts thatdemand exorbitant financial charges to port data in the event of a vendor switch.

 

Establishingproductive EHR data ownership for a healthcare organization takes careful planning.

 

The ZH Healthcare HITaaS (Health IT as a Service) architecture is designed with the needs of medical professionals and their patients in mind, meaning, among other things, that you own your data, and have complete administrative control.

 

 

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The Critical Importance of Comprehensive EHR Survey Data 

The Critical Importance of Comprehensive EHR Survey Data  | EHR and Health IT Consulting | Scoop.it

In order to respond to the question of survey populations, I would like to provide a summary of the survey oversight and governance process as well as a more detailed explanation of the methodology that American EHR uses to conduct EHR surveys.

 

  • American EHR Partners is a vendor neutral eHealth data organization that has been collecting information around EHR systems for over 5 years. Over 5,800 verified clinicians surveys have been completed since the launch of the site in 2010. All of the data collected is free for physicians and professional associations. American EHR Partners does not endorse any products or services. The program provides ratings on certified EHR systems. Ratings are based primarily on surveys of physicians conducted through their professional societies. Ratings are displayed on all EHR vendors regardless of their participation in the program.

 

  • Ratings are only displayed once a minimum number ‘n’ of survey responses have been received; the current minimum value is ten ratings. The rating scores are aggregated from the relevant questions asked on the physician user surveys, and these questions are available to the public. The ‘n’ is presented for all product ratings to assist the user when interpreting the rating data.

 

  • From time-to-time, American EHR Partners develops reports based upon the data collected.

 

  • American EHR Partners has a stringent governance process. Four advisory groups have been established to provide feedback on the American EHR Partners program. These are: Physician Advisory, Professional Society Advisory, EHR Vendors Advisory and a Healthcare Stakeholder advisory that includes national organizations not represented in the first three advisory groups.

 

  • All professional society participants, automatically have a seat on the society advisory group. The purpose of this advisory board is to guide American EHR from a specialty and subspecialty perspective and to provide guidance on education, collaborative initiatives and future development in relation to specialty and subspecialty physician groups.

 

Survey sample selection

 

When conducting a survey in conjunction with a professional society partner, for example the Physician Use of EHR Systems report, a randomized sample of members from each participating organization are surveyed. As the professional society partners are regularly surveying their members on a variety of topics, and in order to prevent over-surveying, each provides a random sample of members with active email addresses in order to conduct the American EHR survey. Each survey group receives an initial invitation to complete the survey as well as 1-2 reminders. Because the sample is selected randomly from the member database, we expect that some individuals will not be using EHRs. These individuals are excluded in the survey registration process. While it is desirable to be able to survey an entire professional organization’s membership, this is not possible due to the number of additional surveys that each organization conducts of their members as well as the issue of survey fatigue.

 

Prior to collection of data for the Physician Use of EHR Systems  report, an extensive review process was undertaken to update the American EHR survey in conjunction with the American Medical Association, American College of Physicians and the American Academy of Family Physicians. In particular, American EHR worked with AMA Market Research staff to formulate new questions designed to examine the economic impact of EHR use and the role of scribes. In order to keep the overall length of the survey at its current level, AMA and American  EHR agreed to eliminate questions that were not effective and/or addressed in other parts of the American EHR  survey.

 

When the 155 question survey is conducted, all physicians are verified either directly in conjunction with their professional society through a verified sample, against the AMA Physician Masterfile or in limited situations through a manual process.

Due to the comprehensive nature of the EHR survey, the survey takes approximately 20 minutes to complete. However, the detailed nature of the data collected also provides key insights into the adoption and use of EHR systems by clinicians in varying practice sizes and by specialty.

 

We stand steadfastly behind the methodology, process, collection of data as well as the interpretation of the results as presented in our most recent report. In particular, we believe that the ability to survey physicians in conjunction with their professional organizations provides the most relevant and representative information on actual experiences in the use of EHRs.

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Why Your EHR Data Is In Migration Concerns ?

