14 Dec

CheckList wins Fierce Innovation Award

PeriCALM CheckList wins Fierce Innovation AwardWe just received word that PeriCALM CheckList has won this year’s Fierce Innovation Award in the Clinical Information Management category.

CheckList was selected by a distinguished panel of CIOs from leading US hospitals and healthcare systems, including Allina Health, Rush University Medical Center, and JFK Health System.  Finalists were evaluated based on care efficiency, competitive advantage, financial impact/value, market need, patient experience, quality of care, and patient outcomes.  The annual award competition is sponsored by the publisher of FierceHealthcare and FierceHealthIT.

Introduced earlier this year, PeriCALM CheckList was created to help hospitals improve compliance with protocols that depend on electronic fetal monitoring. PeriCALM CheckList continuously analyzes fetal heart rate and contractions to identify concerning trends, even those occurring faintly and over a long expanse of time. This level of vigilance and standardization is especially effective when administering oxytocin (a commonly used drug that stimulates contractions).

PeriCALM CheckList simplifies the checklist process by accurately and automatically counting and summarizing specific fetal heart rate and contraction patterns. The color coded displays of PeriCALM CheckList provide quick visual cues when specific criteria have been exceeded. PeriCALM CheckList criteria can be customized by each hospital or health system according to their protocols that govern clinical care.

“Adverse outcomes during childbirth … can bring severe financial consequences when care does not follow widely accepted practices,” says Matthew Sappern, PeriGen Chief Executive Officer. “PeriCALM CheckList is a powerful tool for helping clinicians meet expected standards of care.  We’re proud that its potential to drive better outcomes has been recognized.”

Click to see the official news release “PeriCALM CheckList wins Fierce Innovation Award”

10 Dec

An improved labor curve tool

Last week’s webinar, covering research on a new method to assess labor progress, continues to stimulate comment and debate. The session described a whole new labor curve concept, one that adapts to the multiple factors affect dilation directly and change as labor advances. Recent peer reviewed publications report a five-fold improvement in the rate of identification of first time mothers who actually underwent a cesarean for slow labor using the PeriCALM Curve compared to the rate using the current fixed labor curves that are based on time only (70% vs 12%).

The research, outlined in two articles recently published in the American Journal of Obstetrics & Gynecology, was reviewed by Dr. Emily Hamilton during a lunchtime session offered by PeriGen. The session, titled “Rethinking the Labor Curve,” was recorded and can be viewed here.

Dr. Hamilton led the research team that applied a modern, mathematical approach to the assessment of labor. The team found that the utility of contemporary labor curves was limited because of, among other things, a wide degree of variation in the early stages of labor. In fact, it is not until late labor when dilation reaches six centimeters that this variation enters useful limits and the contemporary curves can be used. The new approach can be applied earlier to assess two essential processes for vaginal birth (dilatation and descent). Results are expressed with percentiles and graphs.

The video, access to the basic research, and the slides are available by clicking here.

We look forward to hearing your thoughts and questions too.

08 Dec

Emily Weighs in on Healthcare Automation Article

Screen Shot 2015-12-09 at 3.52.52 PMEmily Hamilton, PeriGen’s SVP of Clinical Research, found it impossible not to weigh in on a recent discussion in the New York Times about the use of algorithms and automation in healthcare.

“There will always be a need to superimpose clinical judgment because no model or algorithm will account for all the factors influencing labor in every patient…”

Her observation about the importance of standardization in obstetrical care is drawing comment from both clinicians and patients from around the country.

Take a look and let us know what you think

21 Sep

Fetal Heart Rate Physiology Paper

Fetal Heart Rate Physiology Paper

New White Paper Now Available:

The Physiology of the Fetal Heart Rate Control

Dr. Emily Hamilton, PeriGen’s Senior Vice President of Clinical Research, has just posted a new white paper covering the basic physiology of the fetal heart rate (FHR). Ideal for perinatal unit managers and educators looking for information to help their labor & delivery teams understand how electronic fetal monitoring can help identify fetuses with an increased risk of hypoxic injury and the basis of clinical interpretation of tracings as delivered via EFM and perinatal analysis.  The 15-page paper delves into the impact of active labor on the FHR and the researched clinical models used to differentiate between normal and abnormal FHR patterns.

