Saturday, June 17, 2017

Weekly Overseas Health IT Links – 17th June, 2017.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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NQF maps out measures for interoperability

The National Quality Forum is set to finalize a framework that can measure health data interoperability and identify gaps in progress.
June 08, 2017 04:02 PM
The National Quality Forum moved closer to finalizing a framework for measuring interoperability. NQF said the framework will help identify in the nation’s progress to enable widespread health data exchange. 
The agency’s initiative comes as hospitals and electronic health records vendors are struggling with interoperability and the Office of the National Coordinator for Health IT is working to advance standards that enable information sharing. 
“Interoperability is more than EHR to EHR, and all sources of data should be taken into consideration,” NQF said. “All critical data elements should be included in the analysis of measures as interoperability increases access to information.” 
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A growing number of people with chronic conditions also lack internet access

Jun 9, 2017 11:08am
Lack of internet access coupled with high rates of chronic disease plague more than 60% of rural counties.
More than 36 million people live in counties across the United States where high rates of chronic disease are exacerbated by low rates of broadband connectivity.
The Federal Communications Commission (FCC) refers to this trend as a “double-burden” of need, and according to new data released (PDF) by the agency’s Connect2Health Task Force, those numbers are increasing. Between 2014 and 2015, one million additional Americans lived in counties with “double burden.”
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4 ways hospitals can prevent a ransomware attack

Jun 9, 2017 12:09pm
Hospitals are a prime target for hackers, and they can take a few simple steps to help protect their systems from cyberthreats.
Hospitals are a prime target for hackers, but providers can take steps to ensure their systems are better protected against ransomware and other cyber threats.
The federal government has taken steps on the national level to improve cybersecurity, but hospital leaders can also encourage staff to engage in simple behaviors to prevent cyberattacks, wrote Paul H. Keckley, Ph.D., healthcare analyst and author of The Keckley Report, in an article for Hospitals & Health Networks.
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Could Automation Solve the Healthcare Industry’s EHR Problem?

Automating certain tasks within the systems could be the key to settling EHR dissatisfaction.

Kate Monica

June 08, 2017 - As healthcare professionals attempt to navigate an increasingly data-driven, high-tech industry, some providers and patients remain skeptical that increased reliance on EHR systems is the right move.
EHRs have their advantages: several studies cite examples of the systems being key assets in efforts to improve preventive medicine, patient-provider communication, and positive drug interactions. Additionally, EHR systems offer patients increased transparency through patient portals providing a view of their own health information.
However, not everyone is a fan of the technology. The question of whether EHR systems help or hurt the industry has driven a wedge between providers on either side of the argument.
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Patients with metastatic cancer live longer using web-based tool

Published June 09 2017, 6:56am EDT
A web-based tool that enables patients with metastatic cancer to report their symptoms in real time, providing alerts to clinicians, has been shown to have major benefits, including longer survival rates.
In a randomized clinical trial of 766 patients, those who used the tool to regularly self-report symptoms while receiving chemotherapy lived a median of 5 months longer than those who did not use the tool. Results of the study were presented June 4 in the plenary session of the 2017 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
The study was led by Ethan Basch, MD, professor of medicine at the Lineberger Comprehensive Cancer Center of the University of North Carolina, who was practicing at Memorial Sloan Kettering Cancer Center in New York when the clinical trial was conducted.
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HIT Think Why using AI in healthcare requires a balance of efficiency and ethics

Published June 09 2017, 4:50pm EDT
Along with predicting epidemics, diagnosing diseases and counseling patients, artificial intelligence is also proving its worth in healthcare delivery to enable a better patient experience.
From making sense of the unwieldy mass of medical data trapped in healthcare systems to tapping into the collective knowledge gathered from several thousand healthcare providers and millions of patient visits, doctors can now start to analyze which treatments work best and when.
Now, AI can recommend a line of action even in clinically challenging situations, assisting radiologists in analyzing simple cases, prescribing a first line of treatment to patients before they see a doctor and help monitor health and medication in chronic conditions.
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The AI Doctor Orders More Tests

