More than 7,700 healthcare organizations have registered with the California Health Information Partnership and Services Organization (CalHIPSO), the largest REC in the country. This figure is significantly higher than the 6,200 care providers that were expected to join the program when it was launched two years ago.

Officials at CalHIPSO are also tasked with a significant challenge in achieving their goal of helping 6,200 of the care organizations registered with the initiative to meet the criteria established by the Centers for Medicare and Medicaid Services' meaningful use incentive program. Currently, only 210 care organizations registered with CalHIPSO have managed to demonstrate meaningful use of clinical informatics systems.

Speranza Avram, chief executive officer of CalHIPSO, told the news source that additional pressure to comply with changes in regulatory policy is also contributing to the REC's workload.

In an attempt to understand how RECs are changing the clinical landscape of the U.S., the Office of the National Coordinator for Health IT (ONC) recently launched its Health IT Dashboard, reports Healthcare IT News.

The ONC's web-based data portal features a range of information on the effectiveness of various grants and federal funding initiatives including RECs, and provides a snapshot of how healthcare IT such as health information exchanges and medical informatics systems are revolutionizing healthcare in the U.S.

VRI, based in Dayton, Ohio, operates a number of remote patient monitoring centers staffed by trained nurses. The collaboration between the two companies will focus on a service aimed at patients suffering from chronic illnesses such as asthma, diabetes and coronary heart disease.

Patients' homes will be fitted with remote monitoring devices that will detect abnormalities in their vital signs. Data on heart rates, blood pressure and glucose levels will be sent electronically from patients to monitoring centers for analysis by nurses. Personnel will be able to assess whether an intervention is necessary based on the readouts, and detailed reports on a patient's overall health can be compiled from the data.

"Health plans and hospitals will no longer have to actively monitor the information because VRI's call center will monitor it for them," Andy Schoonover, chief executive officer of VRI, told the news source. "VRI will only contact them in a case in which a clinician is needed to give the care required to keep them from being hospitalized."

Telehealth is becoming one of the largest growth areas of healthcare IT. Earlier this year, several companies including AT&T, Cisco Systems and Polycom demonstrated new telehealth technologies at the American Telemedicine Association expo in San Jose, California.

The news source cited a report published by a subsidiary of IMS Research that suggests the global telemedicine market will be worth an estimated $1 billion by 2016. Companies such as AT&T are seeking to capitalize on the need for many hospitals to reduce expenditure related to patient readmission. 

Coastal Women's Healthcare serves a community of 20,000 people along Maine's southern coast and was the first healthcare practice in the state to receive incentive payments through the Centers for Medicare and Medicaid Services' (CMS) meaningful use program.

Members of Congress, local healthcare advocates and officials from the CMS commended Coastal Women's Healthcare during a special ceremony earlier this month for its implementation and use of medical informatics technology.

Beverly Neugebauer, the center's executive director, was applauded for her proactive attitude toward adoption of healthcare IT. Neugebauer sought the assistance of the Maine Regional Extension Center (MEREC) when implementing clinical informatics systems at the facility.

"While our providers’ exceptional care of their patients is clearly our priority, the added element of new, secure technology helps us improve patient care while also increasing patient convenience," Neugebauer told the news source. "For example, electronic medical records have helped us ensure our patients are getting the best quality care, while our online patient portal makes it easy for our patients to complete necessary medical history forms, access their lab results or request appointments."

According to Maine Quality Counts, MEREC has been instrumental in assisting healthcare providers across the state with implementing medical informatics technology. Services offered by MEREC include providing physicians with an overview of the CMS' meaningful use program, educational webinars to promote best practices and summaries of reporting procedures, and biannual professional development forums.

The national regional extension centers initiative was introduced under the Health Information Technology for Economic and Clinical Health Act, and aims to enable all healthcare facilities to select and deploy healthcare IT such as medical informatics networks. 

In a letter to Kathleen Sebelius, secretary of the HHS, officials from AHIMA strongly opposed the decision to delay the transition to the new codebase. Originally, the deadline for migration to ICD-10 was October 2013. Officials at the HHS voted to postpone the date by one year to October 2014 earlier this year, despite opposition from several healthcare IT advocacy groups.

The letter recognized the steps taken by the HHS in providing healthcare organizations with adequate assistance in migrating to the new codebase, but urged Sebelius to ensure that no further extensions to the deadline were authorized beyond October 2014.

