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Today's Top Stories
1. Kaiser's EMR facing state investigation
2. VA suffers major data loss, again
3. Chicago hospitals offer Internet options
4. Blue Cross of California launches PHR
5. NYC mayor calls for universal EMRs by 2012
Also Noted: Spotlight On... Brailer: HIT can cut care costs 50%; How to make them join your RHIO; Getting tough on healthcare data security; and much more...
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This week, blogger and consultant William Bryson of Innovative IT for Healthcare outlined an approach which seems may solve some of the key issues dogging the emergence of RHIOs. As I see it the idea, EHR/EMR "banking," certainly has some flaws, but is definitely worthy of further discussion.
In his article, Bryson describes the concept, under which a third-party organization would collect and host clinical on behalf of the states. This approach works around thorny HIPAA privacy issues, as well as making it simpler for patients to control who gets their data and when. (After all, establishing multiple levels of access is much easier with one database than with data living in five, six or even dozens across several organizations.)
Under this model, doctors and other clinicians make "deposits" of clinical information--and are paid to do so. Patients establish and pay for the EMR "account," which then gives them control over any and all withdrawals of medical information. Effectively, the patient's EMR is held in trust by the third party.
I can understand why Bryson was interested in this model. It's easy to see how EMR banking vendors like eHealthTrust could play an important role in calming the fears of competing regional health systems, stifling at the outset the question of how much control each side would have to give up. And it's a very neat trick to place patient info into their own "account," as just about every version of RHIO we've heard of is struggling with how to handle the scores of permissions they'd need to get whenever they share information across the network. This approach blows many of these concerns out of the water.
Honestly, I'm a bit skeptical that patients are sophisticated enough, yet, to see the need to establish a medical bank account. It's sort of a chicken-and-egg problem; so few actually see their PCP using electronic records, it's just not a concept that will resonate with enough to reach critical mass.
Another issue is that the groups most likely to benefit from such an approach--senior citizens on Medicare and poor people on Medicaid--would not be prone to be the most computer-savvy types. I think that taking control of, much less paying for, a computerized medical record would be a hard sell for both groups.
But even if the effort would take patient education, serious security protections and a possible re-structuring of the business model (get, say, the pharmas to underwrite the EMR cost?) I think the idea makes a lot of sense. I'm eager to see whether states take this path in some form, rather than paying for a lot of iron and software and hoping regional health systems can run with the ball. (Do you think this approach can work? I'd love to get your opinion.) -Anne
P.S. I'm sure most of you are going to HIMSS '07 next week. I will be to cover the show in depth, and look forward to meeting as many of you as I can, especially at our hot networking party On The Rocks on Monday the 26th. See you there!
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1. Kaiser's EMR facing state investigation
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Kaiser's massive $4 billion Epic EMR installation has been suffering from serious technical problems throughout its life, despite management claims to the contrary, a new published report says. These concerns have led the California Department of Managed Health Care to request information on the installation, something it does prior to potentially launching a formal investigation. The highly critical report comes as Kaiser begins rolling out the Epic EMR to about three dozen more hospitals. Right now it's only up in two, Baldwin Park Medical Center and South Sacramento Medical Center.
According to the investigative report, which appeared this week in the Los Angeles Times, Kaiser's Health Connect installation has worked so badly that among other problems, patients have been listed in wrong beds, clinicians have gone without crucial clinical information and system outages have delayed care in the ED. What's more, the system has experienced downtime in excess of 20 percent in some locations, according to an internal Kaiser report, a problem attributed to poor design of Health Connect's server infrastructure and backup power supplies.
Fore more information on the Kaiser EMR battle:
- read this Los Angeles Times article
2. VA suffers major data loss, again
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While it's tempting to just say that security breaches happen, we at FierceHealthIT are beginning to be a bit knocked back by the volume of major health organization data losses taking place over the past six months. The latest came early last week, when the VA said that it had lost track of data on 1.8 million veterans and doctors. That includes billing information on about 1.3 million doctors nationwide, and Social Security numbers on about 535,000 individuals. The data, which was missing from an Alabama hospital for about three weeks, was located on an external hard drive used to back up an employee's desktop machine.
This isn't the first time the VA has been caught red-faced after a data loss was reported relatively late. Last year, a VA executive and data analyst ended up out of their jobs after it was discovered that they'd failed to reveal the theft of data on 26.5 million vets quickly.
