Just an occasional post when I come upon a few interesting reports and resources that are worth a download or browse. This week we have a few.
First we have:
Women With Diabetes at Increased Risk for Irregular Heart Rhythm
Kaiser Permanente study finds association between diabetes and atrial fibrillation
PORTLAND, Ore., Sept. 28 /PRNewswire/ -- Diabetes increases by 26 percent the likelihood that women will develop atrial fibrillation (AF), a potentially dangerous irregular heart rhythm that can lead to stroke, heart failure, and chronic fatigue. These are the findings of a new Kaiser Permanente study, published in the October issue of Diabetes Care, a journal of the American Diabetes Association.
While other studies have found that patients with diabetes are more likely to have AF, this is the first large study--involving nearly 35,000 Kaiser Permanente patients over the course of seven years--to isolate the effect of diabetes and determine that it is an independent risk factor for women.
"The most important finding from our study is that women with diabetes have an increased risk of developing this abnormal heart rhythm," said the study's lead author, Greg Nichols, PhD, investigator at the Kaiser Permanente Center for Health Research in Portland, Ore. "Men with diabetes are also at higher risk, but the association between the two conditions is not as strong. For men, obesity and high blood pressure are bigger risk factors from diabetes."
Much more here:
The article abstract is found here:
http://care.diabetesjournals.org/content/32/10/1851.abstract
Again the Kaiser Computer Systems are making useful contributions to clinical knowledge.
Second we have:
Australia - Towards national indicators of safety and quality in health care
This report sets out recommendations for a set of 55 national indicators of safety and quality in health care. The report concludes the National Indicators Project, a major project funded by the Australian Commission on Safety and Quality in Health Care (the Commission) and undertaken by the Australian Institute of Health and Welfare (AIHW) in close consultation with the Commission and a wide range of clinical and other stakeholders.
Authored by AIHW.
Published 29 September 2009; ISBN-13 978 1 74024 961 4; AIHW cat. no. HSE 75; 286pp.; INTERNET ONLY
More here:
http://www.aihw.gov.au/publications/index.cfm/title/10792
There is much more detail and downloads available from the link above. These indicators, once finalised, will doubtless be used to shape a ‘pay for performance’ program in Australia.
Third we have:
Dutch health system retains ‘Best in Europe’ crown
Published: Tuesday 29 September 2009
The Netherlands has the best healthcare system in Europe, according to the annual Euro Consumer Index. Dutch healthcare was top of the list for the second year running, this time with an even bigger margin of victory.
Background:
The annual Euro Health Consumer Index compares health services in 33 European countries based on patient rights, e-health, waiting times, outcomes, range of services offered, and access to medicines.
Last year, the Netherlands edged out Denmark to take the title of Europe's best healthcare system (EurActiv 14/11/08), while Austria came out on top in 2007 (EurActiv 1/10/07).
Greater information sharing and patient choice have been highlighted by proponents of cross-border healthcare in Europe. The European Parliament passed a directive in April which paves the way for greater patient mobility (EurActiv 24/4/09)
In second place was Denmark, which performed strongest in providing patients with access to information and enforcing patient rights, but lost marks for having longer waiting times. While Sweden fared best in the analysis of health outcomes, its e-health investment was weaker. The Netherlands' performance was broadly strong in all categories.
Much more here:
http://www.euractiv.com/en/health/dutch-health-system-retains-best-europe-crown/article-185837
The link between e-Health and the better health systems is explicitly drawn.
The report can be found here:
http://www.healthpowerhouse.com/files/Report-EHCI-2009-090925-final-with-cover.pdf
Fourth we have:
Docs Miss Test Results -- Even With Alerts
Communication woes still plague medical system, researchers find
Posted September 28, 2009
MONDAY, Sept. 28 (HealthDay News) -- Even an advanced, computerized medical-record system with alerts cannot guarantee that patients will receive timely follow-up care when imaging tests turn up signs of trouble, new research suggests.
"Our findings suggest that an electronic medical record that facilitates transmission and availability of critical imaging results to the health care provider through either automated notification or direct access of primary report does not eliminate the problem of missed test results even when one or more health care providers read the results," write the authors of a study in the Sept. 28 issue of the Archives of Internal Medicine.
