As part of an effort to build the medical school of the future, the nation’s leading medical association has launched a new platform designed to train medical students to use EHRs.
The American Medical Association announced the new training platform, which was built by the Regenstrief Institute and the Indiana University School of Medicine with the help of a $1 million grant from the AMA, on Wednesday. The Regenstrief EHR Clinical Learning Platform incorporates deidentified data from Eskenazi Health and will be used at Indiana University, the University of Connecticut School of Medicine and the Southern Indiana University School of Nursing.
Students can use the web-based training module to virtually care for patients by using EHRs to submit orders and review patient records—something most medical students are unfamiliar with when they enter their residency.
“Our medical schools are very good at preparing students for the basic and clinical sciences that are essential to providing patient care,” AMA Vice President for Medical Education Susan Skochelak, M.D., said in the release. “However, many residents and young physicians are coming out of medical school with gaps in their ability to practice in the modern health system. Too often, students enter residency training without the ability to effectively and efficiently work with EHRs, even though they are one of the primary tools physicians use in everyday practice.”
At UConn, students will focus on two distinct uses of EHRs, according to AMA Wire. The first uses electronic systems to understand social, cultural and mental health issues. The second instructs students on how to use data to inform population health decisions.
The training resource comes nearly two years after the AMA adopted a policy encouraging medical schools to incorporate EHR training. Medical schools like the University of California, San Francisco, have since embraced a 21st century curriculum.
OxyContin is widely considered the epicenter of, or at least the drug that started, the country’s ongoing opioid crisis.
Now the drug’s manufacturer, Purdue Pharma, is partnering with Geisinger Health System to study a new approach to drug treatment that allows patients with chronic pain to transmit information to their physician through an iPhone or Apple Watch.
According to Buzzfeed News, Purdue will use Apple’s ResearchKit to test a digital approach to pain management on 200 patients at Geisinger. Data is recorded through an app and fed into a patient’s EHR, allowing physicians to modify pain medication prescriptions or identify alternative pain management techniques based on a stream of real-time information.
Researchers at Purdue and Geisinger hope that wearables and smartphones will help doctors better understand patients’ real-time experiences, prescribe them painkillers only as needed, and cut health care costs. While some public health experts say the study potentially has merit, they acknowledge that Purdue’s involvement can, at the very least, look awkward.
“I’m just very suspicious that they’re interested in developing a tool that will help people get off of their medicines,” Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, told Buzzfeed News. “When I hear about this, I wonder if it’s all an effort by Purdue to get good [public relations].”
Purdue executives, however, say their new ResearchKit study is one of several efforts the company has made to stem opioid abuse. They co-sponsored a prescription-monitoring program in Virginia, so prescribers can see and make decisions based on patients’ medication history, granted $1 million to the National Association Boards of Pharmacy to promote prescription-monitoring nationwide, and they’re reportedly working on non-opioid pain treatments and have distributed the CDC’s new opioid-prescribing guidelines to medical professionals.
Alexandra Wilson Pecci
Joann Elmore, MD, MPH, professor of medicine at the University of Washington School of Medicine, is a slow typist. So slow that one of her patients grabbed the keyboard away from her while she was entering the patient's information into the electronic health record.
"Come on doc, let me type," the patient said. She and asked her Elmore what she should write. Elmore told her she should decide. It was about her, after all.
That simple idea of letting a patient contribute to the medical record in their own words is the central focus of a new study published in the Annals of Family Medicine.
Elmore is the study's lead author and research director for OpenNotes, a national movement that for more than four decades has encouraged physicians to share medical records with their patients.
In what they say is the first OpenNotes study of cogeneration of clinic notes, Elmore and her team of researchers wanted to understand the effects of having patients generate a portion of their own medical records.
They found that letting 101 patients type in pre-visit agendas before a doctor's appointment improved self-reported communication and efficiency.
The patients, all of Harborview Medical Center Adult Medicine Clinic in Seattle, WA, a safety-net facility, contributed to their notes and participated in a post-visit survey.
From June 9 and July 22, 2015, patients were either recruited via telephone the night before their appointments and asked to arrive 30 minutes early, or were approached by a receptionist if they arrived early enough.
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Hundreds of years ago, a Polish astronomer sparked a scientific revolution with one simple observation: The sun—not the earth—was the center of the universe.
A similar revolution is happening in healthcare, where the industry is shifting the center of its universe from the physician to the patient, and some say digital innovation will be the driving force behind that monumental transformation.
Making that transition to patient-centered care requires systematic changes, a group of physicians and researchers wrote in an op-ed for MedCity News. The industry must “redesign its core processes,” and in order to do that, hospital systems need to embrace digital technology that gives patients more access to their health information and easy access to clinicians.
The authors note that some healthcare leaders, like Mayo Clinic CEO John Noseworthy, M.D., have embraced this challenge, but many are still resisting the digital revolution. Soon, those organizations may feel the market pressure from outsiders looking to force that paradigm shift.
“With the writing on the wall, it’s time for those in the healthcare industry to follow the Mayo Clinic’s lead and ask: What is our digital transformation strategy?” the authors wrote. “Healthcare is the largest private-sector industry—accounting for 13% of the total United States workforce and 18% of the Gross Domestic Product, and if it doesn’t transform itself soon, Silicon Valley is waiting to enter the market and bring a new, more customer-friendly experience.”
Those that have advocated for integrating digital tools in an effort to give more control to patients have said hospitals are uniquely positioned to facilitate a technological revolution. Others have pushed for a broader focus on patient engagement to successfully integrate mhealth tools.