Information Technology

Clerk, Scribe, Transporter, Data Manager… a.k.a. the Doctor

We grab some popcorn on the way in. Maybe a drink. The place is bustling, bright lights lead the way, and the kids grab all the new objects at each turn. Another fun Saturday night about to begin. At Target. Yep, spending the weekend evening strolling the aisles of a big box store: family fun at its finest. It is crowded. We are clearly not the only ones who think a night on the town with the kids translates into a stop and shop for milk and new socks. The excursion does have some highlights – in particular, the self-checkout process. The 9-year-old loves to scan the items, bag them, and use the credit card as though she were paying. These machines are enticing, with the promise of efficiency and a way to avoid any chatty cashier – particularly the ones that announce the items as they are scanned. “Hey…

A New Face For Online Modules

It is hard for me to get excited by online modules. Perhaps my reflex repulsion stems from my experience – ok, experiences – completing online traffic school courses. Those timers forcing you to stay on a page for a specific amount of time. The quizzes that might not actually teach you anything. Maybe you are a more cautious driver than I am, but if so, just think of the last time you had to complete a mandatory online module for your hospital. I doubt it gripped your attention. The future of education may increasingly be online, but I am unconvinced that mandatory online modules are a format that will change the world. This is why I have spent so much time working with innovative teams to develop interactive learning modules that do not feel like online modules. Vinny Arora and I recently described on this blog our Costs of Care…

Is Patient-Centered Care Bad for Resident Education? #JHMChat Explores #meded & #ptexp

The term “patient-centered” has become a healthcare buzzword and was certainly popularized by the creation of the patient-centered medical home in ambulatory care. In the inpatient world, patient-centered rounds symbolizes this effort to improve patient experience and is the subject of a new study in this month’s Journal of Hospital Medicine, which we'll discuss on next Monday's #JHMChat at 9 p.m. EST on Twitter. In a randomized trial, Brad Monash and UCSF colleagues explored the impact of patient-centered rounds on patient experience. Patient-centered rounds was a bundle of 5 evidence-based practices: 1) pre-rounds huddle; 2) bedside rounds; 3) nurse integration; 4) real-time order entry; and 5) whiteboard updates. The control group continued with routine practice of attending rounds. The study was impressive for several reasons, but one in particular caught my attention – an army of 30 pre-med students volunteered to be observers (and also get shadowing experience?) to monitor…

Do Clinicians Understand Quality Metric Data?

The number and complexity of quality metrics within healthcare continues to expand, many of which are used to compare performance between hospitals, systems, and/or clinicians. To make these comparisons fair, many quality reporting agencies attempt to “risk stratify” these metrics, so as not to penalize those caring for higher complexity patients. Although laudable, these attempts also increase the complexity of the data and may reduce the ability of clinicians to understand and analyze quality performance. A recent article in the Journal of Hospital Medicine explores clinicians’ understanding of quality metrics using central line associated bloodstream infections (CLABSIs) as an example. The investigators used a unique Twitter-based survey to explore clinicians’ interpretation of basic concepts in public-reported CLABSI rates and ratios. I recently caught up with the lead author, Dr. Sushant Govindan, to better understand his team’s research and its implications for quality reporting. Dr. Govindan is a Pulmonary-Critical Care fellow…

3 Tips for Bringing Doctors and Data Specialists Together

By: Victoria Valencia, MPH, Assistant Director of Healthcare Value Christopher Moriates, MD, Assistant Dean of Healthcare Value Dell Medical School at The University of Texas at Austin With tele-machines beeping, robots rolling by and so many different people rotating in and out of rooms, the hospital environment can be chaotic. Similarly, the data environment of many of our electronic health records (EHRs) can be quite unruly. EHR systems are not always designed for clinicians to input data in a way that can be researched and used in quality improvement. Just as hospitalists become comfortable working amongst the whir of the wards, data specialists learn how to handle the thicket of data libraries. Report writers and clinicians who request reports often have little to no experience with the workflow and context of the other. It’s no wonder why it often feels like we are speaking different languages and why the reports…
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