Health IT for empowering citizens and health professionals
|
|
- Tracey Stewart
- 6 years ago
- Views:
Transcription
1 Health IT for empowering citizens and health professionals Ilkka Kunnamo, MD, PhD, Chief Editor, EBMeDS Duodecim Medical Publications Ltd Adjunct Professor of General Practice, University of Helsinki Disclosure: I am a salaried employee of Duodecim Medical Publications Ltd., the company that develops and and licenses EBM Guidelines and the EBMeDS decision support service WICC
2 Guideline development by Duodecim, the scientific society of Finnish physicians Idea of EBM Guidelines emerged 1987 Pilot electronic version on floppy disks 1989 CD-ROM 1991 Health Internet portal for professionals 2000 Mobile guidelines for smart phones 2001 Health internet portal for citizens 2007 Computerized clinical decision support 2008 rules (EBMeDS) Electronic Health Coaching for citizens 2010 Translations of EBM Guidelines in English, German, Russian, Estonian, Hungarian, Slovenian, Dutch, French, Turkish, Italian
3 Terveysportti ( Over 40 million articles opened in 2015 by health care professionals in Duodecim s portal Uusi hakutoiminto
4 Evidence chain: Guideline Evidence Summary Cochrane review
5 NICE accreditation Evidence-based medicine methodology
6 Knowledge In 2012, the annual number of new scientific medical articles exceeded one million Gillam M & al (digitalhealthdesign.com)
7 Medical knowledge is organized into PICOs Patient group (characteristics of the patient + setting) Intervention Comparator (intervention) Outcome
8 Medical knowledge is organized into PICOs Patient group (characteristics of the patient + setting) Intervention Comparator (intervention) Outcome Computers can process structured evidence: each PICO component must be coded
9 Evidence summaries and recommendations are authored in MAGICApp
10 Ann, 35 years Cholesterol 6.8 Treating high cholesterol with statin reduces Ann s relative risk of stroke, myocardial infarction or death by 25 % Tim, 55 years Cholesterol 6.8 Treating high cholesterol with statin reduces Tim s relative risk of stroke, myocardial infarction or death by 25 % Andres Rodriguez Dreamstime Stock Photos Alamar Dreamstime Stock Photos
11 The absolute risk of stroke or myocardial infarction is estimated on the basis of 9 risk factors
12 Fewer than 1 out of 140 people like Ann would have any of those events in the next 10 years. At least 600 people like Ann would need to take a statin for 10 years to prevent those events in one of them (NNT = 600)
13 More than 1 out of 2 people like Tim would have any of those events in the next 10 years. 6 people like Tim would need to take a statin for 10 years to prevent those events in one of them (NNT = 6)
14 What (CDS is about) Match individual patient data with evidencebased recommendations that would benefit the patient Software providing actionable guidance automatically at the right time at the right point in the workflow
15 Case history A 40-year-old man visits the doctor because of a hernia. The decision support system automatically shows a reminder that the latest data on blood pressure was from 3 years ago: 185/100. The doctor measures the blood pressure, which is now 220/110. Without the reminder the high blood pressure would have remained undetected, and the patient would not have received treatment
16 A comprehensive clinical decision support service with accredited evidence-based methodology Based on guidelines and systematic revies (Cochrane reviews) Easy to integrate with electronic health records Available in 10 languages
17 Demo of the EBMeDS service ent.htm?clientskin=1&serverskin=1&nat=gb&l an=en Open the last profile from the pull-down menu and click Submit
18
19
20
21
22 Drug orders guided by clinical decision support (under development) The patient s diagnosis and need for care (desired outcomes) are first entered. A list of both drugs and non-pharmacologic interventions becomes available for which there is evidence of effectiveness. The drugs are categorized to first or second choice drugs for the given indication (and patient group). The CDS applications tags the drugs on the list automatically with the following characteristics and knowledge: drugs which the patient is already using drugs that are contraindicated or the dose needs to be reduced because of renal insufficiency drugs (of the same class) that have caused adverse effects to the patient in the past and had to be discontinued drugs that have a significant interaction with a drug which the patient is currently using drugs that are unsuitable because of an abnormal laboratory test result drugs that are contraindicated or the dose needs to be reduced because of liver dysfunction drugs that are not recommended because of the patient s age drugs that are unsuitable because the patient is pregnant or lactating drugs that are unsuitable because of pharmacogenetic reasons drugs that significantly increase the cumulative risk of adverse effects of the patient s current medication drugs for which the balance of benefits and harms is questionable or unfavourable
23
24 Using a computer-generated diagnosis-specific summary reduced the time needed to retrieve all relevant data from the electronic health record from 5.5 to 1.7 minutes saved 57 mouse clicks Richelle J. Koopman et al. Annals of Family Medicine 2011;9 (no 5)
25 How are health care information systems built? EHR 1 - Data EHR 2 - Data EHR = electronic health record PHR 1 - Data PHR 1 - Data PHR = personal health record Device 1 Device 2
26 Wearable devices
27 How are health care information systems built? EHR 1 - Data PHR 1 - Data EHR 2 - Data PHR 1 - Data One patient one record Data - Recorded by professionals - Recorded by patients/citizens - Collected by devices Device 1 Device 2
28 Summary medical record Problems/diagnoses Medication Test results Measurements (e.g. blood pressure) Risk factors (e.g. smoking) Procedures Treatment plan Functioning in standardized, coded format
29 Patients recording their own data Symptom history and monitoring Family history Blood pressure, weight, height Peak expiratory flow Blood glucose ECG Pain intensity Functioning and checking their current medication list diagnosis list