"ICD-9 is antiquated and no longer adequately meets the challenge of a 21st-century healthcare system," Lynne Thomas Gordon, chief executive officer of AHIMA, said in a statement. "ICD-10 should be implemented in a timely manner, and AHIMA is ready to continue assisting the healthcare community to prepare for the transition.  We also encourage advance testing of the ICD-10 codes to be sure there are no further delays in the implementation deadline."

Work on the ICD-10 codebase originally began in 1983 and was completed in 1992. The improved codes enable physicians to bill insurance providers for a variety of new medical conditions and diagnoses, but substantial investments in healthcare IT infrastructure and staff training have delayed adoption of the new system.

Several countries have been using ICD-10 or regional variants of the codes for some time. Canada first adopted its own version of the codebase in 2000, and Korea implemented a variant of the system in 2008.

Researchers at Chilmark profiled 22 HIE vendors as part of its "2012 HIE Market Report: Analysis and Trends" paper. Results of the study indicate that payment reform has necessitated changes to the way that small- to mid-size healthcare providers implement HIEs.

In addition to shifting reimbursement models, healthcare providers are becoming less constrained by regulatory requirements necessary for demonstrating meaningful use of medical informatics technology. Stage two meaningful use attestation criteria place significantly more emphasis on the kind of data exchange facilitated by HIEs than in stage one, and changes to reimbursements mean community-wide care is becoming a priority for many providers.

"As federal incentives drive the adoption of electronic health record (EHR) technology in the U.S., we will quickly move into the post-EHR era where the value of patient data is not what is locked in an EHR data silo, but the cumulative patient data that resides in the community HIE network," said John Moore, founder and managing partner of Chilmark Research, as quoted by the news source.

Despite the growing need for larger healthcare organizations to implement an HIE, a recent study indicates that the substantial financial investment necessary to launch an HIE is still a barrier for many providers.

Information Week cited a study published by Beacon Partners that suggests 41 percent of C-Suite executives in healthcare reported high start-up costs and infrastructure development as their main concerns for launching an HIE initiative.

According to the paper, approximately one in five executives polled stated they had no dedicated healthcare IT budget allocated to the implementation of an HIE.

The web-based interface, known as the Archimedes Healthcare Simulator, will be developed with assistance from Kaiser Permanente and promises to enable physicians and healthcare IT personnel to access significant volumes of patient information and medical demographic data. Officials claim the system will improve medical research and analytics, and enable researchers to assess the effects of specific healthcare interventions more quickly and effectively.

"The quality and cost of healthcare are determined by decisions made by policymakers, physicians and others," David Eddy, founder and chief medical officer of Archimedes, said in a statement. "To make those decisions wisely, decision makers need to know the consequences of the different options they face. For a high proportion of decisions, the only feasible way to get the needed information is to use mathematical models that integrate existing evidence, and are validated against evidence."

The Archimedes Healthcare Simulator will be made available to a range of government healthcare agencies, including the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Agency for Healthcare Research and Quality, the National Heart, Lung & Blood Institute and the Food & Drug Administration.

Using healthcare modeling data based on the Archimedes system, Kaiser Permanente suggested that aspirin, lovastatin and lisinopril be administered to patients at high risk of serious cardiac conditions. Based on this recommendation, rates of heart attacks and strokes observed in at-risk individuals fell by 60 percent during a two-year period.

Key objectives of the system include improving preventative policy guidelines, federal incentive programs, in addition to evaluating the effectiveness of different treatment options and healthcare IT systems. Officials say the network will also be used to design clinical trials, more accurately forecast the costs of federal healthcare initiatives and estimate the return on investment of intervention programs. 

The AHA made a series of recommendations to the CMS over the attestation procedures for stage two of the meaningful use initiative earlier this week. However, members of the Health IT Policy Committee have dismissed some parts of the AHA's recommendations as "spurious."

In particular, the AHA's assertions that patients should not be given extensive access to their records and hospital admissions data via medical informatics systems was hotly disputed by the National Partnership for Women & Families, a member of the Health IT Policy Committee.

"We know from the last two years of public debate on meaningful use that the association has really pushed back hard on the requirement around giving patients access to their health information electronically," Christine Bechtel, vice president of the National Partnership for Women & Families, told the news source. "It makes no sense to me that they would fight so hard against it, and create such spurious arguments."

Members of the AHA argue that providing patients with admissions information electronically violates the Health Insurance Portability and Accountability Act (HIPAA), and that requiring hospitals attesting to stage two meaningful use of medical informatics systems was not feasible under present guidelines.