The paper’s references span a wide variety of research on fetal heart rate and its measurement during labor.  Content includes:

Click for complimentary access to “The Physiology of the Fetal Heart Rate”

About the Author

Emily Hamilton, MDCM is PeriGen’s Senior Vice President of Clinical Research and the inventor of the PeriCALM suite of perinatal analysis software.  She and her research team actively engage in research projects designed to develop and improve the mathematical  models used by PeriCALM software to detect and alert on potentially harmful FHR patterns.

She is widely published in leading obstetric journals and often speaks on her research and the use of technology to help labor & delivery clinical teams identify abnormal fetal heart rate patterns during childbirth.  In addition to being an experienced obstetrician, Emily held numerous academic positions at McGill University.  She works and resides in Montreal, Canada.

14 Sep

UCSF, Kaiser Permanente and PeriGen to research birth-related brain injury

PeriGen has joined the University of California, San Francisco and Kaiser Permanente North California to launch a ground-breaking research project to examine potentially preventable causes of birth-related brain injuries in newborns.  The project looks to deepen understanding of how fetal heart rate and uterine contraction patterns indicate risk to the baby during labor in order to help improve clinicians ability to prevent brain damage.

“This project has the potential to make a significant contribution to unraveling some of the preventable causes of a condition that is devastating for far too many babies and their families,” says Matthew Sappern, PeriGen’s Chief Executive Officer.

The collaborative research project among these three highly respected organizations will study the relationship of neonatal encephalopathy and overly frequent uterine contractions and fetal heart rate abnormalities within a large birth cohort delivered by Kaiser Permanente Northern California OB physicians.

Neonatal encephalopathy is a clinically-defined syndrome characterized by disturbed neurologic function in the earliest days of life.  It can lead to lifelong impairment or cerebral palsy, depending on the severity.

Continue reading

23 Jul

Early Registration: EFM Integration Webinar

Free webinar on integration of EFM systems with EHRsRegistration has opened for the August 19th webinar “Special Considerations when Integrating Perinatal Systems,” featuring Bruno Bendavid, SVP of Product Management for PeriGen.  The short free session, scheduled for noon – 12:30 ET, will focus on solving the key challenges faced by labor & delivery units for integration of electronic fetal monitoring systems with major EMRs.

For over 20 years, Bruno Bendavid has been been adapting EFM software to fit hospital EMRs.  He’ll share the perinatal system integration challenges faced and their most common solutions and, then, open the floor to answer questions about specific issues being faced by your unit.

Space is very limited

Register for Integration Webinar Today

Integration Article Also Available

The challenges faced when integrating specialty systems with hospitals EMRs are well documented. (See AHRQ assessment.) Electronic fetal monitoring (EFM) software systems are no exception and, in fact, represent a greater-than-average challenge.

Yet capturing perinatal data is critical and avoiding the need for double data entry is imperative for sustaining a productive labor and delivery department.

In addition to this webinar, Bruno Bendavid has prepared a white paper detailing solutions for the integration of perinatal systems with larger hospital medical record systems.  The article, titled “How PeriCALM Modules Integrate with Major EMR Systems” is openly available.

Click here to access

18 Mar

Evaluating & Choosing Your Next EFM

With advances in healthcare and fetal monitoring software accelerating, many hospitals are considering replacing their existing fetal monitoring system.  The choice can be daunting, time-consuming, and expensive.  Following are suggestions and tips compiled from top technology consultants and perinatal clinicians on evaluating and choosing a fetal surveillance system that meets your specific needs.

1.  Put together a balanced selection team

The fetal monitoring system you choose will impact not only your patient care quality and safety, but may impact your team’s workflow, productivity, EHR data-gathering, and core success metrics.  Put together an evaluation team comprised of individuals with direct responsibility over these areas  led by a “change champion,” someone who can keep the group organized, enthusiastic, productive, and open to available options.

2.  Establish priorities and goals

Define exactly what you expect the new fetal monitoring system to measurably improve and, then, place these goals in priority order.  Remember that each member of the team will have a perspective on these goals, so building a consensus may be challenging, but important for success.

3. Review current clinical and operational workflows and identify potential improvements

Make sure your entire selection team is familiar with how your current fetal monitoring system and processes work. Go beyond the clinical to examine how perinatal information flows from and to your EHR and review the flow of paper, charting, communication patterns, and decision-making protocols that go with labor & delivery.