30 Who are the users of the health record?
31 Who are the users of the health record? 1. Patients and their family members 2. Health professionals other than doctors 3. Doctors
32 How are health care information systems built? Finland: national ehealth archive Applications Data - Recorded by professionals - Recorded by patients/citizens - Collected by devices EHR 1 PHR 1 EHR 2 App 1 PHR 2 App 2
33
34
35 What is the optimum level of granularity in the coding of data Low for viewing High for processing by computer and assisting in decisions
36 What is the optimum level of granularity in the coding of data Low for viewing High for processing by computer and assisting in decisions A hierarchic coding system can meet both needs Different users focus on different levels Labels (names) of concepts may be different for different users
37 Big data how many data elements in health care? Future: millions (billions?) Now: about Nigam Shah (Stanford) 2013
38 GenBank contents: 200 billion = base pairs in August Human genome sequenced The explosion of genome data started in the 2000 s The doubling rate of genome data was 18 months in 2008
39 Health data of the individual EHR PHR User interface Use of genomic data Genome of the individual Query interface Validated associations Directory or data repository Biobank 1 Decision support International database of genomic associations Biobank 2
40 ehealth and esocial strategy Information to support well-being and service renewal 1. Citizens as service users - doing it yourself 2. Professionals - smart systems for capable users 3. Service system - effective utilisation of limited resources 4. Refinement of information and knowledge management - knowledge-based management 5. Steering and co-operation - from soloist to harmony 6. Infostructure - solid foundation
41 Types and volume of services (National ehealth strategy in Finland) Web services Web services with login Contact to service system Health care center Hospital University hospital Informing Selfcare eservices Face to face primary services Face to face secondary services Demanding special services Number of clients Portion of digital services Cost/client Web pages (Personal Health and Wellfare Record) Mental health house Regional and national systems (EHR data repository) Health library Self care path Virtual Hospital Providers directory and comparison Digital primary care (ODA) Next-gen EHRs: Apotti / UNA
42 How are health care information systems built? Finland: national ehealth archive Applications Data - Recorded by professionals - Recorded by patients/citizens - Collected by devices EHR 1 PHR 1 EHR 2 App 1 PHR 2 App 2
43 edeliveries from pharmacies compared to reimbursed prescriptions years Million prescriptions 5,0 Pharmacies Public health care Private health care (>5000 res/v) 4,5 4,0 3,5 3,0 eprescriptions reimbursed prescriptions 2,5 2,0 1,5 1,0 0,5 8/2015 eprescriptions for 4,6 M people 0, (84 % of population)
44 Logins to My Kanta Pages and Number of Visitors by Month 05/ / All logins Number of visitors 1.6 Mill. persons have used service by 30 Apr 2016 Use by citizens (health records and prescriptions)
45 456.2 Mill. ( ) Mill. ( ) Mill. ( ) Mill. ( ) Documents Registered / Archived in the Patient Data Repository Concerning 5.3Mill. ( ) Mill. ( ) 4.9 Mill. ( ) 4.7 Mill. ( ) 45
46 Information Management Service in Patient Data Repository: Number of Informings, Consents and Denials informings Kanta informings total Informings Registered in My Kanta Pages consents Consents Registered in My Kanta Pages denials
47 Information Management Service in Patient Data Repository: Number of Informings, Consents and Denials informings Kanta informings total Informings Registered in My Kanta Pages consents Consents Registered in My Kanta Pages denials 1.6 % of the citizens denied sharing their data
48 In Finland, health related data will be gathered in one place for the generation of new knowledge and for use as the basis of new services Antti Kivelä, Sitra Isaacus was the bishop of Turku who ordered that births, deaths, and causes of death must be recorded
49 Antti Kivelä, Sitra
50 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care
51 Implementing evidence-based care on populations In a virtual health check all decision support rules are executed in a population of patients, and resulting reminders are listed.
52 Two purposes for the virtual health check (VHC); executing decision support rules in a population of patients Clinical: find people who need interventions and contact them Persons identified Analytic: create statistics on quality of care Anonymous
53 Care gaps identified in a Virtual Health Check for a population of by a set of 100 CDS rules Blood-pressure lowering drug not used in moderately high BP and high cardiovascular risk 396 All beneficial drugs not in use in heart failure 143 No visits for a patient with diabetes during last 13 months 58 Check drug dosing (renal dysfunction) 1164 Stop/change drug (contraindicated in renal dysfunction) 28
54 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care Quantitation and synthesis of benefits and harms Care plan
55 Table 1. Example of the calculation of potential to benefit (PTB) for one patient. In this format the table can be used for prioritization of interventions in the situation where no intervention has yet been selected to be implemented. If the same outcome (in this example death) can be influenced by two or more interventions, the ARR obtained from the second intervention is not any more as large after the first intervention has been implemented, because the first intervention will reduce the baseline risk (BR). The total potential to benefit (the sum of PTBs of different interventions, which is 3.16 in the table) would be smaller for a patient who has already stopped smoking, because the baseline risk would be reduced. Diagnosis Intervention Outcome Impor-tance (IO) RRR (and time unit if applicable) BR and time unit ARR (RRR x BR) NNT (1/ARR) PTB (IO x ARR) Coronary disease Smoking cessation counseling Death /10 y Coronary disease Statin Death /10 y Knee osteoarthritis Arthroplasty Pain VAS < /1 y Total 3.16
56 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care Quantitation and synthesis of benefits and harms The citizen/patient chooses - which outcomes he/she wants to pursue - which targets he/she wants to meet - which interventions he/she wants Care plan
57 Prioritization for health benefit The population is listed and sorted by care gap and potential health benefit For each patient, the most important interventions are put on top The patient s values and preferences influence the selection of interventions to the care plan
58 Coded patient data Health problems Analysis of data by CDS based on best evidence Updating data Patient Potential for health benefit Quantitation and synthesis of benefits and harms Tools Self management Action Action Care plan
59 On-line health check report for the citizen
60 On-line health coaching
61 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care Care plan Quantitation and synthesis of benefits and harms Self management Action Tools Action Action Action Workflow Resource planning software (EPR)
62 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care Care plan Quantitation and synthesis of benefits and harms Self management Action Tools Action Action Action Workflow Resource planning software (EPR)
63 Coded patient data Health problems Analysis of data by CDS based on best evidence Potential for health benefit Updating data Patient Health care Care plan Quantitation and synthesis of benefits and harms Self management Action Tools Action Action Action Workflow Resource planning software (EPR)
