This study evaluated the implementation and preliminary results of a pilot program testing the RSNA Image Share Network, a cloud-based personal health record allowing patients to access and share medical images. After modifying recruitment methods to enroll patients during their imaging appointments, enrollment increased significantly. Patient and physician surveys found high satisfaction rates and a belief in the benefits of electronic personal health records. However, some patients reported issues with the online access process. Continued evaluation is needed to assess impacts on healthcare costs and utilization.
eConsent (electronic informed consent) adoption is on the rise!
100% of the Top 10 and 88% of the Top 25 Pharma have implemented eConsent - What's driving their adoption?
Learn more in our new infographic "14 Drivers of eConsent Adoption in Clinical Trials"
Primary care-based, teleretinal-screening protocol (Los Angeles Safety Net) UCLA CTSI
UCLA CTSI-Los Angeles County Department of Health Services (DHS) Projects
Principal Investigators: Lauren Daskivich (DHS), Carol Mangione (UCLA)
Diabetic retinopathy (DR) is the leading cause of blindness among working-age Americans, and among Los Angeles Latinos—the ethnic majority of patients in the Los Angeles County (LAC) safety net—the prevalence of DR is ~50%. Despite evidence that early detection and treatment can prevent blindness from DR, a significant number of persons with diabetes in our system fail to receive annual screening examinations and/or sight-saving treatments due to lack of access to specialty care. To date, the effect of a system level intervention on improving access to eye care and definitive treatment for diabetic retinopathy in an urban medically underserved, or safety net, population has not been evaluated. The objective of this project is to evaluate the impact of teleretinal screening on access to specialty ophthalmic care for diabetic patients in LAC who need monitoring or treatment for diabetic retinopathy. We propose a pre-post analysis of the LAC teleretinal screening implementation, and we aim to evaluate the number of patients screened for diabetic retinopathy, the number presenting for timely ophthalmic follow-up care and treatment, and the cost of the program.
YouROK delivers a positive emotional health platform to help kids, families and professionals prevent mental health issues and build healthier families. The platform includes an app that builds emotional resilience while measuring deterioration in emotional well-being to proactively offer targeted treatment. Using deep learning to assess emotional health, YouROK keeps parents and professionals informed of a child's mental health status through a dashboard and alerts.
Multimodal Question Answering in the Medical Domain (CMU/LTI 2020) | Dr. Asma...Asma Ben Abacha
"Multimodal Question Answering in the Medical Domain". Invited talk at the Language Technologies Institute (LTI), Carnegie Mellon University (CMU).
Dr. Asma Ben Abacha.
April 24, 2020.
This document discusses eVisits, which are online medical evaluations between patients and providers. It provides an overview of eVisits, including relevant CPT codes, research on their efficiency and patient preferences, and stats on eVisit usage at HealthPartners and UPMC. The presentation notes that eVisits provide benefits to patients, providers, insurers and employers by increasing access and convenience while reducing costs compared to office visits. However, challenges include ensuring understanding of appropriate eVisit cases and aligning compensation with other care modalities like phone visits.
What We're Working On Now: Getting the "System" to be a Real System for Heart...3GDR
The document discusses the efforts of Partners HealthCare to create an integrated system for managing heart failure patients. It outlines several components of the heart failure program including enrollment numbers in remote monitoring programs over time, readmission outcomes, and an overview of the heart failure population within Partners. It also discusses challenges in patient identification, engagement, determining the most effective care delivery approach, managing patients efficiently across different care settings and providers, and integrating different systems and communications channels.
As pressure mounts on hospitals to improve quality and reduce costs, they have turned to medicine's fastest growing physician specialty—hospital medicine---to improve clinical performance and operational efficiency. How this new role for hospitalists plays out varies according to the type, location and creativity of individual healthcare organizations and the resources available to them. This editorial webinar will explore the steps health care organizations should take to prepare and position their hospitalists for quality-improvement responsibilities. Our panel of experts will share their insights, experiences and proven strategies for success.
eConsent (electronic informed consent) adoption is on the rise!
100% of the Top 10 and 88% of the Top 25 Pharma have implemented eConsent - What's driving their adoption?
Learn more in our new infographic "14 Drivers of eConsent Adoption in Clinical Trials"
Primary care-based, teleretinal-screening protocol (Los Angeles Safety Net) UCLA CTSI
UCLA CTSI-Los Angeles County Department of Health Services (DHS) Projects
Principal Investigators: Lauren Daskivich (DHS), Carol Mangione (UCLA)
Diabetic retinopathy (DR) is the leading cause of blindness among working-age Americans, and among Los Angeles Latinos—the ethnic majority of patients in the Los Angeles County (LAC) safety net—the prevalence of DR is ~50%. Despite evidence that early detection and treatment can prevent blindness from DR, a significant number of persons with diabetes in our system fail to receive annual screening examinations and/or sight-saving treatments due to lack of access to specialty care. To date, the effect of a system level intervention on improving access to eye care and definitive treatment for diabetic retinopathy in an urban medically underserved, or safety net, population has not been evaluated. The objective of this project is to evaluate the impact of teleretinal screening on access to specialty ophthalmic care for diabetic patients in LAC who need monitoring or treatment for diabetic retinopathy. We propose a pre-post analysis of the LAC teleretinal screening implementation, and we aim to evaluate the number of patients screened for diabetic retinopathy, the number presenting for timely ophthalmic follow-up care and treatment, and the cost of the program.
YouROK delivers a positive emotional health platform to help kids, families and professionals prevent mental health issues and build healthier families. The platform includes an app that builds emotional resilience while measuring deterioration in emotional well-being to proactively offer targeted treatment. Using deep learning to assess emotional health, YouROK keeps parents and professionals informed of a child's mental health status through a dashboard and alerts.
Multimodal Question Answering in the Medical Domain (CMU/LTI 2020) | Dr. Asma...Asma Ben Abacha
"Multimodal Question Answering in the Medical Domain". Invited talk at the Language Technologies Institute (LTI), Carnegie Mellon University (CMU).
Dr. Asma Ben Abacha.
