HMT: Top 10 technology watch list, HIMSS award, data sharing network, and more
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January 7, 2014
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In this issue:

ECRI Institute releases free top 10 technology watch list for the hospital c-suite

HIMSS analytics honors Cincinnati Children’s Hospital with Stage 7 Award and 14 associated ambulatory

A study: The road toward fully transparent medical records

Data-sharing network to give assist to children’s health

ECRI Institute releases free top 10 technology watch list for the hospital c-suite

Each year, hospital leaders are bombarded with new technologies whose makers claim to improve outcomes and control costs. And with that comes mounting pressure from clinicians, vendors, and patients to adopt technologies or infrastructure changes that could profoundly impact the way healthcare providers deliver care and spend money.

Given that, how can hospital leaders make the right decisions when there is so much technology and a weak reimbursement climate? The short answer is "evidence and informed judgment."

ECRI Institute, a nonprofit dedicated to researching the best approaches to patient care, announces the release of its 2014 Top 10 Hospital C-Suite Watch List, an evidence-based, straight-talk reference guide on upcoming noteworthy health technologies or health systems issues. It is available as a no-cost public service.

"This is not a list of 'must-haves,' but rather a 'must think carefully about' list," states Diane C. Robertson, director, health technology assessment information service, ECRI Institute. "We don't profess to have all the answers, but the unbiased evidence that we present about these 10 technologies and infrastructure issues will get healthcare leaders off to a steady start on their often rocky journey of acquiring new technologies or making system-wide changes in 2014 and beyond."

Each of the 10 summaries in this year's list feature key recommendations designed to help leaders decide if they should adopt a specific technology or invest in new infrastructure early, later, or not at all, and the implications for doing so.

Technologies and infrastructure issues on this year's list include:

  • Computer-assisted sedation systems
  • Catheter-based renal denervation for treatment-resistant hypertension
  • Emergency departments designed just for elderly patients
  • Copper surfaces in ICUs for preventing hospital-acquired infections
  • Wearable powered exoskeleton rehabilitation for individuals with paraplegia
  • Magnetic resonance-guided focused ultrasound for cancer pain
  • NanoKnife system to treat cancer

Read the full new release here

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HIMSS analytics honors Cincinnati Children’s Hospital with Stage 7 Award and 14 associated ambulatory

HIMSS Analytics awarded Cincinnati Children’s Hospital in Cincinnati, Ohio, with its Stage 7 Award, and 14 of its associated ambulatory clinics the Stage 7 Ambulatory Awards.

Stage 7 Award: HIMSS Analytics developed the EMR Adoption Model in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals in the HIMSS Analytics Database. There are eight stages (0-7) that measure a hospital’s implementation and utilization of information technology applications. The final stage, Stage 7, represents an advanced patient record environment. The validation process to confirm a hospital has reached Stage 7 includes a site visit by an executive from HIMSS Analytics and former or current chief information officers to ensure an unbiased evaluation of the Stage 7 environments.

Stage 7 Ambulatory Award: Developed in 2011, the EMR Ambulatory Adoption Model provides a methodology for evaluating the progress and impact of electronic medical record systems for ambulatory facilities owned by hospitals in the HIMSS Analytics Database. These facilities include physician practices, clinics, outpatient centers and specialty clinics. Tracking their progress in completing eight stages (0-7), ambulatory facilities can review the implementation and use of IT applications with the intent of reaching Stage 7, which represents an advanced electronic patient record environment.

During the beginning of the third quarter of 2013, 2.2 percent, of the more than 5,400 U.S. hospitals in the HIMSS Analytics Database, received the HIMSS Analytics Stage 7 Award, and as of the second fiscal quarter of 2013, only 1.23 percent of the more than 20,000 U.S. ambulatory clinics in the HIMSS Analytics Database, received the Stage 7 Ambulatory Award.

“We’re proud to be among a very small number of U.S. hospitals that have been recognized for developing and managing a top-notch electronic medical records system,” said Michael Fisher, president and CEO at Cincinnati Children’s Hospital Medical Center. “I’m grateful to the entire team who contributes to this effort every day, and excited about what this means to patient safety, quality care, research, and ultimately, the health of the children and families we serve.”

