They never said navigating the electronic medical record landscape would be easy — at least not at first. And as new regulations from both federal and state spheres begin to tighten their hold around the industry, the valleys of EHR adoption and EHR mastery are sure to only become more congested and therein, even harder to get a handle on. 

Fortunately, current EHR veterans saw it coming and set out early with open minds — ready to note and reroute the process wherever necessary — and are now reporting back at last on the troubles and tricks that arise when dealing with digitized data.

Panelists on deck in Boston for the recent Health IT Summit session titled "EHR Data: A Touchstone for Quality Care" had plenty of diverging facets to share on the topic of EHR integration, but one primary point remained: We are all in this together.

“For things like this, I think all doctors are created equal,” said Jonathan Leviss, MD, chief medical officer for Rhode Island Quality Institute, a physician for Thundermist Health Center and a clinical assistant professor for Alpert Medical School and Brown University.

“The one thing that I’ve learned most importantly is that these are team-based efforts,” he continued. “We’re talking about getting data out of electronic health records, out of different HIT systems, to drive quality initiatives, which requires us to look at data in a way that an individual person can’t, the individual brain, whether that’s a physician, a nurse or a quality person.”

Beyond that need for a pack mentality in the EMR stratosphere, Reid Coleman, MD, chief medical information officer for evidence-based medicine, Nuance Communications, spoke of the importance of roles distributed to people who both know the importance of data and who want to be strictly involved in the pursuit of it.

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The AAMC has released a new report to help medical schools assess the impact of medical school holistic admissions. Roadmap to Excellence: Key Concepts for Evaluating the Impact of Medical School Holistic Admissions is the third in the series of publications from the AAMC Holistic Review Project that aims to help schools establish, implement, and evaluate diversity-related policies to help them achieve their individual missions, while staying within the established legal framework. The publication includes an introductory chapter on evaluation basics and focuses on assessing three main areas: enrollment management, the medical school learning environment, and workforce outcomes.

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A simulated teaching package that focuses on helping undergraduate medical students to improve their ability to conduct arterial blood gas (ABG) testing has been developed by a team at the Bath Academy in the U.K. This simulated teaching package is expected to advance the competence and confidence levels of Bristol university medical school undergrads to perform these important blood tests.

Arterial blood gases (ABGs) testing is often required in testing sick patients to help diagnose the severity of a condition and assist in assessing treatment. We've learned in highschool that as blood passes through our lungs, oxygen moves into the blood and carbon dioxide moves out of the blood and into the lungs. What an ABG test does is check how well the lungs are able to carry oxygen into the blood and remove carbon dioxide from the blood. The test uses blood drawn from an artery to measure its oxygen and carbon dioxide levels before they enter body tissue.

The Bath Academy, which trains the medical students at the Royal United Hospital, hopes the simulated teaching package will help to improve positive patient outcomes and gain valuable experience for the medical students. For more information, click here>>

If it's a Monday, you can usually find Dr. David Brown parked next to a lake in Miami, spending the day inside a 36-foot-long RV. He's not on vacation. Brown is chief of family medicine at Florida International University's medical school. The RV is the school's mobile health clinic. Every Monday it's parked at the Royal Country Mobile Home Park in northwest Miami-Dade County. "It's a beautiful place right here," he says. "But this is not a wealthy community."

Brown helps direct FIU's Neighborhood HELP program. It's part of the school's curriculum that connects medical students with families in neighborhoods where medical care is scarce. Students visit families in their homes where they conduct examinations and provide basic care. But some things are better done in a clinic. So the medical school bought its own RV. "We're able to bring free basic primary care to our households relatively close to their community," Brown says.

In one of the RV's exam rooms, third-year medical student Veronica Alvarez met recently with patient Maritza Flores. Flores has diabetes and high blood pressure. With help from the school's faculty, Alvarez has been treating her since January.

Flores says with Alvarez's encouragement, she's begun exercising more and has improved her diet. And, thanks to FIU's doctors, she's begun taking medication for her diabetes and high blood pressure. In just a few months, Alvarez says, she's seen a big improvement. "The high blood pressure and the diabetes together is what you worry about," Alvarez says. "And now, her diabetes is well-controlled and her hypertension is well-controlled as well."

Over the last decade, a pressing need for new doctors has led many universities to open medical schools. Seventeen new schools have been accredited since 2005, and several are looking at new ways to train doctors. When it was founded just four years ago, Florida International University took on a mission — to improve the health of nearby communities. Another focus for the school is to train more doctors in primary care.

Nationally, there's a shortage of primary care doctors — one that's expected to worsen as millions more Americans get access to health care under the Affordable Care Act. But Dr. John Rock, the medical school's dean, says the two missions go together. Sending students out to treat patients in their communities teaches them the art of primary care.

FIU just graduated its first class from the medical school. Nearly half of the students, Rock says, are doing residencies in primary care. Several other new medical schools are also developing programs that allow students to develop ongoing relationships with patients. And there are others that, like FIU also have a social mission — to improve the quality of life in medically-underserved communities.

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Presented by Richard Pizzi, AIA, VP, and healthcare design principal for Lavallee Brensinger Architects.

We had a great response to today's webinar. Feel free to post your questions/comments for Richard in the comments box below.

Abstract: This interactive webinar will explore the planning, programming, and design of clinical simulation centers. We will discuss a collaborative and inclusive process to define your goals and create a space program that accommodates all simulation activities. The webinar will discuss the design of flexible, multi-functional simulation labs and the spatial relationships between labs and support space. The webinar will also review the integration of simulation, AV, and medical equipment as well as lessons learned and current/future trends from active simulation centers.

