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Hospital Accused Of Firing Nurse For EMR Safety Complaints

Posted on June 29, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The former chief nursing officer of a California hospital is suing her former employer, alleging she was “forced out” of her position after questioning the safety of a little-known EMR donated by a major financial backer of the facility.

The suit filed by nurse Autumn AndRa also names Dan Smith, whose company donated the Harmoni software now used by Sebastopol, CA-based Sonoma West Medical Center. AndRa is claiming that Smith, who has contributed millions in donations and loans to the hospital, has used the hospital as a test bed for his company’s defective system. Smith is president of the medical center’s board of directors.

In an interview with a local newspaper, AndRa said that the Harmoni system has had major problems since the day it went live. Among other issues, the EMR was doing a poor job tracking and updating medications and was “intermingling” medical information between patients, her suit contends. According to AndRa, she went to hospital CEO Ray Hino a week before her dismissal and told him that the system was not safe. (Hino told the newspaper that Harmoni was fine and that no patients had been harmed by the system.)

E-Health Records International Inc., which makes the cloud-based system, primarily serves hospitals outside the U.S., including facilities in the Congo, Jamaica, India and the Philippines. Smith, whose first software development success came when he sold a construction management system to Intuit, serves as the company’s CEO, as well as chairman of telemedicine firm Offsite Care Resources.

Other than that, he seems to have little documented experience as an HIT developer. His other major business venture seems to have been operating a French restaurant with his wife, which he closed after being unable to get back $5.8 million he loaned the hospital.

Regardless of whether AndRa prevails in her suit, I think it’s safe to say that she came out on the wrong end of some questionable political maneuvering by hospital leaders, perhaps including Smith himself. When a hospital is forgiven a large loan, and then fires an executive who raises safety questions about the EMR developed by the lender, eyebrows should be raised.

A Humorous Look at Healthcare as #HFMA2016ANI Begins

Posted on June 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As part of RelayHealth’s (Part of McKesson) announcement during ANI 2016, they put out some cartoons that look at some of the challenges that continue to plague healthcare. I’m sure they’ll be posting a bunch of them on Twitter @McKesson_MHS and @RelayHealth, but these two really gave me a good laugh.

Healthcare Sticky Notes Cartoon

Don’t underestimate the power of sticky notes!

Healthcare Claims Cleanup Cartoon

Looks like it’s going to be another banner year for HFMA’s ANI conference. It’s a unique venue where so much money is flowing since there’s so much financial waste in healthcare. Don’t believe me? I saw one company advertise that they were giving away a Harley Davidson or $15,000. Chew on the ROI of that investment. Says a lot about the type of deals that are signed at ANI.

Operationalizing Health IT Discoveries

Posted on June 24, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been talking a lot lately with people about how we take the health IT discoveries made at one hospital and apply them to another hospital. In a recent conversation I had with Jonathan Sheldon from Oracle, he highlighted that “Many organizations don’t care about research, but just want a product that works.”

I agree completely with this comment from Jonathan. While there are some very large healthcare organizations that do a lot of research, there are even more healthcare organizations that just want to see patients in the best way possible. They just want to implement the research that other organizations have done. They just want something that works.

The problem for big companies like Oracle, SAP, Tableau, etc is that they have the technology to scale up many of these health IT discoveries, but they aren’t doing the discovery themselves. In fact, most of them never will dive into the discovery of which healthcare data really matters.

In order to solve this, I’ve seen all of these organizations working on some sort of partnership between IT companies and healthcare research organizations. The IT company provides the technology and the commercialization of the product and the healthcare research organization provides the research knowledge on the most effective techniques.

While this all sounds very simple and logical, it’s actually much harder in practice. Taking your customer and turning them into a partner is much harder than it looks. Most healthcare organizations know how to be customers. It takes a unique healthcare organization to be an effective partner. However, this is exactly what we have to do if we want to operationalize the health IT discoveries these research organizations make.

We’re going to have to make this a reality. There’s no way that one organization can discover everything they need to discover. Healthcare is too complex as it is today. Plus, we’re just getting started with things like genomic medicine and health sensors which is going to make healthcare at least an order of magnitude more complex.

Population Health Tech Will Lag Until Standards Emerge

Posted on June 22, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

There’s little doubt that healthcare organizations will continue to partner up with peers and acquire physician practices. The forces that drive healthcare network development are only intensifying as time goes by, particularly as the drive toward value-based payment moves ahead. But there’s a lot more to making such deals work than a handshake and a check. To make these deals work, it’s critical that networks become experts at population health management — and unfortunately, that’s going to be tough.