April 24, 2020.
This document discusses eVisits, which are online medical evaluations between patients and providers. It provides an overview of eVisits, including relevant CPT codes, research on their efficiency and patient preferences, and stats on eVisit usage at HealthPartners and UPMC. The presentation notes that eVisits provide benefits to patients, providers, insurers and employers by increasing access and convenience while reducing costs compared to office visits. However, challenges include ensuring understanding of appropriate eVisit cases and aligning compensation with other care modalities like phone visits.
What We're Working On Now: Getting the "System" to be a Real System for Heart...3GDR
The document discusses the efforts of Partners HealthCare to create an integrated system for managing heart failure patients. It outlines several components of the heart failure program including enrollment numbers in remote monitoring programs over time, readmission outcomes, and an overview of the heart failure population within Partners. It also discusses challenges in patient identification, engagement, determining the most effective care delivery approach, managing patients efficiently across different care settings and providers, and integrating different systems and communications channels.
As pressure mounts on hospitals to improve quality and reduce costs, they have turned to medicine's fastest growing physician specialty—hospital medicine---to improve clinical performance and operational efficiency. How this new role for hospitalists plays out varies according to the type, location and creativity of individual healthcare organizations and the resources available to them. This editorial webinar will explore the steps health care organizations should take to prepare and position their hospitalists for quality-improvement responsibilities. Our panel of experts will share their insights, experiences and proven strategies for success.
A Prescription for Achieving Long-Term EMR Adoptionslvhit
Dr. Haugen presents how the economic, political and social pressures on the healthcare will inevitably change the shape of this industry. Topics include how the HITECH Act provides us with an opportunity, but requires significant changes in how we implement Electronic Medical Records (EMR) to ensure the transformation results in increased healthcare quality, error prevention, reduced healthcare costs and increased efficiency. The terms implementation and adoption are often used interchangeably, but the outcomes from them are very different. Moving from an EMR implementation focus to an EMR adoption focus requires a significant overhaul in how we think, how we lead, and how we behave.
The document discusses the development and findings of a pilot Electronic Care Record (ECR) project in Northern Ireland. The key points are:
1) The pilot integrated clinical information from 16 existing health systems and allowed clinicians to access patient data via a single login.
2) Evaluation found the ECR improved clinical outcomes and decision making. 97% of users were satisfied with ease of use and found it useful.
3) The pilot demonstrated that a regional ECR is achievable and could help improve patient safety, quality of care and reduce costs across Northern Ireland.
An ethnographic study of over 600 physicians during the implementation of a computerized physician order entry system at a hospital system found that process-related issues, rather than technological issues, were a major factor in 62% of observations of physician challenges. Specifically, the study found that inefficient or poorly designed ordering processes led physicians to write orders on paper instead of using the new system or to call in orders rather than enter them directly. The study concluded that healthcare organizations often overlook process design and focus too much on technology, risking implementation failures if workflow issues are not adequately addressed to gain physician buy-in.
Mobile health workforce enablement for district nursing. Presented by Mitchell Pham, Augen Software Group and Judith Geary, Gore Health, at HINZ 2014, 11 November 2014, 11.37am, Marlborough Room 3
Challenges of Summative Usability Testing in a Community Hospital Environment...David Schlossman MD
Findings of a summative scenario based ehr usability testing protocol and challenges of conducting the research in a private practice community hospital environment.
Antimicrobial resistance is one of the biggest threats to human health and is rising to dangerously high levels in all parts of the world. Anyone, of any age, in any country, could be impacted. While it's normal for microbes to develop resistance to drugs, the way antimicrobials are currently being used is accelerating the process, and as a result common infections and minor injuries are becoming an increasingly greater threat to our well-being. Organizations from across the world are taking action and making progress on this issue, but is there anything patients, their families and patient advisors can do to help?
See the full presentation here: https://goo.gl/AYCsdd
Contemporary Memo, Merging technologies in the workforceWarren Sprecher
The document proposes using virtual reality technology for medical training at the University of Washington Medical School. It summarizes research showing virtual reality training results in faster procedures, fewer errors, and better outcomes for patients. The author urges adopting virtual reality to improve how students learn procedures and treat mental health conditions like PTSD. Virtual reality could help minimize the increase in patient deaths that occurs when new medical residents start each July. As virtual reality technology advances further, it will likely become an essential tool for medical education.
Digital Solutions putting the patient at the forefront of Risk ManagementMyMeds&Me
Capturing relevant, essential and complete data at the first interaction
Why surfacing targeted questions and FAQs in-stream maximises the value of the initial contact and reduces low-value follow up.
Digital solutions ensure your REMS and RMP commitments are met with appropriate evidence
In this presentation from the Beryl Institute's 2016 Patient Experience Conference, Edwards-Elmhurst Healthcare’s ED Chair and Patient Experience Director detail how they are leveraging technology to follow up with ED Patients and the exceptional results they’ve enjoyed.
The document discusses problems with the current healthcare system such as long wait times to see a doctor and overuse of emergency rooms. It then introduces telemedicine as a solution, noting its benefits like convenience and speed. Telemedicine could help address issues exacerbated by the Affordable Care Act such as a growing doctor shortage. The document outlines how a telemedicine service works and its potential benefits for both customers and employers.
InfoWell Patient Portal: A Case of Patient-Centred Design [05 Cr2 1100 Chan]Gunther Eysenbach
This document summarizes the InfoWell Patient Portal project which aimed to develop a secure website to provide patients with personalized health information, care plans, education, and tools to better manage their health. It describes the objectives of assisting patients and enhancing their experience. It outlines the components of the portal and discusses the patient-centered design approach used, which involved engaging patients at each stage of concept development, design, testing, implementation, and evaluation. Usability testing found high completion and satisfaction rates among patients who used the portal.
This document summarizes a presentation about a prototype primary care EHR system called Small Brain Project. The system aims to increase patient engagement and capture more objective clinical data while reducing clinician documentation burden. It allows patients and providers to jointly manage health problems, goals, and tasks. Encounters are recorded through multimedia and problems are updated based on patient inputs. The system was tested with 375 patients and showed benefits like improved safety, efficiency and patient trust. Next steps discussed were integrating with other systems through FHIR and Dartmouth projects to advance the open source project.
