We're developing augmented reality software to help clinicians with pre-surgical planning by providing them with patient-specific, high fidelity 3D holograms that have been derived from the same data used to generate conventional CT scans and MRIs.
In the new healthcare industry, providers and
patients will thrive by deploying intelligent
technology to deliver care sooner and more
effectively. New solutions include Kofax Smart
Process Applications and Smart Mobile Apps, which
enable healthcare organizations to automatically
and accurately capture, validate, extract and classify
information from anywhere inside or outside the
organization — and then instantly drive business
processes and applications while saving critical
documentation in secure content repositories.
Develop machine learning models that can predict unplanned ICU readmission based on EHR records.
To know more, visit https://bit.ly/2U8cA3j | talk2us@ideas2it.com | www.ideas2it.com
Whitepaper: The Paperless Future of Healthcare and Life SciencesDocuSign
The healthcare industry struggles along the entire paper trail from start to finish. The current process is slow, costly, inefficient, full of errors, vulnerable to security breaches and hurts the people they are chartered to care for.
This complimentary whitepaper will help you discover how DocuSign’s eSignature solutions modernize healthcare and life science organizations by eliminating paper and antiquated signature processes while meeting compliance requirements and reducing costs and errors.
You will learn how eSignatures helps the healthcare industry to:
Save money in overnight shipping costs
Reduce turnaround times for diagnostic result documents by weeks
Cut excessive administrative expenses and eliminate manual rekeying errors
Increase efficiency by eliminating time spent sending paper forms with doctors’ signatures
We're developing augmented reality software to help clinicians with pre-surgical planning by providing them with patient-specific, high fidelity 3D holograms that have been derived from the same data used to generate conventional CT scans and MRIs.
In the new healthcare industry, providers and
patients will thrive by deploying intelligent
technology to deliver care sooner and more
effectively. New solutions include Kofax Smart
Process Applications and Smart Mobile Apps, which
enable healthcare organizations to automatically
and accurately capture, validate, extract and classify
information from anywhere inside or outside the
organization — and then instantly drive business
processes and applications while saving critical
documentation in secure content repositories.
Develop machine learning models that can predict unplanned ICU readmission based on EHR records.
To know more, visit https://bit.ly/2U8cA3j | talk2us@ideas2it.com | www.ideas2it.com
Whitepaper: The Paperless Future of Healthcare and Life SciencesDocuSign
The healthcare industry struggles along the entire paper trail from start to finish. The current process is slow, costly, inefficient, full of errors, vulnerable to security breaches and hurts the people they are chartered to care for.
This complimentary whitepaper will help you discover how DocuSign’s eSignature solutions modernize healthcare and life science organizations by eliminating paper and antiquated signature processes while meeting compliance requirements and reducing costs and errors.
You will learn how eSignatures helps the healthcare industry to:
Save money in overnight shipping costs
Reduce turnaround times for diagnostic result documents by weeks
Cut excessive administrative expenses and eliminate manual rekeying errors
Increase efficiency by eliminating time spent sending paper forms with doctors’ signatures
Why Design Validation is More Than Testing: How do we Validate our Validation?Greenlight Guru
Validation usually involves a lot of testing. But what tests do we do? What tests do we not do? When can we use standard tests and when do we have to develop new ones? More importantly, how do we know we’re doing the right tests? If a test is “required” must we do it? In other words, how do we validate our validation? And how do we defend our validation when FDA criticizes it? This presentation will use the case study approach to take a broad approach to validation in an interactive fashion including:
• What are we required to validate and how/when do we do it?
• How do we validate our validation? How do we defend our validation when FDA questions it?
• What are the consequences if our validation is wrong?
• If we change our device, when and how do we revalidate?
• What are the validation challenges for the future?
This session took place live at the Greenlight Guru True Quality Virtual Summit, a three-day event for medical device professionals to learn to get their devices to market faster, stay ahead of regulatory changes, and use quality as their multiplier to grow their device business.
2012 DIA eSource monitor-site-sponsor relationshipEd Seguine
This presentation discusses some of the unique impacts on the clinical trial process for Monitors, Sites, and Sponsors as they adopt electronic source records.
The term “Big Data” emerged from Silicon Valley in 2003 to describe the unprecedented volume and velocity of data that was being collected and analyzed by Yahoo, Google, eBay, and others. They had reached an affordability, scalability and performance ceiling with traditional relational database technology that required the development of a new solution, not being met by the relational data base vendors. Through the Apache Open Source consortium, Hadoop was that new solution. Since then, Hadoop has become the most powerful and popular technology platform for data analysis in the world. But, healthcare being the information technology culture that it is, Hadoop’s adoption in healthcare operations has been slow. In this webinar, Dale Sanders, Executive Vice President of Product Development will explore several questions:
Why should healthcare leaders and executives care about this technology?
