Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

Indiana Health System Takes On Infection Control With Predictive Analytics

Posted on February 22, 2017 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.

At Indiana University Health, a 15-hospital non-profit health system, they’ve taken aim at reducing the rate of central-line associated bloodstream infections – better known to infection control specialists as CLABSIs.

According to the CDC, CLABSIs are preventable, but at present still result in thousands of deaths each year and add billions of dollars in costs to U.S. healthcare system spending. According to CDC data, patient mortality rates related to CLABSI range from 12% to 25%, and the infections cost $3,700 to $36,000 per episode.

Hospitals have been grappling with this problem for a long time, but now technology may offer preventive options. To cut its rate of CLABSIs, IU Health has decided to use predictive analytics in addition to traditional prevention strategies, according to an article in the AHA’s Hospitals & Health Systems magazine.

Reducing the level of hospital-acquired infections suffered by your patients always makes sense, but IU Health arguably has additional incentives to do it. The decision to attack CLABSIs comes as IU Health takes on a strategic initiative likely to demand a close watch on such metrics. At the beginning of January, Indiana University Health kicked off its participation in the CMS Next Generational Accountable Care Organization Model, putting its ACO in the national spotlight as a potential model for improving fee-for-service Medicare.

According to H&HN, IU Health has launched its predictive analytics pilot for CLABSI prevention at its University Hospital location, which includes a 600-bed Level I trauma center and 300-bed tertiary care center which also serves as one of the 10 largest transplant centers in the U.S.

Executives there told the magazine that the predictive analytics effort was an outgrowth of its long-term EMR development effort, which has pushed them to streamline data flow across platforms and locations over the past several years.

The hospital’s existing tech prior to the predictive analytics effort did include an e-surveillance program for hospital-acquired infections, but even using the full powers of the EMR and e-surveillance solution together, the hospitals could only monitor for CLABSI which had already been diagnosed.

This retrospective approach succeeded in cutting IU Health’s CLABSI rate from 1.7 CLABSIs over central-line days in 2015 to 1.2 last year. But IU Health hopes to improve the hospital’s results even further by getting ahead of the game.

Last year, the system implemented a data visualization platform designed to give providers a quick-and-easy look at data in real time. The platform lets managers keep track of many important variables easily, including whether hospital units have skipped any line maintenance activities or failed to follow-through on CLABSI bundles. It’s also saving time for nurse managers, who used to have to track data manually, and letting them check on patient trend line data at a glance.

The H&HN article doesn’t say whether the hospital has managed to cut its CLABSI rate any further, but it’s hard to imagine how predictive analytics could deliver zero results. Let’s wish IU Health further luck in cutting CLABSI rates down further.

National Health Service Hospitals Use Data Integration Apps

Posted on February 20, 2017 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.

While many providers in the US are still struggling with selecting and deploying apps, the UK National Health Service trusts are ready to use them to collect vital data.

According to the New Scientist, the four National Health Services serving the United Kingdom are rolling out two apps which help patients monitor their health at home. Both of the apps, which are being tested at four hospitals in Oxfordshire, UK, focus on management of a disease state.

One, called GDm-health, helps manage the treatment of gestational diabetes, which affects one in 10 pregnant women. Women use the app to send each of their blood glucose readings to the clinician monitoring their diabetes. The Oxford University Institute of Biomedical Engineering led development of the app, which has allowed patients to avoid needless in-person visits. In fact, the number of patient visits has dropped by 25%, the article notes.

The other app, which was also developed by the Institute, helps patients manage chronic obstructive pulmonary disease, which affects between 1 million and 1.5 million UK patients. COPD patients check their heart rate and blood oxygen saturation every day, entering each result into the app.

After collecting three months of measurements, the app “learns” to recognize what a normal oxygen sat level is for that patient. Because it has data on what is normal for that patient, it will neither alert clinicians too often nor ignore potential problems. During initial use the app, which already been through a 12-month clinical trial, cut hospital admissions among this population by 17% and general practitioner visits by 40%.

NHS leaders are also preparing to launch a third app soon. The technology, which is known as SEND, is an iPad app designed to collect information on hospital patients. As they make their rounds, nurses will use the app to input data on patients’ vital signs. The system then automatically produces an early warning score for each patient, and provides an alert if the patient’s health may be deteriorating.

One might think that because UK healthcare is delivered by centralized Trusts, providers there don’t face data-sharing problems in integrating data from apps like these. But apparently, we would be wrong. According to Rury Holman of the Oxford Biomedical Research Centre, who spoke with New Scientist, few apps are designed to work with NHS’ existing IT systems.

