How I helped researchers show that rectal exams aren't always necessary

This week I experienced perhaps the culmination of my life's nerdiness.

It started last year when I helped one of my company's clients, University of Colorado Hospital, collect some data for a clinical study. At the time, I wasn't fully aware of the scope or even the hypothesis of the study. I only knew it involved something to do with getting information pertaining to feces out of our system. Literally pulling, well, you know what, out of the system, if you will.

Drs. Cleveland and Yaron were great to work with throughout the process. (I did not work with the third co-author, Dr. Ginde.) They recently published their paper in the Annals of Emergency Medicine.

The reason this is duly notable is because of the conclusion of the results findings:
Removal of point-of-care fecal occult blood test from our ED was associated with a reduction in digital rectal examinations -Actual Research Finding

Or, translated into laymen terms:
Doctors don't have to stick their fingers up as many you-know-whats because they found something else that works good -Me

So yes, I was the nerd that wrote a Perl script and a bunch of SQL queries that provided them the data to demonstrate that. Thanks, technology!

HIMSS on Usability

This paper by HIMSS sums up the obvious, but it’s great reading it as written by such an authoritative organization.

Some choice quotes from the first two pages:

  • A key reason, aside from initial costs and lost productivity during EMR implementation, is lack of efficiency and usability of EMRs currently available.
  • Achieving the healthcare reform goals of broad EMR adoption and “meaningful use” will require that efficiency and usability be effectively addressed at a fundamental level.
  • Usability is often mistakenly equated with user satisfaction, which is an oversimplification.
  • We submit that usability is one of the major factors—possibly the most important factor—hindering widespread adoption of EMRs.
  • Effective training and implementation methods affect user adoption rates as well, but training is both harder and more costly, and implementation is more complex and difficult when usability is lacking.

Originally downloaded from himss.org at:

http://www.himss.org/content/files/HIMSS_DefiningandTestingEMRUsability.pdf

(2016 Upate: Unfortunately that link no longer works, and I don't have a copy saved anywhere.)

Set It and Forget It

Update 2016: I'm flabbergasted at how long-winded my writing was just 8 years ago...

Lately, I've been using a few web service-based tools to automate my life. This has been done out of pure necessity due to the sheer volume of everything going on in my life at the moment. Between my day job as a technical analyst, being a grad student, getting enough work under my belt to establish myself as a professional web developer, and meanwhile working on developing a side project, quite frankly, I have little spare time. In order to maximize what time I do have, I need to keep everything else in lock-step order.

While these are tools that I use to organize my personal and professional lives, it makes me wonder why more tools similar to these are not available for medical professionals. I suspect the problem is the usual culprit: the traditional enterprise software business model. I live for the day when we see the demise of the model of selling software to corporate IT departments and charging absorbent implementation and maintenance fees. Such sales require manipulation of all levels of an organization from almost all departments within that organization. Why not sell the software straight to the user?

Smart Devices: Science Fiction or Reality

I've always been baffled at the level of integration found between medical devices and healthcare information systems when concerning the way humans interact with the two. Exceptional integration exists to connect medical devices to healthcare information systems, especially in the critical care arena. Likewise, equally exceptional analysis tools exist to analyze data collected into systems. However, the very existence of these solutions seems to only the scrape the surface. I tend to believe many would agree that further integration is paramount, and even expected on a much larger scale. 

In practice the execution of such integration often leaves much to be desired when 21st century technology is considered. Interfaces between devices and systems are typically designed only to take value X from system A and place it in field Y of system B. Beyond that, little else occurs from an integration perspective unless expressly required for the solution to complete a specific clinical task. What could be done to further integrate a solution?

Google Health: Succeeding Where Traditional HCIT Systems Have Not

Google will present its healthcare platform, Google Health, to the public during a webinar to be held this coming Wednesday, December 10. The webinar will begin at 10am PST and is open to the public (register here).

Google Health offers a fully-featured web-based solution for organizing your healthcare information. Having spent some time using Microsoft's competing HealthVault service a few months ago, I can say without blinking that Google, to be frank, has nailed it.