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IT investment in China’s hospital system estimated to reach 65.7 billion yuan in 2022

A recent article from China Daily stated that IT investment in the country’s hospital system will reach 65.7 billion yuan ($9.47 billion) in 2022, surging 53.5 percent from 2017 and boosting the digitalisation of the Chinese medical system, based on a forecast report by Analysys. The Beijing-based research consultancy’s report also noted that the Hospital Information System has almost achieved full coverage in China’s tertiary hospitals, which is the largest in the country’s three-tier system.

Coverage in primary and secondary hospitals, the lowest two tiers, is currently at 80 percent.

Statistics from the Chinese Hospital Association indicated that in 2017, hardware investment accounted for 44 percent of total hospital digitalisation investment, while spending on software and services represented 56 percent. Chen Qiaoshan, a medical analyst at Analysys said that software and services as the core of hospital digitalisation will a have higher growth potential than compared to hardware.

From 2017 to 2018, 17.43 percent of the country’s hospitals greatly expanded their investment in hospital digitisation, and 29.78 percent slightly increased their investment, showing that in the future, the overall investment into hospital digitisation will continue to rise, according to the same report by Analysys.

Based on the latest statistics from HIMSS Analytics, China has 36 EMRAM Stage 6 validated hospitals and 10 EMRAM Stage 7 validated hospitals. EMRAM is the acronym for Electronic Medical Record Adoption Model by HIMSS Analytics, which incorporates methodology and algorithms to automatically score hospitals around the world relative to their Electronic Medical Records (EMR) capabilities. This eight-stage (0-7) model measures the adoption and utilisation of electronic medical record (EMR) functions and Stage 7 represents a remarkable achievement in which paper charts are no longer used.

Huangshi General Hospital in Hubei province and Children’s Hospital of Shanghai are two such hospitals to achieve EMRAM Stage 7 validation in the first quarter of 2018.

In the same China Daily article, Qu Jing, another medical analyst at Analysys, said, “Although most hospitals attach great importance to information gathering, they do not have a clear development strategy. Statistics from the Chinese Hospital Association showed that while 97.25 percent of China’s hospitals have a specialised information and technology department, 56.29 percent of them lack thorough digitalization development planning.”

Qu also added that hospitals lack regional connectivity, which is important for the development of hospital information platforms, with only 49 percent having a regional information platform.

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Alert fatigue: Are clinical surveillance tools making it any better?

A new KLAS study of 10 vendors who provide clinical surveillance tools, with alerts, found that the technology can save lives, prevent readmissions and improve workflow.

That is at least one small piece of welcome news for IT shops and the clinicians they support, who are widely understood to be overrun by medical alerts.

WHY IT MATTERS

Embedded alerts have created a state of alert fatigue for many users — but these new findings make it evident that the risk of alert fatigue might be worth it.

THE LARGER TREND

Clinical surveillance products are fairly new and use detection algorithms informed by a patient’s EHR, lab results, monitoring devices, and other sources. Currently, most organizations are using these products to monitor and alert for possible cases of sepsis, KLAS said.

KLAS studies the following vendors: Bernoulli, Cerner, Epic, Stanson Health, Ambient Clinical Analytics, Iatric Systems, MEDITECH, PeraHealth, Philips and Wolters Kluwer.

Many of these organizations have also expanded the use of their clinical surveillance technology to monitor for other problems, including fall risks, potential for readmission, preventive treatments and best practices.

“As this field continues to mature and users find new uses for these solutions, the utility experienced by the early adopters will continue to grow and will increase organizations’ ability to deliver better patient care overall,” KLAS said.

Last July, we reported that ECRI Institute’s Partnership for Health IT Patient Safety identified ways technology can reduce and eliminate errors from diagnostic testing and medication mix-ups.

ECRI suggested improving data transmission by using standards for formatting results, reporting actionable findings to include priority and timing via standards, creating recognizable icons for alerts and notifications in EHRs, making diagnostic results easier to communicate, using existing EHR functionality to automate notifications, optimizing alerts to reduce fatigue, and communicating diagnostic finding directly to patients.

KLAS conducts the study annually, which includes interviews thousands of healthcare professionals about the products and services their organizations use, in addition to supplemental evaluations.

Diana Manos is a Washington, D.C.-area freelance writer specializing in healthcare, wellness and technology.  Twitter: @Diana_Manos Email the writer: dnewsprovider@gmail.com

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Judy Faulkner‘s advice to women in health IT

CLEVELAND — Epic CEO Judy Faulkner had a message for women working in healthcare and technology.

“Be a builder,” Faulkner said at the annual Cleveland Clinic Medical Innovations Summit.

WHY IT MATTERS

That advice doubled as a window into Faulkner’s long-standing philosophy to both keep the EHR company she founded private and to develop new technologies rather than acquiring other companies to get obtain them. 

Faulkner also said the corporate culture she created at Epic runs counter to many tech companies because they are run by MBA’s rather than people with technology chops and programming skills.

“Are you a missionary [focused on a mission],” she posed. “Or are you a mercenary?” The latter being beholden to quarterly earnings.

THE BIGGER TREND

 When asked about the Glass Ceiling, Judy Faulkner said she never saw one. Instead, she always felt there was an advantage to being one of one or two women in a meeting with mostly men. “They knew our names, but not each others.”

In other words, she used that sense of standing out to her advantage.

