What is clinical groupware? The precise meaning of the term continues to evolve, and the designation may even fade from the health information technology lexicon in the near future. But the underlying purpose of the technology—to foster collaborative care by allowing health care professionals to seamlessly exchange patient information across disparate care settings—is here to stay.
It’s common sense that if members of an extended care team from diverse locations and institutions can exchange such critical information as test results, medication risks, and clinical summaries, they should be able to generate more efficient and cost-effective patient care, says David C. Kibbe, MD, principal of the health care consulting firm The Kibbe Group, LLC, and a driving force behind the concept of clinical groupware.
To this end, “digital pathology serves as an example of how care team collaboration through clinical groupware could benefit a patient,” says Shahid N. Shah, CEO of the IT services, solutions, and consulting firm Netspective and founder of the blog HealthcareITGuy.com. “With digital pathology, what used to take us days can be done in seconds or minutes. [And] the data can be fed into a collaborative environment and made available to a larger group of participants in the care team.”
One glitch in the progression of groupware, however, is that electronic health record systems have limited capability for communicating with other health care systems. The solution, Dr. Kibbe says, is not to replace EHR systems with a new class of products, but rather to gradually integrate enhanced communication capabilities into new iterations of EHRs. “That will probably come from the Direct Project,” he explains. “It’s a set of protocol specifications [for a] secure e-mail and a universal addressing system, making it possible for data to be moved from one setting to another over the Internet securely. The EHR companies are only just now beginning to integrate the protocol specifications of the Direct Project into their EHRs.”
Trying to fill the void today are a number of products that offer “clinical groupware-like capabilities,” Dr. Kibbe says. “Salesforce.com has developed a program called Chatter that is probably the best example I can think of as a product that was built to be clinical groupware,” he explains. “It allows providers to, in a somewhat Facebook- or Google Plus-like way, set up group communications and share documents over the Internet.”
Software applications created for a broader market can also provide clinical groupware capabilities, says Shah. “Using a cloud-based, software-as-a-service system, you can invite participants into a system and create layers of security beyond a password if you want. Tools like Alfresco or IBM Social Business Toolkit form a great foundation because they are inherently shareable. The way to look at these tools is that the patient is a shared customer among multiple companies or partners. You don’t have to wait for some magical solution from some giant EHR company—you could do it now.”
At the same time, Shah and Dr. Kibbe agree that the trend toward accountable care organizations and patient-centered medical home models is fostering more collaborative EHR platforms. Eventually, says Shah, “I would say that the clinical groupware becomes the front end and the EHR is simply the back end for retrospective documentation purposes. I believe groupware and patient collaboration capabilities will and must be part of the next generation of EHR systems.”
But others take a tamer view of clinical groupware. “My concern is that it’s a bit of a buzzword. What is it actually doing?” asks CAP TODAY “Newsbytes” editor Raymond D. Aller, MD, clinical professor and director of informatics in the Department of Pathology, University of Southern California School of Medicine. “Just because it’s magically Web based doesn’t mean it provides the benefits. The bottom line has to be, where is it running and is it really improving patient care?”
Psyche Systems and Aperio have joined forces to offer a fully integrated anatomic pathology system that combines Aperio’s eSlide Manager with Psyche’s WindoPath anatomic pathology system.
With the integrated solution, pathologists can immediately access, manage, and evaluate whole digital slide images within WindoPath via an intuitive step-by-step process. The new offering provides single sign-on and automatic bi-directional data transfer.
Psyche Systems, 800-345-1514
The clinical documentation solution providers Voicebrook and Nuance Communications have announced that they will work together to deliver comprehensive, speech-enabled reporting products for anatomic pathology laboratories. Voicebrook will pair its VoiceOver software with Nuance’s Dragon Medical 360|Network Edition products.
“By combining Nuance’s Dragon Medical speech recognition and Voicebrook’s experience in developing and implementing pathology reporting solutions, the companies will deliver high-value solutions, empowering pathologists to rapidly create comprehensive, accurate pathology reports at a significant savings and with near-instant turnaround time,” says Carina Edwards, vice president of health care solutions for Nuance Healthcare.
VoiceOver is compatible with all major laboratory information systems and digital pathology systems and allows users to control workflow within those applications.
Nuance and Voicebrook have worked together to offer speech recognition-based reporting solutions for more than 10 years.
Nuance Communications, 888-372-1908
Mitem Corp. has introduced eVigils, a private, closed-loop, secure communications service that allows members of a health care team to exchange messages via iPhones.
“HIPAA and Joint Commission patient confidentiality requirements preclude using public networks, so we created a private network that not only assures patient confidentiality but also offers other valuable benefits to health care providers and medical practices,” says Mitem CEO Aurel Kleinerman, MD, PhD.
With eVigils, messages are encrypted and exchanged only among invited members of a health care team. The system automatically archives all communications into a single searchable system.
The eVigils application for the iPhone can be downloaded from the Apple App store and used via most Web browsers. Mitem plans to introduce applications for other smartphone models.
EVigils enhances Mitem’s Blue Iris product line, which includes the Blue Iris eLaborate connectivity application and Blue Iris Connect EMR integration product.
Mitem Corp., 877-229-4468
Data Innovations has launched EP Evaluator, version 10. This latest release of the method evaluation software offers a factor sensitivity module that helps laboratorians identify the coagulation reagents that are most sensitive to specific factor deficiencies in select patient populations.
The release also includes composite reporting, which allows users to build a custom collection of individual reports within a project and generate “one-button” printing.
Data Innovations, 802-658-2850
SCC Soft Computer has announced that its SoftLab laboratory information system, version 4.0.3, has been certified as an electronic health record module by the Certification Commission for Health Information Technology, an Office of the National Coordinator Authorized Testing and Certification Body.
By receiving ONC-ATCB 2011/2012 certification, the product is deemed capable of enabling providers to meet stage one meaningful use requirements of the American Recovery and Reinvestment Act.
SCC Soft Computer, 800-763-8352
Dr. Aller is director of informatics and clinical professor in the Department of Pathology, University of Southern California, Los Angeles. He can be reached at firstname.lastname@example.org. Hal Weiner is president of Weiner Consulting Services, LLC, Florence, Ore. He can be reached at email@example.com.