What makes Hadoop so attractive and rapidly adopted in other industries but not in healthcare?
Why is Big Data a bigger deal to them than healthcare?
What do they see that we don’t and are we missing the IT boat again?
How is the cloud reducing the barriers to adoption by commoditizing the skilled labor impact at the local healthcare organizational level?
Panel presentation providing an introduction to open source VistA (history, community, and technology) as well as an implementor’s perspective, given at the 2010 Open Source Conference.
Recording of presentation: http://www.youtube.com/watch?v=ExoF_Tq14WY
It is indeed boom time for Big Data in Healthcare. According to CBE insights, Big Data startups garnered USD 400M in investors funding in first half 2014 as compared to USD133M in the whole of 2013.
There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future ...Health Catalyst
In this webinar, which is geared for managers and executives, Dale Sanders provides a new version of a very popular lecture he presented at this year’s Health Analytics Summit in Salt Lake City. Attendees will gain an understanding of:
What to expect from predictive analytics as it relates to human behavior
A general overview of predictive analytics models, and the contexts in which those various models should and should not be used
The scenarios in which predictive models in healthcare are effective and when they are not, given that 80% of population health outcomes are determined by socio-econonic factors, not healthcare delivery
The relationship between predictive analytic accuracy and topics of data management such as data quality, data volume and patient outcomes data
The use of predictive analytics to identify patients who are on a trajectory for poor, as well as good, outcomes
How current predictive analytics strategies are overlookng the cost of intervention and “Return on Engagement”, ROE— the cost per unit of healthcare improvement for patient populations
The cultural, philosophical, and legal conundrums that predictive analytics will create for healthcare, notably healthcare rationing
The success of predictive analytics will not be defined by the simple risk stratification of patient populations for care management teams. Success will depend on the costs of intervention to reduce the risks that are identified by predictive analytics, which boils down to this two-part question: Now that we can predict a patient’s risk for a bad healthcare outcome, “What’s the probability of influencing this patient’s behavior towards a better outcome?” And, “How much effort and cost will be required for that influence?”
Why Design Validation is More Than Testing: How do we Validate our Validation?Greenlight Guru
Validation usually involves a lot of testing. But what tests do we do? What tests do we not do? When can we use standard tests and when do we have to develop new ones? More importantly, how do we know we’re doing the right tests? If a test is “required” must we do it? In other words, how do we validate our validation? And how do we defend our validation when FDA criticizes it? This presentation will use the case study approach to take a broad approach to validation in an interactive fashion including:
• What are we required to validate and how/when do we do it?
• How do we validate our validation? How do we defend our validation when FDA questions it?
• What are the consequences if our validation is wrong?
• If we change our device, when and how do we revalidate?
• What are the validation challenges for the future?
This session took place live at the Greenlight Guru True Quality Virtual Summit, a three-day event for medical device professionals to learn to get their devices to market faster, stay ahead of regulatory changes, and use quality as their multiplier to grow their device business.
2012 DIA eSource monitor-site-sponsor relationshipEd Seguine
This presentation discusses some of the unique impacts on the clinical trial process for Monitors, Sites, and Sponsors as they adopt electronic source records.
The term “Big Data” emerged from Silicon Valley in 2003 to describe the unprecedented volume and velocity of data that was being collected and analyzed by Yahoo, Google, eBay, and others. They had reached an affordability, scalability and performance ceiling with traditional relational database technology that required the development of a new solution, not being met by the relational data base vendors. Through the Apache Open Source consortium, Hadoop was that new solution. Since then, Hadoop has become the most powerful and popular technology platform for data analysis in the world. But, healthcare being the information technology culture that it is, Hadoop’s adoption in healthcare operations has been slow. In this webinar, Dale Sanders, Executive Vice President of Product Development will explore several questions:
Why should healthcare leaders and executives care about this technology?
What makes Hadoop so attractive and rapidly adopted in other industries but not in healthcare?
Why is Big Data a bigger deal to them than healthcare?
What do they see that we don’t and are we missing the IT boat again?
How is the cloud reducing the barriers to adoption by commoditizing the skilled labor impact at the local healthcare organizational level?
Panel presentation providing an introduction to open source VistA (history, community, and technology) as well as an implementor’s perspective, given at the 2010 Open Source Conference.
Recording of presentation: http://www.youtube.com/watch?v=ExoF_Tq14WY
It is indeed boom time for Big Data in Healthcare. According to CBE insights, Big Data startups garnered USD 400M in investors funding in first half 2014 as compared to USD133M in the whole of 2013.