Using Digital Innovation to Establish Authentic Reporter DialogueSophia Ahrel FCIM
Digital solutions that put patients at forefront of safety processes
Capture relevant, essential and complete data at first interaction
Maximise the value of initial contact and reduce low value follow up
Solutions that ensure REMS and RMP commitments are met and are future proofed
This document discusses the importance of collaborative care and care coordination for healthcare delivery systems. It notes that solo practice is no longer a sustainable business model and that fee-for-service payments have limitations. The document provides evidence that care coordination can reduce costs through fewer hospital admissions and readmissions without worse health outcomes. It also shows that patients experience a lack of communication and information sharing between their different doctors. To improve care coordination, mobile access to patient data and collaborative workflows are seen as critical, as mobile devices are increasingly how physicians access information. The right devices and secure mobile computing are needed to enable these new care coordination models.
Patient leakage - What to know and how to avoid itChiron Health
This document outlines an agenda for a webinar on patient leakage to urgent care centers and on-demand telemedicine services. It discusses the rise of these alternatives to traditional primary care and their potential clinical and financial impacts. Specifically, it notes the growth in urgent care centers and four major on-demand telemedicine companies. While these new options offer convenience, they may fragment care and weaken patient-physician relationships. The document promotes offering telemedicine through services like Chiron Health, which integrate with electronic health records and guarantee reimbursement for video visits. Patient satisfaction data is presented showing positive experiences with telemedicine follow-ups.
This document outlines an agenda for a HealthVault conference, including:
- An introduction to HealthVault and why it's important from 10:00-12:00.
- A discussion of security and privacy considerations for HealthVault from 13:00-13:30.
- An overview of how to develop HealthVault applications from 13:30-14:30.
- Information on how patients can engage with their health through tools like remote monitoring and chronic condition management.
Va open notes and blue button va ehealth university dec 2012Susan Woods
This document discusses the VA's Blue Button and Open Notes initiatives which aim to give patients access to their health records and information. It notes that over 1.9 million VA patients have registered for online access to their records through My HealtheVet. The document outlines what health data is currently available to patients through the VA's patient portal as well as what additional data may be made available in the future. It discusses the benefits of open notes and greater patient access to health records based on studies that have found it improves patient-provider communication, patient knowledge and self-care, and patient participation in their care. The document advocates for continued expansion of patient access to health records and greater patient involvement in healthcare design and delivery.
The webcast discussed the benefits of using an application service provider (ASP) for long-term storage and disaster recovery of medical imaging data. ASP provides redundant offsite storage at multiple data centers, ensuring images are securely backed up and accessible. Three medical centers described how ASP allowed uninterrupted access to images even after disasters like Hurricane Katrina, avoiding data loss or access issues. ASP is a cost-effective solution that removes the burden of local storage management and hardware updates.
This document summarizes Nick van Terheyden's presentation on AMDIS documentation panel. It discusses challenges with current documentation methods and how voice recognition and natural language processing can help address these challenges by capturing structured and unstructured data from physician dictations. This can generate detailed patient records to fuel clinical applications and improve patient care by facilitating coding, quality reporting and clinical decision support directly from narrative notes. However, the focus should remain on the patient by showing empathy and addressing their needs rather than focusing solely on technology.
A Prescription for Achieving Long-Term EMR Adoptionslvhit
Dr. Haugen presents how the economic, political and social pressures on the healthcare will inevitably change the shape of this industry. Topics include how the HITECH Act provides us with an opportunity, but requires significant changes in how we implement Electronic Medical Records (EMR) to ensure the transformation results in increased healthcare quality, error prevention, reduced healthcare costs and increased efficiency. The terms implementation and adoption are often used interchangeably, but the outcomes from them are very different. Moving from an EMR implementation focus to an EMR adoption focus requires a significant overhaul in how we think, how we lead, and how we behave.
The document discusses the development and findings of a pilot Electronic Care Record (ECR) project in Northern Ireland. The key points are:
1) The pilot integrated clinical information from 16 existing health systems and allowed clinicians to access patient data via a single login.
2) Evaluation found the ECR improved clinical outcomes and decision making. 97% of users were satisfied with ease of use and found it useful.
3) The pilot demonstrated that a regional ECR is achievable and could help improve patient safety, quality of care and reduce costs across Northern Ireland.
An ethnographic study of over 600 physicians during the implementation of a computerized physician order entry system at a hospital system found that process-related issues, rather than technological issues, were a major factor in 62% of observations of physician challenges. Specifically, the study found that inefficient or poorly designed ordering processes led physicians to write orders on paper instead of using the new system or to call in orders rather than enter them directly. The study concluded that healthcare organizations often overlook process design and focus too much on technology, risking implementation failures if workflow issues are not adequately addressed to gain physician buy-in.
Mobile health workforce enablement for district nursing. Presented by Mitchell Pham, Augen Software Group and Judith Geary, Gore Health, at HINZ 2014, 11 November 2014, 11.37am, Marlborough Room 3
Challenges of Summative Usability Testing in a Community Hospital Environment...David Schlossman MD
Findings of a summative scenario based ehr usability testing protocol and challenges of conducting the research in a private practice community hospital environment.
Antimicrobial resistance is one of the biggest threats to human health and is rising to dangerously high levels in all parts of the world. Anyone, of any age, in any country, could be impacted. While it's normal for microbes to develop resistance to drugs, the way antimicrobials are currently being used is accelerating the process, and as a result common infections and minor injuries are becoming an increasingly greater threat to our well-being. Organizations from across the world are taking action and making progress on this issue, but is there anything patients, their families and patient advisors can do to help?