However, in a blog post published on the Center for Democracy and Technology's (CDT) website, Devan McGraw, a lawyer and director of the Health Privacy Project at the CDT, said there was no basis for the argument that the CMS could not create attestation requirements that grant patients additional rights to access their health information.

McGraw added that hospitals should be seen as partners in healthcare by patients, and that the CMS were on solid legal ground in creating requirements that mandate hospitals provide patients with greater access to relevant information.

Of the four suggestions outlined by the GAO, officials at the CMS agreed with three of them. The first point dealt with establishing a timeframe for evaluating the effectiveness of healthcare facilities' audit processes. The GAO also recommended that the CMS collect additional information from hospitals attesting to meaningful use of medical informatics systems during evaluations. Additional pre-payment reporting verifications were also outlined as a way for the CMS to improve the attestation process.

However, officials at the CMS disagreed with the GAO's fourth recommendation, that the CMS should offer states the option of collecting attestation data on behalf of regional reporting authorities.

The CMS indicated that internal audits into the effectiveness of existing reporting and assessment procedures would be carried out in response to the GAO's suggestions. Such audits are intended to measure how many healthcare providers have been awarded financial incentives based on incorrect or incomplete data.

According to Information Week, many healthcare providers are incapable of successfully demonstrating meaningful use of medical informatics systems due to the lengthy and complicated reporting measures involved. Smaller practices and individual clinicians are particularly affected by the restrictions of the attestation process.

Researchers at the Centers for Disease Control and Prevention (CDC) found that while 51 percent of office-based physicians intended to attest to meaningful use last year, only 11 percent had clinical informatics solutions that could successfully meet the CMS' requirements.

Results of the CDC's National Ambulatory Medical Care Survey indicated that very few physicians were using medical informatics technology with sufficient computational power to meet 10 or more of the 15 core modules required for meaningful use attestation. 

During his address at the event, Mostashari urged healthcare IT professionals and clinicians to focus on the quality of care facilitated by medical informatics technology, and said that healthcare IT was approaching a tipping point.

"In 2016, it’s going to be rare to find a doctor without [electronic health records]," said Mostashari, as quoted by the news source. "We need to focus on what matters. You start with questions like what kills the most people, and how can we improve to save more premature deaths. It’s astounding how few quality measures we actually have that get to that."

He added that, despite the increasingly complex functionality offered by clinical informatics systems, emphasis should be placed on patient-centric approaches to care and that simpler features could lead to better patient outcomes.

Medical informatics systems are not the only technological advances that are rapidly changing the healthcare IT landscape. According to Information Week, cloud-based data archiving is becoming a major part of many healthcare providers' strategic objectives.

Pre-admission and patient screening processes, remote monitoring and point-of-care documentation methods are all being transformed by cloud-based technologies. As increasing numbers of healthcare providers migrate large data sets to the cloud, some experts believe the use of mobile devices such as tablets will become more prevalent in healthcare IT, due in part to the potential for greater data security.

In addition to revolutionizing how clinicians provide treatment, cloud-based healthcare IT could also reduce fraud. The news source reports that some care providers are using predictive modeling techniques to eliminate health fraud, which accounts for as much as 10 percent of the total medical costs in the U.S.

The results of the study indicate that although 89 percent of healthcare providers conduct regular security assessments, few major changes are made as a result. Researchers at the Healthcare and Information Management Systems Society (HIMSS), which conducted the study, identified a "checklist" mentality that may be exposing patient health information at risk needlessly.

"Employees at healthcare organizations touch data tens of thousands of times every day, meaning there is a lot of opportunity for data breaches to occur," Jennifer Horowitz, senior researcher at HIMSS, told the news source. She added that healthcare providers should "have the policies and procedures in place to support a culture in which privacy and security is a top-of-mind focus for organizations."

Horowitz said increasing pressure for hospitals to comply with federal regulations and attempts to demonstrate meaningful use of medical informatics systems are partially to blame for the checklist security mentality observed in the study. However, she added that many healthcare providers have the means to take action based on the results of security risk assessments, and should strive to do so in the future.

Although data encryption and adequate management of security permissions for healthcare IT personnel are vital to the integrity of data on a hospital's network, misplaced or stolen hardware can also be a factor in instances of unauthorized data access.

According to eWeek, Emory Healthcare recently reported the loss of 10 backup disks containing medical records of approximately 315,000 surgical patients who received treatment between 1990 and 2007.

The disks went missing from a storage facility at Emory University Hospital in Atlanta, Georgia. Officials from the facility claim the hospital's healthcare IT network was not hacked or illegally accessed.

