Electronic Medical Records

ALSO NOTED: Brooklyn HIE to begin operations; Mass. e-prescribing up in 2007; and much more...

Mon, 11 Feb 2008 06:59:50 -0500

> The Brooklyn Health Information Exchange has begun developing an enterprise master person index in preparation for beginning operations this summer. Article

> E-prescribing seems to be growing in Massachusetts. Participants in a payer-sponsored e-prescribing network there sent 8.4 percent more prescriptions in 2007 than 2006. Article

> Foundations have agreed to provide almost $1 million to set up an EMR and billing system in at least 13 school-based health centers in greater New Orleans. Article

> Case study: A Las Vegas medical group has rolled out a portal which allows patients to perform key functions such as making appointments, refilling prescriptions and viewing their electronic medical records. Article

> Wyoming's health data organization has set up a Web site to help educate providers about RHIOs and help them come to terms with privacy and security concerns. Article

And Finally... Putting doctors in key health IT positions sounds good, but making it work is harder than it sounds. Article

Providers expanding HIT adoption in '08

Mon, 28 Jan 2008 06:59:57 -0500

Providers are already spending big money on clinical technology, and it looks like they're only planning to spend more this year, according to a new study by strategic marketing firm the Gantry Group. According to the firm's research, healthcare providers allocated 40 percent or more of their current technology budget to clinical technology in 2007, including digital medical imaging, medication management, e-prescribing, RFID solutions, electronic medical records, patient care planning tools, patient documentation, and mobile applications. Generally speaking, CIOs are moving away from custom, in-house created applications and looking for commercial packages that suit their needs, the study concluded.

By the end of 2008, over 80 percent of facilities will have invested in key clinical technologies, Gantry Group predicts. The costliest items on provider budgets were digital medical imaging and electronic medical records, which in combination, ate up 64 percent of providers' clinical technology budgets. Among those surveyed, meanwhile, about 50 percent said they spent more than $10 million in health technology, and 53 percent said they'd probably reach that level within the next year, according to researchers.

To get more data from the study:
- read this Gantry Group press release

Related Articles:
HIMSS: Patient safety top reason for IT investment. Report
Study: Hospital execs stress IT investment for coming years. Report
Senate leader plugs health IT investment. Report
PwC: Hospital IT can lower death rates. Report

ALSO NOTED: AHIMA plans nursing home IT standards; Mass. HIE expanding; and much more...

Mon, 07 Jan 2008 06:59:50 -0500

> AHIMA has launched a new project intended to provide a model for using EMRs and other health IT platforms in nursing homes. Article

> A $50 million Massachusetts-based data sharing cooperative has moved into the next phase of expansion, asking patients to share the data from their electronic medical records with the network. Article

> The CEO of CareFirst BlueCross BlueShield, Maryland's largest health plan, talks about why he's building a secure EMR and setting up a pay-for-performance plan for physicians. Article

> Here's one blogger's argument as to why all EMRs should use open standards. Blog

And Finally... At the University of Buffalo, they're not only recording neurosurgical procedures, they're broadcasting them all over the world. Article

ALSO NOTED: Rush develops cart-based EMR access; Mass. hospitals use bar-code bracelets; and much more...

Mon, 30 Jul 2007 06:59:50 -0400

> Chicago-based Rush University Medical Center is working with CDW Corp. to build out 370 mobile carts with the capacity to run applications, including EMRs, CPOE and other clinical apps from Epic Systems. Article

> Perhaps it's not a bleeding-edge solution, but it's still an important step. Several Massachusetts hospitals have begun using bar-coded wristbands for patients, intended largely to verify that the right patient is getting the right medication. Article

> A presidential commission has strongly recommended that veterans all get electronic medical records. Article

> A Czech hospital has begun working with IBM on a pilot project designed to track chemotherapy drugs using RFID tags. Article

> Hoping to reassure waiting families, an Indiana hospital has installed an airport-style electronic status board tracking the progress of patients' operations. Article

And Finally... On the Internet, no one knows you're a sadist. Study

New Kaiser IT head charts change of course

Sun, 01 Jul 2007 20:01:38 -0400

After months of being in a holding pattern, Kaiser Permanente has hired a new, permanent top technology leader to stabilize its troubled IT organization.

Philip Fasano, former CEO of Capital Sourcing Group, is now vice president and chief information officer. He takes over from Bruce Turkstra, who served as interim IT chief after Cliff Dodd resigned in November. Dodd left practically overnight after a junior employee, Justen Deal, sent an email to Kaiser employees detailing serious uptime problems with its EMR. Since Deal's letter, the California Department of Managed Health Care began investigating problems with Kaiser's $4 billion Epic installation.

Fasano, who comes from the financial services industry, has vowed to bring Kaiser's HealthConnect EMR the "five nines" uptime enjoyed by users of financial information networks. To do so, he's planning to decentralize, giving a group of regional "business information managers" the ability to exercise more control over local IT problems. He's also planning to shift thousands of IT employees over to helping internal customers like physicians. In the past, most IT staffers were focused on maintaining standard IT services. In addition, he hopes to spend $100 million to $200 million on infrastructure investment, on top of his $1.6 billion overall IT budget.

To find out more about Fasano:
- read this East Bay Business Times article

Related articles:
Read Justen Deal's opinion on K-P's new hire. Blog
Controversy topples top IT exec. Article

Google health panel sparks excitement

Sun, 01 Jul 2007 20:01:35 -0400

Google's announcement that it's developed a healthcare advisory panel has created quite a stir. In recent weeks, the search giant has been pitching its secure Web information security technology, arguing along the way that secure authentication is key to building Web-based EMRs. The announcement has further fueled speculation Google will develop its own Web-based EMR.

