Electronic health records suffer from a lack of innovation that thwarts physicians' attempts to advance healthcare processes and workflow. Unlike word-processing programs, search engines, social networks, and mobile phones and apps, EHRs are stuck in the pre-Internet world where EHR vendors not only control the data, but also resist improvements to functionality while reaping huge financial rewards, concludes a commentary that appears in the June 14 issue of the New England Journal of Medicine.
The spread of electronic medical records is helping "officials faced with events of public health significance to know sooner, act faster and manage better," said Dr. Seth Foldy, a senior adviser to the Centers for Disease Control and Prevention. In February, public health officials in Michigan noted an increase in electronic reports from clinical laboratories indicating E. coli cases in several counties. In less than a week, officials had enough evidence to warn the public that the infection appeared to be linked to clover sprouts in food at the Jimmy John's sandwich chain, said James Collins, director of the communicable diseases division at the state's Department of Community Health. The chain quickly removed the sprouts, and by April, the 11-state outbreak was over.
One point I thought worth mentioning was that the best mobile health tools are supported by strong clinical research. One example: WellDoc's DiabetesManager. The study, which was published in the September 2011 issue of the journal Diabetes Care, found that the group whose doctors had access to clinical decision support saw their A1c levels decline by 1.9 percentage points, while patients in the control group had a median reduction of only 0.7 percentage points. A more recent mobile technology experiment reported in the Archives of Internal Medicine also emphasized the value of good research support.
When University of Utah health law professor Leslie Francis learned her name and Social Security number had been exposed in the state's Medicaid breach, she decided to investigate. She deduced that her information was sent to the Utah Department of Health by a provider inquiring whether she was covered by Medicaid. That was a surprise, because she is insured through her employer and none of her providers had declared in privacy notices that they may bill Medicaid. What’s more, when she asked the hospital she believes is at fault to "fess up"—citing the Health Insurance Portability and Accountability Act (HIPAA)—the hospital refused, citing the same law.
If the merger went through, Mark Moroses, CIO of Continuum, would work with partners at NYU Langone to meld dozens of billing, procurement and patient care systems over the next few years. At the same time he is in the process of moving the chain of hospitals, which includes Beth Israel, St. Luke's, and Roosevelt, to digital healthcare records. That will allow the chain to claim $20 million to $30 million in government stimulus incentives over the next four years, he told CIO Journal. Mergers can complicate the transition to electronic records. Hospitals have different technical terms, and methods of documenting care, complicating the migration of data between the two institutions.
Many parents have experienced the angst of a crying baby with an ear infection. Some 30 million medical visits in the U.S. alone are due to pediatric ear infections each year. A startup called CellScope has developed a device that could make such visits unnecessary. It connects to an iPhone and produces a view inside the ear magnified by a factor of 10. Users can capture and upload images to CellScope's Web platform. After adding notes about other symptoms, parents could ask their own doctor to conduct a remote exam. In most cases, that would be enough information for a prescription to be called in, says CellScope CEO Erik Douglas.