64 Patient data 2 Health problems Guidelines: Analysis by CDS Potential for health benefit 4 Care plan 5 Quantitation and synthesis of benefits and harms 6 16 Updating data Patient Self care Action 9 History data (big data) Tools Health care Action 10 Action 8 Action Workflow 11 ERP 12
65 1. All data about the patient (from the EHR, PHR, wearable devices, Kanta earchive, biobanks) is the starting point in making a care plan. 2. Clinical decision support based on trustworthy guidelines analyzes the data by using evidence-based rules, risk calculators and databases (including big data and genomic databases). A PICO ontology links evidence to the health problems and charcteristics of the individual patient. 3. Clinical decision support identifies care gaps and interventions that could improve health outcomes of the patient. 4. s are constructed to fill the care gap. If the patient has many health problems, individual recommendations from many clinical practice guidelines and care pathways will be listed. 5. Clinical decision support tools that utilize risk calculators, prognostic models and interactive summary of findings tables of research evidence are used to quantify benefits and harms individually for the patient, so that the interventions that would benefit the patient most are on top. Interactions of interventions (such as drug-drug interactions), and concordant and discordant recommendations are taken into account at this stage. 6. The recommendations are shown to the patient, using decision aids that make the benefits, harms and burdens of interventions easier to understand. The patient chooses which interventions he or she is willing to use. The patient defines his or her individual targets (together with the professional) according to the principles of the chronic care model. 7. The interventions that have been chosen to be performed are recorded in the structured care plan. Care protocol templates can be used for recording bundles of interventions. 8. The actions recorded in the care plan have codes that can be analyzed to guide the process of care and the provision of care for the whole population. 9. The patients are offered self-care interventions and tools and on-line health coaching. 10. Actions needed from health care professionals serve as input to resource planning tools that link the actions with the competencies, equipment, rooms, and other resources needed for their completion. Bookings can be automated and can also be made by the patient.
66 11. The resource planning tools place the actions on the task list and schedule of professionals. Tools are provided that make the work easier and faster. The right thing is made the easy thing to do. 12. The resource planning tools have access to all care plans of all people in the population. In this way the volume of care needed, and the availability of resources is known when the care plans are made for individual patients. If overuse of resources threatens, the care plan can be modified. When prioritizing actions for individual patients in the population, the conclusions from steps 5 and 6 are used as guidance. 13. The patient and the professional meet face-to-face or virtually. 14. The professionals record observations and interventions in the stuctured EHR from where they are forwarded to the national earchive and big data repository. 15. The patient records his or her health data, symptoms, and functional ability, as well as measurements from home monitoring into the PHR from where they are available for analysis by CDS. 16. The data recorded by the professionals, patients, and devices are anonymized and stored in a big data repository where they are used for the creation of new knowledge and for developing prediction models. The big data repository can also received data from the patient s environment, and position data can be linked with patients. 17. CDS uses both individual patient data and big data for determining the patient s baseline risk for events, and making recommendations ( search from history earlier patients that are similar to the index patient and see what happened to them ). In a learning health care system every single data item (such as a single blood pressure measurement) contributes to knowledge. Similarly, every path of the patient can be analyzed for finding shortcuts in the care of future patients.
67 Table 2. An example of health benefit from filling the care gap in a population for three interventions (for simplicity, the PTB averages in the population has been chosen to be the same as the PTBs for the patient in Table 1. In the real world, interventions that have acceptable cost-effectiveness should be grouped as bundles, and the PTB calculated in a sequential manner (see explanation of Table 1). Intervention PTB average in the population Cost of the intervention for one patient Cost/PTB Number of patients in need of intervention (N) Health benefit in the population (PTB x N) Cost of treating all patients (Cost x N) Smoking cessation counseling Statin Arthroplasty
68
69 The larger the triangle, the larger the health benefit in the population The higher (sharper) the triangle, the more cost-effective intervention Additional benefit from reduction of health inequality
70
71 Traditional medical knowledge Big data P I C O Patient data (problems, drugs, tests, measurements, function, procedures, genome) Interventions - Self care - Tasks/services Tests (order sets) Procedures Therapies Support Desired outcome - Change in health status - Improved function - Coping - Avoiding adverse effects Components of the interventions - Recording of data - Preparation - Guidance - Details of procedures - Follow-up Values and preferences
72 Traditional medical knowledge Big data P I C O Patient data (problems, drugs, tests, measurements, function, procedures, genome) Interventions - Self care - Tasks/services Tests (order sets) Procedures Therapies Support Desired outcome - Change in health status - Improved function - Coping - Avoiding adverse effects Decision support Components of the interventions - Recording of data - Preparation - Guidance - Details of procedures - Follow-up Values and preferences
73 Traditional medical knowledge Big data P I C O Patient data (problems, drugs, tests, measurements, function, procedures, genome) Interventions - Self care - Tasks/services Tests (order sets) Procedures Therapies Support Desired outcome - Change in health status - Improved function - Coping - Avoiding adverse effects Classification of interventions Components of the interventions - Recording of data - Preparation - Guidance - Details of procedures - Follow-up Values and preferences
74 Traditional medical knowledge Big data P I C O Patient data (problems, drugs, tests, measurements, function, procedures, genome) Interventions - Self care - Tasks/services Tests (order sets) Procedures Therapies Support Desired outcome - Change in health status - Improved function - Coping - Avoiding adverse effects Freedom of choice Components of the interventions - Recording of data - Preparation - Guidance - Details of procedures - Follow-up Values and preferences
75 Future: a learning health care system Every data item in the electronic health record contributes to the body of medical knowledge and becomes a part of a prediction tool. Every series of actions of the EHR user and every path of the patient in the IT system helps to understand workflows and find shortcuts.
