Advancing Healthcare: Top 10 EHR Books for Visionary Leaders

Advancing Healthcare

Explore a curated collection of EHR books while discovering the potential of exploring electronic health records books, empowering individuals to navigate complexities and make informed decisions.

Electronic health records (EHRs) have revolutionized the healthcare industry, streamlining patient data management and transforming how medical information is accessed, stored, and shared. A carefully curated list of essential EHR books can be an invaluable resource for healthcare professionals looking to expand their knowledge and expertise in this rapidly-evolving field.

Explore these electronic health records books that deepen insights and help navigate the intricate world of healthcare:


1. Connected for Health

Editor: Louise L. Liang


‘Connected for Health: Using Electronic Health Records to Transform Care Delivery’ explores the implementation of the world's most extensive non-governmental electronic health record system. The book delves into the far-reaching impact of this system on patient care outcomes, operational efficiency, safety, and patient engagement. Louise L. Liang draws upon valuable insights and lessons learned from the successful deployment strategy, showcasing how these technological tools are revolutionizing healthcare delivery and reshaping the organizational culture within the industry. This comprehensive resource sheds light on the transformative potential of electronic health records, offering a glimpse into the future of connected healthcare and its potential to improve patient experiences and drive positive change within healthcare organizations globally.


2. Hacking Healthcare

Authors: Fred Trotter and David Uhlman


‘Hacking Healthcare: A Guide to Standards, Workflows, and Meaningful Use’ is a concise and insightful book that critically evaluates the US healthcare system's adoption of electronic health records (EHRs) and other IT solutions to meet the government's meaningful use requirements. While acknowledging the tremendous opportunities for IT professionals, it also highlights the significant challenges of overhauling outdated record systems, workflows, and practices. EHR books, such as this one, provide a comprehensive overview by examining the unique characteristics of healthcare settings, exploring the complexities of transitioning from paper to digital records, analyzing billing and payment systems, emphasizing patient engagement through EHRs, and addressing the critical issue of avoidable errors.


3. The Innovator's Prescription

Authors: Clayton M. Christensen, Jerome H. Grossman, and Jason Hwang


‘Innovator's Prescription: A Disruptive Solution for Health Care’ presents a visionary prescription for reforming the ailing healthcare system. The book applies the principles of disruptive innovation to revolutionize the broken healthcare system. It identifies and addresses various symptoms, offering proven solutions that will improve the affordability and quality of healthcare. The book explores how precision medicine can reduce costs and deliver personalized care, how disruptive business models can enhance accessibility, affordability as well as quality, and how patient networks can improve the treatment of chronic diseases. Additionally, it highlights the need for employers to adapt their roles in EHRs to compete effectively in a globalized era.


4. The Guide to the Future of Medicine

Author: Bertalan Meskó


‘The Guide to the Future of Medicine (2022 Edition): Technology and The Human Touch’ is an insightful and authoritative book that examines the transformative power of electronic health records (EHRs) and other technological advancements in medicine and healthcare. The author comprehensively assesses how EHRs have revolutionized healthcare delivery, offering a roadmap to tomorrow's potential. By exploring the integration of EHRs with emerging technologies and trends, such as exoskeletons, social media for medical information, and supercomputers in medical decision-making, EHR books like this one offer patients, medical professionals, and healthcare stakeholders an enlightening and fact-based perspective on how technology can shape and enhance their well-being while preserving the essential human touch.


5. The Digital Doctor

Author: Robert Wachter


‘The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age’ explore integrating electronic health records (EHRs) into healthcare. Driven by compelling stories and astute analysis, the book addresses the challenges and opportunities presented by technology in medicine. It raises pertinent questions about the impact of digital systems on patient care, highlighting concerns such as the loss of human connection and the occurrence of medical errors despite computerization. With clarity and compassion, the author emphasizes the need to understand the transformative nature of technology in healthcare and advocates for its proper implementation to ensure a harmonious relationship between humans and machines.


6. The Internet of Healthy Things

Authors: Joseph C. Kvedar, Carol Colman, and Gina Cella


‘The Internet of Healthy Things’ explores the profound impact of IoT on healthcare, with a particular emphasis on electronic health records (EHRs). This integrated electronic health records book delves into the transformative potential of real-time biometric data in understanding the relationship between lifestyle and chronic diseases. The authors describe the driving forces behind this trend and unveil the business opportunities it presents for various sectors, including payers, providers, pharmaceutical and biotech companies, technology vendors, and innovative newcomers. The book provides insights into consumer behavior, strategies for designing compelling health devices and platforms, exploration of novel form factors for health information delivery, strategic guidance for startups and entrepreneurs entering the connected health market, and interviews with industry leaders and innovators.


7. Electronic Health Records

Author: Jerome H. Carter


The second edition of ‘Electronic Health Records: A Guide for Clinicians and Administrators’ offers medical professionals and administrators a comprehensive grasp of the functionality and significance of electronic health records (EHRs). The book addresses the numerous inquiries when assessing, procuring, and utilizing an EHR system. It is a valuable resource for individuals who remain undecided about investing in an EHR system or seek a comprehensive and up-to-date understanding of the growth potential and associated challenges of EHRs. The book offers insightful guidance and effectively combines written explanations with visual aids such as figures and tables. It is an exceptional resource for introductory courses on healthcare systems.


8. Ensuring the Integrity of Electronic Health Records: The Best Practices for E-records Compliance

Author: Orlando López


‘Ensuring the Integrity of Electronic Health Records: The Best Practices for E-records Compliance’ is a comprehensive guide that emphasizes the crucial role of data integrity in the design, implementation, and utilization of systems handling electronic health records (EHRs). The book highlights the importance of recording data accurately and ensuring its consistency throughout its lifecycle. Providing practical insights and up-to-date information enables a better understanding of the controls necessary for maintaining compliance with EHR regulations. With a specific focus on production and quality control systems in the pharmaceutical and medical device industries, the book addresses the suitability of EHR implementation, risk-assessed controls, and proper handling of EHRs, ultimately emphasizing the criticality of data integrity in ensuring patient safety and regulatory compliance.


