Cloud Computing

Practice Fusion EHR gets allergy alerts

I am a fan of web-based healthcare applications, including EHRs. I especially like the web-based EHR available from Practice Fusion. The application is full featured, easy to use and free. I spent a little time playing with it back in June 2010. One of the things I noted during my review was that “there appears to be no cross checking between allergies and newly entered medications.” As a pharmacist this was pretty important. Well, I’m happy to say that allergy checking no longer appears to be an issue.

EHR Bloggers: “We’re excited to bring you a major new feature for your EHR account today: drug-drug and drug-allergy interaction alerts. It’s a frequently requested enhancement and also a big step towards Meaningful Use. And, like all our features, this clinical decision support system (CDSS) is entirely free.

Drug Interaction Alerts
You will now be automatically alerted when a drug you are adding, prescribing or refilling interacts with another drug or with an allergy listed in the patient’s chart. The following video shows you how to set permissions, heed alerts and override alerts. “

The cloud still slow to gain acceptance in healthcare

There’s an interesting article at InformationWeek about healthcare and the cloud. The article talks a little bit about the concerns surrounding security in the cloud and what I believe is an undeserved fear of using cloud based services and storage for healthcare information.

In the article a pediatrician that is also director of clinical informatics for Atrius Health is quoted as saying “At the moment I’m not convinced that there’s a secure enough place in the cloud or that the functionality exists for us to do everything that we need to do in the cloud. The cloud allows for a tremendous amount of interconnectivity between computers because it’s using data storage that’s free amongst different networks and I wouldn’t want healthcare information being scattered in a way that I couldn’t protect it appropriately.” I’m not sure I understand the perceived insecurity of the cloud as the existing infrastructure for storing patient information in healthcare is, by design, insecure.

Speaking of healthcare data, is Microsoft the elephant in the room?

In a previous blog I discussed the need for a uniformed data structure in healthcare. The concept got me thinking about how to accomplish such a monumental task, and make no mistake, it would be a monumental task. There aren't many "people" out there that could develop the hardware and software infrastructure solid enough to handle the needs of the complex data stream coming out of the healthcare industry. Then I noticed a trend at a lot of the web sites that I frequent: Microsoft has slowly, and quietly, been positioning itself to jump into the healthcare market.

Consider the following:

What we need is a system-neutral data structure for healthcare

During a web browsing session the other day I came across a very interesting blog post by Louis Gray titled “The Future: Operating System And Application-Neutral Data”. I enjoy reading Louis’ posts because I think he has a great vision for the future of personal computing, data, and “the cloud”

The blog speaks specifically to the ownership of personal data versus allowing companies to sit on it and possibly hold it hostage secondary to a lack of compatibility with other systems. The information you throw onto the internet defines who and what you are, more now than ever before, and you need to be able to move it around anytime from anywhere.

Louis calls for people to host their own data in a standardized format instead of having data stored by one service provider or another. He goes on to say:

"If I chose to log in with GMail one day, I would authenticate who I was, and GMail would pull down my e-mail stream, complete with e-mail activity history (such as replies and forwards). The data would not be stored on GMail, but instead be more like a read-only process, whereby changes to data, including sent items, would not be stored in GMail, but written back to my personal "cloud", if you will.

Time for a new model of data storage and software distribution in pharmacy

There was a time when I thought all a pharmacist needed to do his job was a pen and a calculator. It was just so cumbersome to carry anything else. If you wanted to have mobile drug information it meant carrying a drug reference book with you everywhere. Who can forget being in pharmacy school where every self respecting pharmacy student had a Drug Information Handbook stuffed in their lab coat pocket along with all the other stuff they carried like a homemade peripheral brain scribbled on the pages of a notebook or on those neat little 3x5 cards.

Looking for patient information wasn’t any less cumbersome. If you needed to read a patient’s history and physical, you went to the chart. If you wanted to look at lab results you had to wait for the lab, or the unit secretary, to print them out and attach them to the chart. If you wanted to see what time a medication was administered, you had to look in the medication administration record, i.e. the MAR. Data was scattered all over the place. Of course, no one thought it a problem because that was the most advanced system available at the time.
Healthcare technology has come a long way, and as pharmacists most of the information we need is much easier to find. Yet here we are still trying to figure out a way to create a unified patient health record that can be used by healthcare professionals not only across the street, but across the continent or world.

SaaS and speech recognition for EHRs

CMIO: “In the past, major barriers to EHR adoption included high upfront costs and lack of IT resources to implement and maintain the technology,” the report stated. “A SaaS model solves both of these issues and Ovum believes it is the best approach for physician offices and small hospitals. With a predictable, monthly expense, a subscription-based SaaS EHR is a much easier cost for providers to swallow." Speech recognition tools have helped increase EHR adoption among clinicians by increasing the accuracy of the patient health record—providers don’t need to make as many corrections. Speech recognition should feed directly into the PHR without the lag time of transcription, according to the report.” – It makes sense that Software-as-a-Service (SaaS) and speech recognition could be used to increase EHR adoption rates. Together they offer several potential benefits as well as creating a better user experience. In fact, I'm a fan of both and have blogged about how I think they could be used in pharmacy; here and here. However, in regards to speech recognition, an educational session at the 95th Annual Meeting of the Radiological Society of North America (RSNA) reports that “a study by Zoltani and colleagues conducted at their facility found that 68 percent of more than 17,000 finalized reports contained errors, 15 percent of which could potentially change the meaning of the report. A radiologist's experience, sex and caseload were not associated with significant differences in error rates.”

SaaS and pharmacy

Software as a service (SaaS) has recently been popping up in healthcare related news, from Fujitsu's SaaS solution for drug trials to the host of web-based applications from Pharmacy OnceSource.

SaaS is different than the traditional enterprise software model because the provider of the software licenses it to the customer as an on-demand service. The vendor often times hosts the software on their own servers where data is manipulated and returned to the customer for viewing. It's kind of like renting software.

The beauty of SaaS applications like those from Pharmacy OneSource are that they can be viewed from any device with a web-enabled browser; Mac, PC, smartphone, etc. In addition, the application is owned, delivered, maintained and managed by the provider, limiting the burden on the customer. A by-product of this model is that delivery of the application over the web ensures that the software is always up to date.

The SaaS model appears to be popular in the “business” world at present, but is increasing in popularity in healthcare secondary to its simplified deployment and reduced cost. With advances in cloud computing strategy, better data storage models and faster internet connections I think it's only a matter of time before we start to see more SaaS solutions in pharmacy practice. And why shouldn't we? By their very nature SaaS applications lend themselves to use on mobile devices like the tablet PC and iPad, which in turn offers greater flexibility for pharmacists practicing at the bedside. Just a thought.

Syndicate content