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I expected this past weekend to be devoted to thinking about final MU changes, however my attention was drawn to the announcement about Verizon’s entry into the HIE arena. It appears Verizon has launched a Web-based health exchange, something of which I have been advocating for the past year or so, and teamed up with several other players to make it work. MedVirginia, a private health exchange operated in Virginia; Medfx, a company knowledgeable in cloud based health care and practice management solutions; and Oracle for its transaction systems, databases and indices. It’s a good model, as it provides knowledge in the practical operation of an exchange and technology necessary to power it across the Web. But it seems to me the new offering — as bold as it is — has missed a critical component. All of this effort is aimed at moving data from one point to another, but where is the skill set to use that data to transform the way providers deliver care, and what metrics will be used to assess quality?

The field of biomedical is full of acronyms — CPOE, HIE, EMR, HL7 — that may be interesting to IT professionals, but merely connote longer days, multiple logins and frustration for clinicians. While people in “healthcare” love it concept of CPOE, physicians feel it slow them down and turns them from docs into secretaries. I recently gave a ground rounds to our large children’s hospital to explain how biomedical informatics is evolving. There is a plan in my mind of how CPOE, HIE, etc., can come together leveraging bar code medication administration and actionable alerts, to prevent beside safety issues and improve care. What will also emerge is quality reporting which can provide data for large scale research.

CPOE systems, on average, missed one half of routine medication order errors and a third of potentially fatal order errors during a study The Leapfrog Group conducted of 214 hospitals using its Web-based simulation tool. Leapfrog CEO Leah Binder characterized the results as “disturbing.” On a positive note, of the 102 hospitals that retook the test following a six-month interval, 94 percent showed some level of improvement. During the time between tests, hospitals adjusted their systems and protocols, said Binder.

Implementing a few clinical systems isn’t going to get you applause at El Camino Hospital. That’s because the organization has “been there, done that,” implementing the first CPOE system some 40 years ago. Considering that tough crowd, the CIO role isn’t for newcomers, and Greg Walton is no newcomer. With 40 years in the business [...]

 

 PODCAST: One-on-One w/ El Camino Hospital CIO Greg Walton, Chapter 3 [8:02m]: Play Now | Play in Popup | Download (31)

It didn’t take an act of Congress to start Carol Dresser and Hallmark Health implementing advanced clinical technologies. Hallmark — which includes Lawrence Memorial Hospital, Melrose-Wakefield Hospital, Hallmark Health Cancer Center and Hallmark Health Medical Center — is now working to increase adoption of CPOE and perfect its bedside bar coded medication administration processes. What [...]

 

 PODCAST: One-on-One w/Hallmark Health VP of IS Carol Dresser, Chapter 3 [10:29m]: Play Now | Play in Popup | Download (129)

“When exploring uncharted waters or embarking on a great adventure often the final destination is not necessarily that which was first envisioned. An adventure, by definition is a venture or gamble. Christopher Columbus did not expect to discover a new world; his intended adventure upon embarkation is not why he is remembered today. The same [...]

I just returned from a weekend with my family at Cedar Point Amusement Park in Sandusky, OH (the “roller coaster capital of the world”).  While we certainly had fun taking in all the coasters, I couldn’t help but think about health IT (I know, what can I say, I need a life!). What really struck [...]

In every industry, there are organizations so pervasive they constitute bellwethers for the entire market segment. In healthcare IT, that company is Meditech. With over 2,200 customers and almost $400 million in software revenues last year, the Westwood, Mass.-based organization’s opinions on national policy — especially the HITECH Act’s Meaningful Use NPRM — should be taken very seriously by D.C.’s policy wonks. Offering those opinions to healthsystemCIO.com editor Anthony Guerra this exclusive interview is President and COO Howard Messing. In the following discussion, Messing — who was recently promoted to CEO subject to a perfunctory confirmation vote — offers his thoughts on the aforementioned HITECH Act, meeting customer demands for the latest software and much more.

 

 One-on-One-w/Meditech President & COO Howard Messing, Part II [17:47m]: Play Now | Play in Popup | Download (341)

Over the past year, John Glaser, Ph.D., has been eating and breathing Meaningful Use and Certification even more than his HITECH-focused CIO colleagues. That’s because while Glaser has kept up his role as VP & CIO at Partners HealthCare on a part-time basis, he’s also been winging down to D.C. every week to fulfill his duties as Senior Adviser to ONC and its chief, National Coordinator David Blumenthal, M.D. In this — his first extensive interview since the culmination of that role in March — Glaser talks frankly with healthsystemCIO.com editor Anthony Guerra about working in the federal government, the proposed regulations, and what the future may hold for both the industry and himself.