There Is A 90% Probability That Your Son Is Pregnant: Predicting the Future ...Health Catalyst
In this webinar, which is geared for managers and executives, Dale Sanders provides a new version of a very popular lecture he presented at this year’s Health Analytics Summit in Salt Lake City. Attendees will gain an understanding of:
What to expect from predictive analytics as it relates to human behavior
A general overview of predictive analytics models, and the contexts in which those various models should and should not be used
The scenarios in which predictive models in healthcare are effective and when they are not, given that 80% of population health outcomes are determined by socio-econonic factors, not healthcare delivery
The relationship between predictive analytic accuracy and topics of data management such as data quality, data volume and patient outcomes data
The use of predictive analytics to identify patients who are on a trajectory for poor, as well as good, outcomes
How current predictive analytics strategies are overlookng the cost of intervention and “Return on Engagement”, ROE— the cost per unit of healthcare improvement for patient populations
The cultural, philosophical, and legal conundrums that predictive analytics will create for healthcare, notably healthcare rationing
The success of predictive analytics will not be defined by the simple risk stratification of patient populations for care management teams. Success will depend on the costs of intervention to reduce the risks that are identified by predictive analytics, which boils down to this two-part question: Now that we can predict a patient’s risk for a bad healthcare outcome, “What’s the probability of influencing this patient’s behavior towards a better outcome?” And, “How much effort and cost will be required for that influence?”
Somos una empresa en la cual usted podrá sentirse un actor más dentro de Costa Rica, conocer su gente, sus playas, bosques y montañas, los lugares más escondidos y recónditos de Costa Rica que poco han sido descubiertos por ustedes.
Presentación de Mariana Rodríguez Zani, Convergencia, en la Clínica Mobile 2010 en la Universidad de Palermo.
Asesor académico, Pablo Capurro, @pablocapurro
"Agile Business Intelligence" lautete der Titel des Vortrags, den Experten von OPITZ CONSULTING auf der TDWI 2011 in München gehalten haben. Tom Gansor, Direktor Strategie & Innovation, und Arno Tigges, Project Manager, führen in das Thema ein. Agile Vorgehensmodelle in der Softwareentwicklung werden seit einigen Jahren sehr erfolgreich umgesetzt. Im Umfeld von BI Projekten werden diese Methoden – insbesondere in Deutschland – eher selten in Erwägung gezogen, geschweige denn angewendet.
Healthstory Enabling The Emr Dictation To Clinical DataNick van Terheyden
EHRs are database centric while medical records are document centric. The conventional wisdom is that documents are bad and discrete data is good. Historically, clinicians have resisted efforts to establish structured data standards for dictated reports. This lack of an industry-wide standard for report content and format confounds interoperability efforts. For nearly two decades, information system specialists have attempted to impose new documentation methods that are more suited to database management but do not meet the needs of the practicing physician. Achieving physician buy-in for electronic record systems that do not accommodate narrative documentation methods such as dictation and transcription has proven to be quite difficult for many EHR vendors
The Health Story Project (formerly the CDA4CDT initiative Clinical Document Architecture for Common Data Types) is an alliance of organizations that have been working together with HL7 for nearly two years to develop and publish data standards for electronic clinical documents. The initiative is based on Clinical Document Architecture (CDA) - a balloted HL7 document markup standard that specifies the structure and semantics of a clinical document for the purpose of exchange. Document templates for the most commonly dictated report types (H&P, Consult, Operative Note, etc) specify required and optional headings. Templates are developed based on prevailing practice and establish consensus on content and format
Healthstory Enabling The Emr - Dictation To Clinical DataNick van Terheyden
EHRs are database centric while medical records are document centric. The conventional wisdom is that documents are bad and discrete data is good. Historically, clinicians have resisted efforts to establish structured data standards for dictated reports. This lack of an industry-wide standard for report content and format confounds interoperability efforts. For nearly two decades, information system specialists have attempted to impose new documentation methods that are more suited to database management but do not meet the needs of the practicing physician. Achieving physician buy-in for electronic record systems that do not accommodate narrative documentation methods such as dictation and transcription has proven to be quite difficult for many EHR vendors.
