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Showing posts with label interoperability. Show all posts
Showing posts with label interoperability. Show all posts

Thursday, May 5, 2022

Hamilton Health Sciences (HHS) to go live with patient-empowered EMR

 https://www.canhealth.com/2022/05/04/hhs-to-go-live-with-patient-empowered-emr/

HHS to go live with patient-empowered EMR
May 4, 2022


Filomena Canci

HAMILTON, Ont. – In June, Hamilton Health Sciences is introducing its new Epic hospital information system. The electronic solution will make patient records available to clinicians in a centralized location, reducing the need to call up different applications. Moreover, patients will have access to their medical information – including test results, lab results and much more – through the Epic MyChart app.
“Our Vision is to provide ‘Best Care for All’,” says Filomena Canci (pictured), HHS’ chief nursing information officer and one of the leaders working to bring Epic to the hospital. “Not only will Epic improve clinical care delivery and enhance patient experience, it will also help us innovate and remain at the forefront of health care in Canada.”
Epic replaces the current health information system, made up of multiple electronic and paper-based systems containing different parts of a patient’s record. It can be difficult for hospital staff, doctors and other healthcare providers to pull together full patient records with the current system.
Using the Epic MyChart app, patients will also be able to read discharge summaries and consultation notes as well as an after-visit summary document which notes medication changes, orders placed during their hospital visit and any instructions or education provided during their visit.
Patients can share records with their doctors and caregivers, enter their own health information within a secure personal health record space, access health education materials and securely communicate with healthcare providers.
Other features include virtual visits through video conferencing and the ability to upload pictures of, for example, a rash or wound, to help with assessing and monitoring care.
Additional feature of HHS’s Epic MyChart app:

  • eCheck-in: This allows patients to update information such as an address or contact info, medications, allergies, health coverage, and complete questionnaires prior to their HHS appointment. The purpose is to shorten the length of time a patient is at registration.
  • Video Visits: Scheduled video visits with doctors, nurses and other healthcare professionals already take place across HHS – MyChart will make it even easier, with all the info and access in one place, no other online tools required.
  • Notes and Results: Patients can view test results and medical notes from their healthcare team. See your medications, test results, lab results and medical notes. Test and lab results include CT scans, MRIs, x-rays, ultrasounds, echocardiograms, pathology results and lab results such as blood work and COVID testing.
  • Questionnaires: Patients can complete questionnaires within MyChart. These questionnaires could be attached to eCheck-in for certain visits or sent in messages from the care team to patients.
  • Patient-Entered Flowsheets: With these forms, patients can enter medical data, like a blood pressure or blood sugar. The data can be trended over time and can be included in their chart. Abnormal readings can also trigger a message to the healthcare provider to follow-up with the patient.
  • Billing Summary and Details: Patients can pay outstanding balances via MyChart and see details of previously paid bills.
Also available for patients of some clinics:
  • Direct Scheduling: This allows certain clinic patients to schedule appointments with a healthcare provider they already have a relationship with.
  • Appointment Requests: Certain clinic patients can send appointment request messages to healthcare providers they already have an existing relationship with. They can explain why they want an appointment and their preferred availability.
  • Direct Messaging: This lets certain clinic patients send messages to their healthcare providers regarding their medical care or test results. Patients must already have a pre-existing relationship with the person they are messaging in order to reach out this way. Patients will also be able to message about issues not directly related to their medical issue such as billing queries, compliments, complaints and web issues.
With Epic, healthcare providers will understand where a patient has been, and where they’re going in their care journey.
HHS’ current hospital information system is comprised of multiple systems, all containing different parts of a patient’s record. One of the biggest advantages of Epic is its promise of “one patient, one record”, which means that, no matter where a patient is in the hospital, staff and providers will be able to view their full medical history in one unified system. Patients will also be able to update parts of their health record on their own (like medications and allergies) using an app called MyChart.
With Epic, patients won’t have to worry about remembering every detail of their medical history, and providers and staff will be able to make more informed decisions about their care. Using one system across HHS will also dramatically reduce the amount of time providers and staff spend searching for information, enabling them to spend more time listening to patients’ concerns and providing care.
In addition to centralizing most patient records, a major benefit to clinicians seeking information about their patients, the Epic solution will also provide other advantages for healthcare professionals:
Medical professionals are notorious for having hard-to-read handwriting, which can infrequently lead to misunderstandings and errors. For example, misreading a note in a patient’s chart might lead to a wrong dosage of medication.
With Epic, staff and providers will use mobile phones, tables and workstations-on-wheels to update patient information electronically, significantly reducing the chance for errors and patient harm.
A challenge for many patients occurs when they leave the hospital and return to their primary care physician or another external health care provider for care. External providers often need access to a patient’s record to continue providing care, and requesting this information from the hospital can cause unnecessary delays or put pressure on the patient to keep track of everything on their own.
An application called EpicCare Link will make it possible for select external organizations to securely access a patient’s chart, schedule appointments, place orders, communicate with the patient’s hospital care team, and more. This will enable better communication and more effective collaboration between care teams within and outside HHS, improving the patient experience overall.
Over the course of the pandemic, virtual care – including medical appointments by phone or video conferencing – increased by 1,500 per cent at HHS, and it’s unlikely that demand will decrease in the future. Virtual care offers a convenient, accessible alternative for appointments that do not require patients to visit the hospital, and it will be part of HHS’ Epic system.
Staying connected to patients using Epic’s virtual care tools has been shown to reduce unplanned emergency department visits and admissions because providers and staff can proactively monitor patients’ symptoms, medications and progress remotely, and check in using secure messaging and video calls. Post go-live, HHS will explore additional features within MyChart that patients can use to send messages and photos to their care team when they have questions or concerns.
Work is well underway to transform HHS into an Epic hospital in June 2022, and providers, staff and patients all have a role to play. Stay up to date by visiting the Project Odyssey page of HHS.

