Why we get sick: Darwinian Medicine

Randolph Nesse talks to Richard Dawkins about ‘Darwinian Medicine’:

Health Informatics Conferences

We’ve been compiling details of upcoming Health Informatics conferences and events on the Health Informatics Discussion Forum:

http://www.healthinformaticsforum.com/events

So far we have:

Health IT Conclave 2009

HIMSS AsiaPac09

Adopting Integrated R&D Informatics Systems

UC Davis 3rd Annual Health Informatics Conference “Innovations in Informatics

HIMSS MiddleEast09

IADIS International Conference e-Health 2009

MedInfo 2010

If you want to add a conference, just register (for free) on the site and post up the details of your conference:

http://www.healthinformaticsforum.com/events

Clinical Information Technologies and Inpatient Outcomes: A Multiple Hospital Study

Interesting article in the Archives of Internal Medicine that concludes: “Hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs.”

Background  Despite speculation that clinical information technologies will improve clinical and financial outcomes, few studies have examined this relationship in a large number of hospitals.

Methods  We conducted a cross-sectional study of urban hospitals in Texas using the Clinical Information Technology Assessment Tool, which measures a hospital’s level of automation based on physician interactions with the information system. After adjustment for potential confounders, we examined whether greater automation of hospital information was associated with reduced rates of inpatient mortality, complications, costs, and length of stay for 167 233 patients older than 50 years admitted to responding hospitals between December 1, 2005, and May 30, 2006.

Results  We received a sufficient number of responses from 41 of 72 hospitals (58%). For all medical conditions studied, a 10-point increase in the automation of notes and records was associated with a 15% decrease in the adjusted odds of fatal hospitalizations (0.85; 95% confidence interval, 0.74-0.97). Higher scores in order entry were associated with 9% and 55% decreases in the adjusted odds of death for myocardial infarction and coronary artery bypass graft procedures, respectively. For all causes of hospitalization, higher scores in decision support were associated with a 16% decrease in the adjusted odds of complications (0.84; 95% confidence interval, 0.79-0.90). Higher scores on test results, order entry, and decision support were associated with lower costs for all hospital admissions (–$110, –$132, and –$538, respectively; P < .05).

Conclusion  Hospitals with automated notes and records, order entry, and clinical decision support had fewer complications, lower mortality rates, and lower costs.

Read the article online

US Health and Human Services Secretary Recognises Health IT Standards

From http://hitsp.wikispaces.com/

On Wednesday, the HHS Secretary has recognized the second set of Interoperability Specifications developed by HITSP, specifically Emergency Responder Electronic Health Record, Consumer Empowerment and Quality. The federal register notice announcing this is located at http://edocket.access.gpo.gov/2009/pdf/E9-1068.pdf

Details of US Health IT Stimulus Package

John Glaser, VP and CIO at Partners HealthCare System has posted up some details on HIStalk on the $20 bn Health IT portion of the US Stimulus Package:

  • Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR
  • Creation of HIT Extension Programs that would facilitate regional adoption efforts
  • Provision of funds to states to coordinate and promote interoperable EHRs
  • Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals
  • Creation of HIT grant and loan programs
  • Acceleration of the construction of the National Health Information Network (NHIN)

The details are from page 138 onwards of the House Ways and Means bill (PDF).

Telemedicine in Australia

Article on Telemedicine in Australia in ‘The Australian’:

THOUSANDS of patients from rural areas could be spared the expense and hassle of travelling to a major city to see a specialist if health systems made more effort to make good use of communications technologies.

Various systems — collectively known as “telemedicine”, in which patients consult doctors remotely using systems such as real-time video links — are already available for such long-distance consultations.

But experts from a Queensland centre that has been pioneering the use of telemedicine have warned uptake of the technology to date has been marred by poor planning and a greater interest in buying hardware than in teaching staff how to use it, or making it easy for them to do so.