“It’s a bit like the Wild West out there with lots of keen and very motivated people producing these apps,” he told the publication. “What we need are consistent standards and an interface with electronic patient records, particularly with the NHS, so that information, with permission from the patients, can be put to use centrally.”

In other words, even in a system providing government-delivered, ostensibly integrated healthcare, it’s still hard to manage data sharing effectively. Guess we shouldn’t feel too bad about the issues we face here in the US.

Is Your Current Analytics Infrastructure Keeping You From Success in Healthcare Analytics?

Posted on February 17, 2017 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.

The following is a paid blog post sponsored by Intel.

Healthcare analytics is all the talk in healthcare right now.  It’s really no surprise since many have invested millions and even billions of dollars in digitizing their health data.  Now they want to extract value from that data.  No doubt, the promise of healthcare analytics is powerful.  I like to break this promise out into two categories: Patient Analysis and Patient Influence.

Patient Analysis

On the one side of healthcare analytics is analyzing your patient population to pull reports on patients who need extra attention.  In some cases, these patients are the most at risk portions of your population with easy to identify disease states.  In other cases, they’re the most expensive portion of your population.  Both of these are extremely powerful analytics as your healthcare organization works to improve patient care and lower costs.

An even higher level of patient analysis is using healthcare analytics to identify patients who don’t seem to be at risk, but whose health is in danger.  These predictive analytics are much more difficult to create because by their very nature they’re imperfect.  However, this is where the next generation of patient analysis is going very quickly.

Patient Influence

On the other side of healthcare analytics is using patient data to influence patients.  Patient influence analytics can tell you simple things like what type of communication modality is preferred by a patient.  This can be used on an individual level to understand whether you should send an email, text, or make a phone call or it can be used on the macro level to drive the type of technologies you buy and content you create.

Higher level patient influence analytics take it one step further as they analyze a patient’s unique preferences and what influences the patient’s healthcare decision making.  This often includes pulling in outside consumer data that helps you understand and build a relationship with the patient.  This analytic might tell you that the patient is a huge sports fan and which is their favorite team.  It might also tell you that this person has a type A personality.  Together these analytics can inform you on the most appropriate ways and methods to interact and influence the patient.

What’s Holding Healthcare Analytics Back?

Both of these healthcare analytics approaches have tremendous promise, but many of them are being held back by a healthcare organization’s current analytics infrastructure.

The first problem many organizations have is where they are storing their data.  I’d describe their data as being stored in virtual prisons.  We need to unlock this data and free it so that it can be used in healthcare analytics.  If you can’t get at the data within your own organization, how can we even start talking about all the health data being stored outside the four walls of your organization?  Plus, we need to invest in the right storage that can support the growth of this data.  If you don’t solve these data access and storage pieces, you’ll miss out on a lot of the benefits of healthcare analytics.

Second, do you trust your data?  Most hospital CIOs I talk to usually respond, “Mostly.”  If you can’t trust your data, you can’t trust your analytics.  A fundamental building block of successful analytics is building trust in your data.  This starts by implementing effective workflows that capture the data properly on the front end.

Next, do you have the processing power required to process all these analytics and data?  Healthcare analytics in many healthcare organizations reminds me of the old days when graphic designers and video producers would have to wait hours for graphics programs to load or videos to render.  Eventually we learned not to skimp on processing power for these tasks.  We need to learn this same lesson with healthcare analytics.  Certainly cloud makes this easier, but far too often we under fund the processing power needed for these projects.

Finally, all the processing power in the world won’t help if you don’t have your most important piece of analytics infrastructure: people.  No doubt, finding experienced people in healthcare data analytics is a challenge.  It is the hardest thing to do on this list since it is very competitive and very expensive.  The good news is that if you solve the other problems above, then you become an attractive place for these experts to work.

In your search for a healthcare analytics expert, you can likely find a data expert.  You can find a clinical expert.  You can find an EHR expert.  Finding someone who can work across all three is the Holy Grail and nearly impossible to find.  This is why in most organizations healthcare analytics is a team sport.  Make sure that as you build your infrastructure of healthcare analytics people, you make sure they are solid team players.

It’s time we start getting more value out of our EHR and health IT systems.  Analytics is one of those tools that will get us there.  Just be sure that your current infrastructure isn’t holding you back from achieving those goals.

If this topic interests you and you’ll be at HIMSS 2017, join us at the Intel Health Booth #2661 on Tuesday, 2/21 from 2:00-2:45 PM where we’ll be holding a special meetup to discuss Getting Ready for Precision Health.  This meetup will also be available virtually via Periscope on the @IntelHealth Twitter account.