See the full presentation here: https://goo.gl/AYCsdd
Contemporary Memo, Merging technologies in the workforceWarren Sprecher
The document proposes using virtual reality technology for medical training at the University of Washington Medical School. It summarizes research showing virtual reality training results in faster procedures, fewer errors, and better outcomes for patients. The author urges adopting virtual reality to improve how students learn procedures and treat mental health conditions like PTSD. Virtual reality could help minimize the increase in patient deaths that occurs when new medical residents start each July. As virtual reality technology advances further, it will likely become an essential tool for medical education.
Digital Solutions putting the patient at the forefront of Risk ManagementMyMeds&Me
Capturing relevant, essential and complete data at the first interaction
Why surfacing targeted questions and FAQs in-stream maximises the value of the initial contact and reduces low-value follow up.
Digital solutions ensure your REMS and RMP commitments are met with appropriate evidence
In this presentation from the Beryl Institute's 2016 Patient Experience Conference, Edwards-Elmhurst Healthcare’s ED Chair and Patient Experience Director detail how they are leveraging technology to follow up with ED Patients and the exceptional results they’ve enjoyed.
The document discusses problems with the current healthcare system such as long wait times to see a doctor and overuse of emergency rooms. It then introduces telemedicine as a solution, noting its benefits like convenience and speed. Telemedicine could help address issues exacerbated by the Affordable Care Act such as a growing doctor shortage. The document outlines how a telemedicine service works and its potential benefits for both customers and employers.
InfoWell Patient Portal: A Case of Patient-Centred Design [05 Cr2 1100 Chan]Gunther Eysenbach
This document summarizes the InfoWell Patient Portal project which aimed to develop a secure website to provide patients with personalized health information, care plans, education, and tools to better manage their health. It describes the objectives of assisting patients and enhancing their experience. It outlines the components of the portal and discusses the patient-centered design approach used, which involved engaging patients at each stage of concept development, design, testing, implementation, and evaluation. Usability testing found high completion and satisfaction rates among patients who used the portal.
This document summarizes a presentation about a prototype primary care EHR system called Small Brain Project. The system aims to increase patient engagement and capture more objective clinical data while reducing clinician documentation burden. It allows patients and providers to jointly manage health problems, goals, and tasks. Encounters are recorded through multimedia and problems are updated based on patient inputs. The system was tested with 375 patients and showed benefits like improved safety, efficiency and patient trust. Next steps discussed were integrating with other systems through FHIR and Dartmouth projects to advance the open source project.
Using Digital Innovation to Establish Authentic Reporter DialogueSophia Ahrel FCIM
Digital solutions that put patients at forefront of safety processes
Capture relevant, essential and complete data at first interaction
Maximise the value of initial contact and reduce low value follow up
Solutions that ensure REMS and RMP commitments are met and are future proofed
This document discusses the importance of collaborative care and care coordination for healthcare delivery systems. It notes that solo practice is no longer a sustainable business model and that fee-for-service payments have limitations. The document provides evidence that care coordination can reduce costs through fewer hospital admissions and readmissions without worse health outcomes. It also shows that patients experience a lack of communication and information sharing between their different doctors. To improve care coordination, mobile access to patient data and collaborative workflows are seen as critical, as mobile devices are increasingly how physicians access information. The right devices and secure mobile computing are needed to enable these new care coordination models.
Patient leakage - What to know and how to avoid itChiron Health
This document outlines an agenda for a webinar on patient leakage to urgent care centers and on-demand telemedicine services. It discusses the rise of these alternatives to traditional primary care and their potential clinical and financial impacts. Specifically, it notes the growth in urgent care centers and four major on-demand telemedicine companies. While these new options offer convenience, they may fragment care and weaken patient-physician relationships. The document promotes offering telemedicine through services like Chiron Health, which integrate with electronic health records and guarantee reimbursement for video visits. Patient satisfaction data is presented showing positive experiences with telemedicine follow-ups.
This document outlines an agenda for a HealthVault conference, including:
- An introduction to HealthVault and why it's important from 10:00-12:00.
- A discussion of security and privacy considerations for HealthVault from 13:00-13:30.
- An overview of how to develop HealthVault applications from 13:30-14:30.
- Information on how patients can engage with their health through tools like remote monitoring and chronic condition management.
Va open notes and blue button va ehealth university dec 2012Susan Woods
This document discusses the VA's Blue Button and Open Notes initiatives which aim to give patients access to their health records and information. It notes that over 1.9 million VA patients have registered for online access to their records through My HealtheVet. The document outlines what health data is currently available to patients through the VA's patient portal as well as what additional data may be made available in the future. It discusses the benefits of open notes and greater patient access to health records based on studies that have found it improves patient-provider communication, patient knowledge and self-care, and patient participation in their care. The document advocates for continued expansion of patient access to health records and greater patient involvement in healthcare design and delivery.
The webcast discussed the benefits of using an application service provider (ASP) for long-term storage and disaster recovery of medical imaging data. ASP provides redundant offsite storage at multiple data centers, ensuring images are securely backed up and accessible. Three medical centers described how ASP allowed uninterrupted access to images even after disasters like Hurricane Katrina, avoiding data loss or access issues. ASP is a cost-effective solution that removes the burden of local storage management and hardware updates.
This document summarizes Nick van Terheyden's presentation on AMDIS documentation panel. It discusses challenges with current documentation methods and how voice recognition and natural language processing can help address these challenges by capturing structured and unstructured data from physician dictations. This can generate detailed patient records to fuel clinical applications and improve patient care by facilitating coding, quality reporting and clinical decision support directly from narrative notes. However, the focus should remain on the patient by showing empathy and addressing their needs rather than focusing solely on technology.
The document summarizes an open house for Framingham State College's MBA program. It provides an agenda that includes introductions of faculty, an overview of the program benefits and structure, course details, and information on costs and discounts. It also lists upcoming GMAT test dates and locations for applying to the program.
The Cyclades Islands in Greece are famous, with Santorini being the most photogenic. Santorini's capital is built on cliffs surrounding a sunken volcano, with the white cliffside houses piled on the slopes. Visitors can see spectacular views of the caldera from Oia, one of the best places to sunbathe in the Aegean Sea.
Here are a few key questions organizations should consider as they assess readiness for emerging leadership roles:
- How developed is our strategic plan for the transition from volume to value?