Thursday, March 26, 2020

digital health initiatives in the wake of COVID-19


6. 17-year-old builds a website to closely track the Coronavirus epidemic and now millions are using it:https://www.democracynow.org/2020/3/13/meet_the_17_year_old_behind

7. Flatten the Curve. Volunteer engineers and clinicians big data real-time heatmap of potential and confirmed COVID-19 cases: https://flatten.ca/

8. Ontario, Alberta, etc., billing codes for primary virtual visits: https://ontariomd.news/

9. Wildly Popular South Korean covid-19 tracker app: https://www.marketwatch.com/story/wildly-popular-coronavirus-tracker-app-helps-south-koreans-steer-clear-of-outbreak-areas-2020-03-18

10. South Korean coronavirus tracking apps: https://www.businessinsider.com/coronavirus-south-korea-photos-apps-location-outbreak-where-2020-3#the-app-collects-data-from-public-government-info-including-the-korea-centers-for-disease-control-to-show-the-date-a-patient-was-diagnosed-with-covid-19-along-with-the-persons-nationality-age-gender-and-where-they-visited-2

11. WeDoctor - free consultation from medical clinicians: https://promo.guahao.com/en/global/pneumonia

12. Donate PPE in Canada: https://togetherwecandothis.ca/

13. National Emergency Library - Free books online: http://www.openculture.com/2020/03/the-national-emergency-library-makes-nearly-1-5-million-books-free-to-read-right-now.html

14. MIT Emergency Ventilator Project: https://e-vent.mit.edu/

15. Canadian MD Ventilator Hack 1 ventilator for 9 people: https://www.upworthy.com/canadian-doctors-brilliant-evil-genius-hack-turns-one-ventilator-into-nine

16. Nobel Laureate Leads Push for Made in Canada Ventilator: https://www.theglobeandmail.com/canada/article-nobel-laureate-leads-push-for-simple-made-in-canada-ventilator/

17. Medical Futurist - COVID-19 Was Needed for Telemedicine to Finally Go Mainstream: https://medicalfuturist.com/covid-19-was-needed-for-telemedicine-to-finally-go-mainstream/

18. Project Northern Lights - Groups of Canadians using Slack to hack projects for COVID:  https://www.theglobeandmail.com/canada/article-canadians-use-crowdsourcing-to-produce-medical-supplies-for-health/

19. SECDEV looking for Cybersecurity IT Professionals to volunteer to protect healthcare centres from disinformation, ransom ware attacks, etc:https://www.secdev.com/

20. FutureLoop - Pandemic Edition: https://futureloop.com/register/coronavirus/












32. How is my Flattening?  includes vaccination percentages for Ontario

33. Canada's Public Health Data Meltdown - MacLeans article by Justin Ling


35. ProMed - International Society for the Infectious Diseases









Friday, October 25, 2019

Axe the fax

From the Globe and Mail December 2018 Health reporter Andre Picard:
https://www.theglobeandmail.com/canada/article-the-british-are-axing-the-fax-will-canada-follow-suit/

It’s not often that a seemingly mundane ministerial announcement reduces one to jealous tears, but this one fits the bill.

On Sunday, Matt Hancock, the British health and social care secretary, banned the purchase of facsimile machines by the National Health Service effective Jan. 1, 2019. He also ordered that faxes be phased out completely in hospitals and physicians’ offices by April, 2020.