76 Additional material WONCA Policy statement on ehealth: A9AB EC-EBDC73B4C040 This video describes a comprehensive medication review tool emo.wmv that is used as the intervention in the ongoing PRIMA-eDS study ( The protocol of the study (which has recruited 4000 patients) has been published: How to build an ideal healthcare information system? Essay in WONCA Europe World Book of Family Medicine Presentations on the Finnish ehealth strategy: ial%20and%20ehealth%20strategy% pdf OPER_Situation%20Review% _VJormanainen_%20EN%20%282%29.pdf aukee_compressed.pdf European Health Observatory Evaluation of Finland s Health and Social Services Reform:
77 Thank you! i ilkka.kunnamo@duodecim.fi
ehealth SUPPORTING CITIZENS AND HEALTHCARE SERVICES case Finland
ehealth SUPPORTING CITIZENS AND HEALTHCARE SERVICES case Finland Finland? population 5,4 million GDP per capita 47 000$ Life expectancy M 77 / F 83 years Total fertility rate 1.85 Infant mortality 2.4/1000
More informationIntegrated care - case Finland, national approach
Integrated care - case Finland, national approach Anne Kallio Ministry for Social Affairs and Health Finland Finland? population 5,4 million GDP per capita 47 000$ Life expectancy M 77 / F 83 years Total
More informationDigital Technologies Improving Patient Outcomes
Digital Technologies Improving Patient Outcomes Maritta Korhonen Ministerial Counsellor Ministry of Social Affairs and Health Finland 3.10.2017 In theory, there is no difference between theory and praxis.
More informationehealth and esocial in Finland - today and 2020 Anne Kallio MSAH Finland
ehealth and esocial in Finland - today and 2020 Anne Kallio MSAH Finland Finland? population 5,4 million GDP per capita 47 000$ Life expectancy M 77 / F 83 years Total fertility rate 1.85 Infant mortality
More informationGovernance for the Many Uses of EHR Data
Governance for the Many Uses of EHR Data Dr. Päivi Hämäläinen, National Institute for Health and Welfare THL, Finland 16.3.2017 Dr. Päivi Hämäläinen 1 Many users, two+ cases 1. Primary use of patient data;
More informationCurrent reality and trends of ehealth in Finland
Current reality and trends of ehealth in Finland PIRKKO KOURI PhD, PHN, RN Principal Lecturer in Healthcare Technology, Savonia University of Applied Sciences Coordinator for the all Savonia s Master programme
More informationDigitalisation enhancing voice of elderly
Digitalisation enhancing voice of elderly PIRKKO KOURI PhD, PHN, RN Principal Lecturer in Healthcare Technology Coordinator for the Master programme development group in Savonia UAS China collaboration
More informationNation-wide Health Information System Estonian experience since 2007
Nation-wide Health Information System Estonian experience since 2007 Prof. Peeter Ross, MD, PhD Tallinn University of Technology, Estonia East Tallinn Central Hospital 08.09.2016 ehealth INNOVATION DAYS
More informationKela s role in the implementation of national e-health services
Kela s role in the implementation of national e-health services 7.5.2010 Background for the Finnish e-health strategy The applications built over the past several decades are fragmented and often lack
More informationKeenan Pharmacy Care Management (KPCM)
Keenan Pharmacy Care Management (KPCM) This program is an exclusive to KPS clients as an additional layer of pharmacy benefit management by engaging physicians and members directly to ensure that the best
More informationNordic perspective: Finland
Nordic perspective: Finland Vesa Jormanainen MD MSc Specialist in Public Health Head of Unit Operational Management Information Services National Institute for Health and Welfare (THL) Lessons Learned
More informationForeign Service Benefit Plan
Simple Steps to Living Well Together Foreign Service Benefit Plan 2018 Wellness Benefits and Incentive Rewards Health Plan Accredited by The FOREIGN SERVICE BENEFIT PLAN has Health Plan Accreditation from
More informationWEBINAR: Check. Change. Control. Cholesterol April 4, 2018
WEBINAR: Check. Change. Control. Cholesterol April 4, 2018 Good afternoon, everyone. My name is Alberta I am from the New England QIN-QIO and I will be your moderator for today s webinar, Check. Change.
More informationSECONDARY USE OF HEALTH DATA
SECONDARY USE OF HEALTH DATA Building new legislation and services Pekka Kahri Director of Information Services THL National Institute for Health and Welfare, Finland Nordic conference on Real World Evidence,
More informationE-health Finland - national and crossborder
E-health Finland - national and crossborder developments 9 June 2016 ehealth Week, Amsterdam Viveca Bergman, Development Manager National Institute for Health and Welfare Check Point 2015 Health care in
More informationCare Management Policies
POLICY: Category: Care Management Policies Care Management 2.1 Patient Tracking and Registry Functions Effective Date: Est. 12/1/2010 Revised Date: Purpose: To ensure management and monitoring of patient
More informationRegistry eform Data Entry Guidelines Version Apr 2014 Updated for eform on 20 Jun 2016
Registry eform Data Entry Guidelines Version 1.0 02 Apr 2014 Updated for eform on 20 Jun 2016 Part 3 General recommendation for data entry in ProMISe and instructions of completion for the Follow up Form
More informationHealth Care Sector Introduction. Thank you for taking the time to complete this Health Care Sector survey.