Why Your EHR Data Is In Migration Concerns ? | EHR and Health IT Consulting | Scoop.it

Migrating EHR data can look daunting. But there are many reasons a practice may wish to migrate its EHR data. But even after weighing costs and benefits of porting data elsewhere, some practices choose to avoid a potentially beneficial migration because of the complicated nature of the transition. However, there are many benefits that are well worth the effort of a successful migration of EHR data.

 

Why Do People Migrate Their EHR Data?

 

Some practices choose to migrate their data as a result of dissatisfaction with their EHR vendor. Others migrate because of a hospital acquisition, or to secure a vendor certified for Meaningful Use, or to move away from a vendor that could not certify.

 

And in the era of Big Data and analytics, it’s increasingly common to see EHR data migrations to vendors or analytics platforms with superior data management and analysis services.

 

A surge in EHR utilization has also heralded a rise in competition amongst EHR vendors. As of 2014, over 80% of office-based physicians had adopted EHRs. This rush in utilization has led to improved service offerings by vendors, spurring more movement of practice data.

 

The Cleanse: What Can You Clean Up in Your EHR

 

While data migration can be stressful for any practice or physician, the process also presents itself as an opportunity to clean up systems and organizedata. And practices don’t have to accomplish this all on their own. EHR vendors can assist with porting and cleaning up data, presenting a valuable benefit to migrating practices.

 

Thistype of project is especially helpful for the cleaning of legacy data, which is often essential to best practices (but frequently impossibly disorganized).

 

What if You Need to Convert Migrated Data?

 

If a data conversion is required, vendors can support this as well. Often, legacy data requires conversion when undergoing EHR data migration to a new system. Butin some cases, such data may not need to be immediately accessible. Experts recommend nonetheless that providers know how to access this information efficiently if the need arises.

 

Some firms may look to hire a data analyst who will have a better understanding what data you have to convert. These professionals advise that if not all your data is being converted; you need to know what is and where it’s going to be so you can get access to it.

 

Categorizing legacy data and conversions can be another great way to clean up databases, but it’s critical to generate backups and test the conversion with a small sample before full execution.

An EHR data migration is a greattime to establish a healthier vendor relationship, clean up data, and review policies for access, utility, and backups.

 

Access your Data

At ZH Healthcare, we believe that it should be easy to migrate your data and that you should always have access—no matter what. Explore our EHR, and especially OpenEMR, migration solutions like data conversion that puts the ownership and backups in the hands of medical providers and practices.

 

Our services are designed to make data transitions as simple and beneficial as possible for medical practices and professionals.

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Health Alerts App Brings Public Health Notifications to Your Mobile Device. 

Health Alerts App Brings Public Health Notifications to Your Mobile Device.  | EHR and Health IT Consulting | Scoop.it

I’m now excited to announce that AmericanEHR has recently released a mobile app called Health Alerts. The AmericanEHR Health Alerts app brings you timely information on outbreaks and incidents on public health emergency topics, including: diseases, infections, natural disasters, drug recalls, travel medicine, and more. This information is pulled directly from live feeds provided by the world’s most trusted sources for public health information, including:

 

  • Centers for Disease Control and Prevention (CDC)
  • World Health Organization (WHO)
  • US Food and Drug Administration (FDA)
  • International Society for Infectious Diseases (ISID)
  • US Department of Agriculture (USDA)
  • US Department of Health and Human Services (HHS)
  • International Society of Travel Medicine (ISTM)
  • European Centre for Disease Prevention and Control (ECDC)
  • Public Health Agency of Canada (PHAC)
  • And many more…

 

It is projected that a coordinated outbreak prevention strategy can help save tens of thousands of lives annually. The U.S. Centers for Disease Control and Prevention reported that by preventing infections from antibiotic-resistant germs through more efficient coordination among healthcare facilities and public health departments, as much as 80 percent of infections could be prevented in the next five years.