Oh, but how Canada – a country even more in the poisonous grip of the fax than Britain – could use this common sense initiative.

“We don’t underestimate the enormity of the challenge to remove all our machines in such a short time, but we cannot afford to continue living in the dark ages,” Mr. Hancock said in the release.

Amen.

In July, the Royal College of Surgeons released a report that revealed the NHS, the country’s publicly-funded national healthcare system, had more than 8,000 fax machines in service. A group of hospitals in Newcastle Upon Tyne had a mind-boggling 603 facsimile machines in use.

To cap it all off, the NHS had the dubious distinction of being the largest purchaser of fax machines in the world.

Richard Kerr, chair of the committee that prepared the report called the situation “farcical” and called on government to invest in 21st century technology.
The government actually listened.

In addition to the fax ban, there are two other important aspects of Sunday’s announcement. Come 2020, communication will be by secure e-mail or apps and, just as importantly, all communication technologies will have to meet a standard that ensure that they can talk to each other across organizational boundaries. 

There will also be some additional money for hospitals and physicians to replace their fax machines – £200-million (about $340-million) – in addition to what the NHS is already spending on IT. 

But we do know that the fax machine is still ubiquitous. A 2017 survey found that two-thirds of Canadian physicians use the fax as their primary means of communication with other health care professionals, such as doctors, pharmacists, and hospitals.

So why do we continue to use technology that is almost universally acknowledged to be absurdly outdated?

Some claim that the fax is more secure than alternatives like e-mail. Our privacy rules also consider the fax the safest form of communication. That’s simply not true, especially with readily available encryption. The continued use of fax machines is bad for privacy and bad for patient safety.

A principal reason the fax endures is habit. Change is always slow in the ultra-conservative health system, especially when it costs money.

But the single biggest impediment to banning the fax is that the computer systems and electronic health records that we have are rarely able to communicate with each other. Interoperability has not been a priority and that has left us beholden to largely paper-based technology.

Many will look at what is going on in Britain with envy. But, in true Canadian fashion, we will find countless excuses for not doing the same.

Expect to hear that, because Britain has a centralized national health-care system, ministerial directives are a lot easier to issue and implement. There is some truth to that; Canada’s 14 ministers of health can barely agree on the time of day, so an initiative to ban fax machines may be a stretch.

But we shouldn’t forget that Britain’s “axe the fax” campaign was a grassroots initiative. The College of Surgeons gave the initial push by providing data that generated a lot of media coverage and made it easy for government to act.
There were also hospitals that showed impressive initiative. For example, the Leeds Teaching Hospitals NHS Trust committed to eliminating its 340 fax machines within three months, sending a message to others that it was doable.
There is no doubt that fax machines can be eliminated, and they must be, sooner rather than later. The only question is who is going to show leadership? What health care organization, hospital, or politician is going to make axing the fax their legacy and drag Canada out of the dark ages?

Monday, February 29, 2016

BlueCloud clinical research informatics


I got this email from Dr. Greg Koski and the ACRES group the other day.  Dr. Koski is working in area which I have alluded to in a few previous blog posts on clinical research informatics.


ACRES Announces Second Phase of Collaborative IT Platform to Support Clinical Research
Cambridge, MA -- The Alliance for Clinical Research Excellence and Safety (ACRES) announces a major advance toward a shared, open information technology platform for all-user integration across the biomedical research enterprise.   

 Follow us on Twitter @acresglobal
The Alliance for Clinical Research Excellence and Safety (ACRES), the global public-interest collaboration building a comprehensive system to transform clinical research, today announced a major second step toward full implementation of a multi-stakeholder shared information technology platform.
Technology solutions to enhance clinical trial performance are multiplying rapidly, but their usefulness is limited by their lack of connectivity and inter-operability. The new platform, dubbed Apollo, provides a shared infrastructure to support the functional integration of existing technologies, including electronic health records (EHRs), electronic data capture (EDC) systems and clinical trial management systems (CTMS), and to enable data exchange and aggregation critical for development and implementation of “big data” analytics essential for next-generation methods for remote monitoring and auditing, real-time pharmacovigilance, and continuous quality improvement enterprise-wide. 

The first phase of the ACRES global IT platform, built on the BlueCloud® 2.0 Networking Technology developed by ACRES’ Austin-based strategic ally HealthCarePoint, provided a common platform for users worldwide to share vital research study documents, including training documentation and verifiable professional credentials essential for study start-up. 

