Just read this discussion paper.
Difficult to argue with the credentials of the organisations behind the paper (Cleveland Clinic, Cincinnati Children’s Hospital Medical Center, Kaiser Permanente, etc.)
And the content of the paper makes lots of sense.
The checklist is as follows:
• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing,
• IT best practices—automated, reliable information to and from the point of
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and
Care delivery priorities
• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for
Reliability and feedback
• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs
For those of us interested in health informatics much of this speaks to streamlined and managed processes, information technology embedded in everything that happens, use of information technology to improve patient outcomes. And the importance of an effective EHR is very much to the fore.
Well worth a read – would be interesting to see the views of healthcare provider CEOs.
As we follow the determined efforts in the US to push EHR/EMR interesting to read that they have many of the problems that we see in our own marketplace. What do we do for medics who do not type or do not type quickly & accurately?
Interesting piece about the resistance to having doctors spend their time typing in the US. This in particular relates of use of CPOE – if you don’t enter the data then you don’t get the warning (then and there) about what you are ordering. Abd, in the US, Meaningful Use has been set up to incentivise medics to use EHR – including CPOE.
This is nothing new. Keyboard skills have been a challenge in banking & finance, retail, engineering & construction. Having experience of pushing out ERP solutions across multinationals have seen lots of these challenges. We need to keep the eye on the end game – capture the data once and leverage the data. Can definitely apply also in healthcare.
Obviously application design/ interface and relevant devices all have a role to play in making all of this a lot easier. We want consultants, nurses, pharmacists, doctors all updating the EHR. So we need to design smartly, support users and provide relevant and customised training. Lastly, those inputting the data, must see the end benefit – safer experience for patients, less mistakes by professionals, streamlined processes. All of this has to pay for the effort expended in inputting the data.
Many hospitals find themselves in a state of transition – where some of the patient record is held on computer, while some is held on a manual chart. Various processes are put in place – including printing of information from computer systems and inclusion of the hardcopy on the patient chart. But surely this type of scenario must give rise to a risk that a nurse or doctor dealing with a patient may not have all the relevant, up to date information, to hand?
With this in mid was interested to read about a new protocol being tested to address handoff between medical teams at ehd end/ beginning of a shift. This piece reports on an initiative at Boston’s Children’s Hospital. It’s not looking to address any specific gaps in the manual v. electronic record but rather to ensure effective and complete communication between teams at changeover of shifts.