Tag: ehr

Health Informatics insights: remote health monitoring


I just got better from a month long ordeal with an infection, which required daily visits to a care provider to assess the state and provide care. Though, the care was exemplary by Ontario CCAC, there are areas of improvement needed in care coordination among providers and remote health monitoring to increase efficiencies.

Remote health monitoring, means different things to different people.  The following report from California Health Foundation offers the current state of the market with a clear definition on the terms and the state of the market.

The Connected Patient: Charting the signs of remote health monitoring


Image Source: California Health Foundation – The connected patient: charting the vital signs of remote health monitoring.

Key insights: little has changed in the last four years with mixed results from pilot projects

Why little has changed when the economic benefits offer several millions and billions of dollars in savings and efficiencies ?   The author of the report points to the structural issues of the US health care system, which tends to be fragmented and focused on episodic care.  I believe that this is not just a US problem and is a common issue between the publicly funded Canadian healthcare& and friends south of the 49th parallel.  By far the biggest barrier to more pervasive adoption of DM has been the continued fragmentation of operations and information technology across health systems.

That is a well known problem with the providers paid on a fee for service basis.   In the US there are recent developments with the introduction of HITECT act and Accountable Care Organizations towards an outcomes based system.  In Canada, from my view the change appears even slower and the outcomes based model is being discussed at the provincial level, who are essentially payors of the service.

Though there are several drivers for remote health monitoring including communication technology advancements, mobile data standards, the chronic care tsunami we are facing as a society,  there are some significant challenges in adoption at the physician office,  consumer engagement and payment models for this service.

In spite of the challenges there are significant economic benefits and prospects to remote health monitoring both in US and Canada.

& Rethinking Our Approach to Disease Management: Technology and Information Flow Considerations

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IHE International meeting in Toronto


Keith Boone presented about CDA and CCD history at the IHE dinner in Toronto last night.

Highlights from Keith’s presentation:

– Interesting to know that CCD came from Vancouver Island Health Authority Electronic Medical Summaries project.

– Schematron for message conformance over XSD and it’s an ISO standard. Good to know.

– What is the difference between a document and a message?

Whenever you go back and ask for Information and if you get the same thing back then it’s a document. It is persistent compared to a message, if you are caught up in document vs messages.

– Where in the world is XDS ?
http://tinyurl.com/wwxds

– Checkout CDA Tools

– Keith also has a new book coming out in May 2011 on CDA.

And here is Keith’s post on his speech if you are looking for meat.

http://motorcycleguy.blogspot.com/2011/02/if-i-were-king-of-canada.html

——

Great to hang out with the standards geeks from IHE and meet great people and catch with up with old friends who are involved in improving healthcare and healthcare standards.

Thanks to HIMSS for the wine.

Saravana Rajan

HIMSS Webinars on Meaningful Use


HIMSS provides six part webinar on Meaningful Use and implications.

1. Overview of Meaningful use final rule

http://www.himss.org/content/files/MU_Overview_Slides.pdf?src=winews20100728

2. Implications of Meaningful Use on Hospitals:

http://www.himss.org/content/files/Implications_of_MeaningfulUse_in_Hospitals_072810.pdf?src=winews20100728

Key highlights from #2 above,

  • CCHIT not grand‐fathered as an ATCB, previously certified products must be re-certified – work on the vendor side and I cant gauge the impact
  • Key Applications Needed to Meet Stage 1 Meaningful Use Requirements
    •  Core HIS System with Clinical Data Repository
    •  Clinical Documentation
    •  Clinical Decision Support
    •  Computerized Physician Order Entry
    •  Medication Management
    •  ED System or module

Source: HIMSS

Happy Canada Day! and eHealth good news from Canada


Happy Canada Day everyone !

News (good and bad) from Canadian Healthcare Technology World!

Good News First –

NEODIN (North Eastern Ontario Diagnostic Imaging Network) a diagnostic imaging(DI) repository that will connect all north eastern Ontario hospitals shown in the map below for sharing diagnostic images and results has connected one more major hospital, Thunder Bay to the DI network.

As stated in the Canada Health Infoway press release here, benefits of a DI-R are

  • Enables diagnostic images and reports to be shared between facilities, eliminating the need for patients to transport images and reports between doctors on CDs, films, or by fax.
  • It also allows specialists at one facility to access the reports for images acquired at other hospitals allowing for faster and more convenient information sharing between doctors. This improved access to patient information will help health care providers make more informed and timely medical decisions.
  • Helps reduce duplicate testing that results from lost, misplaced or otherwise unavailable images

One more step closer to EHR!

Congratulations to NEODIN!, Infoway and eHealth Ontario.

Bad News –

Province of Manitoba’s eHealth program is in the news for wrong reasons.

The eHealth program will be slow (another 20 years) and will cost more (another $450 million).

Here is the link to the article and a perspective from Michael Martineau, who has spent time analyzing the Canadian eHealth market with a market research firm.

Saravana Rajan

ehealth Consultant

“The Magical Vanishing EHR” – WIHIR seminar for Jan 2010


Wish you all a Happy New Year 2010 and Happy New Decade !

1.  A New Year always starts with predictions and here is the funny one I saw on Healthcare 2010 predictions, 2010 HIT predictions from Healthcare Informatics Blog

2. First of the predictions of acquisition has already been announced, although its in the PACS space: AMICAS got acquired by private equity firm.

WIHIR – Waterloo Institute for Health Informatics Research is hosting Doug Tessier of Senior VP of eHealth Ontario

for the Jan 2010 seminar titled “The Magical Vanishing EHR”. The topic is intriguing and expecting good insights as well! Register at Infranet, if you have the time.

http://infranet.uwaterloo.ca/infranet/s201001.htm