Category Archives: bReviews

2014 Report finds the U.S. ranks last among 11 countries for Health Care Quality

Posted on by
Reply

The Commonwealth Fund (TCF), a private foundation headquarted in New York City and started by a woman philanthropist Anna M. Harkness and established in 1918, aims to promote (TCF 2014) “a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults.”

The TCF produces more than 100 publications a year. In its 2014 edition of Mirror, Mirror, a study entitled “Mirror, Mirror on the Wall” reports data analysed from 11 western, industrialised nations which incorporates patients’ and physicians’ survey results on care experiences and ratings on various dimensions of care. Researchers had analysed in each of those countries that related to five overall performance areas relating to Health, Quality, Efficiency, Access,and Equity.

Once again, even in the 2014 “Mirror, Mirror on the Wall” report, the U.S. health care system has shown that it underperformed relative to the other 11 countries surveyed, and ranked last among them despite the U.S. spending far more on health care per capita and been the most expensive in the world.

The chart below shows how the overall rankings (click on the image to open a new tab of your current browser window to view a larger image).

How the U.S. Health Care System Compares Internationally 2014

Image credit : The Commonwealth Fund

Combing through the report, I found the following references to health information systems:

  1. timely information not reaching doctors, thus affecting health outcomes, quality, and efficiency;
  2. adoption of modern health information systems and meaningful use of health information technology systems can encourage the efficient organisation and delivery of health care; and
  3. medical records or administrative data capture important dimensions of effectiveness or efficiency, thus in any attempt to assess the relative performance of countries, medical records or administrative data captured must be included to minimise inherent limitations in similar studies when only patients’ and physicians’ assessments are used, since patients’ and physicians’ experiences and expectations which could differ by country and culture, and thus could affect findings from such studies.

References:

  1. The Commonwealth Fund (TCF) 2014, About Us, viewed 18 June 2014, <http://www.commonwealthfund.org/about-us>
  2. The Commonwealth Fund (TCF) 2014, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, viewed 18 June 2014, <http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror?utm_source=twitter&utm_medium=social&utm_campaign=>
Page-&-Post-footer

 

Understanding reasons for making a request to change the medical record

Posted on by
Reply

It is rare to find any research topic ever published on why requests are made by patients who want to make changes to their medical record. I found one recently, and here to share with you what researchers discovered as the main reasons for making a request to change the medical record, and what types of information they wanted changed, and whether they result in modifications to the medical record.

In their qualitative research, the researchers studied content analysis of all patient-initiated amendment requests, an ‘amendment request’ defined as the process by which patients ask for changes to be made to their records, received over a 7-year period.

Readers can now view the infographic below (click on the infographic to view a larger image in a new tab of your current window) which shows a summary of all relevant findings from this research.

Medical-Records-Amendment-Requests-Study

Also from this study, I deduced that when patients were given the opportunity to further participate in their care by allowing them to review their medical record, their medical record accuracy could lead to improvement after the identification and correction of errors or omissions.

I agree with the authors that doctors can make mistakes in the medical record, and that it is necessary to correct these mistakes at some point This is especially true when a patient discovers any mistake or omission upon reviewing his or her own medical record. However, it is uncommon when a patient will not want any information there anyway but such requests must be expected.

An ‘amendment request’ is a rare request as most patients, in the developing and under-developed world and even perhaps in the developed countries are unaware of the basic right to review their own medical record and the absence of any policy to grant patients the right to make an ‘amendment request’.

References:

  1. David A Hanauer, Rebecca Preib, Kai Zheng, Sung W Choi 2014, Patient-initiated electronic health record amendment requests, J Am Med Inform Assoc amiajnl-2013-002574 Published Online First: 26 May 2014 doi:10.1136/amiajnl-2013-002574, viewed 1 June 2014, <http://medicalresearch.com/author-interviews/electronic-medical-records-study-examines-patient-initiated-amendment-requests/5721/>
Page-&-Post-footer

Five Reasons Why Electronic Medical Records Are Good For Patients

Posted on by
Reply

Investment in developing a good Electronic Medical Record (EMR) system to provide value to patients by driving up safety, quality, operational excellence, transparency and access can be seen as shown by the example at Cleveland Clinic Abu Dhabi, a carefully designed EMR system modelled after the famous EMR model at Cleveland Clinic, Ohio, United States – a long time leader in EMR systems.

The infographic below (click on the image to open in a new tab of your current window to view a larger image) shows a summary of five (5) good reasons why EMRs are good for patients as from the example at Cleveland Clinic Abu Dhabi.

Reasons-Why-Electronic-Medical-Records-Are-Good-For-Patients

References:

  1. Five Reasons Why Electronic Medical Records Are Good For Patients, Marc, H 2013, LinkedIn, viewed 15 July 2013, <http://www.linkedin.com/influencers/20130715101824-13527628-five-reasons-why-electronic-medical-records-are-good-for-patients>

Healthcare Big Data – Part 2a

Posted on by
Reply

Big Data 3Vs cardboard-box-iconIn the post Healthcare Big Data – Part 2 (this link will open in a new tab of your current browser window), I wrote that no matter the size of Healthcare Big Data, a known fact of the current state of healthcare industry worldwide which is in general afflicted with poorly coordinated care, fraud and abuse and administrative and clinical efficiency, the goal is ultimately to improve patient care and reduce costs.

