Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. A New Vision for the EHR Sam Brandt, MD Chief Medical Informatics Officer Siemens.

Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved.

A New Vision for the EHR

Sam Brandt, MD

Chief Medical Informatics Officer

Siemens Health Solutions

Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved.Page 2

How Tall is K2?


How Tall is K2?


What Toxin is in the Skin of Poison Dart Frogs?


What Toxin is in the Skin of Poison Dart Frogs?


A pet store employee presents in the ER with rapid onset of confusion, hypotension, and decreased respiratory rate??



The Place for Calculators in 1974?

ProsFaster

Easier to use

More significant places

Eliminates decimal point transposition errors

ConsRequires electricity

Floating point errors

Fosters “Laziness”


The Place for EHR’s in 2009?

ProsFaster & remote access to information

Easier to find data

Helps avoid double entry

Can help with billing

ConsRequires electricity

Less portable

Doesn’t allow random data entry

? Fosters laziness


But….We Didn’t Stop with Calculators!

Spreadsheet programs allowed for “modeling” of financial data, with “what if” scenarios

Word processors eliminated retyping for corrections, and added spell checking


And then…We Pushed the Envelope

Computers opened new possibilitiesExpressing complexity

Simulating scenarios

Exploration and recognition

Solving exhaustive computions


So…How Will EHR’s Push the Envelope?

Changing delivery system models

Point of care decision support

Personalized medicine – Genomics/Proteomics

Patient-centric delivery models


Mar 5, 2009 7:45 pm US/Eastern

Obama: Healthcare At 'Thelma And Louise' MomentPresident Borrows Dire Movie Metaphor To Describe U.S. System As Heading Toward Cliff CBS News Interactive: Healthwatch

Obama said the participants - doctors, lawmakers, insurers, even skeptics - were universal in agreement that the need for health care reform "is here and now."


Impacts

Bundled payments for hospitals and providers

Efficacy standards imposed with controls on utilization variance

Emphasis on healthcare delegation to most cost-effective venues with incentive alignments


Impacts EHR Contributions

Bundled payments for hospitals and providers

Efficacy standards imposed with controls on utilization variance

Emphasis on healthcare delegation to most cost-effective venues with incentive alignments

Increased connectivity supports “Virtual” delivery systems


Enterprise research scheduling and process management


Genomics & Personalized Medicine

Numerous Genotype/Phenotype correlation efforts Potentially thousands of significant variants

Genome sequencing for $100 within 5 years

Rising expectations for preemptive intervention

Physicians will need to consider all diagnostic and therapeutic decisions in the light of the patient’s gene sequence


A Polymorphism* in the 5' Flanking Region of the CD14 Gene Is Associated with Circulating Soluble CD14 Levels and with Total Serum Immunoglobulin E Mauro Baldini, et alAm. J. Respir. Cell Mol. Biol., Volume 20, Number 5, May, 1999 976-983 TGF-β1 gene polymorphisms

D. Bučkova et alVolume 56 Issue 12, Pages 1236 – 1237Published Online: 20 Dec 2001 Gene polymorphism in Netherton

and common atopic disease

Andrew J. Walley1 et alNature Genetics 29, 175 - 178 (2001) Published online: 4 September 2001; | doi:10.1038/ng728

Managing the Avalanche of Genomic Information


EHR and Personalized Medicine

PatientInformation

ClinicalKnowledge

PatientCategorization

Indications/Contraindications

Dx/TxSelection

VarianceDB

GeneSequence


Patient-Centric Delivery Models

Coordinates care across delivery systemSchedules

Tracks

Intervenes

Workflow orchestration

Dx/TxSelections

PatientProcessesPatient

ProcessesPatientProcessesPatient

Processes

Cross-processoptimization

(patient & resource)

Patient-centricProcess

Sequence

Workflow engine Simulation optimizer


The Place for EHRs

2009Brings valuable benefits compared with the limitations of paper charts

2011 and beyondProvides the needed framework for

Changing delivery system models


Personalized medicine – Genomics/Proteomics

Patient-centric delivery models

Copyright © 2007 Siemens Medical Solutions USA, Inc. All rights reserved. A New Vision for the EHR Sam Brandt, MD Chief Medical Informatics Officer Siemens.

Documents

siemens medical solutions

laziness slide

process management slide

exhaustive computions

patients gene sequence

delivery system models

cd14 gene

gene polymorphisms