- What data and analytics capabilities do we have/need to effectively manage under value-based models?
- How well do our current IT systems and processes support value-based care delivery and payment models?
- What is the understanding and engagement level of our frontline staff around the need for transformation?
- Do our performance metrics and incentives reinforce or impede the shift to value?
- Do we have leaders in place who can drive innovation, change management and digital strategies?
- Are we exploring new digital technologies like mobile,
The document discusses the future of clinical documentation and the need to expand the current physician notes paradigm to support care coordination and the team care model. It notes that achieving care coordination is key to realizing the Triple Aim and that the current notes are not adequate. The notes need to include clinician colleagues, patients, and outcomes of the care plan. It also addresses principles of clinical documentation and the need to support care coordination through documentation during transitions of care.
This document summarizes a presentation about implementing a real-time patient experience survey system called "My Experience Matters" at Western Sydney Local Health District. The system captures feedback from patients and families using tablets, online forms, and paper to get real-time data. Survey questions and reporting are customized for each ward and clinic. Free-text comments provide insights into root causes and allow staff to address issues. An integrated 6E framework supports improving patient experience outcomes through staff engagement. Initial results show over 1500 responses identified focus areas and led to actions that improved communication, noise levels, cleanliness and food variety. Key lessons included the importance of leadership, a holistic culture change approach, and resources to handle the increased workload.
Clinicians Satisfaction Before and After Transition from a Basic to a Compreh...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
Presentation 223 rebecca brittain als tele health_ a patient centered approa...The ALS Association
This document discusses the development of an ALS tele-health program that allows patients to receive multidisciplinary care through virtual clinic visits. A nurse was trained to conduct remote assessments using video conferencing equipment. Standardized assessment tools were identified or developed for each discipline. The nurse would visit patients' homes to record exams and gather data, which was then reviewed virtually by the care team. An evaluation found high patient and provider satisfaction with the tele-health approach, which expanded access to care for patients unable to attend in-person clinics. The program aims to continue improving the process and identifying sustainable funding.
The document is a presentation about polyclinic waiting time problems and solutions at Tawam Hospital in the UAE. It introduces the presenter and states that the presentation will be divided into four parts: an overview, study results, current and proposed processes, and recommendations/conclusions. It provides background on Tawam Hospital and defines waiting time. It discusses implementation of a Health Information System (HIS) and benefits, as well as research aims, methodology involving questionnaires, and results showing specialists are satisfied with HIS but it is not the main cause of delays. Results of patient questionnaires show waiting times at various stages with most waiting over 60 minutes for required service.
The document discusses patient engagement requirements under Meaningful Use Stage 2, Accountable Care Organizations, and the Patient-Centered Medical Home model. It outlines 7 proposed core measures for Stage 2 that focus on clinical summaries, education resources, secure messaging, and reminders. It also lists 7 patient experience measures required by ACOs and notes the 66 factors assessed by NCQA for medical homes. The document emphasizes that meaningful patient engagement requires real change by both providers and patients through improved experiences and patient involvement.
Acute hospitals end of life care best practiceNHSRobBenson
Delivering reliable best practice in an acute hospital setting for patients whose recovery is uncertain. Including details of the AMBER care bundle. Presentation from Anita Hayes and colleagues from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
Patient Engagement is growing in importance as consumer expectations of healthcare providers change and as portals and other technologies improve. Early studies show affects on outcomes for patient engagement technologies
This document discusses patient generated data (PGD) and how mobile health (mHealth) technologies can be used to capture it. PGD includes data recorded by patients about their health symptoms, medication adherence, biometric data from wearables, and patient reported outcomes. The document outlines how PGD can help with clinical trials and care by providing more comprehensive real-world data. Challenges with PGD like data quality, privacy and regulatory issues are discussed. The document provides examples of how the Aparito platform captures different types of PGD through mobile apps and connected devices to improve disease understanding and drug development.
Patient Compliance, ePRO and the Role of the CaregiverCRF Health
Sponsor companies are increasingly requiring methods like electronic patient-reported outcomes (ePRO) to ensure accurate and timely data collection from patients in drug trials. ePRO systems, like electronic diaries (eDiaries), have been shown to improve patient compliance compared to paper-based methods. eDiaries allow for real-time data entry and monitoring of compliance. ePRO can collect data from both patients and their caregivers, such as in pediatric studies or diseases affecting motor or cognitive function. Contrary to assumptions, the elderly and caregivers of children often have high compliance rates when using ePRO systems. Proactive eDiary design with simple questions, reminders and monitoring can help maintain compliance for diverse patient populations and study types.
The document discusses a telepsychiatry program implemented in rural nursing homes to improve access to mental healthcare. The program saw success in increasing psychiatric consultations, reducing anti-psychotic drug usage, and gaining acceptance from residents, staff, and psychiatrists. Key benefits included improved quality of care, reduced hospitalizations and transportation costs, and increased psychiatrist productivity through telemedicine. Some technical, administrative, and acceptance challenges were encountered but addressed over time.
Nursing Research and Evidence Based Practice DQ.pdfbkbk37
This document describes a study that aimed to increase nurse compliance with bedside shift report and improve patient satisfaction scores. A standardized approach to bedside report was implemented using Lewin's change theory. Patient satisfaction scores and nurse compliance with bedside report were compared before and after implementation. Results showed improved nurse compliance with bedside report and higher patient satisfaction scores post-implementation, indicating the standardized approach helped increase nurse compliance and improved the patient experience.
An electronic early warning score system was proposed to address the shortcomings of a manual paper-based system. The electronic system would calculate scores based on recorded vital sign observations and trigger alerts and escalation pathways for deteriorating patients. The system could be deployed on mobile devices at bedsides or fixed iPads to facilitate real-time data entry and alerts. It leverages an existing electronic medical record platform already in use in New Zealand to provide an integrated, feasible solution.
