Posts tagged ‘Electronic Health Record’

RE: EHRs in Surgical Practices

Recently, on his blog “Life as a Healthcare CIO,” Dr. John Halamka gave advice on how to implement EHRs for surgical practices. Dr. Halamka points out many of the issues we’ve found when meeting with surgical practices and ambulatory surgery centers (ASCs). Surgical practices offer a unique set of problems as they have a very specific purpose, are less likely to have many returning patients, and capture a limited amount of information (the rest being captured by referring general practitioners/primary care physicians and their respective facilities). So where is the incentive for these practices to adopt an electronic solution? How can EHRs address these particular needs without being too disruptive to the surgeons’ workflows? Dr. Halamka has some ideas – based on his own experiences – but I think there’s more to add to this discussion.
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November 17, 2010 at 4:25 pm Leave a comment

From the Ashes: Ensuring that Your Health IT Data is Secured & Easy to Recover

The Most Popular Recovery Plan Today (Via Leonid Manchenkov's blog)

“Expect the unexpected.”

It’s one of those oxymoronic idioms that have become so ingrained in our culture, it’s hard to determine its origins but it’s taken as a universal truth. Obviously, if you expect the unexpected, then it’s no longer unexpected; but it’s not meant to be a literal set of instructions. As we all know, expect the unexpected means to assume that things will go wrong, or to at least have some contingencies in case your plan doesn’t work out as you intended them. I was reminded of this phrase while reading this list of Top 5 EHR Adoption Barriers and came upon the last one:

Can the Networks Support the Data?
Today’s data explosion is driven by many industries, but healthcare records and imaging are fueling a big part of the growth. Healthcare providers are worried about the complex networking capabilities and their ability to handle the 24×7 influx of massive amounts of data and the disaster recovery plans needed to support that data. VARs play a pivotal role in the networking and disaster recovery markets, so smart VARs will use their knowledge to close the deal.

It was an interesting issue that I hadn’t spent much time thinking about. That’s not to say that we hadn’t taken all of this into account when designing our products, but I personally had never conceived that this would be an obstacle or imposing barrier to health facilities that want to adopt electronic health solutions. And that’s when I decided to look at our products to see how they fare if the unexpected happened and we needed to recover data.
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July 1, 2010 at 2:28 pm Leave a comment

Common Language: The Rise of Standard Formatting for Surgical Reports

Gottfried Wilhelm von Leibniz

Gottfried Leibniz. That name doesn’t mean much to most people, outside of math nerds with a penchant for historical trivia. Leibniz is credited with simultaneously creating calculus at the same time of Sir Isaac Newton. Years of debate ensnared the scientific community as patriotic mathematicians of Germany and Britain argued for their respective countrymen. Each camp tried to prove the independent, solitary insight needed to develop calculus solely rested with one man or the other – but were unable to find definitive proof that Newton or Leibniz had been the one to originally conceive of this new field of mathematics. There are suggestions that Leibniz was inspired by some of Newton’s works but, as there’s still too many gaps in the works of Newton that would have been available for Leibniz to consult in order to develop calculus, there’s no substantial proof that Leibniz plagiarized Newton’s work.

Rob's attempt to innovate calculus was met with much less enthusiasm

So what happened then? Perhaps this is an example of Rupert Sheldrake’s pseudo-scientific theory of “morphic resonance” in which behavior is somehow transported across great geographical distances between similar types of animals or people. And while it is always interesting and neat to consider such a possibility – an example of some innate telepathic or cultural osmosis that seems to exist on a cellular level between people – it’s rather unlikely. How, then, did this rise of a new way of thinking occur at the same time in two different places? How were two men able to discover the same mathematical principles without being in collaboration? And what does any of this have to do with surgical reporting?

To put it simply – great minds think alike. The fact of the matter is that both Newton and Leibniz recognized a need for something in the world – in this case, the lack of a particular mathematics field that could be applied to many facets of our lives and used to explain so much of what we don’t understand. It is this same ability for multiple people, unrelated and independent of one another, to see the writing on the wall in the medical community and recognize the absolute need and demand for standardized and structured surgical reporting.
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June 23, 2010 at 10:22 am Leave a comment

Security in the Time of EHRs

You are online right now.  I don’t just mean that you are sitting in front of your computer or using your smartphone to read this post on the internet.  I mean the majority of your “vital” information about your identity – bank account, social security, address, etc. – can be found somewhere in cyberspace right now.  You exist in the internet; and not just you, but also various versions of you complete with your interests, past transactions and other personal information that you’ve added to your social networking sites or the online store where you buy things.  All of these pieces of you are captured online and are out there in the ether of the web if someone wanted to find them.

It’s a bit creepy, isn’t it?  The fact that so much of our lives these days exist online – and therefore so much of who we are is being captured or constructed on the net – leaves many feeling unsettled.  This is especially true if you’re a person who doesn’t know much about software security, who doesn’t follow how data is captured and stored, who isn’t sure how much of the web works but you are fairly certain it will be working against you.

Now add in the idea that soon some (if not most, if not ALL) of your personal medical information will be stored on a similar system – and you understand why people are apprehensive about the idea of an Electronic Health Record (EHR).  There are those who believe that web-based data storage will only lead to security breaches or identity theft issues.  And there’s definitely the potential for such shenanigans to abound with an EHR.  While these concerns are valid and need to addressed as new systems are created, they shouldn’t stop us from proceeding with developing portable EHR systems.