Google and its rivals are pushing into machine-learning diagnoses.
by  Mark Bergen
June 8, 2017, 8:00 PM GMT+10
Few U.S. industries are growing as fast as health care, but the big public-cloud companies—Amazon.com, Microsoft, Google—have struggled to crack the $3.2 trillion market. Even as hospitals and insurers collect mountains of health data on individual Americans, most of their spending on extra data storage is for old-school systems on their own premises, according to researcher IDC.
The public-cloud kingpins are trying to lure health-care providers with artificially intelligent cloud services that can act like doctors. The companies are testing, and in some cases marketing, AI software that automates mundane tasks including data entry; consulting work like patient management and referrals; and even the diagnostic elements of highly skilled fields such as pathology.
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Electronic Alerts Help Reduce Missed Sepsis Diagnosis in Children

Alexandra Wilson Pecci, June 9, 2017

Using this method to identify children in a pediatric emergency department with severe sepsis reduced missed diagnoses by 76%. 

It’s long been said that health IT should enhance, but never replace, traditional medicine, and a method of identifying sepsis in children that combines electronic alerts with physician judgement is an example of that idea. 
Researchers found that using this method to identify children in a pediatric emergency department with severe sepsis reduced missed diagnoses by 76%. The study, along with an accompanying editorial, were published online in Annals of Emergency Medicine.
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Patient safety jeopardized by EHR downtime, JAMIA says

A three-year study on a large mid-Atlantic hospital found that the laboratory department was hit the hardest during downtime, with patient identification as the largest challenge.
June 07, 2017 03:59 PM
Downtime events in hospitals that shut down the functionality of the electronic health record can result in serious patient safety risks, according to a recently published study in the Journal of the American Medical Informatics Association.
In fact, over the three-year analyzation period of a large health system in the Mid-Atlantic, 76 incidents were reported that were directly related to downtime. And that included scheduled downtime, as well.
Downtime hit the lab department the hardest -- accounting for about half of the reports. Medication administration was the second most-affected with 14.5 percent of all incidents. And about 13.2 percent of the reports stemmed from a general delay in care.
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New PRSB standards published on e-discharge summaries

Laura Stevens

7 June 2017
A re-worked version of the e-discharge summary standard has been published by the Professional Record Standards Body.
Issued 31 May, the revisions aim to improve communication between hospitals and primary and community care. Changes include how information about a patient’s medication is entered.
Using this standard, hospitals can now transfer standardised clinical information using PRSB headings and coded data (SNOMED CT and dm+d), which can then be transferred directly into GP IT systems.
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How technology upgrades sparked a financial resurgence at two rural hospitals

Jun 8, 2017 8:11am
Coteau des Prairies Health Care System in rural South Dakota has leaned heavily on telehealth to streamline costs and patient care.
On his second day as CEO of Coteau des Prairies (CDP) Health Care System in Sisseton, South Dakota, Michael Coyle had to borrow $500,000 to make payroll. That was just the start of the hospital’s financial struggles.
CDP is a 25-bed critical access hospital located about 160 miles north of Sioux Falls on the edge of the Lake Traverse Indian Reservation. When Coyle arrived in December 2014, the hospital faced an array of financial issues, most of which were tied to delinquent payments from Indian Health Services. Several years earlier, the hospital saw a massive increase of ER visits after the reservation demolished its hospital and replaced it with a medical clinic.
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Main Characteristics of Successful EHR Vendors, Technologies

The most successful EHR vendor technologies used by hospitals and health systems around the globe share several traits in common.