Optimizing your EHR Value through Patient EngagementBrian Ahier
The document discusses optimizing EHR value through patient engagement. It lists several Stage 1 and Stage 2 Meaningful Use objectives related to engaging patients and families, such as providing clinical summaries and discharge instructions electronically. It describes ways physicians can use health IT to facilitate patient involvement, like arranging exam rooms so patients can see screens and using portals and PHRs. The document also discusses enabling engagement between visits through secure messaging, reminders, and accessing records online. It promotes joining ONC's Pledge Program to empower patient partnership in health.
The document summarizes research from the Robert Graham Center on telehealth projects and surveys of family physicians and residency directors. It finds that while family physicians see benefits to telehealth, adoption has been limited due to barriers like reimbursement and technology issues. A survey of family physicians found 15% had used telehealth in the past year, with higher rates in rural areas. Barriers to more use included reimbursement, costs, and preference for in-person visits.
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
Clinician Satisfaction Before and After Transition from a Basic to a Comprehe...Allison McCoy
Healthcare organizations are transitioning from basic to comprehensive electronic health records (EHRs) to meet Meaningful Use requirements and improve patient safety. Yet, full adoption of EHRs is lagging and may be linked to clinician dissatisfaction. In depth assessment of satisfaction before, during, and after EHR transition is rarely done. Using an adapted published tool to assess adoption and satisfaction with EHRs, we surveyed clinicians at a large, non-profit academic medical center before (baseline) and 6-12 months (short-term follow-up) and 12-24 months (long-term follow-up) after transition from a basic, locally-developed to a comprehensive, commercial EHR. Satisfaction with the EHR (overall and by component) was captured at each interval. Overall satisfaction was highest at baseline (85%), lowest at short-term follow-up (66%), and increasing at long-term follow-up (79%). This trend was similar for satisfaction with EHR components designed to improve patient safety including clinical decision support, patient communication, health information exchange, and system reliability. Conversely, at baseline, short-term and long-term follow-up, perceptions of productivity, ability to provide better care with the EHR, and satisfaction with available resources, were lower at both short- and long-term follow-up compared to baseline. Persistent dissatisfaction with productivity and resources was identified. Addressing determinants of dissatisfaction may increase full adoption of EHRs. Further investigation in larger populations is warranted.
The development of a Patient Safety Programme for Primary Care is being informed by the learning from two ongoing primary care safety projects. This session highlights the approaches used, the early findings and describes how to sustain and spread the success of this work.
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Similar to The RSNA Image Share Network: Initial 12 Month Results from the UCSF Pilot Site (20)
This document provides a summary of 6 late-breaking sessions to attend at the Heart Rhythm Society Scientific Sessions in Boston from May 13-16, 2015. The sessions include: (1) a study on the impact of remote monitoring on clinical events and healthcare utilization; (2) a randomized global trial comparing uninterrupted rivaroxaban to vitamin K antagonists in patients undergoing catheter ablation; and (3) a study comparing cryoballoon versus open irrigated radiofrequency ablation in patients with paroxysmal atrial fibrillation. The other sessions include: (4) first-in-human experience with a miniaturized transcatheter pacing system; (5) results from the Canadian Registry of Card
This document provides details on the top 5 sessions to attend at the HIMSS.15 conference. The sessions cover topics like structured cardiology procedure reporting, connected heart health using American Heart Association resources, using BI and analytics to reduce sepsis and heart failure readmissions, how health information exchanges can support population health through New York's Million Hearts initiative, and a session on transforming data into information and driving transformation. Speakers include doctors, public health experts, and data analysts.
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This document summarizes 7 innovative technologies that will be on display at ACC.15:
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The document summarizes several imaging sessions at the upcoming American College of Cardiology's Annual Scientific Session & Expo on March 14-16 in San Diego. Key sessions include:
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If you want to avoid damaging litigation, concentrate on dialogue and details. Cardiologists who fail to maintain detailed, two-way conversations with patients and thoroughly assess diagnostic data are at risk of negligence lawsuits, a study shows.
The 2014 RSNA conference in Chicago saw over 56,000 attendees, up 5% from the previous year, with more than 2,000 additional professional registrations. Although exhibitor attendance dipped slightly by 2%, the conference floor was packed with 636 exhibits occupying over 426,000 square feet. The conference featured special exhibits celebrating RSNA's 100th anniversary and highlighting the organization's contributions to advances in medical imaging over the past century.
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This study compared the real-world effectiveness and safety of rivaroxaban versus warfarin for stroke prevention in nonvalvular atrial fibrillation patients using claims data. The study found:
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This document summarizes a study examining the length of stay and economic implications of treating pulmonary embolism with rivaroxaban versus low molecular weight heparin-vitamin K antagonist (LMWH-VKA) in an emergency room setting. The study found that among patients in North America from the EINSTEIN PE trial, the median length of stay was 1 day shorter for those treated with rivaroxaban (3 days) compared to LMWH-VKA (4 days). This 1 day reduction in length of stay was associated with an estimated $2040 savings per patient for the rivaroxaban cohort based on average hospital costs. The study concluded that rivaroxaban was associated with a consistent
Shorr and bria innovation at the point-of-care rethinking the doctor-patient...Trimed Media Group
The document discusses innovations in doctor-patient interactions through technology. It proposes two solutions: 1) Creating a "story" of the patient's medical history and presenting issues for doctors to review before visits to improve care. This would be generated through automated document assembly. 2) Developing an "ad hoc" user interface optimized for point-of-care use, allowing doctors to take notes digitally in various formats like ink, checkboxes and dictation to focus on patient interaction instead of formal documentation. The goal is to enhance both the patient and provider experience through disruptive technology.
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
The RSNA Image Share Network: Initial 12 Month Results from the UCSF Pilot Site
1. Anand S. Patel MD*, Wyatt M. Tellis PhD, Mary Torosyan,
David E. Avrin MD PhD, and Ronald L. Arenson, MD
UCSF Department of Radiology and Biomedical Imaging
Laboratory for Radiological Informatics
*Correspondence: anand.patel@ucsf.edu
2. Introduction
Medicare expenditure on imaging has nearly
doubled from $6.5B in the year 2000 to $11.7B in
2009.