9. Electronic Health Records

Author: Richard W. Gartee


‘Electronic Health Records: Understanding and Using Computerized Medical Records’ is an instructional resource for Health Information Management and Health Information Technology programs. Written by Gartee, this electronic health records educational book effectively utilizes EHR in medical practice through practical exercises and activities. Suitable for various educational institutions, the book includes a Student CD with networking capabilities. The ‘Medcin Software’, integrated into the instructors' manual, enhances learning with its multi-user functionality and widespread use in EHR systems. This comprehensive resource prepares students to apply their skills in real-world EHR applications.


10. Electronic Health Records and Medical Big Data

Author: Sharona Hoffman


‘Electronic Health Records and Medical Big Data: Law and Policy’ is a comprehensive book that offers a profound understanding of electronic health record (EHR) systems, medical big data, and the regulatory landscape governing them. It is a valuable resource for students and professionals alike, providing interdisciplinary analysis and insights. The book explores the impact of EHR systems on clinical care and the generation of medical big data, examining their benefits, drawbacks, and the legal framework surrounding their use. It addresses various challenges, including privacy, security, data quality, and analysis. With detailed recommendations for regulatory, policy, and technological improvements, the book emphasizes the vital role of the law in safeguarding and enhancing EHR systems and the medical big data derived from them. Its structure comprises two main parts, focusing on EHR systems in clinical settings and the utilization of medical big data for research and non-clinical purposes.


Final Chapter

This curated list of engaging electronic health records books serves as an essential read for patients, providers, and C-suite executives alike. These EHR books not only unravel the intricacies of the digital age but also provide valuable insights into the evolving healthcare industry. For healthcare professionals, these resources offer a deeper understanding of EHR implementation, usability, and the legal considerations surrounding them. Additionally, professionals can leverage the knowledge gained from these electronic health records educational books to navigate the complexities of integrating EHR systems within their organizations, driving strategic decision-making, and ensuring the delivery of effective and compassionate healthcare services. By embracing the transformative potential of these EHR books, informed by the wisdom shared within them, healthcare leaders can forge a path toward a more efficient, patient-centered, and technologically-advanced healthcare system.

Spotlight

Alameda Health System

Alameda Health System is the East Bay's premier patient and family-centered care system. Our trauma center and teaching hospital are considered among the best in the country. We are committed to continually improving health through individual patient experiences. Our mission, Caring, Healing, Teaching, Serving All, speaks to the vital role we play in the community and the critical responsibility we accept in promoting wellness, eliminating disparities and optimizing the health of a diverse East Bay.