The Health Story Project (formerly the CDA4CDT initiative Clinical Document Architecture for Common Data Types) is an alliance of organizations that have been working together with HL7 for nearly two years to develop and publish data standards for electronic clinical documents. The initiative is based on Clinical Document Architecture (CDA) - a balloted HL7 document markup standard that specifies the structure and semantics of a clinical document for the purpose of exchange. Document templates for the most commonly dictated report types (H&P, Consult, Operative Note, etc) specify required and optional headings. Templates are developed based on prevailing practice and establish consensus on content and format
Speech Understanding Dictation To Clinical Data - TEPR 2009Nick van Terheyden
Speech Understanding automatically converts the spoken work into structured and encoded clinical data that provides access to relevant diagnostic support, evidence based medicine and real time alerts.
Unlocking the data tucked away in the vast mountain of documents produced as part of delivering care to patients is possible today with Speech Understanding, the next generation of speech recognition technology that not only improves the overall efficiency of the documentation process by producing higher quality, more accurate clinical data but also produces structured encoded clinical data that can populate EMR’s that are crying out for high quality input. This information is encoded using the HL7’s Clinical Document Architecture (CDA) and Common Document Types (CDA4CDT).
With knowledge of the meaning the output from Speech Understanding is now able to identify concepts, organize documents into meaningful categories and create a semantically interoperable document .
Clinical Narrative And Structured Data In The Ehr Venus And Mars Live In Harm...Nick van Terheyden
For nearly two decades healthcare technology has attempted to impose new documentation methods that are more suited to database management but do not meet the needs of the busy practicing physician. Conventional wisdom is that documents are bad and discrete data is good but historically clinicians have resisted efforts to establish structured data entry methodologies trying to replace the clinician preferred method of data capture – dictation. Clinical Document Architecture for Common Document Types (CDA4CDT) offers a bridge between the two opposing worlds of clinical documentation creating semantically interoperable data while retaining the precise clinical content contained in free flowing narrative
CORD Rare Drug Conference, June 8 - 9, 2022
Opportunities and Challenges for Data Management Real-World Data and Real-World Evidence
• Patient support programs: Sandra Anderson, Innomar Strategies
• AI for Data Management and Enhancement: Aaron Leibtag, Pentavere
• Patient Support and RWE: Laurie Lambert, CADTH
An overview of clinical healthcare data analytics from the perspective of an interventional cardiology registry. This was initially presented as part of a workshop at the University of Illinois College of Computer Science on April 20, 2017.
Similar to Healthstory - Dictation to Clinical Data: Automating the Production of Structured and Encoded Documents (20)
Exploring the potential of technology and innovation - everything from wearables, genomics and robotics that are washing over healthcare at an exponential rate and influencing every aspect of our lives and what it will mean to our healthcare system and in particular to how we deliver healthcare to the population.
What are the next big innovations that will affect telehealth and how might they affect you and your organization. How should you plan for these changes and what can you do to incorporate them into your business? What small incremental improvements can you take to move you along the path towards the next leap in innovation.
Predictive Modeling is Here - Dance with the Dragon of Artificial IntelligenceNick van Terheyden
Presentation at AHIMA on Predictive Modeling given on September 24, 2018:
Welcome to the age of data – the revolution has arrived made possible by new sources of data available in every industry and every walk of life. No area has been untouched and we see examples from baseball to the steady stream of customized adverts and content. Big data is improving the utilization of resources, efficiency, capacity, and ultimately access to healthcare. The next frontier is predicting futures. Can we identify the patients that are sickest and mitigate their disease progression? Traditional population health programs have focused on the high utilization patients predicting their progression and applying interventions to improve their health and decrease the costs associated with treating their disease progression. But the analysis of data has its perils risking false discoveries as our unconscious bias impacts our search of these huge troves of data in a modern-day version of “I know the facts, now let’s find ‘em” to “confirm” our facts. But the reality of healthcare and increasing insights into a precision-guided healthcare system it is increasingly clear that no membership population is “average”. The interplay between even a couple of input factors and comorbidities can be very non-linear.
Dr Nick will explore the potential for technology and innovation - everything from wearables, genomics and robotics that are washing over our world at an exponential rate and influencing every aspect of our activities and what it will mean to our lives and in particular to the delivery of healthcare.
How can this technology revolution change the cost profile and democratize access to healthcare? Join Dr Nick as he takes you on an exciting journey into the future of healthcare and the exciting developments that will increase accessibility to healthcare and will revolutionize the way care is delivered.
Patients’ own expectations for technology are growing and they have shared that digital technologies need to become more integral in the care delivery process. In the U.S., nearly half of Americans would opt for online capabilities vs. handling over the phone, such as getting lab test results, filling out paperwork ahead of a doctor’s appointment, accessing their medical records, and filling prescriptions. Given the increasing desire for a tech-driven care experience, patients are helping to spur technology adoption by their providers.
