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Showing posts with label Electronic Health Records. Show all posts
Showing posts with label Electronic Health Records. Show all posts

Monday, April 15, 2019

Death by a Thousand Clicks: Where Electronic Health Records Went Wrong

Erika Fry and Fred Schulte
Fortune.com
Originally posted on March 18, 2019

Here is an excerpt:

Damning evidence came from a whistleblower claim filed in 2011 against the company. Brendan Delaney, a British cop turned EHR expert, was hired in 2010 by New York City to work on the eCW implementation at Rikers Island, a jail complex that then had more than 100,000 inmates. But soon after he was hired, Delaney noticed scores of troubling problems with the system, which became the basis for his lawsuit. The patient medication lists weren’t reliable; prescribed drugs would not show up, while discontinued drugs would appear as current, according to the complaint. The EHR would sometimes display one patient’s medication profile accompanied by the physician’s note for a different patient, making it easy to misdiagnose or prescribe a drug to the wrong individual. Prescriptions, some 30,000 of them in 2010, lacked proper start and stop dates, introducing the opportunity for under- or overmedication. The eCW system did not reliably track lab results, concluded Delaney, who tallied 1,884 tests for which they had never gotten outcomes.

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Electronic health records were supposed to do a lot: make medicine safer, bring higher-quality care, empower patients, and yes, even save money. Boosters heralded an age when researchers could harness the big data within to reveal the most effective treatments for disease and sharply reduce medical errors. Patients, in turn, would have truly portable health records, being able to share their medical histories in a flash with doctors and hospitals anywhere in the country—essential when life-and-death decisions are being made in the ER.

But 10 years after President Barack Obama signed a law to accelerate the digitization of medical records—with the federal government, so far, sinking $36 billion into the effort—America has little to show for its investment.

The info is here.

Wednesday, April 10, 2019

FDA Chief Scott Gottlieb Calls for Tighter Regulations on Electronic Health Records

Fred Schulte and Erika Fry
Fortune.com
Originally posted March 21, 2019

Food and Drug Administration Commissioner Scott Gottlieb on Wednesday called for tighter scrutiny of electronic health records systems, which have prompted thousands of reports of patient injuries and other safety problems over the past decade.

“What we really need is a much more tailored approach, so that we have appropriate oversight of EHRs when they’re doing things that could create risk for patients,” Gottlieb said in an interview with Kaiser Health News.

Gottlieb was responding to “Botched Operation,” a report published this week by KHN and Fortune. The investigation found that the federal government has spent more than $36 billion over the past 10 years to switch doctors and hospitals from paper to digital records systems. In that time, thousands of reports of deaths, injuries, and near misses linked to EHRs have piled up in databases—including at least one run by the FDA.

The info is here.

Thursday, March 15, 2018

Apple’s Move to Share Health Care Records Is a Game-Changer

Aneesh Chopra and Safiq Rab
wired.com
Originally posted February 19, 2018

Here is an excerpt:

Naysayers point out the fact that Apple is currently displaying only a sliver of a consumer’s entire electronic health record. That is true, but it's largely on account of the limited information available via the open API standard. As with all standards efforts, the FHIR API will add more content, like scheduling slots and clinical notes, over time. Some of that work will be motivated by proposed federal government voluntary framework to expand the types of data that must be shared over time by certified systems, as noted in this draft approach out for public comment.

Imagine if Apple further opens up Apple Health so it no longer serves as the destination, but a conduit for a patient's longitudinal health record to a growing marketplace of applications that can help guide consumers through decisions to better manage their health.

Thankfully, the consumer data-sharing movement—placing the longitudinal health record in the hands of the patient and the applications they trust—is taking hold, albeit quietly. In just the past few weeks, a number of health systems that were initially slow to turn on the required APIs suddenly found the motivation to meet Apple's requirement.

The article is here.

Tuesday, January 10, 2017

Why are doctors burned out? Our health care system is a complicated mess

By Steven Adelman and Harris A. Berman
STAT News
Originally posted December 15, 2016

Here is an excerpt:

Burnout and dissatisfaction with work-life balance are particularly acute for adult primary care physicians — the central figures in our unsystematic health care “system.” A system that was already teetering in 2011 has been stressed by the addition of 20 million covered lives by the Affordable Care Act. It’s little wonder that in Massachusetts, where near-universal coverage has filled up the offices of primary care physicians, malpractice claims against them are rising. Patients and physicians alike complain about the unsatisfying brevity of office visits, and many harbor intense feelings of antipathy towards cumbersome electronic health records and growing administrative burdens.

