Electronic Health Records

A recent article from China Daily stated that IT investment in the country’s hospital system will reach 65.7 billion yuan ($9.47 billion) in 2022, surging 53.5 percent from 2017 and boosting the digitalisation of the Chinese medical system, based on a forecast report by Analysys. The Beijing-based research consultancy’s report also noted that the Hospital Information System has almost achieved full coverage in China’s tertiary hospitals, which is the largest in the country’s three-tier system. Coverage in primary and secondary hospitals, the lowest two tiers, is currently at 80 percent. Statistics from the Chinese Hospital Association indicated that in 2017, hardware investment accounted for 44 percent of total hospital digitalisation investment, while spending on software and services represented 56 percent. Chen Qiaoshan, a medical analyst at Analysys said that software and services as the core of hospital digitalisation will a have higher growth potential than compared to hardware. From 2017 to 2018, 17.43 percent of the country’s hospitals greatly expanded their investment in hospital digitisation, and 29.78 percent slightly increased their investment, showing that in the future, the overall investment into hospital digitisation will continue to rise, according to the same report by Analysys. Webinar: The EHR App Store Is Open - What Is on the Shelf? Based on the latest statistics from HIMSS Analytics, China has 36 EMRAM Stage 6 validated hospitals and 10 EMRAM Stage 7 validated hospitals. EMRAM is the acronym for Electronic Medical Record Adoption Model by HIMSS Analytics, which incorporates methodology and algorithms to automatically score hospitals around the world relative to their Electronic Medical Records (EMR) capabilities. This eight-stage (0-7) model measures the adoption and utilisation of electronic medical record (EMR) functions and Stage 7 represents a remarkable achievement in which paper charts are no longer used.   Huangshi General Hospital in Hubei province and Children’s Hospital of Shanghai are two such hospitals to achieve EMRAM Stage 7 validation in the first quarter of 2018. In the same China Daily article, Qu Jing, another medical analyst at Analysys, said, “Although most hospitals attach great importance to information gathering, they do not have a clear development strategy. Statistics from the Chinese Hospital Association showed that while 97.25 percent of China’s hospitals have a specialised information and technology department, 56.29 percent of them lack thorough digitalization development planning.” Qu also added that hospitals lack regional connectivity, which is important for the development of hospital information platforms, with only 49 percent having a regional information platform.

University Hospital Southampton NHS Foundation Trust CIO Adrian Byrne discusses his organization's route to developing an electronic patient record (EPR), which involved an integration engine and standard messaging.

The U.S. Department of Health and Human Services has announced the winners of a new challenge to develop software for identifying and reporting safety and usability issues in EHRs in a way that doesn’t disrupt clinical workflow. The winning tools aim to make it easy to report IT issues within the healthcare workflow: giving feedback to developers and guiding the formation of best practices. The hope is to targeting usability challenges before they become major problems. Three winners were announced: The James Madison Advisory Group came in first, with a hotkey that allows a clinician to document an issue without leaving their EHR and which simplifies the process of reporting issues. Pegwin, in second place, developed an intuitive reporting system that allows a user to document an issue “in as few as three clicks.” Jared Schwartz and team came in third with a Google Chrome plugin which integrates with common IT ticketing platforms, making it easy to work into existing systems. The winners received $45,000, $25,000, and $10,000 respectively. WHY IT MATTERS Like any software, EHRs sometimes have flaws or malfunctions. An already busy clinician who is trying to manage a full patient load, perform diagnostic work and enter data usually doesn’t have time to document and report safety or usability issues to his or her IT department. Webinar: Improving Patient Matching in your EHR: A Case Study Finding a way to work tools into the care workflow that allow practitioners to capture and share potential safety and usage concerns results in greater efficiency without disrupting a clinical workflow. "Improving the safety of health IT remains an important priority," said Dr. Andy Gettinger, ONC chief clinical officer. "We believe that making it easier for end users to report will help in that goal." THE LARGER TREND EHRs have the potential to be the first point of data capture in a new landscape of precision care. First, though, they need to win over physicians who see them as cumbersome and byzantine replacements to the old pen and paper methods. Some healthcare systems are focusing on identifying those problems and addressing them to enhance the value of their EHR systems. Practitioners are experiencing EHR burnout – something ONC has also recently been working to help combat – where poor usability or other IT safety concerns can have a detrimental impact on effective patient care. ON THE RECORD "Helping reduce the burden of health IT continues to be a key area of focus at the Office of the National Coordinator for Health Information Technology, and we anticipate the winning submissions to the Easy EHR Issue Reporting Challenge will help with those efforts," said ONC chief Dr. Don Rucker. Benjamin Harris is a Maine-based freelance writer and and former new media producer for HIMSS Media. Twitter: @BenzoHarris.

Last week, Calvary Mater Newcastle Hospital in New South Wales (NSW), Australia became the 17th Intensive Care Unit (ICU) across the state to replace paper charting with Electronic Record for Intensive Care (eRIC), which digitally integrates patient data from bedside monitors, ventilators and other specialised equipment every minute. With this latest go live, more than a third of NSW’s 44 ICU hospitals are onboard the eRIC clinical information system. The electronic Record for Intensive Care (eRIC) is an electronic clinical information system within an Intensive Care Unit (ICU) that integrates patient data every minute from multiple systems, to improve patient safety and provide better clinical decision-making. “eRIC will cut manual documentation work, which is very time consuming,” said Kelly Duff, Clinical Nurse Educator and Change Manager at Calvary Mater. “With eRIC, we expect that documentation and compliance will improve, resulting in fewer mistakes relating to these.” Webinar: Leveraging Cloud to Revolutionize Health IT and Transform Your EMR System Calvary Mater Newcastle is the major cancer care centre for the Hunter New England Local Health District, delivering more than 320,000 occasions of outpatient services and in excess of 16,000 inpatient treatments per year. In October 2016, Port Macquarie Base Hospital (PMBH) was selected as the first ICU in NSW to deploy eRIC. Subsequently, there were eight hospital deployments of eRIC in 2017 and this year, there were nine hospital deployments, including the latest deployment by Calvary Mater Newcastle Hospital. Including Calvary Mater’s ICU, 345 beds in 17 health facilities across nine Local Health Districts (LHDs) have been enabled with eRIC as part of the ongoing digital transformation of NSW Health. Deployments of eRIC will continue in 2019, starting with Gosford Hospital and Wyong Hospital in Central Coast LHD. eRIC will also be introduced next year in the ICUs of St Vincent’s Private Hospital within South Eastern Sydney LHD, Broken Hill Base Hospital in Far West LHD and Nepean Hospital in Nepean Blue Mountains LHD.

The draft plan addresses physician concerns around usability, regulation and note bloat, and aims to help vendors improve their designs to improve productivity and user satisfaction.

(Sponsored) Ali Slimani, Cerner's general manager of strategic partnerships for Middle East sales, says Cerner is aligned with IHI's "Quadruple Aim," which includes improving patient and clinician experience well as lowering overall cost of care.

Health Minister Datuk Seri Dr Dzulkefly Ahmad also said in a recent HIMSS TV interview that even if an organisation has a good programme and system in place, digitising healthcare will not succeed if there is no clinical buy-in underpinned by training.

In the decade-and-a-half since the startling “To Err is Human” report, it’s still hard to discern whether billions invested in electronic medical records are improving patient safety.

Hospitals and health systems using IT from CommonWell member companies will be able to bilaterally exchange patient data within their EHR workflows.

New research from HIMSS Analytics finds widespread interest in patient-generated data and interoperability, along with a need for tech talent and bigger cybersecurity budgets.