If a hospital room could speak, it would say things like: Keep my patients safe. Make my bed foolproof so that patients don't fall out. Keep those Latex gloves away from allergic patients. And make sure the patient on the left side of the room doesn't get the medication intended for the one on the right. A recent visit to a digitally enhanced "smart room" at University of Pittsburgh Medical Center convinced me that some hospital rooms can, in fact, deliver on these priorities. These rooms, which are jointly funded and operated by UPMC and IBM, are called SmartRoom and use real-time location tracking devices to bring patient information from the EMR to computer screens in the patient's room. At the UPMC hospital I visited, clinicians were recognized by the room with the help of ultrasound-enabled badges, which then allowed them to access patient data.
These days, some surgeons have four arms and are made of metal and plastic. Use of a robotic assistant called the Da Vinci Surgical System has quadrupled in the last four years, and the machine now helps with incisions and sutures in 2,000 hospitals around the world. Da Vinci is a multi-purpose robot — the only one of its kind — that can scrub in on heart bypass and valve repair operations, hysterectomies, prostate removal surgeries and other procedures. The Da Vinci robot is not actually performing operations; it only mirrors the movements of the surgeon's hands on two joystick-like controllers. Hospitals with the robot proudly proclaim its modern capabilities. Some patients insist on being treated by the mechanical surgeon. But despite the Da Vinci's popularity, its surgical talents may not surpass those of flesh-and-blood physicians. "There's never been a study showing clinical superiority," says Dr. Marty Makary, a surgeon at the Johns Hopkins University School of Medicine in Baltimore. "For the patient, there's clearly no difference."
Healthcare IT stakeholders gathered Oct. 14 in Washington for a work meeting, discussing ways IT could help improve transitions in care. The invitation-only meeting was hosted by the Office of the National Coordinator for Health Information Technology, the John A. Hartford Foundation, the Gordon and Betty Moore Foundation, and Kaiser Permanente. Attendees included federal officials, electronic health record vendors, entrepreneurs, grantees, leaders from ONC's Beacon Communities and foundation funding organizations. "We basically have all the tribes together today," said Aaron McKethan, director of ONC's Beacon Program, as he kicked off the meeting. National Coordinator Farzad Mostashari, MD, was both realistic and optimistic in his charge to attendees. "Our healthcare system is in trouble," he said. "It doesn't keep people safe and it's too costly. But I'm incredibly optimistic that this is the time when we're going make this better."
Even in the vast world of apps, Dr. Patrick J. Gagnon has one with an unusual distinction: it had to be cleared for use by the Food and Drug Administration. Dr. Gagnon, a radiation oncologist, uses the app when he sees patients in his Fairhaven, MA, office. He pulls his iPhone out of his pocket, and then he and a patient, side by side, can view images on it and discuss treatment. "It's a nice way to go through a scan with a patient," he said. The app he uses, called Mobile MIM, made by MIM Software, can turn an iPhone or an iPad into a diagnostic medical instrument. It allows physicians to examine scans and to make diagnoses based on magnetic resonance imaging, computed tomography and other technologies if they are away from their workstations. Dr. Gagnon says the app will also prove useful when he wants to give physicians at other hospitals rapid access to images for immediate decisions.
The Nemours Foundation's Wilmington-area offices have lost three computer backup tapes containing sensitive personal and financial information on about 1.6 million patients, employees and other people associated with the four-state children's health care provider. The lost tapes do not contain detailed medical records, and patients' treatment information is stored on the tapes in a coded format, according to John Grabusky, spokesman for the foundation that operates the Alfred I. duPont Hospital for Children north of the city. The tapes do include patient billing and employee payroll data, including name, address, date of birth, Social Security number, insurance information and direct-deposit bank account information. The Nemours Foundation's Wilmington-area offices have lost three computer backup tapes containing sensitive personal and financial information on about 1.6 million patients, employees and other people associated with the four-state children's health care provider. Most of the information on the tapes dates from 1994 to 2004 and was generated at the Nemours facilities in Delaware, Pennsylvania, New Jersey and Florida. That includes the children's hospital's many pediatricians' offices.
The Nebraska Health Information Initiative has signed 14 critical access hospitals to its statewide health information exchange in recent weeks, with others expected to join as more hospitals roll out digital health record systems. Nebraska, which has a population of about 1.8 million, is one of the most rural states in the U.S., and with 65 critical access hospitals, or CAHs, has more of these facilities than most other states. And while more than a dozen CAHs just joined the Nebraska Health Information Initiative, many of the remaining CAHs in Nebraska "are still implementing e-health records," said Deb Bass, a former nurse and NeHII executive director. "Until these other hospitals get that work done, having all of them part of NeHII is still a pipedream," she said. There are many constraints on CAHs rolling out EHRs, including "a lack of technology skills," she said. "Many have only a part-time IT person," she said. Some of those hospitals in Nebraska are so small that they treat fewer than five patients a day, she said. Still, having the state's CAHs part of NeHII is vital, she said in an interview with InformationWeek Healthcare. Among other government requirements, CAHs must be located in rural areas and separated from other hospitals by at least 35 miles, or less in mountainous regions.