patient safety
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New York’s Ongoing Blackout: Hospitals In Lower Manhattan
Long after power is restored from Sandy, the effect of another more-precarious outage is still taking shape: Some of the largest hospitals in lower Manhattan remain shuttered. Other hospitals are scrambling to fill the gap, and concern is rising that the patchwork system can't last for long. Read More »
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Noted: Experimenting With Open Access Notes In Medicine
As health information technology continues to evolve, new and creative uses for electronic health records (EHRs) are beginning to develop. One such “potentially disruptive innovation” is the use of EHRs and patient portals to give patients access to the notes doctors prepare on patients after an office visit. Read More »
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Nurses Want Probe into EMR Failure
Nurses at a California hospital are asking state officials to investigate the failure of the hospital's electronic medical record system, an incident they said led to the closure of its emergency room and compromised patient safety. The EMR system at the 420-bed Antelope Valley Hospital in Lancaster, California, reportedly failed last weekend, resulting in clinicians unable to review patient labs, verify physician orders and access patient records, according to the California Nurses Association and the National Nurses United union.
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Nurses Warn Epic EHR Causes Serious Disruptions to Safe Patient Care at East Bay Hospitals
Introduction of a new electronic medical records system at Sutter corporation East Bay hospitals has produced multiple problems with safe care delivery that has put patients at risk, charged the California Nurses Association today...In over 100 reports submitted by RNs at Alta Bates Summit Medical Center facilities in Berkeley and Oakland, nurses cited a variety of serious problems with the new system, known as Epic. The reports are in union forms RNs submit to management documenting assignments they believe to be unsafe. Read More »
On the Need for a Universal Health Record
The current path of progress of the EHR, with its concentration on “meaningful use,” and an intellectual property regime that does not fully exploit the capacity for innovation by end-users is approaching an evolutionary dead-end. It is time to treat the EHR as what it should be: an integral part of medical care that has limitless potential for maximizing the use of information acquired in the provision of health care, and not an impediment to optimal care and a bugaboo for the physician. Read More »
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On the Need for Human-Centered Design in EHRs
Health information technology (HIT) has become the hottest political issue in Washington. The healthcare industry in the United States is facing a crisis as medical facilities have spent hundreds of billions of dollars implementing electronic health record (EHR) systems, yet patients and the physicians and nurses that care for them are seeing few benefits. Congress has been holding hearings focused on detailing the problems and trying to write legislation that will provide a solution to the crisis. The HIT interoperability bill drafted by Rep. Michael C. Burgess (R-TX) is one example. These are welcome first steps. However, none of the bills currently before Congress, and none of the hearings, are addressing the two most important issues facing medical providers today. These are lack of EHR usability, and the inability to have a patients’ entire medical record at the point of care.
On the Need to Improve User-Centered Design (i.e. Design Thinking) for Healthcare IT Usability
The lack of usability of electronic health records (EHRs) and healthcare IT applications, in general, has been in the news a lot again. This time it is a research report published in the Journal of the American Medical Association (JAMA) on March 27. The study analyzed voluntary error reports associated with EHR systems and found that problems with EHR usability may have directly resulted in patient harm. Unfortunately, this situation is all too common in the healthcare industry. Numerous health care systems are designed and created ad hoc, or with a very engineering-centric approach. End users are dissatisfied and often systems or workflows are abandoned and/or dangerous work-a-rounds created. A lot of people are saying Healthcare IT needs a disruption. What HealthIT needs is to begin to learn about and understand the needs, goals, and methods of the actual end-users, like doctors, nurses, medical assistants, etc.
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ONC Contract Guidance Attempts To Level The EHR Playing Field
Regular readers of FierceEMR know that I tend to be cynical about new developments. I don't take them at face value and delve deeper to see if there's anything in addition going on behind the scenes. And so it is with the Office of the National Coordinator for Health IT's new "legal" guidance on EHR contract terms.
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ONC Gets It Mostly Right with TEFCA 2.0
On April 17, 2019 the Office of the National Coordinator for Health Information Technology (ONC) released the second draft of its Trusted Exchange Framework and Common Agreement (TEFCA) for comment. The initial version was released more than a year ago in January 2018 (see my original blog). As before, this is in response to a requirement imposed by Congress in the 21 Century Cures Act. After a somewhat lengthy (but well written) introduction, the document contains three parts (compared to just two parts the first time around)...
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ONC Plan Makes Reporting IT Hazards Easy
With sights set on utilizing health IT to curb the alarming number of medical errors that transpire each year, ONC officials unveiled Tuesday their final plan to bolster patient safety initiatives nationwide. Read More »
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ONC Plans Stronger EHR, Patient Safety Features
The Office of the National Coordinator for Health IT wants to use electronic health record certification criteria to make it easier for physicians to report patient safety events, which provide critical raw data for developers, healthcare providers, researchers and policymakers to improve the safety of health IT and make care safer. Read More »
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ONC Playbook Breaks Down Health IT, EHR Tasks and Buzzwords
The healthcare industry seems to be largely driven by buzzwords: quick and snappy phrases that reduce complex, difficult, expensive and often confusing initiatives into keywords that may not mean much to the uninitiated. From big data and population health management to electronic health records and value-based care, these short and sweet terms have come to define the new direction of one of the nation’s largest sectors...
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Online-only Pharmacies That Don't Require Prescriptions Could Fuel Antibiotic Resistance
The researchers from Imperial College London analysed 20 pharmacies that were available for UK citizens to access online. This is one of the few studies to have examined the online availability of antibiotics and to have explored the potential effects on public health. The research is published in Journal of Antimicrobial Chemotherapy. Antibiotics are classed as prescription only medicines in the UK, meaning they cannot legally be sold to consumers without a valid prescription...
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Only 12% Of Docs Meet Meaningful Use Rules
Just over 12% of about 509,000 eligible physicians said they met requirements for meaningful use incentives for electronic health records (EHRs), early study results show. Read More »
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Open Source Electronic Health Records For Education And Training
In spite of being very involved in the field of Health Informatics I only recently became aware of VistA for Education (VFE), which has all of the aforementioned attributes of an excellent solution for EHR education purposes. VFE was developed as a result of a grant from the Office of the National Coordinator (ONC) to supplement the ONC Health Information Technology (HIT) curriculum. Electronic health records (EHRs) are more than just the electronic equivalent of paper-based health records. Electronic health data is easier to search, share and archive, compared to paper records. Additionally, EHRs can be embedded with clinical decision support to alert and remind physicians of patient safety and preventive medicine measures.