Article – Trainees in Radiology and Other Specialties See Dream Jobs Disappearing

dondennison Radiology

Trainees in Radiology and Other Specialties See Dream Jobs Disappearing

…this article has been shared in many places, but if you haven’t read it, do.

Also, see this blog post response.

Article – Healthcare analytics market to exceed $10bn by 2017

dondennison Healthcare IT ,

Healthcare analytics market to exceed $10bn by 2017

…digitize, codify, manage/secure, consolidate/exchange and analyze.

Article – EHR Adoption Report: The Latest Trends

dondennison Healthcare IT

EHR Adoption Report: The Latest Trends

Some interesting tidbits…

The Office of the National Coordinator (ONC) for Health Information Technology’s most recent data briefs, reporting hospital adoption of EHR technology based on American Hospital Association (AHA) data, indicated the number of nonfederal acute-care hospitals with EHR systems–also known as electronic medical record (EMR) systems–has more than tripled since 2009, increasing from 12.2 percent to 44.4 percent.

Use of electronic active medication lists and clinical decision support rules increased to 87 percent, from 62 percent and 66 percent, respectively. The percentage of hospitals using computerized provider order entry (CPOE) jumped 167 percent, from 27 percent in 2008 to 72 percent in 2012.

The ACP/AmericanEHR study showed user satisfaction fell 12 percent from 2010 to 2012, with the percentage of very dissatisfied clinicians increasing by 10 percent. Thirty-nine percent of physicians would not recommend their EHR to a colleague. The numbers were similar for physicians in a variety of practice settings.

…physicians do not like being forced to use electronic technologies and that EHRs do not measure up to what they are used to in their day-to-day lives, which include iPad apps and smartphones, saying that record systems are fairly rigid with a flat interface.

Article – Get set: New HIPAA has teeth

dondennison Policy

In this article, the new HIPAA Privacy and Security final rule—also known as the HIPAA Omnibus Rule—which became effective on March 26, 2013, is discussed.

Some thoughts…

  • Access to protected health information by 3rd parties, such as vendor support staff, is mentioned. In the related article referenced at the bottom (note: link is broken; corrected link here), it mentions that “Third parties account for 40 percent of the breaches reported and 75 percent of the records exposed”. It will be interesting to see how effective a vendor’s support staff will be when they are unable to analyze data referenced in a reported problem; invalid or corrupt data is a common enough problem that analyzing the original data to eliminate this as a root cause of the problem is a routine task. Also, wide scale analysis of databases to detect frequency of missing or invalid data elements is also a common method. If this data is not made available, or is stored in an encrypted form (at rest), it will be interesting to see how effective current support methods and tools will be (may need to be updated).
  • Same question as above for Business Intelligence (BI) applications that often mine databases (and sometimes files) containing patient record information.
  • Encryption of data on disk (by the storage subsystem or the application) is relatively common (often as an option), but encryption of the database files is less common (though technically feasible with many database management systems). It seems to me that most of the detected and reported breaches are of laptops and portable media (e.g. USB drives).
  • I wonder, if this rule is heavily enforced, if the fines will become enough of a revenue source to be viewed as a way of offsetting the costs of enforcement, or even funding—much like speeding and parking tickets subsidize police operations.

Article – mHIMSS executives say FDA regulation won’t hold back app innovation

dondennison Healthcare IT , ,

This short Q&A article discusses the role and impact of FDA regulation, as well as the new medical device excise tax.

Some thoughts…

  • Someone explain to me how applications accessed on a tablet or smartphone are so much different than a desktop app being accessed on a netbook on Wifi. A tablet is a computer, typically without a keyboard and mouse. The user input method varies slightly and we have a whole new class of device? I don’t get it. If an application is collecting clinical data (e.g. dermatology photo), it should be subjected to appropriate regulations regardless if the user is using a mobile computer or a full desktop to run the application. This seems to me like a lack of understanding of computing by policy makers.
  • I believe the driving issue are mobile app developers getting into healthcare rather than registered medical device manufacturers getting into building mobile apps. Those familiar FDA regulations (and similar ones in other jurisdictions) generally know the rules. It is the mobile app developers unaware of the FDA regulations that are likely facing the greater challenge (mostly learning the requirements of being a medical device manufacturer). Providing the right guidance to the app developer community could be a growing opportunity for experienced regulatory affairs contractors/consultants.

Article – At Healthcare Experience Design conference, designers rethink ‘broken processes’

dondennison Product Management , ,

In this article, the topic of user experience design in Electronic Medical Record (EMR) applications is explored. They also briefly discuss the use of EMR technology by patients.

Some thoughts…

  • The fact that EMR user interfaces are often hard-to-use, and are undesirable by the user community they are intended to serve, is not news. EMRs are often, at their core, records management systems, presenting medical records generated by other systems, or by users typing data into the EMR. It is no surprise that information is presented like a big electronic filing cabinet. Niche players are trying to layer solutions on top of the EMR to present the information relevant for a given interaction in a more meaningful way. Often, if the EMR is not built with an open architecture (with APIs for external applications to discover and access information), a copy of (some of) the data is kept in a secondary system. Hopefully, IHE FHIR succeeds and enables an integration ecosystem for EMR add-ons that is tantamount to the platform needed to have an “App Store”.
  • Designing applications for trained medical professionals is hard enough. Trying to build a user interface that makes sense to, and it optimized for the use by, both an Oncologist and my grandmother is near impossible. Medical terminology alone is enough to confuse most patients. Then consider the questions and concerns of the patient as they start to review their CT images and wonder what that little whitish spot might be. In this article, many of the docs surveyed expressed concern over patient access to their own electronic medical records (which is why Personal Health Records were created, friends).