Electronic Health Records (EHR, EMR)

Electronic health records are very good at being repositories for valuable patient data. But they need help when it comes to putting that data to work for more innovative care delivery. The ever-expanding volume and variety of clinical and social-determinant factors will require more advanced technologies to be optimally harnessed for precision medicine. Enter AI and machine learning, which "will play a growing role in healthcare, under two main categories – generating knowledge and processing data," according to Auckland, New Zealand-based Kevin Ross, who will speak next month at HIMSS19. Ross is General Manager at Precision Driven Health, launched as a partnership between Orion Health (where he is Director of Research) and government agencies and academic organisations in New Zealand to explore and promote precision medicine. He sees machine learning as a key enabler in the years ahead as health systems look to unlock the data and in their EHRs and put it to work for more personalised care. "Health records have been electronic – and therefore accessible for analysis – for a relatively short period of time, but we are now seeing huge volumes of data being generated from different sources," he explained. "We've had insufficient computational power to process the volume of data in a genome, let alone a microbiome, etc. until fairly recently." The advent of AI and machine learning opens new avenues for healthcare wisdom to be accrued. Medical research has traditionally come through "targeted studies on narrow subsets of the population," he said, "now we can analyse over large populations in relative real time, because the data is being collected digitally. New knowledge will come about by applying machine learning to these increased data sets to uncover patterns that are occurring today without being noticed." In Orlando, Ross will explain how he and other researchers are making the most of some unique aspects of New Zealand's healthcare landscape – connected electronic healthcare data across the population, leading-edge research organisations – to enable the development of new technologies and data strategies for precision medicine. "New Zealand has some unique benefits, including a long history of digital health records with well managed health ID numbers, so it is a lot easier to link different data sets together," he said. Add to that: Linked data between social services (health, education, justice, welfare, tax) available for research purposes; A single payer system whereby the incentive of patient, provider, and system are typically well aligned (e.g. early intervention benefits all) Willing collaboration between commercial and public provider organisations as well as between clinical and data science researchers A unique ethnic diversity (74 per cent European, 15 per cent Maori, 12 per cent Asian, seven per cent Pacific Islander – including those identifying multiple) A strong data science research community A population relatively comfortable with technology and with broad access

University Hospital Geelong is upgrading its emergency department clinical workflows with the aim of delivering quality, patient-centred clinical care. The healthcare organisation will soon go-live with its new FirstNet ED Information System (EDIS), from Cerner, and replaces the Symphony ED System that it used previously as it is no longer supported in Australia. Cerner FirstNet is an integrated emergency solution that supports a wide range of functions including registration, triage and tracking, checking nursing documentation, managing physician transfer of care, and integration of documentation into a patient's Electronic Health Record (EHR), all in one system. It also lets the healthcare practitioner include and manage a patient’s past medical, family, social or surgical history, in addition to keeping a record of a patient’s transfer movements. Barwon Health Chief Information Officer Associate Professor Sharon Hakkennes told HITNA that Cerner’s emergency information system was picked following a comprehensive procurement process and will be critical in supporting its goals of high-quality, patient-centred clinical care across the entire care continuum into the future. “We have worked closely with Cerner to ensure the system functions with our current workflows and processes,” Hakkennes said. “The switch to FirstNet has required staff training and preparation in order to minimise clinical disruption and maximise the benefits of the new system when we go live.” According to Hakkennes, implementation of FirstNet at the University Hospital Geelong is aligned to Barwon Health’s strategy to implement a fully integrated EHR over the coming years. “The EHR will enable seamless transfer of health information across Barwon Health services, general practice and other health services, and will support upload of information to My Health Record,” Hakkennes said. “The importance of such functionality cannot be underestimated given the growing population of the Barwon region and the increasing burden of chronic disease.” [Read more: Allscripts and Cerner offer glimpses at tech priorities in new earnings reports | Cerner tops the EHR global market share with almost double that of closest rival Epic] Most recently, Bass Coast Health migrated its systems to experience the benefits of a complete EMR solution, having equipped its healthcare facility with MasterCare EMR. The solution will be used by Bass Coast Health clinicians to govern the assessment and management plans of clients, along with the monitoring and measuring of ongoing outcomes. The contract between Cerner and University Hospital Geelong also follows the former’s largest ever EHR undertaking in the US, announcing in October last year that it will support the US Department of Veterans Affairs’ transition from its legacy VistA EHR, alongside 24 vendors.

Organization says 5 will build on FHIR 4 with more normative content, support for apps that use multiple versions of the spec and other advancements.

Health information exchanges can help providers and public health departments overcome common obstacles. 