OTHER ARTICLES
Health Technology, Digital Healthcare, Medical Devices

Innovation Insight for Healthcare Provider Digital Twins

Article | December 7, 2022

A digital twin is a digital representation of a real-world entity or system. The implementation of a digital twin is a model that mirrors a unique physical object, process, organization, person or other abstraction. For healthcare providers, digital twins provide an abstraction of the healthcare ecosystem’s component characteristics and behaviors. These are used in combination with other real-time health system (RTHS) capabilities to provide real-time monitoring, process simulation for efficiency improvements, population health and long-term, cross-functional statistical analyses. Digital twins have the potential to transform and accelerate decision making, reduce clinical risk, improve operational efficiencies and lower cost of care, resulting in better competitive advantage for HDOs. However, digital twins will only be as valuable as the quality of the data utilized to create them. The digital twin of a real-world entity is a method to create relevance for descriptive data about its modeled entity. How that digital twin is built and used can lead to better-informed care pathways and organizational decisions, but it can also lead clinicians and executives down a path of frustration if they get the source data wrong. The underlying systems that gather and process data are key to the success for digital twin creation. Get those systems right and digital twins can accelerate care delivery and operational efficiencies. Twins in Healthcare Delivery The fact is that HDOs have been using digital twins for years. Although rudimentary in function, digital representations of patients, workflow processes and hospital operations have already been applied by caregivers and administrators across the HDO. For example, a physician uses a digital medical record to develop a treatment plan for a patient. The information in the medical record (a rudimentary digital twin) along with the physician’s experience, training and education combine to provide a diagnostic or treatment plan. Any gaps in information must be compensated through additional data gathering, trial-and-error treatments, intuitive leaps informed through experience or simply guessing. The CIO’s task now is to remove as many of those gaps as possible using available technology to give the physician the greatest opportunity to return their patients to wellness in the most efficient possible manner. Today, one way to close those gaps is to create the technology-based mechanisms to collect accurate data for the various decision contexts within the HDO. These contexts are numerous and include decisioning perspectives for every functional unit within the enterprise. The more accurate the data collected on a specific topic, the higher the value of the downstream digital twin to each decision maker (see Figure 1). Figure 1: Digital Twins Are Only as Good as Their Data Source HDO CIOs and other leaders that base decisions on poor-quality digital twins increase organizational risk and potential patient care risk. Alternatively, high-quality digital twins will accelerate digital business and patient care effectiveness by providing decision makers the best information in the correct context, in the right moment and at the right place — hallmarks of the RTHS. Benefits and Uses Digital Twin Types in Healthcare Delivery Current practices for digital twins take two basic forms: discrete digital twins and composite digital twins. Discrete digital twins are the type that most people think about when approaching the topic. These digital twins are one-dimensional, created from a single set or source of data. An MRI study of a lung, for example, is used to create a digital representation of a patient that can be used by trained analytics processes to detect the subtle image variations that indicate a cancerous tumor. The model of the patient’s lung is a discrete digital twin. There are numerous other examples of discrete digital twins across healthcare delivery, each example tied to data collection technologies for specific clinical diagnostic purposes. Some of these data sources include vitals monitors, imaging technologies for specific conditions, sensors for electroencephalography (EEG) and electrocardiogram (ECG). All these technologies deliver discrete data describing one (or very few) aspects of a patient’s condition. Situational awareness is at the heart of HDO digital twins. They are the culmination of information gathered from IoT and other sources to create an informed, accurate digital model of the real-world healthcare organization. Situational awareness is the engine behind various “hospital of the future,” “digital hospital” and “smart patient room” initiatives. It is at the core of the RTHS. Digital twins, when applied through the RTHS, positively impact these organizational areas (with associated technology examples — the technologies all use one or more types of digital twins to fulfill their capability): Care delivery: Clinical communication and collaboration Next-generation nurse call Alarms and notifications Crisis/emergency management Patient engagement: Experiential wayfinding Integrated patient room Risks Digital Twin Usability Digital twin risk is tied directly to usability. Digital twin usability is another way of looking at the issue created by poor data quality or low data point counts used to create the twins. Decision making is a process that is reliant on inputs from relevant information sources combined with education, experience, risk assessment, defined requirements, criteria and opportunities to reach a plausible conclusion. There is a boundary or threshold that must be reached for each of these inputs before a person or system can derive a decision. When digital twins are used for one or many of these sources, the ability to cross these decision thresholds to create reasonable and actionable conclusions is tied to the accuracy of the twins (see Figure 2). Figure 2: Digital Twin Usability Thresholds For example, the amount of information about a patient room required to decide if the space is too hot or cold is low (due to a single temperature reading from a wall-mounted thermostat). In addition, the accuracy or quality of that data can be low (that is, a few degrees off) and still be effective for deciding to raise or lower the room temperature. To decide if the chiller on the roof of that patient wing needs to be replaced, the decision maker needs much more information. That data may represent all thermostat readings in the wing over a long period of time with some level of verification on temperature accuracy. The data may also include energy load information over the same period consumed by the associated chiller. If viewed in terms of a digital twin, the complexity level and accuracy level of the source data must pass an accuracy threshold that allows users to form accurate decisions. There are multiple thresholds for each digital twin — based on twin quality — whether that twin is a patient, a revenue cycle workflow or hospital wing. These thresholds create a limit of decision impact; the lower the twin quality the less important the available decision for the real-world entity the twin represents. Trusting Digital Twins for HDOs The concept of a limit of detail required to make certain decisions raises certain questions. First, “how does a decision maker know they have enough detail in their digital twin to take action based on what the model is describing about its real-world counterpart?” The answer lies in measurement and monitoring of specific aspects of a digital twin, whether it be a discrete twin, composite twin or organization twin. Users must understand the inputs required for decisions and where twins will provide one or more of the components of that input. They need to examine the required decision criteria in order to reach the appropriate level of expected outcome from the decision itself. These feed into the measurements that users will have to monitor for each twin. These criteria will be unique to each twin. Composite twins will have unique measurements that may be independent from the underlying discrete twin measurement. The monitoring of these key twin characteristics must be as current as the target twin’s data flow or update process. Digital twins that are updated once can have a single measurement to gauge its appropriateness for decisioning. A twin that is updated every second based on event stream data must be measured continuously. This trap is the same for all digital twins regardless of context. The difference is in the potential impact. A facilities decision that leads to cooler-than-desired temperatures in the hallways pales in comparison to a faulty clinical diagnosis that leads to unnecessary testing or negative patient outcomes. All it takes is a single instance of a digital twin used beyond its means with negative results for trust to disappear — erasing the significant investments in time and effort it took to create the twin. That is why it is imperative that twins be considered a technology product that requires constant process improvement. From the IoT edge where data is collected to the data ingestion and analytics processes that consume and mold the data to the digital twin creation routines, all must be under continuous pressure for improvement. Recommendations Include a Concise Digital Twin Vision Within the HDO Digital Transformation Strategy Digital twins are one of the foundational constructs supporting digital transformation efforts by HDO CIOs. They are digital representations of the real-world entities targeted by organizations that benefit from the advances and efficiencies technologies bring to healthcare delivery. Those technology advances and efficiencies will only be delivered successfully if the underlying data and associated digital twins have the appropriate level of precision to sustain the transformation initiatives. To ensure this attention to digital twin worthiness, it is imperative that HDO CIOs include a digital twin vision as part of their organization’s digital transformation strategy. Binding the two within the strategy will reinforce the important role digital twins play in achieving the desired outcomes with all participating stakeholders. Building new capabilities — APIs, artificial intelligence (AI) and other new technologies enable the connections and automation that the platform provides. Leveraging existing systems — Legacy systems that an HDO already owns can be adapted and connected to form part of its digital platform. Applying the platform to the industry — Digital platforms must support specific use cases, and those use cases will reflect the needs of patients, employees and other consumers. Create a Digital Twin Pilot Program Like other advanced technology ideas, a digital twin program is best started as a simple project that can act as a starting point for maturity over time. Begin this by selecting a simple model of a patient, a department or other entity tied to a specific desired business or clinical outcome. The goal is to understand the challenges your organization will face when implementing digital twins. The target for the digital twin should be discrete and easily managed. For example, a digital twin of a blood bank storage facility is a contained entity with a limited number of measurement points, such as temperature, humidity and door activity. The digital twin could be used to simulate the impact of door open time on temperature and humidity within the storage facility. The idea is to pick a project that allows your team to concentrate on data collection and twin creation processes rather than get tied up in specific details of the modeled object. Begin by analyzing the underlying source data required to compose the digital twin, with the understanding that the usability of the twins is directly correlated to its data’s quality. Understand the full data pathway from the IoT devices through to where that data is stored. Think through the data collection type needed for the twin, is discrete data or real-time data required? How much data is needed to form the twin accurately? How accurate is the data generated by the IoT devices? Create a simulation environment to exercise the digital twin through its paces against known operational variables. The twin’s value is tied to how the underlying data represents the response of the modeled entity against external input. Keep this simple to start with — concentrate on the IT mechanisms that create and execute the twin and the simulation environment. Monitor and measure the performance of the digital twin. Use the virtuous cycle to create a constant improvement process for the sample twin. Experience gained through this simple project will create many lessons learned and best practices to follow for complex digital twins that will follow.

