Meet Eva, the voice-activated ‘assistant’ for doctors

Visit The Boston Globe Share on Twitter Share on Facebook Comment on this Scroll to top of page Priyanka Dayal McCluskey Globe Staff  January 09, 2018 It takes only a few seconds to click a button and open a window on a computer. But for a busy doctor sifting through patient records, those clicks can add up to extra hours spent at a computer each day completing tedious but necessary tasks.Now, in response to doctors’ demands for more efficient software, several companies that make electronic health record systems are offering a new tool: voice-activated virtual assistants. Think Apple’s Siri or Amazon’s Alexa, but for health care providers.Westborough-based eClinicalWorks, a large vendor of electronic health records, has launched what the company calls a first-of-its kind virtual assistant, named Eva, to help doctors and other care providers more quickly find patient information. Advertisement Just like an Alexa user can stream music and ask for the weather forecast, a physician using Eva can order a prescription or ask for a patient’s medical history. Unlike Alexa, Eva is built into the computer and doesn’t use a standalone device. Get Talking Points in your inbox: An afternoon recap of the day’s most important business news, delivered weekdays. Thank you for signing up! Sign up for more newsletters here “It’s a gamechanger,” said Millie Shinn, a nurse and director of clinical informatics at Hamilton Healthcare System in rural Texas, which uses eClinicalWorks software. “To say, ‘Eva, show me today’s lab,’ and it just pops up — that efficiency is huge.”Virtual assistants are in development at other big medical software vendors, including Watertown-based athenahealth Inc. and Epic Systems Corp. of Verona, Wis., whose software is widely used by Massachusetts doctors and hospitals.The voice-activated technology for health records is available Continue Reading

4 Industries in the Midst of Major Disruptions, Thanks to Data

In these cases, disruption is a good thing. Lucinda Honeycutt Published 11:00 am, Thursday, January 4, 2018 Photo: Hinterhaus Productions | Getty Images Image 1of/1 CaptionClose Image 1 of 1 Photo: Hinterhaus Productions | Getty Images 4 Industries in the Midst of Major Disruptions, Thanks to Data 1 / 1 Back to Gallery Research suggests that some 90 percent of the data in the world today was created within the last two years, and our current output is an estimated at 2.5 quintillion bytes per day. Hiding in those virtually endless strings of ones and zeroes, we suppose, are all kinds of insights, ready to help improve the way we do business and live our lives. All we need is good business intelligence, which is what allows our best and brightest, to convert data into ideas we can actually act on. Big data is useful in nearly every industry, but over the past year, it's been making a statement and disrupting the standard in four industries in particular. As 2018 approaches, let’s take a look at how analytics can continue to shape these verticals. LATEST SFGATE VIDEOS Now Playing: Now Playing How big waves find Bay Area beaches sfgate Skier rescued at Mammoth Mountain after dangling upside down on chairlift sfgate Opening day for legal marijuana sales in Humboldt sfgate SF's Boxing Room makes New Orleans cocktails sfgate A beginner's guide to recreational marijuana sfgate SFPD search for suspect wearing a Santa hat and armed with handgun in the Tenderloin sfgate Recreational+cannabis SFGate Building the Golden Gate Bridge sfgate Santa Clara cardboard factory fire sfgate What are 'Spare the Air' days? sfgate Related: How is Big Data Streamlining Business Operations 1. Urban planning. In just over 30 years, the United Nations predicts that Continue Reading

VA falls short on commitment to female veterans’ health care, despite $1.3 billion investment: report