Cincinnati Children’s Hospital, a non-profit organization, is one of the top three recipients of pediatric research grants from the National Institutes of Health, and a research and teaching affiliate of the University of Cincinnati College of Medicine. The medical center is internationally recognized for improving child health and transforming delivery of care through fully integrated, globally recognized research, education and innovation.

The hospital will be recognized at the 2014 Annual HIMSS Conference & Exhibition on Feb. 24-26, 2014, in Orlando, Fla.

“Cincinnati Children’s Hospital demonstrated a solid deployment of acute care as well as ambulatory care EMR in this very highly specialized pediatric care environment,” said John P. Hoyt, FACHE, FHIMSS, executive vice president, HIMSS Analytics. “Cincinnati Children’s certainly can quiet the critics who say EMR’s cannot be deployed in a sub-specialty environment. This is truly a paperless environment that is now successfully taking advantage of the rules and alerting capability that reinforces best practices.”

Read the full news release here

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A study: The road toward fully transparent medical records

Forty years ago, Shenkin and Warner argued that giving patients their medical records “would lead to more appropriate utilization of physicians and a greater ability of patients to participate in their own care.” At that time, patients in most states could obtain their records only through litigation, but the rules gradually changed, and in 1996 the Health Insurance Portability and Accountability Act entitled virtually all patients to obtain their records on request. Today, we're on the verge of eliminating such requests by simply providing patients online access. Thanks in part to federal financial incentives, electronic medical records are becoming the rule, accompanied increasingly by password-protected portals that offer patients laboratory, radiology, and pathology results and secure communication with their clinicians by e-mail.

One central component of the records, the notes composed by clinicians, has remained largely hidden from patients. But now OpenNotes, an initiative fueled primarily by the Robert Wood Johnson Foundation, is exploring the effects of providing access to these notes. Beginning in 2010, at Beth Israel Deaconess Medical Center (which serves urban and suburban Boston), Geisinger Health System (in rural Pennsylvania), and Harborview Medical Center (Seattle's safety-net hospital), more than 100 primary care doctors volunteered to invite 20,000 of their patients to read their notes securely online.

Although only a small minority of these doctors' patients used the portals, the initial findings were striking. At the end of a year, four of five patients had read the notes, and among those who responded to a survey, large majorities reported having better recall and understanding of their care plans and feeling more in control of their health care. Moreover, two thirds of patients who were taking medications reported improved adherence. Doctors reported little effect on their work lives and were surprised by how few patients appeared troubled by what they read. Although the notes were not formally evaluated, the majority of doctors reported not modifying their tone or content. A minority, however, reported changing the way they addressed four potentially charged topics: cancer, mental health, substance abuse, and obesity. After the first year, 99% of the patients surveyed wanted “open notes” to continue, 85% of the patients indicated that ready access would be important for their future choice of a provider or system, and no doctors chose to discontinue the practice.

Read the full New England Journal of Medicine article here

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Data-sharing network to give assist to children’s health

Derek Streat, father of a 6-year-old girl who had a kidney transplant in 2010, has a very personal reason to help Seattle Children’s connect with other pediatric hospitals around the country.

He sees a day when doctors looking for the best treatment for a patient could study medical records for hundreds or thousands of similar patients at hospitals across the country.

That could help identify ideal levels of anti-rejection medications for kids such as his daughter — crucial because too little and her kidney is rejected, but too much and the medication becomes toxic to her kidney.

Streat’s wish has just received a $7 million kick-start. Over the next 18 months, a grant from the Patient-Centered Outcomes Research Institute (PCORI), a federally funded nonprofit, will help connect Seattle Children’s with seven other pediatric hospitals to create a national network of patient data.

The aim is not only to help find better treatments for children but to make it easier for researchers to enroll patients in studies and speed up research projects.

“At heart, it’s really pretty simple — it’s sharing data and doing it in a privacy-protected way,” says Streat, a member of an advisory group that has helped Children’s with the grant.

With the eight hospitals combined, the databank will contain patient information from well over 1 million children, said Dr. Mark Del Beccaro, a researcher, emergency-department physician and vice president of medical affairs at Seattle Children’s.

Read the full Seattle Times article here

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