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| Vol. 13 No. 11, June 1, 2016 |
Does this Ankle Need an X-ray? There's an App for That
The Ottawa Rules, a set of rules used around the world to help health professionals decide when to order x-rays and CT scans, are now available as a free mobile health app. Developed by emergency department physicians at The Ottawa Hospital and the University of Ottawa, the Ottawa Rules are evidence-based decision trees that help physicians determine whether a scan is needed for injured bones, cutting down on unnecessary radiation and wait times. The existing rules for ankle, knee and spine injuries have been bundled together in a mobile app to appeal to a new generation of wired doctors, nurses and paramedics. The app includes the Ottawa Knee Rule, the Ottawa Ankle Rules and the Canadian C-spine Rule, which were previously only available as posters or online. The Ottawa Rules have been validated by more than 20 studies, translated into several languages and adopted worldwide.
Seeing the potential of mobile technology to put the Ottawa Rules into the hands of health-care professionals, Dr. Ian Stiell, an emergency physician and research chair at The Ottawa Hospital, joined forces with The Ottawa Hospital mHealth Research team led by Dr. Kumanan Wilson, a specialist in general internal medicine and senior scientist at The Ottawa Hospital and professor at the University of Ottawa. The team, which includes Cameron Bell, Julien Guerinet, Yulric Sequeria and Katherine Atkinson, also developed the popular ImmunizeCA app to help Canadians keep track of their immunizations and make informed decisions.

A Digital Health Milestone: Heart & Lung Sounds Become Part of Electronic Health Records for the First-Time
For the first time in history, clinicians are able to capture patients' heart and lung sounds and integrate them into the electronic health record (EHR). This milestone represents a groundbreaking advance in longitudinal patient care. Three companies have joined forces to launch this groundbreaking effort: Direct Urgent Care, Eko, and drchrono. Using a quick three step process, clinicians can now seamlessly incorporate heart and lung sounds into patient health records.
1. Direct Urgent Care, a Berkeley-based urgent care provider with 30,000 patients, enables providers to record important heart and lung sounds using the Eko Core Digital Stethoscope
2. The Eko Core Digital Stethoscope wirelessly transmits stethoscope sounds to a HIPAA-compliant Mobile App on a smartphone or tablet.
3. The information is then uploaded to the drchrono EHR, an online medical platform with comprehensive EHR capabilities, to enable clinicians to seamlessly incorporate heart and lung sounds alongside patient health records.
Combining Municipal Immunization Registries and Electronic Health Records: When Worlds Come Together Rather than Collide!
Those of us who practice general pediatrics everyday are quite familiar with the importance of keeping records of vaccines administered to our patients, and more and more we are doing this through data entry into our office-based electronic health record (EHR) systems. We are also aware of the need for large municipal areas or even states to maintain population-based immunization data registries—but perhaps never recognized how both the EHR and a data registry could help each other by sending and receiving information from each other.


Person-Centred App Helps Women with Breast Cancer
The face-to-face meetings between the patient and the care provider might be successfully complemented with person-centred e-support. A preliminary evaluation of breast cancer patients shows that a newly developed app can assist women undergoing treatment for breast cancer in handling symptoms and side effects and provide support.
A thesis at Sahlgrenska Academy, University of Gothenburg, has developed and preliminarily evaluated an interactive app for person-centred e-support that facilitates self-care. The app, called Care Expert, has been developed expressly for women undergoing treatment for breast cancer and contains functions for self-assessment of health and quality of life, self-monitoring, self-validation and direct reporting to the person's contact nurse.
BIOTRONIK Releases CardioMessenger Smart Cardiac Implant Home Monitoring System in US
BIOTRONIK is releasing in the US its CardioMessenger Smart device for connecting patients’ implanted pacemakers, implantable cardioverter defibrillators, and insertable cardiac monitors to the firm’s Home Monitoring system. From there, cardiologists are able to view any events that they are interested in seeing and can create customized alerts as well. Dangerous events are sent over immediately to the cardiologist, while everything else is updated on a daily basis.
The CardioMessenger Smart is about the size of a common smartphone and uses GSM cellular connectivity to pass data from a cardiac implant to the internet and onto the Home Monitoring platform. It’s fully automatic, so as long as the patient has it nearby, the data will magically sync all on its own.
Australia: NT Government Commits $186m to e-Health Record System
The Northern Territory has announced plans to spend $186 million on a jurisdiction-wide, integrated electronic health record system. Implemented as part of the 2016 Budget, the investment will be spread over five years as part of the Core Clinical Systems Renewal Program (CCSRP).
Minister for Corporate and Information Services Peter Styles said the program to upgrade the existing core clinical information systems will be the “largest ICT reform ever undertaken” in the Territory. The e-health program will replace four existing clinical information systems with a single end-to-end clinical information system at the point of care for all public health facilities, including all NT public hospitals and more than 50 health clinics.
Hong Kong: How to Engage Private Doctors in e-Health Record Sharing
In Hong Kong, after ten years of experiments and preparation, the territory-wide patient-oriented Electronic Health Record Sharing System (eHRSS) commenced operating in mid-March this year.
With patients’ consent, the sharing of electronic health record (eHR) or electronic medical record (eMR) assists medical practitioners in providing more timely and accurate treatment. Data that participating doctors can retrieve includes allergies, medication, appointments records and discharge summary, etc. Errors otherwise arising from transferring paper records and duplication of tests can therefore be minimized. The success of the eHR sharing in Hong Kong, however, depends heavily on the participation of private practitioners. Unlike Mainland China where majority of medical services measured in terms of expenditure are state-operated, over half of Hong Kong’s medical service is provided by private organizations. There are 11 private hospitals and around 3,700 private clinics. All private hospitals here have already agreed to join the eHRSS, but the response from private clinics is considered as just lukewarm at best with only 30 or 1% having committed, according to the latest news reports.

Philips and SURFsara Team up to Provide Hospitals with 'Big Data' Research Services in the Cloud for Precision Medicine and Population Health Management
Philips and SURFsara (a subsidiary of the SURF cooperation), the Dutch supercomputing and data infrastructure provider for education and academic research, announced a new collaboration with the aim to connect the Philips HealthSuite cloud platform to the SURFsara National Research Infrastructure to provide new cloud-based research services.
The services will specifically support research into precision medicine and population health. An example are new targeted therapies for colon, prostate or breast cancer that require bringing together massive amounts of data from medical scanners, tissue biopsies, lab results and genomics over long periods of time to generate deep and comprehensive views on a patient’s individual situation. Studies into population health need to combine extremely large health data sets of large groups of people. These are analyzed to find even the smallest correlations and patterns that could eventually lead to new approaches to enable early intervention and improve treatments.

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