As the population ages, technology adoption and information exchange within the long term and post-acute care settings becomes increasingly more important. How can post-acute care agencies overcome challenges of limited resources (financial and workforce) to bring patient care delivery into the 21st century? Patients who take prescription medications for chronic conditions are also feeling the pain from a lack of tech-adoption when their doctors typically don’t offer them access to online condition management tools or make themselves available online or via email for questions. Dr. Van Terheyden will discuss what needs to happen to break down these barriers.
Digital health summit - Baylor Scott & White innovation panelNick van Terheyden
Overview of the status and need for Digital Health delivered at the Baylor Scott and White Digital Health Summit focusing on innovation and the risks and rewards and the innovation process
Will healthcare be delivered by george jetson in the futureNick van Terheyden
Gartner ranked Dell the #1 worldwide IT services provider in healthcare in 2014. Dell sees global disruptions in healthcare delivery and continues to invest in strategies to address these rapid changes. They are actively enhancing development, implementation and adoption of novel technologies, services, and applications that will revolutionize information-driven care, resulting in improved patient outcomes and overall cost savings worldwide. Dr. Nick is responsible for providing strategic insight and will discuss some Dell’s strategies to achieve an IT environment that is interconnected, efficient and patient-focused.
Gartner ranked Dell the #1 worldwide IT services provider in healthcare in 2014. Dell sees global disruptions in healthcare delivery and continues to invest in strategies to address these rapid changes. They are actively enhancing development, implementation and adoption of novel technologies, services, and applications that will revolutionize information-driven care, resulting in improved patient outcomes and overall cost savings worldwide. Dr. Nick is responsible for providing strategic insight and will discuss some Dell’s strategies to achieve an IT environment that is interconnected, efficient and patient-focused.
AHIMA Game of documentation - dance with the icd10 dragonNick van Terheyden
Following on from AHIMA 2014 this AHIMA 2015 session will follow last years Successful Presentation “Game of Documentation: Winter is Coming – Surviving ICD-10” to address the genuine concerns of clinicians and demonstrate to them why they must not just accept ICD10 but should be demanding it. As Yoda said
“Always in motion is the future…a little more knowledge lights our way.”
ICD-10 has been implemented but resistance remains high and in a recent remarks by the AMA president that said
“If it was a droid, ICD-10 would serve Darth Vader… For more than a decade, the AMA kept ICD-10 at bay – and we want to freeze it in carbonite!”
But despite this the financial viability and performance of hospitals and physicians are impacted by poor quality of data that is captured with an outdated 1970s-era coding system
The first leap into big data is collecting information with precision and clarity – something that cannot be achieved with a coding system that does not capture Ebola nor the basic classification of myocardial infarction STEMI and Non-STEMI. Everyone – ICD10 supporters and opponents wants the best possible care when they access our healthcare system – but how do they know they are receiving this if we are unable to accurately collect information about diseases and treatments and link outcomes to treatments.
https://ahima.confex.com/ahima/87am/webprogram/Session6176.html
I manage my health with digital tools and I’m not alone. An estimated and growing 69% of consumers and patients are also engaged in monitoring their own healthcare . The interest in personal wellness combined with the proliferation of healthcare ‘wearables’ available to consumer puts us on the cusp of an extraordinary shift in healthcare: Technology enabled patients are empowered to change their lifestyle to prevent or stop chronic disease, and become healthier than ever before. The implications of this on every aspect of the healthcare industry –from delivery and population health to access and cost will be astounding.
But wearable technology is still in its infancy, quite complex and limited in what it can do. The next generation will be intelligent and voice-enabled and go beyond tracking to interacting with and assisting consumers with their healthcare choices, and changing behaviors for the better. Imagine a wearable that could warn you of risks developing, nudge you towards better choices for that day based on your health profile, and keep you engaged in a treatment regime.
Connected Health - The small matter of price - Nick van Terheyden, MDNick van Terheyden
The Centers of Medicare & Medicaid Services decision to include some reimbursement in 2015 for remote monitoring is hailed as a revolutionary step for mHealth. Here are some insights from the different ecosystem players.
- With more insurance plans being open to telemedicine coverage and remote patient monitoring, see how you can take advantage of these new payments and partner with the right groups
- With Medicare fining a record number of hospitals - 2,610 - for having too many patients returning within a month. See how hospitals are adapting to the charges and changes
- Explore the advantages of preventative care at a population management and enterprise level, creating healthier workforces with less strain on the medical system and lowering insurance pay outs
An exploration of Social media through the eyes of a Chief Medical Officer and clinicians. How can they effectively leverage resources in healthcare marketing and social media. Learn about the roles, responsibilities and activities of these clinical professionals and how they can be effectively used to extend marketing reach and build market thought leadership programs
Your health is personal, and largely your responsibility. It’s good to know then that growing numbers of people are increasingly interested in their health and are taking matters into their own hands – especially when it comes to behaviors they can change that benefit their wellbeing
Wearable’s can be always present and personal offering ease of use but more importantly using voice to reinforce good behaviors and maybe even admonish bad.. What if you could have your physician or some other personal inspirational figure record a reminder for you take your medicine on your wearable?
