Stories about: healthcare IT

DisCo: Keeping in touch with families after discharge

Mom & child receiving a text-ShutterstockKelly Dunn, a pediatric nurse practitioner in Medicine Patient Services at Boston Children’s Hospital, is primarily focused on helping families with hospital discharge and improving patient throughput.

A child hospitalized on 9 East, a general medical floor at Boston Children’s Hospital, was nearly ready to go home. The discharge order was written, and prescriptions were sent to the pharmacy. The staff nurse and I completed discharge teaching, competing with a very wiggly toddler for her tired mother’s attention.

Before this family went home, I had one more question: Would you like to receive a text message or email to check up on you once you are home?

Within a minute or two, I had entered the mom’s contact information and her preferred mode of communication (a text message to her cell phone) on an iPad. The family left, reassured to have a way of reaching a nurse familiar with their hospitalization should a problem or question arise at home—and pleased to have the option.

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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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SHRINE: Clinical & population research by the numbers

Clinical research is all about numbers. A new informatics network called SHRINE could help make it easier to get find out if the numbers of patients are there to answer complex questions. (victoriapeckham/Flickr)
Ed. note: This morning at 8:15 EDT, Isaac Kohane, MD, PhD, will tell the audience at TEDMED 2013 about his goal of using every clinical visit to advance medical science. 

To preview his talk, we’ve updated a past Vector story about SHRINE, a system Kohane helped develop to allow scientists to use clinical data from multiple hospitals for research.

Clinical research really comes down to a numbers game. And those numbers can be the bane of the clinical researcher. If there aren’t enough patients in a study, its results could be statistically meaningless. But getting enough patients for a study, particularly for rare diseases, can be a daunting challenge.

The Shared Research Information Network (or SHRINE) could help solve this vexing problem. Developed through Harvard Catalyst by a team led by Isaac “Zak” Kohane, MD, PhD, director of Boston Children’s Hospital’s Informatics Program, SHRINE links the clinical databases of participating Harvard-affiliated hospitals—currently Boston Children’s Hospital, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Massachusetts General Hospital—letting researchers at those hospitals see how many patients from those hospitals meet selected criteria.

Why is this important?

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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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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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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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Learned helplessness: Millennials and electronic medical records

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

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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Empowering patients: Intelligent devices and apps for better health

Melinda Tang, MEng, is a software developer for the Innovation Acceleration Program at  Boston Children’s Hospital.

When children return home from the hospital after surgery, parents can be overwhelmed by the written information and instructions for follow-up. At the MIT Media Lab’s Health and Wellness Hackathon earlier this year, the focus was on empowering patients to take an active role in their health. As my colleague Brian Rosman described, our team from Boston Children’s Hospital attended and spent two weeks developing “Ralph,” a mobile application for managing post-operative care that incorporates an avatar and features of gaming to engage and motivate children to follow their regimen. I was one of the primary programmers for our group.

We won third place, working alongside five other talented teams. Here are some snapshots of what they were up to — helping patients manage asthma, diabetes, pain, cardiac rehab and more.

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BEAPPER: a Twitter-like app for emergency clinicians

Debra Weiner speaks with Emergency Department Fellow Joel Hudgins who holds one of the iPhones piloting BEAPPER

For Debra Weiner, MD, PhD, working in the Emergency Medicine Department is a numbers game. During a 12-hour shift she works with more than 50 other providers, sees up to 25 patients and analyzes multiple lab results. Every day she’s also meeting new staff members in addition to new patients.

“People don’t know each other,” Weiner said at a recent Innovators’ Forum, a monthly internal lecture series intended to showcase and encourage new developments at Children’s Hospital Boston. “We have over 100 nurses and physicians and over 200 trainees that filter in [every two to four weeks]… it’s hard to remember who everyone is and what they do.”

Coupled with the frenetic pace of Children’s Emergency Department (ED), remembering names and managing the flow of patients becomes a constant challenge.

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Could texting patients reduce hospital readmissions? Thinking through an innovation

(Lars Plougmann/Flickr)

Your child has been in the hospital and it’s discharge day. It’s a chaotic scene: You’re trying to take care of him and maybe his little sister who keeps running down the hall, while completing hospital paperwork and packing your bags.

You’re finally out the door, in your car, kids strapped in and … what?  You’ve just lost contact with the medical professionals who took care of your son. What was it they said to do at home again?

Perhaps you try phoning but can’t get through to your doctor. Or you try to email through the hospital’s secure system, but can’t put your hands on the password. The doctors hope you remember to pick up your son’s meds.

Vinny Chiang, a physician at Children’s Hospital Boston, came up with a simple idea. Could day-after communication with patients be “pushed” — proactive and automated? Could it be texted?

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