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Digital Healthcare, Medical Devices

The Key Ingredient in Healthcare Compliance Success

Article | July 7, 2023

The healthcare industry has become a prime target for cybercriminals in recent times. According to The State of Ransomware in Healthcare 2023 report from Sophos, six in 10 healthcare organizations have been hit by ransomware in the last 12 months, up from 34% in 2021. Among this uptick have been several headline-grabbing attacks. For example, Shields Health Care Group became the subject of the single-largest breach affecting any organization globally in April 2023, when 2.3 million patients of the Massachusetts-based medical services provider had their personal data stolen after a cybercriminal gained unauthorized access to the organization’s systems. Meanwhile, in the UK, a ransomware attack on the University of Manchester occurred in June, affecting an NHS patient data set holding information on 1.1 million patients across 200 hospitals. Critically, the wealth of data housed in healthcare networks, and the potential impact of data unavailability in healthcare, make the industry both attractive and lucrative to threat actors. It’s no coincidence that the Sophos report shows the rate of encryption in the healthcare sector is at its highest level in recent years. Of those healthcare organizations which suffered a ransomware attack in 2023, 73% had their data encrypted – up from 61% in 2022. When cybercriminals can successfully take down hospital systems and/or encrypt patient data so it can’t be used, they can blackmail health service providers, demanding significant sums before reinstating systems and/or data availability. Considering healthcare's critical role as the highest-stake industry in our society, where people's lives depend on its success, the likelihood of attackers achieving their goals is greater than in other sectors, as confirmed by the Sophos report. Indeed, of the 73% of healthcare organizations that had their data encrypted, 42% reported that they paid the requested ransom to recover data. DSPT and the compliance burden Without question, the security-related challenges in healthcare are mounting. Right now, industry organizations are operating against a backdrop of unprecedented operational and workforce pressures, spiralling demand for care and industrial action. Moreover, there is a growing regulatory burden, with organizations continually asked to comply with evolving cybersecurity rules, battling with multiple compliance mandates at any given time. Take the NHS as an example. According to the 2023 NHS Providers’ Regulation Survey, just over half (52%) of respondents said the regulatory burden on their trust had increased. And this is expected to ramp up further in the future, with the UK government setting out a new 2030 strategy aimed at bolstering cyber resilience in healthcare. Among the compliance burdens that the NHS faces is the challenge of meeting the requirements of the newly updated Data Security and Protection Toolkit (DSPT). Mandated to minimize cyber risks and enable healthcare providers to maintain a robust information security posture, the DSPT is not a simple checklist of security controls, but a comprehensive toolkit to evaluate current security maturity and establish a risk management programme. Indeed, in more recent times, DSPT has moved away from being a guide for achieving certain levels of assurance, and toward a mandatory evidence-based system which demands NHS organizations align with 10 precise National Data Guardian (NDG) standards: 1. The organization assures good management and maintenance of identity and access control for its networks and information systems. 2. The organization closely manages privileged user access to networks and information systems supporting essential services. 3. The organization ensures passwords are suitable for the information being protected. 4. Process reviews are held at least once a year where data security is put at risk and following security incidents. 5. Action is taken to address problems as a result of feedback at meetings. 6. All user devices are subject to anti-virus protections, while email services benefit from spam filtering and protection deployed at the corporate gateway. 7. Action is taken on known vulnerabilities based on advice from NHS Digital, and lessons are learned from previous incidents and near misses. 8. The organization has a defined, planned and communicated response to data security incidents impacting sensitive information or key operational services. 9. The organization has demonstrable confidence in the effectiveness of the security of technology, people, and processes relevant to essential services. 10. The organization securely configures the network and information systems that support the delivery of essential services. Reducing Compliance Challenges with the Right Solutions Taken individually, these standards may not seem too strenuous to adhere to. However, to be compliant with DSPT, all 10 items need to be completed and deemed ‘satisfactory’. To tick all 10 key boxes in the most effective and efficient manner simultaneously, organizations should consider their strategy carefully. This could involve embracing supportive tools to accelerate and enhance their compliance journey. Boiled down, DSPT demands several key things, including unincumbered visibility of the entire ecosystem, as well as the ability to demonstrate secure access, logs and storage, and essential auditing processes to maintain data security. Achieving these things might appear complicated, even daunting. However, there are solutions known as Security Information and Event Management (SIEM) systems on the market that can make achieving these capabilities, and in turn DSPT compliance, easy. Here, we outline some of the key features to look out for to meet compliance: • Log retention: A modern SIEM should be able to provide a centralized log storage and big data platform that scales to any organization’s size. Platforms should be able to provide role-based access to log data, including ‘data privacy’ functionality that can mask sensitive data until approved. Log data should not be modified or removed by users once ingested into the platform, while all data held should also be indexed and fully searchable. • Identifying and disabling unnecessary accounts: A good SIEM will also provide account auditing facilities for Active Directory that allow administrators to quickly identify dormant accounts. They should also be able to remove privileged user access when no longer required or appropriate. More sophisticated platforms will be able to do this in an automated manner. • Easy identification of issues: Clear and easily readable dashboards, alerts and reports for user logging activity should be provided, including failed login, apparent brute-force attempts, and bad password management practices. Further, those using machine learning will be able to identify unusual behavior patterns based on a baseline of activities of users and their peer group. • Integrate with third-party threat feeds: It will also be able to integrate with a wide variety of third-party threat feeds that provide information about specific known threat payloads/hashes and destination domains/addresses. Meeting the mandate Of course, having the right features in place is only part of the puzzle. For organizations to be truly successful in embracing tools that enable them to meet DSPT compliance more effectively, they should work to ensure that solutions providers offer them ongoing support – both in terms of ease of deployment and to ensure that they are using key systems in an optimal manner. Scalability is another important aspect to consider. Systems should be able to scale and continue to support the organization as data volumes increase and become more complex over time. In respect of scalability, organizations should take time to think about pricing models, ensuring that these are based on the number of devices (nodes). In doing so, it will become easier to accurately budget future costs, as well as provide greater budgeting certainty over the short, medium and longer term. A converged SIEM allows organizations to prioritize the big picture over individual tools, enabling them to develop a seamless and easy to use security operations setup. Not only does this approach boost cost transparency and eliminate potential complexities with managing a variety of siloed products – equally, it reduces the burdens on security teams, eliminating complexities over system integration and enhancing performance. A converged SIEM combines key technologies easily to offer improved security outcomes. In doing so, organizations can easily home in on specific standards and adopt security best practices while reducing the burden on security teams tasked with meeting DSPT compliance.