Carla Smith, executive vice president of HIMSS and founder of the HIMSS Most Influential Women in Health Information and Technology Awards, said that we need to build a pipeline for women and minorities in health IT.

“Knowledge is power,” Smith said. “Know your value and negotiate.”

Smith moderated a panel in the HIMSS Innovation and Conference Center, including Aashima Gupta, the global head of healthcare solutions at Google, Christina Caraballo, director at Audacious Inquiry and Linda McHugh, chief human resources officer at Cleveland Clinic. 

“Building diverse teams shouldn’t just be an enterprise goal, it should be a personal responsibility of each individual,” Gupta said.  

Diversity, in fact, is a great beginning and teams should also strive to be inclusive and foster a feeling of belonging, Caraballo said.

“Diversity is being invited to the party; inclusion is being asked to dance; belonging is dancing like no one is watching,” Caraballo added.

Healthcare, like so many other industries, has a long way to go to achieve diversity, inclusion and belonging.

McHugh, for instance, recounted a story of a meeting encompassing all male leaders on diversity in which one man said that hiring a woman would mean lowering standards.

How to make such misperceptions a thing of the past?

Smith said that women would be smart to seek helpful mentors and to address these kinds of statements strategically and not with a heated exchange.

"You need a mentor who you believe believes in you,” Smith said. “Don’t just look for a mentor that you admire."

John Sharp is Senior Manager at the HIMSS Personal Connected Health Alliance.

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Epic introduces App Orchard low-cost option

Epic has reduced the price for startups to participate in its App Orchard developer program and revealed a new entry-level tier.

The new option, dubbed Nursery, costs $100 a year. Epic also said it has cut the pricing on its three existing tier by 33-80 percent.

WHY IT MATTERS

When electronic health record vendors first started launching developer programs, the going rate was usually to charge 30 percent of top line revenue. In the time since, however, companies have realized that is too steep for startups trying to decide whether they should write new apps for, say, Allscripts, athenahealth, Cerner, eClinicalWorks or Epic. Other EHR vendors have also restructured their pricing, accordingly.

Nursery, for its part, provides fledgling innovators access to public API documentation, developer sandboxes for testing code, FHIR, Smart on FHIR and the CDS Hooks API.

Nursery is for testing apps. “When a company is ready to go to market it can graduate to the next tier,” said Epic App Orchard Director Brett Gann.

ON THE RECORD

“These updates will help drive healthcare innovation as interested developers have the opportunity to build on top of Epic’s comprehensive health record platform, using emerging industry standards such as FHIR,” Gann explained.

About that tem "comprehensive": Epic CEO Judy Faulkner said this past year that EHRs should now be called CHRs – as in comprehensive health records – reflecting that they incorporate more data types, such as social determinants of health. Epic’s chief rivals are moving in the same direction toward a CHR, regardless of what the software is named. (Other experts, meanwhile, have questioned whether "comprehensive" is even a goal to be striving for – preferring instead for records to be "connected.")

OUR TAKE

For our Focus on Innovation in Sept. 2018, we spoke with entrepreneurs about the challenges and opportunities of working with EHR vendor developer programs. High on the list of downsides: Pricing. That 30 percent of top line revenue inhibited innovation, many said.

Fair and transparent pricing, in fact, is one of the seven tenets developers need from EHR vendors.

Among the others: a playbook, clear terms of service, broader support for a single version of FHIR, business side process support and a truly open mindset more akin to Amazon than what exists today.

Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com

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Stroke: Preventing the damage by acting on the neuronal environment?

To protect neurons and limit the damage after a stroke, researchers from the CNRS, the University of Caen-Normandie, University Paris-Est Créteil, and the company OTR3 have targeted the matrix that surrounds and supports brain cells. Their results, just published in the journal Theranostics, have confirmed this strategy on rats, and will lead to a clinical study between now and late 2019.

With over 300 cases per day in France, stroke is the leading cause of handicap among adults, and the second cause of death. Eighty to 85 percent are caused by the occlusion of a cerebral artery by a blood clot (ischemic stroke), with nearby neurons dying because of oxygen deprivation. The only existing treatment involves eliminating the blood clot, which is only possible during the first few hours following a stroke, and consequently available only for a minority of patients. Moreover, brain lesions can persist and worsen long after the start of a stroke, with no treatment being currently available to slow them, or to improve functional recovery.

Numerous avenues of research are studying how to protect neurons from this degeneration. However, treatments attacking this degeneration have only met with clinical failure, which prompted a team led by a CNRS researcher, Myriam Bernaudin, to take an interest in a little explored domain: the environment of the cells, known as the extracellular matrix. This matrix, which offers the cells structural support and houses growth factors, ends up being disorganized following a stroke, thereby amplifying neuronal death. The team from the laboratory Imagerie et stratégies thérapeutiques des pathologies cérébrales et tumorales (CNRS/UNICAEN/CEA) thus approached colleagues specializing in the extracellular matrix at the laboratory Croissance, réparation et régénération tissulaires (CNRS/UPEC), along with the biotechnology company OTR3, which had already brought to market “matrix therapy” treatments for the healing of cutaneous or corneal ulcers.

The researchers demonstrated on rats the effectiveness of this new approach in protecting the brain and improving functional recovery after an ischemic stroke. The intravenous injection of an agent that mimics certain structural components of the extracellular matrix, known as heparan sulfates, protects and reconstitutes this matrix, promotes the development of new neurons and the regeneration of blood vessels, and improves the recovery of sensory and motor functions.