Merging Electronic Health Record Data and Genomics for Cardiovascular Research

Electronic health records (EHRs) have assumed a major role in medical practice in the United States.  EHRs also have the potential to accommodate genetic and genomic data in a manner similar to how they handle clinical laboratory data. Including genomic data with the clinical information in EHRs provides the potential to improve our understanding of the underlying mechanisms of health and disease and to improve the overall care of patients. The announcement of the Precision Medicine Initiative by the US government reaffirms the change in patient care on the horizon. In this report, the American Heart Association summarizes the existing landscape and current hurdles of genomic research in cardiovascular disease in the era of the EHR.

The full AHA science advisory can by viewed below

Blockchain Technology for Healthcare: Facilitating the Transition to Patient-Driven Interoperability

Authors William J. Gorgon and Christian Catalini review blockchain technology as a way to improve patient centered interoperability.  Interoperability in healthcare has traditionally been focused around data exchange between business entities, for example, different hospital systems. However, there has been a recent push towards patient-driven interoperability, in which health data exchange is patient-mediated and patient-driven. Patient-centered interoperability, however, brings with it new challenges and requirements around security and privacy, technology, incentives, and governance that must be addressed for this type of data sharing to succeed at scale. This paper looks at how blockchain technology might facilitate this transition through five mechanisms: (1) digital access rules,(2) data aggregation, (3) data liquidity, (4) patient identity, and (5) data immutability. This review then look at barriers to blockchain-enabled patient-driven interoperability, specifically clinical data transaction volume, privacy and security, patient engagement, and incentives. It concludes by noting that while patient-driving interoperability is an exciting trend in healthcare, given these challenges, it remains to be seen whether blockchain can facilitate the transition from institution-centric to patient-centric data sharing.

The full review can be accessed below.  
 

Mixing Electronic and Non-Electronic Health Records Limits Physician Productivity - The Arizona Experience

This study aimed to estimate the effects of electronic health records (EHRs) on physician productivity in day-to-day practice by including the combinations of EHRs with nonelectronic records that typify current practice. The potential productivity of EHRs is severly limited by the typical practice of combining EHRs withnon-electronic records. Reducing the number of different types of records used in a practice will increase the positive effects of EHRs on productivity. One requirement for such reductions is an increased availability of health information exchanges.

The full study can be viewed below.  

Physicians’ Estimates of Electronic Prescribing’s Impact on Patient Safety and Quality of Care

Electronic prescribing (e-prescribing) is a potentially important intervention that can be used to reduce errors. It provides many potential benefits over handwritten medication prescriptions, including standardization, legibility, audit trails, and decision support. Electronic health record (EHR) and e-prescribing systems may greatly enhance communication and improve the quality and safety of care.  This particular study aimed to better understand physicians' perspectives on e-prescribing in Finland.  Physicians’ perceived usefulness of e-prescribing was significantly associated with patient safety and quality of care. The interoperability of an EHR had a significant effect on both the perceived ease of use and perceived usefulness of e-prescribing. The findings show that experience with an e-prescribing system has a positive effect on participants’ perceived ease of use and perceived usefulness of e-prescribing. This study highlights potential safety and efficiency benefits associated with integrated health information technology in health care. 

The full study can be viewed below.  

Presentation slides by Regina Zimmerman, NYC DOHMH, from eHealth Initiative’s Advisory Council on Data Governance on May 3, 2018.

Presentation slides by Mark Jacobs, Delaware Health Information Network, from eHealth Initiative’s Advisory Council on Data Governance on May 3, 2018.

Presentation slides by Katherine Downing, AHIMA, from eHealth Initiative’s Advisory Council on Data Governance on May 3, 2018.

Presentation slides from Dana Richter, Office of  Senator Shelley Moore Capito​, from eHealth Initiative’s Executive Advisory Board on Privacy and Security on May 1, 2018.

Presentation slides by CRISP at eHealth Initiative’s Executive Advisory Board on Privacy and Security on May 1, 2018.

Presentation slides from Paul Uhrig at eHealth Initiative’s Executive Advisory Board on Privacy and Security on May 1, 2018.