Kate Monica

June 06, 2017 - EHR vendors are experiencing an upsurge in client acquisitions as EHR adoption and implementation continue throughout the healthcare industry, most notably in the form of EHR replacement.
While hundreds of technology vendors and solutions remain on the market, a select few repeatedly rise to the top each year as the most popular vendors among healthcare organizations.
Specificity and range of functionality
Recent market share reports show hospitals of different sizes, specialties, and regions have different priorities when choosing an EHR system that best fits their practice.
For small hospitals, that means specificity.
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Mobile Health Technology is Breathing New Life Into CPAP Therapy

Healthcare providers are using mobile health technology to transform clunky CPAP devices into high-tech mHealth platforms, giving doctors better insight into sleep and breathing problems.

Source: ThinkStock

Eric Wicklund

June 07, 2017 - Healthcare providers are turning to mHealth technology to make CPAP therapy more productive – for both doctors and patients.
Continuous positive airway pressure (CPAP) machines have been around for decades, helping doctors to monitor patients with breathing problems, like obstructive sleep apnea (OSA). But the clunky devices, which typically consist of an airflow generator, hose and full face mask, aren’t comfortable, and often prevent the patient from getting a good night’s sleep.
Now companies like ResMed, SRETT and Philips Respironics are developing mobile health platforms that connect wirelessly to the CPAP machines and care providers, enabling patients to use the devices at home, rather than in a sleep lab.  With that online connection, data from CPAP devices, including vital signs and sleep activity, is transmitted to providers, who in turn can track and identify problems and intervene, or offer coaching and support.
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Coast Guard next to pick Cerner? Vendor is already prepping its EHR for the high seas

USCG ranked interoperability with DoD and VA as a priority while Cerner, meanwhile, has been testing its software on submarines.
June 06, 2017 03:10 PM
Now that Veterans Affairs Secretary David Shulkin, MD, revealed that VA has officially opted to replace its VistA EHR with one from Cerner, the overarching question: Is Cerner now a shoo-in for the Coast Guard’s upcoming EHR implementation?
USCG, after all, listed interoperability with DoD and VA as among the top attributes it is seeking in an electronic health record platform.
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Researchers, healthcare providers navigate a new era of data sharing

Jun 7, 2017 11:45am
Data is an integral part of advancing medical research and improving clinical care. Sharing it is the next critical step.
Data is quickly becoming king in the healthcare industry, and that means sharing it is increasingly important and complex for researchers and health systems.
Data sharing is particularly important in the quest to advance cancer therapies, the directors of the Swedish Cancer Institute at Providence St. Joseph Health in Seattle and the Sylvester Comprehensive Cancer Center at the University of Miami Health System wrote in an op-ed for Stat.
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Patient mortality could be predicted through computer analysis of organs

Written by Honor Whiteman
Published: Monday 5 June 2017
Using a computer to analyze CT images of patients' organs, researchers were able to predict their 5-year mortality with almost 70 percent accuracy. This is according to a new study recently published in the journal Scientific Reports.
Lead study author Dr. Luke Oakden-Rayner, of the School of Public Health at the University of Adelaide in Australia, and colleagues believe that their findings could advance the field of precision medicine.
The National Institutes of Health (NIH) define precision medicine as "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person."
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Cybersecurity Taskforce Issues EHR Security Recommendations

An HHS taskforce recently submitted recommendations to Congress including improvements to EHR security.

Kate Monica

June 06, 2017 - A healthcare industry cybersecurity taskforce recently submitted a report to Congress analyzing and addressing various issues with healthcare security including problems unique to EHR technology.
The task force was initially convened in March of 2016 by HHS and consisted of members representing organizations ranging from hospitals to pharmaceutical companies.
Throughout the year, taskforce members shared information regarding cybersecurity best practices, trends, threats, and general concerns regarding health IT safety.
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HIT Think How to mitigate the risks of browsing in healthcare organizations