At least 10-20% of these costs are due to
duplicate exams, frequently due to inadequate
access to prior exams when transferring patients
between institutions.
In response the RSNA, in partnership with the
NIBIB, launched the Image Share Network in
2009.
3. Introduction
The Image Share Network is a secure cloud-
based electronic personal health record (ePHR)
where patients directly control, view, share, and
manage their imaging exams.
The RSNA has partnered with 5 pilot sites in the
USA to evaluate the Image Share Network:
University of California, San Francisco (UCSF)
Mount Sinai Medical Center
Mayo Clinic (Rochester, MN)
University of Chicago Medical Center
University of Maryland Medical Center
4. Introduction
GOAL: to improve efficiency, safety, reduce
repeat exams, and empower patients with direct
control of their images and reports via a secure
HIPAA compliant internet cloud-based ePHR.
As 1 of 5 national pilot sites, we present our
experience at UCSF with patient enrollment,
adoption, and patient/physician satisfaction.
5. Network Design Overview
The Image Share network has a hub and spoke
design with a central ―clearinghouse‖ through
which all data are transferred.
Clearinghouse is hosted in a HIPAA-compliant,
distributed data center with physical access
controls.
Having a distributed data center provides
business continuity by allowing the clearinghouse
to continue operating in the event of a failure at
one or more of the data center sites.
7. Network Security
Communication with the clearinghouse takes
place over the internet and is secured using TLS
1.0 encryption. All nodes are authenticated
through the exchange of TLS certificates.
Additional security is provided by a firewall with
an access control list that permits only
authorized IP addresses to connect.
Once data are at rest within the clearinghouse
they are encrypted and automatically deleted
after thirty days to minimize the chance of data
theft.
8. Network Technical Details
To remain vendor agnostic, the network utilizes the IHE
XDS-I.b standard for data exchange.
2 vendors currently provide PHR accounts to patients
participating in the network
Dell (InsiteOne)
lifeIMAGE
Each site is interfaced to the clearinghouse via an
―edge server‖ which acts as an XDS ―document
source.‖
HL7 and DICOM are used to retrieve reports and
images from the site‘s RIS and PACS respectively.
9. Network Technical Details
Since the focus of XDS-I.b is the exchange of imaging
data across affiliated enterprises, modifications were
required for use in a consumer-oriented environment.
A unique, single use security token is used to identify
submission sets within the network.
To retrieve content from the network, an ePHR must
be able to reconstruct the token hash, the patient‘s
date of birth and a password known only to the
patient.
By using this approach the network is able to abide
by the XDS-I.b standard while providing an increased
level of security by minimizing the exposure of PHI.
10. Methods
With IRB approval, Network enrollment began in Aug
2011 with patients coming to the department‘s film
library to obtain a CD of their exams.
During the first 10 months of the enrollment period
(Aug 2011 – May 2012), our site enrolled patients as
they contacted the film library for a copy of their
images on a CD, either in person or over the phone.
Patients were educated about the system with a
standard informational script communicated by the
film library as well as formal brochures.
11. Methods
Starting in Aug 2012, patients were also provided a
brief survey (2 pages for patient, 1 page for
physician) to be completed after use of the system.
Incentive $20 gift cards are provided to those patients
who mail back the survey.
Surveys gauge patients and physicians on:
Perceived benefits/utility of patient-controlled ePHRs
Importance of health record privacy
Baseline computer, internet, and social media usage
Satisfaction using the Image Share system (ease of
use, etc)
Satisfaction with the Image Share system‘s security
Whether difficulty with access to CD or Image Share
system led to repeat imaging
12. Methods
Preliminary follow-up survey questions will be
grouped and scored with mean response values
based on the following scales:
1 most satisfied, 2 satisfied, 3 neutral, 4 unsatisfied,
5 very unsatisfied
A score of 1 (daily) – 4 (never) is used to assess
patient and physician baseline computer/internet
usage
13. Preliminary Results
During this initial period (Aug 2011 – May 2012) a total of
only 90 patients (avg of 9 patients/mo), were enrolled.
When asked about the low enrollment rates, film library
staff indicated that low enrollment patients were in a
hurry, and not willing to spend time to go through the
educational and consent process.
Starting in June 2012, the patient recruitment process
was redesigned to enroll patients while they waited for
their scans.
A recruitment coordinator was hired and dedicated to
the task.
14. Overview of Modified Patient
Recruitment Process
Patients checks in at
Radiology reception area
If patient is not interested
Research coordinator in the program, then
introduces the RSNA patient awaits his or her
Image Share Network scan
If patient wishes to enroll, research Patients access their
coordinator goes through the images/reports, and
educational process prior to consent request past and future
studies with the capability
to send the studies to any
Once reports have been finalized, research coordinator doctors, family, and
sends requested images to the clearinghouse, emailing friends, simply with a click
the patients with simple instructions for access of a button
15. Results
After starting the new process with a study
coordinator, (3 months, Jun–Aug 2012), 357
patients were enrolled.
Monthly average of 119 patients
Increase of 1222% over the previous 10 month avg.
4 of the 5 pilot sites are currently enrolling
patients
Total of 1383 patients and 5807 exams.
447 patients enrolled at UCSF for a total of 2288
exams.
16. Results – Enrollment Overview
Significant enrollment rate increase in May
2012 after hiring of a study coordinator.
17. Results – Patient Survey
N = 66 total surveys returned as of Nov 1, 2012
Mean age 44 yrs (range 15 days to 87 years).
Parents/legal guardians comprised 15% of enrollees
Frequency of general Frequency of internet use for social
computer use networking or online purchasing
5%
6% 12%
Daily
Weekly
Monthly 55%
27%
Never
95%
18. Results – Patient Survey
Perceived benefits/utility of patient-controlled ePHRs.