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Digital Healthcare, Medical Devices

Medical Computers: A Necessity of the Future Healthcare

Article | June 14, 2023

Over the last couple of years, the healthcare industry has witnessed significant technological advancements transforming numerous procedures and treatments, ranging from magnetic resonance imaging scanners and radiotherapy to antibiotics and anesthetics. In addition, the introduction of novel technologies (new pharmaceuticals and treatments, new equipment, new social media support for healthcare, etc.) has further provided air to the fire for innovation in the sector, encouraging healthcare providers to upgrade their technological infrastructure. Medical Computers Paving the Way in Healthcare Use of modern technology, such as medical computers, is becoming more and more crucial in healthcare institutions, including hospitals, clinics, and specialized treatment centers. These computers are used in hospitals for a variety of purposes, from better laparoscopic, minimally invasive surgical techniques used by surgeons to patient tracking and health monitoring gadgets. Medical computers are becoming more prevalent as they help medical professionals make faster, more reliable, and more accurate decisions. Additionally, they enable the emergence of new data, integrate advanced technologies such as artificial intelligence, and enhance decision-making processes, which are particularly crucial when it comes to medical diagnostics and treatment. New computer and technology solutions in the healthcare sector are enabling a wide range of outcomes that were previously unimaginable. They assist medical practitioners in both data collection and data interpretation, enabling them to make decisions that are thoroughly informed by insight. Here are some of the applications that have experienced immense transformation in recent years Hospital Information Systems Medical Personnel and Staff Management Data Analysis in Medicine Medical Imaging Computer-assisted Therapy Laboratory Computing Critical Patient Care Computer Assisted Decision-making (CMD) Patient Check-In and Status Growing Adoption Encouraging Product Launches With technologies like medical computers becoming essential for processing numerous day-to-day operations in the healthcare industry, the need for these computers is growing at a rapid pace. Hence, a number of medical equipment providers are emphasizing on offering cutting-edge solutions to modern healthcare facilities. For instance, in 2021, American Portwell Technology, Inc., a world-leading innovator of the Industrial PC, unveiled two certification-ready all-in-one medical computers - MEDS-P2410-P200 (23.8″) and MEDS-P2210-P200 (21.5″) with features such as true-flat capacitive touchscreen and optional hot-swappable batteries.

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Health Technology

The Internet of Medical Things and What Powers It?

Article | June 22, 2022

Technology in the 21st century is the fuel that drives innovation and ease in almost every industry today. The healthcare sector isn’t far behind. In fact, the medical industry has taken the concept of the Internet of Things and took it to a new level altogether to reimagine the use of medical technology. Imagine multiple devices like phones, cameras, GPS sensors, and computers interacting with each other through a seamless transfer of data. Now consider wearable medical devices. The exchange of critical medical information through a web of real-time data networks activates near instantaneous responses from doctors, nurses, and medical services. The aim is to anticipate the need for medical attention long before it is needed and remedy the concerns before they reach a critical stage. That is exactly how the future of the Internet of Medical Things (IoMT) is shaping out to be. How IoMT is Redefining Everyday Health? IoMT is a next-generation solution that embeds cutting-edge monitoring and analysis of individual healthcare journeys through medical devices. The smart watch is the most recognizable wearable medical device that is used by millions of people daily to keep tabs on their vitals. For instance, the Apple Watch series 6 maps blood oxygen levels, sleep patterns, ECG levels, and also reminds the user to wash their hands after returning home. The market for healthcare IoT products is vast and is constantly expanding. The Tango Belt is a leading example of smart wearable technology that is revolutionizing elderly and disability care. The belt is designed to sense falls and deploy airbags to soften the impact. In addition, it alerts caregivers in the event of a fall. The belt also uses data analytics by collecting mobility data that is then synced to a smartphone app for displaying metrics. Technologies that Empower IoMT With the diverse tasks that medical devices must perform, applications exist across a wide spectrum, from artificial intelligence to 5G networks to the cloud. Consider a pacemaker, for instance. Modern pacemakers are embedded with a multitude of technologies that communicate with each other to send critical patient data to physicians. A pacemaker is a bioelectronic implant that is placed in the chest to control the heartbeat. But a smart pacemaker goes a step further. It is equipped with wireless bluetooth technology that communicates with the patient’s wearable medical device. The smart device or phone will then transfer this data to physicians for check-ups and even alert doctors in the case of anomalies. To Round It Off IoMT will subsequently power all medical devices and usher in a future where technology forms the backbone of healthcare service delivery. Although wearable medical technology has been around for decades, the development of a streamlined communication channel between them has redefined their use. Smart medical devices are no longer just an aid but a source of vital individual medical data as well as a way to anticipate care and medical attention.

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Spotlight

Alameda Health System

Alameda Health System is the East Bay's premier patient and family-centered care system. Our trauma center and teaching hospital are considered among the best in the country. We are committed to continually improving health through individual patient experiences. Our mission, Caring, Healing, Teaching, Serving All, speaks to the vital role we play in the community and the critical responsibility we accept in promoting wellness, eliminating disparities and optimizing the health of a diverse East Bay.

