Quality and Safety

As the industry moves toward data-driven medicine clinicians are going to need more decision support tools than in the past. "Medicine has always strived to be data driven," said Gaurav Singal, MD, a physician at Massachusetts General Hospital and director of the Innovations Unit of Foundation Medicine. “But now there's a shift happening between what we call data and what we call evidence.” Although healthcare won't get to a point that a patient is 100 percent unique, Singal said, historic information is crucial to ensuring providers aren't flying blind. See all of our HIMSS16 previews "I don’t think randomized control trials are going to be less effective," he said. "But in an evidence-based world, it won't be the whole picture. Random isn't enough … patients are just too precisely defined and unique." Singal leads technology and data-centric product development at Foundation Medicine. He helped launch its Interactive Cancer Explorer, otherwise known as ICE, a physician-facing clinical decision support and patient management platform that uses data collection and aggregation to aid physicians with clinical decision-making. He said it's these types of Web-based technologies and digital innovations that can improve therapeutic decision making at the point-of-care. In his talk titled, “Precision Medicine in the Information Age,”  Singal will discuss how physicians and insurers are embracing actionable molecular information to positively impact care delivery. Singal's work at Foundation Medicine is focused on molecular oncology, using genomic information to produce and analyze tumors or genomes where the cancer has mutated. These molecular characteristics of tumors can actually guide cancer treatments. His work in both medicinal and engineering fields creates a unique duality in his perspective, he said. He's always looking for ways to combine health and technology with data-centric solutions that are clinically relevant to impact both patients and providers. Singal’s team designs and builds tools for physicians to determine the best course of action for their patient. They built ICE with this goal in mind, to connect with doctors from a scientific standpoint to see what works and what doesn't. [Like Healthcare IT News on Facebook] It's no longer about generic treatments for these patients but, instead, about treating patients based on their molecular data to offer more precise care. "Providers have been interested in clinical decision support for a long time," Singal said. "I think there's a cultural shift happening, with the data that drives these decisions. And more doctors are seeing this shift." Singal’s session, “Precision Medicine in the Information Age,” is scheduled for March 2 from 8:30 to 9:30 a.m. in the Sands Expo Convention Center Sands Showroom. Twitter: @JessiefDavis This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

More than one-third of hospitals aren't meeting National Database of Nursing Quality Indicators performance metrics, a new Ohio State University study on chief nurse executives finds. At the same time, it showed that evidence-based practice – a care-delivery approach that integrates problem solving, best practices, clinician expertise and patient preferences – is a low priority across the United States. Although multiple studies show evidence-based practice results in high-quality care, improved patient outcomes and lower costs, and nurse executives recognize its effectiveness, implementation is relatively low. [Also: IBM Watson to help tackle heart disease] "EBP isn’t being implemented to the state that it really needs to be to accomplish high quality healthcare safety and cost," said Bernadette Melnyk, MD, dean of Ohio State University's College of Nursing. "There's a major disconnect between the priorities of chief nurses and evidence-based practice." While the majority of surveyed nurses placed quality and safety as top priorities, EBP was ranked at the bottom. Melnyk said this suggested that nurses "don’t truly understand that EBP is a direct path to get their hospitals to quality safety and reduce costs." A lack in budget allocations is one of the major reasons for this gap, the survey found. Hospitals and CNEs aren't investing resources into this evidence-based culture to help implement EBP measures for a care foundation. [Also: Clinical decision support: It's about more than technology] "Hospitals need to invest in getting all providers and clinicians, really up to scale in EBP," Melnyk said. "Then create a culture and environment that support their clinicians to consistently practice this way. "There are a lot of barriers that exist in the healthcare system; there are misconceptions, politics and the tradition of 'that's the way we do it' that's alive and well in many institutions across the U.S," she added. When most Americans head to the hospital, they assume they're getting evidence-based care, but that's not the reality, the report suggests. Nurse executives need EBP education and skill-building to implement the practice, the survey found. But furthermore healthcare systems need to support staff to utilize EBP. [Like Healthcare IT News on Facebook] Research shows EBP teamwork leads to better care quality and outcomes, but hospital must promote the practice as essential and expect clinicians to implement them. "We also need to get academia up, where they're creating students steeped in EBP and they come into a healthcare environment where that is expected," Melnyk said. Twitter: @JessiefDavis

Physician adoption of electronic health records rose steadily between 2013 and 2014, with nearly 75 percent of doctors going digital, according to the Centers for Disease Control and Prevention’s National Electronic Health Records Survey. The CDC’s four key findings based on the survey: In 2014, 74.1 percent of office-based physicians had a certified electronic health record system, up from 67.5 percent in 2013. The percentage of physicians who had a certified EHR system ranged from 58.8 percent in Alaska to 88.6 percent in Minnesota. In 2014, 32.5 percent of office-based physicians with a certified EHR system were electronically sharing patient health information with external providers. The percentage of physicians with a certified EHR system electronically sharing patient health information with external providers ranged from 17.7 percent in New Jersey to 58.8 percent in North Dakota. Access the full CDC report here.

