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How Doctors Could Rescue Health Care
October 27, 2011
Arnold Relman
The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer. The federal share, including payments for Medicare and Medicaid, was 23 percent of the national budget in 2009 and is a prime cause of the deficit.1
There is no current prospect of raising taxes. If the federal long-term debt is to be reduced, government health expenditures on Medicare and Medicaid must be controlled. However, there is no agreement in Washington on how that can or should be done. Both parties claim to have the answer but, as I will make clear, no initiatives proposed by either party have much chance of significantly slowing the rise in federal health costs without reducing access to needed services. Major reform will be required, but that is not even under consideration. In any case, health legislation is currently stalled by a bitter political deadlock. No initiatives to improve health care will come out of Congress until after the 2012 elections and, unless the results are unexpectedly decisive, probably not even then. Still, as I will explain here, there is a chance that new developments in the way physicians are organizing themselves to deliver care might improve the currently dismal prospects for action on major reform and cost control.
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Q&A: Blumenthal Talks EHRs, Healthcare Reform
President Obama's former national coordinator for health IT, Dr. David Blumenthal, shares his thoughts on progress with meaningful use of electronic health records, and what's next for healthcare reform.
By Marianne Kolbasuk McGee, InformationWeek
October 26, 2011
During his two-year stint as National Coordinator of Health IT, Dr. David Blumenthal oversaw the development and implementation of the American Recovery and Reinvestment Act's $27 billion HITECH Act stimulus programs to encourage the adoption and "meaningful use" of electronic health records by hundreds of thousands U.S. hospitals and clinicians. Blumenthal--a former primary care physician at Massachusetts General Hospital--left his Office of National Coordinator job in April to return to his tenured post at Harvard. InformationWeek Healthcare senior writer Marianne Kolbasuk McGee caught up with Blumenthal at the recent Partners Healthcare's Connected Health Symposium in Boston.
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http://www.popularmechanics.com/print-this/how-text-messages-could-change-global-healthcare?page=all
How Text Messages Could Change Global Healthcare
There are now more than 5 billion mobile phone subscribers, and 90 percent of the world’s population is covered by a cell signal. Josh Nesbit, the 24-year-old CEO of Medic Mobile, is on a mission to use these far-reaching networks to change how patients and doctors interact. Can low-tech SMS programs revolutionize global health?
By Chris Sweeney
Josh Nesbit sees a bright future for the cellphones that most of us see as antiquated. The 24-year-old Nesbit is the CEO of nonprofit Medic Mobile, and this startup exec’s vision is to take those chunky Nokias and other phones of the recent past—the kind that most Americans threw out or relegated to the junk drawer long ago—and use them to radically change how health care is delivered in developing nations.
These old phones don’t have the touchscreens and slick software features of our shiny new smartphones. But they can text, and in Nesbit’s eyes, a simple technology like text messaging is a tool that can be used to track disease outbreaks, help first responders quickly locate victims after disasters, and more.
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Health information technology: Keep it simple
Making electronic record-keeping systems easier for health providers to use can help prevent dangerous or even fatal mistakes, says the draft of a project [3] by the National Institute of Standards and Technology [4] (NIST).
The draft, titled “Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records,” is available for informal public comment until Nov. 10, 2011. It provides guidance from NIST, a technical research agency within the Department of Commence, for testing electronic health record-keeping systems to make sure they are understandable for health care practitioners. The draft was released last month.
One of the aims of simplifying the devices is to avoid potentially dangerous medical errors, says the report. At the moment, though, there is no government agency specifically directed to regulate or enforce the safety of the devices being sold to medical offices.
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EHR Market To Reach $6.5 Billion By 2012
Hospital EHR adoption is expected to expand significantly as advanced systems are implemented to meet Meaningful Use criteria, a Frost & Sullivan study says.
By Nicole Lewis, InformationWeek
October 21, 2011
Total market revenue for electronic health records (EHRs) is expected to hit $6.5 billion in 2012, which is more than a sixfold increase from the $973.2 million posted in 2009, a study from Frost & Sullivan predicts. The rise in EHR revenues is primarily due to new licensing and upgrades as hospitals get their EHR systems ready to meet Meaningful Use requirements.
The new report, U.S. Hospital EHR Market, 2009-2016: Charting the Course for Dramatic Change, found that today's IT infrastructure at many hospitals is very different from 2009 when approximately 12% of hospitals were using what could be considered either a basic or advanced EHR, and only 2% of those hospitals were using EHRs in a way that would qualify for Meaningful Use.