Introduction Thank you for taking the time to complete this Health Care Sector survey. The purpose of this survey is to provide a snapshot of the policy, systems, and environmental (PSE) conditions that
More informationPredicting 30-day Readmissions is THRILing
2016 CLINICAL INFORMATICS SYMPOSIUM - CONNECTING CARE THROUGH TECHNOLOGY - Predicting 30-day Readmissions is THRILing OUT OF AN OLD MODEL COMES A NEW Texas Health Resources 25 hospitals in North Texas
More informationTopic I. COURSE DESCRIPTION
PROGRAM: Pharmacy Technician Bridging Education Program COURSE NAME: Pharmacology COURSE DURATION: 33 hours PRIOR LEARNING ASSESSMENT AND RECOGNITION: CH Exam Portfolio N/A I. COURSE DESCRIPTION This course
More informationMOBILE HEALTH NATIONAL APPROACH, FINLAND. Anne Kallio Head of Development Ministry for Social Affairs and Health
MOBILE HEALTH NATIONAL APPROACH, FINLAND Anne Kallio Head of Development Ministry for Social Affairs and Health FINLAND? population 5,4 million GDP per capita 47 000$ Life expectancy M 77 / F 83 years
More informationUsing Electronic Health Records for Antibiotic Stewardship
Using Electronic Health Records for Antibiotic Stewardship STRENGTHEN YOUR LONG-TERM CARE STEWARDSHIP PROGRAM BY TRACKING AND REPORTING ELECTRONIC DATA Introduction Why Use Electronic Systems for Stewardship?
More informationPATIENTS + DOCTORS + MACHINES
Meet Today s Healthcare Team: PATIENTS + DOCTORS + MACHINES Accenture 2018 Consumer Survey on Digital Health 2 Healthcare consumers are more open to using intelligent technologies, sharing data and allowing
More informationTopic I. COURSE DESCRIPTION
PROGRAM: Pharmacy Technician Bridging Education Program COURSE NAME: Pharmacology COURSE DURATION: 33 hours PRIOR LEARNING ASSESSMENT AND RECOGNITION: CH Exam Portfolio N/A I. COURSE DESCRIPTION This course
More informationHIE Implications in Meaningful Use Stage 1 Requirements
s in Meaningful Use Stage 1 Requirements HIMSS Health Information Exchange Steering Committee March 2010 2010 Healthcare Information and Management Systems Society (HIMSS). 1 An HIE Overview Health Information
More informationBuilding & Strengthening Your Evidence Based Practice Literature Searches
Building & Strengthening Your Evidence Based Practice Literature Searches Created and Presented by: Ken Wright, MSLS Health Sciences Librarian ktwright@mchs.com 614-234-5222 1 Outline of Evidence-Based
More informationArtificial Intelligence Changes Evidence Based Medicine A Scalable Health White Paper
Artificial Intelligence Changes Evidence Based Medicine A Scalable Health White Paper TABLE OF CONTENT EXECUTIVE SUMMARY...3 UNDERSTANDING EVIDENCE BASED MEDICINE 3 WHY EBM?.....4 EBM IN CLINICAL PRACTICE.....6
More informationUsing the patient s voice to measure quality of care
Using the patient s voice to measure quality of care Improving quality of care is one of the primary goals in U.S. care reform. Examples of steps taken to reach this goal include using insurance exchanges
More information1 Title Improving Wellness and Care Management with an Electronic Health Record System
HIMSS Stories of Success! Graybill Medical Group 1 Title Improving Wellness and Care Management with an Electronic Health Record System 2 Background Knowledge It is widely understood that providers wellness
More informationMeaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 2
Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 2 Table of Contents Introduction 3 Meaningful Use 3 Terminology 4 Computerized Provider Order Entry (CPOE) for Medication, Laboratory
More informationInsights as a Service. Balaji R. Krishnapuram Distinguished Engineer, Director of Analytics, IBM Watson Health
Insights as a Service Balaji R. Krishnapuram Distinguished Engineer, Director of Analytics, IBM Watson Health Data & Knowledge Explosion: New data about individuals, used in new ways helps determines health
More informationKidney Health Australia
Victoria 125 Cecil Street South Melbourne VIC 3205 GPO Box 9993 Melbourne VIC 3001 www.kidney.org.au vic@kidney.org.au Telephone 03 9674 4300 Facsimile 03 9686 7289 Submission to the Primary Health Care
More informationPeripheral Arterial Disease: Application of the Chronic Care Model. Marge Lovell RN CCRC BEd MEd London Health Sciences Centre London, Ontario
Peripheral Arterial Disease: Application of the Chronic Care Model Marge Lovell RN CCRC BEd MEd London Health Sciences Centre London, Ontario Objectives Provide brief overview of PAD Describe the Chronic
More information7/7/17. Value and Quality in Health Care. Kevin Shah, MD MBA. Overview of Quality. Define. Measure. Improve
Value and Quality in Health Care Kevin Shah, MD MBA 1 Overview of Quality Define Measure 2 1 Define Health care reform is transitioning financing from volume to value based reimbursement Today Fee for
More informationPromoting Interoperability Measures
Promoting Interoperability Measures Previously known as Advancing Care Information for 2017 and Meaningful Use from 2011-2016 Participants: In 2018, promoting interoperability measure reporting (PI) is
More informationecw and NextGen MEETING MU REQUIREMENTS
ecw and NextGen MEETING MU REQUIREMENTS ecw version 9.0 is Meaningful Use certified and will be upgraded in Munson hosted practices. Anticipated to be released the end of February. NextGen application
More informationPrimary Care Development in Hong Kong: Future Directions
Primary Care Development in Hong Kong: Future Directions HA Convention 2014 8 May 2014 Professor Sophia CHAN PhD, MPH, MEd, RN, RSCN, FAAN, FFPH, JP Under Secretary for Food and Health, Government of the
More informationINTEGRATED CARE SERVICE AND OUTCOMES
DR. HADAS LEWY INTEGRATED CARE SERVICE AND OUTCOMES 10/8/2014 1 Maccabi Healthcare Services Second largest and fastest growing HMO in Israel ( 25% of Market) Non-profit mutual Recognized health fund -
More informationEssential Characteristics of an Electronic Prescription Writer*
Essential Characteristics of an Electronic Prescription Writer* Robert Keet, MD, FACP Healthcare practitioners have a professional mandate to prescribe the most appropriate and disease-specific medication
More informationSNOMED CT AND ICD-10-BE: TWO OF A KIND?
