Hospitals across the country are racking servers and hiring consultants with one goal in mind: to meet the Meaningful Use requirements set out by the government. The purpose of meeting meaningful use is for hospitals to be fully electronic when charting which will reduce medical errors and save a substantial amount of time for nurses and doctors. But how realistic are these deadlines being set out by hospitals. If the hospital wants to install a full EMR(electronic medical record) it is going to take a great deal of time to fully understand the system needs for that particular site, build it all out, test it, and then to train the entire staff on the new system. It is not a simple task by any means. Teams are working hard across the country to accomplish this goal of one electronic medical record to store all of the patients’ data from allergies to medications to time of departure to the final bill. Hospitals would like to meet the deadlines set out in the Meaningful Use guidelines in order to receive incentive payments. If hospitals wait too long, they will be penalized for not being electronic. Cerner Corporation is a leader in innovation and transforming healthcare one hospital at a time. These strict guidelines and tight deadlines are creating a lot of work and a lot of jobs in the healthcare IT sector. CEO’s and CIO’s are making sure their hospital/clinics are meeting the Meaningful Use requirement and doing it at a fast pace to avoid the penalties and take advantage of the incentive payments. Some hospitals have set unrealistic expectations but are doing everything in their power to conquer the task of installing an electronic medical record that will meet all of their business needs. The great thing about a Health IT company like Cerner is they allow full customization which caters to each hospital specifically. This type of software implementation can create many barriers and hurdles to overcome but in the long run will provide the best solution possible for that particular site.
Archive for the ‘Health IT’ Category
Tags: cerner, healthcare, IT, meaningful use
A focus on patient safety has created a need for new technology and tools to improve the quality of service rendered at hospitals. RFID’s can reduce problems in hospitals and increase safety. Problems such as drug authenticity, wrong or mislabeled blood bag, temperature of pharmaceuticals, employee and patient location, and sanitation are decreasing thanks to the rapid growth of RFID’s. They have also decreased the amount of medical errors through the use of tagging, real-time location and instance-level information. A bar coded wrist band on the wrists of patients is used to receive instant information about patient name, allergies, medication administration, and reason for being in the hospital. This is critical to the patients care and safety.
Monitoring with RFID’s is essential to safety. Hospitals can use RFID’s to monitor and report on the results of surgeries. Drug dosages can also be monitored. When a nurse administers a drug to a patient, it must be logged correctly using RFID to make sure another nurse doesn’t administer the same drug to the patient. If drug doses aren’t properly tracked using RFID’s, a drug overdose could easily occur. RFID’s ensure patients are to be administered the right medication, right dose, at the right time, and to the right patient. (Zebra Technologies, 2010) A few other implications leading to greater patient safety include RFID implanted surgical instruments to ensure they are not left inside a sewn-up body. If an instrument is misplaced, especially inside a body, that could mean a huge law suit for the hospital, not to mention extreme health risks for the patient. RFID’s can also be used to tell if the patient is the right person for the planned surgery. The number one way to increase safety is to reduce the amount of errors. RFID’s are being used to track the disposal of hazardous medical waste to keep track of materials that need to be thrown away immediately. RFID’s are being used to identify proper laboratory specimens including biopsy samples and containers of blood or urine. RFID tagged blood bags reduce accidental mismatches including wrong blood type or wrong blood correlating to the patient. Not only can blood type being transfused into the body be monitored with RFID’s, but they can monitor temperature and the time at which to administer it to the patient.
At the Florida Hospital in Orlando, one of the largest hospitals in the United States, new Wi-Fi RFID tags are being used to track temperatures of refrigerators from a central server. Battery-powered AeroScout 2.45 GHz RFID tags are used to monitor what temperature each refrigerator is with the use of temperature probes. The Florida Hospital has installed more Wi-Fi nodes for better coverage across the hospital. Every five minutes RFID tags transmit data with the temperatures of the refrigerator and tag ID number to Cisco Wi-Fi access points. This data is collected and reviewed using the AeroScout MobileView software located on the hospital’s back-end server. Each tagged refrigerator can be seen on a map showing all seven buildings with icons representing each refrigerator. (Swedberg, 2010) AeroScout is a leading developer in Wi-Fi RFID temperature monitoring. They strive for patient care and safety by requiring strict temperature ranges on pharmaceuticals, organs, blood bags, vaccines, tissues, food, and other items. Other monitoring applications provided by AeroScout include humidity monitoring of patient, storage, and operating rooms. (Wi-Fi Tempterature Monitoring)
RFID’s are also being used to monitor the safety of newborn infants. They are helpful in matching mothers to their baby. Once a baby is born, the RFID tag on the mother’s wrist is cross referenced with a tag placed on the infant’s ankle. The baby is then taken away from the mother and placed in the intensive care unit. RFID tags make information readily available to the mother such as photograph, height, weight, skin color, and temperature.
