The Informatics Review
e-journal of the Association of Medical Directors of Information Systems and The Improve-IT Institute

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Home > Archive > Dec 15, 2006 : Vol.9 No.24
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The Connecting for Health Common Framework: Overview and Principles
Many people are enthusiastic about the benefits of using information technology (IT) to manage health information. Prompt, reliable access to health information can improve the quality and efficiency of care. Most patients’ health information is scattered across many facilities—the offices of numerous current and former physicians, labs, pharmacies, and imaging centers. Whether for routine care or in an emergency far from home, patients and their formal and informal caregivers need access to this distributed web of information in order to make well-informed medical decisions. At the same time, the movement of personal health information through a vast electronic network calls for a profound new commitment to protecting each person’s privacy.

A National Web conference on the First Consulting Group Inpatient and Ambulatory CPOE Assessment Tool
In 2007, The Leapfrog Group is planning to release self-assessment tools for hospitals and physician practices/medical groups that evaluate the clinical decision support (CDS) in implemented clinical systems (CPOE in the hospital and EMR in the ambulatory setting). If you are involved in implementing and maintaining a CPOE system and are seeking guidance on how to determine how effective your system implementation is, don’t miss this opportunity to learn about the First Consulting Group Inpatient and Ambulatory CPOE Assessment Tool.

Saving Lives, Reducing Costs -- Computerized Physician Order Entry Lessons Learned in Community Hospitals
A group of Chief Information Officers (CIOs) and CPOE project managers from Massachusetts hospitals that are implementing CPOE or are planning to implement CPOE in the near future gathered to identify support needs. This group identified six areas as its top concerns where managers could most benefit from assistance:

  • Physician incentives
  • Process redesign – focus areas, approaches/tools
  • Metrics – baseline and post-implementation
  • Physician training
  • Organization/governance of clinical decision support
  • Leadership commitment
  • Reducing surgical site infections through a multidisciplinary computerized process for preoperative prophylactic antibiotic administration
    Responsibility for antibiotic administration was shifted from preoperative nursing staff to the anesthetist. Electronic quick orders were developed to encourage appropriate antibiotic selection and simplify order creation. Timely administration of preoperative antibiotics improved from 51% to 98% from February 2005 to February 2006. Appropriate antibiotic administered improved from 78% to 94%. The clean wound infection rate decreased from 2.7% to 1.4% over the same time period.

    Evaluation of Spoken Dialogue Technology for Real-Time Health Data Collection
    A real-time assessment of patients’ experiences is an important methodology for studies in health care, quality of life, behavioral sciences, and new drug and treatment development. The results of this feasibility study indicated that desired accuracy of data can be achieved with a high degree of automation (98% in the study) and that the users were indeed capable of utilizing the flexible interface, the sessions becoming more and more efficient as users’ experience increased, both in terms of session duration and avoidance of troublesome dialogue situations.

    Use and Impact of an Automated Telephone Outreach System for Asthma in a Managed Care Setting
    Patients with persistent asthma were randomly assigned to telephone outreach (automated = 3389, live caller = 192) or usual care (n = 3367). Intervention participants received 3 outreach calls over a 10-month period. The intervention provided brief, supNo warnings or errors were found. portive information and flagged individuals with poor asthma control for follow-up by a provider. This study did not find improved health outcomes in the primary analyses. The intervention was well accepted by providers, however, and the individuals who participated in the calls appeared to have benefited from them.

    Kaiser Permanente will fund study of Program to track prescriptions in real time -- System would guard against narcotic abuse
    Kaiser Permanente recently agreed to pay for a study of a proposed computer program to give doctors, pharmacists and some law enforcement officials instant online access to medical records. The plan raises privacy concerns with some, but supporters say it would reduce "doctor-shopping" by drug abusers seeking multiple prescriptions.





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