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| Hospital system's online drug system leads to reduce mistakes Source: eHealth Smartbrief The University of Michigan Health System has completed a $95 million, three-year implementation of UM-CareLink, an online order-entry system designed to reduce drug errors and phase out paper forms. UMHS was able to slash medication mistakes by 29% in 2007 with the help of the new system. A big area for hospital mistakes is in medication, mistakes brought to light again May 14, when actor Dennis Quaid testified before Congress about the overdose of Heparin given to his twins. University of Michigan Health System has moved to stem those types mistakes with a new online order entry system and said it has cut medication mistakes by 29 percent. The health system recently completed a $95 million, three-year implementation of its UM-CareLink, eliminating many paper forms, said Jocelyn DeWitt, chief information officer for the health system. UMHS cut those mistakes in the last year when the system was used for patients in the women's and children's hospitals, accounting for 200 of the system's 809 staffed beds. At least 1.5 million people every year are injured by medication, according to a 2006 report from the Institute of Medicine of the National Academies. The extra medical costs of treating drug-related injuries occurring in hospitals alone amount to $3.5 billion a year, the study says. "There is room for improvement everywhere ( said Dr. Darrell A. Campbell Jr., chief of staff and senior associate director) and the UMHS full system rollout provides the opportunity for cutting even more mistakes". (read more...) |
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| Evidence-Based use of I.T. in the Delivery Room Source: HealthData Management ( http://www.healthdatamanagement.com ) Louise Miner, M.D., an obstetrician, knew that the baby of an expectant mother she treated was at high risk for shoulder dystocia during the impending delivery. Shoulder dystocia occurs when a baby's shoulder is dislocated during delivery because of problems squeezing through the birth canal. The dislocation can lead to arm paralysis and in rare cases even brain damage or death. If a child is thought to be at risk for shoulder dystocia, it's recommended that the mother undergo a Cesarean section. But Miner's patient was extremely resistant to the idea and wanted to deliver the child naturally. To convince her of the risks, Miner, director of OB-GYN at Jewish General Hospital in Montreal, used information technology to try and change her mind. Miner ran her patient's clinical data through the CALM Shoulder Screen application from LMS Medical Systems, a Montreal-based clinical software company. The Web-based software analyzes data such as the mother's height and weight, the estimated size of the child, as well as risk factors such as whether the expectant mother has gestational diabetes. The result is a risk score for shoulder dystocia. The general risk for the condition is about 1 in 4,000, but the analysis showed that the baby of Miner's patient had a 1 in 150 risk. That score convinced the expectant mother to undergo a C-section. "The numbers are important to justify the case," Miner says. Evidence-based approach Jewish General Hospital is using two evidence-based applications from LMS Medical to identify potential risks for expectant mothers and their babies. The other system, CALM Curve, monitors real-time data during labor to provide caregivers an analysis of that specific patient's condition, based on information such as medications, contractions and vaginal dilation, among other data. (read more...) New Page com Texto completo The hospital implemented the specialized applications because the clinical protocols that obstetricians use before and during labor often are inexact or outdated, Miner contends. For example, the American College of Obstetricians and Gynecologists has guidelines for predicting shoulder dystocia, but the criteria are vague, Miner says. "The college's guidelines suggest that there is a risk if the baby is going to be more than 10.5 pounds with other specific factors weighed in," she says. "But those guidelines don't take into account all the factors we believe have an impact on the level of risk. We estimate that following the college's guidelines would enable us to prevent less than 20% of the cases of shoulder dystocia that occur. The LMS application should help us prevent up to 70% of the cases-no software or protocol could predict every case of shoulder dystocia." The reason is that predicting the condition is so difficult. For example, Miner treated a patient whose child for all appearances was at high risk-the mother was short, overweight and diabetic, all indicators of danger. In addition, an ultrasound showed that the child was overly large, another red flag. As a result, the patient was scheduled for a C-section. However, an analysis by the software showed that those risk factors were mitigated by other clinical factors, and the child actually was at low risk for shoulder dystocia. The woman and Miner decided it was safe to have a natural birth, which occurred without complications. Typically, the software helps to persuade expectant mothers to undergo C-sections, but in this case "we used the tool backward, in a sense, but it still worked," Miner says. Jewish General is using both the shoulder dystocia and monitoring applications to help clinicians gauge the necessity of performing C-sections, both as planned and emergency procedures. The shoulder dystocia tool helps clinicians and expectant mothers decide whether the risk to the child is so high that a C-section should be used for the delivery. The monitoring application, on the other hand, helps clinicians better understand