95% felt this was very important or important
Average satisfaction score 1.5 +/- 0.7 (1 most – 5 least
satisfied)
4% 11% Very satisfied or satisfied
Neutral
Unsatisfied or very
85% unsatisfied
2% stated they had repeat imaging because their
physician had difficulty accessing it
19. Results – Patient Survey Q‘s
Strongly agree
―In general I am particularly / agree
16%
concerned about
maintaining the privacy of Neutral
my health records.‖ (1 strongly 22%
agree – 5 strongly disagree) 62%
Strongly
disagree /
Avg score 2.3 +/- 1.3 disagree
2%
―I was comfortable with the
Strongly agree
privacy and security of how 11% / agree
my medical images were Neutral
transferred to my doctor or
consultant.‖ (1 strongly agree – 5 Strongly
strongly disagree) disagree /
87%
disagree
Avg score 1.6 +/- 0.8
20. Results – Patient Comments
―I love it!‖
―Easy…helpful‖
―The system works really well.‖
―…pleased by the speed and grateful not to have to
bring the image‖
―This is really neat. I‘ve always been curious about the
images of my own organs.‖
―I loved having the option to review my daughter‘s scan
with my husband who could not be at our appointment
in SF as we live a couple hours away…‖
―This was a great tool! I really appreciate the
opportunity to take all the time I wanted to read the
report and look at the images on my own.‖
21. Results – Patient Comments
―had difficulty registering…‖
―takes forever to download…‖
―Felt process to access images online was not well
defined. Need more detailed instructions on creating
account and URL to use. Also, no instructions on what
viewer to use for downloaded images. Took multiple
attempts to download file…
―A link would be easier rather than having to highlight
the address and open a new search‖
―It was easy for me to access the images however I
had a hard time accessing the report online.‖
22. Results –Physician Survey
N = 34 total surveys returned
Average satisfaction score 1.8 +/- 1.3 (1 most – 5
least satisfied)
21%
Very satisfied or satisfied
79% Neutral
8% stated difficulty accessing CD exams led to
repeat imaging study
12% stated difficulty accessing Image Share
Network led to repeat imaging study
23. Results –Physician Survey Q‘s
6%
―It was critically important that Strongly
I saw the medical image(s) in agree /
a short period of time.‖ (1 agree
strongly agree – 5 strongly disagree) Neutral
N = 33, avg score 1.2 +/- 0.6 94%
11%
―I am comfortable with the Strongly
privacy and security of how agree /
this patient‘s images were sent agree
to me‖ (1 strongly agree – 5 strongly Neutral
disagree) 89%
N = 27, avg score 1.4 +/- 0.7
24. Results – Physician Comments
―Dr. is at UCSF, so not applicable‖
―I think this is great‖
25. Discussion - Enrollment
The lengthy conversation required by the
enrollment process proved to be an impediment for
enrolling patients when they contacted the film
library to request a CD copy of their images.
The modification to include a study coordinator
helped increase numbers to their highest monthly
total to date.
When patients were a ―captive‖ audience in the
waiting room they were far more willing to learn
about the network.
Once they understood the process and its benefits,
the majority of patients were enthusiastic to enroll.
26. Discussion – Patient Survey
85% of patients are satisfied or very satisfied with their
experience using the RSNA Image Share Network.
11% nonetheless are unsatisfied or very unsatisfied,
perhaps due to online access/registration issues
87% either agreed or strongly agreed that they felt
comfortable with the privacy/security of the system
38% of patients either disagree, strongly disagree, or
are neutral that health record privacy is important
This is perhaps higher than would be expected
27. Discussion – Physician Survey
79% of referring physicians are satisfied or very
satisfied with their experience using the RSNA Image
Share Network.
None reported dissatisfaction
94% felt it was critically important to see medical
images in a short time
~10% reported the necessity for repeat imaging
regardless of using CD or the Image Share Network
89% were comfortable with the privacy/security of
the system
None reported dissatisfaction
28. Discussion - Comments
Patients overall reported ease of use
Certain patients voiced concerns that the online
registration process and system could be improved
Physician use is often difficult to gauge since
most patients have a UCSF referring physician
Already using the medical center‘s own online
medical record and image viewer, thus obviating
the need to use Image Share Network
29. Discussion - Survey
Potential considerations that could confound results:
Most patients could be considered ‗computer
literate‘ based on their computer/internet usage
Most patients believe ahead of time that there would
be significant utility of patient-controlled ePHRs
Physician cohort may have been mostly
homogenous working at UCSF
Larger sample size needed to determine any
relationships between the above patient
characteristics
Focus on identifying and surveying physicians outside
the UCSF network who do not already have access to
the images via the UCSF medical record
These physicians may be able to elucidate if the
Image Share system could obviate repeat exams
30. Further Studies
Further demographic and patient analysis will be
performed to assess factors that may relate to adoption
of the system, such as:
Age
Sex
Distance patient resides from the medical center
Type(s) of imaging exam patient underwent
Chief diagnosis
Radiology department cost-analysis
Are there savings from reductions in CD distribution?
Enrollment and surveying will continue through 2013
Cumulative results from all 5 pilot sites will be tabulated
31. Conclusion
A cloud-based image exchange network is
technically feasible
Patients strongly feel that having a patient-controlled
ePHR would be of benefit
Physicians strongly believe that viewing their patients
images in a timely manner is critical
Patients and physicians are overall quite satisfied with
their experience and the security of the RSNA Image
Share Network
Patient education is critical to the adoption of the
concept and the expansion of its use
32. References
1. Report to Congressional requesters: Medicare Part B imaging services—
rapid spending growth and shift to physician offices indicate need for
CMS to consider additional management practices. GAO-08-452.
Washington, DC: Government Accountability Office, June 2008
2. Brenner DJ, Hall EJ. Computed tomography: an increasing source of
radiation exposure. N Engl J Med 2007; 357:2277–2284
3. Brooks, L. (2009, November). RSNA Awarded Contract to Develop
Medical Image Sharing Network. RSNA Press Release. Retrieved August
24, 2012, from
http://www2.rsna.org/timssnet/media/pressreleases/pr_target.cfm?ID=46
0
4. ITI Planning and Technical committees. (2011, August 19). IT Infrastructure
Technical Framework. IHE International, Inc. Retrieved August 28, 2012,
from http://www.ihe.net/Technical_Framework/index.cfm#IT