Existence is reasonable: EMR based on cloud computing

The remote host clinical program based on cloud computing technology has shown a strong momentum in the medical it field because of its potential to reduce operating costs and stimulate medical improvement. But is the technology really ripe?

If the Texas Fort Worth company initially launched the EMR System, MD (M.D.), MPH (Master of Public Health) and Cmio (Chief medical Information Officer) of the Cook Children's medical system were also present, and he would certainly criticize the EMR scheme based on cloud planning. , accusing it of being "very laughable". The choice of a cloud-based EMR and the hiring of Shuman as a system of Cmio two decisions took place in 2009, before the Shuman.

Simplicity is an advantage

As early as February 2010, when the new cloud-based system of the Cook Children's medical system came to market, it was seen as a pediatric benefit. For example, the weight-related drug dose calculator is installed in the important information store of the patient in the EMR system, so that the clinical dose can be monitored in time to reach or exceed a reasonable dose. "In pediatric clinics, the size of the dosage is critical," Shuman said.

Cloud based systems are widely used in all outpatient procedures of the Cook Children's medical system (including basic care and 10 paediatric branch specialties, such as respiration, surgery, cardiovascular and hereditary diseases, etc.), and are also used in patient review and drug dosage adjustment programs outside the system of inpatient procedures.

"In 2012, the cloud-based EMR system was not able to incorporate all the patient's information, so we had to interact with the Shuman in other ways," said the man. For those outside the Cook children's medical system that need to be contacted by fax, the cloud-based EMR serves as a service that automatically shares patient barcode information with the cloud.

In Shuman's view, one of the main advantages of cloud-based systems is ease of operation. Shuman developed a primary EMR product before joining the Cook Children's medical system, and he spent a year continuing to refine the project. The cook Children's medical system manages more than 60 pediatric and specialist outpatient offices across the United States. Its system-wide implementation was completed in November 2010, 8 months from the start.

Another feature of Shuman's appreciation is that this system helps speed up archiving and productivity. "If someone had told me before that he or she wanted to add a button to the generic EMR, I would have to write code, test it and upload it to the system, which would take days," Shuman said, "And now I can proudly say that I can solve the same problem the same day. ”

In addition, the operation of the cloud-based system does not require the Cook children's medical system to create a dedicated team to provide the necessary server maintenance, Shuman added. In the 1th year of the market, the total download time for this system did not exceed 90 minutes.

New buzzwords?

In the early years of cloud computing, some people thought it was just a new form of old creativity. "Cloud computing is really just a new word for a remote host," said Maureen Gaffney, medical assistant dean of the Minola City Winthrop University Hospital in Rn and Cmio. And it is unique because it is flexible to connect to those databases and privatized public information cloud storage. ”

Gaffney says the 590-bed hospital has been using cloud computing technology for 10 years. Hospital equipment uploaded a cloud based clinical information system in 1996 and upgraded to EMR in 2005, so Winthrop collaborators can use the hospital's servers to get patient information.

However, the survey on cloud computing penetration shows that its application prospects are not yet clear. Symantec, a famous American software company, has launched a survey called "The current research on cloud computing applications in the 2011". The company commissioned 5,300 agencies from 38 countries to conduct cloud computing penetration surveys, which showed that 73% of respondents had been or were receiving cloud services. Among them, the most popular cloud services include e-mail, security management, and information management security. Only 20% of respondents made full use of the key technologies of cloud computing, while 25% were just in touch with the technology.

Security issues are hidden

The survey found that there are several major security problems in cloud computing. Those surveyed also took security as a primary performance indicator, giving great attention. 87% of respondents to the cloud after the inclusion of the information security has not decreased, some even improved. However, they still regard security as a top priority and are wary of potential dangers, such as malware, hacking and the disclosure of confidential information.

"The EMR system based on cloud computing is acceptable to users not only because it is a new technology, but also because it is not blocked by the fact that it is at risk," JD from Davis Wright Tremaine Consulting Group, senior medical it and privacy Security Advisor to the Civil Rights Office (OCR) (J.D.) and MPH Adam H. Greene said.

By analyzing large information-affected cases (more than 500 people), Greene says, 50% is data theft-but only 2% of the cases received by OCR from September 2009 to September 2011 are EMR-related. In the same time period, 15% cases were data loss, and 7% were hacker attack/IT technology issue events.

The main cases of large data intrusion are from paper media (26%). "These organizations should keep in mind that when they enable electronic systems, they must properly deal with those paper materials and not ignore their potential security risks," Greene. Since September 2009, OCR has received 372 cases of large information intrusion.

"Users are obligated to comply with the HIPAA Act (Health Insurance Liquidity and Liability Act) security regulations when using cloud computing services, especially access programs," Gaffney said. "She believes that Winthrop because of the use of certified EMR technology, they can be in the federal government financial allocations 2011 for meaningful use to provide strong proof."

From the usability point of view, Gaffney that it would be unusual if those who installed EMR could immediately use EMR without hindrance. In fact, cloud computing services need to be constantly tuned, improved, and progressively user-implemented. If you do not spend enough time to really integrate the EMR into the day-to-day work of the physician, it will eventually cause problems for the patient.

One possible way to avoid potential job failures is to achieve EMR optimization. Given that each clinician has different ways of viewing patient information, Winthrop has a hyperlink for the EMR system so they can instantly choose the patient information they need, which is a realistic way to achieve integration. "This is a match between the outpatient workflow and the way doctors look at information," she said. With the combination of workflow and functionality, cloud computing system as a powerful tool can inspire doctors to improve the quality of service enthusiasm. With the continuous improvement of cloud-based EMR Technology, other department technologies may also be incorporated to help EMR continue to improve medical care and workflow.

(Responsible editor: The good of the Legacy)