We believe that to alleviate the stress and burnout in the medical professions, we must pay attention to system factors that lead to what we call the “occupational health crisis in medicine.” We recently surveyed 425 practicing physicians and health care leaders and executives, seeking their opinions on the importance of eight approaches to transforming health care. We presented the results this fall at the International Conference on Physician Health.

The article is here.

Monday, August 15, 2016

Medical students track former patients' electronic health records

By Stephen Feller
United Press International
Originally published July 26, 2016

Although it is suspected to be largely for educational purposes, researchers in a recent study say the following of patient electronic health records as part of training poses ethical questions for the handling of those records.

A majority of medical students reported they find it beneficial to follow patient medical histories by accessing electronic health records, but some are checking cases they are not involved with out of curiosity -- which may not pose an actual problem, but poses an ethical one, say researchers at Northwestern University.

Some doctors have complained that electronic records, considered essential for better coordination of patient care and improvement of precision medicine, is too significant a burden on their time.

At the same time, most hospitals and doctors have invested heavily in moving to electronic records, with some groups of medical professionals saying the shift from paper to digital has made their jobs easier.

The article is here.

Monday, January 11, 2016

Cyber security: Attack of the health hackers

Kara Scannell and Gina Chon
FT.com
Originally published December 21, 2015

Here is an excerpt:

Hackers accessed over 100m health records — 100 times more than ever before — last year. Eight of the 10 largest hacks into any type of healthcare provider happened this year, according to the US Department of Health and Human Services.

Insurers scrambled to hire cyber security companies to scrub their systems. Premera Blue Cross, CareFirst BlueCross BlueShield, and Excellus Health Plan announced breaches affecting at least 22m individuals in total since March, including hacks that stretched back more than a year. Investigators told the FT that they believe some of the hacks are related and trace back to China.

The insurers face multiple investigations from state insurance regulators and attorneys-general and some could face fines for failing to comply with state data privacy laws, while federal law enforcement agencies are investigating who is behind the hacks.

The article is here.

Tuesday, June 9, 2015

Danger: Electronic Records Ahead

By Stephen A. Ragusea, Psy. D., ABPP
The National Psychologist

Some 30 years ago, I was building a psychiatric hospital in central Pennsylvania and we discussed the possibility of starting-up the new facility’s operation with all electronic records. It was the early days of computer use but it seemed like a good idea at the time. Ultimately, we decided against the plan because we couldn’t find a technical mechanism to guaranty the security of patient records against the threat of unauthorized access.

That was a long time ago.

The truth is that not much has changed in the last three decades regarding computer security, except for one thing: Our society seems to have decided that open health records are more important than confidentiality.

As a society, we not only keep our records electronically, but we increasingly are making those records available to anybody with a password. There are real advantages to that kind of system for cardiac patients in crisis. But, making psychological records available in such a system would scare the hell out of me; it would be extraordinarily dangerous and fraught with unintended consequences.

The entire article is here.

Wednesday, May 20, 2015

How is the doctor-patient relationship changing? It’s going electronic.

By Suzanne Allard Levingston
The Washington Post
Originally posted April 27, 2015

Here are two excerpts:

Almost three-quarters of American adults use the Internet to search online for health information each year, according to the Pew Research Center. While patients are digging through new information, so are doctors. A “tsunami of knowledge” from hundreds of journals pours over doctors, says Jack Cochran, executive director of the Permanente Federation.

All this information changes the culture. “Doctors say they’re taught to know things that others don’t,” said Dave deBronkart, a cancer survivor and advocate for patient engagement. Today, thanks to online searches and communities, a patient may know about advances before a doctor does.

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Not only should you read your electronic health record, you should check for errors. “Most people’s records contain mistakes,” deBronkart said. His 2009 blog about mistakes in his Google Health record led to a front-page story in the Boston Globe and a career as an advocate known as e-Patient Dave. (Google Health, a free service intended to help consumers pull together medical and wellness information, was discontinued in 2013 because it failed to generate broad interest.)

The entire article is here.

Friday, May 1, 2015

Obama Administration Report Slams Digital Health Records

By Melinda Beck
The Wall Street Journal
Originally published on April 10, 2015

The Obama administration took vendors of electronic health records to task for making it costly and cumbersome to share patient information and frustrating a $30 billion push to use digital records to improve quality and cut costs.

The report, by the Office of the National Coordinator for Health Information Technology, listed a litany of complaints it has received about vendors allegedly charging hefty fees to set up connections and share patient records; requiring customers to use proprietary platforms; and making it prohibitively expensive to switch systems.