 

 One-on-One w/Former ONC Senior Adviser John Glaser [47:38m]: Play Now | Play in Popup | Download (664)

Over 75 percent of CIOs prefer to take on the massive challenge of implementing bedside-barcoded electronic medication administration records (eMAR) versus the equally massive task of converting to CPOE, according to the May healthsystemCIO.com SnapSurvey. But it doesn’t look like a weakness in the clinical decision support functionality of CPOE is to blame for the eMAR preference.

Psychologists say people don’t research problems to find solutions, but rather to support the solution they’ve already decided upon. To cite a recent political example, many said the Bush administration “cherry picked” intelligence to foster support for a war it was already committed to. In addition to the selection side, this type of analysis entails [...]

Using bar-code technology with an electronic medication administration record (eMAR) “substantially reduces transcription and medication administration errors, as well as potential drug-related adverse events,” says a new study funded by AHRQ. The findings have important implications because bar-code eMAR technology is being considered as a 2013 criterion for Meaningful Use under HITECH. (Skip to Podcast)
Researchers [...]

NQF has formed a new Health Information Technology Advisory Committee (HITAC) to develop a strategic plan and provide guidance for NQF’s HIT portfolio; offer input on HIT projects; review electronic specifications for NQF-endorsed and candidate standards; and make recommendations on the endorsement and maintenance of HIT-related consensus standards.
HITAC is a standing committee of the NQF [...]

Health Affairs recently published an interesting article that may have gone unnoticed by many in the industry. The article, entitled “Mixed Results in the Safety Performance of Computerized Physician Order Entry”, was authored by Jane Metzger and Dr. David Classen of CSC, Dr. David Bates and Stuart Lipsitz, of Partners Healthcare, and Emily Welebob, a [...]

A new study from the W. P. Carey School of Business at Arizona State University shows “there are some real negatives that come with the positives of EMRs … Everyone has been saying that health IT will save money, but our study and others cast doubt on some of the savings,” explains Assistant Professor Michael Furukawa, one of the study’s authors. “The bottom line is that EMRs do appear to help lower mortality rates at hospitals, but they don’t necessarily help reduce the number of patient medical complications or reduce costs, especially in the area of nursing.”

Earlier this week, Pamela McNutt, SVP and CIO of Methodist Health System in Dallas, gave a presentation entitled “Meeting Stage 1 Meaningful Use: A View from a Healthcare System,” at the AHA’s Annual Membership Meeting in Washington, D.C.  McNutt — chair of CHIME’s Policy Steering Committee and former chair of the organization’s Advocacy Leadership Team [...]

This is a follow-on to my previous post regarding the safety issues of EHRs. But first, one comment and point of emphasis before I dive into the Top 10 details:  Tightly-integrated, monolithic EHR solutions that rely on a single data model are much less prone to safety-risk scenarios than those associated with loosely integrated, best-of-breed [...]

Gordon Schiff, M.D., associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, is getting ready to head up an ambitious study on CPOE-related errors. The year-long study, funded by The National Patient Safety Foundation, will examine 200,000 reports to elicit common themes and, hopefully, identify possible solutions. Schiff [...]

The National Patient Safety Foundation (NPSF) has awarded a research grant to the Center for Patient Safety Research and Practice at the Brigham and Women’s Hospital and Harvard Medical School to research errors associated with CPOE, as well as the vulnerability of leading CPOE systems.
Quantros (the company that manages MEDMARX, a Web-based solution that collects [...]

Safety concerns took center stage at the HIT Policy Committee meeting today in Washington, D.C., as Certification and Adoption Workgroup Co-chairs Paul Egerman and Marc Probst reported their recommendations on those issues to the full committee. The workgroup’s report was a refinement on an earlier presentation Egerman, a software entrepreneur, and Probst, CIO at Utah-based Intermountain Healthcare, gave after receiving testimony about HIT-related patient safety incidents on Feb. 25.

As chair of CHIME’s certification committee, St. Vincent’s Health System SVP & CIO Tim Stettheimer, PhD, has been instrumental in developing the CIO-focused organization’s new CHCIO program. And as chair of CHIME’s Board of Trustees, he’s also been at the forefront of crafting the organization’s comment letters on the Meaningful Use and Certification NPRMs. But [...]

Below is a discussion motivated by four sentinel events which were root-cause attributable to electronic health records (EHRs) for which my teams and I were personally responsible.
Remember when safety belts in automobiles first became popular?  They were simple lap belts, no shoulder strap.  Did they aid passenger safety?  Yes, in some ways… but they also [...]

While everyone tries to create a sensation at the annual HIMSS conference, few actually achieve it. But with the release of its open-architecture Helios platform, Eclipsys managed to surmount that bar. The iPhone-esque vision of an open platform which independent application designers can build on seems to many a refreshing proposition. And some see it [...]