the real-time condition of their patients and make a more informed decision about C-sections, which expectant mothers typically want to avoid because of potential complications during recovery. "The software enables us to be more patient and not jump to a C-section," Miner says. "It helps us know what to expect during the labor of that particular patient." Jewish General Hospital, which hosts about 4,300 deliveries a year, uses the monitoring software to analyze data streamed to computers at the bedside and nearby nursing stations. The application takes into account factors such as whether the patient has been given an epidural, which can slow contractions and labor, or has been given pitocin, which speeds up the process. Based on that data, it creates a blueprint of how the labor should proceed and issues alerts if the labor process begins to deviate from the plan. For example, if the mother's contractions become too frequent based on that analysis, it can signal that the child is in imminent danger and an emergency C-section needs to be performed, Miner explains. "We used to fly by the seat of our pants. But now we have a tool that uses real-time, user-specific data," Miner says. In addition, the software gives a standard starting point, Miner says. "Every doctor interprets a fetal heartbeat strip differently," she says. "But the software does away with the guesswork-it uses evidence-based protocols that doctors can base their decisions on."The software uses mathematical algorithms based on data gleaned from 7,700 pelvic exams from 1,200 women in two urban facilities and one rural setting. The clinical data repository compares data from women who had normal deliveries and those who suffered complications. A significant benefit of using the software is its ability to gauge the likelihood of uterine ruptures. The ruptures occur when there is a weak spot in the uterus. The result is that the baby breaks out of the uterus and into its mother's abdomen. The child loses oxygen and can suffer brain damage; the mother is at risk of massive blood loss that can result in death. Another complication is that the mother often cannot give birth again. Jewish General also uses the monitoring program to track individual statistics for its obstetricians, such as C-section rates of women having their first baby, the number of operational vaginal deliveries, natural deliveries that require the use of tools, and cases of perinatal trauma. Using evidence-based software to guide decision making in obstetrics is relatively new, says Janet Gordon Kennedy, executive director at the Kennedy Group, a Chicago-based health care consulting group. But the challenges to using it in this care setting are similar to its use elsewhere. Physicians will not rely on the technology if they don't trust the data it's built on, she says. Conversely, another danger is that clinicians will rely on it too much and won't focus on finding the optimal care for each individual patient. "If doctors base everything on the software, they don't think anymore and lose their sensitivity," Kennedy says. "Something has to be really out of whack for them to notice." |
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| CDISC Article : "EHRs, Medical Research, and the Tower of Babel" In: the "New England Journal of Medicine" (NEJM - http://content.nejm.org/ ) CDISC was recently invited to write an article specifically aimed at physicians. The article outlines the benefits that CDISC standards can bring to their work within a clinical study and is part of CDISC's ongoing commitment to enhance the link with healthcare. This article is now available to our readers. "..…two decades. Ten years ago, the Clinical Data Interchange Standards Consortium ( CDISC ) began to develop standards for medical research data. In 2001, recognizing the large intersection between these two arenas, CDISC and HL7 began to harmonize their standards. Together, they have developed a structured…" Read Article |
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| Keep it simple: User research driving eHealth adoption Source: HealthcareIT News.eu LUXEMBOURG -- Healthcare IT vendors say the greatest barrier to eHealth adoption in Europe these days may not be technology hurdles, regulatory issues or even the lack of proven financial models. With refreshing honesty, many are acknowledging that a certain "engineering arrogance" may be to blasme. The silver lining to that arrogance, however, is new multidisciplinary research aimed at involving end users in the design and development of eHealth tools. "Too often we have developed software and pushed it on to providers," conceded Eric Maurincomme, Afga's vice president for eHealth, speaking at the "2008 Med-e-Tel" Conference in Luxembourg on April 17. "And we got push back. We have to work with users to meet their needs and develop solutions for them." And while Maurincomme was speaking about provider adoption, the same is true when the end user is the patient. Alcatel-Lucent's Casena project, which aims to support the elderly at home through technology, is currently responding to demographic trends which should prompt greater utilization of eHealth in Europe. But, said Alcatel's Johan Criel, study after study shows that in-home technology must respond to a set of considerations beyond simple costs or utility. "User research showed us how important the feeling of control is in a domestic space," he said. End users wouldn't adopt so-called ambient eHealth tools unless they were virtually invisible and didn't call attention to dependency. To tease out what will work and what won't, the lab is deploying multidisciplinary teams of scientists, engineers and ethnologists. Next month, the project is kicking off a house-based pilot project with users suffering from mild dementia. NEW PILOT PROJECTSIn the past, such pilot projects have often been criticized for delaying production-ready tools and taking up funds that could be used for larger scale deployment efforts, but even vendors say they are seeing now great value from the efforts. (read more....) |