Published June 07 2017, 4:33pm EDT
The freedom to browse comes with inherent security risks. While healthcare organizations must adhere to strict compliance rules to ensure data security and privacy, ransomware and malware threats are widespread and show no signs of slowing down.
We have seen hospitals such as Hollywood Presbyterian and major healthcare organizations, such as the UK's National Health Service, held hostage by cyberthreats. Even healthcare organizations with more proactive security measures are vulnerable. For example, Urology Austin, which operates in 13 locations throughout Texas, managed to thwart a ransomware attack –but despite early detection, the medical records and associated personal information of nearly 280,000 patients had already been exposed by the hack.
The reality is that today’s healthcare organizations are increasingly relying on cloud infrastructure, mobile devices and browser-based applications to support both front- and back-office processes. Thus, organizations are challenged with maintaining a balance between deploying solutions that provide the utmost in accessibility and security without impacting workflow and most importantly, day-to-day operations.
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Electronic scripts could aid fight against opioid abuse

Published June 07 2017, 4:24pm EDT
Since 2016, electronic prescribing of controlled substances has been legal in all 50 states, an initiative that is helping to fight the opioid abuse epidemic, but that form of prescribing is not mandated in all states.
Mandate or not, physicians treating patients with opioids need to go electronic, contends Bob Twillman, executive director at the Academy of Integrative Pain Management.
The organization oversees federal and state pain management policy developments with a mission to advance a person-centered integrative model of pain care. It also offers education and certification programs on the treatment of pain for physicians, physician assistants, nurse practitioners and other prescribers.
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Harnessing the full potential of eHealth

‘Health is a difficult place to work – The Irish Healthcare Awards give recognition’
The signing of the commencement order in relation to the Individual Health Identifier (IHI) — winner at last year’s Irish Healthcare Awards — provides the “fundamental block” in building a better health service through the availability of digital solutions, IMT reports.
One of the award winning projects at last year’s Irish Healthcare Awards has taken an important step towards its ultimate goal of digitalising Ireland’s health service, IMT reports.
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VA decision to select Cerner EHR gets high marks

Published June 06 2017, 7:14am EDT
Monday’s announcement by the Department of Veterans Affairs that it plans to follow the lead of the Department of Defense and acquire a commercial off-the-shelf electronic health record system from Cerner was met with approval from healthcare IT groups and stakeholders.
They contend that the VA’s decision to replace its decades-old legacy Veterans Health Information Systems and Technology Architecture (VistA) with Cerner’s Millennium EHR, the same platform that DoD is currently implementing, has a symmetry and logic to it.
“The Department of Veterans Affairs’ selection of Cerner to develop its electronic health records system is wonderful news for U.S. veterans and their families,” said David Kibbe, MD, president and CEO of DirectTrust.
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VA secretary: Cerner EHR choice brings big clinical gains

Seamless interoperability with MHS Genesis will enable development of better treatment plans between VA and DoD physicians – and could help prevent veterans' suicides, which Shulkin says is his "top clinical priority."
June 05, 2017 04:06 PM
Veterans Affairs Secretary David Shulkin, MD, addressed reporters at the White House on Monday to explain the agency's decision to update their EHR system with Cerner.
Veterans Affairs Secretary David Shulkin, MD, said he was speaking as a physician when he said choosing Cerner to replace VistA was "the right thing to change veterans' healthcare."
Addressing reporters at the White House daily briefing on Monday, Shulkin said that "having an electronic health record that can follow a veteran during the course of his treatment is one of the most important things you can do to ensure their safety, health and well-being."
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Hospitals, turn up the heat on vendors if you want EHRs to improve

EHRs are essentially multi-million dollar products that capture data, but what hospitals really need is decision support information that reduces the possibility of physician errors to improve patient safety, expert says.
June 05, 2017 03:19 PM
NEW YORK — The time has come for hospital IT executives to become much more demanding customers of their electronic health records vendors to bolster clinical decision support, reduce medical errors and ultimately improve patient safety.
“It’s up to us to demand that EMR vendors provide us with good decision support,” Mount Sinai President and COO David Reich said at the HealthImpact East Conference Monday. “Interacting with Epic or other EMR vendors presents certain challenges because they tend to want things in their domain, so we have to innovate outside their domain.”
Part of the issue is that the healthcare industry currently has a lot more innovation than it does validation, according to Neil Carpenter, Vice President of Strategic Planning and Research at LifeBridge Health.
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New research shows patients value the convenience of telehealth—even for bad news