SAN FRANCISCO — Already pilloried for long wait times for medical appointments, the beleaguered Department of Veterans Affairs has fallen short of another commitment: to attend to the needs of the rising ranks of female veterans returning from Iraq and Afghanistan, many of them of child-bearing age. Even the head of the VA's office of women's health acknowledges that persistent shortcomings remain in caring for the 390,000 female vets seen last year at its hospitals and clinics — despite an investment of more than $1.3 billion since 2008, including the training of hundreds of medical professionals in the fundamentals of treating the female body. According to an Associated Press review of VA internal documents, inspector general reports and interviews: — Nationwide, nearly one in four VA hospitals does not have a fulltime gynecologist on staff. And about 140 of the 920 community-based clinics serving veterans in rural areas do not have a designated women's health provider, despite the goal that every clinic would have one. — When community-based clinics refer veterans to a nearby university or other private medical facility to be screened for breast cancer, more than half the time their mammogram results are not provided to patients within two weeks, as required under VA policy. — Female veterans have been placed on the VA's Electronic Wait List at a higher rate than male veterans. All new patients who cannot be schedule for an appointment in 90 days or less are placed on that wait list. — And according to a VA presentation last year, female veterans of child-bearing age were far more likely to be given medications that can cause birth defects than were women being treated through a private HMO. "Are there problems? Yes," said Dr. Patricia Hayes, the VA's chief consultant for women's health in an AP interview. "The good news for our health care system is that as the number of women increases dramatically, Continue Reading

Doctors order fewer laboratory tests when they know prices: study

Doctors order fewer laboratory tests during a patient's hospital stay if they know how much the tests cost, according to a new study. Researchers found that doctors at one U.S. hospital ordered about 9 percent fewer lab tests - such as blood work - when their computerized records system displayed the price. "(Before the study) we saw a lot of waste. We saw a lot of tests that didn't need to be ordered," said Dr. Leonard Feldman, the study's lead author from The Johns Hopkins University School of Medicine in Baltimore. Part of the reason doctors order a lot of tests could be that they don't know how expensive they are, according to the researchers. It's estimated that the U.S. healthcare system wasted about $226 billion on overtreatment and unnecessary use of lab tests during 2011, Feldman and his colleagues wrote in JAMA Internal Medicine on Monday. As well as adding cost, unnecessary tests can put patients at risk of being harmed by additional screenings or procedures if the first comes back with a false positive. "The rational approach to ordering tests is something we should all be interested in, and something - if we did better - that would save the system money and save the patients the horror of causing harm," Feldman said. For the new study, the researchers compiled a list of some of the most common and most expensive lab tests ordered at The Johns Hopkins Hospital. From November 2009 to May 2010, they had the hospital's record system display the cost of half of those tests. Doctors didn't know why the prices started being displayed. They were only told that it was part of a research project if they asked. Feldman's team found doctors ordered an average of 3.4 lab tests per hospitalized patient per day with prices displayed during those six months. That compared to 3.7 tests per day before the prices were shown between 2008 and 2009. That reduction was slightly offset by a small uptick in the number of tests ordered from the Continue Reading

More doctors are ditching the old prescription pad for electronic ones; Changes can be safer for patients

Doctors increasingly are ditching the prescription pad: More than a third of the nation's prescriptions now are electronic, according to the latest count. The government has been pushing doctors to e-prescribe, in part because it can be safer for patients. This year, holdouts will start to see cuts in their Medicare payments. Thursday's report from Surescripts, the largest network for paperless prescribing, shows more doctors are signing up fast. At the end of 2011, 36 percent of all prescriptions were electronic - the doctor wrote it by computer and sent it directly to the pharmacy with the push of a button, the report found. That's up from 22 percent of prescriptions that were paperless a year earlier. For patients, the convenience is obvious - shorter drugstore waits. Pharmacists like not having to squint at the doctors' messy handwriting. And computerized ordering systems allow doctors to easily check that a new drug won't interact badly with one the patient's already taking. New research by Surescripts and some pharmacies and pharmacy benefit managers uncovered another benefit: More patients pick up a new prescription when it's filed electronically. Doctors know that too often, patients never fill some of their prescriptions. Maybe they lose the slip of paper, or forget to drop it off, or decide they can't afford it. The new research examined 40 million prescriptions, a mix of paper, phoned, faxed or electronic ones - and found a 10 percent increase in patients who fill a prescription when it's e-prescribed. The main reasons: Drugstores receive every paperless prescription, and they can call patients to come in and pick up their waiting medicine, said Surescripts' researcher Seth Joseph. Also, e-prescribing programs automatically show the doctor which brands are covered by the patient's insurance with the lowest out-of-pocket cost. For several years, the government has run incentive programs to encourage doctors to adopt Continue Reading