4.  Make sure that team members have a working knowledge of fetal monitoring software features and capabilities

Some of you team may never have seen your existing fetal monitoring system and processes in action.  Demonstrating the current system and then distributing literature about fetal surveillance advances and system helps build a shared understanding of what’s possible — and what’s not.  In fact, based on this data-gathering, many team find themselves re-examining their goals and priorities.

5.  Define your system and vendor requirements

Establish exactly what clinical and technical features are a must for you and then develop second, third, and, if necessary, fourth “tiers” of capabilities.  Document the level of implementation and service you’d like.  These are best delineated by using service “cases” and “what if” scenarios.  Don’t omit financial requirements such as purchase and operating budget guidelines and desired financing arrangements.

6.  Gather and review published vendor comparisons to develop a list of potential partners

With your requirements at hand, you’re now ready to identify a short list of vendors who best match them.  Use third-party comparisons where available and supplement this data with vendor marketing literature.  Match each systems capabilities to the points listed on your requirements documents and pick the best matches.

7. Check references

Contact at least three-five vendor client sites that are using the system in a live environment.  Develop a questionnaire that will yield answers to how capable the vendor will be to meet your clinical, operational, financial, and service requirements.

8.  Visit a client site

Review how the system is used in a live environment.  When you do, compare the workflow in view with your existing or planned processes.  Ask questions about implementation that will show you what to expect.

9.  Reconfirm key issues and understanding

Once you’ve checked references and visited a client site, your selection team will still have some outstanding “wish list” items.  Ideally, these will be requirements originally placed in the third-fourth tiers of importance, but outstanding issues may include financial arrangements and implementation strategies.  Outline these in writing and request that answers be provided in writing as well, along with a confirmation that the original estimated pricing still stands and includes a reliable set of quotes that covers all components discussed and viewed during demonstration.  The goal for this step is to set the baseline for price negotiation and help protect against unexpected add-on fees.

10.  Make your choice with confidence

Your due diligence pays off!  Your team has gathered the data they needed to compare their options and identify the solution that best matches their top, prioritized needs.  Because the decision is shared among key stakeholders, implementation and adoption are more likely to go smoothly.




11 Dec

What Have We Learned & Where Are We Going?

by Emily Hamilton, MDCM
Senior Vice President, Clinical Research, PeriGen

“In the New Year, you carry all the experiences of the past years and that is the greatest power of every New Year! This year, you are less student and more master!”
~Mehmet Murat Ildan, Contemporary Novelist & Playwright


Flling rates of intrapartum-related neonatal encephalopathy

Figure 1. Falling rates of intrapartum-related neonatal encephalopathy

Just as individuals gain experience and wisdom on life’s journey, so do organizations, professions and companies. Experience helps because as professionals we are entrusted with responsibility both at a personal and organizational level to provide safe maternity care. Among the myriad of challenges crying for our attention, which ones are critical, have a chance for success, or bring the greatest benefit for our mothers, babies and their families? With the New Year beginning it is time to pause and reflect on some of the lessons learned and past accomplishments because they will help us plan our journey for the coming year. As you read on, note the clarity of insights gained by using “Big Data” and “Wide Lenses” for time and geography.

One of the United Nation’s Millennium Goals – to reduce child mortality, has brought us more reliable data on an important obstetrical topic: namely, intrapartum-related neonatal encephalopathy (IP-NE). On a world scale, intrapartum-related hypoxic events are estimated to have a huge impact – contributing to ¼ of neonatal deaths and ½ of late pregnancy stillbirths. They make the largest single-condition contribution to disability adjusted life-years. 1-4

When one examines progress over 20 years in multiple countries, steady incremental improvement is evident. Figure 1 shows the falling rates of IP-NE in regions including and most similar to the US1 Rates in all the other geographical regions were much higher. They all showed progressive descent fell except for the region of Sub-Saharan Africa.

Two other recent and large studies provide further important insights regarding the nature of IP-NE and related clinical care. 5, 6 Researchers in Sweden, where infant mortality rates are generally amongst the best in the world, examined 71,189 birth records to investigate the association between EFM patterns and neonatal outcome. 5 The rates of neonatal encephalopathy were very low at 1.1 per 1000 births. They concluded that moderate and severe encephalopathy was attributable to asphyxia in 60% of their NE cases and most evolved during labor.