In this post I like to share with you this infographic below (click on the image of the infographic below to view a larger image which will first open  in a new tab of your current browser window, click again on the image in this new tab which will then show you a full view of the infographic in the same tab) which I think rightly supplements what I wrote in the post mentioned above.

This infographic visualises the worldwide trend to digitize healthcare patient information from paper-based medical records to Electronic Medical Records. This trend continues to gather increasing momentum to produce infinite volumes of Big Data, an estimated 50 pentabytes of data in the healthcare realm. This influx of Big Data will create more jobs to handle all these data, especially new jobs that demand new talent in analytics,

This infographic also visualises the bulk of the internal source of Healthcare Big Data as originated by medical providers and ancillary services providers during the course of providing their services. More Big Data is accumulated when these internal data source is in turn used for insurance claims and payments, to a greater extent In advanced economies and lesser in less advanced economies. The technology vendors provide the technology interface for the internal source of Healthcare Big Data.

Then there is the external and public as well as private storage of Healthcare Big Data. Public Health agencies also generate Healthcare Big Data mandated by legislation and regulations e.g. immunisation and cancers data, and store them in data repositories. Third-party organisations also generate Healthcare Big Data when they coordinate between healthcare providers. Private data are also stored in remotely stored and web-based repositories when some consumers maintain personal (private) health records online.

From this infographic, patient care is improved when streaming data is used to decrease patient mortality as these data moves in healthcare. However the bigger challenge is to harness the 80% of all the unstructured data of patient information in Healthcare Big Data.

When it comes to healthcare Big Data is a Big Deal

Infographic credit: healthcareitconnect.com/

I shall discuss the ways of Big Data which will transform healthcare, in the near future with cost savings, quality of care, and care coordination after I have blogged about Big Data solutions in a future post.

Healthcare Big Data – Part 2

Posted on by
Reply

Big Data 3Vs cardboard-box-iconIn this second instalment of Healthcare Big Data, let’s look at the multiple sources of data that are responsible for Healthcare Big Data.

The internal data found in existing paper-based medical records is one large source of Healthcare Big Data.

With more and more hospitals in the health care industry around the world turning to creating digital representations of existing data in paper-based medical records and acquiring everything that is new in the form of Electronic Medical Records, there is an infinite data growth rate in this internal data source.

Then there is also Big Data from other sources, those from external, private, and public sources.

The discovery process, both oral and written discovery initiated by the legal profession outside the healthcare industry which adds terabytes or even petabytes of information is one source of external Healthcare Big Data, when individual doctors, hospitals, and medical practice groups become defendants in malpractice lawsuits.

No matter the size of Healthcare Big Data, a known fact in healthcare is to improve patient care and reduce costs.

Thus to improve patient care and reduce costs through Healthcare Big Data, one of the biggest challenges for most healthcare organisations is to mine the data or dig for something of value from these multiple sources of data. Healthcare organisations must find i.e locate the appropriate data, identify useful data i.e determine whether the data set is appropriate for use,  and aggregate all of the Big Data from the multiple sources and push through an analytics platform as part of their analytics processes.

Since I am running a blog for the general benefit of Health Information Management (HIM) / Medical Records (MR) practitioners, I shall not be diving deeper into big data sources, to avoid driving readers into the IT realm nor writing on the business analytics (BA) and business intelligence (BI) processes to determine how large-scale data sets can be used. I must say that all the posts on Big Data I have published on this website-blog , including this one is to facilitate HIM / MR practitioners to have a rudimentary understanding of Big Data.

Now that HIM / MR practitioner readers  know that Big Data is out there, Frank (2013) states that “analytics is part science, part investigative work, and part assumption.” The idea is to capture as much as data the healthcare organisation deals with, so all of any data are located, included and gathered from as many data sources as possible so that the more data there will be to work with and bring all of these data into an analytics platform.

While the healthcare organisation locates, includes and gathers from as many data sources, healthcare organisations will find a vast wealth of external public information. This external data makes up the public portion of Big Data. This includes customer sentiments from research companies and social networking sites e.g Twitter, Facebook to geopolitical issues e.g. weather information and traffic pattern information, from government entities, e.g census data, and a multitude of other sources.

In the next instalment, I shall gather more information on how the multitude of sources of Healthcare Big Data must be integrated and managed to set priorities so that Big Data solutions could analyse and get the results into the right hands to improve patient care and reduce costs.

Resources:

  1. Frank JO 2013, Big Data Analytics: Turning Big Data into Big Money, Wiley and SAS Business Series, John Wiley & Sons, Inc, New Jersey, USA