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Magee-Womens Hospital of UPMC and CMU Develop App for High-Risk Pregnant Women

May 1, 2017
by Heather Landi
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Maternal-fetal medicine specialists at Magee-Womens Hospital of UPMC collaborated with decision scientists at Carnegie Mellon University (CMU), also based in Pittsburgh, to develop and test a personalized smartphone application designed to combat preterm birth by engaging a typically hard-to-reach population of pregnant women.

The findings of a pilot study, reported in the Journal of Medical Internet Research mHealth and uHealth, indicate that the app was successful in providing accessible and personalized obstetrical care, designed specifically to target preterm birth risk by focusing on high-risk pregnant women.

Preterm birth, the leading cause of neonatal death or long-term disability, is on the rise in the United States with approximately one of every 10 births occurring prior to 37 weeks of gestation, according to the researchers, and these rates are disproportionately high among some socioeconomic groups, including African Americans and families living in poverty. These patient groups often are the hardest to reach due to limited access to and attendance at routine prenatal care, the researchers contend.

“Mobile phone apps are a great way to engage a vulnerable population in their health care because approximately 86 percent of American adults own a mobile phone, regardless of racial and ethnic groups,” Tamar Krishnamurti, Ph.D., lead author and assistant research professor of engineering and public policy at CMU, said in a statement. “Moreover, 20 percent of all smartphone owners downloaded a pregnancy app in 2015. Although hundreds of pregnancy-related apps exist, few have been developed through a scientific process that is patient-centered and grounded in behavioral decision research.”

To develop the app, CMU decision scientists and Magee maternal-fetal medicine specialists conducted interviews and user testing with medical experts and women recruited from high-risk groups. Sixteen study participants from Magee’s outpatient clinic, which specializes in high-risk pregnancies, were then provided a smartphone with the preloaded app and a digital weight scale. Through the app, participants were queried daily over three months to assess such risk factors as rate of weight gain, smoking, alcohol consumption, depression and intimate partner violence. Because transportation to appointments is often a barrier to prenatal care, free transportation using Uber was incorporated into the app’s functionality.

The researchers found that use of the app was higher among participants at higher risk, as reflected in such factors as poorer daily moods or being earlier in their pregnancies. Participants had an attendance rate of 84 percent at prenatal appointments compared with the clinic norm of 50 percent. The researchers also conservatively estimated cost savings of $450 per patient over three months.

Participants voluntarily logged into the app to complete daily risk assessments, and computer algorithms delivered patient-specific risk feedback and recommendations tailored to individual users. When the app detected high-risk events such as intimate partner violence or thoughts of suicide, it sent real-time alerts to medical staff. Women were then contacted directly and linked to appropriate medical and social service resources.

“While we do not understand why certain socioeconomic groups are at a higher-risk for preterm birth, we do know that prenatal care that starts early in pregnancy is critical for a healthy baby and mother,” Hyagriv Simhan, M.D., professor, obstetrics, gynecology, and reproductive sciences, University of Pittsburgh School of Medicine, and chief, division of maternal-fetal medicine at Magee, said in a statement. “This pilot shows that smartphone apps are a promising and potentially cost-saving way to provide personalized care for the highest-risk patients.”

The researchers’ next steps include conducting a randomized controlled trial over the entire pregnancy of participants and evaluating the effects of the app on behavioral and clinical outcomes, including adverse birth outcomes.

 

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/news-item/mobile/labcorp-joins-apple-health-records-project

LabCorp Joins Apple Health Records Project

November 5, 2018
by Rajiv Leventhal, Managing Editor
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LabCorp, a provider of clinical laboratory and end-to-end drug development services, has announced that it has enabled Apple’s Health Records feature for its patients.

This iPhone feature aims to make it easier for LabCorp patients to access their LabCorp laboratory test results, along with other available medical data from multiple providers, whenever they choose, according to officials.

In January, Apple announced that it would be testing the Health Records feature out with 12 hospitals, inclusive of some of the most prominent healthcare institutions in the U.S. Since that time, more than 100 new organizations have joined the project,  according to Apple.

LabCorp test results are viewable in the Apple Health app for LabCorp patients who have an account with the company, and enable integration with the Health Records app. In addition to their LabCorp test results, patients will have information from participating healthcare institutions organized into one view, covering allergies, medical conditions, immunizations, lab results, medications, procedures and vitals.

Patients will receive notifications when their data is updated, and the Health Records data is encrypted and protected with the user’s iPhone passcode, Touch ID or Face ID, according to officials.

“LabCorp on Health Records will help provide healthcare consumers with a more holistic view of their health. Laboratory test results are central to medical decision making, and broadening access to this information will help patients take charge of their health and wellness, and lead to more informed dialogues between patients and their healthcare providers,” David P. King, chairman and CEO of LabCorp, said in a statement.

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HIMSS Analytics Introduces Infrastructure Adoption Model for Health Systems

October 25, 2018
by Rajiv Leventhal, Managing Editor
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HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society, announced the introduction of the Infrastructure Adoption Model, or INFRAM, which is designed to measure the technical infrastructure used within a health system.

The INFRAM focuses on five technical subdomains, allowing organizations to benchmark how their infrastructure operates within the following areas: mobility; security; collaboration; transport; and data center.

Similar to HIMSS Analytics’ well-known Electronic Medical Record Adoption Model, or, EMRAM, the INFRAM is an eight-stage model (0 – 7) that allows healthcare IT leaders to map the technology infrastructure capabilities required to reach their facility’s clinical and operational goals, while meeting industry benchmarks and standards.  The final stage, Stage 7, guides organizations towards optimized information integration, contextualization and orchestration essential for the delivery of higher order local and virtualized care processes.

For reference purposes, Stage 0 on the model represents that an organization does not have a VPN, intrusion detection/prevention, security policy, data center or compute architecture. Stage 3 signifies that an organization has an advanced intrusion prevention system, while Stage 5 represents having video on mobile devices, location-based messaging, firewall with advanced malware protection, and real-time scanning of email hyperlinks.

HIMSS officials note that by identifying specific benchmarks for organizations to reach before they go live with EMR, systems, the INFRAM aims to ensure that a health system’s infrastructure is stable, manageable and extensible. Through this, organizations can ideally improve care delivery and create a pathway for infrastructure development tied to business and clinical outcomes.

 “The INFRAM is a welcome addition to our maturity model suite and addresses a longstanding need – guiding healthcare organizations in securely implementing the infrastructure with which their EMRs are built upon,” Blain Newton, executive vice president, HIMSS Analytics, said in a statement. “We have seen health systems engage with advanced clinical applications, only for them to ‘glitch’ under infrastructure that isn't powerful enough to support their tools. With the INFRAM, healthcare providers can develop a detailed, strategic technology plan that defines their organization's current state, desired future state, and each stage in between to achieve their clinical and operational goals.”

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Clinical Team Communication and Data Access in the Palm of Your Hand

Thursday, October 25, 2018 | 1:00 p.m. ET, 12:00 p.m. CT

Eisenhower Health, a west coast-based Magnet Hospital, implemented an enterprise-wide solution enabling mobile communications and collaboration across all care teams, linking the entire enterprise, advancing its communications capabilities, creating access to an enterprise directory, and improving care team response and turnaround times.

Additionally, the system provided extensive and comprehensive reporting with data analytics showing where and to what extent response improvements were made, but also providing the information the hospital needed to better utilize the system and make adjustments to improve results.

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