Patient Records

Article: How Not to Engage Patients in Stage 2

dondennison Change Management ,

Some interesting observations in this article. We always need to consider the right moment to get users (patients, in this case) to engage when rolling out a new program and trying to get adoption. It can be the right application with the right value to the right people, but presented to them at the wrong time.

Article: Healthcare Imaging Strategies Not Exactly a Snap

dondennison Healthcare IT , , ,

An article on enterprise imaging and image sharing that is worth a read.

Some thoughts…

  • Informatics at the time of capture is (very) important, but this doesn’t mean we are back to typing data in–most of what is needed can easily be discovered on demand by a Web service
  • VNA’s are still being considered a component distinct from PACS and the EMR–they should be considered an EMR component, enabling the management of imaging records within the EMR
  • You can question the ROI of including images in the EMR or assess the clinical relevance (both noble goals), but one thing I have learned: EMR users want them there (and you should want to make them happy)
  • People still think we need to move a full copy of the DICOM images around to share; when I share a video on YouTube, I share just a link. The state-of-the-art of medical imaging is at the same level. Only make a copy of the full data if you need to incorporate it into your systems as a new record.
  • Something I have recently observed: regardless of whether including images in an EMR is an optional menu or required core item in MU, if the people interpreting these rules believe they need image access display for referring physicians inside and outside the hospital, they are going expect to be able to put them there.

WSJ.com: The Coming Failure of Accountable Care

dondennison Policy ,

The Coming Failure of Accountable Care

Interesting (and perhaps correct) predictions.

While a change to the financial motivations–from reimbursement for procedures (which leads to volume) to funding based on clinical outcomes, quality of care and savings achieved–is admirable, the issue of change management looms. If the systems changes, but those in the system do not, what is accomplished?

Also, one thing I still have to figure out (more reading needed) is how an ACO serving a statistically high elderly or obese or otherwise higher health risk population is compared to one that serves a relatively young and healthy population. Is there some form of “base line” measurement done and the ACO is measured based on improvement from there?

5 CIOs imagine health IT in 10 years

dondennison Healthcare IT , ,

via Healthcare IT News.

Patterns…

  • Interoperable (HIE) and integrated (EMR) patient records
  • Sensors/monitors (bedside, mobile, home) integrated with health records
  • Shift of risk from payers to providers (providers funded based on outcomes, quality measurements, savings realized–not volume of procedures)