Informatics

Article – CPOE use can reduce unneeded CT scans

dondennison Radiology , , ,

Not a mind-blowing revelation, but when doctors are told that the information they want already exists, they don’t order more tests (usually).

And while the results of the study summarized in this article reflect only a small decrease in new CT exams being ordered (“physicians canceled orders after receiving the alerts about 6 percent of the time, making for a net cancellation of 1.7 percent of studies. In a control group, physicians canceled only .9 percent of alerts.”), every bit counts.

And it reduces the radiation the patient receives, as well as helps keep the Radiology schedule free for really important exams.

A goal to simply reduce the number of exams performed is misguided. This blog post summarizes a proposed model to help separate the necessary from unnecessary exams.

Article – The 8 RIS innovations you need now

dondennison Healthcare IT , , , ,

Here is a summary (note: may need to register with site to access) of some RIS (Radiology Information System) innovations that providers should be looking for.

Sneak peek…

  1. Digital dashboards
  2. Electronic medical record aggregation
  3. Clinical decision support
  4. Critical results reporting
  5. Customer service
  6. Technologist feedback
  7. Peer review
  8. Data mining, surveillance, and outcomes

I am working on an article on how (and why) RIS and PACS will be deconstructed and will not exist (as we know them today) in the future. Stay tuned for that.

Article – HIStalk Interviews Keith Figlioli, SVP Healthcare Informatics, Premier

dondennison Policy , , ,

A friend shared this interview with me. Worth the read.

Some thoughts…

  • Keith (BTW, I have never met him) has a unique perspective having spent time on the vendor side, then the provider side, and is now also involved in policy. I think his points are spot on.
  • I believe that some of the EMR monolith disruption will come from HIE vendors. They are slowly taking more parts of the EMR, and generally have newer architectures than most EMR systems. This will allow them to adapt to new standard APIs and protocols, such as those being defined in HL7 FHIR. They are also more open—they have to believe in openness, because without data sharing, they have no business.
  • HIE vendors also typically have some form of clinical data repository, which can act as the data warehouse that Keith mentions. Adding moderns APIs to these can open the door to information freedom (without compromising security and privacy, BTW), without waiting for EMR vendors to do it.
  • I like the analogy to the transformation that the travel industry went through. I make this comparison often. I also look at how banking and telecommunications have transformed themselves to provide new and improved services. The lessons for healthcare are all out there—we just need the leadership.

UK study: Telehealth not cost effective

dondennison Healthcare IT , , ,

UK study: Telehealth not cost effective …I have two thoughts on this.

One, telehealth is not only about cost reduction—it is also providing patients access to scarce resources, such as a cardiac specialist. Patients with chronic disease in rural or otherwise under served areas can use telehealth to get services where they otherwise would go without. In this case, telehealth costs equal to, or even a premium above, standard costs may be warranted (or, at least, a comparison to average costs is unfair considering the inflated costs to provide equal services in an area where resources would need to travel to the patient).

Two, costs will come down. And, an 80% reduction in costs (as cited in the article) is not that difficult to achieve if one compares dedicated enterprise solutions to consumer solutions (e.g. smartphone apps). The cost of a widely shared set of web services in the cloud accessed by off-the-shelf, multipurpose consumer devices, like smartphones and tablets, is much lower than deploying and maintaining dedicated vendor-proprietary solutions.

SIIM Blog: Part 2 – Organizing Concepts to Focus Learning Efforts

dondennison Change Management , , ,

Part 2 of 2 of a SIIM blog post. Enjoy.

I have been discussing what it would take to create a “check list” of sorts (a scorecard?) to assess ones facility’s capabilities and strategies along the proposed themes listed. Would be fun to work on, but would need lots of help from people with bigger brains than mine. Stay tuned for a bonus Part 3, maybe? 🙂

P.S. Part 1 is here.