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Healthcare Analytics

Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint into Louisiana

Keystone Healthcare Partners | February 05, 2024

Keystone Healthcare Partners a leading provider of emergency medicine, hospital medicine, critical care medicine, and telehealth staffing and management services, as well as revenue cycle management, recently announced that it has formed a partnership with Trinity Medical in Ferriday, Louisiana. Keystone's delivery of emergency medicine services at Trinity Medical will commence on February 1, 2024. This contract represents an exciting expansion of Keystone's regional influence into Louisiana; the company has managed contracts in Mississippi for decades. Glenn Adams, Keystone's CEO & Co-founder, notes, "We are excited to kick off another partnership with a client where we see opportunity for real impact. We've hit the ground running to shore up areas of frustration for the client and bring value-add and innovative solutions, such as Keystone Connect AI technology to the emergency medicine program." While the healthcare landscape has been challenging for rural and critical access hospitals, the two entities share a patient-centered ethos that will be paramount to the partnership. The two entities share a community- and patient-focus that is embodied by Trinity's motto, "People you know, caring for people you love." "We are very excited to start our partnership with Keystone Healthcare," states Keisha Smith, CEO of Trinity. "My goal for Trinity Medical has always been to provide our patients with the best healthcare and customer service possible in the Miss-Lou area. We feel that Keystone shares the same goals that we have and will be a true asset to our hospital. Henry Ford stated, 'Coming together is a beginning, staying together is progress, and working together is success.' We are looking forward to a long lasting, successful partnership with Keystone Healthcare." Trinity Medical, a 23-bed licensed facility, continues to grow and upgrade their services and facilities in addition to recruiting physicians to meet the growing needs of their expanding community. About Keystone Healthcare Keystone Healthcare™ is a leading provider of Emergency Medicine, Hospital Medicine, Critical Care Medicine and Telehealth clinical management services and staffing solutions for hospitals. We efficiently deliver high-quality, patient-centered care through strong physician leadership and involved management that drive our innovative and integrated business model. About Trinity Medical Trinity Medical is operated by Concordia Parish Hospital Service District No. 1. Trinity Medical, formerly Riverland Medical Center, opened in 1964 as Concordia Parish Hospital and has continuously served the residents of the area for more than 55 years. In addition to emergency and acute care, Trinity Medical offers surgical services, diagnostic imaging, infusion center, cardio-respiratory care, gastroenterology, lab services, otolaryngology, urology, and an in-hospital rehabilitation service as well as an extensive range of out-patient services, both diagnostic and for treatment.

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Digital Healthcare

UCI Health Reaches Definitive Agreement to Acquire Four Southern California Hospitals From Tenet Healthcare Corporation

UCI Health | February 02, 2024

The Regents of the University of California, on behalf of the University of California, Irvine, has entered into a definitive agreement with Tenet Healthcare Corporation to acquire Tenet's Pacific Coast Network. The network will become part of UCI Health, the clinical enterprise of UC Irvine. "UC Irvine has deepened its healthcare commitment to the future of Orange County, our region and California," said UC Irvine Chancellor Howard Gillman. "This journey in healthcare is deeply intertwined with the University of California's dedication to bettering our communities, expanding access to premier healthcare, and pioneering the medical innovations of tomorrow, today. Our vision will bridge gaps in regional care and reinforce UCI's place among the nation's leading academic health systems while advancing solutions to challenges facing healthcare." Pending customary regulatory approvals, clearances, and closing conditions, the proposed acquisition would bring four medical centers in Lakewood, Los Alamitos, Fountain Valley and Placentia and associated outpatient locations into the UCI Health system. UCI Health currently delivers care at UCI Medical Center in Orange and a growing network of multispecialty care centers. "At UCI Health, we are excited to add these new care sites to the UCI Health network and extend the benefits of our compassionate, high-level care, clinical innovation, and scientific discovery," said Chad Lefteris, president and chief executive officer of UCI Health. "As Orange County's only academic health system, UCI Health is unique in its ability to offer the highest level of advanced care powered by the research and innovation of a world-class public research institution." UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by Tenet Healthcare's Pacific Coast Network. "These four hospitals are well-regarded in their communities for providing high-quality, compassionate care," said Saum Sutaria, M.D., chairman and chief executive officer of Tenet Healthcare. "The local communities will benefit from the nationally recognized advancements, medical knowledge, research, and community focus that UCI Health brings as an innovative academic health system. UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by the Pacific Coast Network." In a region with a population greater than that of two dozen states, UCI Health operates the only Level I trauma center, locally based National Cancer Institute-designated comprehensive cancer center, high-risk perinatal-neonatal service and is the largest regional burn center and leading provider of complex tertiary and quaternary care. The system's clinical excellence has consistently placed UCI Health in the top 10 for quality and safety among the nation's leading comprehensive academic health systems. The acquisition also means more patients will have access to advanced therapies in the region's largest and most diverse portfolio of clinical trials, ranging from cancer to neurosciences, digestive diseases, orthopedics and internal medicine specialties. UCI Health and Tenet Healthcare's Pacific Coast Network patients can continue receiving care at their local facilities as they normally would from the care teams they know and trust. The transaction is expected to be completed in spring 2024, subject to customary regulatory approvals, clearances, and closing conditions. "It is a privilege to provide world-class care to Californians and we are excited to welcome the clinicians and co-workers from these Tenet Healthcare sites to UCI Health as partners in improving the health of local communities," Lefteris said. About UCI Health UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. About UC Irvine About the University of California, Irvine: Founded in 1965, UCI is a member of the prestigious Association of American Universities and is ranked among the nation's top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 37,000 students and offers 224 degree programs. It's located in one of the world's safest and most economically vibrant communities and is Orange County's second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. About Tenet Healthcare Tenet Healthcare Corporation is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates or has ownership interests in more than 480 ambulatory surgery centers and surgical hospitals. We also operate 58 acute care and specialty hospitals, approximately 110 other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers, and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.

