Link: Mining Clinical Data

Optimistic predictions by RAND Corporation in 2005 encouraged adoption of electronic medical records (EMRs) and encouraged the federal government to "give billions of dollars in financial incentives to hospitals and doctors that put the systems in place." Does HITECH Meaningful Use come to mind?

Interestingly, RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, who profited from widespread report dissimenation describing the value of technology. It is no surprise that "Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005."

"The 2005 report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. However, the study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems (EMR)."

No doubt the savings was overstated and the report (sponsored and paid for by those who could benefit) causes healthy scepticism in its results. Other reasons cited for increased costs in the report include:

• "Sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and
• The failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT."

Although I agree there has been sluggish adoption, I disagree that we MUST reengineer care processes to reap the benefits.

EMR systems should be flexible enough to adapt to the workflow of users - even if minimal changes to the workflow are necessary. The ability to analyze the system and compare features to the clinical workflow (for example) will result in less risky patient care. Re-engineering the entire clinical workflow to adapt to the system is permeated with risk and could be a potential source for unintended patient harm. This is the "Geek Nurse" in me talking now..

 Thoughts?

Go to Part 2

Part 2 touches on the hidden costs of Healthcare Information Technology (HIT) and drivers for improving quality of patient care.

Go to Part 1

The largest investment in Healthcare technology goes beyond installation and to the training and use of these systems. Training is often a hidden cost which impacts perspective on Total Cost of Ownership that may, in fact, be one of the largest costs.

Keep in mind that from a clinical perspective, one of the most important benefits of HIT is to reduce inefficiencies and improve the quality of care. So, there are some costs savings to be realized when the technology is used accurately.

Improving the quality of patient care is a major goal for healthcare, across all disciplines, driven by the National Quality Strategy (among others) for adoption of quality and compliance measures to monitor quality of care. Compliance with these aims can be monitored in the aggregate or at a patient level in most CDS systems.

The National Quality Strategy is driving change in healthcare to improve quality. The 3 aims of the National Quality Strategy are:

Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.

Healthy People and Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.

Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.

But a new twist on the value of Clinical Data available for "mining" and "drilling" are "databases of clinical information" that can be used for medical research.

Given this opportunity, some costs associated with traditional Clinical Trials may be mitigated by using information obtained from an EMR and Clinical Decision Support system (CDS).

Using this technology, data can be massaged and analyzed in a manner that provides retrospective views of medical data for research.  These technologies become enablers for Medical Research and Clinical Decision Support Analysis.

Coming from HealthIT News Week, a report on anticipated future developments for "Big Data" and clinical decision support.

Link: http://www.healthcareitnews.com/news/6-keys-future-analytics-and-big-data-healthcare?single-page=true

Excerpt:

"A recently released report by Ewing Marion Kauffman Foundation proves the value of big data is certainly something to take seriously. And as more organizations create plans to make better use of and leverage their big data, Joe Petro, senior vice president of healthcare research and development at Nuance Communications, believes the industry is on the brink of seeing some pretty remarkable things as a result."

Link to article above.