 

AmericanEHR’s Health Alerts app can not only slash the spread of these types of diseases and infections, but it provides clinicians, the public, health agencies and healthcare facilities with real time alerts and updates to stop outbreaks in their tracks. Being aware of the latest health bulletins and the symptoms to keep a watchful eye open for means lower healthcare costs, and faster, more accurate responses to health threats as they materialize.

 

The AmericanEHR Health Alerts app is free to use with an AmericanEHR account. The app is available for iOS (Apple) devices such as iPhone, iPad, and iPad Mini. It’s currently in limited release to select clinicians and patients as we gather feedback from the medical community.

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A Successful Approach to EHR Data Conversion - Healthcare Technology Consulting, EHR Implementation & Vendor Selection

A Successful Approach to EHR Data Conversion  - Healthcare Technology Consulting, EHR Implementation & Vendor Selection | EHR and Health IT Consulting | Scoop.it

As the field of healthcare IT continues to grow, there is an increasing demand for healthcare organizations to implement electronic health records (EHR). In order to ensure a successful transition into a new EHR, organizations must include the process of data conversion into their implementation plan. EHR data conversion, so

 

metimes referred to as data migration, is the process of taking data from an old health record system and transferring it into a new system. This process may occur between paper-ba

sed health records and an EHR as well as between an old EHR and a new EHR. At Afia, we have worked with multiple companies to assist with numerous data conversions. Though all conversion processes are not created equal, we have developed a three-step approach to help make the complexities easier to manage.

First Step: Establish the Scope of Data

This step is crucial and must occur at the forefront of the data conversion process. Initially, organizations must select what specific data they want converted. Organizations may decide to covert as little information as possible or they may want the scope to be more overarching and exhaustive. If there is data deemed useless in the legacy system, it is important to take note of this since some organizations may decide to not transfer such data over to the new system. It is also important to determine what level of data cleanliness the organization is comfortable with. Deciding on the level of cleanliness for data saves organizations time from fixing parts of data that don’t necessarily have to be fixed and can dramatically reduce the amount of time it takes for a successful conversion. Additionally, some parts of converting the data will have to be done manually. It’s important to outline in detail what the automated pieces of the conversion process cannot handle. Inevitably, there will be a handful of things that need to be hand entered for one reason or another. The manual conversion pieces can often get lost during the rush to get the other data converted, but without careful planning you can easily find yourself without critical information in the new system. Defining the scope at the beginning of this process prevents organizations from having to redo work and saves organizations precious time and money. It can be a painful process to get everything organized properly, but it can easily derail your entire system launch without proper planning.

Second Step: Map Out the Conversion

This requires organizations to determine where data from the legacy system will be inserted in the new system to ensure that data is properly transferred between the two systems. This part of the process focuses on making sure that the new system houses data in a way that is easy to find and interpret by healthcare personnel. Often, this requires database professionals to manipulate tables to ensure that data is transferred in the correct manner.

Third Step: Extract the Data

The last step of our approach is to extract the data from the legacy system and place it into the new system. At this point, the computer will inform organizations when data is incorrect which will require database professionals to manipulate tables to accommodate such findings or to manually change the data to ensure it is placed in the new system correctly. This is where the level of cleanliness is relevant. The level of cleanliness that the organization decides upon will influence how many extractions are required. Typically, multiple extractions are needed to ensure data is clean enough for an organization’s liking. The number of extractions will also determine the time, money, and number of people dedicated to data conversion project.

HIPAA Requirements

Lastly, it is important to keep in mind that all HIPAA requirements apply whenever discussing protected health information (PHI). Since PHI is the main source of discussion during a data conversion, it is of utmost importance that all individuals participating in the data conversion are aware of how to avoid HIPAA breaches. The most important aspect of abiding by HIPAA requirements is to ensure that the data conversion is occurring in a secure place where vendors and organizations can sort through errors and communicate about specific client information. Through experience and creative thinking, Afia has created a reliable approach to data conversion that helps to navigate through an unpredictable process. We offer data conversion services for all parts of the process and can oversee organizations through the entire process. Afia also offers our Cloud Services where organizations have the option to host their PHI with us in our secure server space to avoid HIPAA breaches.

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