Workflow

When developing, funding, scaling and evolving innovation projects, it's key to gain insights from around the world – and to keep consumer top of mind, HIMSS innovation expert Ian Hoffberg says.

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One has a moat surrounding its products no one can get through while the other offers an open operating system for all to use.

Collaboration between AT&T, Merck and others combines IoT monitoring, temperature-controlled packaging and the drone to get meds to remote villages.

Hospital chief medical information officers are almost unanimous in recognizing the patient safety improvements that have been brought about by better medication management processes, according to a new poll from their U.S. trade group, the Association of Medical Directors of Information Systems. The results come amid the ongoing opioid epidemic in America. Technology vendors are trying to help in the battle. IT-savvy hospitals such as Intermountain, which has tweaked its Cerner EHR to reduce such prescriptions in the first place, and Ochsner, which has integrated an opioid monitoring tool into its Epic system, are taking matters into their own hands. More and more states, meanwhile, are passing e-prescribing laws and standing up prescription drug monitoring programs. Even with all that going on, there is a lot that can be done to further boost hospital safety initiatives, said AMDIS members, and that depends largely on bigger and better investments in health IT systems for inpatient settings. Nearly all of the physician informaticists surveyed, in a poll sponsored by e-prescribing and med management developer DrFirst, agreed that patient safety issues are less likely to occur today, as compared to five years ago. In large part, that's due to better medication administration processes enabled by technology. Some 82 percent of the CMIOs polled say such initiatives have led to fewer adverse drug events, for instance. That said, many still thought there was big room for improvement in medication management processes, and saw broader tech deployments to be a way to further safeguard their patents. Only half of the AMDIS members polled said they were satisfied their hospitals' processes, and 12 percent said they were dissatisfied. The CMIOs pointed to gaps such as incomplete patient medication histories (80 percent) and misaligned medication reconciliation and care transition cycles that lead to misinformed decisions by care teams (75 percent), according to DrFirst. The AMDIS survey also noted several other areas where bolstered technology infrastructure could improve medication safety surveillance. For instance, 91 percent of CMIOs said one of their biggest challenges was a lack of visibility into their patients' medication adherence: Pharmacies know when a prescription has been filled, but hospitals are often left in the dark. And 85 percent of the clinical informaticists polled pointed to the fact that patients aren't often active participants in the med rec process as a big culprit when when it comes to spotty medication history at their hospitals, suggesting a bigger role for more integrated patient engagement technologies. Meanwhile, large majorities of CMIOs pointed to challenges with interdepartmental workflow variations, and challenges with process buy-in, compliance and ownership as issues that could adversely impact safety. Nearly all of the AMDIS members surveyed said a holistic focus on the entire medication management process was key to building on safety improvements. At the same time, they said reducing order entry and data validation burdens for pharmacy and clinical staff will enhance patient safety and process efficiencies, according to DrFirst. "While the industry has clearly made significant strides to improve medication management processes, CMIOs remain troubled by a number of gaps that compromise patient safety and quality outcomes," said the company's president, G. Cameron Deemer, in a statement. Opioid risks top concern The survey also found a lot of concern among informaticists specifically related to opioid related monitoring gaps. Nearly two-thirds (65 percent) of CMIOs called for more tightly integrated clinician workflows to enable better coordinating the entire medication management process – including electronic prescribing of controlled substances and access to state prescription drug monitoring programs. While PDMPs have their limitations, being able to better discern patients opioid histories and EPCS data could help stem the spread of addiction and avoid harmful drug combinations. And almost half (41 percent) of AMDIS members said they had concerns about hospitals' opioid readiness, given the difficulty to get discern so-called drug shoppers from patients with genuine pain management needs. As we noted earlier this week, several technology vendors are exploring, from different angles, the potential of blockchain to help solve that challenge. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Absent more rigorous federal regs, Pew Charitable Trusts, MedStar Health and AMA offer model test cases to help vendors and providers detect potentially dangerous usability risks.

Epic is working to take interoperability global, CEO Judy Faulkner told more than 10,000 attendees at the company's annual Users Group Meeting. "You've eliminated the silos from within your organization," said Faulkner, speaking at Epic's headquarters in Verona, Wisconsin, according to the Madison Capital Times. "Now it's time to eliminate the silos from outside." Faulkner was referring to Epic's One Virtual System Worldwide initiative, which it launched early this year. The initiative enables "clinicians across all organizations using Epic" to more easily gather, share and interact with health data no matter the location and presents it in a unified view. "We’re taking interoperability from being able to 'view more' to being able to 'do more,'” said Dave Fuhrmann, Epic's vice president of interoperability, when the project was first announced. This spring, for example, UNC Health announced it was using the "Happy Together" component of One Virtual System Worldwide to pull in EHR data from other health systems to create a more comprehensive narrative view of its patients – improving care for diabetes patients. As is often the knock against the company, the focus on exchange across Epic customers is not quite the same as true interoperability. But Epic said the initiative does include "organizations that use other EHRs." It certainly represents an Epic-esque approach to the idea of more widespread data sharing. Given the scope of Epic's customer footprint, with nearly two-thirds of U.S. patients and increasingly more in Europe, it's on a scale that could credibly live-up to the project's bold name. In some ways, the One Virtual System Worldwide concept is similar to Epic's ideas for "comprehensive health records" – CHRs, not EHRs – that incorporate more and bigger data. It's a branding of sorts, that reflects the new scope of tech-enabled 21st Century healthcare but also highlights Epic's own outsized ability to shape the conversation – even if some healthcare professionals take issue with that branding. In Verona, Faulkner told the customers assembled in Epic's 11,000-seat Deep Space Auditorium that the possibilities enabled by the shared network of One Virtual System Worldwide were huge. By connecting its customers across the globe and making data more seamlessly available and actionable within their and others' clinical workflows, Faulkner said Epic could help a wide range of organizations improve care for their patients and collaborate on medical advances that could have a global impact. "Together, we can find answers to many puzzling questions, and prevent many diseases," said Faulkner, according to the Cap Times. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Although the health system has been repeatedly dinged for lax security practices, most NHS hospitals aren't discouraging use of consumer messaging tools.

It hopes decision support and clinical surveillance tools will help boost standards of care at all sites across its 10-state health system.

Omkar Kulkarni, innovation chief at Children's Hospital Los Angeles, says adoption of tech requires commitment, focus.