Thursday, October 22, 2009

#ITOH IT Optimization in HealthCare - Lyle Berkowitz Keynote

These are realtime notes from the IT Optimization in HealthCare conference. Please excuse typos and sometimes cryptic comments.

Dr. Lyle Berkowitz - Professor of Medicine, Feinberg School of Medicine

EMRs and Innovation 

"There is no Meaningful Use without Use"

What is an EMR/EHR - it is:
A database that provides:
- Review
- Messaging
- Orders (eRx)
- Notes

That taken together provides Decision Support capabilities.

How are we doing?

"Not well"
Been around since the 1960's. We are still "Five Years away"

Barriers to adoption:
- Incentives (Focus on Efficiency and Volume) EMRs don't support that. 
$44k per Doctor is not a big incentive.

- Usability
Not very usable

Paradigm problem - Built to look like Paper charts.
Focused on compliance not care.
Too much clinician data entry
Transaction system rather than thinking system
Problems with data sharing and integration

Demanding too much data entry of the most expensive resources in the system

Do you really need an EMR?
- ePrescribing alone - is that meaningful use.

Reporting on measures?
Most EMRs are poor at reporting

Information Exchange
- Uncertain on scope of information exchange . To a local hospital, to regional or national exchange?

Data rich EDWs can provide reporting?

What type of adoption rates?
To get good adoption:
- Aligned incentives
- address staffing

What we need in an EMR?
Metaphor: Paper
- Word/Excel
- Info overload
- Static views
Task oriented:

Future EMR:
Metaphor: iPhone, Web
- Graphical
- Information Vizualization
- Interactive/Actionable views
Workflow Oriented
- Context is critical
- One click
- Documentation as byproduct
User Control:
- Widgets

Bill Stead - Get vendors to separate data from application


In patient doc: Sharing data - if I import it how do  I trust it like "My Data". 

The question of trust in data keeps coming up. This ties in with my thinking on Portable Reputation.

Vendors are paying lip service to standards. They say the support standards such as HL-7 but data doesn't flow between systems easily.

(tags: HealthCare, PHR)

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