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March 30, 2010 at 4:18 pm 1 comment

Introducing the OpNote Consultants: Carl Brown, MD, MSc, FRCSC

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. Carl Brown completed medical school at McMaster University in 1995 and his general surgery training at the University of Calgary in 2003.  He subsequently worked as a general surgeon at the Peter Lougheed Centre in Calgary.  In 2004, he moved to Toronto to train as a sub specialist in Colorectal Surgery. Concurrent with his fellowship, Dr. Brown completed his master’s degree in clinical research at the University of Toronto.   In 2006, he joined the surgical staff of St. Paul’s Hospital in Vancouver.

Dr. Brown is the chairman of the Research and Outcomes Evaluation Committee at the British Columbia Cancer Agency and an active member of the Colorectal Cancer Outcomes Unit. He is a member of the Surgical Oncology Network of British Columbia Executive. The goal of these groups is to improve the outcomes of patients with colorectal cancer through research initiatives.

Dr. Brown is the assistant program director of the general surgery residency program at the University of British Columbia. He coordinates the Surgery Leadership Program for general surgery trainees.  Over the past three years, Dr. Brown has published several studies on surgery for colorectal cancer, the ileal pouch procedure and surgery for Crohn’s disease. Furthermore, he has taught courses in laparoscopic colorectal cancer surgery.

How did you get interested in medicine?

I was always interested in science but, more importantly, I like interacting with people and helping people.  While it may seem cliché, [medicine] has turned out to be everything I had hoped it would be.  I do get to help people every day.  There’s never a day that I go home after work without feeling satisfied that I’ve accomplished something.

Wow – that’s great.

Yeah, it’s really true.  You know, it sounds kind of clichéd and maybe even a little cheesy, but it is so true.

What attracted you to surgery?  What made you go with that specialty out of all the possible paths in medicine?

Firstly, I’m a fix-it kind of guy.  I like to fix things.  It’s always been something I’ve been fairly strong at – growing up in a small town, we always took it upon ourselves to fix things around the house.   A lot of what we do in medicine is tweaking things: giving a little medication to make someone feel a little bit better.  And that is very important.

But I like the “fix”.  I like the stress and the pressure of having someone who has a life threatening illness and taking on the incredible responsibility and trust of that person by operating on them.  Many times what I do cures the person of that problem.  It’s very gratifying – very immediate.  It’s sort of what I think medicine’s all about.

How did you first hear about mTuitive and the OpNote product?

I’m an academic surgeon at a major Canadian university.  My main research interest for over seven years now has been synoptic reporting and improving processes of care in surgery.  About 6 years ago I published an article in the journal Surgery about synoptic reporting and its benefits.  It’s always been an interest of mine.

Concurrently, as I’ve worked through my career, I’ve become more interested in cancer.  There’s a big push to have synoptic reporting in cancer surgery – much like there is excellent synoptic reporting in cancer pathology.  I feel strongly that [synoptic reporting in surgery] is a simple thing that we can add that can potentially improve patient care and save lives.

Through my work with the provincial organization in British Columbia I was introduced to the mTuitive products.  I saw it as a possible solution to a lot of our problems.

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March 26, 2010 at 4:18 pm Leave a comment

Strategies for a Brave New World

Via Minnesota 2020

Despite our current economic climate, with its historic unemployment numbers, studies are showing that there will be a workforce shortage in healthcare within the next 5 – 10 years.  This conclusion has been drawn from multiple reports issued from different investigative committees – including committees formed by the American Hospital Association and the National Academies – Institute of Medicine.  So while it’s hard to think of any sector right now wanting for jobs – that appears to be the direction in which healthcare is heading.

One of the key issues exacerbating the declining worker population is the impending retirement of around 78 million members of the “Baby Boomer” generation.  As National Academies points out, currently there is one physician trained in geriatric medicine for every 2,500 older Americans.  The average 75 year-old American has three chronic conditions and uses at least four prescription medications.  As this demographic expands (as Baby Boomers age), this will mean an increase in patients who need more care, more attention and more workers.

What are solutions to this problem?  How can health professionals ensure that this steep decline in workers won’t translate into a lack of care for patients or added stress on an already overextended workforce?  And how do Health IT products – like the mTuitive OpNote – help physicians and facilities improve their workflows and organizations to cope with this transition?

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March 19, 2010 at 4:02 pm Leave a comment

HITECH – One Year Later

This Healthleaders Media article examines the efficacy of Health Information Technology for Economic and Clinical Health (HITECH) Act after its one year anniversary.  Built on other Health IT initiatives originating in 2004, HITECH Act incorporates monetary incentives to encourage health professionals to adopt electronic health records and to utilize more health information technology.

In the wording of the law, “eligible professionals” must demonstrate “meaningful use” of a certified EMR in 2011 in order to receive incentive payments of up to $44,000 from Medicare and $65,000 from Medicaid per individual physician – to help cover the cost of EMR adoption.

And while there are ongoing debates about privacy issues and the effectiveness of digitization, one of the main goals of the project seems to be portability: the ability to have a individual’s medical history readily available to any physician where ever/when ever that individual seeks treatment.  This is the ideal that Dr. H. Walter Kaess and Dr. Roger Chabra spoke of when I interviewed them recently.  GE has illustrated this idea dynamically in its recent commercials for EMRs that have been airing recently.

But what does this all mean for physicians?  How is the Health IT market working with physicians to deliver on the promise of portability without any cost to caring for patients or impeding the physician’s workflow?

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March 12, 2010 at 9:01 am 1 comment


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