Moving closer to home, Clark et al examined the effect of compliance vs non-compliance with an oxytocin administration protocol in 14,398 women undergoing induction of labor at HCA.6 Oxytocin misuse is a common finding in births with severe metabolic acidosis. 7-9 Furthermore, oxytocin misuse is a modifiable risk factor. In this most recent study compliance was associated with:

  • Fewer admissions to the NICU (3.8% vs  5.2% P=0.01)
  • Fewer low Apgar scores (4.9% vs 6.4% P=0.04)
  • Fewer cesareans     (15.8% vs 18.8% P<0.01)
Figure 2. PeriCALM Patterns display showing the analysis related to uterine tachysystole.

Figure 2. PeriCALM Patterns display showing the analysis related to uterine tachysystole

Members of our own PeriGen family have experienced similar success stories. 10 MedStar Franklin Square Medical Center launched a highly successful IT initiative focusing on uterine tachysystole (overly frequent contractions). PeriCALM Patterns fetal monitoring software with built-in pattern recognition and specialized long-term graphical displays was introduced in 2011. At a glance any clinician could detect if uterine tachysystole (UT) was present, if it was transient or persistent, if it provoked fetal heart rate decelerations and see the Montevideo units as is shown in Figure 2.

This study involved the systematic re-examination of each 30-minute segment of tracing from all 10,518 monitored term labors. Comparing years before immediately before and after the introduction of PeriCALM Patterns they observed that:

  • The rate of UT with oxytocin fell from 22.7% to 17.3% P<0.0001.
  • Average duration of UT fell from 64 minutes to 54 minutes.
  • Total time spent in UT fell by 36.5%.

Long term trends analysis is a key component of helping humans see significant trends and to anticipate what is about to happen. In psychological parlance this ability to assess current conditions and project the most likely development is known as situational awareness. In medical behavioral studies it is one of the key skills required across all acute care settings.

Computers are masters of rapid computation and efficient data visualization. Anecdotes from nursing staff related how the displays made easy it was to see when uterine tachysystole was present or even about to occur. Continuous calculations removed the subjectivity of choosing where to count the contraction rates. Quantitative data facilitated communication because predominant patterns were clearly evident. Nurses had the authority to stop oxytocin when uterine tachysystole occurred.

There is abundant evidence today that the human brain has a fixed functional capacity and that every mental task we perform detracts from our ability to do another at the same time. 11 Computers are very consistent at number crunching, that is counting, adding, measuring or doing exactly what they are programmed to do. In contrast, humans are very good at reasoning based on deep clinical understanding Clinicians will always have to integrate EFM tracing findings with other clinical information. That said, the repetitive analytic capacity of PeriCALM Patterns and its long-term displays are useful adjuncts for clinicians. This study demonstrated the synergistic effects of this technology and dedicated clinicians. Together they achieved an impressive reduction in UT.

In summary, what lessons have we learned?

Lesson 1. It is impossible to see progress in rare conditions using small samples over short periods of time.  Rates derived from large data sets and trends over long periods are much more revealing.

Lesson #2. A substantial portion of NE arises and evolves during labor.

Lesson #3.  The incidence of intrapartum-related NE, a devastatingly serious condition, is falling.

Lesson #4.  Clinical actions matter. Oxytocin protocol compliance is associated with better neonatal condition and lower cesarean rates. Uterine tachysystole rates can be reduced.

Lesson #5.  Computers and clinicians can be highly synergistic.

No one is suggesting that technology replace clinicians. However, computerization is useful for tasks like calculations, data visualization, reminders and communication thus freeing clinicians to focus applies their energy on higher level reasoning and clinical interventions.

Maternal child health care has come a very long way. Detractors of EFM often refer to randomized clinical trials conducted more than 30 ago that showed no neonatal survival benefit with EFM, although EFM use was associated with a substantial reduction in the incidence of neonatal seizures. In the largest of these studies, deaths or seizures occurred at an astonishing rate of 1 in 225.12 Today, intrapartum fetal death is exceedingly rare and moderate and severe IP-NE are estimated to occur in approximately 1.5/1000 births among the High-Income countries and 0.6/1000 specifically in the Swedish study. This achievement did not happen by chance. Concerted efforts on many fronts have contributed. It happened in part, because most clinicians did not adopt a defeatist attitude such as believing that the origins of IP-NE were beyond our influence or that EFM held no value. Rather these clinicians continued to find better ways to fine tune the imperfect tools that are available and improve our health care systems.