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| 10 Best-Practices for selecting EMR Software January, 2008 Your degree is in medicine, not computer science. Why then are so many physicians finding themselves focused on software these days? Government, payers and market forces are all pushing physicians to consider an Electronic Medical Records (EMR) strategy. As if practicing medicine weren't challenge enough, now you need to adopt a new layer of technology infrastructure… At the same time, the value in going digital with your patient records is increasingly clear and the technology has come of age. Just like a practice management system optimized your patient schedule and improved your receivables, today's EMRs promise to automate your clinical workflows. An EMR can reduce time spent charting, provide more efficient patient visits and help meet regulatory requirements. The good news is that selecting an EMR doesn't require in-depth technical knowledge. Instead, you simply need to roll up your sleeves and run a disciplined selection process - knowing what criteria to consider is half the battle. Here we present ten best practices for selecting an EMR system. While there are hundreds of software packages.. (read more...) |
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| Telemedicine Interview : The Pacific Telehealth & Technology Hui An interview with Leigh W. Jerome, Ph,D By: Bob Pyke, Jr. RN, CPNP Dr. Jerome, Aloha |
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| “HEALTH IT SEXY MARKET ?” INTERVIEW In “iHealthBeat” ( www.ihealthbeat.org ) Coming to a RHIO Near You If it's not one hot technology, it's another. If it's not a rosy ending, it's an even rosier one. Panaceas abound, while tough work and reform remain out of the limelight. It's difficult to say whether the current initiatives receiving mainstream media attention today will have the staying power to develop long-term, practical solutions for the future. But regardless, the current wave of Web 2.0 and personal health record promotion should provide for unique summer expectations and entertainment. Here's what you can look forward to on the big screen in 2007. (read more...) |
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| IBM Director
Bart Lautenbach Forecasts E-Business Future With such a roller-coaster business as e-commerce, anticipating the next mile of track is no easy task. However, Bart Lautenbach, director of WebSphere Commerce at IBM, had the courage to do some forecasting in an interview with the E-Commerce Times. See the Full Story: http://www.ecommercetimes.com/perl/story/33067.html
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| MyDoom: A Wrap-Up
on the World's Most Vicious Worm The family of MyDoom e-mail worms remains an active threat from compromised computer systems and unprotected personal computers even though the virus was programmed to shut down last month. As a result of the prevalent infections, the MyDoom creators still can mobilize a vast network of computers at any time. See the Full Story: http://www.ecommercetimes.com/perl/story/33068.html |
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WashTech president Marcus Courtney told the E-Commerce Times that in the first three years of the group's existence, the number of subscribers to its e-mail newsletter held steady at about 2,000 readers. In the last year, that tally has increased to 17,000. (more) |
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Try inputting your business name into a search engine and see if it pops up on the first page. If not, then it is not a name. Rather, it is a dead weight, sinking your e-commerce dreams.(more) |
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| Interference of
Wireless Problems in Healthcare Interference between wireless access points of different networks will occur if the wireless access points are within range of each other. In one incident I discovered, a dental office using the same building as a hospital experienced problems when network traffic from the hospital's wireless network and the dental office's network "leaked" into both networks. (more) |
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| Technology Tipping
Point May Be Nigh "The promise of technology has eluded healthcare," pronounced David Lubinski, the head of Microsoft's year-old healthcare division, in his keynote address at last week's TEPR conference and exhibition in San Antonio. It's a diagnosis that Lubinski and the other 4,000 TEPR attendees don't plan to take lying down. (more) |
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| Creative ways to reward
outstanding help desk analysts Source: TechRepublic (www.techrepublic.com) Date: 27.05.2003 Finding qualified, motivated help desk analysts is a tough job. You want someone with the right balance of communication skills and technical ability. Ideally, you also hope those talented people will stick around for a while and become experienced help desk analysts. But what can you do to keep those folks happy? (more) |
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| High-impact projects
require both an IT and business project manager Source: TechRepublic (www.techrepublic.com) Date: 01.07.2002 Tim was a wreck when I saw him today. His sponsor was beating him up over the difficulties Tim was having trying to deploy wireless devices to the sales organization. Tim’s a good guy and a decent project manager, but it looks like he’s missing a key person on his project. (more) |
