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    Author: 
    Resource Central
    Sponsor: 
    Carestream
    Resource Central: 
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    Short Headline: 
    Imaging Portals: Driving Patient Engagement, Improving Patient Experience and Satisfaction
    Newsletter hed: 
    Imaging Portals: Driving Patient Engagement, Improving Patient Experience and Satisfaction
    Newsletter teaser: 
    Patient engagement and electronic HIE are the game changers of Stage 2 ...

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    Author: 
    Healthcare IT News
    Sponsor: 
    NextGen
    Resource Central: 
    Content Directory: 
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    EHR Insider's Guide: The Secrets of Optimizing your EHR
    Newsletter hed: 
    EHR Insider's Guide: The Secrets of Optimizing your EHR
    Newsletter teaser: 
    Unlock the Power of Your EHR! Gain leverage by optimizing your EHR. That’s what EHR optimization is all about. Creating leverage for your practice to be all it can be for your patients, your staff, and you! This eBook will summarize best practices for fine tuning your EHR system.

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    Author: 
    Healthcare IT News
    Sponsor: 
    NextGen
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    Content Directory: 
    Body: 
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    Short Headline: 
    EHR Replacement: Do It Right - An eBook Guide to EHR Replacement
    Newsletter hed: 
    EHR Replacement: Do It Right - An eBook Guide to EHR Replacement
    Newsletter teaser: 
    Did you know that nearly 50% of providers are switching EHRs? There are many ...

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    Author: 
    Healthcare IT News
    Sponsor: 
    NextGen
    Resource Central: 
    Content Directory: 
    Body: 
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    Short Headline: 
    Make ICD-10 Easier: Get Answers, Get Ready, Get Going
    Newsletter hed: 
    Make ICD-10 Easier: Get Answers, Get Ready, Get Going
    Newsletter teaser: 
    The move to ICD-10 can be daunting. But it doesn’t have to be. That’s why ...

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    More of the healthcare world is going digital and the race for maximum patient engagement continues. As the systems involved increase in complexity and importance, healthcare execs are saying that quality tech support will be one of the most important factors in staying competitive in 2019.

    A new Black Book research paper shows that eighty percent of clinicians report being "impeded" by inadequate tech support, and that most help desks are falling short of the needs of healthcare systems.

    The IT support landscape is expected to undergo massive changes as healthcare organizations react to the opportunities – and challenges – that increased support offerings present. Among the findings from the new report:

    • Technologies such as AI are expected to help pick up the slack for support organizations using deep learning to create robust virtual agents that can help support teams scale up or down services without changing their workforce numbers.
    • The Internet of Things requuires better monitoring and management – needs that are not being fully met currently.
    • The emergence of ever more ways to connect (cloud, mobile, or social) means more security risks. With greater access comes a corresponding need for support to help safeguard data and systems.

    WHY IT MATTERS
    Patient satisfaction is increasingly tied to ease of use of online systems like portals and personal health records. Black Book's survey finds that quality tech support has a major impact on client loyalty. Healthcare organizations are finding the need to transition their tech support from purely internal to an external, customer-facing role as well.

    As the complexity of the systems and providers involved increase, having proper support for both internal and external users will be a major step that allows healthcare organizations to sidestep roadblocks on the path towards having a greater digital presence.

    "The increasing complexity of healthcare technology has made it even harder for an in-house help desk team, especially in small and medium sized communities to have sufficient expertise to meet all of an organizations' tech support needs," said Doug Brown, managing partner of Black Book Research.

    THE LARGER TREND
    Eighty-three percent of hospital decision makers polled by Black Book say they prefer that their electronic health record vendor deliver direct, comprehensive tech support, rather than delegating the responsibility to third parties or the health system itself.

    As similar majority of providers employing third-party IT support are "significantly dissatisfied" with the experience, the report shows, and often have to use one vendor for their help desk services, another for their upgrade services and more.

    "Vendors scoring highest among the four comprehensive levels of technical support are Cerner, Allscripts and MEDITECH," Black Book notes. "The majority eighty-four percent of tech support for Epic clients were attributed to third party outsourcers, consultants, and independent tech support firms working in Epic Systems client facilities."

