Commentary
By Kenneth A. Kleinberg, Managing Director, Research and Insights, The Advisory Board Company
Paper and language are as old as civilization itself, but when it comes to locating and controlling the spread of infectious diseases, IT can help.
As we transition to a more complete digital health environment, we can use technology advances to keep infections that used to kill tens of millions in check. With Ebola in the news, just about every vendor, provider and health-related industry or government body is stepping forward with their guidelines – but how will these be put into effect? And how will they become part of a more comprehensive and scalable, coordinated approach inclusive of other types of health threats?
Here are five technologies that are key to effective infectious disease control:
Communications: Expert sources need to ensure they can get the word out (e.g., guidelines) to the right people within and across organizations in a timely manner. Email, text alerts, portal postings, interactive voice response (IVR) and social media (e.g., Twitter) can be used to reach (and receive information from) healthcare workers and patients, but an accurate directory and priority system must be utilized lest important information get drowned in a sea of endless messages.
Data capture and EHRs: A broader array of data capture is now possible that can extend beyond the provider’s office, such as the use of wireless tablets and smartphones and via telehealth. eForms and templates can be readily modified to capture specific information during interviews/encounters. Improved documentation tools with use of controlled medical vocabularies, natural language processing and more granular ICD-10 coding can ensure the relevant infection control-related information is captured and then later retrievable. Baking protocols/guidelines into workflow and decision support can help ensure the right steps are being followed and nothing falls between the cracks.
Locationing: The use of GPS, cell-phone position data and in-building locationing (via WiFi, RFID, etc., some of which can be expensive) can provide huge benefits. Knowing where someone has been (and when), and whom and what equipment they have been in proximity to can improve the tracking of infections back to their origin, and to track down the people and equipment that might be compromised.
Consolidated reporting: The use of electronic submission of infection control information to local, regional and national reporting systems and registries offers many advantages to paper and batch-type approaches of the past.
Big Data and analytics: Experience being gained in BI/analytics and data visualization can be used to discern trends and to make predictions so that action can be carried out (e.g., targeted communications, proper distribution of vaccines).
Analytics
Salesforce launches powerful self-service analytics tool
Wave aims to make it easier than ever for companies to quickly deploy sales, service and marketing analytics, or build custom mobile analytics apps, using any data source. Users get a dynamic user experience, indexed search and a powerful computing engine integrated into a single cloud platform. They can also create mash-ups of relevant third-party data sources in a single dashboard to identify data correlations and develop action plans. Dashboards can then be shared via Salesforce Chatter, and new workflows and tasks can be triggered.
Wave is integrated with the Salesforce1 Platform and uses the same trusted, single sign-on data security and compliance features of the core platform. Developers can use Wave application programming interfaces (APIs) and other data connectors to easily link to third-party data sources – from structured SAP and Oracle data to unstructured machine and social data.
The Wave platform license includes all compute, data management, API and security infrastructure. Monthly subscription pricing is based on the number of Wave Explorer and Wave Builder licenses. The Wave mobile app is available on Apple iOS for iPhone and iPad, with additional device support forthcoming.
IBM has a similar new cloud-based utility, called Watson Analytics, that was highlighted in HMT in November.
Electronic Records
Why EMRs are a good thing
Advanced EMR capabilities really can improve hospital performance and mortality rates – and HIMSS Analytics says it has the numbers to prove it.
Using HIMSS Analytics’ Electronic Medical Record Adoption Model (EMRAM) and mortality rate measures collected by Healthgrades across 19 unique procedure- and condition-based clinical cohorts, a new analysis found that hospitals with advanced EMR capabilities (as reflected in high EMRAM scores) demonstrated significantly improved actual mortality rates, most notably for heart attack, respiratory failure and small intestine surgery.
4,583 facility records were selected from the HIMSS Analytics Database, representing the total number of facilities with complete data from 2010 through 2012. “EMR Effectiveness: The Positive Benefit Electronic Medical Record Adoption has on Mortality Rates,” the whitepaper describing the study, methodology and findings, is available at www.himssanalytics.org.
Health Imaging Exchanges
State-of-the-art VNA installation is one of world’s largest
After four full years of multi-phased, multi-location go-live events, Milwaukee-based TeraMedica’s Evercore Vendor Neutral Archive (VNA) state-wide Health Imaging Exchange (HIE) installation that serves 110 clinical facilities and more than 7 million patients in New South Wales (NSW), Australia, is finally complete. The system connects nine different PACS vendor solutions processing more than 3 million imaging procedures annually in an area as large as the state of Texas. Project management was handled by the government agency HealthShare NSW.
The solution supplies true PACS-to-PACS and RIS-to-RIS sharing of images and reports, providing interoperability among data from disparate applications with shared formatting and centralized archiving. All facilities participating in the HIE use existing patient identifiers, with a comprehensive state-wide patient registry reconciling and managing varied patient information across sites. Every facility stores its imaging and all cross-department clinical data in centralized patient folders in the TeraMedica Evercore VNA.
When it receives an imaging order, the HealthShare NSW system automatically performs real-time searches for all previous studies and results associated with the patient across all participating facilities. It also automatically inserts a link into a patient’s electronic medical record (EMR), providing quick access to lightweight, compressed images and reports at the point of care.
Learn more about TeraMedica VNA solutions at www.teramedica.com.
Meaningful Use
Disappointing data prompts renewed cry for change
After lower-than-expected Medicare numbers and nationwide difficulty in meeting federal guidelines for electronic health records (EHR) requirements were reported in early November, industry leaders nationwide called for a renewed effort by the Centers for Medicaid and Medicare Services (CMS) to shorten the Meaningful Use (MU) reporting period in 2015 and provide more program flexibility.
According to newly released figures from CMS, less than 17 pertcent of the country’s hospitals have demonstrated Stage 2 capabilities, and less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either stage of Meaningful Use in 2014. While eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities so far.
Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing yet predictable, according to a CHIME statement November 4.
The new Meaningful Use participation data “continue to underscore the need for a sensible glide-path in 2015,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO. “Providers have struggled mightily in 2014, in many instances for reasons beyond their control. If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with Meaningful Use.”
CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015, and more than 260,000 EPs will need to be similarly positioned. Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365 days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.
A coalition of national provider groups has repeatedly told CMS that a shortened reporting period will have a dramatic, positive effect on program participation and policy outcomes sought in 2015. Additionally, allowing flexibility in how providers meet the Stage 2 requirements, particularly related to Transitions of Care and View, Download, Transmit measures, would also improve program participation.
Source: CHIME
