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The Good,                                            The Bad,                                             And The UglyJaso...
Briefly discuss technological advances in treatmentEMR vs. EHRThe positive and negative outcomes of technologyOverview...
fastcodesign.comnews.stanford.edu   /
studio5.ksl.comvarian.commediluxhealthcare.us
 EMR vs. EHR   Electronic Medical Record      Electronic Version of a Paper Chart      Record and Verify Systems      ...
• Recovery and Reinvestment Act of 2009 Health Information Technology for Economic and Clinical Health Act or HITECH Act  ...
1. Use of CPOE (computerized provider order entry) formedication orders;2. Drug to drug and drug allergy interaction check...
• Medicaid-  – Physicians whose caseloads include at least 30%     Medicaid patients are eligible to receive up to $63,750...
Eligible professionals who cannot demonstrate that they are meaningful users of certified EHR by January 1, 2015, will re...
Technology Positives and                Negatives“WITH GREAT POWER THERE MUST ALSO COME - -GREAT RESPONSIBILITY! “-Stan Le...
Better patient care Share patient information securely Dose distribution and escalation Decrease side effects Living ...
More organized and timely Thank you computer No more missing charts Neat charts/save room Faster Turn around time MD...
The computer Slow or stuck computers Server issues Trusting the computer is always  right. Outdated procedures, QA
Education and Training Under staffed departments New generation of students Clinical based vs. Technical based  knowle...
Digital Immigrant vs. Digital NativeDigital Native: K through college – represent the first generations to grow up with n...
New grads are experiencing a whole new world of learning.   Education has come into the digital age   The need to teach...
New York Times articles  A series of articles “The Radiation Boom.”   by Walt Bogdanich  Cases looked at in Radiation T...
• Release of statements  – ASTRO     • Letter to the New York Times January 25, 2010 Tim R.       Williams MD.     • Radia...
Definition:Human error, the propensity forcertain common mistakes bypeople; the making of an error as anatural result of ...
30 patient=150 treatments per week =  600 treatments a month and 3600 in 6  months.1 incident occurs1/3600=0.003% probabil...
IHE-RO was established in 2004   www.wiki.ihe.net   Vendor equipment connectivity issuesPatient Safety Organizations  ...
What do we as therapists need to doThe development of the reporting cultureThe trail of the incidence reportIncidence ...
Voluntary incident reporting systemDiscussed last year at the VA Radiation Oncology Meetingswww.rosis.info
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
Technology: The Good, the Bad and the Ugly
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Technology: The Good, the Bad and the Ugly

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Technology: The Good, the Bad and the Ugly