While the development of accurate predictive analytics has the potential to head off debilitating and costly conditions among patients, one veteran of the burgeoning field says it’s important not to rush in without the proper planning. "The first thing to understand is you need to have the right technical infrastructure components in place and it has to address what you are looking to do with it," said David M. Seo, MD, associate vice president of IT for clinical applications and chief medical informatics officer for the University of Miami Health System. "But there is a lot people don't think about – like data curation and quality," he said. "Is the data you have good enough to even do predictive analytics? Because if it isn't, that prediction may actually harm you more than it helps. You may go off on a wrong tangent." Seo and Chitra Raghu, senior program manager and innovations officer for Lockheed Martin Health and Life Sciences, presented will be presenting the U of M system's experience in preparing its predictive analytics platform in "Predictive Analytics Drives Population Health Management" at HIMSS16 on Tuesday. Beyond the quality of the data itself, Seo said other factors, including the presence or absence of skilled data scientists; a thorough understanding of how to localize predictive models from other health systems; and how to best integrate existing investments in electronic health records with analytics technology, must be carefully considered before pulling the trigger on new platforms. "There are so many technologies," said Raghu. "You have to find what is the right one that will help hospitals achieve what they are trying to achieve, at the lowest cost." Seo added even health networks with a dozen or more hospitals are not likely to already have the necessary skill sets in-house. And even a platform that offers great analytics capabilities, for instance, may not be popular with either clinicians or financial executives if the caregivers need to toggle back and forth between an EHR and an analytics platform. "If I'm looking at a patient in front of me right now, I don't have time to go somewhere else, and when I've gone somewhere else I've already lost the advantage of this massive investment in my EHR,” Seo said. “So it has to be part of your system's ecosystem." The session "Predictive Analytics Drives Population Health Management" is slated for March 1 from 2:30-3:30 p.m. in, Palazzo I at the Sands Expo Convention Center.

CHIME on Tuesday, through a partnership with SpaceX-affiliated crowdfunding site HeroX, launched a $1 million patient identification contest in the hope that private industry can fix the safety risks posed by patient matching.

Healthcare IT News and HIMSS are accepting speaking proposals for the Big Data & Healthcare Analytics Forum, which will be presented June 14-15 in San Francisco.

Jonathan Bush, the high-octane, no-holds-barred co-founder and CEO of athenahealth, became Johnny-on-the-spot on Wednesday. While in San Francisco to attend the annual J.P. Morgan Healthcare Conference, Bush took a few minutes to perform CPR on a man he found lying on the sidewalk. The man appeared to not be breathing, possibly suffering from a heart attack, according to an account of the incident published in Bush's hometown newspaper, The Boston Globe. The incident occurred near the corner of Mission and 1st Street in San Francisco's downtown. According to the Globe, Bush had been to a nearby Walgreens drugstore to buy an ice pack (he recently hurt his knee skiing). He was on his way to a meeting at the J.P. Morgan event when he saw the man lying on the sidewalk, turned him over, saw his face was blue and he seemed to not be breathing. After Bush performed CPR, the man started breathing again. Bush, who has long been critical of inefficiencies in American healthcare, is quoted by the Globe as saying, "It was like the U.S. healthcare system. Everybody was standing there, nobody was helping." Long before he and former U.S. CTO Todd Park started athenahealth, Bush worked as an emergency medical technician in New Orleans. He writes about it in his book, Where Does It Hurt?: An Entrepreneur's Guide to Fixing Health Care. [See also: Jonathan Bush on where it hurts most.] Bush writes in his book that he was looking for a summer job when a family acquaintance told him that, to save lives, the best thing he could do was to work on an ambulance and get to know a crack trauma unit. That's how Bush ended up that summer working with the trauma unit at Charity Hospital in the Big Easy. He and the crew did save lives, he writes. New Orleans gave him hands-on training in urgent care, "and, just as important, a primer on American society." A spokeswoman for Bush told Healthcare IT News on Thursday that athenahealth could confirm the event in San Francisco happened, but would not comment at this time because Bush and his staff are still working to understand how the man is doing. [See also: Newsmaker interview: Jonathan Bush.]

MedStar Health, the largest not-for-profit healthcare organization in the Maryland and Washington, D.C., region, is collaborating with Uber to increase access to health appointments.

The Department of Health and Human Services is not doing enough to manage its workforce programs, according to a recent report from the Government Accountability Office, the federal government's watchdog agency.

The American Medical Association has invested $15 million to become founding partner of Health2047, a high-tech incubator that will explore innovative solutions to some of the biggest challenges facing the nation's 1.1 million physicians and their patients.