With RFID tags people’s movements can be monitored. This can reduce time spent looking for patients or staff. Location of staff and patients is critical to safety, especially if time is of the essence. Not only is location of the staff being monitored using RFID’s, but credibility can be monitored. Only authorized personnel are allowed in certain areas and RFID’s are key to making sure patients and staff aren’t wandering into areas of the hospital they shouldn’t be. This has been found effective for patients with Alzheimer or special needs. Alzheimer facilities have RFID readers installed at doors to maintain patient safety should they enter unauthorized areas.
At the University of Miami Center for Patient Safety RFID and infrared technologies are being tested to monitor employee hand washing. Sanitation can be a major issue when dealing with sick people. The system uses tiny sensors installed in soap dispensers which read staff ID badges and the location and duration of time of someone washing their hands. The data is recorded and used to identify which employees are not washing their hands long enough. (FL hospital uses RFID to monitor hand washing, 2009) According to a study, 36% of patient’s visits have been reduced because of RFID based hand washing systems because they greatly reduce the spread of infection. The system was implemented at Princeton Baptist Medical Center located in Birmingham, Alabama. The tags perform at 2.4 GHz and utilize IEEE 802.15.4 specification. The system allows healthcare professionals to examine information presented on the screen placed over the soap. The screen presents information like identification number, number of times an individual washes their hands, and the location and time of use. The RFID reader recognizes personalized information for the particular dispenser. This requires mandatory hand sanitation.
At the Pensacola Fleet Hospital in Iraq the United States navy replaced a manual patient location system with RFID-enabled wrist bands to accurately identify, locate and obtain updates on patients. According to the Hospital Chief Petty Officer Michael Stiney, “ The ability to keep important information with each patient, and to track his or her whereabouts automatically have helped medical professionals at this facility better manage patient care.” (UPS, 2005)
The right software used with RFID’s can make it easier for hospitals to accurately track and identify patients. Whether they are identifying a patient for a certain procedure or pulling up a history of treatment, RFID technology can increase efficiency and safety in the hospital. Being able to correctly identify a patient in a fast paced environment is extremely important. The hospital is in charge of taking care and keeping track of each and every patient. If a patient were to go missing that could mean major problems for the hospital. RFID tags worn on the wrist of patients can even be read through bed linens so a patient does not need to be disturbed. (RFID Solutions for Healthcare Industry, 2009)
Although RFID has proven to be quite expensive, there are many benefits to using them. With patient identification, staff location monitoring, drug and equipment monitoring, and mandatory sanitation, the overall safety in a hospital can be greatly improved through the use of RFID’s. The cost of passive RFID tags has dropped from a dollar in 2002 to less than 50 cents since 2004. The active RFID tags are still a little pricey ranging from 50 to 100 dollars. The benefits of using RFID tags certainly outweigh the risks. RFID tags ensure the right patient is receiving the correct medicine, dose, surgery, and treatment leading to greater safety throughout the hospital.
The Big Bend RHIO has developed into the largest medical record exchange system in the southeast. It originated in January 2005 and established a board of directors in November of 2005. The Agency for Health Care Administration FHIN Grants Program awarded BBRHIO a great amount of funding and stakeholders have donated over a million dollars. The FCC also provided funding for Big Bend. In January of 2008 the HIE system was finally opened to community health care providers. BigBendHealth.com has a sustainable business model by providing benefits to the local community through data sharing, patient demographic download, referral management, document upload, and interfacing. BigBendHealth provides access to millions of medical records for over 450,000 people and to physicians and hospitals who can now securely exchange information more effectively.
