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Tag: Electronic Health Record

EMR Integration Done Better, Cheaper, & Faster…Again? | Sansoro Health CEO Jeremy Pierotti

By JESSICA DaMASSA, WTF Health

Sansoro Health is a next-gen EHR integration platform for Health IT companies that need a better, cheaper, and faster way to integrate their products into EMR systems. What sets them apart in this crowded space? Listen in to hear co-founder and CEO Jeremy Pierotti paint a picture of perfect-world of interoperability.

Filmed at HIMSS 2019 in Orlando, Florida, February 2019

Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health

An Epic Struggle for the Soul of Medicine

Martin SamuelsThis week I attended an all day “training” session in a new medical record system.  I thought it was interesting that the experience was called “training,” which prompted me to remind myself of a few useful definitions.

Education, from the Latin root meaning a drawing forth, implies not so much the communication of knowledge as the discipline of the intellect; an intra-cerebral process aimed in large part at creating principles upon which new knowledge may be elaborated.  Instruction is that part of education that furnishes the mind with knowledge.  Teaching is often applied to practice as in “teaching a dog to do tricks.”

Training is an element of education in which the chief characteristic is exercise or practice for the purpose of imparting facility, as in “training for the marathon.” Breeding relates to manners and outward conduct as in “standing when elders enter a room is a sign of good breeding.” Regimentation is the prescription of a particular way of life or thinking usually involving the imposition of discipline. The term, arising from military regiment, is related to the medical usage of regimen, as in “the patient keeps his prescription medications in separate compartments of a plastic container in order to accurately adhere to his regimen.”  Propaganda is the systematic propagation of a doctrine, cause or information reflecting the views and interests of those advocating such a doctrine or cause, as in “ACCME is propagating the view that elaborate re-certification maneuvers will improve the lives of patients.”

A cheerful instructor started the session by asking each of us to introduce ourselves and reveal a “secret guilty pleasure.”  Mine is to create elaborate cocktails.  If only I had had one of my famous Marty’s Beerjitos with me the whole experience could have been much more pleasant.  In addition to the instructor, there were several “super-users” in the room to facilitate the process.  It was immediately obvious to me that the super-users hovered behind my chair. These friendly young people had correctly identified me a “super-loser.”  Had I been litigious I would have reported the experience to our ombudsperson as blatant ageism.

But, alas, they were correct.  I was hopeless.  Besides, I don’t believe in ombudspeople.  I believe one should speak for oneself.

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A New Era for our Military Health System

flying cadeuciiThe last day of October was the deadline for proposals in response to the U.S. Department of Defense’s call to overhaul its electronic health record software, also known as the Defense Healthcare Management Systems Modernization (DHMSM). PwC’s proposed solution, called the Defense Operational Readiness Health System (DORHS), seeks to bring innovations from the commercial marketplace to the military health system by using technology that is seamless, proven and reliable.

With team members DSS, Inc., Medsphere Systems Corporation, MedicaSoft and General Dynamics Information Technology, PwC’s goal is to enable every healthcare professional to provide the finest medical care possible to members of the military and their families during every phase of service, through retirement, and assist the Defense Health Agency in its continued business transformation to help implement and manage effectively the world’s largest healthcare delivery system.

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An Open Note to Open Notes Objectors

Screen Shot 2014-07-20 at 5.59.22 PMThere is a growing group of articulate and engaged patients committed to getting access to all their medical information in order to be better positioned to work collaboratively with their clinical teams. Published studies like the OpenNotes project have consistently shown significant benefits and a lack of serious problems. Health care systems are slow to change and just beginning to understand both the need and value to this more transparent and collaborative approach.

My institution, for example, is not ready (or even interested) in anything approaching opening chart notes to patients. In fact, although our secure portal will be launched in the near future, there was some resistance to making even problem lists, medication lists, lab and x-rays available through the portal.

That need not prevent individuals from contributing to change. A few years ago I began providing every patient with a copy of their office visit note as they left the office after their visit. The intent was for us to do the assessment and plan collaboratively and make sure they have a copy of our (collaborative) plan.  Patients have been very appreciative, and use it to share the assessment and plan with family and consultants, and as a reference. A few bring it back at the next visit with notes on it about what they did and what happened.

To the objectors who say that one cannot be honest in a note if the patient is going to see it, I say: balderdash. (Actually, what I say is much stronger…)  For one thing (the smaller point) the patient is already allowed to see it if they but ask.  More importantly, this argument depends entirely on the principle that the clinician knows best and needs to keep secrets in the interest of the patient. What I have experienced is a variation on the advice I got many years ago regarding relationships: if it’s important, then it’s important enough to be open about and deal with. If you aren’t willing to deal with it openly, you are not allowed to save it up and spring it on your partner (patient) later.

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Why Getting to a Digital Health Care System Is Going to Be Harder Than We Thought Ten Years Ago

A leading scientist once claimed that, with the relevant data and a large enough computer, he could “compute the organism” – meaning completely describe its anatomy, physiology, and behavior. Another legendary researcher asserted that, following capture of the relevant data, “we will know what it is to be human.” The breathless excitement of Sydney Brenner and Walter Gilbert —voiced more than a decade ago and captured by the skeptical Harvard geneticist Richard Lewontin [1]– was sparked by the sequencing of the human genome. Its echoes can be heard in the bold promises made for digital health today.

The human genome project, while an extraordinary technological accomplishment, has not translated easily into improved medicine nor unleashed a torrent of new cures. Perhaps the most successful “genomics” company, Millennium Pharmaceuticals, achieved lasting success not by virtue of the molecular cures they organically discovered, but by the more traditional pipeline they shrewdly acquired (notably via the purchase of LeukoSite, which ultimately yielded Campath and Velcade).

The enduring lesson of the genomics frenzy was succinctly captured by Brown and Goldstein, when they observed, “a gene sequence is not a drug.”

Flash forward to today: technologists, investors, providers, and policy makers all exalt the potential of digital health [2]. Like genomics, the big idea – or leap of faith — is that through the more complete collection and analysis of data, we’ll be able to essentially “compute” healthcare – to the point, some envision, where computers will become the care providers, and doctors will at best be customer service personnel, like the attendants at PepBoys, interfacing with libraries of software driven algorithms.

A measure of humility is in order. Just as a gene sequence is not a drug, information is not a cure. Getting there will take patience, persistence, money and aligned interests. The most successful innovators in digital health will see the promise of the technology, but also accept, embrace, and ideally leverage the ambiguity of disease, the variability of patients, and the complexities of clinical care.
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