Posts Tagged ‘EHRs’

Dr. Ari Robicsek on Big Data & Healthcare

Wednesday, August 14th, 2013

Dr. Ari Robiszek podcast iconBig Data have become ubiquitous buzz words for the aggregation of information in data sets and the use of algorithms to define patterns. Overall, the growth of the sector is being driven by the trend towards backing up data in the proverbial cloud, online shopping (which grew 14% between 2011 and 2012 to $42.3b in sales), and all the time we spend posting content on social media. McKinsey & Company predicts a 40 percent growth annually in the data being generated. American healthcare providers currently have $300 billion invested in data, including GPS and mobile apps. With the adoption of Electronic Health Records (EHR), it is estimated that data could save providers between $300 billion and $450 billion annually (we spend about $2.6 trillion overall on healthcare).

There is no question that Big Data is a heuristic change in medicine. Through the data compiled in EHRs, it allows use of predictive modeling in order to address health issues at a population level.   For example, we are able to find out if patients are doing preventive care, taking their medication, and whether they might be at risk for chronic conditions. Population health management is a new, more proactive way to segment patients by need (both financial and clinical) and to target them for outreach. It provides a powerful tool to address hospital readmissions and hospital-based infections. For example, NorthShore University HealthSystem (NorthShore) in Evanston, Ill., aggregated 40,000 patients into a data set and analyzed 50 different pieces of data to build a predictive model. This allowed NorthShore to evaluate whether patients might be at a high risk for being carriers of particular bacteria like MRSA, a highly antibiotic-resistant strain.

There are issues going forward such as the barrier that EHRs put between the patient and the physician; in the new tech-enabled world, the doctor might spend the visit staring at the computer rather than the patient. This is a real concern. Doctors have also noted that it is harder to retrieve information in EHRs than from a paper chart. On the flip side, EHRs do provide patients with more transparency, including a portal to their lab tests, billing, scheduling, doctor notes as well as email contact with their physicians.

To listen to Dr. Ari Robicsek’s full interview on Big Data and Population Health Management, click here for the podcast.

The Doctor and His iPad Will See You Now

Tuesday, November 8th, 2011

The Department of Veterans Affairs has started connecting as many as 100,000 of its staff members at VA medical centers with tablet computers running on three operating platforms in a move toward electronic health records (EHRs).  According to Federal Business Opportunities, the VA plans to acquire 60 tablet devices every year, which will be shared by doctors, nurses and technicians.

The government’s wish list includes iPads running Apple’s iOS system, tablets running Google’s Android OS and devices using Microsoft Windows.  They’re asking for 20 tablets of each operating system annually.  Additionally they want the vendor to develop an applications store geared specifically to the VA.  The documents detail a multitude of security concerns which they want the vendor to address.  Although Apple’s and Google’s operating systems don’t comply with federal wireless standards, VA officials concluded that security for those systems was sufficient.

Roger Baker, the VA’s chief information officer, previously had announced that the department was working to make iPhones and iPads available to staffers so they could connect to VA networks.  Baker also began testing out an iPad himself.  The tablets are primarily meant for the VA’s medical clinicians, although some might go to staff and managers at its headquarters.  “The solution allows VA to gain visibility to the devices as well as apply enforcement of VA security, management and other applicable policies to the devices from an enterprise perspective.” Baker said.

The VA’s program is virtually identical to a similar pilot test started earlier by the FAA, which experimented with replacing paper copies of electronic flight manuals with an electronic version stored on an iPad.  Federal regulations require encryption and credentialing programs, as well as concerns about lost devices.  Nevertheless, some agencies are under growing pressure to find ways to accommodate mobile technologies to make federal employees more productive.

Baker tried to downplay the impact of the program.  “At this introduction point, it’s not going to have dramatic effect,” Baker said.  “For what you can do with it right now, it’s only somewhat more useable than the other mobile devices we’ve had in our infrastructure.  It will have the same level of encryption, but you will be able to access our information gateway that is more viewable.”

Baker also envisions using the tablets for clinical applications that take advantage of the devices’ display properties, including heart rate monitors and blood chemistry charts, which will allow clinicians to do on-the-spot analysis.  Ultimately, the VA could supply patients in remote areas with tablet computers equipped with full-motion video capabilities to support home tele-health programs.  Baker believes tech-savvy Veterans Affairs physicians will develop future medical applications for tablets that could be provided through an internal VA app store.  By focusing on evidence-based medicine, Baker said VA will have the opportunity to create its own “brand”.