FHIN is the Florida Health Information Network and is concerned with providing better health care in Florida. The main goal of FHIN is to create a statewide health information exchange system for Florida which addresses issues involving technical infrastructure, health information services, better data integration for clinical decision support, and improved exchange of patient records during time of care. RHIOs fit into the FHIN plan by allowing a direct connection to the system. FHIN collaborates with RHIOs and the Agency for Health Card Administration to integrate a statewide health exchange program.
AVOCARE helps communities set up Health Information Exchanges. They make sure the healthcare records are exchanged securely in a HIPPA-compliant manner. They operate the Big Bend RHIO in Tallahassee and are concerned with providing health IT solutions that allow healthcare providers to take control over their data. AVOCARE provides referral management, secure messaging, demographic and encounter data access, clinical data access, and document publishing. AVOCARE was awarded a grant and developed and manufactured the Automated Medication Dispenser.
Region Extension Centers are funded by the federal government to help in the adoption of Electronic Health Records by physicians. The main objective is to help primary care providers achieve meaningful use of certified EHR technology by providing training and support to doctors, offering information and guidance to help with EHR implementation, and giving technical assistance. REC’s will improve workflow by looking at practice needs, talking with vendors, and implementing project management. There are currently four REC’s in the beautiful sunshine state of Florida: The Center for the Advancement of Health IT in the north, PaperFree Florida in the west, University of Central Florida College of Medicine in Orlando and to the east, and South Florida Regional Extension Center in the Miami area. The main objective of these RECs is to successfully implement and meaningfully use certified EHR systems to improve health care. The RECs are not for profit and provide unbiased advice on EHRs, making sure to avoid conflict of interest. Privacy and security are important issues that are addressed, as well as disaster recovery.
Health Informatics is ever changing and evolving as technology becomes better. One of the newest advancement known as cloud computing allows physicians and clients to easily access information stored in the “clouds”. “Cloud computing” is a service offered over the internet. In most cases of cloud computing users do not need to download or install anything. This is known as software as a service. The only thing a user needs is a browser and access to the internet. The biggest obstacle to adopting health IT is cost and ease of use. With cloud computing these obstacles are reduced, if not eliminated. This type of technology is easy to use, secure, up to date, and little to no cost. Cloud computing prevents problems such as poor disaster-recovery in the case of a natural disaster (fire, tornado, hurricane, flood) which can wipe out local data. The only point of failure with cloud computing is loss of internet access. Security of data is provided through high-level encryption and security requirements follow al l meaningful use criteria. Making sure to comply with HIPAA regulations, providers are choosing a private-cloud model as opposed to a public model so hospital staff can share information privately and securely. Cloud computing can be used to migrate e-mail, share information in near real-time, and collaborate with web applications. Platforms such as Google Health, Health Vault, SharePoint Online, and Practice Fusion to name a few are providing these services to improve health care.
Other services such as mobile health and remote health services are also on the rise as technology continues to evolve and become better and more useful. Companies like AT&T, Verizon, Dell, IBM, and Intel are offering health care services. Mobile health is estimated to be a 1.76 billion dollar market by 2014 and 500 million people will use smart phone health apps worldwide by 2015. These apps allow people to get the answers they need without having to step foot in a doctor’s office or hospital. Remote services are ever popular for this very reason. Telehealth and remote patient monitoring is one of the smallest but fastest growing health management services. To reach its full potential, insurers must broaden their reimbursement practices. Intel’s Health Guide is a great example of the direction Telehealth is going.
EMix is a medical record health information exchange stored in the clouds which launched very recently. It was on display at HIMSS 2010 conference in Atlanta. It can be downloaded from the internet with a validated email and password. Reports and medical exams can be shared between medical facilities in real time simply and securely by uploading and downloading. Radiology photos can easily be shared with little to no cost. EMix aims at keeping medical records private and involves an eight layer HIPAA compliant security system. The goal of this technology is to stray away from CD burning and allow legacy systems to remain in place. EMix is an addition which can benefit hospitals by providing real time photos without requiring a huge amount of funding. A portal is being developed to give patients access to their medical images and let them share it with anyone.