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Health Technology

Beckman Coulter Unveils DxC 500 AU Chemistry Analyzer, Expanding Portfolio with Proven Six Sigma Performance

Beckman Coulter Diagnostics | January 30, 2024

Beckman Coulter Diagnostics, a clinical diagnostics leader, will unveil its new DxC 500 AU Chemistry Analyzer, an automated clinical chemistry analyzer, at Medlab Middle East in Dubai, taking place February 5-8, 2024. The DxC 500 AU Chemistry Analyzer is one of several recent Beckman Coulter solutions designed to address the complete needs of healthcare systems that are looking to complement central hub laboratories by advancing the technology and capabilities of satellite and independent hospital laboratories. "Healthcare systems around the world are strategically adopting hub-and-spoke models for better efficiency and healthcare access," said Kathleen Orland, Senior Vice President, Business Unit, General Manager, Chemistry and Immunoassay for Beckman Coulter Diagnostics. "Hub-and-spoke clinical laboratory models optimize resources to improve access to testing services and enhance overall standardization for quality testing and positive impact on inventory and cost management across a health system. The new DxC 500 AU Chemistry Analyzer advances capabilities of spoked labs with a broad menu of high-quality assays that deliver consistent, commutable results across Beckman Coulter's AU clinical chemistry systems, positively impacting clinical decision-making and patient outcomes." The DxC 500 AU Chemistry Analyzer features advanced automation technology, onboard guided workflows, and standardized reagents for use across healthcare networks. Its menu of more than 120 assays has been independently and objectively verified for high quality Six Sigma performance, supporting confidence in clinical results, reducing QC trouble shooting and lab operational costs. "Our Six Sigma assessment has shown that the DxC 500 AU analyzer easily exceeds the demands of the new, more stringent CLIA 2024 performance specifications," stated Sten Westgard, Director of Client Services and Technology for Westgard QC. The DxC 500 AU Chemistry Analyzer is for in vitro diagnostic use only. It is available throughout North America and the Middle East. Global commercial availability is planned for March 2024. About Beckman Coulter. Inc. A global leader in advanced diagnostics, Beckman Coulter has challenged convention to elevate the diagnostic laboratory's role in improving patient health for more than 80 years. Our mission is to Relentlessly Reimagine Healthcare, One Diagnosis at a Time – and we do this by applying the power of science, technology and the passion and creativity of our teams. Our diagnostic solutions are used in complex clinical testing, and are found in hospitals, reference laboratories and physician office settings around the globe. We exist to deliver smarter, faster diagnostic solutions that move the needle forward from what's now to what's next. We seek to accelerate care with an extensive clinical menu, scalable lab automation technologies, insightful clinical informatics, and optimize lab performance services. Headquartered in Brea, Calif., with more than 11,000 global team members, Beckman Coulter Diagnostics is proud to be part of Danaher. Danaher is a global science and technology leader. Together we combine our capabilities to accelerate the real-life impact of tomorrow's science and technology to improve human health. ©2024 Beckman Coulter. All rights reserved. Beckman Coulter, the stylized logo, and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

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Healthcare Analytics

Keystone Healthcare Partners Establishes Partnership with Trinity Medical to Expand Emergency Medicine Footprint into Louisiana

Keystone Healthcare Partners | February 05, 2024

Keystone Healthcare Partners a leading provider of emergency medicine, hospital medicine, critical care medicine, and telehealth staffing and management services, as well as revenue cycle management, recently announced that it has formed a partnership with Trinity Medical in Ferriday, Louisiana. Keystone's delivery of emergency medicine services at Trinity Medical will commence on February 1, 2024. This contract represents an exciting expansion of Keystone's regional influence into Louisiana; the company has managed contracts in Mississippi for decades. Glenn Adams, Keystone's CEO & Co-founder, notes, "We are excited to kick off another partnership with a client where we see opportunity for real impact. We've hit the ground running to shore up areas of frustration for the client and bring value-add and innovative solutions, such as Keystone Connect AI technology to the emergency medicine program." While the healthcare landscape has been challenging for rural and critical access hospitals, the two entities share a patient-centered ethos that will be paramount to the partnership. The two entities share a community- and patient-focus that is embodied by Trinity's motto, "People you know, caring for people you love." "We are very excited to start our partnership with Keystone Healthcare," states Keisha Smith, CEO of Trinity. "My goal for Trinity Medical has always been to provide our patients with the best healthcare and customer service possible in the Miss-Lou area. We feel that Keystone shares the same goals that we have and will be a true asset to our hospital. Henry Ford stated, 'Coming together is a beginning, staying together is progress, and working together is success.' We are looking forward to a long lasting, successful partnership with Keystone Healthcare." Trinity Medical, a 23-bed licensed facility, continues to grow and upgrade their services and facilities in addition to recruiting physicians to meet the growing needs of their expanding community. About Keystone Healthcare Keystone Healthcare™ is a leading provider of Emergency Medicine, Hospital Medicine, Critical Care Medicine and Telehealth clinical management services and staffing solutions for hospitals. We efficiently deliver high-quality, patient-centered care through strong physician leadership and involved management that drive our innovative and integrated business model. About Trinity Medical Trinity Medical is operated by Concordia Parish Hospital Service District No. 1. Trinity Medical, formerly Riverland Medical Center, opened in 1964 as Concordia Parish Hospital and has continuously served the residents of the area for more than 55 years. In addition to emergency and acute care, Trinity Medical offers surgical services, diagnostic imaging, infusion center, cardio-respiratory care, gastroenterology, lab services, otolaryngology, urology, and an in-hospital rehabilitation service as well as an extensive range of out-patient services, both diagnostic and for treatment.

