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Doctors Are Drowning In Data
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KryptiqCareManager
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KryptiqCareManager,
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4/2/2014 | 6:50:17 PM
Re-focusing attention on the patient
"Within seconds, I knew the medications he was on and had been on." This single line captures the sense of gestalt that physicians seek in preparation to attend to their patient. As the author rightly points out, the lethal combination of misinformation and too much of it has effectively made this "within seconds" gestalt extremely  elusive. Any tool that seeks to aid the physician's preparation for a visit should strive to a) simplify the available information to enable rapid visual assimilation – think red, green and yellow. It should impose no more than 15 seconds of cognitive burden. And b) To only draw attention in the context of what needs to happen; not a wholesale recounting of all available information. This is where leveraging evidence based guidelines can help – subject to the earlier constraint a). These two steps can help make some of the information in the EHRs more useful and the physician more productive. And it is not just the physicians, but the entire care team surrounding the patient that needs access to such information. Ultimately, these tools will need to help amplify the role of the physician by making the patients' care team more successful.
DonK403
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DonK403,
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4/2/2014 | 12:41:25 PM
Drowning in Data
Good article David.  We spend so much time designing EMRs to accumulate every little crumb of data, yet spend little time trying to figure out how to extract that data in a meaningful way.

There is a lof of work with 'Big Data Analytics'

http://healthcareitsystems.com/2013/05/artificial-intelligence-and-healthcare-analytics/

...however this would not help someone in your situation. All of this data noise eats up a tremendous amount of time and actually takes cycles away from treating patients.
dentdavi
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dentdavi,
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4/2/2014 | 10:59:31 AM
Re: Data
You are right. Managing data well and having useful interfaces for dealing with it is something that happens very well in many industries.

Currently healthcare IT consists of a hodgepoge of poorly designed and poorly interconnected products. These products were 'mandated' by threats of decreased reimbursement and penalties. They were not ready to be used in the real world. See my article - http://www.informationweek.com/healthcare/electronic-health-records/ehrs-must-solve-real-problems/d/d-id/1113823?

Believe me we have been working on trying to get better software, but vendor lock in and mandates have created an artificial market for these products that has squelched development. In the meantime we have to manage more data with tools that can't do it. For some reason, healthcare seems to have a shortage of developers who understand the problems well enough to create useful products.
anon6656322472
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anon6656322472,
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4/2/2014 | 7:36:05 AM
Data
Being able to properly filter a Google search is basic computer literacy. 

As for the too much and wrong information with client data, you have bad software.

American health care will eventually come into the the modern era. Until then you would do better to campaign for suitable software, not less information.  
dentdavi
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dentdavi,
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4/1/2014 | 5:49:21 PM
Re: Isn't Everyone Drowning in Data?
Certainly wouldn't want to imply that health care providers are more inundated with data than any other profession. However, one of the unintended consequences of excessive data without filters is missing important information, resulting in medical errors. This is a real problem than hasn't been solved by EHR. I am on the committee that reviews these cases in our hosptial. We have had some significant problems directly related to missed information that was buried in poorly organized EHR's or mis-information from data that was copied and pasted over and over again. This certainly could happen on paper, but happens much better on electronic systems. Finding the important often becomes a treasure hunt, but sometimes you don't even know you are supposed to hunt for a treasure. There is nothing to tip you off that something important hides within. 
anon4146962068
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anon4146962068,
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4/1/2014 | 4:01:26 PM
Isn't Everyone Drowning in Data?
I'm sorry, but I don't feel sorry for doctors "drowning in data".  Every profession is.
madhu_v
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madhu_v,
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4/1/2014 | 3:54:26 PM
Re: Coding System
It is always a tough balance between usability (templates), functionality (ability to provide the necessary info related to the uniqueness of medical diagnosis) especially in a high-traffic area like HCP's office as opposed to say an office-based usage. There is a need for speed but at the same time, accuracy, completeness. There is no easy way to do a UAT and be able to accomplish the mission. The healthcare space is ripe with opportunities to improve and articles like these highligt that need to mature as the entire HC space moves on.  

 

Very interesting and a pragmatic need !!
Elaine Herrmann
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Elaine Herrmann,
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4/1/2014 | 11:58:23 AM
Re: Coding System
Using EHR's poses challenges that stymie medical record abstractors yet hospital reimbursement depends on accurate reporting. Documentation is often duplicative as everyone is diligently documenting, and none of them at the same minute and second, while the auditor drowns in information. No longer is it simply finding "a needle in the haystack". It is how many needles of the same information are there, and which among the needles is the accurate one. If the correct response isn't found, or doesn't exist, compliance is lower ( as are, possibly, Administrator's bonuses). How does a physician manage the care of a patient with a diagnosis of "intracerebral hematuria?"
CHFH
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CHFH,
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4/1/2014 | 10:53:35 AM
Coding System
Natural language is a coding system. Soon we should be able to extract the relevant information for the various stakeholders from a record written in natural language. We should not need to force the doctor to adapt for the machines - the machines should adapt to the doctor.


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