Jun 6, 2017 10:58am
Patients and primary care physicians are enthusiastic about the convenience of telehealth.
Patients appear to be climbing aboard the telehealth bandwagon for the convenience of staying at home, and doctors are keen on the ability to use video consultations for follow-up care.
All 19 telehealth patients at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia indicated they were satisfied with their telehealth visit, according to a series qualitative interviews published in the Annals of Family Medicine.
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How a simple tech tool can help cancer patients live longer

Laurie McGinley June 4
CHICAGO — Doctors often don't hear about the serious side effects of chemotherapy because patients are reluctant to complain or don't have enough time to talk about such problems during jam-packed office visits, experts say.
But a new study points to a potential solution: using simple technology to encourage “real time” reporting of symptoms. Its findings show that patients with advanced cancer who reported side effects frequently via an online tool lived a median of five months longer than those who waited to mention problems during office visits.
Lead study author Ethan Basch, an oncologist at Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill, acknowledges that a five-month improvement might sound modest. But, he notes, it is a greater benefit than what's provided by many targeted drugs for metastatic cancer.
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Patient-Generated Health Data is Valuable Personalization Tool

Consumers are starting to feel empowered to make personal decisions based upon the patient-generated health data from their mHealth devices.

Thomas Beaton

June 05, 2017 - Sixty-two  percent of consumers believe that patient-generated health data (PGHD) from their mHealth devices will put them in control of their own health, according to an industry report from Ericsson.
In a survey of 4500 mHealth and broadband users, researchers found that a majority of consumers saw PGDH as a way to improve their preventative care needs.
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Only 3% of FL Emergency Medicine Providers Consistently Use Opioid Database

Alexandra Wilson Pecci, June 5, 2017

More than half of health providers surveyed said they only use the database when they suspect a patient may misuse the medication.

Despite Florida's availability of a statewide database that aims to reduce opiate abuse and diversion, just 3% of emergency medicine providers reported using the database every time they prescribed opioid pain relievers, according to researchers at University of Florida Health.
Instead, 51% of health providers surveyed said they only use the database when they suspect a patient may misuse the medication.
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Scottish Government seeks views on its eHealth strategy

Written by Sooraj Shah on 6 June 2017 in News
Government wants to know about successes and failures of telecare and telehealth plans to ensure its vision is on the right path
The Scottish government’s health and sport committee is seeking views from citizens and healthcare professionals on its approach to eHealth.
The committee said that it wanted to hear about the successes and failures of existing telecare and telehealth strategies and the opportunities future developments might present. It said that it also wanted to explore barriers to innovation in the NHS.
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HIT Think 5 takeaways from the WannaCry ransomware attacks

Published June 02 2017, 3:21pm EDT
Will information technology ever reach the point in the future where security is strong enough, reliable enough, secure enough to block any and all attacks?
It’s a dubious proposition made more uncertain by the recent WannaCry ransomware incident that started a couple of weeks ago and continued around the globe for several days. The virus was seemingly halted on Friday, May 12, when a security researcher found weaknesses in the code, but additional versions without those weaknesses have been sent out since.
Whoever is sending out WannaCry will continue—or someone else, someplace else, will send something similar or more virulent. The war is never over.
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What would the end of net neutrality mean for healthcare?

