News

A recent study funded by Agency for Healthcare Research and Quality suggests that patients with fully electronic health records experienced fewer adverse events such as hospital-acquired infections. In order to be considered a fully electronic EHR, "physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically generated," according to researchers. Using 2012 and 2013 Medicare Patient Safety Monitoring System data, AHRQ examined outcomes for cardiovascular, pneumonia and surgery patients – specifically with regard to occurrence rates of 21 adverse events in four clinical domains: hospital-acquired infections, adverse drug events, general events (falls or pressure ulcers, for instance) and post-procedural events. [Also: CMS awards $110M for patient safety] "To assess the role of EHRs in preventing adverse events, the researchers measured to what extent care received by patients in the 1,351 hospitals was captured by a fully electronic EHR," said Amy Helwig, MD, deputy director of AHRQ's Center for Quality Improvement and Patient Safety, and Edwin Lomotan, MD, medical officer and chief of clinical informatics at AHRQ's Center for Evidence and Practice Improvement, in a blog post. The findings of the study, published in the Journal of Patient Safety, show that, of more than 45,000 patients at risk for nearly 350,000 adverse events in the study sample, 13 percent were exposed to fully electronic health records. Among all patients examined in the study, the occurrence rate of adverse events was 2.3 percent, or 7,820 adverse events. Patients with EHRs, meanwhile, had 17 to 30 percent lower odds of any adverse event. Helwig and Lomotan said that health IT has shown patient safety gains, but research to prove it has often looked at just one healthcare provider at a time. "A question that remains unanswered is the impact of fully installed electronic health records systems used in multiple organizations," they wrote. "Another big question: can EHRs go beyond improving safety-related processes to actually preventing adverse events, such as potentially deadly hospital-acquired infections, from reaching patients?" The findings from "Electronic Health Record Adoption and Rates of In-hospital Adverse Events"  suggest hospitals with EHR can offer more coordinated care from admission to discharge to reduce the risk of patient harm. They note, however, that adverse event odds varied by medical condition and type of event. “For example, patients hospitalized for pneumonia and exposed to a fully electronic EHR had 35 percent lower odds of adverse drug events, 34 percent lower odds of hospital-acquired infections, and 25 percent lower odds of general events. Among patients hospitalized for cardiovascular surgery, a fully electronic EHR was associated with 31 percent lower odds of post-procedural events and 21 percent fewer general events," they wrote. [Like Healthcare IT News on Facebook] Helwig and Lomotan caution that the AHRQ study raises a few questions. “The findings showed a significant relationship between fully electronic EHRs and adverse drug event rates for patients hospitalized with pneumonia, but not for those with cardiovascular disease or needing surgery,” they wrote. “This may be due to the fact that certain high-alert medications, such as opioids, which are often associated with adverse drug events, were not included in the MPSMS measures." Still, the authors said as more hospitals mature in their use of EHRs, those systems can play a key role in preventing adverse events. Twitter: @MikeMiliardHITN

Patients with access to their online health information who received timely alerts about gaps in care were more inclined to receive preventative tests and screenings compared with patients who didn't use the service, according to a Kaiser Permanente study published in the American Journal of Preventative Medicine. Rates of preventive health screenings, chronic disease management tasks and vaccinations around the country remain low, according to the study. More than  20-80 percent of adults fail to obtain the health services they need. "Making sure patients receive appropriate tests and screenings is a critical part of providing high-quality healthcare, but it can be challenging and time-consuming to get patients to follow through due to a variety of reasons,” the study’s lead author Shayna L. Henry, Kaiser Permanente Southern California Department of Research & Evaluation, said in a statement. The study found that 8.8 percent of patients who used an online portal were more likely to receive colorectal cancer screenings than those members who didn't, and online users were 11.9 percent more likely to complete their HbA1c testing than non-users. [Also: Patients struggle with sharing health information online] Additionally, 9.1 percent of online users were more likely to visit providers for mammogram screenings, while 6.1 percent were more likely than non-users to receive a Pap smear. However, there was no noticeable difference between online and non-registered members when it came Patient access to health data, appointment reminders improve care gaps and patient engagement to receiving vaccinations. Researchers analyzed the electronic health records of 838,638 Kaiser Permanente members in Southern California. Around 40 percent of these members use the online Patient Action Plan, or oPAP, a Web-based system launched in 2012 that provides access to personalized health information. It also sends emails to members if they're in need of preventative care based on their last appointments for preventative screenings and specific health conditions, such as smoking and diabetes. [Like Healthcare IT News on Facebook]  “Our study demonstrates that by creating a customized and personalized communication to patients about their care needs, healthcare providers can directly engage patients and close important gaps in care, particularly for preventive screenings for cancer,” Henry said. "Although the findings represent only a small segment of the overall KPSC membership and the effect sizes are modest," the study's authors said, "the results of the present study indicate the oPAP has considerable potential to be a model for cost- and resource-effective patient engagement in health maintenance and disease prevention." Twitter: @JessiefDavis

