EPtalk by Dr. Jayne 8

EPtalk by Dr. Jayne 8/28/25 Researchers from Indiana University have created an algorithm that helps clinicians search through patient data from health information exchanges and other sources. The tool identifies the most relevant data for a given visit such as in the ED, where surfacing key information quickly can impact treatment decisions. It also suggests next search terms based on those used by other clinicians, similar to what we’re used to on retail and commercial platforms. The team has earned two patents for its work. Public health informatics is a key domain that must be mastered to obtain board certification in clinical informatics. I hadn’t done much work in that area when I prepared for my board exam, but I found it to be fascinating. It’s also challenging due to limited US public health funding and the need to work across disparate systems — state registries, public health center clinics, disease surveillance platforms, and environmental data sources. I’d like to give a shout-out to the public health informatics teams in Mississippi that provided the data that led state health officials to announce a public health emergency from rising infant mortality rates. That declaration lets the state mobilize resources it otherwise couldn’t. Mississippi has previously been on watch lists for its high numbers of preterm births. It also a “maternity-care desert,” with wide regions lacking hospitals that offer obstetric care. Informatics will underpin many of the proposed solutions, such as improving standardization of care, expediting transfers to different levels of care, monitoring prenatal care opportunities, expanding home visit programs, addressing gaps in maternal care, and improving patient education and engagement around safe sleep practices. If you’re working on any of these healthcare IT projects in Mississippi, we’d love to hear from you. Speaking of love, props to one of my favorite PR people, Grace Vinton, for channeling her inner Swiftie into healthcare advocacy with a series of reflections on what has become the social media story of the week. I was excited to see a healthcare tie-in so that HIStalk wouldn’t be the only media outlet that didn’t do at least some kind of coverage. Other captions included: “When prior auth says immediately yes;” “When there’s a telehealth option; “When there’s a patient access quality measure;” and “When the war for patients to get full access to their own data is finally won”. I never thought I would see the day when I would add “Swiftie” to my Microsoft Word dictionary, but here we are. Mr. H called this recent sponsorship announcement to my attention last week. I’m always leery of hospitals that spend their money on stadium-naming rights or on partnerships that seem nebulous. This one seems to be more than just name recognition, with a Mount Sinai Health System web page detailing the ways they’ll be supporting the event. There will be a booth for player meet-and-greets, a Children’s Sports Zone for family activities, and a broad swath of Mount Sinai physicians on standby, representing specialties including orthopedic surgery, emergency medicine, sports medicine, anesthesiology, psychiatry, radiology, and urology. There are also some health and wellness videos including one on “how to prepare for a day at the US Open” and another one on “heart health and tennis.” Kudos to the health system for turning this into more than a name-on-the-wall moment. From Lost in the Archives: “Re: medical records requests. My hospital is being absolutely crushed by requests dating back decades, since the Radiation Exposure Compensation Act (RECA) was extended to cover hazardous exposures in St. Louis. The Department of Justice is requiring that hospitals certify all the medical records for patients to receive cancer-related compensation. Most of the records being requested have already been purged. This is a nightmare for patients and our skeleton crew in medical records.” I did a little digging to find that the legislation adds eligibility for residents in 21 ZIP codes in and around the St. Louis metropolitan area that were contaminated with uranium waste after processing that was related to Cold War efforts. The compensation program, which is administered by the Department of Justice, previously covered certain cancers for patients who lived in New Mexico and other areas that were affected by release of radiation during atmospheric nuclear tests. I cold-called one of the academic medical centers in the area. They are putting together their own guidance for patients since the phone number for the program doesn’t work. The rep I spoke to declined to be identified, but said that the stories are “heartbreaking” and patients “just start sobbing” when told that their records have been purged. She mentioned that they are directing patients to the Missouri Cancer Registry, which started gathering data in the 1980s. I’d be interested to hear from anyone who is working there to understand how they’re managing the request volume. OSF Healthcare is using virtual care solutions at some of its facilities in an effort to reduce emergency department wait times. Patients are screened to ensure that they are appropriate candidates for virtual services. Those who opt in receive their care in a dedicated virtual exam room. Patients can be examined by the virtual physician using electronic stethoscopes, otoscopes, and ophthalmoscope technology as well as standard audio and video tools. As someone who has worked in various emergency settings with a wide range of acuity levels, it makes sense to have lower-acuity patients seen virtually if doing so helps the overall staffing model while providing the same quality of care. People often don’t realize that a fair amount of the care that goes on in the emergency department these days is really primary care. Hospitals have been caring for these patients in fast-track units for years. Unfortunately, even those units get saturated. During the years I worked fast-track, I was usually the only physician on the unit. Patient care could have been so much more efficient if we’d had another 0.3 or 0.5 FTE physician working, but staffing half a human is hard to do. These virtual approaches allow that additional human to provide staffing to two or more facilities, which makes it more cost effective. Have you ever had a virtual visit in the ED? Would you object if it were offered? Leave a comment or email me.