Not only telehealth, but cloud-based EHRs and remote monitoring connectivity could all be affected by regulation rollbacks, Health Affairs says.
June 01, 2017 03:53 PM
The Federal Communications Commission hasn't yet overturned existing net neutrality rules, but the Republican-led agency is widely expected to soon.
Even ardent supporters of rules to ensure web traffic isn't subject to preferential treatment by internet service providers seem ready to throw in the towel on the fight, including Netflix CEO Reed Hastings, whose company (along with Google, Facebook and many others) has long fought for stronger regulations on ISPs such as Comcast, AT&T and Verizon.
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HHS task force spells out ‘urgent challenge’ of cybersecurity in healthcare

Jun 5, 2017 10:45am
A much-anticipated cybersecurity report highlighted the gaps among small and medium-sized providers.
Classifying cybersecurity as a patient safety concern, a long-awaited report by a federal task force identified some of the key cybersecurity vulnerabilities in healthcare and stressed the importance of collaboration between all stakeholders to close those gaps.
Over the past year, 21 members of the Department of Health and Human Services’ (HHS) Cybersecurity Task Force discussed some of the key vulnerabilities facing the industry. On Friday, the group released (PDF) a report that many had been anticipating for the last month, particularly in the wake of the WannaCry ransom attack that impacted dozens of NHS hospital and left others concerned that subsequent attacks could have an even bigger impact on patient care
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Study: Real-time electronic symptom reporting helps cancer patients live longer

Jun 5, 2017 11:38am
New research shows that reporting symptoms electronically helped cancer patients live longer.
Promising new research shows that technology can help extend the lives of cancer patients by giving providers real-time updates on treatment symptoms.
Patients that electronically reported chemotherapy symptoms to their provider using a tablet or computer lived five months longer than those that reported symptoms during their monthly checkup with their oncologists, according to a study published over the weekend in JAMA. It’s one of four “clinically significant” studies presented at the American Society of Clinical Oncology annual meeting on Sunday.
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HHS task force wants cybersecurity treated as a patient safety issue

By Rachel Z. Arndt  | June 2, 2017
The Health Care Industry Cybersecurity Task Force today released the final version of its cybersecurity report, calling on the government to write policies that would help healthcare organizations boost their defenses—a need made even more evident after last month's WannaCry ransomware attacks.

The final report, which was mandated by the Cybersecurity Information Sharing Act of 2016, barely differs from the draft that hit the web
in early May (most of the changes were to punctuation). As in the earlier version, the final report sets out six "imperatives" for bolstering cybersecurity, including better information-sharing about threats and developing ways to protect research and development from cyberattacks. The task force called for a new healthcare-specific cybersecurity framework and for amendments to the Physician Self-Referral Law and the Anti-Kickback Statute to make it easier for large health systems assist smaller practices with their cybersecurity.
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VA picks Cerner to replace legacy EHR system

Published June 05 2017, 2:49pm EDT
In an effort to achieve interoperability with the Department of Defense, the Department of Veterans Affairs has decided to replace its decades-old electronic health record system with a commercial off-the-shelf EHR from Cerner.
While the VA will not be adopting the identical EHR that DoD uses, it will be on a similar Cerner platform. The U.S. military has started to deploy Cerner’s Millennium system, the same platform that has now been named as the replacement for the VA’s legacy Veterans Health Information Systems and Technology Architecture (VistA).
VA Secretary David Shulkin, MD, made the announcement on Monday at a news briefing at the department’s headquarters in Washington.
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HIT Think It’s time to stop and refocus EHR efforts

Published June 05 2017, 4:47pm EDT
Every day, physicians, nurses, pharmacists, therapists, orderlies and janitors walk into a hospital, clinic or medical office with only one thought in mind: “What little part can I do today to help heal those who are sick?”
Healthcare’s uniqueness stems from its personal and emotional characteristics, and deep ties to our sense of humanity. While workers in other industries focus on delivering great service or exceptional products, only in healthcare do staff experience the joy of saving a life or the pain of sharing bad news with a patient’s loved ones.
Yet as health providers moved to quickly deploy EHRs, many in the profession believe we had put up barriers between ourselves and our patients. We now regularly hear patient complaints about their caregivers “treating” their computers rather than talking directly to them as patients, and of physicians and nurses putting in extra hours just to complete documentation that, in their view, has no impact on patient care.
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Enjoy!
David.

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