Innovating through integration with electronic health records: The UCSF Digital Diagnostics and Therapeutics Committee (Preprint)

2019 ◽  
Author(s):  
Andrew Auerbach ◽  
Russell Cucina ◽  
Kelsey Sobomehein ◽  
Priyanka Agarwal ◽  
Aaron Neinstein ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Health Systems ◽  
Digital Health ◽  
Software Tools ◽  
Lessons Learned ◽  
Health Records ◽  
Review Team ◽  
Wide Availability ◽  
Electronic Health ◽  
Therapeutics Committee

UNSTRUCTURED Despite the wide availability of Digital Health Software Tools (DHSTs) and increasing technical ease with which they can be added to Electronic Health Records (EHRs), many hospitals and health systems struggle with how to select, screen, and then implement them in actual practice. Developing a multidisciplinary review team – one we call the ‘Digital Diagnostics and Therapeutics’ Committee at UCSF – represents a key solution to ensuring innovations are vetted and adopted effectively, and allows health systems and providers to evaluate DHST in practice. In this paper, we describe the rationale, early work, and lessons learned from our team’s efforts.

scholarly journals Digital Health and the State of Interoperable Electronic Health Records (Preprint)

2018 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

UNSTRUCTURED Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

scholarly journals Electronic Health Records

2021 ◽  
pp. 74-84
Author(s):  
Eric D. Perakslis ◽  
Martin Stanley
Keyword(s):  
Electronic Health Records ◽  
Digital Health ◽  
Healthcare Spending ◽  
Lessons Learned ◽  
Health Records ◽  
Risks And Benefits ◽  
Clinical Encounters ◽  
Potential Risks ◽  
Electronic Health

A key opportunity for anticipating and understanding the potential risks and benefits of digital health is readily available in the form of electronic health records (EHRs). Touted as a transformation in health care and funded by tens of billions of dollars in federal investment, the outcomes remain mixed. Although the anticipated benefits of increased visibility to healthcare spending and utilization are real, the massive ongoing expense, the time taken away from clinical encounters, and the massive burden on clinicians are all frequently reported unsolved problems. The need to address all stakeholders, to obtain objective measurement, to spend equal time spent examining risks and benefits, and to achieve long-term sustainability are just a few examples of lessons learned from the implementation of EHRs that should be applied to digital health.

scholarly journals Digital Health and the State of Interoperable Electronic Health Records

10.2196/12712 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e12712 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

scholarly journals Clinical Research Informatics: Contributions from 2017

2018 ◽  
Vol 27 (01) ◽  
pp. 177-183 ◽  
Author(s):  
Christel Daniel ◽  
Dipak Kalra ◽  
Keyword(s):  
Electronic Health Records ◽  
Clinical Research ◽  
Association Studies ◽  
Bias Reduction ◽  
Lessons Learned ◽  
Editorial Team ◽  
Private Industry ◽  
Health Records ◽  
Clinical Research Informatics ◽  
Electronic Health

Objectives: To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select best papers published in 2017. Method: A bibliographic search using a combination of MeSH descriptors and free terms on CRI was performed using PubMed, followed by a double-blind review in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the editorial team was organized to finally conclude on the selection of best papers. Results: Among the 741 returned papers published in 2017 in the various areas of CRI, the full review process selected five best papers. The first best paper reports on the implementation of consent management considering patient preferences for the use of de-identified data of electronic health records for research. The second best paper describes an approach using natural language processing to extract symptoms of severe mental illness from clinical text. The authors of the third best paper describe the challenges and lessons learned when leveraging the EHR4CR platform to support patient inclusion in academic studies in the context of an important collaboration between private industry and public health institutions. The fourth best paper describes a method and an interactive tool for case-crossover analyses of electronic medical records for patient safety. The last best paper proposes a new method for bias reduction in association studies using electronic health records data. Conclusions: Research in the CRI field continues to accelerate and to mature, leading to tools and platforms deployed at national or international scales with encouraging results. Beyond securing these new platforms for exploiting large-scale health data, another major challenge is the limitation of biases related to the use of “real-world” data. Controlling these biases is a prerequisite for the development of learning health systems.

scholarly journals Designing Decentralized Ledger Technology for Electronic Health Records

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Vikram Dhillon
Keyword(s):  
Electronic Health Records ◽  
Open Source ◽  
Digital Health ◽  
Health Records ◽  
Distributed Ledger ◽  
Distributed Ledger Technology ◽  
Electronic Health

No abstract available. Editor’s note: A proposal to implement distributed ledger technology for electronic health records is outlined here. The rationale for integration of distributed ledgers in the healthcare domain is introduced, followed by a discussion of the features enabled by the use of a blockchain. An open source implementation of a distributed ledger is then presented. The article concludes with an examination of opportunities and challenges ahead in deploying blockchains for digital health.

scholarly journals Adapting electronic health records-derived phenotypes to claims data: Lessons learned in using limited clinical data for phenotyping

2020 ◽  
Vol 102 ◽  
pp. 103363 ◽  
Author(s):  
Anna Ostropolets ◽  
Christian Reich ◽  
Patrick Ryan ◽  
Ning Shang ◽  
George Hripcsak ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Clinical Data ◽  
Claims Data ◽  
Lessons Learned ◽  
Health Records ◽  
Electronic Health

Biomedical Data Science and Informatics Challenges to Implementing Pharmacogenomics with Electronic Health Records

2020 ◽  
Vol 3 (1) ◽  
pp. 289-314 ◽  
Author(s):  
James M. Hoffman ◽  
Allen J. Flynn ◽  
Justin E. Juskewitch ◽  
Robert R. Freimuth
Keyword(s):  
Electronic Health Records ◽  
Data Science ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Biomedical Data ◽  
Clinical Knowledge ◽  
Health Records ◽  
Knowledge Resources ◽  
Electronic Health ◽  
Clinical Systems

Pharmacogenomic information must be incorporated into electronic health records (EHRs) with clinical decision support in order to fully realize its potential to improve drug therapy. Supported by various clinical knowledge resources, pharmacogenomic workflows have been implemented in several healthcare systems. Little standardization exists across these efforts, however, which limits scalability both within and across clinical sites. Limitations in information standards, knowledge management, and the capabilities of modern EHRs remain challenges for the widespread use of pharmacogenomics in the clinic, but ongoing efforts are addressing these challenges. Although much work remains to use pharmacogenomic information more effectively within clinical systems, the experiences of pioneering sites and lessons learned from those programs may be instructive for other clinical areas beyond genomics. We present a vision of what can be achieved as informatics and data science converge to enable further adoption of pharmacogenomics in the clinic.

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