Are EHRs Truly Improving the Quality of Healthcare? A Closer Look.

During the past five years Electronic Health Records have matured despite the regulations of CMS and HHS.  The additional requirements of Meaningful Use have added cost and bureaucracy to the process of gathering data from disparate sources.  The current EHR does not support MU completely and practices must gather required data by other means.

Physicians had the fantasy of EHR providing them with a usable source and record of patient clinical information.

During the initial period 2006-2014 there was resistance to EHR by providers due to the cost of acquisition and maintenance.  The HITECH act was implemented to offset these concerns and the adoption process proceeded.  In retrospect it was a hurried decision, fueled by a fear of exclusion by non EHR users.  Vendors capitalized and profited due to the inflationary addition of 20 billion dollars into HIT.


Adding Value to the  EHR

In a very recent survey discussed in this video almost 80% were concerned or very concerned about the return of investment for their EHR system.

After watching the above video, which pertains to Texas Children's Hospital Dr. Maacias provides some positive aspects of analytics

Known for leading large-scale healthcare improvement using data and analytics to drive positive change, Dr. Charles Macias speaks to creating greater value in the EMR through analytics. This approach has done more to increase value than many other cost-reduction efforts. In this webinar you will:
Explore each component of the value equation, Learn how TCH has increased the value of its healthcare using data to drive quality an ever more important need of those facing capitated or value–based care reimbursements and Consider a new ROI equation for systems who have invested heavily in their EMRs

Why an EMR Is Only a Partial Solution

Sometimes used interchangeably with EHR, an Electronic Medical Record (EMR) is a digital version of paper charts. Will an EMR alone solve your meaningful use, ACO and healthcare internal and external reporting needs? The answer is likely to be no for three reasons:

1.      Meaningful information requires near-real time data to monitor, diagnose and treat the root causes before you report.

EMR reports are typically provided weekly or monthly; they are static and one-dimensional, like the sample above.

What happens if you want to drill into the data and view trends related to a measure, say for example, an ED measure, where you might want to look at differences in the day of the week or time, differences by providers, etc.?  You could request another EMR report be built.  However, if you’re like many clients, your request would be in the EMR report queue for 120 days or more.  Then you would end up with multiple reports that you’re trying to cobble together to make sense of the data.

You may also want to look at data from other source systems such as operations, patient satisfaction and finance to analyze ED throughput and disposition of departure related to staffing ratio, department census/capacity, inpatient length of stay (LOS) and the impact on patient satisfaction. 

Are EHRs Truly Improving the Quality of Healthcare? A Closer Look.: Wondering if your EHR is truly improving the quality of your health care? Dr. Macias takes a closer look and shares what Texas Children’s Hospital…

15 Virtual Reality Startups in Healthcare - Nanalyze

Virtual reality or VR is not taking off in gaming. Business applications like healthcare are a different story. 16 VR startups in healthcare and medical.



Virtual reality (VR) is usually associated with gaming — you put on a headset and step into a virtual world where you can solve puzzles, slay enemies or gain experience. While we were simply floored by how amazing it was to play games in VR, everyone else just shrugged and went back to arguing about politics. While a great medium for playing video games, VR just hasn’t taken off as expected and is now in the “trough of disillusionment“. While VR gaming stalls, commercial applications are looking promising. In the same way that artificial intelligence is being focused on healthcare, many startups are creating virtual universes to change the face of healthcare for many people.

When  you are ready to dive in




15 Virtual Reality Startups in Healthcare - Nanalyze:

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Medical device creation: Everything you need to know

Everything you need to know about medical device creation

Medical device creation can require know-how in areas as wide-ranging as electrical components, high-performance polymers, molding and FDA regulations.

From increasing costs and an aging population, to the demand for affordable and personalized care, the healthcare industry is facing a variety of challenges. These challenges have opened the door for a new wave of low-cost technology to replace the outdated and struggling medical devices of the past. This new technology comes in the form of connected medical devices, which are not only a more affordable option but also significantly improves the quality of patient care. Medicare estimates $17 billion is spent each year on avoidable readmissions that can be mitigated with early intervention and better at-home care. With the world becoming more connected since the introduction of IoT and connected medical devices, this presents a unique opportunity to prevent some of these readmissions.