Eric Paternoster, chief executive officer of Infosys Public Services, told the news source that the Supreme Court's ruling would have little effect on many healthcare providers' plans to proceed with HIE initiatives. In the event that the PPAC Act is unconstitutional, Paternoster believes many hospitals and care organizations will continue to work on wide-scale healthcare IT projects.

"Given their reading of what happened during the hearings, their thinking [is that if] the mandate is removed and the state exchanges fall, [they will] go ahead with a private exchange or a hybrid model where the state would license private exchanges," Paternoster told the news source.

Infosys surveyed 100 chief information officers and healthcare IT executives shortly before the PPAC was first evaluated by the Supreme Court. Results of Infosys' research indicates that approximately 80 percent of healthcare managers plan to implement healthcare IT projects based on the Affordable Care Act.

A further 80 percent of individuals polled stated they plan to participate in a health insurance exchange project, despite regulatory uncertainties raised by the Supreme Court's assessment of the PPAC Act.

According to Healthcare Finance News, many experts believe the Supreme Court will deliver its ruling on the constitutionality of the PPAC in June.

The news source reports that speculation on the outcome of the three-day hearings has abounded, with many experts believing the PPAC will be declared unconstitutional. Controversy surrounding the individual mandate of the PPAC has taken center stage in the world of healthcare policy, with opponents of the PPAC arguing that Americans should not be federally mandated to purchase health insurance coverage. 

The report, titled "Policy in Practice," aims to assist healthcare IT professionals, regulatory compliance officers and medical executives navigate the increasingly complex field of clinical data in the 21st century.

Researchers at the Markel Foundation discussed the healthcare IT industry with a number of technology, regulatory and management professionals in order to draft the guidelines.

"The landscape for health information sharing is changing," Laura Bailyn, senior director for health initiatives at Markle, told the news source. "As health information sharing needs and capabilities continue to evolve, it is critical to incorporate new knowledge and lessons learned."

Although Markel has published other documentation that is similar in nature to "Policies in Practice," including the Common Framework in 2006, the healthcare industry's increasing focus on regulatory compliance through legislation such as the Health Information Technology for Economic and Clinical Health (HITECH) Act necessitated a more current set of policy guidelines.

Large hospitals and smaller healthcare providers alike have struggled with the industry's shift toward greater accountability and regulatory compliance.

According to Clinical Advisor, the requirements outlined in the HITECH Act have placed a significant burden on care environments attempting to demonstrate meaningful use of medical informatics technology.

Despite widespread adoption of clinical informatics systems, many care providers are still experiencing challenges in aligning their practices and procedures in accordance with HITECH and Health Insurance Portability and Accountability Act guidelines.

William Chin, executive medical director of HealthCare Partners in Torrance, told the news source that clinical informatics systems were not merely a way for doctors to digitize paper medical records, but had to completely transform the way physicians care for patients.

Officials at CHIME claim healthcare providers require more time to demonstrate meaningful use of clinical informatics systems during stage two of the CMS' federal financial incentive program. Other suggestions for the initiative outlined by CHIME include revising the language of reporting requirements to be more clear and lowering of the thresholds necessary for hospitals and physicians to meet stage two of the program.

CHIME also recommended that the introduction of a 90-day reporting period would enable more care providers to demonstrate meaningful use of medical informatics systems. Some healthcare IT experts have expressed concern over hospitals' capability to attest to stage two of the program in light of continued technological advances in the clinical informatics space.

"Even in the best-case scenario, we are unconvinced that newly certified technologies would be widely available before January 2013 – this leaves 9 months to a year for more than 100,000 providers to adopt, implement and use new technology," Jeffery Smith, CHIME's assistant director of advocacy, told the news source.

According to Becker's Hospital Review, officials at CHIME also expressed concerns over certain reporting requirements, specifically those relating to ambulatory and inpatient care environments.

The news source reported that the list of requirements for healthcare providers operating in these areas is relatively small in comparison to other clinical care facilities, leaving eligible providers with few options for successfully attesting to stage two meaningful use of clinical informatics systems.

In a letter to the CMS, CHIME stated that the restrictions faced by ambulatory and inpatient care providers could have significant cost implications if the 42 core requirements outlined in stage two are not addressed.

Officials from the AHA agree in principal with the CMS' and Department of Health and Human Services' efforts to encourage widespread and accelerated medical informatics adoption, but claim the requirements necessary to achieve stage two certification are too demanding for many healthcare facilities.

