Infobuttons for 2014

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on January 31, 2014

Infobuttons are context-sensitive links from electronic health records (EHRs) to knowledge resources. They are designed to make it easier for clinicians to find answers to their questions in a timely fashion. I have written about Infobuttons at length on this blog, but having just returned from the January 2014 HL7 working group meeting, I thought it would be worthwhile to post an update on the most recent changes to this standard. Read further >

Hospital Groups Challenge Two-Midnight Rule; Legislators Seek to Delay It

Law and Health Blog
Written by Law and Health Blog
on January 29, 2014

The American Hospital Association, along with regional hospital associations and four hospital systems, have taken the first steps to challenge the two-midnight rule and other Medicare payment changes implemented on October 1, 2013 under the Inpatient Hospital Prospective Payment System (IPPS) update for fiscal year (FY) 2014. In addition, the House of Representatives is considering legislation that would delay implementation of the rule until October 1, 2014. Read further >

Clinical Informatics – A New Subspecialty

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on January 24, 2014

Since 1934, the American Board of Medical Specialties (formerly the Advisory Board for Medical Specialties) has been recognizing medical specialty boards in various disciplines, such as Internal Medicine, Surgery, and Radiology. The complete list of the 24 approved ABMS member boards can be found here. In addition, some member boards offer subspecialty certificates in various areas, such as Geriatric Medicine as a subspecialty of Internal Medicine, or Neuroradiology as a subspecialty of Radiology. The complete list of subspecialty certificates can be found here. Read further >

The Power of Privacy and The Value of Confidentiality

Raymond Blijd
Written by Raymond Blijd
on January 06, 2014

Google’s Vint Cerf, who is recognized as one of “the fathers of the Internet,” stated “Privacy May Be An Anomaly.” Historically, he is right in some context. We used to bathe in the open and wore less and more revealing clothes in the past. Some won’t mind going back to those days but ever since humans acquired the ability to communicate it always had the option to do it in private. Moreover, confidentiality is the corner-stone of several business sectors such as Health, Legal and Finance. So the question is: as a professional, who will you trust? Read further >

Design of Decision Support Interventions

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on August 21, 2013

Medication safety screening, as I have written about at length previously, has the potential to reduce prescribing errors and therefore to improve patient safety. I have also previously described alert fatigue, which occurs when the signal:noise ratio is so low that providers start to ignore the alerts. Design of clinical decision support (CDS) systems is therefore a critical factor in order to optimize the impact of these systems on patient care. Read further >

Health eDecisions Use Case 1 Pilot Wraps Up

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on July 17, 2013

The Health eDecisions (HeD) Use Case 1 pilot program wrapped up this week. This federal (US) initiative is working on identifying, defining and harmonizing standards for shareable clinical decision support (CDS). Please see my previous blog post on this topic for additional background on the initiative. Use Case 1 deals with standards to structure medical knowledge in a shareable and executable format. In particular, it defines a harmonized XML schema for rules, order sets and documentation templates. This schema was piloted over the last few months by a variety of content and electronic health record vendors. For example, Wolters Kluwer participated by providing a clinical documentation template for urinary tract infections in the HeD format, which was then successfully converted to a format that could be used by the Veterans Health Administration (VA). Read further >

Mining for Drug Information

Howard Strasberg MD MS
Written by Howard Strasberg MD MS
on April 08, 2013

In a typical electronic health record (EHR), patient data are entered and stored using some combination of structured data (e.g. diagnosis codes) and free text. In general, analyses of EHR data focus on the structured data portion, which can be leveraged more easily by standard query tools, and which avoids some of the problems with free text, such as ambiguous terms and negation. Still, there’s a lot of useful information buried in the free text portions of these records. If there were some way to mine the free text, gold might well be discovered. Read further >

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