Healthcare informatics has also evolved. We have seen a maturation of software for basic hospital wide electronic medical records and convergence on a few products. With this accomplishment we have seen an increasing demand for the efficient overlay of smart modules with real clinical benefits. In parallel, the PeriGen experience has confirmed our belief that the most useful smart software applications are those that harness the power of computers to do what they do best especially in areas that humans find challenging or time consuming.

As for the New Year, we will continue to apply sound analytical methods on high impact clinical issues where objective quantitative analysis helps clinicians see critical factors or developing trends and intervene in a timely fashion. We have reached a new level in medical informatics and a very exciting one indeed. Stay tuned as we work to bring these ideas to the bedside.


1. Lee AC, Kozuki N, Blencowe H, Vos T, Bahalim A, Darmstadt GL, Niermeyer S, Ellis M, Robertson NJ, Cousens S, Lawn JE. Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990. Pediatr Res. 2013 Dec;74 Suppl 1:50-72. doi: 10.1038/pr.2013.206.

2. Wn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ. 2005 Jun;83(6):409-17. Epub 2005 Jun 17.

3. Lawn JE, Lee AC, Kinney M, Sibley L, Carlo WA, Paul VK, Pattinson R, Darmstadt GL. Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done? Int J Gynaecol Obstet. 2009 Oct;107 Suppl 1:S5-18, S19. doi: 10.1016/j.ijgo.2009.07.016

4. Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997 May 17;349(9063):1436-42.

5. Jonsson M, Agren J, Nordén-Lindeberg S, Ohlin A, Hanson U. Neonatal encephalopathy and the association to asphyxia in labor. Am J Obstet Gynecol. 2014 Dec;211(6):667.e1-8. doi: 10.1016/j.ajog.2014.06.027. Epub 2014 Jun 17.

6. Clark SL, Meyers JA, Frye DK, Garthwaite T, Lee AJ, Perlin JB. Recognition and response to electronic fetal heart rate patterns – impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor. Am J Obstet Gynecol. 2014 Nov 22. pii: S0002-9378(14)02249-2. doi: 10.1016/j.ajog.2014.11.019. [Epub ahead of print]

7. Clark SL, Belfort MA, Dildy GA, Meyers JA. Reducing obstetric litigation through alterations in practice patterns.  Obstet Gynecol. 2008 Dec;112(6):1279-1283.
8. Berglund S, Grunewald C, Pettersson H, Cnattingius S. Severe asphyxia due to delivery-related malpractice in Sweden 1990-2005. BJOG. 2008 Feb;115(3):316-323.

Jonsson M, Nordén SL, Hanson U. Analysis of malpractice claims with a focus on oxytocin use in labour. Acta Obstet Gynecol Scand. 2007;86(3):315-319.

10. Smith S, Bunting K, Hamilton E. Using Intelligent Electronic Fetal Monitoring Software to Reduce Iatrogenic Complications of Childbirth: A Case Study.J Healthc Inf Manag, in press

10. Rock D., Your Brain at Work: Strategies for Overcoming Distraction, Regaining Focus, and Working Smarter All Day Long Harper Business. Harper Collins, New York, NY.

12. MacDonald D, Grant A, Sheridan-Pereira M, Boylan P, Chalmers I. The Dublin randomized controlled trial of intrapartum fetal heart rate monitoring. Am J Obstet Gynecol. 1985 Jul 1;152(5):524-39

24 Jun

Obstetrics: overlooked ACO domain

Obstetrics is one area in which ACOs can make a huge difference.

ACO approach promises to reduce risks, lower cost

June 23, 2014

There are many dimensions to the Accountable Care Organization challenge, including the logistics of changing a well-established acute care model, the process of configuring the network, analyzing IT capabilities across the spectrum and determining how all those moving parts will work together.

It’s a tall order indeed, which is why ACOs remain largely in a gestational state.

Another equally important part of the formation process is in risk assessment and how an ACO will manage a value-based performance model in a way that it generates the same returns as fee-for-service, said Matthew Sappern, CEO of Cranbury, N.J.-based PeriGen.