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MGMA: Overnight EHR roll-outs aren’t effective
Written by Justine Cadet
October 25, 2011
LAS VEGAS—If EHRs are going to be optimized to increase efficiency and the bottom line, administrators should consider more inclusivity in the implementation process, staff and physician workflows, training time and a phased-in implementation, according to an Oct. 24 presentation at the Medical Group Management Association (MGMA) 2011 annual conference.
While implementing an EHR, “think inclusively,” encouraged presenter Ron Anderson, of CHMB, which provides technology and business services for healthcare providers. He said this involves bringing all the stakeholders to the table—both internally (front office, back office, management and providers) and externally (patients and outside resources, such as labs, device manufacturers, hospitals and business service vendors).
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Cerner Reports Third Quarter 2011 Results
Record Revenue, Bookings, Earnings and Cash Flow
KANSAS CITY, Mo., Oct 27, 2011 (GlobeNewswire via COMTEX) -- Cerner Corporation CERN +1.88% today announced results for the 2011 third quarter that ended October 1, 2011, delivering record levels of bookings, revenue, earnings and cash flow.
Bookings in the third quarter of 2011 were $650.3 million, an increase of 31 percent compared to third quarter 2010 bookings of $495.7 million. Bookings were an all-time high for a third quarter and the second highest result in company history.
Third quarter revenue was $571.6 million, an increase of 24 percent compared to $462.7 million in the year-ago period.
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mihealth™ Consumer Health Application Achieves Infoway Certification
Assures product built according to National privacy and security standards
October 27, 2011 (Toronto, ON) - Canadians are one step closer to having secure access to their personal health records as mihealthTM achieves Infoway certification, announced Richard Alvarez, President and CEO, Canada Health Infoway (Infoway).
"I congratulate Mihealth Global Systems Inc. for having their mihealthTM consumer health application successfully complete the Infoway certification process," said Alvarez. "The mihealthTM application was assessed to show that it complies with national privacy and security requirements."
The application will receive the Infoway certification mark, which demonstrates Mihealth Global Systems Inc.'s leadership and commitment to national standards and best practices.
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Survey: Hospitals Have High Hopes for Information Exchanges
HDM Breaking News, October 27, 2011
A survey of more than 340 hospitals finds almost 80 percent have or plan to join a health information exchange.
Thirty-two percent of respondent hospitals already are part of an HIE while 47 percent plan to join such an initiative. The primary driver toward HIE is meeting electronic health records meaningful use criteria, cited by 48 percent of respondents. Other reasons include connecting to the community (21 percent), connecting to impatient/ambulatory environments (15 percent), connecting to the state (12 percent) and driving toward accountable care organizations (2 percent).
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Culture 'stumbling block' to revolution
26 October 2011 Rebecca Todd
The greatest challenge to making the health service information-driven is cultural, not technical, a new report has suggested.
The report commissioned by BCS Health canvassed the views of NHS and non-NHS organisations on the current state of health information practices.
Of 232 respondents to an online survey, 170 (73%) said the “organisational culture within the NHS” was a “major” or “almost insurmountable” challenge to making the health system information driven.
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EHR Worst Practices
Just a partial list of EHR snafus emphasizes the need for a better system of tracking errors.
By Paul Cerrato, InformationWeek
October 26, 2011
We need the equivalent of the National Transportation Safety Board to monitor EHRs, according to Dean Sittig, PhD, a member of the faculty at the School of Biomedical Informatics, University of Texas Health Sciences Center. After listening to his presentation at this week's American Medical Informatics Association (AMIA) Scientific Sessions, I can see the wisdom of that suggestion.
NTSB was launched in 1926, when the automotive industry was in its infancy and few people thought about all the fatalities that lie ahead. Over the years, it has been responsible for insisting on speed limits, seatbelts, airbags, and a host of other invaluable safety measures.
An NTSB-like organization for EHRs would at the very least provide a reporting mechanism to keep track of incidents and life-threatening consequences of misusing e-records. More importantly, it could police vendors and healthcare providers who repeatedly ignore these dangers.
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Electronic Records May Increase Malpractice Lawsuit Risk
EHRs may reduce medical liability for some errors, but could create new forms of medical liability and expose existing liability issues, says report.
By Neil Versel, InformationWeek
October 25, 2011
The rapid movement toward electronic health records (EHRs) may unwittingly raise physician risk for malpractice lawsuits and push liability insurers to raise their premiums, a new report suggests.
EHRs may reduce the medical liability for certain errors, but it appears they "both create new forms of medical liability and expose existing liability issues in the healthcare environment that might otherwise remain unknown," says a white paper published by the AC Group, a Montgomery, Texas, health IT research and consulting firm.