Rick Pollack, executive vice president of the AHA, said there was a growing disparity in adoption of medical informatics systems between urban and rural hospitals. He added that many smaller facilities have yet to achieve stage one of the CMS' meaningful use initiative.

"Taken as a whole, the proposed requirements for meeting stage two raise the bar too high and are not feasible for the majority of hospitals to achieve," said Pollack, as quoted by the news source. "Given the experience to date in stage one, the AHA is concerned that elements of the proposed rule for stage two would stand in the way of a successful program to support widespread adoption by all hospitals."

Suggestions for improving the meaningful use program outlined by the AHA included the introduction of a 90-day reporting period during each stage, as well as the extension of each phase of the initiative to three years. AHA officials said such measures would ensure that hospitals can safely and efficiently migrate to each stage of the program without causing undue pressure on financial and healthcare IT infrastructure resources.

According to AHA News, as many as 80 percent of hospitals across the country have yet to demonstrate stage one of the meaningful use initiative due to an emphasis of regulatory compliance over hospital experience, accelerating costs and limited medical informatics vendor capacity.

The news source cited a study published by the Institute for Health Technology Transformation (IHTT) that revealed a growing need for healthcare IT professionals to capture more patient data, improve clinical workflow automation procedures and expand regional and local networks. The report also indicated the potential benefits of providing a higher quality of care for certain patient demographics served by ACOs.

Medical informatics systems, telehealth platforms, data management software, information archiving and analytics systems were identified as technologies that could help care facilities provide better care for their patients and reduce hospital readmission rates, which are key objectives of ACOs.

"When you talk about population health management, you're talking about interventions, you're talking about stratifying a patient population and targeting those patients who are at most risk today but also next year, and then you're talking about having a system in place to take preventative action," Waco Hoover, chief executive officer of the IHTT, told the news source.

The study also highlighted difficulties healthcare providers may experience in managing large volumes of patient data. Interconnectivity issues, differing medical informatics systems and other interoperability concerns can contribute to ineffective sharing of patient health information that could be used more effectively.

According to FierceHealthIT, PHM is vital to improving conditions and the quality of care at patient-centered medical homes.

Connie White Delaney, dean of the University of Minnesota's School of Nursing, echoed the findings of the study, saying that mobile and telehealth initiatives were crucial in improving PHM in patient-centered medical homes, and that information exchange between medical informatics systems and care providers must be maximized to cater to the needs of an aging population.

Lead researcher Chun-Ju Hsiao and her team at the National Center for Health Statistics within the Centers for Disease Control and Prevention compiled responses from a survey of more than 3,390 physicians from all 50 states to arrive at their conclusions.

The study revealed that while 91 percent of physicians nationwide believed they were eligible to receive payments under the Centers for Medicare and Medicaid Services' (CMS) meaningful use incentive program, only 10 percent actually did so. These figures were substantially lower than officials at the CMS had originally predicted.

The CMS initially expected between 10 and 36 percent of Medicare-eligible professionals and 15 to 47 percent of Medicare providers to demonstrate meaningful use of medical informatics systems last year.

Results of a report published by KPMG indicate that despite rising levels of medical informatics adoption at care facilities across the country, many healthcare providers see the CMS' meaningful use guidelines as a compliance challenge.

Key findings of the study indicate that 71 percent of hospitals polled said they were more than 50 percent done with completing a clinical informatics implementation project. Although 48 percent of respondents said they were confident they would demonstrate stage one meaningful use of their medical informatics networks, 10 percent were not aware of their overall state of readiness. A further 3 percent indicated they felt that they would not achieve stage one compliance by the end of the year.

"Achievement of meaningful use is a major organization-wide transformational initiative, and associated challenges must be effectively managed from the beginning or organizations may face serious project risk issues down the line," Brad Benton, partner and national account leader for KPMG Healthcare, said in a statement.

Malaz Boustani, associate director of the Indiana University Center for Aging Research, and his team conducted an in-depth survey of how the CDS functionality of the clinical informatics system at Wishard Memorial Hospital in Indianapolis affected patient outcomes. The report suggests that there were no statistically significant benefits of using CDS tools when treating patients suffering from cognitive impairment (CI).

Boustani told the news source that medical informatics vendors need to reassess how CDS tools provide information to physicians.

"The entire industry of clinical decision support is going in the wrong direction," Boustani said. "We want computerized decision support to start working in the same way as a diagnostic tool or a diagnostic order."