Many Providers Still Struggle With Basic Data Sharing

Posted on February 15, 2017 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.

One might assume that by this point, virtually every provider with a shred of IT in place is doing some form of patient data exchange. After all, many studies tout the number of healthcare data send and receive transactions a given vendor network or HIE has seen, and it sure sounds like a lot. But if a new survey is any indication, such assumptions are wrong.

According a study by Black Book Research, which surveyed 3,391 current hospital EMR users, 41% of responding medical record administrators find it hard to exchange patient health records with other providers, especially if the physicians involved aren’t on their EMR platform. Worse, 25% said they still can’t use any patient information that comes in from outside sources.

The problem isn’t a lack of interest in data sharing. In fact, Black Book found that 81% of network physicians hoped that their key health system partners’ EMR would provide interoperability among the providers in the system. Moreover, the respondents say they’re looking forward to working on initiatives that depend on shared patient data, such as value-based payment, population health and precision medicine.

The problem, as we all know, is that most hospitals are at an impasse and can’t find ways to make interoperability happen. According to the survey, 70% of hospitals that responded weren’t using information outside of their EMR.  Respondents told Black Book that they aren’t connecting clinicians because external provider data won’t integrate with their EMR’s workflow.

Even if the data flows are connected, that may not be enough. Researchers found that 22% of surveyed medical record administrators felt that transferred patient information wasn’t presented in a useful format. Meanwhile, 21% of hospital-based physicians contended that shared data couldn’t be trusted as accurate when it was transmitted between different systems.

Meanwhile, the survey found, technology issues may be a key breaking point for independent physicians, many of whom fear that they can’t make it on their own anymore.  Black Book found that 63% of independent docs are now mulling a merger with a big healthcare delivery system to both boost their tech capabilities and improve their revenue cycle results. Once they have the funds from an acquisition, they’re cleaning house; the survey found that EMR replacement activities climbed 52% in 2017 for acquired physician practices.

Time for a comment here. I wish I agreed with medical practice leaders that being acquired by a major health system would solve all of their technical problems. But I don’t, really. While being acquired may give them an early leg up, allowing them to dump their arguably flawed EMR, I’d wager that they won’t have the attention of senior IT people for long.

My sense is that hospital and health system leaders are focused externally rather than internally. Most of the big threats and opportunities – like ACO integration – are coming at leaders from the outside.

True, if a practice is a valuable ally, but independent of the health system, CIOs and VPs may spend lots of time and money to link arms with them technically. But once they get in house, it’s more of a “get in line” situation from what I’ve seen.  Readers, what is your experience?

Hospital EMR and EHR Milestone – 1 Million Pageviews

Posted on February 13, 2017 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 was just looking over the stats for Hospital EMR and EHR and noticed that were right at 1 million pageviews for this site. That’s a pretty amazing accomplishment for such a niche site. Especially since we’ve moved a lot of the traffic off of the site and onto our email list. Looks like this will make the 1111th blog post for Hospital EMR and EHR and it has 25,293 email subscribers (Subscribe Here) to the content we generate on this site. That’s a really amazing thing since we email those on the list 3-5 times per week. Hospital EMR and EHR has become a really important part of Healthcare Scene and we’re happy to contribute to the hospital healthcare IT industry at large.

On this milestone, we want to thank some of our recent sponsors that have made what we do possible. If you enjoy reading our content, please take a second to look through our sponsors to see if one of them can help make your life easier.

Stericycle Communication Solutions – Stericycle has been a long time sponsor of multiple Healthcare Scene blogs. Plus, they have written the Communication Solutions Series of blog posts which are an excellent read if you’re interested in strategies for healthcare engagement. They also have a free guide that addresses the question Patient or Consumer? This is a great company that’s really working to make the patient experience better.

Galen Healthcare Solutions – We’ve had the chance to work with Galen Healthcare Solutions across a number of different mediums including email, display ads, and sponsored content. You’ve probably read their Tackling EHR and EMR Transition series where they’ve shared a lot of great insights into how your organization should handle archiving old legacy data and also how you can migrate data from one EHR to a new EHR. Both of these topics are going to become increasingly important and Galen Healthcare Solutions have become real experts. Be sure to check out their Free Data Archive whitepaper and their Free EHR Migration whitepaper.

Medical Software Advice (A Gartner Company) – I’ve been working with Medical Software Advice for a very long time. They’ve provided a really great service to my readers around EHR selection. With 300+ EHR vendors out there, it can be hard to cut through the various options. Medical Software Advice has helped out hundreds of companies with their EHR selection including setting up EHR demos and getting EHR pricing. Check out their Top 5 EHR Software list.

