Category Archives: Technology

Arizona Statewide Health Information Exchange

The above video is a succinct explanation of the Arizona Statewide Health Information Exchange. The video explains clearly the opt-out clause as well as drawing attention to the interaction between the health information exchange and state and federal laws. In the video it is also reported that 5% of people opt-out (I am presuming that this is in the state of Arizona). The reference to accessing information in emergencies was interesting as well as how the Part 2 data is handled.

Appendix A – Other Posts in the Series on Health Information Exchanges

Health Information Exchanges

HIPPA and Health Information Exchanges

Creating a Health Information Exchange in Arizona

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

 

 

 

 

 

Creating a Health Information Exchange in Alabama

There is an interesting talk by Paul Brannan about setting up a health information exchange (HIE) in Alabama. Paul Brannan is the state health IT coordinator as well as the director of One Health Record®.

Brannan talks about how multiple care providers can link up through One Health Record®. What I found interesting was the opportunity for healthcare providers to become part of a community through the HIE. Barriers were lowered for providers by the utilisation of middleware that simplifies the process of joining.

The benefits that were espoused for patients and providers were also quite interesting. The suggestion that patients might want to seek out providers who have electronic records and were part of a HIE was particularly interesting.

What was particularly fascinating was that Brennan describes how people that were displaced during tornadoes and hurricanes, were at an advantage in terms of being treated elsewhere if their original provider used electronic health records.

The Health Information Exchange is the new healthcare paradigm of the early twenty first century which holds promise for better healthcare delivery in the future.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Health Information Exchanges

The Health information exchange is a term with at least two meanings – one refers to sharing of health data between organisations and the other is the actual structure that allows this sharing. I’ll stick with this definition (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Think of the example where a person visits their GP, has some blood tests and then goes to the specialist. The specialist might not have the results due to this type of information being retained within the primary care organisation. There is a good reason for this. In the UK we have the data protection act (1998), the outcome of the Caldicott review and also professional guidance on patient confidentiality.

Even with all of these complexities, it should be possible for two or more health information systems to exchange information. The process for creating an exchange between two healthcare systems can be costly both in terms of time and other resources. Given that there are multiple healthcare systems, there are a considerable number of interfaces that can be created.

A more elegant solution is to create an independent flexible database of health information that can interact with multiple health information systems. The principles are outlined in the video above by the company GE Healthcare. I should say at this point that any discussion about health information exchanges cannot be separated from the work of private providers. The private sector are leading the development of healthcare information exchanges.

This does mean however that some thought has to be given about how this can be translated across to the UK. This article for instance shows that in America, the discussions about health care exchanges occur in the context of an insurance based healthcare system which is distinct from the UK healthcare system.

From a UK perspective I can see there is much we can learn from the American healthcare system. At the same time, there are subtle and complex differences including drivers for change that mean lessons are not so straightforward.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

 

 

 

Digital Psychiatry

iStock_000005946607Medium

Dr John Docherty has written an interesting piece on ‘Preparing the Field for Transformation: The Practice of Psychiatry in the Digital Age‘. The article is an overview of how digital technology might change the practice of Psychiatry.

Dr Docherty refers to  ‘objective, quantitative, and momentary and continuous assessment’. There have been lots of debates about whether psychiatry assesses ‘objective’ or ‘subjective’ phenomenon and so the concept of providing numerical measures of behaviours has an appeal to the ‘objective’ camp.  However this is in reality more of a metaphysical question. No matter how many different types of rulers you use, the mind is always there and is the essence of what psychiatry deals with. Bringing more measures will be useful, but as always will be just one part of the picture.

‘Momentary and continuous assessment’ are useful concepts. Even in inpatient settings, the data is not continuous recorded but is rather summarised for a period of time. This type of information is invaluable and not likely to be supplanted. Dr Docherty refers to the addition of new types of  data continuously recorded such as movement data and it will be interesting to see how this develops.

Teleconferencing and computerised therapy have developed over many decades and have a practical role in specialised settings. Perhaps this mirrors the wider adoption of these types of technologies as they become more acceptable.

I was interested to hear about technology supporting care-coordination and again it will be interesting to see how this develops.

This is a brief overview of the field but one which helps the reader to take stock of the current situation and to see how management may develop in the future.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.