Smart Phones and Informatics

                The use of smart phones over the last several years has steadily increased in the cell phone market. Users are able to make the traditional phone call, send messages, send and receive emails, browse web sites, and connect to other devices to send and receive data. The smart phone product has reached such a large potential, that it may just be a perfect fit in the developing healthcare IT arsenal. There are many vendors out in the market now promoting the use of software on smart phones that enables them to interface with existing hospital systems, whether it’s just to replace radios and intercoms, or to access patient information in the EMR.

                Hospitals also can leverage the fact that smarts phones are readily available in the market, with a reported 81% of physicians who own smart phones by 2012 (Voalte, 4). The main focus behind the smart phone is to interface it with the EMR, to receive alerts on patients the physician is monitoring or to remotely request new orders / medications be administrated to the patient.

Physicians, as well as other nursing staff, would have quick access to communications (either by phone, text, or email) as well as patient information all available on one device. There would no longer be a confusion of different signals and alarms from various devices and intercoms throughout the hospital. Streamlining communication and patient access and putting it in the hands of the user could offer a variety of enhancements for both patient care as well as job satisfaction with the team members.

Reference:

Smart Hospitals Embracing Smart Phones At The Point of Care. 2010. Accessed online: http://www.healthcare-informatics.com/Media/DocumentLibrary/Smart-Hospital_WP_by-Voalte.pdf

Roaming Technology In Healthcare

Providers, ambulatory practices, and acute care settings are sold on the idea that they will receive an electronic system that manages their patient’s health information. When people compare paper versus electronic, electronic is almost synonymous with automation. There is one problem with this that is often very difficult to overcome. Vendors compete to sell their own specialized products for lab systems, radiology, diagnostic software, etc. Clinicians end up having to learn how to use multiple information systems to manage a patient’s healthcare. Remembering different passwords, using different computers around the office, and the time it takes to search for records in these different systems can often lead to inefficient healthcare delivery.

One article caught my eye on a solution to these issues; where mobility of a provider meets quick access to any system and workstation or computer that they travel around to without having to carry around a laptop or wait for a nurse to log out so they can log in. This technology is referred to as a “Follow-Me Desktop” for providers who “roam” the office, going from patient to patient, floor to floor. This is done through virtualized desktops, single-sign on technologies, and biometrics. When a provider roams from one computer to the next, the system using this technology knows where the provider left off from and what location they’re in now. Specific patient lists, settings, applications that load, and so on automatically allow the provider to spend less time logging into systems and searching for their patient, decreasing the frustration levels of clinicians expected to see as many patients as possible, quickly, all while providing excellent patient care.

Technologies such as these that combine different support mechanisms to aid clinicians in using a myriad of different systems allows for increased provider buy-in, productivity gains, and an increase in the quality of care patients receive. The virtual desktops allow providers to access systems easier, “Follow-Me” technology providers instant access to clinical systems after verifying credentials, and a centralized server that hosts these applications allows for easier IT management of computers spread across a geographical area. In my professional experience dealing with 60 providers in a multi-specialty ambulatory practice environment, it seems technology like this would promote physician adoption of systems and make it easier to provide a higher level of care for patients.

References:

VMWare (2011). Enabling Fast and Secure Clinician Workflows with One-Touch Desktop Roaming. Palo Alto, CA. Accessed Online: http://www.healthcare-. informatics.com/Media/DocumentLibrary/VMware-Imprivata-Workflows.pdf

Health Information Exchange (HIE)

The general conversation in healthcare technology / informatics today seems to focus around what standards need to be implemented and how to achieve those standards in your system (if you’re in the vendor world) or how to adapt to those standards if you are in a decision making role such as a VP, Administrator, Operations or in other words a key stakeholder in a healthcare organization. However, I believe the ultimate goal should be kept in mind which is Health Information Exchange -- which has been promoted by U.S. presidents, large communication firms such as AT&T, healthcare organizations, patients, and doctors. The seamless exchange of health information between healthcare entities or others who have a ‘need to know’ is crucial to forming a better, more efficient, and safer healthcare industry in the United States, and in an even broader sense, the world. As we build our systems and networks, the focus needs to remain on the ultimate goal of information sharing. Otherwise, organizations will waste time and finances reinventing the wheel when they get to this point when our infrastructure is ready to support this goal.