To learn more about the incident:
- read this piece in The Tennessean
Related Articles:
Johns Hopkins loses patient, employee data. Report
Massive data loss at HCA. Report
Allina suffers patient data theft. Report
VA pledges better data security. Report
3. Chicago hospitals offer Internet options
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Like health organizations in other parts of the country, a growing number of Chicago's hospitals are making Internet connectivity an integral part of a patient's stay. For example, at University of Chicago's Comer Children's Hospital, patients get an entertainment and education system, based around a 42-inch LCD television, which allows patients to surf the Net and get e-mail, along with downloading movies, reviewing educational content and playing games from their beds. Comer, along with Bernard A. Mitchell Hospital, is also rolling out free WiFi connections that visitors bearing laptops are allowed to use.
Another health system, Evanston Northwestern Healthcare (ENH), is implementing out a campus-wide Internet access system for hospitals over the next two years; Glenbrook Hospital will have WiFi by 2008 and Highland Park by 2009. The system won't just be WiFi oriented, however--it will cover all wireless devices, including cell phone and pagers.
ENH is doing more than connecting patients, however. It also offers a service it calls ENHfirst, a patient information portal allowing patients to view lab, X-ray and EKG results, e-mail their doctor, schedule appointments, renew medications and pay hospital and doctor bills.
To get more information on these deployments:
- read this piece from the Chicago Tribune
Related Article:
Hospital portal helps patient-MD communication. Article
4. Blue Cross of California launches PHR
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One of the nation's largest health insurers, Blue Cross of California, has joined the PHR craze. The Blue has launched an integrated wellness, care management and physician communication program--360 Degree Health--with its personal health record model as a central component. The program is intended to better reach the 20 percent of the health plan's members at greatest risk. Like other new PHRs, it's also an exercise in seeing how much useful information patients can actually be tempted to provide. It seems likely that any PHR, no matter how catchy the interface, would have a "shopping cart abandonment" problem.
The new PHR will include both member-provided data and claims data, both of which will be accessible by telephone and the Web. Wrapped around the PHR is a more comprehensive wellness initiative, offering members lifestyle programs, alternative medicine information and live health education. The website also offers interactive online tools helping patients make well-informed health choices.
To get more background:
- read BCC's press release
Related Articles:
GA insurers unveil easy-access PHRs. Report
Groups sink $5.3 million into PHR apps. Report
5. NYC mayor calls for universal EMRs by 2012
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So you thought absolutely everyone had an opinion on EMRs? Add publishing magnate and New York City mayor Michael Bloomberg to the list. "In this day and age, there is no more excuse for delay," said Bloomberg, speaking at a health policy conference last week. The mayor apparently practices what he preaches, with the city recently committing $27 million to help make EMR technology affordable for smaller medical practices. Due in part to his advocacy, New York was one of the first cities to implement EMRs in public hospitals and community health centers, Bloomberg told the conference.
So how will the country meet this five-year EMR goal? Among other things, some keys are to subsidize hospitals and doctors' purchase of EMRs and pay doctors incentives for using IT for prevention, he said. Bloomberg estimates that the transition to EMRs will cost about $20 billion, which he said was a small number when compared with overall U.S. healthcare spending.
For more information on Bloomberg's proposals:
- read this United Press International article
Related Article:
Bronx group gets $4.1 million RHIO grant. Report
It's a popular date: Washington state plans universal health by 2012. Article
ALSO NOTED
TODAY'S SPOTLIGHT... Brailer: HIT can cut care costs 50%
Former U.S. health IT czar David Brailer is very bullish on health IT's ability to cut costs, but he says it will only happen if we're patient. In remarks to journal Health Affairs, Brailer said that he believes a strong HIT base nationwide will lower healthcare spending by as much as 50 percent. However, it will take a decade or getting used to the tools before users start building new processes around tools like EMRs, which is when the real benefits will manifest themselves, he told Health Affairs. Article
> Here's an in-depth analysis of how nonprofit hospitals get even direct competitors to participate in a RHIO--and what factors might give you a leg up in RHIO negotiations. Blog
> There's just no excuse for hospitals not to encrypt critical data, particularly given how often it has gotten lost or stolen of late, one security expert says. Blog
> New Orleans-based hospital Touro Infirmary has struck an IT management deal with Siemens Medical Solutions. Release
And Finally... Not sure if you're performing CPR correctly? Automation to the rescue! It's the CPR Glove. Blog
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