Some medical informatics vendors are moving toward a more individualized approach to CDS. The Moffit Cancer Center in Tampa, Florida, recently implemented healthcare IT solutions from Oracle Health Sciences Technology that use sophisticated algorithms to provide physicians with more relevant information on patients' medical conditions.

The new network gathers data and intelligence from the various components of the center's clinical informatics systems to deliver treatment solutions at an individual level. Since deploying the system, officials at the center say they have reported an increase in the amount of data being requested by researchers and clinicians, and that leveraging the volume of data available to analysts will enable them to identify patients eligible for clinical trials more effectively.

Data collected and distributed throughout the network will also be gathered for advanced research studies into the oncological applications of various treatments.

Healthcare IT solutions

The news source cited a report published by healthcare research and analytics firm KLAS that indicates a significant number of medical facilities plan to adopt a CAC system in the next two years. Results of the study suggest that CACs are becoming an integral part of many healthcare providers' ICD-10 readiness strategies.

"Providers worry their staff will not be ready in time for ICD-10," Graham Triggs, a research manager at KLAS and author of the report, told the news source. "Though the market is young and no vendor has fully proven itself in the inpatient space, provider confidence that computer-assisted coding technology will ultimately create greater efficiency, productivity and ICD-10 readiness is high."

Fears of lost productivity

The original deadline for healthcare providers to migrate to the new coding system was October 2013. Although this was recently extended to October 2014, many healthcare facilities and care providers are anxious about losing the momentum gained prior to the announcement.

Lynne Thomas Gordon, chief executive officer of the American Health Information Management Association, told Information Week that the HHS' decision to extend the ICD-10 deadline effectively penalizes healthcare providers who were on track to meet the original migration date. She added that the extension also creates problems for colleges and universities who developed curricula based on the original deadline. 

Medical informatics becoming standard in healthcare IT

The figures indicate that adoption and use of medical informatics technology are becoming increasingly important to clinicians across the country. The news source reports that the states with the highest levels of medical informatics adoption and meaningful use attestation are California, Texas, Pennsylvania, Florida and New York.

Officials from the CMS also predict that many organizations beyond the initial Medicare first-adopters will register or attest to meaningful use of clinical informatics systems this year.

According to official data from the CMS, more than $1.3 billion was paid to eligible professionals under the Medicare program alone from May to December of last year. Figures from the CMS also indicate that more than 176,000 clinicians and healthcare facilities are registered in the medical informatics meaningful use incentive program across the country.

Marketplace becoming more competitive

Despite strong indications that clinical informatics usage is rising, some experts have observed struggles experienced by some vendors. According to a report published by IDC Health Insights, adoption of medical informatics systems is expected to reach 80 percent by 2016, placing electronic health record (EHR) developers under additional pressure to compete in an already crowded marketplace.

"The magnitude of the commitment that these EHR vendors need to make to produce functionality that both supports the operations of a practice and allows them to participate in meaningful use projects is fairly great and I think I saw some vendors struggle under that burden while others seem to thrive," Judy Hanover, research director at IDC Health Insights, told Information Week.

Big data, big solutions

The news source cited a study published by the Stanford University School of Medicine, which focused on the treatment of a seriously ill teenager suffering from systemic lupus erythematosus (SLE), complicated by kidney dysfunction and pancreatitis. After searching the available literature on the condition, a lack of data from randomized controlled trials hampered efforts to treat the girl effectively.

Before agreeing upon a course of treatment, doctors consulted data in the hospital's medical informatics network and the Stanford Translational Research Integrated Database Environment (STRIDE) data warehouse. Using this system, clinicians discovered records for 98 other patients suffering from SLE with similar complications. Examination of the records revealed that this illness places the patient at increased risk of blood clots. As such, doctors administered anticoagulant drugs to the girl as a primary course of treatment.

The next level of data warehousing

This case serves as an example of how medical informatics systems combined with large volumes of patient data can provide clinicians with the information they need to tackle complex medical conditions.

At a recent meeting of the Managed Care Executive Group (MCEG) in Florida, officials from healthcare providers across the country identified the top 10 concerns facing care facilities and providers in the coming year. Sophisticated use of medical informatics systems alongside advanced data warehousing were among the issues discussed at the event.

"This year there was an overwhelming sense that everything seems to be a top priority," Vince Ferri, chairperson of MCEG and chief information officer of AvMed Health Plans, said in a statement. "The forum discussions provided critical insight for MCEG members to consider relevant factors that will lead to their health plan's success."