While merging health systems into ACOs or acquiring referring physicians has merit, this strategy won’t grow the steadily dropping pace of hospital admissions, notes William Faber, M.D., senior vice president of the GE Healthcare Camden Group. “Though clinically integrated networks do enlarge the patient base, one of their aims is also to reduce the percentage of admissions from that base,” making it unlikely that the networks will grow admissions, he points out.

To make a clinically integrated network successful, it certainly helps to take the initiative – to get to market more quickly than competitors – and to do a better job of controlling costs of care and demonstrating higher quality and service. Where things get stickier, however, is in managing that care across a large group. “The creation of a clinically integrated network must not be just a marketing or physician alignment strategy – it must truly enable effective population health management,” he writes.

And this, I’d argue, is where things get very tricky. Well, judge for yourself, but I’d argue that the HIT industry is ill-equipped to support these goals. Despite many years of paper-chart experimentation with population health, and several with population health technology, my sense is that the tech is far behind what it needs to be. Health IT vendors won’t get far until providers do a better job of defining what they need.

A different mindset

The truth is, this generation of EMRs is designed to track individual patients across an experience of care. While CIOs can add a layer of analytics technology to the mix, that is a far cry from creating tools that natively track population health trends. Looking at populations is simply a different mindset.

Admittedly, vendors will tell you that they’ve got the problem licked, but if they were completely candid many would have to admit that their products aren’t mature yet. Until someone creates an EMR or other basic tool which is designed, at its core, to track group health trends, I foresee more half-baked hacks than results.

What’s more, I doubt the health IT business will be able to help until it has at least an informal standard to which such products must adhere. Should such tools measure costs of care by diagnosis code? Compare such costs to national standards? Highlight patients in outpatient settings whose tests or exams suggest a crisis is about to happen? If so, which settings, and what cutoffs should be tracked for test scores? Does such a system need natural language processing to scour physician notes for trigger words, and if so which ones?

Without a doubt, medical and business executives leading integrated networks will come together and develop more answers to these questions. But until they do, health IT vendors won’t be able to help much with the population health challenge.

Methods of Data Exchange in Healthcare

Posted on June 20, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Jane Sarasohn-Kahn has a great chart on her Health Populi blog which shows how healthcare shares health data:
Healthcare Data Sharing Methods and Options

The chart is great even if the results are pretty awful. Plus, the data is a little dated. I wonder how those numbers have changed since early 2015.

Amazing that the top 3 forms of data exchange in healthcare were old analogue technologies: paper, information (phone), and fax.

This will come as no surprise to anyone in healthcare. I do find it interesting that the 4th most popular method is scanning the documents directly to the provider. That illustrates that most clinics would love to have an electronic option for sharing data, but there’s not an easier way. The options that are currently available are too hard. If they were easier, then I believe almost every practice would adopt them.

With all the benefits of direct exchanges, HIE, portals, Direct, FHIR, etc, it’s amazing that a simple document scan sent directly to a clinic is more popular. It makes me take a step back and wonder if we’ve over complicated the process of health data exchange.

Would the best option be to step back and make exchange much easier? Could we strip out all the extra features that are nice but impede participation from so many?

I can’t wait for the day that my health data is available wherever it’s needed. The first step to that reality might be taking a step back and simplifying the exchange of data.

Hospitals’ Progress Towards Value Based Reimbursement

Posted on June 17, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

After posting the value based reimbursement research results that were shared by McKesson Health Solutions in anticipation of the AHIP Institute, I came across this infographic from Health Catalyst about hospitals participation in value based reimbursement.

This infographic illustrates a slower adoption of value based reimbursement, but it does illustrate that pretty much every hospital is participating in value based reimbursement. The other thing that stood out to me in this infographic was how small hospitals are going to have a hard time accessing the capital they need to manage this shift. This should be troubling to those of us in healthcare. Those smaller hospitals play an important role in our healthcare system.

Hospitals Progress to Value Based Reimbursement

The Cost of Encouraging Patient Engagement

Posted on June 15, 2016 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

We all know that healthcare providers want to encourage patient engagement to ensure patients have the information they need to manage conditions and share information with other providers. There has been a longstanding push for the adoption and maintenance of personal health records for many years to give patients the power to share and disseminate information wherever it is needed. We have seen a remarkable new interest in this with Meaningful Use and population health initiatives. Since HIM professionals are charged with maintaining and producing legal copies of records, we are aware that the tasks surrounding these processes can be very expensive. This is especially true if any of the tasks are not handled properly and breaches of protected information occur.

