NewYork-Presbyterian Hospital Blazes Trail to Age of Digital Recordkeeping
April 07, 2009
Microsoft HealthVault and Microsoft Amalga will give patients unprecedented online access to medical information.

NEW YORK — April 7, 2009 — Like all physicians, Dr. Mehmet Oz considers what his patients experience when they come to see him. “The first thing new patients are asked to do is fill out yet another medical history form, just as they have at every other medical office they have visited. And they probably ask themselves why there isn’t an electronic form that they can fill out once and then make available to any new doctor they need to see. I’ve asked myself the same question. After all, it would be faster, more accurate, easier for both patients and doctors, and probably more secure,” says Oz, who is director of the Cardiovascular Institute at NewYork-Presbyterian Hospital/Columbia University Medical Center.

A screen shot of the myNYP.org Web site shows how users can update immunization records, one of many tasks they now can perform with NewYork-Presbyterian Hospital’s new digital health record system.
A screen shot of the myNYP.org Web site shows how users can update immunization records, one of many tasks they now can perform with NewYork-Presbyterian Hospital’s new digital health record system.
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Now, Oz’s hospital is leading the way to that digital-records future. This week NewYork-Presbyterian announced a new service called myNYP.org, a health record portal built upon Microsoft Corp.’s HealthVault and Amalga unified intelligence system (UIS) technologies. Now, eligible patients will be able to access their medical information wherever and whenever they need it.

HealthVault is an open, security-enhanced platform that allows users to create a Web-based account that can manage several sets of records, from blood tests to CAT scans, even for an entire family. Amalga aggregates vast amounts of clinical, administrative and financial data from disparate information systems — so-called “data silos” — and tailors that information for use by physicians, analysts, laboratory technicians, nurses and administrators. Today, hospitals in the US typically have to deal with about 100 different data silos.

Empowering Consumers

NewYork-Presbyterian Hospital is one of the largest hospitals in the world. Actually composed of two renowned medical centers, NewYork-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Weill Cornell Medical Center, the hospital is also affiliated with two Ivy League medical schools, Columbia University College of Physicians and Surgeons and Weill Medical College of Cornell University.

Presidential Support for Digital Health Records

President Barack Obama has made healthcare reform a central part of his first-term agenda. And a key element of that reform is Obama’s determination to create, within the next five years, digital health records for everyone in the United States. The president hopes to spend $19 billion to help modernize medical records systems. That money may help overcome one of the biggest obstacles to their adoption — cost.

That is one reason why hospitals and doctors have been slow to make the digital transition. An absence of standards is another. As a result of those hurdles, fewer than one in 10 U.S. hospitals have even partially replaced paper medical charts with health information technology systems, according to a study published in the March 26 online edition of the New England Journal of Medicine. An earlier study by the same authors — from the Harvard School of Public Health, several hospitals, and George Washington University — showed that only 17 percent of doctors had begun to use electronic health records.

Because NewYork-Presbyterian Hospital is the first large institution to move beyond the pilot stage for consumer-controlled health records, the program is apt to be closely watched, The New York Times reported on April 6, 2009. As Dr. Corwin told the Times, a personal health record is a “powerful additional tool for improving health care.”

The myNYP.org portal allows patients to move medical data into secure digital records for later access by healthcare workers. The platform can store prescriptions, surgery reports, hospital discharge instructions, laboratory results, radiology and EKG images, insurance information, emergency contacts, and more. In addition to managing their own health information, patients can add health information for family members, including spouses, children, parents and dependents.

To allow a service provider to retrieve the stored data, a patient types in the doctor’s e-mail address and sets up permissions for that doctor to view and/or modify particular files. In this way, patients can give particular service providers access only to the specific information they need. Physicians can then add comments and explanations to the records to help patients understand their medical tests and procedures.

NewYork-Presbyterian and Microsoft spokespeople agree that this element of patient control is a key feature of myNYP.org. “This technology not only gives patients access to their health information, but puts them in the driver’s seat, with complete control to take their information with them, add to it and share it with their family, other doctors and healthcare providers, and anyone they choose,” says Dr. Steven J. Corwin, executive vice president and chief operating officer of NewYork-Presbyterian Hospital.

Adds Peter Neupert, corporate vice president of the Health Solutions Group at Microsoft, “NewYork-Presbyterian is bringing health information technology into the 21st century. Just as consumers have been encouraged and enabled to manage their credit scores, myNYP.org sets a new standard for patient empowerment, helping them understand their care and gain stewardship of their medical information to use and share at their discretion. In time, this is likely to reduce the need for redundant paperwork and testing, make it easier for physicians to retrieve digital radiology images and other patient records, and reduce costs.”

The myNYP.org portal is currently available only to cardiology and cardiac surgery patients at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Other Uses for the Data

The collective data stored in the myNYP.org platform is proving useful not just for treating individual patients, but as a database that can be mined for new insights. “Amalga brings together data that has been collected in disparate systems in a relatively easy way that does not eat up a lot of our resources,” says Aurelia Boyer, senior vice president and chief information officer at NewYork-Presbyterian. “Once that data has been collected — in addition to delivering it to the patients — we can use it to perform analytics.”

Dr. Craig Smith, chief of cardiothoracic surgery at NewYork-Presbyterian Hospital, provides a dramatic example: “For some time my department has wanted to conduct a thorough analysis of post-operative infections,” he says. “Such infections can require extended hospitalization or a repeat operation, not to mention the possibility that a patient might not recover. So there are significant improvements to be realized if we can use this e-record technology to eliminate some of the current uncertainty and establish some new best practices.”

Several factors can contribute to infections, including the patient’s blood glucose level at the time of surgery, the management of the chest tubes and other devices that are inserted through the patient’s skin, and which antibiotics are given to the patient.

“We decided to use the data collected by Amalga to take on the issue of chest tube drainage and how quickly the tubes are being removed from patients — something we’ve never been able to easily study before,” says Smith. “It was astonishing. Suddenly we had week-by-week charts telling us how long the chest tubes have been in.

“Thanks to this analysis, we’ve identified an optimum time to remove the tubes and have provided this new information to our surgeons. Sure enough, we’ve seen a decrease in the number of insertion-site infections,” adds Smith.

Dr. Susan Bostwick, physician liaison for information technology at NewYork-Presbyterian, offers another example. “The new technology gives us another important capability in the area of pediatric vaccinations,” she says. “Right now, it’s very hard to keep track of which children are eligible for vaccinations and which have already been vaccinated, especially for families that are coming to NewYork-Presbyterian for the first time or for whom our hospital is one of several healthcare providers. It’s just not realistic to expect all parents to be able to keep accurate records of their children’s vaccinations.”

For more information:

Learn more about myNYP.org and watch video interviews with the hospital’s president, CIO and doctors at http://www.mshealthstories.com.

The result, says Bostwick, is that some children who really should be vaccinated because they are especially susceptible to the flu aren’t getting the shots, and others are getting unnecessary duplicate shots because their parents weren’t sure if they had already gotten them.

“But now, with myNYP.org, parents will have a safe, secure place in which family vaccination records can be kept.”

Microsoft is showcasing the myNYP.org portal this week in its booth at the Healthcare Information and Management Systems Society (HIMSS) 2009 Annual Conference & Exhibition in Chicago.

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