So what’s the holdup?  Digital Health Space will attempt to list the challenges and opportunities.

Positive: diagnostic improvement

Connected medical devices fall into an umbrella category referred to as the Internet of Medical Things (IoMT). The role of the IoMT is to allow medical devices to be connected to applications and the cloud where information is processed and stored. The applications then use this information to create the user interface. Connected medical devices directly benefit the patient and healthcare provider through the use of improved patient compliance, data collection that can lead to more personalized care, and most importantly the detection of device failures before they become serious.

So how do these seemingly magical devices work? The answer lies in machine learning. Using machine learning techniques to comb through data and identify patterns in a patient’s health over a period of time, medical devices will be propelled into the future. This information helps identify new products and patterns of care. Connected medical devices also help with diagnostic services that may be too complex for a stand-alone medical device. As engineers and researchers collect data, diagnostic algorithms are improved over time, helping to quickly and efficiently provide the best possible care to patients.

Positive: failure prediction

One of the most important features of connected medical devices is that they have the ability to predict potential device failures before they become a life-threatening scenario. For example, if a heart pump manufacturer changed the type of lubricant used in the pump bearings. The product may be the same, but any slight difference can cause an issue. Perhaps the operating temperature was different than the original lubricant, resulting in a higher wear pattern on the bearings, which would normally be undetected until the device failed. However, with a connected medical device, a notification would be issued to the physician and manufacturer, so the pump can be replaced before failing, which saves the patient’s life along with others who’s pump contains the new lubricant.

Along with early diagnosis and predictive abilities, connected medical devices also have the ability to track the effectiveness of patient care. This provides physicians with more comprehensive and frequent information about their patients, along with improved outcomes.

Negative: cost and regulations

While connected medical devices clearly have numerous benefits, including the ability to reduce long-term costs of patient care, the initial cost of developing and maintaining a connected solution is a major concern. Connectivity infrastructure either is the medical device itself, or an extension of the medical device. Either way, all regulatory requirements must be met. Creating products that fall into the connective category and meet all regulatory requirements is a tough process. This is also one that requires an extensive expertise in the space and a highly specific skill set, both of which are hard to come by, making device development and regulation a great expense.

Negative: data privacy and cybersecurity

There are more than 3.7 million medical devices in use. What if all of these devices were connected and someone managed to obtain sensitive medical or financial information from patients by interrupting the connectivity? Cybersecurity and data privacy are two of the largest concerns when considering adoption of connected medical devices. Connected devices are much more vulnerable to brute force, deliberate attacks as well as undirected malware. Cloud-integrated manufacturers are continually trying to prevent this possibility from occuring by listening to the FDA and other regulatory agencies that have issued guidelines on how to mitigate cybersecurity risks. In order to provide manufacturers with incentive to make changes, the FDA allows manufacturers, who have implemented mandated security updates on medical devices, to not repeat the entire regulatory approval process.

Solutions

Can these possibilities be managed and prevented? Absolutely. Thorough risk analysis should be performed to determine risk posed by connectivity threats since each medical device has a unique risk profile.

Considerations:

• What kind of data is stored and transmitted? Does this data include private medical information?
• What is the potential harm if data is erased?
• What are the risks of connecting or not connecting a device?

Potential strategies:

• Choose the right type and level of encryption.
• Create a list of cybersecurity procedures and guidelines
• Use appropriate security controls for access to data
• Train your workforce on good cybersecurity practices
• Ensure good engineering by prioritizing secure design and coding
• Track cybersecurity risks during product development
• Limit the amount of data stored
• Include cybersecurity verification and frequent reviews
• Use the right type and level of encryption
• Establish a post-market surveillance program and conduct assessments

Connected medical devices provide a variety of benefits including automated alerts, remote monitoring, early diagnosis, lowered healthcare costs, and most importantly improved patient outcomes. When properly secured and maintained, these devices can be a very beneficial tool for improving patient health. In most cases, the benefits outweigh the risks.

Abbas Dhilawala is CTO of Galen Data (Houston). Dhilawala has more than 13 years of experience developing enterprise-grade software for the medical device industry.

The opinions expressed in this blog post are the author’s only and do not necessarily reflect those of Medical Design and Outsourcing or its employees.

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