    Those companies and their contractors must recognize that operational and patient experience needs are two of the most critical priorities for forward progress in the healthcare provider space, the report shows. Privacy and security concerns remain ever-present. Even the roles of top IT execs in healthcare are changing rapidly.

    Digital transformation is taking the industry by storm and meeting consumer expectations is an area most healthcare systems still struggle with. All of these factors point to the necessity of a robust and responsive tech support team that can help practitioners navigate internal tech issues as well as patients and outside clients resolve their usability concerns.

    ON THE RECORD
    "As technology becomes more profoundly entrenched into every turn of the healthcare consumer journey, vendors are also beginning to realize that the traditional internally-focused support organization may be best suited to help their provider clients successfully shift their focus to consumers," said Brown. "Given the enormous level of competition found in virtually all areas of the healthcare delivery industry, this edge can drive the success or failure of your system."

    Benjamin Harris is a Maine-based freelance writer and and former new media producer for HIMSS Media.
    Twitter: @BenzoHarris.


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    What's holding back widespread interoperability? The latest KLAS report says it's governance and organizations dragging their feet on participating in new national interoperability frameworks, such as the CommonWell-Carequality link.

    "Even Epic and athenahealth customers report diminished value from their connection when local exchange partners opt not to connect to the national networks," according to a new KLAS report on interoperability. "Until other vendors take an opt-out approach, you as an organization will have to be proactive in promoting local connections to these networks to ensure high value from your connection."

    WHY IT MATTERS
    Since the last KLAS report on interoperability was published in March 2018, hospitals and physician groups have been taking critical steps forward in sharing data via national networks, KLAS finds. What have been the most notable steps? KLAS cites:

    • The CommonWell-Carequality link;
    • MEDITECH's initial connection to CommonWell; and
    • Carequality's adoption among NextGen Healthcare customers.

    KLAS says that as of now, all of the most prevalent EHR vendors except Allscripts and MEDHOST are connected to the national framework provided by CommonWell-Carequality – "putting the ability to exchange patient records within the reach of most acute care or clinic-based provider organizations, regardless of size or financial situation."

    THE LARGER TREND
    Vendors are at very different stages of supporting provider organizations in the national framework effort, KLAS says. All the major vendors have made commitments to support the CommonWell-Carequality link, because healthcare providers are demanding it, and it is such a low-cost option for them.

    Many vendors have eliminated obstacles on the path to participation, with all of them but Virence offering connections to the link for their customers at no cost. In addition, all but Cerner have made participation in the network plug-and-play.

    KLAS notes that Epic's and athenahealth's approach to facilitating participation, via an opt-out option, while removing governance barriers, "shows that regardless of customer size, vendors can facilitate widespread adoption if they choose."

    The latest findings by KLAS show a huge leap over a year ago, when Carequality, reported participation at about 50 percent, with more than 1,000 hospitals, 25,000 clinics, and 580,000 healthcare providers connected.  According to Dave Cassel, vice president of Carequality, the organization was born out of industry demand, shaped by industry and government collaboration and it will ultimately succeed through industry support and participation.

    This summer, we reported that EHR interoperability was closing in on a signature moment with the advance of the CommonWell-Carequality link, comparing it to the cusp of a breakthrough akin to AT&T customers being able to pick up their phones and call Verizon subscribers. The CommonWell-Carequality link is changing the current thinking about the future of FHIR and open APIs, and laying the foundation for really using data in a meaningful way.

    ON THE RECORD
    "With CommonWell and Carequality linked, the biggest technical obstacle to widespread patient-record sharing has been removed," says the KLAS researchers in the December 2018 Interoperability Report.

    Diana Manos is a Washington, D.C.-area freelance writer specializing in healthcare, wellness and technology. 
    Twitter: @Diana_Manos
    Email the writer: dnewsprovider@gmail.com


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    Why sharing genetic information is vital for the future

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    Three winners and one honorable mention have been announced in the Office of the National Coordinator for Health IT'’s Certified Health IT Product List Data Challenge. The competitors were tasked to find ways for users of the Certified Health IT Product List to make better use of the granular data it keeps on every technology product that has been approved by ONC.