4Med – 4Med is another partner that we’ve worked with for a very long time. They’ve consistently offered some great educational content (include CEUs) for the healthcare IT professional. Here are some of their upcoming courses that are great examples: HIPAA Compliance Officer, Patient Centered Medical Home Project Manager, and ACI MACRA-MIPA Project Manager. Each of those links gives you a discount off the regular registration price.

HIPAAOne – HIPAA compliance has always been essential to healthcare, but meaningful use and now MACRA have made the HIPAA Risk Assessment a priority for many organizations. What’s shocking to me is how many organizations haven’t done a proper HIPAA Risk assessment. HIPAA One has created a really great software solution to automate your HIPAA Risk Assessment. I like to call them the Tax Act or H&R Block software for HIPAA compliance. If you’ve got a stack of Excel spreadsheets managing your HIPAA Risk Assessment, take a second to look at how HIPAAOne can make your job easier. Also, they have a great 5 min HIPAA compliance quiz to assess some of key HIPAA compliance areas.

We’re also excited to announce our new Healthcare Scene media kit. It’s been amazing to see the evolution of what we’re able to offer healthcare IT vendors. We really want to develop deep relationships with our advertisers and not just take their money and run. We think that’s the best thing for both our readers and our advertisers. If you’re trying to get the word out to the hospital market, let us how we can help on our contact us page.

I couldn’t finish this post without saying a massive thank you to our readers. It’s hard to know exactly what kind of impact you’re having when you blog. However, every once in a while you get a glimpse into the benefit your blog posts are providing readers and that makes it all worthwhile. Thank you to each of you who read and support our work.

Now, on to the next million pageviews!

When Healthcare IT Isn’t Enough

Posted on February 10, 2017 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.

This week I’ve gone through close to 200 pitches from companies who want to meet with me at the HIMSS Annual conference. While I can’t say that this is a fun task (especially since I have to tell 95% of them no), it is an educational experience to see what 200 companies are sharing as we head into the biggest healthcare IT conference in the world.

If I were to summarize the pitches in general, I would describe them as incremental. I’ll admit that this is a pretty disappointing perspective since we all know that healthcare needs something transformational. Don’t get me wrong. I believe that regular incremental improvement is transformational, but I’d say that most of the pitches lacked ambition.

Along with this observation is the idea that in most cases technology isn’t enough. If it were enough, EHR software that’s in use in most of healthcare would have already transformed the industry. The longer I spend in this industry, the more I realize that technology is just a tool in the tool belt. The real transformation comes from something more than technology. Technology might be a catalyst or facilitator, but that’s all.

This is actually a theme that really began at last year’s HIMSS conference. The areas that excite me most are those that literally change behavior. This might be the patient’s behavior or it might be the clinician’s behavior. It might also be the payer, health system, or government’s behavior.

The challenge is that changing behavior is hard. Slapping an EMR system is easy compared to behavior change. Implementing a secure text message solution is easy compared to behavior change. Rolling out an enterprise data warehouse is easy compared to behavior change.

At HIMSS and throughout the year I’m most interested on those companies who understand not only the technology side of things, but the behavior side of things as well.

If you’re interested in healthcare transformation and what it requires, join us at the Digital Transformation Meetup at HIMSS17. It’s happening Tuesday, 2/21 from 11:30-12:30 at the Dell EMC Booth #3161. More details on this meetup and other HIMSS17 meetups can be found here.

Suggestions and Tips for Hospital IT Professionals at #HIMSS17

Posted on February 8, 2017 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.

Hard to believe that the 2017 HIMSS Annual Conference is less than a week and a half away. For someone who eats, breathes, and sleeps Health IT, HIMSS is like winning the golden ticket to visit Willy Wonka’s chocolate factory. However, for a lot of hospital IT professionals, it might be their first time attending HIMSS and it can be quite overwhelming. 40,000-50,000 attendees and approximately 1300 exhibitors should be overwhelming.

While I’m certainly not a HIMSS veteran like many people, I’ve learned a number of important tips and tricks that will help you get the most out of HIMSS. Hopefully some of these will help you have a better HIMSS experience.

Standard Conference Answers – Instead of listing these individually, I’ll list them all in one since they’re true for any conference and their reasons should be now apparent. Wear comfortable shoes. Drink lots of water. Plan for good meals. Bring a battery pack or charge whenever possible. Expect bad internet. Have fun.

CHIME-HIMSS CIO Forum – As a hospital IT professional, the CHIME-HIMSS CIO Forum on Saturday and Sunday before HIMSS is excellent. They put together a great program of speakers, but more importantly you get the chance to network with 1000 or so of people like you. Don’t miss it if you come from the hospital IT world.