The number one killer in the US is heart disease. Diagnosoft developed a technology appropriately named Flow which can accurately track blood flow quantitatively through heart vessels. The technology shows how well the heart is pumping and lets doctors see dead tissue in the heart. Unlike an MRI, this technology does not use radiation resulting in fewer risks. Diagnosoft is an industry leader in developing cardiac technology. They have also developed HARP and SENC(strain encoded imaging) in which advanced post processing software is used to generate real time images which can be shared over the clouds.
Mobile health is on the rise as more and more people acquire smart phones. With the development of 4G, which allows 5 to 10 megabits per second, better live video feeds are being used to connect doctors with patients. There are many apps in the market that allow patients to take control of their healthcare. The Itriage app is a free health app which allows patients to get answers without having to actually go to a hospital. The app uses a picture of the body to select aches or pains to diagnose symptoms. Itriage can find the nearest hospital, doctor, or pharmacy along with hospital wait times. When you first open the app, you are asked if it is an emergency. Then you are able to explore over 300 symptoms, 1000 diseases, and 250 procedures. Treatment and specialists for particular diseases are available and you can email content to your friends. It also shows images such as an x-ray of a broken leg.
One mobile app known as Mobile Health Pal allows you instant access to control and utilize you or your family’s personal Health Records. Mobile Health Pal connects to leading Patient Centric Electronic Health Record Systems like Google Health and Microsoft Health Vault to allow you to view and share health information such as Demographics, Conditions, Medications, Allergies, Procedures Test Results, Notices, Immunizations and Insurance. The information is encrypted to ensure security.
Health services from home have been around for decades. Patients with diabetes have been monitoring their own glucose level since the 70’s. It is extremely important for diabetic patients to be able to test their glucose level everyday and look at patterns to better manage their diabetes. Remote monitoring through mobile and web services is allowing patients to get better care because doctors can make more informed decisions.
Remote services are becoming the future because it is allowing patients to get the care they need without having to wait in a doctor’s office. Blood pressure, x-rays, and EKG’s can be sent with little bandwidth from tens of hundreds of miles away. New technology is allowing doctors to administer services remotely. Cisco’s HealthPressence is a TV which basically allows a doctor to evaluate and prescribe a patient remotely. A patient enters a specific center where an assistant is used to connect the doctor to the patient. When the patient arrives to the center, they are asked to change into a gown. The assistant then gets the patients height and weight and takes their vital signs. The information is input into the system and sent over to the doctor. The patient is then connected to the doctor via two way video calling. Say a patient has an ear ache, the assistant could stick a camera in the patient’s ear and show a live feed of the inside of the patient’s ear to the doctor and the doctor could give a diagnosis. The doctor can then remotely prescribe medication.
AT&T has developed a Telehealth system which was on display at the HIMSS 2010 conference. This system monitors blood pressure, pulse rate, and oxygen saturation, utilizes an electronic stethoscope, ENT scope which examines the ear drum and can also look at the back of the throat. A camera is used to give an overall body view of the patient to see color, sweat, rash, or burn. The software package collects data in an electronic medical record and can be integrated into AT&T’s healthcare community online. This has proven to reduce medical errors and keep costs down.
Intel Health Guide was developed by Intel aimed at helping patients with long-term chronic conditions. This remote health management service combines in-home patient devices, the Intel Health Guide PHS6000, and the Intel Health Care Management Suite. The Health Guide PHS6000 enables sessions between healthcare professionals and patients to measure vital signs, respond to health assessment questions, and receive educational information. Vital sign devices have been tested and validated to ensure interoperability. From blood pressure monitors and glucose meters to pulse oximeters, peak flow meters, and weight scale measurements can be obtained. This allows patients to take a more active role in their own health care and doctors to give more informed and personalized care. Intel’s remote patient care helps to reduce hospitalization and readmission rates, increase patient compliance with disease management programs, offer cost-effective extended care to more patients, improve continuity of care for chronically ill patients, reduce the cost of care, and increase patient satisfaction. The Intel Health Guide is extremely secure using encryption at the data-field, database, and file-system levels and is protected with 128-bit Secure Sockets Layer/Transport Layer Security and VPN encryption. The Intel Health Care Management Suite is software that has an integrated video camera which allows two way calling between healthcare professionals and patients so doctors can provide advice and encouragement. Healthcare professionals can use the Management Suite to review patients’ progress and data quickly and simply with aggregated charts and graphs.