With nearly 1,000,000 current member-users in healthcare, research, and industry globally, the BlueCloud® is already benefiting sponsors, CROs, investigators, research sites, regulatory agencies and ethics committees worldwide. Now, the second phase of this global collaborative platform, spearheaded by ACRES strategic partner HealthIDx, includes initial roll-out of a federated trust framework for secure enterprise-wide identity management and single sign-on access to multiple end-user applications on the ACRES Apollo platform. Apollo utilizes a proven cloud-based integration platform—originally developed by Detroit-based Covisint to support the complex supply chain, distribution and marketing logistics of the automotive industry—to enable seamless connectivity and inter-operability of multiple applications across the industry’s diverse stakeholders, including sites, sponsors, CRO/SMOs, regulatory agencies and supply chain providers and ethics committees.
“We are delighted to be working with ACRES and its many allies in this important effort,” said J. Scott Lowry, Founder and CEO of HealthIDx. “In this next phase, which includes secure cloud-based data exchange, aggregation, visualization, and analysis, we are addressing critical challenges of security, multi-user identity management, and fine-grain access control.” Lowry further noted that several technology applications, including the BlueCloud®, have been integrated via open APIs onto the ACRES Apollo platform and more such integrations are planned, including platforms of other organizations, thereby extending their power, connectedness and effectiveness. 

“The ability to acquire and exchange data seamlessly among a wide array of EHR, EDC and CTMS platforms within a secure cloud-based environment and move them into shared data vaults where they can be used in real-time will support clinical research performance, quality, safety and oversight as never before,” said Greg Koski, ACRES co-founder and CEO. “Apollo provides the ability to achieve true connectivity among the many applications already in use, as well as new applications being developed, across the entire drug development and clinical trials endeavor, saving time and money for all, while creating innovative opportunities for creativity, efficiency and effectiveness.” 

“This is a collaborative effort,” added ACRES COO Matt Whalen. “Rather than create a proprietary platform, ACRES is deploying a robust integration platform that can connect all stakeholders, whatever applications they currently use, in a timely and cost-effective manner. The power of this approach lies in what can be done through the application of soft systems engineering and the use of standards developed by organizations like OASIS, ICE, CDISC, GS1 and SAFE Biopharma.” 

The Apollo platform also incorporates an “app store” to take advantage of the several technologies and point solution capabilities available to users, working in parallel with second-level integrations of EHR, EDC, CTMS and data management systems. A live demonstration of the Apollo’s robust systems capabilities for multiple high-value use-cases is planned in the second quarter of 2016. Click here to obtain a diagram of the ACRES Global System supported by the Apollo platform or to submit information regarding integration of your application into the system.
---
ACRES Press Release Logo - smallestThe Alliance for Clinical Research and Excellence (ACRES) is a non-profit leveraging the expertise of stakeholders worldwide to collaboratively build a shared global system for clinical trials that are responsibly conducted according to the highest standards of safety, quality and efficiency, based in principles of Accountable Research™. Adapting lessons from industries that have successfully implemented principles of systems and safety engineering, this global system will employ integrated information technologies as well as interoperable standards, policies and practices to enhance clinical research safety, quality and efficiency worldwide. For more information, please contact Dr. Mary F. Tobin or call +1 (844) 60-ACRES (22737).
iiBIG_smalliiBIG (International Institute for Business Information & Growth LLC) is a boutique conference organization dedicated to producing business-to-business conferences and seminars for senior-level executives in three (3) business verticals: (1) Financial services/Investment; (2) IT/Cloud technology; and, (3) Life sciences/Clinical research sectors. We provide learning and networking settings for BIG thinkers – those who occupy the highest levels in their companies and organizations. iiBIG is also proud to be an ACRES Strategic Ally.

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Tuesday, April 1, 2014

Coursera, Health Hacking, Diagnosis Apps, and Interoperability

There has been a lot happening and this is just briefly some of the things I have been tracking. A lot of my time is being spent taking a Coursera online course taught by Dr. Peter Singer (the Australian, not the U. of T. Ethicist) called "Practical Ethics". It is a 12 week course and there are about 25,000 people taking this MOOC. There are writing assignments, peer evaluations of such, video lessons, guest lecturers, discussion forums, essential background readings - I am very impressed and at the same time, very busy just trying to hang on.

COACH recently had a webinar on Health Hacking, facilitated by some of the founders of this fascinating organization. I would strongly recommend that anyone with an interest in healthcare technology and informatics, take a serious look at their website, and / or attend one of their hackathons. It is becoming so popular the next eHealth conference will have a Hackathon. During the webinar they mention how even the Canadian Medical Association thought highly of the concept. I was trying to find the article the CMA wrote about it but could only find this one:

We all know what happened to Google Health, and I am not sure today where Microsoft Healthvault is these days, so I am skeptical about any buzz we might hear about Apple Healthbook.