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Digital Healthcare

UCI Health Reaches Definitive Agreement to Acquire Four Southern California Hospitals From Tenet Healthcare Corporation

UCI Health | February 02, 2024

The Regents of the University of California, on behalf of the University of California, Irvine, has entered into a definitive agreement with Tenet Healthcare Corporation to acquire Tenet's Pacific Coast Network. The network will become part of UCI Health, the clinical enterprise of UC Irvine. "UC Irvine has deepened its healthcare commitment to the future of Orange County, our region and California," said UC Irvine Chancellor Howard Gillman. "This journey in healthcare is deeply intertwined with the University of California's dedication to bettering our communities, expanding access to premier healthcare, and pioneering the medical innovations of tomorrow, today. Our vision will bridge gaps in regional care and reinforce UCI's place among the nation's leading academic health systems while advancing solutions to challenges facing healthcare." Pending customary regulatory approvals, clearances, and closing conditions, the proposed acquisition would bring four medical centers in Lakewood, Los Alamitos, Fountain Valley and Placentia and associated outpatient locations into the UCI Health system. UCI Health currently delivers care at UCI Medical Center in Orange and a growing network of multispecialty care centers. "At UCI Health, we are excited to add these new care sites to the UCI Health network and extend the benefits of our compassionate, high-level care, clinical innovation, and scientific discovery," said Chad Lefteris, president and chief executive officer of UCI Health. "As Orange County's only academic health system, UCI Health is unique in its ability to offer the highest level of advanced care powered by the research and innovation of a world-class public research institution." UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by Tenet Healthcare's Pacific Coast Network. "These four hospitals are well-regarded in their communities for providing high-quality, compassionate care," said Saum Sutaria, M.D., chairman and chief executive officer of Tenet Healthcare. "The local communities will benefit from the nationally recognized advancements, medical knowledge, research, and community focus that UCI Health brings as an innovative academic health system. UCI Health recognizes a unique opportunity to build on the quality care already being delivered in the communities served by the Pacific Coast Network." In a region with a population greater than that of two dozen states, UCI Health operates the only Level I trauma center, locally based National Cancer Institute-designated comprehensive cancer center, high-risk perinatal-neonatal service and is the largest regional burn center and leading provider of complex tertiary and quaternary care. The system's clinical excellence has consistently placed UCI Health in the top 10 for quality and safety among the nation's leading comprehensive academic health systems. The acquisition also means more patients will have access to advanced therapies in the region's largest and most diverse portfolio of clinical trials, ranging from cancer to neurosciences, digestive diseases, orthopedics and internal medicine specialties. UCI Health and Tenet Healthcare's Pacific Coast Network patients can continue receiving care at their local facilities as they normally would from the care teams they know and trust. The transaction is expected to be completed in spring 2024, subject to customary regulatory approvals, clearances, and closing conditions. "It is a privilege to provide world-class care to Californians and we are excited to welcome the clinicians and co-workers from these Tenet Healthcare sites to UCI Health as partners in improving the health of local communities," Lefteris said. About UCI Health UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. About UC Irvine About the University of California, Irvine: Founded in 1965, UCI is a member of the prestigious Association of American Universities and is ranked among the nation's top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 37,000 students and offers 224 degree programs. It's located in one of the world's safest and most economically vibrant communities and is Orange County's second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. About Tenet Healthcare Tenet Healthcare Corporation is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates or has ownership interests in more than 480 ambulatory surgery centers and surgical hospitals. We also operate 58 acute care and specialty hospitals, approximately 110 other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers, and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.

Read More

Health Technology

Beckman Coulter Unveils DxC 500 AU Chemistry Analyzer, Expanding Portfolio with Proven Six Sigma Performance

Beckman Coulter Diagnostics | January 30, 2024

Beckman Coulter Diagnostics, a clinical diagnostics leader, will unveil its new DxC 500 AU Chemistry Analyzer, an automated clinical chemistry analyzer, at Medlab Middle East in Dubai, taking place February 5-8, 2024. The DxC 500 AU Chemistry Analyzer is one of several recent Beckman Coulter solutions designed to address the complete needs of healthcare systems that are looking to complement central hub laboratories by advancing the technology and capabilities of satellite and independent hospital laboratories. "Healthcare systems around the world are strategically adopting hub-and-spoke models for better efficiency and healthcare access," said Kathleen Orland, Senior Vice President, Business Unit, General Manager, Chemistry and Immunoassay for Beckman Coulter Diagnostics. "Hub-and-spoke clinical laboratory models optimize resources to improve access to testing services and enhance overall standardization for quality testing and positive impact on inventory and cost management across a health system. The new DxC 500 AU Chemistry Analyzer advances capabilities of spoked labs with a broad menu of high-quality assays that deliver consistent, commutable results across Beckman Coulter's AU clinical chemistry systems, positively impacting clinical decision-making and patient outcomes." The DxC 500 AU Chemistry Analyzer features advanced automation technology, onboard guided workflows, and standardized reagents for use across healthcare networks. Its menu of more than 120 assays has been independently and objectively verified for high quality Six Sigma performance, supporting confidence in clinical results, reducing QC trouble shooting and lab operational costs. "Our Six Sigma assessment has shown that the DxC 500 AU analyzer easily exceeds the demands of the new, more stringent CLIA 2024 performance specifications," stated Sten Westgard, Director of Client Services and Technology for Westgard QC. The DxC 500 AU Chemistry Analyzer is for in vitro diagnostic use only. It is available throughout North America and the Middle East. Global commercial availability is planned for March 2024. About Beckman Coulter. Inc. A global leader in advanced diagnostics, Beckman Coulter has challenged convention to elevate the diagnostic laboratory's role in improving patient health for more than 80 years. Our mission is to Relentlessly Reimagine Healthcare, One Diagnosis at a Time – and we do this by applying the power of science, technology and the passion and creativity of our teams. Our diagnostic solutions are used in complex clinical testing, and are found in hospitals, reference laboratories and physician office settings around the globe. We exist to deliver smarter, faster diagnostic solutions that move the needle forward from what's now to what's next. We seek to accelerate care with an extensive clinical menu, scalable lab automation technologies, insightful clinical informatics, and optimize lab performance services. Headquartered in Brea, Calif., with more than 11,000 global team members, Beckman Coulter Diagnostics is proud to be part of Danaher. Danaher is a global science and technology leader. Together we combine our capabilities to accelerate the real-life impact of tomorrow's science and technology to improve human health. ©2024 Beckman Coulter. All rights reserved. Beckman Coulter, the stylized logo, and the Beckman Coulter product and service marks mentioned herein are trademarks or registered trademarks of Beckman Coulter, Inc. in the United States and other countries.

Read More

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