The paper calls on federal officials to slow the pace of the federal Meaningful Use incentive program to get medical practices and hospitals to use EHRs. Co-authors Mark Anderson, CEO of the AC Group, and veteran clinical informatics professional Dr. Larry Ozeran say the "artificially short deadlines" for implementation could raise malpractice risks by spurring vendors to cut corners on developing products and rushing users through training.
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http://www.healthdatamanagement.com/news/aurion-health-information-exchange-open-source-43478-1.html
Aurion Open Source HIE Software Upgraded
HDM Breaking News, October 24, 2011
The Alembic Foundation has released version 4.1 of its Aurion open source health information exchange software.
Aurion 4.1, downloadable here, is a private-labeled and enhanced version of the federal government's Connect software. The foundation last spring released version 4.0 of Aurion with multiple long-standing bugs fixed and additional functionality. This included the adding of "multiple assigning authority" to better identify organizations and information systems participating in HIE.
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Health IT Wins More Venture Capital in 2011
Venture capital for healthcare software and IT services hit $207 million in the third quarter of 2011, a 14% increase compared to Q3 2010.
By Nicole Lewis, InformationWeek
October 25, 2011
Venture capital investments in companies that provide health IT and services hit $207 million in the third quarter of 2011, a 14% increase when compared with the $182 million raised during the same period last year, new figures from Dow Jones VentureSource reveal.
The latest figures, which were published Friday, also show that the health IT and services sector has raised $445 million for the first three quarters of this year and could possibly surpass the $508 million invested in all of 2010.
VC investment in medical software and services is "trending nicely," said Jessica Canning, global research director for Dow Jones VentureSource. "Given the momentum that the industry has already seen over the past year and a half, we'll most likely see a fairly significant increase in deals in the fourth quarter, bringing us above the 2010 level."
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4 best health IT innovations within the past year
October 24, 2011 | Michelle McNickle, Web Content Producer
New health IT was anywhere and everywhere in 2011, promising ways to streamline data and increase patient care. Now, with even more technology on the cusp of the mainstream market, it’s only natural to wonder what’s the best.
That’s why we asked Ahmed Ghouri, MD, co-founder and CMO of Anvita Health, what he believes were the most influential new technologies within the past year and what will be game changers in the years to come. “If you look at the stages of healthcare we’re going through, the first is structural, which includes CPOE, EMRs, and health information exchanges," said Ghouri. “So data management in storage, and data exchange. I think once we solve the structural problems, it will be like creating a Web browser; dramatic value is created once everyone is on the Internet. It’s not just getting online, but also doing things with the data online.”
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Mostashari: 'Never going to be easier than now' to tackle ACO, EHR, ICD-10
October 25, 2011 | Eric Wicklund, Contributing Editor
To all those healthcare CIOs out there worried about ICD-10, meaningful use, accountable care organizations, patient-centered medical homes and a host of other government-backed efforts to reform healthcare, Farzad Mostashari, MD, has some words of advice: Don’t stay on the sidelines.
In other words, the Department of Health and Human Services’ National Coordinator for Health Information Tehnology says, “it’s never going to be an easier time than now” to adopt an electronic health record, meet meaningful use guidelines and move toward an ACO.
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AHIMA members make case for hospital chief knowledge officer position
Published: 24 Oct 2011
The hospital medical records department is evolving from a paper-based repository to a digital knowledge base giving rise to more compliance and data-mining requirements. Specifically, the accountable care organization (ACO) model and a growing number of other quality-based payer incentive programs require data mining. Compliance with HIPAA privacy requirements, not to mention legal e-discovery requests, point to the need for more than just a CIO to implement and secure IT infrastructure.
All these tasks add up to what other service sectors and industries call knowledge management, headed by the chief knowledge officer (CKO). Health care organizations have been slow to embrace the hospital CKO position, but ACOs and other emerging data initiatives point toward the need for it, said Cindy Zak, health information management (HIM) director and privacy officer at Milford (Conn.) Hospital. She made her case for the chief knowledge officer in a presentation at the American Health Information Managers Association's 83rd AHIMA Convention and Exhibit.
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http://gazette.jhu.edu/2011/10/24/survey-reveals-reasons-doctors-avoid-online-error-reporting-tools/
October 24, 2011
Survey reveals reasons doctors avoid online error-reporting tools
Too busy and too complicated. These are the typical excuses one might expect when medical professionals are asked why they fail to use online error-reporting systems designed to improve patient safety and the quality of care. But Johns Hopkins investigators found instead that the most common reasons among radiation oncologists were fear of getting into trouble and embarrassment.