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| Stop Wasting Money
on Security Source: ZDNet (www.zdnet.com) Date: 20.11.2002 While viruses, worms and hacking attacks continue to evolve, the costs of security failure have about doubled for each of the last five years. It has been standard practice for too long for companies to counter this trend by investing in additional security technology. In the end, however, they still lag the hackers and the malefactors of malicious code. All that's left is a rapidly growing budget with no end in sight to a growing security headache for IT departments. (more) |
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| Web Services Won't
Take Off Yet Source: CRMDaily (www.crmdaily.com) Date: 22.11.2002 It could be years before Web services
live up to their full potential, according to analysts, vendors and early
adopters. "Caution is the keynote," he told delegates attending the analyst group's Web services symposium in London. "Web services is a long haul -- the dream of being able to connect systems in a real-time manner will not materialise for many years." (more) |
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| The Cult of Hackers Source: NewsFactor (www.newsfactor.com) Date: 21.11.2002 Hackers are typically portrayed as one of two stereotypes: digital Robin Hoods taking on the Internet's wired establishment or sinister masterminds who can upend everyday users' lives with their technical exploits. In reality, hackers -- who tend to resist that blanket term in favor of more specialized designations, such as cracker, white hat or black hat -- are usually tech-savvy individuals experimenting with their skill sets by probing applications and Web sites for vulnerabilities, security expert Ryan Russell told NewsFactor. But how did hacker myths arise? What sparks our fascination with those who illicitly explore computer systems? (more) |
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| Is HTML on Its Way Out? Origin: NewsFactor Network Date: 09.10.2002 A mere eight years ago, the "HT" in HTML stood as much for
"hot" as it did for "hypertext." This language of
the Internet was on everyone's lips, from bedroom coders to boardroom
capitalists. Now, though, "X" is slowly starting to mark the
hypertext spot as XML, XHTML and other, more sophisticated Internet languages
nimbly supplement -- and in some cases supplant -- their older and stodgier
cousin. |
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| IT Department's Next
Incarnation Origin: NewsFactor Network Date: 10.10.2002 Current economic conditions and the need to cut costs have resulted in
a shift from the independent, autonomous IT departments of ages past to
more centralized IT shops. As a result, experts said, the IT department of the future will be more generalized -- focusing on infrastructure issues like network architecture, enterprise resource planning (ERP) and relationship management. The more mundane tech support and administration tasks will increasingly be delegated to "outside" consultants. (more) |
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| CRM Flunks the Usability
Test Origin: NewsFactor Network - E-Commerce Minute Date: 20.06.2002 Harley Manning, a Forrester research director, likens CRM's usability
to Ford's Model T car. |
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| EU
Plans to Tax Non-European Companies on Internet Sales
The European Union is planning to
approve a controversial tax requiring all Internet-based companies
to pay tax on their sales of digitally downloaded products to customers
based in EU countries. Under the current system, European e-commerce
companies pay a tax on all of their digital download sales, but in
the U.S., companies are exempt from levying sales taxes on e-commerce
transactions, thanks to a temporary moratorium, which has been extended
several times by Congress. The U.S. and EU are negotiating a global
strategy for e-commerce taxation through the Organization for Economic
Cooperation and Development, but guidelines aren't expected to be
issued until sometime next year. Meanwhile, the EU is pushing ahead
with its own system unilaterally. U.S. lobbyists say the EU's system
would discriminate against U.S. companies because they would be required
to pay sales taxes at the rate applicable where the sales is made
- and some of those countries may have higher tax rates than the ones
that EU companies have to charge. (Wall Street Journal 7 May 2002) |
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| Globalization and Anxiety
In "The Lexis and the Olive Tree," author Thomas Friedman describes how things have changed since the world moved from the Cold War period into the present Age of Globalization. The book was published in 1999. (more) |
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| The
Perplexing Paradoxes of Project Management Project Management contains a series
of recurring paradoxes-seemingly self-contradictory statements that
are or may be true. The earliest challenge of effective project management
is to manage the paradoxes and not to avoid them in the early stages.
Avoiding them only leads to more serious problems later on, problems
which can cripple and even doom the |
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The Art of Managing the Stars of Innovation Few factors weigh as heavily in the success of a business today as the ability to attract, retain and nurture top creative talent. Technological innovators who can help a company introduce breakthrough innovations or optimize incremental product improvements are worth their weight in platinum, so a primary challenge for human resources experts is to develop practices designed to keep them happy. According to William M. James of the |
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