My concern is that lately I have heard many discussions that are pushing for more access yet with fewer costs to patients to encourage patient engagement. Some are even pushing for patients to have “free” access to records- paper or electronic. Don’t get me wrong, I am a huge proponent for patients having copies of their records and I personally keep copies of my own records. The Office of Civil Rights (OCR) recently published further guidance on charging for records. In a nutshell, the OCR says: “copying fees should be reasonable. They may include the cost of labor for creating and delivering electronic or paper copies; the cost of supplies, including paper and portable media such as CDs or USB drives; and the cost of postage when copies of records are mailed to patients at their request.” The OCR actually has the authority to audit the costs of producing records if they feel your organization is violating this patient right and overcharging for release of information.

Living in a state such as Florida where the state law has allowed facilities to charge up to $1 per page means most facilities have charged $1 per page without blinking an eye. The latest OCR guidance has led to questioning if that amount is actually “reasonable” or true to cost. Afterall, HIM professionals must use expensive systems, supplies, and labor costs to produce these records. Many organizations have outsourced release of information functions (another cost) but it is still the responsibility of the custodian of records to oversee the processes for compliance.

That being said, it is beneficial for HIM departments to evaluate the expenses and methods used to produce records as technologies and laws change. Dr. Karen Desalvo of the Office of the National Coordinator (ONC) strives to lead the EMR interoperability movement. At the top of the ONC’s list of commitments is consumer access to records. HIM professionals should continue to assist in the quest for interoperability and electronic data sharing at the notion of patient engagement. We must lead patients to use EMR patient portals and facilitate the efficient electronic data sharing among healthcare providers. We must be creative in lowering overhead costs to produce and maintain the records in order to ensure costs are affordable for healthcare consumers. There will always be costs associated with this important task, whether on the provider’s end or the patient’s end, just as costs are incurred with most services or products in every industry.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Creating Alliances with Large Health IT Vendors – Benefits and Challenges

Posted on June 13, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Scene recently sat down with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) to talk about their alliance with Philips Healthcare and the impact it’s had on their healthcare organization.

Along with talking about the benefits and challenges of creating a long term contract with a healthcare IT vendor, we also dive into the details of how medical device standardization has impacted their organization. Not to be left out, we also talk about how this relationship has impacted patients and doctors. If your organization is looking at how to standardize your medical equipment, this interview will give you some insight into creating a long term alliance with your vendor.

In the second part of my interview with Nancy Hannan, Philips Relationship Director at Augusta University Health System (formerly known as Georgia Regents) we discuss how they’re taking the lessons learned from the Philips alliance and applying them to their agreement with Cerner. We also talk about how cybersecurity is better having a vendor representative on site like they have with Philips.

Are Your Health Data Efforts a Foundation for the Future?

Posted on June 10, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently was talking with Jonathan Sheldon from Oracle and I was inspired by the idea that today’s data projects could be the essential foundation for future healthcare analytics and care that form what we now call Precision Medicine. Chew on that idea for a minute. There’s a lot of power in the idea of building blocks that open up new avenues for innovation.

How many healthcare ideas have been shot down because “that’s impossible”? Lots of them. Why are so many of these things “impossible”? They’re impossible because there are usually 10-15 things that need to be accomplished to be able to make the impossible possible.

Take healthcare analytics as an example. I once worked with a clinician to do a study on obesity in our patient population. As we started to put together the study it required us to pull all of the charts for patients whose BMI was over a certain level. Since we were on an EHR, I ran the report and the clinician researching the study easily had a list of every patient that met her criteria. Imagine trying to do that study before EHR. Someone would have had to manually go through thousands of paper charts to identify which ones met the criteria. No doubt that study would have been met with the complaint “That’s impossible.” (Remember that too expensive or time consuming is considered impossible for most organizations.)

What I just described was a super simple study. Now take that same concept and apply it beyond studies into things like real time analytics displayed to the provider at the point of care. How do you do that in a paper chart world? That’s right. You don’t even think about it because it’s impossible.

Sometimes we have to take a step back and imagine the building blocks that will be necessary for future innovation. Clean, trusted data is a good foundational building block for that innovation. The future of healthcare is going to be built on the back of health data. Your ability to trust your data is going to be an essential step to ensuring your organization can do the “impossible”.

HIMSS Social Media Ambassador Debate: FHIR and Patient Focus

Posted on June 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at HIMSS, I had a chance to do a “debate” with my good friend, partner and fellow HIMSS Social Media Ambassador, Shahid Shah. This was facilitated by Healthcare IT News, and the debate was moderated by Beth Jones Sanborn, Managing Editor of Healthcare Finance. Shahid and I had a good debate on the topics of healthcare interoperability and FHIR. Plus, we talked about the need for healthcare IT companies to focus on the patient and whether they deserve the bad rap they get or not. Enjoy the video debate below:
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