 Health Information Exchange can also be viewed as interoperability between organizations in healthcare. It means the ability to exchange patient health information among disparate clinicians and other authorized entities in real time and under stringent security, private, and other protections. HIE also promotes the ability of different information technology systems and software applications to communicate (Amatayakul, 433). HIE’s begin with forming regional health information organizations (RHIOs). RHIOs are basically the same thing as a HIE only on a smaller, regional scale. In our case, it could be seen as current work between Florida Hospital, Orlando Health, and Health First all starting to share information. I’m sure Shands may also be in on it as well. Many see RHIOs at a state level, connecting most of the larger healthcare organizations’ systems through standardized HIPAA and HL7 defined exchanges that exist today or may exist in the future (Sterling, 157). This is no easy undertaking as there are multiple problems or issues that need to be ironed out. First, you have the legal issue of breaches of confidentiality if shared information gets leaked due to security breaches at one organization. It also requires competitors to communicate with each other and although the information being shared can be seen not as “their” information, but the patient’s information, it technically and legally is data owned and managed by the healthcare organization. This same data is what those organizations use to assess risk analysis within their organization to reshape the way they deliver healthcare. Many competing organizations may also not want to share how exactly they treat patients and how they achieve high patient satisfaction scores which help make them a “destination health” organization.

Never-the-less, it is in the best interest of our nation, the healthcare industry, doctors, and, most of all, the patient to share this information among healthcare entities for better medical decision making. Some other key benefits are based on research that it projects saving the U.S. economy $78 billion, provides better outcomes through shared patient records letting providers spot warning signs faster, improves patient-caregiver relations, streamlines workflows, and promotes positive perceptions to patients that healthcare organizations are working together to do what’s best for the patient (Amatayakul, 434).In the today’s scenarios, organizations are still trying to figure out first, how to get their health information from paper onto electronic mediums. Those who have transitioned to EHRs may still be trying to figure out how to get their own best of breed systems to connect and interface with each other. However, as those organizations continue to look towards the future, they should keep their ultimate goal focused on RHIOs and HIEs. My role as a Health Information Management RHIA certified professional, working on my Masters in Healthcare Informatics, currently is to educate and support my colleagues with my own knowledge and expertise by recommending steps that should be taken to move forward with these difficult, but achievable, goals. The day a National Health Information Network thrives is the day patients can worry less about negative outcomes with their own healthcare due to obstructed flow of their health information.

References:

Amatayakul, M. K. (2007). Electronic Health Records: A Practical Guide for Professionals and Organizations. Chicago: American Health Information Management Association.

Sterling, R. B. (2010). Keys to EMR/HER Success: Selecting and Implementing an Electronic Medical Record. Phoenix: Greenbranch Publishing.

Imaging In Healthcare

One major component of EHR's that cannot be forgotten is document imaging. Document imaging is involved with taking pictures, films, or other non-digital documents and scanning them into an image solo. Any health care facility, large or small, can benefit from the installation of a robust imaging system.

There are many great systems out there, but in order to make your document imaging system successful, it needs to be able to interface with the EHR first and foremost. It also should have analysis and work flow management built in, as well as other reporting tools. Professionals in the Informatics field or other related fields will be able to analyze documents and their work flows for greater productivity and faster turn-around times for report completion.

Converting from hard copy films, pictures, and paper documents to an electronic medium, when implemented successfully, can be a driver in a well tuned health care organization. It sets the stage for electronic transfer of records, films, or other pictures to internal and external sources instantly to help work towards providing the highest level of care possible.