UPMC doctors are piloting a new program to administer gene tests to patients to determine whether they are likely to respond to medications. For example, a simple blood test can determine whether a patient with clogged arteries has a gene variant that makes them less likely to respond to blood-thinning medication. At UPMC, doctors are testing for that gene before prescribing medications to patients who receive a stent. With this pilot, UPMC is among first-mover health networks embracing genomics to improve patient care. NorthShore University Health System, for instance, earlier this year opened a pharmacogenomics clinic and is working to incorporate that data into patient records so clinicians can access what it called “systematic and discrete data points” when treating patients. [Also: Pharmacogenomics coming to EMRs] UPMC’s goal is to use clinical pharmacogenomics knowledge to individualize patient treatments – part of a broader program at UPMC that officials say could eventually include a wide variety of drugs to improve outcomes for patients. "Increasingly we are able to pinpoint gene variations and other factors that affect how patients metabolize drugs, allowing us to more precisely target the right drug for the right patient," said Philip Empey, assistant professor of pharmacy and therapeutics at the University of Pittsburgh School of Pharmacy, and the leader of the program, in a statement. [Like Healthcare IT News on Facebook] The genetic and clinical information that is gathered for the PreCISE-Rx program, also feeds UPMC's data analytics program, which is expected to lead to new scientific insights into how and why drugs work for some patients but not others, and to identify new drug targets. More than 700 patients are expected to be treated through this project at UPMC Presbyterian's cath lab in the coming year. Past studies show that 30 percent of patients are unlikely to appropriately metabolize clopidogrel (the blood thinning medication), and about 10 percent experience complications because of the blood thinner's ineffectiveness. The UPMC research team will follow up with patients and collect data to evaluate their outcomes. UPMC plans to roll out the program at other hospital cath labs and expand it to include other medications. Twitter: @HealthITNews

McKesson Health Solutions and Health QX on Wednesday announced an alliance designed to help insurers quickly design and scale complex bundled payment models. The agreement also aims to ensure those programs provide timely and accurate payment to providers. Under the terms of the agreement, HealthQX and McKesson will jointly market their solutions to their respective customers, as well as coordinate consulting and service offerings, giving payers a single point of contact when creating bundled payment programs. The announcement was made at the Healthcare Financial Management Association's annual National Payment Innovation Summit, which is being held this week in Memphis, Tennessee. [Also: McKesson gears up for the next era] The agreement unites industry leaders whose combined offerings start with claims analysis, using HealthQX's ClarityQX; it extends to enterprise-class operation using McKesson's Episode Management and its other value-based reimbursement tools. This closes the gaps that can derail bundled payment programs, as payers and providers define how payments should be administered or -- later -- as payers attempt to scale operations to enterprise levels. [Like Healthcare IT News on Facebook] The development is expected to be positive for payers and providers struggling to master the complexity of bundled payment models. Just last month, the Centers for Medicare and Medicaid Services implemented the final rule for its first mandatory bundled payment program. Starting in April, acute care hospitals in targeted regions will receive bundled payments for lower extremity joint replacements or reattachments. This aligns with CMS's goal of having 30 percent of reimbursement made via alternative payments this year, and 50 percent by 2018. "Interest in bundled payment as a fast path to (value-based reimbursement) has never been greater, and payers and providers alike need help getting started and scaling up," said Carolyn Wukitch, senior vice president of McKesson Health Solutions, in a statement. Twitter: @JELagasse

(SPONSORED) Do your mobility solutions include communication and data exchange strategies? While seemingly a basic question, it's actually critical to determining efficacy.

(SPONSORED) Telemedicine is a hot topic in healthcare, with consumers more willing than ever to see a doctor remotely.

Matthew R. Fisher chairs the Health Law Group within the firm Mirick O'Connell in Worcester, Massachusetts, a fitting role given his passion for understanding the practicality of healthcare regulations in the real world. At the end of this month at HIMSS16 he'll bring this legal background to the Social Media Ambassadors program. [Also: Bill Bunting talks 2016 predictions, patient engagement] Fisher shared insights including understanding the next steps for IT security in healthcare, the microbreweries he cannot wait to visit in Las Vegas, and what he’s most looking forward to at the conference. Q: One health IT prediction for 2016? A: I think the HIPAA audits will finally occur. After the first round we'll likely find widespread noncompliance and that, in turn, will finally spur others to immediately put into place the minimum security measures of HIPAA. But HIPAA is just the ground floor: true security measures need to go above and beyond the regulation. Q: What’s something about you that even your devout followers likely don’t know? A: They don't know how much I love craft beer. I'm definitely a craft brewery fan and try to visit one wherever I go. I even have some planned out in Vegas: Hop Nuts and Camo Brewing. Q: What inspired you to apply for the Social Media Ambassador program? A: Having followed HIMSS through the social media channels and selected social media ambassadors in the past, I wanted to add my voice to that. And hopefully I can bring a different perspective on things coming from the legal side, as opposed to the health IT-side, which is already well represented. See all of our HIMSS16 previews Q: What is the untold benefit of social media in healthcare today? A: The ability to make connections with people you often wouldn’t be able to meet or otherwise interact with. We also can gain access to vast amounts of information and the ability to learn from others. I'm certainly learning from people I wouldn’t have come across in the health law field – and it helps to understand how the laws affect them rather than just stating regulations without knowing the consequences. Q: What are you most looking forward to learning about at HIMSS16? A: Learning more about the current thinking in health IT, in terms of what people are doing regarding security and how they're responding to threats. Unfortunately, healthcare has gotten a lot of bad press lately, in that payers and providers haven’t been focusing on security enough. The world has changed so quickly they haven’t been able to keep up. It will be interesting to learn about the new solutions and options out there. It's always nice to see what's really happening since the legal side only gets a small portion; it’s the tech side that drives the focus. See all of our HIMSS16 previews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

