Sunday, March 3, 2013
Reflections from the HIMSS/AMDIS Physicians' IT Symposium at #HIMSS13
Today, I was in the HIMSS/AMDIS Physicians' IT Symposium: Reviewing the Past, Assessing the Present and Planning for the Future. Let me highlight a few key points and reflections I jotted down as I sat through several presentations about Meaningful Use (MU) and the future of clinical informatics:
Health IT is about improving clinical workflow efficiency and patient care. The HITECH Act was signed in 2009. How far have we come? New laws and regulations are forcing physicians and hospitals to change. They may not want to change, but they have no choice. The carrot and the stick approach is driving people to buy systems and force changes in workflow. Are these changes all beneficial for patients? Not necessarily. Some are clearly going to help patients as physicians rely on evidence-based information when they make clinical decisions. We should see a reduction in medical errors. Medication tracking and reconciliation will be easier. But, are we actually improving patient care? Or, are we putting too much emphasis on achieving Meaningful Use?
We've seen many physicians and hospitals achieve Meaningful Use (MU) Stage 1. Now, we are hearing growing discussions around Stage 2. It's probably a good thing that Stage 2 was delayed to 2014.
Speaking of MU, have you gone through a MU audit? Hearing from several people who have gone through this process - it sounds like you have to be very careful with your auditor. Your auditor may not understand how EHRs work. They may not understand that you can't order a drug that is not on your hospital formulary. They may not understand the limitations of EHRs. They may not understand clinical workflow issues. In other words, you can expect many headaches as you go back and forth to explain simple, fundamental elements to the auditor.
It is inspiring to hear how physicians are using health IT to improve care quality and increase patient safety. We now have access to data that can show us how physicians are improving the rates of immunizations, intensifying treatment to reach goal levels, and enhancing patient communication. This is where I hope we will be spending more time focusing on health IT innovation that will really enhance clinical outcomes.
By the way, did you know that the average physician typing speed is 40 words per minute. How fast can you type?
I had the pleasure to have lunch with Dr. Steve Davidson (@sjdmd) and Dr. Dirk Stanley (@dirkstanley). I really enjoy reconnecting with physician colleagues here at HIMSS every year.
Following lunch, there were some sessions that explored the question: how are we using all this health IT data that we're collecting? Do we know how to use this data? Can we improve our clinical decision support systems and make them more intelligent so that we can go beyond simple alerts? CPOE alert fatigue is a common challenge these days. Do these alerts change clinical behavior? Or, do physicians simply click through those alerts so that they can complete their tasks?
Data, data, data. Small data, big data. What do we do with all this data? Where is the data coming from? We are seeing consumers gathering and using all types of health data. We have seen the rise of the e-Patient: the electronic, empowered, engaged patient. They are wearing self-monitoring fitness trackers. They are digging into their own medical device data from devices like implantable cardiac defibrillators and continuous glucose monitors. I think they will be the ones to develop a medical tricorder someday.
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