Queensland Ambulance Service (QAS) has rolled out a digital system that aims to give paramedics greater access to a patient’s vital medical information in an emergency. The SafeMate emergency medical information program is under trial for Medibank customers with chronic illnesses that are living in Queensland. Patients must be enrolled under Medibank’s CareComplete chronic disease management service. The SafeMate program houses a patient’s medical and personal information that they enter online. QAS personnel can then access this data by scanning a QR code on a patient's SafeMate card using iPads. “This is crucial information that a patient wants the paramedic to know in a medical emergency,” Queensland Government Minister for Ambulance Services Steven Miles said. “Paramedics will use their operational iPads to tap the patient’s SafeMate card or device, and the medical information will appear on the screen. It eliminates the time it would normally take a paramedic to ask the patient a range of questions in order to obtain their medical history and other pertinent details.” This gives paramedics access to important information, such as details on allergies and medical history, letting them identify best courses of treatment earlier and improving patient outcomes. It also aims to reduce paramedic and patient stress, time-consuming hospital visits and costs in the health system, in addition to improving ambulance efficiencies. Prior to December 1 last year, paramedics were unable to access these records as the organisation was not in the Australian Health Practitioner Regulation Agency (AHPRA) regulated health profession registry.   The digital system is a testament to Queensland’s ongoing digitisation journey, with the launch of a digital hospital program to improve the state’s healthcare and patient outcomes.  In December last year, through findings from a report tabled by the Queensland Audit Office (QAO), Miles outlined the benefits of the digital hospital program in Queensland. He said that as a result of the digital hospital program, Queenslanders face improved health service delivery and patient outcomes, including a reduction in unplanned readmission rates, faster access of clinical information by medical staff and more legible patient records. “Digital hospitals are making Queensland hospitals safer than ever before. Doctors and nurses have told me when I’ve visited hospitals that the digital system helps them do their jobs and helps patients,” Miles said. Ambulance Victoria has also ramped up its digitisation strategy, with the organisation most recently announcing that it will soon deploy a predictive analytics platform for its paramedics to access real-time information, enhancing and accelerating its decision making as the need for emergency services grows. This article first appeared on Healthcare IT News Australia.

AI will be key to the high-intensity modeling needed for personalized care – and New Zealand is offering a unique test bed for the development of new approaches.

(Sponsored) The AMA's award-winning tools help alleviate the problem of physician burnout, improving clinical workflows and removing patient-care barriers, says Laurie McGraw, SVP of Health Solutions at the AMA.

The private sector and government have accomplished a lot and the next phase is critical to the best use of APIs.

The health system takes a practical approach, building analytics dashboards for nurses to enable proactive quality improvement.

Queensland Ambulance Service (QAS) has rolled out a digital system that aims to give paramedics greater access to a patient’s vital medical information in an emergency. The SafeMate emergency medical information program is under trial for Medibank customers with chronic illnesses that are living in Queensland. Patients must be enrolled under Medibank’s CareComplete chronic disease management service. The SafeMate program houses a patient’s medical and personal information that they enter online. QAS personnel can then access this data by scanning a QR code on a patient's SafeMate card using iPads. “This is crucial information that a patient wants the paramedic to know in a medical emergency,” Queensland Government Minister for Ambulance Services Steven Miles said. “Paramedics will use their operational iPads to tap the patient’s SafeMate card or device, and the medical information will appear on the screen. It eliminates the time it would normally take a paramedic to ask the patient a range of questions in order to obtain their medical history and other pertinent details.” This gives paramedics access to important information, such as details on allergies and medical history, letting them identify best courses of treatment earlier and improving patient outcomes. It also aims to reduce paramedic and patient stress, time-consuming hospital visits and costs in the health system, in addition to improving ambulance efficiencies. Prior to December 1 last year, paramedics were unable to access these records as the organisation was not in the Australian Health Practitioner Regulation Agency (AHPRA) regulated health profession registry. [Read more: EMRs and the Royal Flying Doctor Service – how the iconic institution approaches innovation | Head of eHealth Queensland on stunning ieMR stats and a future of interstate digital health collaboration] The digital system is a testament to Queensland’s ongoing digitisation journey, with the launch of a digital hospital program to improve the state’s healthcare and patient outcomes. In December last year, through findings from a report tabled by the Queensland Audit Office (QAO), Miles outlined the benefits of the digital hospital program in Queensland. He said that as a result of the digital hospital program, Queenslanders face improved health service delivery and patient outcomes, including a reduction in unplanned readmission rates, faster access of clinical information by medical staff and more legible patient records. “Digital hospitals are making Queensland hospitals safer than ever before. Doctors and nurses have told me when I’ve visited hospitals that the digital system helps them do their jobs and helps patients,” Miles said. Ambulance Victoria has also ramped up its digitisation strategy, with the organisation most recently announcing that it will soon deploy a predictive analytics platform for its paramedics to access real-time information, enhancing and accelerating its decision making as the need for emergency services grows.