Decision Support

UC Health – the flagship University of Cincinnati Medical Center, as well as 167 of its affiliated practices – has reached the Stage 7 on the HIMSS Analytics EMR Adoption Model. HIMSS Analytics developed the EMRAM in 2005. Its eight stages (0-7) track a hospital’s implementation and use of health IT applications. In 2011, it launched the ambulatory model, meant to evaluate the progress and impact of EMRs for ambulatory facilities – physician practices, outpatient centers and specialty clinics – owned by hospitals in the HIMSS Analytics Database. Only 4.2 percent of more than 5,400 U.S. hospitals in HIMSS Analytics' database have attained Stage 7; just 7.9 percent of more than 34,000 ambulatory clinics have scored a Stage 7 Ambulatory Award. [Also: Benchmarks: Stage 7 success stories] UC Health, the University of Cincinnati’s affiliated health system is the region’s only academic health system.  It includes University of Cincinnati Medical Center, three additional hospitals, and the University of Cincinnati Physicians, Cincinnati’s largest multi-specialty practice group with more than 700 board-certified clinicians and surgeons. John H. Daniels, global vice president of HIMSS Analytics' healthcare advisory services group, said UC Health "has gone above and beyond the EMRAM Stage 7 criteria. They have already extended the closed-loop medication administration process to their infusion clinic and for interventional radiology cases. Combined with a strong population health program, the UC Health team is making a real difference in their community." "This accomplishment is due to our commitment to improved patient outcomes through the expanded use of information technology," said Jay Brown, UC Health's senior vice president and chief information officer, in a statement. "As the region’s only academic health system, we are surrounded by innovators and visionary leaders who have recognized the importance of leveraging these tools," he added. "The HIMSS Analytics Stage 7 Award highlights our dedication to delivering the highest quality of care and enhancing the experience of our patients."

The Agency for Healthcare Research and Quality will dedicate nearly $2 million for the creation of the PCOR Clinical Decision Support Learning Network, aiming to address the barriers hindering the incorporation of patient-centered outcomes research into CDS tools.

New findings from hospital watchdog the Leapfrog Group shows many hospitals across the country are failing to meet national performance targets for  quality of maternity care. The study comes on the heels of Leapfrog's twice-yearly Hospital Safety Score, which assigns letter grades to hospitals based on their adherence to various safety standards. According to the report, 798 hospitals earned an 'A,' 639 earned a 'B,' 957 earned a 'C,' 1162 earned a 'D' and only 15 earned an 'F,' [See also: Leapfrog out with troubling hospital safety numbers.] When it comes to maternity care, facilities were deficient in a number of different areas, such as the rate of episiotomies. A once-routine incision made in the birth canal during childbirth, it's now recommended only in a very narrow set of cases; Leapfrog's target for all hospitals is to perform the incision in 5 percent or less of all cases. Yet the rates were too high among 68 percent of hospitals. Too many C-sections were also being performed, the data showed. At 60 percent of reporting hospitals, the rates surpassed Leapfrog's target rate of 23.9 percent for all hospitals, and the variation was dramatic -- ranging from as low as 10 percent to as high as 54 percent in one unidentified east coast city. Not all of the findings were dour. Four out of five hospitals meet Leapfrog's target of 5 percent for early elective deliveries, which are medically unnecessary inductions or C-sections performed at 39 weeks. That, the report said, means the facility is taking steps to minimize risks to the mother and child be delivering too soon. [See also: Leapfrog Group: Rate of serious, even fatal, hospital infections still too high.] Additionally, the early elective delivery rate has shrunk dramatically, with the national average at 2.8 percent, compared to the 17 percent reported in 2010. But the study also shows many hospitals don't have adequate experience with high-risk deliveries. Low-weight infants born with complications are more likely to survive if the hospital has an experienced neonatal intensive care unit on-site, yet 78 percent of hospitals performing high-risk deliveries don't meet the Leapfrog standard. "This report underscores the importance of understanding the risks associated with specific delivery choices and of improving the quality of care during birth for the wellbeing of both mothers and their babies," said Kristin Torres Mowat, senior vice president of plan development and data operations at Castlight Health, in a statement.

IBM Watson said it will provide free storage to nonprofit organizations and academic medical center researchers using Apple’s ResearchKit. But developers looking to tap into the supercomputer's analytics will have to pay.

Geisinger Health System has enlisted 100,000 people for its genomic study and did so more quickly than expected. Attracting so many volunteers over two years has prompted program executives to raise the bar to 250,000 or more participants.

Intermountain Healthcare and the Stanford Genome Technology Center will work together on research aimed at developing advances in precision health.

The aim is to save $25 million annually and Health Catalyst’s profits are directly tied to MultiCare meeting that goal.

IBM and the American Cancer Society are putting IBM Watson’s cognitive computing skills to work to advise people with cancer, as well as to counsel caregivers and survivors, officials said on Tuesday. Watson will filter countless health websites to draw insights from relevant, accurate and trustworthy information to enhance ACS resources and guidance targeted for each individual. In what the organizations are calling an advisory role, the supercomputer will use cancer.org’s 14,000 pages of information on more than 70 cancer topics. Watson will also take part in the ACS National Cancer Information Center’s de-identified and aggregated data about self-management, support groups, health and wellness activities, and cancer education. Eventually, ACS and IBM plan to integrate the advisor with IBM’s existing Watson for Oncology offering for doctors, a clinical decision support tool. Sixteen cancer institutes are working with Watson today to help doctors translate DNA insights into personalized treatment options for patients. Researchers from Baylor College of Medicine are using Watson to develop solutions for automated hypothesis generation. At Mayo Clinic, Watson is helping doctors match patients to relevant clinical trials. Once developed, the advisor will anticipate the needs of people with different types of cancers, at different stages of disease and at various points in treatment. It will become increasingly personalized as individuals engage with it, getting “smarter” each time, say IBM executives. ACS and IBM also envision incorporating Watson’s voice recognition and natural language processing technology to enable users to ask questions and receive audible responses. More than 1.6 million Americans are diagnosed with cancer each year, according to ACS. Memorial Sloan Kettering and MD Anderson are also conducting pilot programs to harness Watson’s supercomputing for evidence based treatment options and individualized care for patients with cancer.  Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

The nonprofit patient safety organization found that nearly  40 percent of potentially harmful drug orders weren’t flagged by existing software systems, including medication orders for the wrong condition or the wrong dose based on things like a patient’s size, other illnesses or likely drug interactions. 

Clinical decision support misfires are commonplace but often hard to detect, according to a close examination of CDS systems at Brigham and Women's hospital in Boston published in the most recent Journal of the American Medical Informatics Association.