Federal Public Service of Health, Food Chain Safety and Environment Directorate-General Health Care Department Datamanagement Arabella D Havé, chief of Terminology, Classification, Grouping & Audit arabella.dhave@health.belgium.be
More informationBelgian Meaningful Use Criteria for Mental Healthcare Hospitals and other non-general Hospitals
Belgian Meaningful Use Criteria for Mental Healthcare Hospitals and other non-general Hospitals Introduction This document is the result the conclusion of the WG Belgian Meaningful Use Criteria for Mental
More informationMeaningful Use Hello Health v7 Guide for Eligible Professionals. Stage 1
Meaningful Use Hello Health v7 Guide for Eligible Professionals Stage 1 Table of Contents Introduction 3 Meaningful Use 3 Terminology 5 Computerized Provider Order Entry (CPOE) for Medication Orders [Core]
More informationPATIENTS WANT A HEAVY DOSE OF DIGITAL. Healthcare consumers in Saudi Arabia want a digitally enabled care experience to better manage their health.
PATIENTS WANT A HEAVY DOSE OF DIGITAL Healthcare consumers in Saudi Arabia want a digitally enabled care experience to better manage their health. Healthcare consumers want to take control of their data
More informationUNIVERSITY OF PENNSYLVANIA HEALTH SYSTEM
Gilead Sciences, Inc. GS-US-248-0123, Amendment 1, 19-JUN-2012 A Long Term Follow-up Registry Study of Subjects Who Did Not Achieve Sustained Virologic Response in Gilead-Sponsored Trials in Subjects with
More information4. Hospital and community pharmacies
4. Hospital and community pharmacies As FIP is the international professional organisation of pharmacists, this paper emphasises the role of the pharmacist in ensuring and increasing patient safety. The
More informationPossible Competencies to Highlight in Rural & Small Hospital Rotation food service management & clinical
MDI Supervised Practice Competencies Clinical Nutrition: Rural & Small Hospital SP # Possible Competencies to Highlight in Rural & Small Hospital Rotation food service management & clinical 1 1.1/4.7 Select
More informationSpecial topic: Becoming a Patient: A Major Decision
BIOLOGY OF HUMANS Concepts, Applications, and Issues Fifth Edition Judith Goodenough Betty McGuire 1a Special topic: Becoming a Patient: A Major Decision Lecture Presentation Anne Gasc Hawaii Pacific University
More informationehealth in Finland local, regional, national and international aspect
ehealth in Finland local, regional, national and international aspect Anne Kallio Head of Development Ministry for Social Affairs and Health Organization of health care in Finland Population 5.3 million
More informationEVOLENT HEALTH, LLC Diabetes Program Description 2018
EVOLENT HEALTH, LLC Diabetes Program Description 2018 1 Evolent Health Diabetes Program Description 2018 Table of Contents Section Page Number I. Introduction... 3 II. Program Scope... 3 III. Program Goals...
More informationThe Role of the Agency for Healthcare Research and Quality (AHRQ) in the US Drug Safety System
The Role of the Agency for Healthcare Research and Quality (AHRQ) in the US Drug Safety System Scott R. Smith, MSPH, PhD Center for Outcomes & Evidence Agency for Healthcare Research & Quality July 20,
More informationThe Heart and Vascular Disease Management Program
Element A: Program Content The Heart and Vascular Disease Management Program GHC-SCW is committed to helping members, and their practitioners, manage chronic illness by providing tools and resources to
More informationOccupation Description: Responsible for providing nursing care to residents.
NOC: 3152 (2011 NOC is 3012) Occupation: Registered Nurse Occupation Description: Responsible for providing nursing care to residents. Key essential skills are: Document Use, Oral Communication, Problem
More informationSymptom Management? Complex cases? Difficult decisions?
Symptom Management? Complex cases? Difficult decisions? What can help us to help our patients? Who can help us to help our patients? Anita Margulies BSN RN 1 Zürich, Switzerland EBM, EBN, Evidence-based
More informationFoundational Informatics: INFORMATICS COMPETENCIES
Foundational Informatics: INFORMATICS COMPETENCIES Developed for: Project: Transformational Learning CST Project Version no.: 1.0 Issue date: March 22, 2016 Developed by: Naomi Monaster Owner: Diana Trifonova/TLAG
More informationCase-mix Analysis Across Patient Populations and Boundaries: A Refined Classification System
Case-mix Analysis Across Patient Populations and Boundaries: A Refined Classification System Designed Specifically for International Quality and Performance Use A white paper by: Marc Berlinguet, MD, MPH
More informationLeveraging the EHR to Connect Physicians and Consumers
Leveraging the EHR to Connect Physicians and Consumers DRG Digital DRGDigital.com Contact 2017 Digital@TeamDRG.com DR/Decision Resources, LLC. or All rights visit reserved. DRGDigital.com for more physician
More informationDigitizing healthcare Digital Innovation Forum Henk van Houten Chief Technology Officer, Philips
Digitizing healthcare Digital Innovation Forum 2017 Henk van Houten Chief Technology Officer, Philips Digitization is transforming every industry The digital revolution: how photography evolved Mechanization
More informationThe History of Meaningful Use
A Guide to Modified Meaningful Use Stage 2 for Wound Care Practitioners for 2015 The History of Meaningful Use During the first term of the Obama administration in 2009, Congress passed the Health Information
More informationCorso di Informatica Medica
Università degli Studi di Trieste Corso di Laurea Magistrale in INGEGNERIA CLINICA CENNI DI TELEMEDICINA Corso di Informatica Medica Docente Sara Renata Francesca MARCEGLIA Dipartimento di Ingegneria e
More informationCLINICAL PRACTICE EVALUATION II: CLINICAL SYSTEMS REVIEW
Diplomate: CLINICAL PRACTICE EVALUATION II: CLINICAL SYSTEMS REVIEW A. INFORMATION MANAGEMENT 1. Does your practice currently use an electronic medical record system? Yes No 2. If Yes, how long has the
More informationText-based Document. Advancing Nursing Informatics to Improve Healthcare Quality and Outcomes. Authors Sensmeier, Joyce E.