The report also cited complaints that some hospital systems make it difficult to transfer patient records to rival systems or physicians as a way to control referrals and enhance their market dominance.

The entire article is here.

Monday, March 9, 2015

Debate heats up over safety of electronic health records

Jayne O'Donnell and Laura Ungar
USAToday
Originally posted February 3, 2015

Department of Health and Human Services officials said Tuesday that the safety benefits of electronic health records far outweigh any potential problems, but critics say regulators are pushing health care providers to use them while downplaying the risks to patients.

"This transition to electronic health records has led to far better safety than (it has) created new problems," said Andy Gettinger, an physician who heads health information technology (HIT) safety at HHS, at a government-sponsored conference here.

The entire article is here.

Wednesday, September 24, 2014

8 Malpractice Dangers in Your EHR

By Neil Chesanow
MedScape
Originally published August 26, 2014

Many physicians are so concerned about being sued for malpractice that they routinely order unnecessary tests and procedures to practice defensive medicine. And yet, when it comes to legal risks in using their electronic health records (EHRs), their concern is often nonexistent, experts assert.

Many doctors use their EHRs in nonstandard ways, without considering how this may affect them in a liability suit. Or they gloss over other aspects of using an EHR.

"Every aspect of EHR selection, implementation, and use may be examined in the course of medical malpractice discovery to uncover the source of the incident, or undermine the records that are being presented in defense of the malpractice claim," warns Ronald B. Sterling, CPA, MBA, an EHR expert in Silver Spring, Maryland, and author of Keys to EMR Success.

"Anything could be a malpractice issue," Sterling says, "from the product itself, to the way it was set up, to how you've been using it."

Are your EHR practices setting you up for a rude awakening should a patient sue you for malpractice? Let's take a look.

The entire article is here.

Tuesday, July 29, 2014

Millions of electronic medical records breached

New U.S. government data shows that 32 million residents affected since 2009.

By Ronald Campbell and Deborah Schoch
The Oregon Country Register
Published: July 7, 2014

Thieves, hackers and careless workers have breached the medical privacy of nearly 32 million Americans, including 4.6 million Californians, since 2009.

Those numbers, taken from new U.S. Health & Human Services Department data, underscore a vulnerability of electronic health records.

These records are more detailed than most consumer credit or banking files and could open the door to widespread identity theft, fraud, or worse.

The entire article is here.

Friday, July 18, 2014

Electronic Health Records: First, Do No Harm?

EHRs are commonly promoted as boosting patient safety, but are we all being fooled?

By David F. Carr
InformationWeek
Originally published June 26, 2014

One of the top stated goals of the federal Meaningful Use program encouraging adoption of electronic health records (EHR) technology is to improve patient safety. But is there really a cause-and-effect relationship between digitizing health records and reducing medical errors? Poorly implemented health information technology can also introduce new errors, whether from scrambled data or confusing user interfaces, sometimes causing harm to flesh-and-blood patients.

The entire article is here.

Tuesday, July 1, 2014

An analysis of electronic health record-related patient safety concerns

By D. W. Meeks, M. W. Smith, L. Taylor and others
J Am Med Inform Assoc doi:10.1136/amiajnl-2013-002578

Here is a portion of the Discussion Section

Our findings underscore the importance of continuing the process of detecting and addressing safety concerns long after EHR implementation and ‘go-live’ has occurred. Having a mature EHR system clearly does not eliminate EHR-related safety concerns, and a majority of reported incidents were phase 1 or unsafe technology. However, few healthcare systems have robust reporting and analytic infrastructure similar to the VA's IPS. In light of increasing use of EHRs, activities to achieve a resilient EHR-enabled healthcare system should include a reporting and analysis infrastructure for EHR-related safety concerns. Proactive risk assessments to identify safety concerns, such as through the use of SAFER guides released recently by The Office of the National Coordinator for Health Information Technology, can be used by healthcare organizations or EHR users to facilitate meaningful conversations and collaborative efforts with vendors to improve patient safety, including developing better and safer EHR designs.

Friday, June 13, 2014

Doctors Are Talking: EHRs Destroy the Patient Encounter

By Neil Chesanow
MedScape
Originally published May 22, 2014

There's no doubt that electronic health records (EHRs) spark strong emotions in doctors -- and many of those emotions are negative.

The gripes cover three main areas: One, EHRs have made the patient encounter far more annoying and complex than it ever was before.

Two, many physicians feel that EHRs take doctors who were trained to be independent thinkers and constrain their ability to make independent decisions, causing them to feel like data entry clerks, with a computer telling them how to practice medicine.