This presentation will bring together the concepts of wearable devices, the connectivity of the internet of things and the importance of intelligent voice in turning this exciting vision of our future into the reality of tomorrow
Master chef in healthcare- integrating social media - @DrNic1Nick van Terheyden
Social Media is rapidly becoming an integral part of our lives. Despite the pervasive nature of the communication channel healthcare remains a technology laggard. This presentation will offer insights to help understand why they should join the community,
Whether the user is interacting with a mobile device, a web site, or a phone-based health technology system, there is often a large gap between what the user wants to accomplish and how they want to accomplish it, and what they actually get from the system. The interface can be challenging and capturing any feedback or user interactions is difficult using on keyboards and point and click tools. Speech Recognition is changing this interaction by capturing the clinical input and allowing clinicians and healthcare users to access systems that listen and responds seamlessly understanding the context and the intent turning what the users wants into what they get.
In this billion dollar industry, there is no shortage of investment. How to make these investments grow is an area where more clarity is required.
See facts & stats about how mHealth services e.g. remote monitoring reduces pay outs for both the single (gov) and private (insurer) payers to develop an irresistible pitch and win payer clients
Explore the payment model The Centre of Medicaid has adopted for telemedicine services to see if this can be extended for broader health management and expand your services
Assess how corporations are rolling out mHealth services throughout their workforce to reduce absenteeism and health plan payouts to align sales strategies and build market momentum
Game of documentation, Winter is coming Surviving ICD10Nick van Terheyden
Accurate clinical documentation is a prerequisite for high quality patient care, medical record and billing compliance,
accuracy of quality metrics, and support of revenue cycle and HIM functions. While current EMRs address many of the issues surrounding
aggregation of clinical data, they present significant challenges to physicians especially as they try to capture accurate and the clinically
relevant information necessary to deliver high quality care. The resulting smorgasbord of content is left to CDI specialists and HIM staff to
review abstract and assess for completeness and compliance. Additionally as ICD-10 implementation require increasingly complex and
detail content with specific terminology to meet the more detailed coding requirements placing a burden on everyone involved in the care
and capture of clinical patient information.
Discuss challenges of EMR content awareness and analysis, and current disconnected documentation clarification processes;
Explain methodologies to engage physicians in the CDI process
Describe how technology can assist with documentation improvement and acceptance
Identify status of current advanced CDI programs and the opportunity for integration of evolving technological innovations
Pipeline session speech and medical intelligence – revolutionizing the doctor...Nick van Terheyden
speech and medical intelligence – revolutionizing the doctor and patient experience
Speech is delivering efficiencies and improves EHR adoption
Adding Clinical Language Understanding is set to revolutionize healthcare delivery allowing the clinician to focus on the patient not the technology delivering real time medical intelligence at the point of care.
Medical Intelligence helps healthcare providers transform patient stories into high-value clinically actionable medical information
Improving the quality, efficiency and value of documentation and help drive better care without burdening the clinicians with data entry tasks
Pipeline session speech and medical intelligence – revolutionizing the doctor...
Healthstory - Dictation to Clinical Data: Automating the Production of Structured and Encoded Documents
1. The Health Story Project
Dictation to Clinical Data: Automating the Production of
Structured and Encoded Documents
Kim Stavrinaki
WHIMA, May 8, 2009
Nick van Terheyden, MD
s aka – SnakeDoctor
Chief Medical Officer, M*Modal
www.healthstory.com
2. Presentation Overview
Background: The Current Situation
Enabling the EMR with the Missing Link
A User Experience (GE/RISL)
The Health Story Project
Conclusion
www.healthstory.com
4. Problems Facing Clinicians
According to an American College of Physician Executives survey, 6
in 10 physicians have considered leaving the profession due to:
burnout
low morale/depression
loss of autonomy
low reimbursement rates
patient overload
bureaucratic red tape
loss of respect, and
medical liability environment
Complexity and workload is crippling physicians and
hindering their ability to deliver high quality care
www.healthstory.com
5. Electronic Health Record Universe
Critical to the success
of EHRs is to reconcile
two opposing needs
Enterprise need for
structured and coded
information capture
Physician’s practical
need for a fast and easy
method for creating
clinical notes.
www.healthstory.com
6. The Current Situation – Structured
Tedious manual process
Time-consuming
Documentation lacks expressiveness
of natural language
Lack of Flexibility
Poor user interface
Cost
Fails to Meet Individual Physician Time vs.