The stellar 21-member panel, which will advise Google on consumer and provider issues and offer product ideas, includes the CEO of Cleveland Clinic, Linda Dillman, a Wal-Mart EVP with benefits responsibility, former FDA commissioner David Kessler, Harvard Medical School CIO John Halamka and American College of Physicians CEO John Tooker.

Panel members are paid a pittance, $1,500 per quarterly meeting, and it doesn't seem they're getting any privileged access to stock or other corporate benefits. So I guess they share many other observers' view that whatever Google develops, it will be important to the industry--and you can't beat a front-row seat on that kind of thing.

To learn more about the group:
- read this Google blog entry
- read this iHealthBeat article

AMA develops EMR security guidelines

Sun, 24 Jun 2007 20:01:36 -0400

The American Medical Association has developed some proposed guidelines intended to make sure patient access to EMR systems is secure and appropriate. The guidelines, while not breaking any major ground from an IT perspective, could give practices some much-needed confidence that they're doing the right thing. The AMA's guidelines recommend that:

Interactions with EMR systems should take place over a secure, encrypted network.
Physicians should authenticate patient access to EMRs, and should establish standards for authenticating patients that are known to all practice employees.
If patients edit or annotate the EMR, those changes should be clearly attributed to the patient.
Patients should not be allowed to delete health information.

AMA members will be reviewing the guidelines this week at the group's House of Delegates meeting.

To find out more about the proposals:
- read this Modern Healthcare piece

Related Articles:
Study: Physicians at EMR "tipping point." Report
Bill would pay for physician health IT costs. Report
MD group asks for federal help with EMRs. Report
Smaller practices still behind in IT adoption. Report

The EMR recruiting crisis

Sun, 17 Jun 2007 20:01:39 -0400

I doubt anyone reading FierceHealthIT objects to the idea of federal subsidies for EMR adoption. After all, if legislators want to see broad EMR use, offering grants, loans or expanded tax advantages for EMR investment is merely putting their money where their mouth is.

But will financial incentives solve the problem? My take, in short, is "no." As I see it, biggest obstacle to building a national, interoperable, efficient EMR network isn't money, but talent. Where on earth will thousands of hospitals and scores of medical practices find the corps of specialized IT experts needed to successfully integrate an EMR into their clinical operations?

As readers already know, recruiting IT talent for healthcare organizations is costly and time-consuming. When you consider that EMR implementation is a specialty within a specialty, your recruiting prospects start to look a bit, well, grim.

And don't count on new college grads to solve the problem. Even as things stand today, we'll need 6,000 health information management professionals each year through 2010, but schools are only turning out 2,000 per year, according to AHIMA figures. And worse, the number of students enrolling in HIM programs is falling, the trade group says.

OK, I'll admit, smaller medical practices will probably squeak by with the same consultants that implemented their practice management system. And big health systems will probably have the resources to bring expert help on board. But what about the huge mass of mid-market organizations?

Mid-sized medical practices and community hospitals won't have the luxury of implementing an inexpensive, feature-poor system that can be tacked onto existing systems in days or weeks. They simply can't afford to do that; while they're not giants, they're seeing too many patients to risk rolling out kludgeware. But they're also going to be in a poor position to compete with the larger players for the specialists.

So, in all this deliberation on the Hill and in state legislatures, maybe it's time for lawmakers to fund more programs training IT pros on the ins and outs of clinical data sharing.

They could subsidize the heck out of schools with large corps of promising IT undergrads that are willing to offer a clinical information systems program. They could offer to pay for EMR-focused education in exchange for commitments to work in areas where IT staffers are in short supply. They could create special grant programs to fund experienced pros who want to become EMRs pros.

Hey, they could just start by publicly acknowledging the problem...that when it comes to building a national EMR network, it will take more than hardware and software to get the job done. - Anne

VA could spend $20M on data breach response

Sun, 17 Jun 2007 20:01:38 -0400

It looks like a recent data breach suffered by the Department of Veterans Affairs could be very pricey. Officials continue to deal with the recent loss of a hard drive, which disappeared from a VA medical center in Birmingham, AL in January of this year. The disk contained confidential data on any U.S. doctor billed Medicaid or Medicare through 2004, as well as more than 500,000 VA patients. To date, the hard drive has not been found, despite a $25,000 reward for information on its whereabouts. According to VA officials, security weaknesses at the heart of the VA's VistA health information system played a role in the breach. While the VA is working to update VistA security, the process could take until 2015. In the mean time, the agency has gotten hammered by members of Congress over this incident, as well as a lapse last year which exposed 26.5 million records. That breach cost the agency $160.5 million just for credit counseling and related services for affected patients.

To learn more about the VA's reaction to the security breach:
- read this iHealthBeat article

Related Articles:
VA revamping IT infrastructure. Report
VA pledges better data security. Report
VA suffers major data loss, again. Report

Consumer, biz groups push pro-EMR legislation

Sun, 17 Jun 2007 20:01:37 -0400

A trio of advocacy groups--including the AARP, the Service Employees International Union and the Business Roundtable--have begun a lobbying effort encouraging Congress to push EMR adoption. In a joint statement, the groups cited a 2005 study by RAND which estimated that the health system would save as much $165 billion if providers adopted health IT more broadly. The groups have asked legislators to pass legislation immediately which would give all Americans access to secure EMRs. The three organizations believe that Congress should foster EMR adoption by offering providers grants, loans and tax credits. They'd also like to see the legislation require payers and providers develop interoperable systems as soon as possible. Congress is already considering a bill, the National Health Information Incentive Act, which would offer physicians grants, loans and tax incentives to encourage EMR adoption.

To find out more about the initiative:
- read this United Press International article
- read the groups' joint press release