Last but not least, a large number of physicians feel that EHRs erode the doctor-patient relationship by creating a barrier between the two.

This article, and several others, about EHRS are here.

Wednesday, April 2, 2014

US Health Information Breaches Up 137%

By Roger Collier
CMAJ News
Originally posted March 5, 2014

More than seven million health records in the United States were affected by data breaches in 2013, an increase of 137% over the previous year, according to the annual breach report by Redspin, an information security company based in Carpinteria, California.

Since 2009, there has been a rapid rise in the adoption of electronic health records in the US. There have also been 804 breaches of health information affecting nearly 30 million patient health records reported to the Secretary of Health and Human Services, as required by law.

The entire article is here.

Thursday, July 25, 2013

EHR Adoption Steady, but More Work Needed

By David Pittman
MedPage Today
Originally published July 9, 2013

Physicians are continuing to adopt electronic health records at a steady clip, but more work is needed to have those systems communicate with each other, according to two studies published Tuesday.

In 2012, 72% of physicians had adopted some type of EHR system and 38.2% had capabilities required for a basic system (P<0.05), a review by the CDC's National Center for Health Statistics in Hyattsville, Md., found.

The number of basic EHR adopters was up from just over 25% in 2010, Chun-Ju Hsiao, PhD, and colleagues reported in a study that appeared online in Health Affairs. A basic EHR was defined as having seven capabilities including recording patient history and clinical notes, viewing lab results and imaging reports, and using computerized prescription ordering.

The entire story is here.

Friday, June 21, 2013

Your Smartphone Might Hold Key To Your Medical Records

By Elizabeth Stawicki
Minnesota Public Radio
JUN 17, 2013

It's one of those unhappy holiday surprises -- a visiting family member gets sick. That happened to Dr. Farzad Mostashari last Thanksgiving.

"My dad comes downstairs and he has acute pain in his eye where he had cataract surgery. And I said, 'What's the matter, what's the story?'" recalled Mostashari, who lives in Bethesda, Md. "And he said, 'Well, I think they put the wrong lens in my eye, I'd gone back to the doctor and...'" His father didn't remember exactly what had happened at his last doctor's appointment and the office was closed anyway.

How could a local doctor in Maryland access his dad's medical record in Boston? Through Medicare Blue Button, a computer program that allows patients to download their medical history into a simple text file on their smartphones and personal computers. Then third-party applications that you download help organize this information.

Mostashari certainly knew how to handle his dad's problem. After all, he's the coordinator for health information technology at the U.S. Department of Health and Human Services, and it's his passion and profession to promote electronic health records.

And, he had signed his dad up for Blue Button, which downloads three years of a patient's medical history, as well as the Humetrix iBlueButton, a smartphone app that translates and displays the information in a simple-to-understand way. The file includes names, phone numbers and addresses of physicians as well as diagnoses, lab tests, imaging studies, and medications.

So when Mostashari took his father to a local doctor, his dad was able to hand over his iPhone and say, "Here's my history."

The entire story is here.

Here is a link to Medicare's Blue Button program.

Tuesday, June 18, 2013

Large Hospital Breach Caused by Inside Inappropriate Access

Health Data Management
Originally published May 31, 2013

Bon Secours Mary Immaculate Hospital in Suffolk, Va., is notifying about 5,000 patients after discovering a significant amount of inappropriate access to patients’ electronic health records from two employees inside the facility.

“During an April 2013 audit of a patient’s medical record, the health system identified suspicious access that prompted an investigation,” according to a notice the hospital issued. “The investigation revealed that two members of the patient care team accessed patients’ medical records in a manner that was inconsistent with their job functions and hospital procedures, and inconsistent with the training they received regarding appropriate access of patient medical records.”

The entire story is here.

Tuesday, June 4, 2013

Electronic Health Data Gaining Favor

By LOUISE RADNOFSKY
The Wall Street Journal
Originally posted on May 22, 2013

More than half of U.S. doctors have switched to electronic health records and are using them to manage patients' basic medical information and prescriptions, according to federal data set to be released Wednesday.

The Department of Health and Human Services says it has reached a tipping point as it seeks to steer medical providers away from paper records. Advocates for electronic health records say they have the potential to make medical care safer and more efficient. In 2015, the federal government will start penalizing providers that haven't begun using electronic health records in reimbursements they get for treating patients.

But some doctors have been cautious about changing long-standing practice, saying that typing into a computer while talking with patients requires more attention than taking notes by hand. Others are concerned that electronic systems don't allow for enough family history or fail to highlight the important parts of a patient's medical record. Some critics also cite privacy concerns.

The entire story is here.