Benefit Test
Cultural resistance
Oblivious to HIM Requirements
Direct Data Entry:
Incomplete and Inadequate Semantic Structured and
encoded information.
Standards
www.healthstory.com
7. “Although completing such templates may help
physicians survive a report-card review, it directs
them to ask restrictive questions rather than
engaging in a narrative-based, open-ended
dialogue.”
Pamela Hartzband, M.D., and Jerome Groopman, M.D.
n engl j med 358;16 april 17, 2008
www.healthstory.com
8. The Current Situation
Transcription can be expensive
Subject to longer turn-around times
Clinical data lost, because documents
are neither structured nor encoded
Majority of attested information is only
in the document
Contains the detail and
comprehensive scope of patient
information
Support human decision making
Reimbursement is based on narrative
documentation
Retains current workflow, favored by
physicians
Interoperable Dictation:
Under utilized source of data for EMR Fast and easy,
expressive.
www.healthstory.com
9. The Current Situation
High cost of documentation
Cost of ownership and physician time vs. transcription cost
60% of the data lost to the EHR
Care process inefficiencies and impact on quality
www.healthstory.com
10. Enabling the EMR
The Missing Link in
Information Capture in Healthcare
www.healthstory.com
11. Data Entry Time
The average physician spends 33 seconds dictating an
establish office visit
92% of all office visits are established
If the average physician sees 40 patients a day, total
dictation time of 30 minutes plus time to search for the
data.
Using a traditional EHR application, the same number of
patients would require 140 minutes of data entry time.
Physicians are not willing to spend an additional 90
minutes per day for data entry.
(40 X 92% x 33 seconds) + (40 x 8% x 125) = < 30 minutes per day
www.healthstory.com
Data and Chart courtesy Mark R. Anderson, FHIMSS, CPHIMS, CEO, AC Group
12. Crossing the Chasm…
What if you could continue to use
narrative and dictation and at the same
time increase usage of the EMR and
make more records available for the
health information exchange?
www.healthstory.com
13. A word About Speech
Recognition
What speech recognition often means for physicians…
Disruption of their workflow
Change in their dictation style
More time spent on documentation
“Typing with your tongue”
The real world of dictation:
Disorganized speakers
Mumbled/fast speech
Corrections
Instructions to transcriber
Different dictation habit
www.healthstory.com
14. Health Story Project Vision
Comprehensive electronic clinical records that
tell a patient’s complete health story
All of the clinical information required for
good patient care
administration
reporting and
research
will be readily available electronically, including
information from narrative documents
www.healthstory.com
15. Goals
Bridge the gap between narrative documents
and structured data
Encourage proliferation of information for the
EHR
www.healthstory.com
16. Based on HL7 CDA
Clinical Document Architecture Requirements
Human readable document
Must be presentable as a document
Rendered version covers clinical information intended by the
author
Can contain machine-processable data
Cross platform and application independent
Can be transformed with style sheets
www.healthstory.com
17. Adoption
Incremental adoption overcomes the “not me
first” dilemma
Not dependent on recipient’s ability to receive or
process
Reverse adoption (can encode headers of
existing documents)
Non-proprietary
Readable with any browser
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18. Encoding
Does not preclude “once and done” concept
Compatible with Speech
Understanding/Recognition
Can be facilitated by Natural Language
Processing
Leverage existing relationships with
transcriptionists/editors/knowledge based
workers
Potential for automated coding (billing)
Supports data abstraction/research
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20. User Experience
GE/RISL
The Missing Link in
Information Capture in Healthcare
Kim Stavrinakis
Sr. Manager, Product Definition, GE Healthcare
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22. Why CDA?