Investigators emailed an anonymous survey to physicians, nurses, radiation physicists and other radiation specialists at Johns Hopkins, North Shore–Long Island Jewish Health System in New York, Washington University in St. Louis and the University of Miami, with questions about their reporting near misses and errors in delivering radiotherapy. Each of the four centers tracks near misses and errors through online intradepartmental systems. Some 274 providers returned completed surveys.
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A new age of biosurveillance is upon us
By Gregory Goth
Created 2011-10-23 10:29
The CDC will overhaul BioSense in November, amid a wave of new data-sharing tactics rolling in from other fields that promises to bolster surveillance methods and architectures.
Krista Hanni doesn't consider herself an expert on the latest developments in IT-enabled syndromic and biosurveillance, but she does recognize that a groundswell of change is about to hit the discipline.
“We're at the beginning of a new field here,” said Hanni, the surveillance and preparedness manager for the Monterey County, Calif., Public Health Department. “That’s what we’re running into.”
The traditional epidemiological approach, which helps public health officials deal in an authoritative but delayed manner with outbreaks and disease caused by calamities, is being challenged by new forms of data and new approaches using methodologies from other fields.
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4 data breach response best practices
October 24, 2011 | Rick Kam, President and CEO, ID Experts and Christine Arevalo, director of healthcare identity management, ID Experts
We’ll be honest. This is not another article about the details of data breach response—notification timelines, identity protection, remediation, and so forth. Data breaches are stressful events, and experience proves that such details are best handled by an expert third party. Instead, we’ll focus on the framework, or set of best practices in which to place these details — the how of a data breach response.
Most healthcare providers have their patients’ well-being at heart, and it’s this attitude of caring that can help an organization achieve compliance almost automatically. These best practices can help organizations demonstrate that goodwill in tangible, effective ways.
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Love of Health Tech Doesn't Have to be (Double) Blind
Gienna Shaw, for HealthLeaders Media , October 25, 2011
One of my favorite quotes from last week's Center for Connected Health Symposium in Boston came from Peter Tipett, MD: "Information technology can reduce cost, increase quality, and advance science," said the vice president of industry solutions and security practices at Verizon's business unit. "But other than that it's not worth it."
In so many ways, so many kinds of Health IT make perfect logical sense. Making patient medical records easily accessible in electronic format? A no-brainer. Giving patients access to their own records which, after all, belong to them? Makes sense. Tools that help clinicians make quick and accurate evidence-based diagnoses at the point of care? Well, of course that's a good idea.
But try proving it.
There is some research suggesting that electronic health records can have a positive impact on quality. But for medicine, so enamored with empirical evidence, double-blind studies, and peer review, it isn't always enough. Telemedicine, remote health, and m-health are particularly vulnerable to that phrase that concludes so many academic papers: "more research must be done."
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EMIS Web installations put back
25 October 2011 Rebecca Todd
A number of GP practices waiting for EMIS’ next generation system, EMIS Web, will have to wait until after the New Year.
EMIS says it has delayed some GP installations to allow it to focus on issues such as training needs for new users.
EMIS Web will enable primary, secondary and community clinicians to view and contribute to a patient’s core GP record.
At the end of August, it had been installed at 228 GP practices and the company had taken 1,130 orders for the system.
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Research finds GP e-prescribing errors
25 October 2011 Shanna Crispin
New research has found that more than 4% of electronic prescriptions written by general practitioners contain errors.
Researchers from Reading University have been studying prescription data from 15 general practices over the past 18 months and are on the verge of publishing the results.
Lead researcher, Dr Rachel Howard, presented preliminary results at a forum on electronic prescribing held in London.
She said the research found that 4% of the prescriptions had “significant clinical errors” and another 0.9% had errors relating to the monitoring of medicines.
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SCR clocks up over 9m records
21 October 2011 Linda Davidson
There are now over nine million summary care records available for use in urgent and emergency care in England, the Ascribe User Conference heard this week.
Dr Emyr Wynn Jones, secondary care clinical lead for the SCR and HealthSpace programmes at Connecting for Health, told the conference that the milestone was passed on 18 October.
He said the SCR programme had suffered a ‘lot of collateral damage’ from the recent announcements about the demise of the National Programme for IT, with some people mistakenly thinking that the SCR was being abolished.