IT veteran Laura Young will share best practices for health information exchange among long-term post-acute care and mental and behavioral health providers  at HIMSS16.

It’s a futuristic idea to be sure: Harnessing the intelligence of IBM Watson, the Jeopardy-winning supercomputer, to support cardiac-care recovery, reduce hospital readmissions, and save healthcare costs. But that’s what the Colorado-based healthcare nonprofit Centura Health and consumer enterprise platform vendor Welltok are doing right now with CaféWell Concierge, currently in pilot with consumers who are transitioning back to everyday life after experiencing a heart condition. See all of our HIMSS16 previews “Cognitive computing mimics the way humans think by combining artificial intelligence and machine-learning algorithms,” said Jeff Margolis, CEO of Welltok. “IBM Watson understands natural language in context; it can determine the intent of a phrase or question and provide a pertinent, useful response.” Margolis, along with Pam Nicholson, senior vice president of strategy for Centura Health, will present “Applying Cognitive Computing to Population Health” at HIMSS16. Nicholson said that the technology the companies are piloting learns from interactions to provide personalized recommendations over time. For example, if a consumer has opportunities to join a team activity challenge and schedule a one-on-one coaching session, and consistently chooses the team activity, the app would recognize that this person favors social activities and recommend a support group at the local community center. [Also: IBM Watson picked to help tackle heart disease] Among the other ways that patients interact with CaféWell: Finding options for cardiac rehabilitation exercises and activities; researching new heart-healthy recipes and dishes at local restaurants, and identifying educational resources and videos on living with heart conditions. In these ways, cognitive computing is broadening the scope of healthcare delivery “so that it can happen outside what we normally think of as the healthcare setting,'” Nicholson said. “The contrast with traditional health care, where we only get to interact with the consumer when they step inside our four walls and temporarily become a patient, is profound.” As the real-world pilot users continue to train the application’s “brain,” as Margolis put it, these innovators see ample opportunities for cognitive computing to have an impact in the four areas of health: healthy behaviors, genetics, medical interventions, and environment. [Like Healthcare IT News on Facebook] “In five years, we believe that predictive analytics will further evolve and enable providers and consumers to make better health decisions while allowing for care to be highly personalized,” Nicholson said. “This will require us to continue to build solutions that incorporate timely and new data sources, offer reliable, consistent predictive models, deliver convenient and immediate personalized health and lifestyle recommendations, and learn intuitively and rapidly.” The session "Applying Cognitive Computing to Population Health,” is slated to take place March 3, 2016 from 1 to 2 p.m. in Rock of Ages Theater at the Sands Expo Convention Center. Twitter: @HenryPowderly This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

NewYork-Presbyterian has deployed its Patient Placement Operations Center, designed to support the hospital's existing patient teletracking systems. PPOC integrates NYP's advanced teletracking system with automated patient flow data and real-time patient information to efficiently place patients in the right departments for a smoother admission and placement process. Teletracking was in place within NYP for about five years and was built by senior leadership to combat issues with patient flow among its campuses, which include six main campuses in Manhattan, one behavioral health center in Westchester and two medical centers, among others. [Also: NewYork-Presbyterian says hospital integration not without hurdles] NYP also created the position of vice president of patient access, to focus on teletracking and patient flow, with the hiring of Holly Meisner this past year. Meisner says that although teletracking was in place, it wasn't fully utilized. Her task was to streamline patient flow in all of its campuses. But she soon realized although "the opportunities were present many different processes, we didn't know what the left hand was doing from the right hand." Back in October, NYP relaunched the teletracking initiative on the Columbia campus. It eventually will incorporate Allen, Morgan Stanley, and Cornell campuses into the teletracking system. Construction began in November and was completed in two months. PPOC is the centralized location for the project and is just the first of other projects to be implemented this year at NewYork-Presbyterian. Its Weill Cornell campus is next in line to have a PPOC constructed. [Like Healthcare IT News on Facebook] "Teletracking is a great tool for patient flow software," Meisner said. "I think some of the challenges in health IT is a lot of the large organizations want to create a single platform to integrate the revenue cycle, as well as EMR. That is ideal state." However, it's difficult to access all of the data. "Teletracking does a good job of pulling the data in real-time minutes," she added. "The downside is you're bringing in another system – especially in a world where we're trying to streamline. But the amount of data is worth it to drive results." Twitter: @JessiefDavis