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
More informationREMOTE PATIENT MONITORING SYSTEM WITH DECISION SUPPORT
Proceedings of the IASTED International Conference Biomedical Engineering (Biomed 2011) February 16-18, 2011 Innsbruck, Austria REMOTE PATIENT MONITORING SYSTEM WITH DECISION SUPPORT Jaakko Lähteenmäki
More informationOverview of the Leapfrog CPOE Evaluation Tool. An educational update to the HIMSS EIS Steering Committee August 13, 2009
Overview of the Leapfrog CPOE Evaluation Tool An educational update to the HIMSS EIS Steering Committee August 13, 2009 1 Overview What is the CPOE Evaluation Tool? Development of the Tool Why is Tool
More informationMeaningful Use Stage 1 Guide for 2013
Meaningful Use Stage 1 Guide for 2013 Aprima PRM 2011 December 20, 2013 2013 Aprima Medical Software. All rights reserved. Aprima is a registered trademark of Aprima Medical Software. All other trademarks
More informationSystematic Review Search Strategy
Registered Nurses Association of Ontario Nursing Best Practice Guidelines Program Adult Asthma Care: Promoting Control of Asthma, Second Edition- March 2017 Systematic Review Search Strategy Concurrent
More informationCompetencies for NHS Health Check Enhanced Service using the General Level Framework & Service Specification
Competencies for NHS Health Check Enhanced Service using the General Level Framework & Service Specification This is a comprehensive mapping of the GLF against the enhanced service specification (where
More informationFor fully insured groups of 100 or more eligible employees. HealthyOutcomes. A fully-integrated health management solution that works for you
For fully insured groups of 100 or more eligible employees HealthyOutcomes wellness case management condition care maternity A fully-integrated health management solution that works for you HealthyOutcomes
More informationTechnologies in Pharmacology
Technologies in Pharmacology OBJECTIVES/RATIONALE Modern health care is increasingly dependent upon technology. Health care workers must be able to select appropriate equipment and instruments and use
More informationHealthy Aging Recommendations 2015 White House Conference on Aging
Healthy Aging Recommendations 2015 White House Conference on Aging Chronic diseases are the leading causes of death and disability in the U.S. and account for 75% of the nation s health care spending.
More informationGet Started with Health Cloud
Get Started with Health Salesforce, Winter 19 @salesforcedocs Last updated: September 12, 2018 Copyright 2000 2018 salesforce.com, inc. All rights reserved. Salesforce is a registered trademark of salesforce.com,
More informationHAAD Guidelines for The Provision of Cardiovascular Disease Management Programs
HAAD Guidelines for The Provision of Cardiovascular Disease Management Programs March 2017 Document Title: HAAD Guidelines for The Provision of Cardiovascular Disease Management Programs (DMP) Document
More informationEVOLENT HEALTH, LLC. Asthma Program Description 2018
EVOLENT HEALTH, LLC Asthma Program Description 2018 1 Evolent Health Asthma Program Description 2018 Table of Contents Section Page Number I. Introduction... 3 II. Program Scope... 3 III. Program Goals...
More informationWorking with GPs to help deliver the NHS Health Checks Programme
Working with GPs to help deliver the NHS Health Checks Programme Dr Matt Kearney GP Castlefields, Runcorn National Clinical Advisor Public Health England and NHS England Why do we need GP engagement? 1.
More informationInaugural Barbara Starfield Memorial Lecture
Inaugural Barbara Starfield Memorial Lecture Wonca World Conference Prague, June 29, 2013 Copyright 2013 Johns Hopkins University,. Improving Coordination between Primary and Secondary Health Care through
More informationA complete step by step guide on how to achieve Meaningful Use Core Set Measures in Medgen EHR.
