Stories about: electronic health records

Real-time influenza tracking with electronic health records

influenza tracking
Data captured from healthcare visits could be a tool for medical surveillance.

Early influenza detection and the ability to predict outbreaks are critical to public health. Reliable estimates of when influenza will peak can help drive proper timing of flu shots and prevent health systems from being blindsided by unexpected surges, as happened in the 2012-2013 flu season.

The Centers for Disease Control and Prevention collects accurate data, but with a time lag of one to two weeks. Google Flu Trends began offering real-time data in 2008, based on people’s Internet searches for flu-related terms. But it ultimately failed, at least in part because not everyone who searches “flu” is actually sick. As of last year, Google instead now sends its search data to scientists at the CDC, Columbia University and Boston Children’s Hospital.

Now, a Boston Children’s-led team demonstrates a more accurate way to pick up flu trends in near-real-time — at least a week ahead of the CDC — by harnessing data from electronic health records (EHRs).

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A banquet of tools for health tech innovators

Tools-Shutterstock-donatas1205-croppedWant to hack something in medicine? Vendors are increasingly eager to contribute their tools to problem-solving teams, like those who will gather November 14 for Boston Children’s Hospital’s Hacking Pediatrics. Seeing an array of tools presented at a showcase at Boston Children’s last week, I felt excited about the possibilities ahead.

Here are a few tools that can help innovators improve health care for patients, caregivers and providers.

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Ebola in the U.S.: Can EHRs help connect the dots between public health and clinical practice?

Dallas map Ebola electronic health records
(Google Maps)

The Ebola situation in Dallas—with one patient death, two nurse exposures, dozens under quarantine, and talk last week of declaring a state of emergency in the city—has thrown into stark relief the gaps between public health and frontline clinical care. But those gaps also present opportunities to make public health data work harder and to change how doctors approach clinical care in times when events and information are changing at Internet speed.

That’s the gist of an editorial by Boston Children’s Hospital’s Kenneth Mandl, MD, MPH, published Monday in the Journal of the American Medical Association.

It comes down to making electronic health records (EHRs) work more flexibly, in ways that help promote situational awareness among clinicians during times of crisis and flag instances when a patient’s condition may require more attention than usual.

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Patient-generated health data: Is health care ready to absorb it?

Health care data tsunamiIsrael Green-Hopkins, MD, is a second-year fellow in Pediatric Emergency Medicine at Boston Children’s Hospital and a fierce advocate for innovation in health information technology, with a passion for design, mobile health, remote monitoring and more. Follow him on Twitter @israel_md.

A few months ago, I spent 15 minutes filling out a detailed health data form at the doctor’s office. The paper form contained multiple questions about my health, family history, medications and basic demographic information. I assumed that an administrative specialist would code it into the practice’s electronic medical record (EMR) to be put to use. So it came as a surprise when I spent another 5 minutes reviewing the form with my physician, who then proceeded to type this information into the EMR herself. I’m confident neither my physician nor I felt enabled by the experience.

Countless people have had a similar experience—or worse, filled out a form with no sign that any clinician ever saw the information. Though the industry has made outstanding progress in adopting EMRs, the practice of data acquisition from patients remains cloudy. Patient-generated health data (PGHD), a term encompassing all forms of data that patients provide on their own, is a relatively new concept in health care. It falls into two broad groups: historical data and biometric data.

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Has the patient experience changed in 20 years? Retooling for engagement

Israel Green Hopkins MD croppedIsrael Green-Hopkins, MD, is a second-year fellow in Pediatric Emergency Medicine at Boston Children’s Hospital and a fierce advocate for innovation in health information technology, with a passion for design, mobile health, remote monitoring and more. Follow him on Twitter @israel_md.

The Centers for Medicare & Medicaid Services (CMS) defines patient engagement as having two primary objectives: to enable patients to “view online, download and transmit their health information” and to enable providers to conduct secure messaging with patients.

In 2007, focusing largely on these goals, Microsoft launched HealthVault—a Web-based electronic health record designed to fit the needs of both patients and providers. Countless private and public institutions have followed, including Boston Children’s Hospital.

But aside from satisfying regulatory requirements, are these interventions the improved engagement that patients are demanding? How can we be transformative in our approach to care and create an environment that is receptive to the engaged patient?

We first need to reconsider what it means to maneuver through the health care system as a patient.

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Health care software innovation: Why in-house accelerators are better

People & info-Shutterstock-croppedNaomi Fried, PhD, is Boston Children’s Hospital’s first Chief Innovation Officer and a founder of the hospital’s Innovation Acceleration Program. She tweets @NaomiFried.

Considering that Boston is home to some of the country’s best medical, scientific and technological minds, it is little surprise that the city has a vibrant startup ecosystem. That ecosystem lowers barriers to creating groundbreaking innovations, connecting innovators to funding, mentorship and human capital. Yet, it isn’t very well-suited to help health care software innovators, who face a unique set of challenges.

The unique and increasingly complex IT environment within health care institutions is one of the biggest barriers to the development of novel clinical software solutions. To start with, health care delivery IT environments boast complicated safeguards to keep medical information secure. In addition, as these environments grow in scope and complexity, keeping pace with advances in clinical technology, it becomes harder to incorporate new software.

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Can I have my health data? Some doctors still think no.

(Courtesy Accenture and Harris Interactive)

One of the big selling points of electronic health records (EHRs) is patient empowerment. By letting patients have their data, the thinking goes, they’ll be more engaged in their own health and empowered to take actions that will make them healthier.

Which is good not just for the patient, but for society as a whole, since living healthier means you’ll need to make use of fewer health care resources. Plus, a small study by doctors at a Veterans Affairs hospital showed that patients like having access to their records. Seems like a win-win, right?

While some physicians agree, there are some holdouts. That’s the take-home message from a survey recently published by Accenture and Harris Interactive, in which they asked 3,700 physicians in eight countries their opinions about letting patients have access to their medical and health data.

“The results of the survey are certainly quite interesting, although not surprising,” says Fabienne Bourgeois, MD, MPH, a pediatrician at Boston Children’s and leader of the hospital’s MyChildren’s EHR project.

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Disrupting health care: The unique challenges facing health tech entrepreneurs

Inventions need a little extra incubating to make them attractive to health care.

Jenna Rose is director of Healthbox, a platform that brings together entrepreneurs, strategic partners, industry experts and investors to accelerate innovative healthcare solutions. She spoke recently at Boston Children’s Hospital at a forum sponsored by the Innovation Acceleration Program. She welcomes inquiries from entrepreneurs and others at info@healthbox.com

When we think about the future of health, it’s generally medical science that captures our imagination—the source of groundbreaking pharmaceuticals, medical devices and diagnostics. But what about the business of health care? With the passage of the Affordable Care Act and the widespread adoption of mobile technologies, there has never been a better time to be a health tech entrepreneur. One recent report suggests that the healthcare IT sector could receive more than $1B in venture capital in 2012.

But change won’t be easy. As they seek to disrupt this $2.7 trillion industry, health tech entrepreneurs face a unique set of challenges.

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