“Healthcare executives are still trying to get their arms around the definitions of ACOs,” he said. “My definition is that it involves risk management — how are you managing risk no that pay-for-performance is front and center. Risk mitigation is the cutting-edge issue here.”

Population health and its big data subset are of primary concern to the provider community, and Sappern acknowledges that the attention being paid to it is warranted. Even so, he says there is one area that is being vastly overlooked in its potential to dramatically reduce risk and save costs: Obstetrics.

“OB accounts for the most of the malpractice lawsuits, and legacy systems have perpetuated the risk exposure,” he said. “It does nothing to help clinicians understand what is going on and doesn’t help nurses spot emerging patient trends. That adds up to more exposure and a negative effect on the balance sheet.”

The OB field is unlike any other in medicine, which makes it a clinical outlier in ACO equations. The patients are primarily young, giving birth is a natural body function rather than an illness and labor status can be a critical minute-by-minute monitoring process. Real-time accurate information is paramount and ironically, is not often available to OB nurses, Sappern said.

“OB nurses have tough jobs,” he said. “They have multiple patients and they are trying to keep track of key data elements that are changing all the time. They need to spot non-reassuring trends and do something about them immediately — OB cases can go wrong quickly.

To eliminate the guesswork and “hyper-vigilance” associated with OB cases, PeriGen has developed a solution that applies computing algorithms to interpretations of maternity ward patient developments. This way nurses can focus on their duties without constantly checking on how different patients are doing, Sappern said.

“We allow the computer to count the factors going on and steer the nurse toward potential concerns,” he said.

To be sure, system disparity still exists within enterprises and across the ACO ecosystem, agrees Nalin Jain, delivery director of advisory services for Buffalo, N.Y.-based CTG Health Solutions.

“Siloes and disparate systems remain a challenge, but those are technical details to be ironed out after successfully moving toward a performance-based culture and attitude,” he said. “You need to first get the right governing structure and get people doing the right things. That is the work that needs to be done first.”

To appreciate the magnitude of difficulty involved with forming ACOs, Jain refers to the 1980s and ‘90s, when acute care entities experimented with acquiring post-acute properties, but soon gave up because the methodologies and reimbursement structures were too different. Now, however, Jain believes these organizations have a chance at success because technology has forged better connections and fostered greater understanding about what is needed to make them work.

“If accountable care is a verb and not a noun, then you can see it is just good medicine,” he said. “In advising our clients on what is needed for ACOs, we are very clear about what lies ahead and that they should have a triple aim of maintaining a caring population and providing a positive patient experience while cutting healthcare costs.”

Nick Stepro, director of analytics at Burlington, Mass.-based Arcadia Healthcare Solutions, also sees a massive challenge for providers in aggregating data from disparate, siloed entities within the ACO confines.

“Over the past year, health systems engaged in ACOs or similar care models have begun to understand the real challenge of getting timely visibility into the navigation, costs, and health status of their populations,” he said. “In many cases, this means integrating data from thousands of providers across of EHRs, hospital systems, and claims feeds. ACOs that had not invested in these type of capabilities were effectively flying blind, with no visibility into performance until it was time to submit data at year-end.”

In order to avert getting this unpleasant surprise, the health systems involved in ACOs are now investing in a clinical data integration strategy to enable real-time performance monitoring and care coordination, Stepro said.

As experts point out, aging infrastructure prevents the interoperability facet necessary for facilitating ACO communications and coordination – in essence, the healthcare industry is being trapped by its past and the technology of yesterday is preventing forward progress. Another major inhibitor is the prevention of seamless workflow, says John Gobron, CEO of Denver-based Aventura.

“It seems like everyone benefits from the digitization of data except clinicians, who have found it to be a cumbersome process,” he said. “The computer shouldn’t be an impediment.”

There is still too much complexity in workflow, Gobron says, with too many levels and layers between users and the right information. That is why he says Aventura is focused on improving workflow so that clinicians can get the data they need in as easy a manner as possible.

“The problem is easier to solve when it concerns the data instead of the infrastructure,” Gobron said.

“But the workflow and usability factors just are not there yet. We’re still trying to shake off the paper age. Digitization doesn’t mean electronically generated paper. This is more than just data entry. Until the workflow issue can be solved, it just won’t happen.”


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