    The winners include:

    • ResearchAE. First place winners ResearchAE took their background in developing health IT dataset search engines to map out many of the different realms of data CHPL contains, enabling users to analyze how ONC certified health IT is being used and by whom. The prize was $20,000
    • Shiro Labs. Shiro Labs claimed runner-up for an application enabling providers to cross-analyze their Medicare Quality Payment Program and CHPL data, helping them see how they are meeting their reporting requirements. The prize was $10,000.
    • Darena Solutions. Darena Solutions also won runner-up for CheckEHR, a program that lets users view which certified criteria different certified health IT modules meet, allowing them to better reach goals like patient engagement or care coordination. The prize was $10,000.
    • Tom Nguyen. Nguyen won an honorable mention for a Google Chrome extension that helps users more easily navigate the CHPL listings.

    WHY IT MATTERS
    The CHPL contains a massive amount of very granular data which has only recently been made available in a structured and actionable way. Providers already have to abide by a wide range of standards and regulations, so having easier access to the CHPL data and finding ways to make more efficient use of it will help enable organizations to better use their health IT.

    THE LARGER TREND
    As the healthcare technology marketplace evolves, new to health IT start to take bigger roles in the space, providers will continue to roll out new IT services to meet those demands and remain competitive. Being able to make intelligent searches of CHPL data means providers can chart a more informed course though the array of technology options available.

    ON THE RECORD
    "This challenge shows that there is more to the CHPL data than meets the eye. It is great to the see the creativity and ingenuity each participant put into their submissions," said Steve Posnack, executive director, office of technology, ONC.

    Benjamin Harris is a Maine-based freelance writer and and former new media producer for HIMSS Media.
    Twitter: @BenzoHarris.


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    Memorial Hermann Health System reduced its fall rate to one of the lowest in the nation in 2016 -- using clinical decision support (CDS) and for that was honored with a HIMSS Davies Award of Excellence

    The Davies recognizes outstanding achievement of organizations that have utilized health information technology to substantially improve patient outcomes and value.

    To achieve such success, a team at Memorial Hermann used the AGS Beers Criteria, a resource that helps physicians find potential medication-related dangers that often lead to geriatric patient falls. Memorial Hermann started using CDS oversight with the support of a Beers Criteria workgroup led by physicians, pharmacists, medical informatics professionals and an acute care medical informatics committee, according to HIMSS.

    Memorial Hermann used CDS in the form of order sentences and alerts to limit the ordering of medications for the elderly patient population. The EHR’s ability to add filters for age and conditions, in addition to dose range checking alerts, improved the automation and reliability of the CDS alerts.

    WHY IT MATTERS

    “Every second of every day in the U.S., an older adult falls, making falls the number one cause of injuries and deaths from injury among older Americans,” according to the Centers for Disease Control and Prevention (CDC). In 2014, CDC reported some 29 million falls by older Americans, resulting in seven million injuries at an estimated $31 billion in Medicare costs.

    Falls are a growing public health issue, particularly with the surging Baby Boomer population, says the National Council on Aging (NCOA).

    “Older adult falls are increasing and, sadly, often herald the end of independence,” said former CDC Director Tom Frieden. “Healthcare providers can make fall prevention a routine part of care in their practice, and older adults can take steps to protect themselves.”

    THE LARGER TREND

    More and more providers are using advanced predictive analytics to reduce falls. The 420-bed El Camino Hospital in California dramatically lowered its hospital fall rates, as we reported last April. “It seemed like a lot of the efforts we tried were not getting us to where we wanted to be,” said chief nursing officer Cheryl Reinking, who helped spearhead the effort to transform the organization’s fall prevention program. The effort involved going beyond traditional “predictive analytics” into what Reinking called action-focused insights that allow providers to immediately respond and impact patient safety.

    We also reported about a blueprint for fall prevention that can also be applied to heart attacks and other patient conditions, using telehealth and predictive analytics applied to population health data.

    Physician and clinical informatics fellow Andrew Muth, MD, has developed a fall prevention program that uses predictive analytics to identify veterans who are at risk of falling. Some factors that can lead to a higher risk of falling include taking strong medication for pain, narcotics like benzodiazepine or antipsychotics, which can cause you to be a little shakier and more likely to fall.

    ON THE RECORD

    HIMSS senior director of quality and value-based care Jonathan French: “Memorial Hermann Health System significantly decreased the overall rate of unnecessary, high-risk medication orders, and are now leading the nation with the least amount of patient falls.”