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Global CTOs call for faster progress on e-health standards
By Emeka Aginam
No fewer than 21 Commonwealth Telecommunications Organizations (CTOs) from leading companies in the information and communication technology (ICT) industry rose up from a meeting yesterday in Geneva at the ITU Telecom World 201 urging the International Telecommunications Organization, (ITU) to accelerate technical standardization work in the field of e-health.
According to CTOs reliable, interoperable standards were key to providing patients and health professionals with the means to utilize remote consultation services, advanced ICT-based diagnostic procedures and electronic health information services.
The meeting among other things agreed that international coordination on standards will be vital, and that growth in telemedicine services will also demand aggressive roll-out of broadband networks.
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HIT Barriers to Patient Engagement Persist
Gienna Shaw, for HealthLeaders Media , October 24, 2011
The correlation between accountable care models and healthcare information technology that connects and engages patients permeated conversations at The Center for Connected Health annual symposium in Boston last week.
As news of the final rules broke, participants weighed the importance of electronic health records in a successful ACO business model. And panelists at two sessions discussed accountable care's merits and pitfalls, touted the model's potential to make healthcare more connected and participatory, and warned that many barriers still stand in the way to patient engagement.
Midday Thursday, the first day of the conference, came word that the federal government had released final ACO regulations with major concessions to the original plan. One of the critical changes: The rule no longer requires that 50% of participating physicians be meaningful users of electronic health records.
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Final ACO rule holds great possibilities for health IT
October 22, 2011 — 6:06pm ET | By Ken Terry
Compared with the draft rule on accountable care organizations (ACOs) that the Centers for Medicare & Medicaid Services (CMS) issued last March, the final rule has made it significantly easier for ACOs to qualify for the Medicare shared savings program in the area of health IT. What CMS has done, in effect, is to recognize that healthcare organizations are in a variety of stages on their road to electronic perfection. Yet that doesn't mean that the less technologically advanced groups aren't trying to provide accountable care that lowers costs and raises quality.
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Monday, October 24, 2011
Federal Health IT Activity Heats Up in Q3 2011
During the third quarter of 2011, the federal government continued to implement the HITECH Act, which was enacted as part of the American Recovery and Reinvestment Act. This update summarizes key developments and milestones between July 1 and Sept. 30.
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ACO Rule Gives Patient Control Over Data Sharing
HDM Breaking News, October 21, 2011
Centers for Medicare and Medicaid Services officials, in a final rule establishing the Medicare Shared Savings/ACO program, stuck to their guns on enabling beneficiaries participating in an ACO to opt-out of letting their claims data be shared.
"Although we have the legal authority, within the limits described previously, to share Medicare claims data with ACOs without the consent of beneficiaries, we nevertheless believe that beneficiaries should be notified of, and have control over, who has access to their personal health information for purposes of the Shared Savings Program," according to the final rule issued on Oct. 20. "Thus we proposed to require that, as part of its broader activities to notify patients that its ACO provider/supplier is participating in an ACO, the ACO must also inform beneficiaries of its ability to request claims data about them if they do not object."
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CDW: Healthcare sector to lead IT spending
October 20, 2011 | Molly Merrill, Associate Editor
VERNON HILLS, ILL – In the midst of economic uncertainty, IT decision-makers in the healthcare industry report expected growth in overall IT budgets and hiring, according to the latest CDW IT Monitor.
While the latest wave of the CDW IT Monitor noted numerous fluctuations among sectors and industries surveyed, the comprehensive figures indicate that, on the whole, IT sentiment is holding steady. The Six Month Growth Outlook, which measures long-term anticipated investment, decreased one point from June, to 67, and was unchanged from one year ago.
“Despite ongoing economic uncertainties, the overall outlook remains relatively stable,” said Neal Campbell, senior vice president and chief marketing officer, CDW. “This shows that while IT decision-makers are evaluating and scrutinizing their investments, they are still spending, especially in areas such as software and security."
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Emergency Room Patients Tracked With RFID Tags
EHR vendor Meditech is integrating its system with Awarepoint's tracking software for better emergency care.
By Neil Versel, InformationWeek
October 21, 2011
Awarepoint, a San Diego-based vendor of real-time location systems (RTLS) for healthcare environments, will integrate its technology with Meditech's enterprise electronic health record (EHR) in an effort to improve throughput and patient safety in hospital emergency departments.
The partnership combines Awarepoint's awareEDtracker system with the EHR's ED management module, known as Meditech EDM. As patients present in a hospital's ED, they are registered in the EDM, then given radio-frequency identification (RFID) tags so awareEDTracker can find them. The RTLS technology also records patient interaction with physicians and other ED staff, who wear tracking tags, too.
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Enjoy!
David.