The Kuzweil Accelerating Intelligence news reported on a new Do It Yourself Medical Diagnosis App.  I have not had time to look into the details of this, but it might be a software candidate for an integrated Tricorder project.

The last item is really a gem, and it is the keynote talk given at HIMISS interoperability showcase, by Malcolm Gladwell. Malcolm uses 3 examples in the evolution of technology to make comparison to how new standards in interoperability can transform healthcare technology: shipping containers, Israeli military technology example called the Bekaa Valley Turkey Shoot, mp3 players.




Wednesday, May 22, 2013

Programmableweb Healthcare API List

I have been having problems recently trying to understand "integration engines" or "Application Program Interface - API". This is list of Healthcare APIs helps shed some light on what I am thinking about - from the programmableweb site. I knew that Google Health, when it was active, had an excellent API system for those living in the United States who could use a variety of health services. Joining up databases in the cloud is technologically doable. In healthcare, it would seem to me that live, real time in-sync linkage of databases would be critical - something I think you might call data driven architecture (which I blogged about before). Anyhoo, still trying to understand better such things as WSDL, SOAP, REST, and web services in general. Interoperability is one of the most difficult problems in health informatics.

37 Health APIs: Google Health, Avvo and Fitbit

Wendell Santos, March 21st, 2012
AvvoOur API directory now includes 37 health APIs. The newest is the DailyMed API. The most popular, in terms of mashups, is the Avvo API. We list 2 Avvo mashups. Below you’ll find some more stats from the directory, including the entire list of health APIs.
In terms of the technical details, REST and XML lead the way. There are 29 health REST APIs and5 health SOAP APIs. Our directory lists 30 health XML APIs and 16 health JSON APIs.
The most common tags within health are 17 medical health APIs8 reference health APIs and 6 sports health APIs
On the mashup side, we list 40 health mashups. We named Hello Vaccine as mashup of the day in August.
For reference, here is a list of all 37 health APIs.
  AIDSinfo API: Government info on HIV/AIDS treatment
  AT&T mHealth Platform API: Health system backend
  Avvo API: Lawyer and doctor directory service
  BigOven Recipe API: Recipes, grocery list, and nutrition API
  BioLabeler API: Library of Medicine text extractor and indexing engine
  BodyMedia API: Fitness tracking service
  CDC Wonder API: CDC health statistics retrieval service
  Centers for Disease Control (CDC) Content Syndication API: Health information content syndication service
  DailyMed API: Marketed drugs information service
  Data.Medicare.Gov API: Medicare information and datasets
  Deepdyve API: Scientific and medical journals
  DeepFitness API: Fitness and nutrition article service
  Diabetic Complications Consortium API: Diabetes and health care information service
  Dossia API: Health information aggregation service
  FatSecret API: Food, nutrition and recipe database and diet tools
  Fitbit API: Fitness Tracking Tools
  GoodGuide API: Green healthy product ratings
  Google Health API: Health data service
  Health 2.0 API: Directory of health-related APIs
  Health Indicators Warehouse API: Health indicators database
  HealthTap API: Online health network service
  Indivo Health API: Health record manipulation services
  MapMyFitness API: Fitness tracking service
  MedlinePlus API: Health information service
  MedlinePlus Connect API: Health information service
  Microsoft HealthVault API: Health-related data storage, security, and records
  NHS API: UK National Health Service
  Patient Opinion API: UK health ratings service
  PHIN VADS API: Public health terminology service
  Pizza-Rat Restaurant Health API: Restaurant health inspection scores
  RunKeeper Health Graph API: Health & fitness tracking service
  SimpleUPC API: Product information database
  Skinnyr API: Weight loss tracking service
  SweetSpot API: Diabetes management service
  Thomson Reuters Pharma API: Investigational drugs data
  Walker Tracker API: Step tracking service
  Withings API: Connected health devices

Saturday, October 13, 2012

eHealth and Event Driven Architecture

I have not seen too many articles on eHealth and Event Driven Architecture but when I was studying about Web Services and Service Oriented Architecture, the idea was compelling. In particular I was interested in the idea that any event related to one's Health ID could trigger ehealth record keeping, especially to the personally controlled health record (PCHR).  In this ubiquitous connected internet of things world, the PCHR would  become the master patient index. No need to give everyone a personal health record on a national architecture - a staggering expense a majority of people might never use.  If someone gets ill and needs to enter into the health care system HIAL (Health Information Access Layer)  the service starts to trigger and generate records.  Even Apple's iCloud could be a service for eHealth events.  Or maybe I have been reading too much of Steve Job's biography (which actually didn't have much about eHealth in it). More in the future...