Doctors have the medical techonology, now they need to cultivate the human touch with patients

Medical student Gregory Shumer studied the electronic health record and scooted his laptop closer to the diabetic grandfather sitting on his exam table. "You can see," he pointed at the screen - weight, blood sugar and cholesterol are too high and rising. The man didn't reveal he was too nearsighted to see those numbers, but he'd quietly volunteered that he'd been ignoring his own health after his wife's death. The future-Dr. Shumer looked away from the computer for a sympathetic conversation - exactly the point of Georgetown University's novel training program. As the nation moves to paperless medicine, doctors are grappling with an awkward challenge: How do they tap the promise of computers, smartphones and iPads in the exam room without losing the human connection with their patients? Are the gadgets a boon, or a distraction? "That's the tension I feel every day," says Dr. Vincent WinklerPrins, a family medicine specialist at Georgetown. The medical school is developing one of a growing number of programs to train new doctors in that balancing act, this one using actors as patients to point out the pitfalls ahead of time. Across the country at Stanford University this summer, medical students will bring a school-issued iPad along as they begin their bedside training - amid cautions not to get so lost in all the on-screen information that they pay too little attention to the actual patient. Face your patient, excuse yourself to check the screen and put away the gadget when you don't really need it, say Stanford guidelines that specialists say make sense for physicians everywhere. And, of course, no personal Internet use in front of a patient. "The promise of these devices to augment the delivery of clinical care is tremendous," says Stanford's Dr. Clarence Braddock. He uses a secure app on his iPad to pull up patient charts if he's called after hours no matter where he is. Braddock helped develop Stanford's standards understanding there are Continue Reading

Get the records straight: Electronic health data system in Bronx clinic

The patients had the same name, lived in the same city and were born only one day apart. But the girl in front of Dr. Shamiza Ally was not the one in the photo on her medical record. It turns out the front office staff had inadvertently checked in the wrong patient, and Ally had filled in the wrong person's chart. Ally did not catch the error until it was time to schedule a followup visit. "It could have ended much worse if medication were involved," said Ally, a pediatrician at Urban Health Plan, a Bronx clinic serving 31,000 patients, many of them from low-income backgrounds. The photo in the health chart might not seem like a big deal, but it's part of the Urban Health Plan's ongoing system of electronic health records, first implemented six years ago. The changes include everything from electronic prescriptions sent straight to the pharmacy, scanned X-rays, digital referrals and lab results. President Obama's plan to direct $20 billion in stimulus money to computerize health records has been lauded as a big step toward modernizing an inefficient and unwieldy health care system. The program's goal is to improve the quality of medical treatment, and prevent medical errors that kill thousands each year. Administrators and doctors at Urban Health Plan say their electronic system is already doing that. "We've been able to see a much higher number of patients with the same number of staff," said Alison Connelly, clinical systems administrator at the clinic. Urban Health Plan and Brooklyn's Maimonides Medical Center are considered leaders in the use of electronic health records in New York City, and have won awards for their work. No one knows exactly how much stimulus money New York will see for electronic health records, but Urban Health Plan received $1.3 million in March for a new site in Jackson Heights, Queens, to serve 4,000 people. Getting more doctors to use electronic health records is an ambitious undertaking considering Continue Reading