Radiology results is key tool in providing diagnosis
Results need to be:
concise
consistent representing the highest quality
precipitate alerts before the report is distributed
Radiology Information System
rich in data
eliminates redundancy
streamlines workflow
CDA benefits
standard for clinical communication
foundation for structuring data
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23. Precision Reporting
Building a reporting tool that
leverages standards for
structuring data that
drives patient care
Screen drives outcomes for best
shot of practices
report drives research for better patient
with halo care and outcomes
Utilizing data at each point of care that
culminates in rich information for the radiologist
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24. Key Workflows
Self Editing
real time – read, proof, sign each exam
batch mode - read multiple exams then sign via signature queue
VR edits
Option to send to medical editor during reporting process
Batch Option – dynamic combinations of
workflow based on confidence models
user based thresholds that determines how report is
returned/reviewed to signature queue
preliminary/draft to signature queue
transcriptionist then preliminary to signature queue
Transcriptionist – medical editor workflow
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25. Results Reporting Workflow
Data Center
Dictation Report in
Edit Mode using
conversational
local capture tool –
speaking
can either type to
correct or voice
commands
When dictation is
Report is returned
Dictating the complete and
ready for edits
Procedure EOL is pushed
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26. Results Reporting Workflow 2
Data Center
After final sign
the report is
Edit Mode using
local capture tool –
processed in
voice in selection
the NLP engine
between brackets
for learning
Voice in options
for brackets,
sign report, add
via voice more
dictation in the
sections, then
sign
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27. Results Reporting Batch Mode
Report goes to
Dictating the medical editor or
When
Procedure signature queue,
dictation is
Radiologist moves
complete
on to next exam
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28. Understanding Diagnostic Reporting
Values Benefits Attributes
Means (Why?) Does (How?) Is (What?)
• Enables easy Radiologist • Easy to create reports using a • Multiple modes of workflow
adoption by adjusting to your variety of workflow models around dictation
workflow
• Focus time on findings and • Speedy process • Pre-configured document models
results
• Capture a competitive advantage • No re-dictate existing information • Compliance alerts
over other RAD groups
• Increase revenue with more • Easily identify items to be • Pre-populated patient information
reports / day confirmed or corrected; Deliver
reports to referring MDs faster
Source: GE analysis www.healthstory.com
29. Radiology Imaging of Lakeland Florida
Radiology & Imaging Specialists (RIS)
physician-owned
twenty board-certified radiologists
many sub-specialized
live since November 12, 2008
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30. “You didn’t change the radiologists’ work,
and that is what made it easy on me.”
David Marichal, CIO, Radiology and Imaging
Spec. of Lakeland, FL
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31. Results
VOC:
flexibility is key
• full-time rads: 70% medical editor workflow/30% self-edit
• part-time rads can use it in batch digital dictation mode
rads love not having to dictate accession #,
name, signs/symptoms, etc…
quality of the engine is very good
self-edit for stat exams has reduced # of calls
from the hospital
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32. Conversational Documentation
… transformation of dictation directly into
structured clinical documents while encoding
data depending on the care givers and
organizations needs
EHR
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33. Meaningful Clinical Documents
Meaningful Clinical Documents are a blend between
free form text and fully structured documentation that
represent the thought process, and
capture the clinical facts
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35. The Health Story Project and
Meaningful Clinical Documents
The Missing Link in
Information Capture in Healthcare
Kim Stavrinakis
Sr. Manager, Product Definition, GE Healthcare
www.healthstory.com
36. Meaningful Clinical Documents vs. Text
Structured and encoded clinical content enables…
pre-signature alerts,
decision support,
best documentation practices,
multiple output formats,
multi-media reporting,
data mining
Implements HL7 CDA4CDT standard compliant
document types
Increases quality of documentation
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37. Health Story Document Types
Implementation Guides
Completed
History & Physical
Consultation
Operative Report
DICOM Imaging Reports
Upcoming
Discharge Summary w/IHE
Billing and Reimbursement Requirements
Progress Notes
.PDF work with Adobe
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40. Crossing the Chasm…Babel Must Go
Medical text “typed” from dictation
has “no meaning”
black marks on a page…
info must be tagged as discrete data
elements in order to assign meaning
Clinical documentation uses wide variety
of terms with same meaning….
and terms that sound the same that have
different meanings…..
authors have a wide variety of styles, accents,
methods of dictation…
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41. Health Story…
Captures meaningful clinical documents
Is the bridge between
free form narrative and expressive notes, and
fully structured clinical data
Improves the quality of clinical documentation
Generates semantically interoperable clinical
data that will
solve the fundamental challenges with EMRs - allowingclinical
decision support, alerts, decision support, data mining
enable interoperability, reporting, patient safety initiatives, PQRI
(pay for performance), PSI (patient safety indicators) and improve
billing data capture
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42. Impact
Allows providers to maintain preferred workflow
and documentation methods
Increases the value and usability of narrative
documents (dictation/trans, SRT)
Accelerates the implementation of interoperable
electronic health records
Allows reuse of information
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43. Getting Involved
Join the Health Story Project
www.healthstory.com
Participate in HL7 Structured Document
work group
Participate in HL7 ballots
Encourage implementation
EHR vendor adoption
provider preference
transcription RFPs
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