Richard Pizzi, AIA, VP, is a healthcare design principal for Lavallee Brensinger Architects regional healthcare design firm. Rich has specialized in healthcare design for nearly 19 years. For the past 6 years, he has focused on the research, programming, and design of clinical simulation centers. During this time, Rich has programmed and designed clinical simulation centers for large academic medical centers, community hospitals, medical schools, and nursing schools. His efforts have also included first-hand training observations, site visits, and post-occupancy reviews. Rich is a member of the Society for Simulation in Healthcare.

Each year, on average, medical school admissions committees sift through some 4,500 applications for each entering class of 100 to 200 or more students. The first cut is most fierce; of those thousands of applicants, only a few hundred are invited for an interview. From there, roughly one in every four of those interviewed will be accepted.

Medical schools have traditionally relied on undergraduate science grades and the MCAT to decide which applicants to interview. They based this approach in part on numerous studies that found good correlations between science G.P.A. and MCAT scores and subsequent medical school performance.

But more recent studies have also revealed that MCAT scores are significantly influenced by a student’s race, gender and socioeconomic background. Observers have noted, too, that a large and lucrative industry has developed around MCAT preparation; and students who could not afford the substantial tuition or time required by such prep courses were finding themselves at a disadvantage.

In response, a few medical schools and the Association of American Medical Colleges began to experiment with a different approach to admissions. Instead of using grades and MCAT scores as cut-off points to whittle down the initial applicant pool, they began assessing those numbers in the context of life experiences, socioeconomic status, cultural and ethnic background, gender identity and the medical school’s particular mission, be it to produce research scientists, compassionate clinicians or both.

But unlike traditional medical schools that might have been reserving such “holistic review” for the few candidates fortunate enough to be interviewed, these schools went one step further; they engaged in holistic review from the get-go, applying it to every submitted application.

The results have been both uplifting and unexpected. Since Boston University School of Medicine began incorporating holistic review in all phases of its admissions process five years ago, faculty members have noted that students appear to be more collegial, supportive of one another, open to new ideas and perspectives and engaged in community activities. They also have turned out to be as prepared as previous students, with no significant differences in average MCAT scores and college grades.

And, despite a lack of quotas or caps, students from groups underrepresented in medicine have nearly doubled, to 20 percent.

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U.S. Medical school enrollment is projected to increase 30 percent by 2017 to 21,434, according to the results of an annual AAMC survey that monitors ongoing enrollment trends. Of the projected growth in enrollment between 2002 and 2017, 31 percent of the growth will stem from schools accredited since 2002, and 7 percent from schools currently in applicant or candidate status with the Liaison Committee on Medical Education. The survey was released during the AAMC’s Ninth Annual Physician Workforce Research Conference where researchers, policymakers, and educators discussed federal and state workforce issues, focusing this year on new models of care delivery.

The survey also found that 40 percent of medical school deans surveyed expressed “major concern” about enrollment outpacing the number of available residency training positions. “Increasing enrollments show that medical schools are doing their part to avert the shortage of more than 90,000 primary care and specialty doctors this nation faces by 2020,” said AAMC President and CEO Darrell G. Kirch, M.D., in a press release. “However, this will not result in a single new practicing physician unless Congress acts now to lift the cap on residency training positions.”

Read on: Results of the 2012 Medical School Enrollment Survey

PHILADELPHIA (CBS) — A training tool developed locally will help future doctors and medical personnel save lives during childbirth.

C-Celia is a one-of-a-kind, lifelike “manikin” used to teach students at the Drexel University College of Medicine to perform caesarean sections before seeing a real patient.

Dr. Owen Montgomery, chair of the department of obstetrics and gynecology, says the device allows a surgery resident “to actually do a caesarean using a knife and cutting through tissue and delivering a baby, just as if it was happening in the real world.  Simulation allows us to put residents in situations where they need to prepare for the future.”

Second-year resident Roxanna Irani said it was like doing the surgery for real.

“It was kind of a fun surprise to get a scalpel and, rather than be saying, ‘Okay I’m going to cut into the abdomen,’ to actually get to do it,” she said.

The damaged parts are repaired or replaced, and C-Celia is ready for the next procedure.

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Training healthcare providers to be able to respond to any situation they might find themselves in is crucial to their development as healthcare professionals. With recent advancement in the use of technology, simulation training provides an excellent (and safe) learning environment in the curriculum of students as well as for ongoing training for current healthcare professionals.

While hands-on learning with real patients cannot be completely replaced, simulation training provides a safe environment for learning. Making mistakes can be a valuable part of the learning process. In the simulation environment, patients at not put at risk.

According to the Society for Simulation in Healthcare, simulation training is “the imitation or representation of one act or system by another” and serves as “a bridge between classroom learning and real-life clinical experience.” No longer must students practice giving injections by using an orange or budding surgeons practice suturing by using a piece of felt.

Healthcare is catching up to other industries in using scenario based training. For instance, aviation has been a long-time user of simulation training for pilots. In fact, the first known flight ‘simulator’ was the Antoinette Trainer developed in 1909. Rudimentary by today’s standard, the simulator consisted of a “half-barrel mounted on a universal joint, with flight controls, pulleys, and stub-wings.” Over time, the setup became more advanced. Beginning in the 1950’s, technology was introduced to aviation simulation. By the 1980‘s, it was much more integrated. Today, many aviation simulators are so advanced, it would be tough to tell them apart from the real thing.

Aviation knew the importance of training pilots in situations where they could “achieve, test, and maintain proficiency in the operation of an airplane without risk to person or property and at a lower cost to training in the air” (Aviation WikiJournal).

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