She gets lowdown on hi-tech VA hosp

The James J. Peters Veterans Administration Medical Center in the Bronx has some of the most cutting-edge systems and technology in the country. Patient records are computerized and accessible at any of the 160 VA Medical Centers in the country. Medications are delivered to patients using bar codes on their ID wristbands. Yet Lynda Olender has a decidedly unsophisticated way of making sure all is right at the giant facility off Kingsbridge Road in Kingsbridge Heights. She asks. "When I make my rounds every week, I always go in and ask the patient how's the care," said Olender, the hospital's chief nurse executive. "I'm not afraid to ask them if they know who their nurse is. Then I compliment the nurse on a job well done, or ask what we can change to improve the patient's stay." Olender is one of three people - along with the associate director and the chief of staff - charged with making sure things run smoothly at Peters. Her weekly rounds cover considerable ground: The hospital's patient care centers include three medical surgical units, an intensive care unit, an emergency room, 13 speciality clinics, an extended-care nursing home, a 62-bed spinal care unit and a rehabilitation center, where paralyzed veterans are taught how to drive a vehicle. Olender, a mother of three, started as a candy striper at St. Vincent's Hospital on Staten Island when she was 16 years old, graduated from the Kings County Hospital School of Nursing in 1967 and received a master's degree in nursing from New York University. She is an adjunct professor at NYU, where she is in the doctoral program. She came to Peters in 1999, just as the bar code system to deliver medication was being put in place in Veterans Administration hospitals around the nation as a way of cutting down on the all too common incidents - at all hospitals - of patients being given the wrong medication. "It [implementing the system] was quite an ordeal because it's change and people don't like Continue Reading

On health reform, forget politicians. What do doctors and patients want?

I have fallen into the same trap that many of my fellow doctors have: I have analyzed the potential options for repealing and replacing the Affordable Care Act from the same place that politicians and policy wonks do — choosing and arguing about alternatives that may have no real bearing on the day to day functioning or dysfunctioning of the doctor’s office. Democrat or Republican, Liberal or Conservative, this was the same mistake we all made back in 2009 and we are making it again today.So as the so-called debate over health care continues in the Senate, let me take a step back and look at actual health care reform through the lens of my daily experience as a physician, and yours as a patient. Not theory but practicality.The first relevant issue is computerization. Since 2009, Electronic Health Records have been mandatory, and though they present an advantage in terms of the speed of information exchange, they also saddle doctors to their chairs, where a routine 20-minute visit is doubled by the time the documentation is complete. For this doctors receive no additional reimbursement.A physician survey by the consulting firm Deloitte back in 2013 revealed that six in 10 physicians reported that the practice of medicine is in jeopardy. The greatest reason given by primary care doctors like me was not enough time to spend with our patients. Instead we are dealing with the computer, reimbursements, approvals and referrals. Here's how Republicans should try for a bipartisan health plan Obamacare costs way more than it should: Column According to the Deloitte survey and every physician I speak to, we are increasingly unhappy because of shrinking reimbursements (especially but not exclusively Medicare and Medicaid), fear of malpractice, and increasing regulations. We are also swamped with too many patients, in the middle of a growing doctor shortage. The Association of American Medical Colleges estimates that we Continue Reading


MORE THAN three dozen staffers at Woodhull Medical Center face disciplinary action - including unpaid suspensions - for peeking into the medical file of abuse victim Nixzmary Brown, authorities and sources said yesterday. The city Health and Hospitals Corp. said 39 Woodhull employees, including doctors, nurses, technicians and clerical staff, improperly accessed the high-profile patient's confidential file on the hospital's computerized records system. Such records are restricted to personnel involved in the patient's medical care or for other legitimate reasons. Each employee has an access code, and each viewing or entry is recorded. The 7-year-old girl died Jan. 11 after being allegedly starved and beaten by her stepfather and mother in their Bedford-Stuyvesant home. Four nonunion employees were suspended without pay yesterday. The others, who are union members, are entitled to hearings. They could be socked with unpaid suspensions ranging from 30 to 60 days, costing each employee from $750 to $3,750 a week. HHC President Alan Aviles said the disciplinary action demonstrates the agency's zero tolerance for invading a patient's medical privacy "regardless of how prominent or little-known the patient may be." HHC did not disclose the workers' names or that of the patient. But Nixzmary had a history of being treated at Woodhull and several sources, who asked not to be identified, confirmed that her file was the one involved. Join the Conversation: Continue Reading