Medgen EHR A complete step by step guide on how to achieve Meaningful Use Core Set Measures in Medgen EHR. Contents Important information regarding Meaningful Use... 2 How to generate your measure report
More informationGuidance for Medication Reconciliation and System Integration Process
Guidance for Medication Reconciliation and System Integration Process Identifying points of failure within the medication reconciliation process and determining systematic approaches (via health IT) to
More informationOldham Council Provision of NHS Health Checks Programme in Partnership with Local GP Practices
Oldham Council Provision of NHS Health Checks Programme in Partnership with Local GP Practices 1. Population Needs 1. NATIONAL AND LOCAL CONTEXT 1.1 NATIONAL CONTEXT 1.1.1 Overview of commissioning responsibilities
More informationPolicies Approved by the 2017 ASHP House of Delegates
House of Delegates Policies Approved by the 2017 ASHP House of Delegates 1701 Ensuring Patient Safety and Data Integrity During Cyber-attacks Source: Council on Pharmacy Management To advocate that healthcare
More informationPHARMACIST HEALTH COACHING CARDIOVASCULAR PROGRAM. 1. Introduction. Eligibility Criteria
PHARMACIST HEALTH COACHING CARDIOVASCULAR PROGRAM 1. Introduction Heart disease and stroke are among the leading causes of hospitalization and death in Canada. In 2008, nearly 30% of all deaths reported
More informationManaging Patients with Multiple Chronic Conditions
Managing Patients with Multiple Chronic Conditions Sponsored by AMGA and Merck & Co., Inc. 1 Group Pre-work Affinity Medical Group Heart, Lung & Vascular Center COURAGE Clinic 2 Medical Group Profile Affinity
More informationMedication Therapy Management
Medication Therapy Management Presented by Sylvia Saade, PharmD Ghada Khoury, Pharm D, BCACP Objectives Describe the components of medication therapy management (MTM) programs Discuss the needs of MTM
More informationDescribe the process for implementing an OP CDI program
1 Outpatient CDI: The Marriage of MACRA and HCCs Marion Kruse, RN, MBA Founding Partner LYM Consulting Columbus, OH Learning Objectives At the completion of this educational activity, the learner will
More informationAdvancing Care Information Measures
Participants: Advancing Care Information Measures In 2017, Advancing Care Information (ACI) measure reporting is optional for Nurse Practitioners, Physician Assistants, Clinical Nurse Specialists, CRNAs,
More informationHospital Readmissions
Hospital Readmissions The Long-Term Care Provider s Ultimate Survival Guide to Incorporating INTERACT TM Into Health Information Technology (HIT) In this survival guide, we ll give you the tips you need
More informationMEANINGFUL USE STAGE 2
MEANINGFUL USE STAGE 2 PHASED-IN IMPLEMENTATION PROCESS DECEMBER 2014 - PREPARATION MONTH Start this process as early as possible WATCH VIDEO TRAINING SESSIONS: (Sessions available starting December 1,
More informationExecutive Summary: Davies Ambulatory Award Community Health Organization (CHO)
Davies Ambulatory Award Community Health Organization (CHO) Name of Applicant Organization: Community Health Centers, Inc. Organization s Address: 110 S. Woodland St. Winter Garden, Florida 34787 Submitter
More informationTable 1: Limited Access Summary of Capabilities
What is the Practice Fusion Limited Access EHR product? The Practice Fusion Limited Access EHR product will be provided to current Practice Fusion customers who have not purchased an EHR subscription plan
More informationA. DIABETES AND HEART/STROKE Data Detail
A. DIABETES AND HEART/STROKE Data Detail Under the category of Effective Care, MHMC currently reports practices who have achieved national recognition for any of the Bridges to Excellence (BTE) clinical
More informationCare360 EHR Frequently Asked Questions
Care360 EHR Frequently Asked Questions Table of Contents Care360 EHR... 4 What is Care360 EHR?... 4 What are the current capabilities of Care 360 EHR?... 4 Is Care 360 EHR an EMR?... 5 Can I have Care360
More informationNURSING (MN) Nursing (MN) 1
Nursing (MN) 1 NURSING (MN) MN501: Advanced Nursing Roles This course explores skills and strategies essential to successful advanced nursing role implementation. Analysis of existing and emerging roles
More informationMeaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond)
Meaningful Use Measures: Quick Reference Guide Stage 2 (2014 and Beyond) Core Measures Required: All 17 objectives Objective: Requirement: Exclusions: Accomplish in Clinical 1. Computerized - Documenting
More informationHEALTHCARE TRENDS IN NORTH AMERICA ANDY TIPPET SR. MARKETING MANAGER HEALTHCARE, AMERICAS. ScanSource Smart VAR Conference August 21, 2014
HEALTHCARE TRENDS IN NORTH AMERICA ANDY TIPPET SR. MARKETING MANAGER HEALTHCARE, AMERICAS ScanSource Smart VAR Conference August 21, 2014 GOALS Discuss trends that are driving healthcare today Advent of
More informationEVOLENT HEALTH, LLC. Heart Failure Program Description 2017
EVOLENT HEALTH, LLC Heart Failure Program Description 2017 1 Evolent Health Heart Failure Program Description 2017 Table of Contents Section Page Number I. Introduction. 3 II. Program Scope. 3 III. Program
More informationQualifying for Medicare Incentive Payments with Crystal Practice Management. Version 1.0
Qualifying for Medicare Incentive Payments with Crystal Practice Management Version 1.0 July 18, Table of Contents Qualifying for Medicare Incentive Payments with... 1 General Information... 3 Links to
More informationGetting Started Guide. Created by
Getting Started Guide Created by December 2, 2016 Table of Contents 1 Getting Started... 2 2 Patient Overview... 2 2.1 Creating Patients... 2 2.2 Patient Information... 2 2.3 Visual Indicators... 3 2.3.1
More informationUsing Centricity Electronic Medical Record Meaningful Use Reports Version 9.5 January 2013
GE Healthcare Using Centricity Electronic Medical Record Meaningful Use Reports Version 9.5 January 2013 Centricity Electronic Medical Record DOC0886165 Rev 13 2013 General Electric Company - All rights
More informationCMS Quality Payment Program: Performance and Reporting Requirements
CMS Quality Payment Program: Performance and Reporting Requirements Session #QU1, February 19, 2017 Kristine Martin Anderson, Executive Vice President, Booz Allen Hamilton Colleen Bruce, Lead Associate,
More informationMove the Needle on Difficult Quality Measures: How Health Plans Can Control High Blood Pressure
Move the Needle on Difficult Quality Measures: How Health Plans Can Control High Blood Pressure A Centauri Health Solutions Sm White Paper By melanie Richey 2016 by Centauri Health Solutions, Inc. All
More informationAdvancing Care Information Performance Category Fact Sheet
Fact Sheet The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced three quality programs (the Medicare Electronic Health Record (EHR) Incentive program, the Physician Quality Reporting
More informationNextGen Meaningful Use Crystal Reports Guide
NextGen Meaningful Use Crystal Reports Guide Version 5.6 SP1 NextGen Healthcare Information Systems, Inc. Copyright 1994-2011 NextGen Healthcare Information Systems, Inc. All Rights Reserved. NextGen is
More information