Stories about: health records

Enhancing patient / care team interaction with an iPad “passport”

In just a 24-hour period, patients in the hospital typically see a variety of doctors, nurses, x-ray technicians and other medical professionals, and undergo a plethora of diagnostic tests—without an understanding of how all of it comes together to make them well.

The Diversity and Cultural Competency Council (DCCC) at Boston Children’s Hospital recently conducted a three-year study on patient satisfaction. It found that the main reason patients were sometimes dissatisfied was because they felt unfamiliar with the medical information they were receiving, and had difficulty understanding who was part of their care team and how best to communicate with them. And so the idea of MyPassport was born.

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Learned helplessness: Millennials and electronic medical records

Is healthcare IT ready to grow up? (N Kasp/Wikimedia commons)

As I read more about the Millennials, the generation to which I myself belong, I’m starting to see a connection between their attitude toward the world and the problems plaguing healthcare IT, an industry I research for a living.

Millennials (by one definition, people born between 1981 and 2000) tend to perceive greatness as something that is inherent, not acquired. This fallacy comes in part from the coddling we were given as young people. Millennials received trophies just for participating. Thanks to grade inflation in college, we could sleep through classes and still earn a B. We were told we were special: Success came to us simply by showing up.

This type of attitude leads to inevitable discouragement post-college, when Millennials are faced with challenges they haven’t been prepared to handle. Jobs aren’t handed out just because the applicant has a degree, but instead require connections or specialized skills or experience, and once in those jobs, success doesn’t come automatically. When he doesn’t face immediate success, the Millennial assumes that he’s “different” than the successful people, and attributes the failure to an intrinsic, unchangeable quality rather than faulty methods.

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Let’s liberate clinical trial data

The Gutenberg press disseminated ideas to a wider society. But in the clinical world, much information is still on "lockdown." (Wikimedia Commons)

The best things in life are free: friends, sunny days, beautiful vistas. Wouldn’t it be nice if knowledge were also free? Historically, libraries promulgated knowledge sharing because it was for the public good. We see this spirit increasingly embraced on the Internet – take the recent announcement of a collaboration between Harvard and MIT to make their courses freely available to users around the world via the edX platform.

But have we made all useful knowledge available in a way that allows for the greatest societal advancement? Not really. According to Ken Mandl, MD, MPH, director of the Intelligent Health Laboratory at the Children’s Hospital Informatics Program (CHIP), one important source of information still on lockdown is clinical trial data. In an article called, “Learning from Hackers: Open-Source Clinical Trials” published this month in Science Translational Medicine (not currently available in full text), Mandl and his coauthors call for making raw, de-identified clinical trial data free to the public.

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Turning medicine inside out: It’s all about the data

(Mike Deal aka ZoneDancer/Flickr)

From the ashes of the demise of Google Health may yet rise a health care information system that really works — for doctors and patients alike. And let’s not forget caregivers – those responsible for the health of their children or aging parents. They need all the help they can get.

Interviewed last week for CommonHealth, WBUR.org’s health blog, Ken Mandl of the Children’s Hospital Informatics Program (CHIP) argues that Google’s effort fell short on a key ingredient: data. Mandl co-founded Children’s Hospital Boston’s open-source patient-controlled record, Indivo, and wants to see a world where medical data flows unfettered – brings real value. Here’s how he put it to CommonHealth:

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Application building for dummies: Filling unmet medical needs

Photo: fdecomite/Flickr

What do you invest in if you’re a venture capitalist looking for the next big thing? I’d invest in a company that makes it easy to create your own healthcare mobile apps. Think: the WordPress of health care applications.

I believe this is an important unmet need in medicine. As a market analyst specializing in healthcare IT, I’ve supported physicians who have an idea for an application and are trying to make it a reality. Their goals vary widely, ranging from improved communication with patients to enhanced health data analytics for decision support to streamlined workflow using administrative shortcuts.

All of these disparate ideas face a common bottleneck: the physician’s inability to quickly embody an idea as a software prototype.

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Innovation on inpatient floors: 21st century white boards

Our old white board (patient names erased for privacy)

Imagine walking into your first day of work, being introduced to a new colleague and hearing, “Here’s the person who’s going to help you solve your problem.” I was a new Project Manager in Patient Care Operations at Children’s Hospital Boston. This brief introduction to Carlos, a Patient Service Associate on 9 South, marked the beginning of a year-long journey.

The problem Carlos laid out is common in hospitals, where multiple information systems, people and tools function in a fractionated, inefficient manner, culminating in a finished product that takes a village to maintain. It’s the problem of keeping the unit’s large, white dry-erase board up to date 24/7.

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Advanced computing meets healthcare: Disruptive changes to come

(alikins/Flickr)

The recent Bio-IT World meeting featured some exciting forecasts about disruptive healthcare advances from advanced computing technology. We’re closer than ever to process streamlining, artificial intelligence and combining the best ideas from other industries. Many themes I like to blog about — clinical decision support, data visualization, patient-entered health data — were addressed provocatively in the talks. Here are some trends I’m watching.

•    New data visualization systems will increase scientific productivity. Keynote speaker Bryn Roberts of Hoffmann-La Roche demoed a futuristic, multi-touch tool for reviewing and designing compound molecules,

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Disease management meets intelligent design

At a conference in Texas a couple of years ago, I found myself – as at all good national conferences — talking to a colleague from my own institution. As we browsed the poster session, we talked about our respective work.

Eugenia Chan works in the Developmental Medicine Center at Children’s Hospital Boston, where I’m an emergency physician and health services researcher. I told Eugenia about The Online Advocate, a Web-based system I’d been developing for the past eight years. It screens patients and families for health-related social problems, provides feedback and helps them find services in their area that can assist them.

Eugenia was excited about bringing The Online Advocate to her patients.“This is really great, and I want to use it,” she said. “But I have another idea that I would like to explore with you.”

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Shadowing ADHD with web-based tools

This is how  it used to be when I saw a child with attention-deficit hyperactivity disorder: “You know, Dr. Chan, I really don’t think the medicine’s working,” the parent would tell me. “I just don’t see any difference in his behavior.”

“Well, the medicine has probably worn off by the time you see him at home,” I’d say. “What does his teacher think?”

“She hasn’t called me, so I assume there hasn’t been any trouble.” Then: “Oh—I was supposed to give her that questionnaire to fill out, wasn’t I?  I’m so sorry, I totally forgot.”

As a developmental-behavioral pediatrician specializing in ADHD, I used to have this conversation with parents at almost every single follow-up visit, leaving me frustrated.

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Using health-records technology to bring value

The shelves that used to hold Children's Hospital Boston's paper medical records now stand empty.

What does paperlessness mean? It’s about helping patients, says Daniel Nigrin, Chief Information Officer at Children’s Hospital Boston. This approach helps explain why he was named one of the InformationWeek Healthcare 25, a short list of leaders driving the healthcare IT revolution.

“The integration of a patient’s data has to be one of the topmost national priorities,” Nigrin says. “It will eventually lead to better care, and hopefully a reduction in cost.”

This need is becoming critical as healthcare reform rolls out and primary-care practices become patients’ medical homes, integrating information from

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