    Diana Manos is a Washington, D.C.-area freelance writer specializing in healthcare, wellness and technology. 
    Twitter: @Diana_Manos
    Email the writer: dnewsprovider@gmail.com 

    Healthcare IT News is a HIMSS Media publication. 


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    "At its core, technology would seem to be the antithesis of humanity," said Dr. Chris Derienzo, chief quality officer at Asheville, North Carolina-based Mission Health System. "It doesn't feel, it doesn't think and it can't see the humanity of the person in front of it," he explained."

    Ask physicians how the feel about electronic health records, or read Atul Gawande's recent New Yorker feature, "Why Doctors Hate Their Computers," and it's apparent that most healthcare professionals' relationship with technology is ambivalent at best.

    "It's tempting to say there's no way we can build or leverage technology in order to restore some humanity to the practice of medicine," said Derienzo. "But I think that's fundamentally a wrong assumption."

    At HIMSS19 in Orlando, in one of the new TED Talk-style SPARK Sessions, titled "Humanity and Technology in Medicine: Antithetic or Symbiotic?" Derienzo will explain why.

    The reason technology seems to pull us away from people, rather than bring us together, mostly boils down to "how we've designed it and what we've designed," Derienzo said. But rethinking both of those, IT could be repositioned in a way where it enhances, rather than detracts, from the clinician and patient experience.

    With funny personal anecdotes and real-life case studies, he'll show how technology, properly deployed, can restore joy to healthcare – helping burnt-out physicians better engage person to person, enabling them to practice at the top of their license and use their skills to solve complex challenges

    "If we focus on the right types of technology, and we build it right, then we can actually use it to empower people to do more of the things that only people can do in healthcare," said Derienzo.

    How technology is designed, and what it's used for, plays a big role in how well it is liked by its end-users. Consider tech that's intentionally created connect people, such as telemedicine. "We see much more positive reaction to it."

    EHRs, on the other hand, were not designed with joy in mind. They were developed under certain conditions, with necessary check-the-box functionalities related to regulatory compliance and billing capture.

    And they were "based on a world where we took what we did on paper then did the same thing on computers," said Derienzo. They effectively ignored a lot of the human factor elements for how to design a way to document and record care electronically."

    But EHRs are only one challenge, he said. "Our monitors are another. How we use algorithms is another very important one."

    Derienzo predicts that "our electronic documentation will evolve drastically over the next few years as we move away from this built environment and toward a world where human factors matter a whole lot more."

    In the meantime, he sees one technology doing a lot to return humanity to healthcare. One that may seem ironic, to say the least, given the trepidations many have about its potential to disrupt and displace: artificial intelligence.

    "AI stands positioned to be one of the core technological advances that allows us to return humanity to healthcare," he said.

    For example, he explained, "we've built a machine learning model at Mission Health and we've now gotten it fully up and running. Its purpose is to help risk-stratify patient who are case managers need to focus on. To serve them, not only by a ranked-ordered list but a concept as to why our model thinks they may be at a high risk of being readmitted."

    That's a fairly AI application, "but its purpose is to pull out things that people don't have to be doing so now my care manager team can spend less time wondering who to focus on and more time actually focusing on people," said Derienzo.

    Ditto with radiology, he said: "I don't think that reading a thousand normal chest X-rays brings radiologist a ton of joy. But doing the really complex work – is it this, is it that? – is what they enjoy. How do we bring the expertise and brains of these terrific musculoskeletal and neuroradiologists tp the things we actually need them to be doing? That is how something like AI can actually empower humans.

    The practice of medicine is an ancient art, and one that's long depended on the power of human interaction, he explained.

    "At one point that was all we had – other than leeches and bloodletting, all we had was the ability to interact with our patients one on one and be human with them," said Derienzo.

    "We've vastly improved our ability to care since then, but in some ways we've lost an appreciate for that aspect of a clinician patient relationship," he explained. "My fervent hope is that once we get this right, we'll actually be returning, somewhat, to a place where it's that person to person relationship that's the most valuable part of our day."

    Chris Derienzo's HIMSS19 SPARK session, "Humanity and Technology in Medicine: Antithetic or Symbiotic?" is scheduled for Tuesday, February 12, from 3-3:30 p.m. in room W300.