According to the authors, communication breakdowns are blamed in cases when doctors don't follow-up on abnormal test results. In some cases, all the doctors involved in a patient's care don't receive information about, say, a lung mass.
More here:
The article abstract is available here:
http://archinte.ama-assn.org/cgi/content/short/169/17/1578?home
Fifth we have:
EHR Implementation is a Journey, Not a Destination
Carrie Vaughan, for HealthLeaders Media, September 29, 2009
If you have seen one physician practice, you have seen one physician practice. I often hear that phrase when talking with healthcare executives about best practices and lessons learned from successful electronic health record implementations. Health systems, hospitals, and clinics all have their own unique personality that is shaped by their geographic and organizational culture. That means there is no set formula to guarantee a successful EHR implementation. Organizations must find the path that works best for them.
A recent report by healthcare market research firm IDC Health Insights analyzed how two Norwegian hospitals—St. Olavs Hospital in Trondheim and Ahus Hospital in Oslo—successfully adopted digital technologies. The study, "Best practices: Norway's hospital evolution—A tale of two cities," concluded that there wasn't a single template for successful health IT implementations. Both projects were full replacements of aging facilities, but they used different methods to realize the vision of a digital hospital.
For example, St Olavs chose a single-vendor and an outsourced solution, whereas, Ahus worked with multiple vendors, retained some of its legacy systems, and managed its IT transformation internally. Even though Ahus was able to adopt more mature technology, since it began its implementation two years later than St. Olavs' project, both systems are now fully operational and their digital transformations deemed a success by their staff members and communities.
More here:
A useful report – the link is in the text.
Sixth we have:
Health IT prevents heart attacks?
Kaiser Permanente is pushing a study in today’s American Journal of Managed Care as proof that health IT saves lives.
It proves to me my pill regimen may be keeping me alive.
In the study 68,560 people with diabetes or heart disease were given a combination of generic statins and hypertension drugs, resulting in 1,271 fewer heart attacks and strokes.
But what’s the health IT angle?
- KP HealthConnect, the insurer’s Electronic Health Record system, was used to identify the patients at risk.
- The findings validate a computer-created model predicting that the bundled drugs would cut heart attack and stroke in the target population by 71%.
- Kaiser researchers conducted the study.
Much more here:
http://healthcare.zdnet.com/?p=2777
Link in the text. Kaiser strikes again!
Lastly we have:
Electronic medical records give early warning of domestic abuse
Posted by Elizabeth Cooney September 29, 2009 07:09 PM
Boston researchers reported today a novel use for electronic medical records -- using data in patient records, they say they were able to identify likely victims of domestic abuse an average of two years before a diagnosis was actually made.
Ben Reis, Dr. Isaac Kohane, and Dr. Kenneth Mandl of Children's Hospital Boston and Harvard Medical School studied six years of hospital admissions and emergency visits for patients over 18 years old. Based on the patient's history, including injuries and assaults, they determined whether patients met a definition of domestic abuse. Then they looked at actual diagnoses of domestic abuse.
"Our model predicted abuse two years before it appeared on medical records," Reis said in an interview. The article appears online in the British Medical Journal.
The risk factors linked to a future domestic abuse diagnosis differed between men and women. For women, the red flags were trips to the hospital to treat injuries, poisoning, and alcoholism. For men, depression and psychosis were associated with the greatest risk.
The researchers developed a visual display that could become part of a patient's electronic health record. The work is not ready to be implemented, they said, but the model could form the basis for an early warning system that would help busy doctors decide which patients need further screening and perhaps intervention.
"This is not a diagnosis but a screening support system," Reis said.
Their hope is to bring the wealth of information about a patient to the forefront during a doctor-patient encounter encumbered by competing demands. They plan to study other health problems, from diabetes to depression, that might lead to what they call "predictive medicine."
More here:
http://www.boston.com/news/health/blog/2009/09/post_31.html
The full report is here:
http://www.bmj.com/cgi/content/abstract/339/sep29_1/b3677
Good stuff!
Enjoy!
David.
Fifth is an EMR, not an EHR.
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