  1. 1. The Good, The Bad, And The UglyJason Morneau RT(T)Chief Therapist Boston VAMC http://geofflivingston.com/2011/02/21/the-good-the- bad-and-the-ugly-of-online-cause-marketing/
  2. 2. Briefly discuss technological advances in treatmentEMR vs. EHRThe positive and negative outcomes of technologyOverview of human errorPublicized treatment errors/incidencesDiscuss the use of online incident reporting services.
  3. 3. fastcodesign.comnews.stanford.edu /
  4. 4. studio5.ksl.comvarian.commediluxhealthcare.us
  5. 5.  EMR vs. EHR  Electronic Medical Record  Electronic Version of a Paper Chart  Record and Verify Systems  ARIA/Varian  MOSAIC/ELEKTA  Electronic Health Record  What is it?  HL7  Developed in the start of 1970’s  1971 tested at Brunswick Naval Air Station  1978 launched at 20 VA’s  1981 named DHCP and put into law  Finland Hospital first outside US www.wikipedia.com www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/ www.elekta.com www.varian.com http://www.uwlax.edu/md/studentresources/Documents/Heath%20Revised%20Manuscript.pdf
  6. 6. • Recovery and Reinvestment Act of 2009 Health Information Technology for Economic and Clinical Health Act or HITECH Act  President Obama wanted all hospitals paperless by 2014  $17 Billion of funds available in incentives  Medicare and Medicaid want it by 2015  What is Meaningful Use? http://www.elekta.com/healthcare-professionals
  7. 7. 1. Use of CPOE (computerized provider order entry) formedication orders;2. Drug to drug and drug allergy interaction checks;3. E-Prescribing (eligible professionals only);4. Recordation of demographics and smoking status, andchanges in vital signs;5. An up-to-date problem list;6. Active medication list and medication allergy lists;7. One clinical decision support rule;8. CQM as specified by the Secretary;9. Providing patients with an electronic copy of theirhealth information (eligible professionals and hospitals)and discharge instructions (hospitals only);10. Providing clinical summaries for patients for eachoffice visit (eligible professionals only); and Protectingelectronic health information.
  8. 8. • Medicaid- – Physicians whose caseloads include at least 30% Medicaid patients are eligible to receive up to $63,750 over the course of 6 years• Medicare – – Physicians seeing Medicare patients can receive up to $44K over the course of 5 years• Eligible professionals who cannot demonstrate that they are meaningful – January 1, 2015, will receive an adjustment to their Medicare fee schedule of 99% for 2015, 98% for 2016, and 97% for 2017 and each subsequent year. www.gfrlaw.com
  9. 9. Eligible professionals who cannot demonstrate that they are meaningful users of certified EHR by January 1, 2015, will receive an adjustment to their Medicare fee schedule of 99% for 2015, 98% for 2016, and 97% for 2017 and each subsequent year.
  10. 10. Technology Positives and Negatives“WITH GREAT POWER THERE MUST ALSO COME - -GREAT RESPONSIBILITY! “-Stan Lee Amazing Fantasy #15(August 1962)
  11. 11. Better patient care Share patient information securely Dose distribution and escalation Decrease side effects Living longer Improved QA Treating the untreatable Decrease in treatment time
  12. 12. More organized and timely Thank you computer No more missing charts Neat charts/save room Faster Turn around time MD approval of films
  13. 13. The computer Slow or stuck computers Server issues Trusting the computer is always right. Outdated procedures, QA
  14. 14. Education and Training Under staffed departments New generation of students Clinical based vs. Technical based knowledge Dirty Word “Competency” Proper QA/Commissioning of the machines
  15. 15. Digital Immigrant vs. Digital NativeDigital Native: K through college – represent the first generations to grow up with new technology.Digital Immigrant: Everyone else. Have become intrigued by the computer age and want to learn. Marc Prensky Digital Natives Digital Immigrants ©2001 Marc Prensky
  16. 16. New grads are experiencing a whole new world of learning.  Education has come into the digital age  The need to teach things from the past as well pastThe veterans are trying to keep up with a whole new world.  AHHHH you want me to what?  Getting left behind
  17. 17. New York Times articles A series of articles “The Radiation Boom.” by Walt Bogdanich Cases looked at in Radiation Therapy IMRT plan missing for 3 treatments Missing filter for 27 treatments Field Size issue Cases in other modalities.
  18. 18. • Release of statements – ASTRO • Letter to the New York Times January 25, 2010 Tim R. Williams MD. • Radiation therapy 99.99 percent safe and effective • The White Papers – ASRT • ASRT Responds to New York Times Article Jan. 27, 2010, Diane Mayo, R.T.(R)CT) – NESRT • We must look to and support our regional representation www.asrt.org www.astro.org
  19. 19. Definition:Human error, the propensity forcertain common mistakes bypeople; the making of an error as anatural result of being human(www.dictionary.com)
  20. 20. 30 patient=150 treatments per week = 600 treatments a month and 3600 in 6 months.1 incident occurs1/3600=0.003% probability of an error or 99.997% reliability factor.(Swain, 1963)
  21. 21. IHE-RO was established in 2004  www.wiki.ihe.net  Vendor equipment connectivity issuesPatient Safety Organizations  GE PSORadiation Oncology reporting systems  Hospital based  AHFMR/HTA  ROSIS www.ihe.ca/documents/HTA-FR22.pdf www.astro.org/Practice-Management/IHE-RO/In/www.rosis.infodex.aspx
  22. 22. What do we as therapists need to doThe development of the reporting cultureThe trail of the incidence reportIncidence vs. Reportable medical event DPH 105 CMR Section 120.435
  23. 23. Voluntary incident reporting systemDiscussed last year at the VA Radiation Oncology Meetingswww.rosis.info

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