7- DATA, DATA,& MORE DATA IN HEALTHCARE by PHARMAGEEK

Using electronic health records (EHRs) to create a learning healthcare system, say the authors, can enable researchers to generate new knowledge that will accrue benefits to future generations of patients.

Real-world data are increasingly viewed as a crucial factor in the eventual acceptance of biosimilar drugs, and indeed, current real-world evidence points to the safety and efficacy of these products in the marketplace.

In a recent paper, officials from the European Medicines Agency, the Organisation for Economic Cooperation, and other European government entities explained that such data can help make decisions about pharmaceuticals—from development to reimbursement—more efficient.

The authors called for international cooperation on a learning healthcare system that will better harness these data. 

The authors note that the expense of prospective data generation in a research setting is high, limiting the number of research questions that can be answered in a randomized controlled trial (RCT).

RCTs are rarely large enough to detect infrequent outcomes, nor are they long enough to determine long-term outcomes. 

Using electronic health records (EHRs) to create a learning healthcare system, say the authors, can enable researchers to generate new knowledge that will accrue benefits to future generations of patients.

However, current inadequacies of EHRs present a “technical bottleneck” to the objective of gathering real-world data.  

The paper’s authors propose that governments establish and implement national health data governance frameworks to encourage the use of personal health data to serve the public interest.

The collection of data must translate into the production of useful evidence.

A coordinated and international effort will be key to speed the implementation of a true learning healthcare system for global benefit. 

read the news article at https://www.centerforbiosimilars.com/news/european-officials-promote-use-of-ehrs-to-gather-real-world-data-on-pharmaceuticals--

Incorporating persuasive design concepts into primary care electronic health records (EHRs) increased same-day data entry by 10 percent per physician, demonstrating the potential for persuasive design to change data entry behavior, a study published in JMIR Human Factors revealed.

Persuasive design is a way of developing technology to influence behavior by leveraging social processes. Healthcare stakeholders have primarily focused on using persuasive design in consumer-facing mobile apps to improve outcomes, but there are few examples of using persuasive design to influence clinician behavior.

In primary care settings, providers often face barriers to entering data into EHRs in a timely manner.  Data entry tasks often take a long time, and users may feel as if completing documentation is a lower priority than seeing patients or finishing other tasks.

“Persuasive design is a viable approach for designing and encouraging behavior change and could support effective data capture in the field of medical informatics. There may be opportunities to continue improving this approach, and further work is required to perfect and test additional designs,” the team concluded.

read the original unedited article at https://healthitanalytics.com/news/persuasive-ehr-workflow-design-increased-same-day-data-entry-by-10

A study to correlate EHR Communication with patient outcomes for diabetes patients reported that "EHR team communication flow patterns may be an important avenue to explore in raising quality of care and lowering costs for patients with diabetes in primary care." The study found that Primary care teams whose EHR communication reached more team members indirectly (ie, via message forwarding) had worse outcomes and higher medical costs for their patients with diabetes.

The study was carried out to determine how changes in electronic health record (EHR) communication patterns in primary care teams relate to quality of care and costs for patients with diabetes.

The Study Design: EHR-extracted longitudinal observational study.

A total of 83 health professionals in 19 care teams at 4 primary care clinics associated with a large Midwestern university participated in the study.

Counts of messages routed between any 2 team members in the EHR in the past 18 months were extracted. Flow-betweenness, defined as the proportion of information passed indirectly within the team, was calculated.

The analysis related changes in team flow-betweenness to changes in emergency department visits, hospital stays, and associated medical costs for the teams’ patients with diabetes, while adjusting for team face-to-face communication, patient-level covariates, comorbidities, team size, and clinic fixed effects.

Results: Patient hospital visits increased by 13% (standard error [SE] = 6%) for every increase of 1 percentage point in team EHR message forwarding (ie, higher team flow-betweenness). Medical costs increased by $223 (SE = $105) per patient with diabetes in the past 6 months for every increase of 1 percentage point in team flow-betweenness.

Conclusions: Primary care teams whose EHR communication reached more team members indirectly (ie, via message forwarding) had worse outcomes and higher medical costs for their patients with diabetes.

EHR team communication flow patterns may be an important avenue to explore in raising quality of care and lowering costs for patients with diabetes in primary care.

read the whole study details at  https://www.ajmc.com/journals/issue/2018/2018-vol24-n10/putting-the-pieces-together-ehr-communication-and-diabetes-patient-outcomes