So, I just got back from Wisconsin, hob-nobbing with over 15,000 people at Epic’s UGM 2016 (national user group meeting). We sent a half-dozen folks to present talks on such topics as our Physician Builder governance program where our physician informaticians are trained and given the keys to build sophisticated charting, ordering and reporting tools directly into Epic; our Smart-pump integration to deliver safer IV medications to patients; and this, my participation on the Slicer-Dicer discussion panel.
Slicer is an Epic tool for the average Epic physician user to “surf” the de-identified patient data in a simple self-explanatory way in order to see patterns in the data (in our case, applying to over 5 million unique patients). The tool can make it easier to look for quality improvement opportunities (what percent of my coronary artery disease patients are taking the recommended aspirin dose?), for teaching opportunities (does an increasing BMI correspond to an increasing rate of being diagnosed with diabetes?), for process improvement (which clinics have the highest patient-adoption of our online patient-portal for communication?), and even pre-research, hypothesis generating questions (which blood pressure medications are associated with the highest rate of patients with blood pressures below 140 systolic?). The tool shows bar graphs of de-identified data that can point out surprising trends and lead to more sophisticated projects downstream.
Of course, in case the audience of 250+ wasn’t adequately entertained with our expert panel’s recommendations (Stanford Childrens, Novant, and ourselves at UCHealth), I volunteered to play my uke to illustrate the finer points of our academic arguments…
In the world of ideas, well-written posts speak loudly. I have struggled to put coherent words together, and to post regularly enough to establish a voice. Those of you who have read and commented and “liked”, thank you. Both of you.
However, I have a sister. Michelle (@M_Lin) is an academic Emergency Department physician at UCSF-SF General Hospital, and runs an award-winning, million-follower medical website, called ALiEM (www.aliem.com). At least one colleague has quipped: “Michelle is your SISTER!? Wow, she must be the smart one in your family.”
So be it. Kudos to the smart one. Her most recent article celebrates the brand new partnership between ALiEM, representing the new digital frontier of healthcare, with a well-established brand in medical literature, the Western Journal of Emergency Medicine. Congratulations, sis!
I’m gratified that the public conversation on electronic (and also paper) medical records continues. Its a dry topic, but oh so important. Ms. Sanger-Katz writes about Casey Quinlan (and her QR code!), and the difficulty of assembling a longitudinal health record that becomes more important as we get older. The morass of privacy, mistrust, bureaucracy, swiss-cheese implementation of EHR (electronic health records) with few electronic connections, throw numerous barriers into this journey. Open Notes is just the opening salvo in trying to ease that journey.
Those who succeed in pulling together their medical records to coordinate their care are lucky indeed:
Dr. Tierney worked for years in Indiana to help the state develop a cutting-edge health information exchange, a place where most of the state’s hospitals shared patients’ medical data. After 44 years in the state, he queried the exchange for his records before leaving. He paid $100 for an inch-and-a-half-thick stack of papers.
“I went to my new doctor,” he said. “I put it on the table. And she said, fill out the form.”