People – This one is obvious once you think about it, but is often missed by attendees. The people you hang out with at a conference will make all the difference. If you hang out with smart, well connected people, you’ll meet a bunch of other smart, well connected people and you’ll have a great experience. If you feel you don’t know anyone good to hang out with, hit social media and start interacting with people you find interesting. Friendships will develop quickly if you put in a little effort. Who you spend time with can transform your HIMSS experience for good or bad.

Plan for Serendipity – Everyone likes to suggest that the key to HIMSS is to have a plan. Considering the volume of sessions and exhibitors, a plan is good. However, don’t forget to plan in time for serendipitous interactions. Maybe that’s putting a party on your schedule that will broaden your horizon. Maybe that’s putting some down time on your schedule to sit at a table and connect with some random strangers. Maybe that’s some time trolling the exhibit hall to meet new people and companies that will provide you new perspectives. My favorite experience at HIMSS16 was a random dinner that came together after meeting someone at an impromptu meetup.

Don’t Be a Wallflower, Engage with Others – It’s easy to go to a conference and spend your entire time listening to sessions and exhibitor presentations and pitches. While this is valuable, you’ll have a deeper, more engaging experience at HIMSS17 if you engage with the people around you. Yes, I’m suggesting you go beyond just the usual casual platitudes of where you work and where you’re from. If this scares you or you don’t know how to get started, join us at a #HIMSS17 meetup where everyone is there to do just that. Education is valuable, but engagement is priceless.

Those are a few of my tips for #HIMSS17. What tips would you add to the list?

An Approach For Privacy – Protecting Big Data

Posted on February 6, 2017 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 the healthcare industry is zeroing in on some important discoveries as providers and researchers mine collections of clinical and research data. Big data does come with some risks, however, with some observers fearing that aggregated and shared information may breach patient privacy. However, at least one study suggests that patients can be protected without interrupting data collection.

In what it calls a first, a new study appearing in the Journal of the American Medical Informatics Association has demonstrated that protecting the privacy of patients can be done without too much fuss, even when the patient data is pulled into big data stores used for research.

According to the study, a single patient anonymization algorithm can offer a standard level of privacy protection across multiple institutions, even when they are sharing clinical data back and forth. Researchers say that larger clinical datasets can protect patient anonymity without generalizing or suppressing data in a manner which would undermine its use.

To conduct the study, researchers set a privacy adversary out to beat the system. This adversary, who had collected patient diagnoses from a single unspecified clinic visit, was asked to match them to a record in a de-identified research dataset known to include the patient. To conduct the study, researchers used data from Vanderbilt University Medical Center, Northwestern Memorial Hospital in Chicago and Marshfield Clinic.

The researchers knew that according to prior studies, the more data associated with each de-identified record, and the more complex and diverse the patient’s problems, the more likely it was that their information would stick out from the crowd. And that would typically force managers to generalize or suppress data to protect patient anonymity.

In this case, the team hoped to find out how much generalization and suppression would be necessary to protect identities found within the three institutions’ data, and after, whether the protected data would ultimately be of any use to future researchers.

The team processed relatively small datasets from each institution representing patients in a multi-site genotype-disease association study; larger datasets to represent patients in the three institutions’ bank of de-identified DNA samples; and large sets which stood in for each’s EMR population.

Using the algorithm they developed, the team found that most of the data’s value was preserved despite the occasional need for generalization and suppression. On average, 12.8% of diagnosis codes needed generalization; the medium-sized biobank models saw only 4% of codes needing generalization; and among the large databases representing EMR populations, only 0.4% needed generalization and no codes required suppression.

More work like this is clearly needed as the demand for large-scale clinical, genomic and transactional datasets grows. But in the meantime, this seems to be good news for budding big data research efforts.

Boston Children’s Benefits From the Carequality and CommonWell Agreement

Posted on February 3, 2017 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.

Recently two of the bigger players working on health data interoperability – Carequality and the CommonWell Health Alliance – agreed to share data with each other. The two, which were fierce competitors, agreed that CommonWell would share data with any Carequality participant, and that Carequality users would be able to use the CommonWell record locator service.

That is all well and good, but at first I wasn’t sure if it would pan out. Being the cranky skeptic that I am, I assumed it would take quite a while for the two to get their act together, and that we’d hear little more of their agreement for a year or two.

But apparently, I was wrong. In fact, a story by Scott Mace of HealthLeaders suggests that Boston Children’s Hospital and its physicians are likely to benefit right away. According to the story, the hospital and its affiliated Pediatric Physicians Organization at Children’s Hospital (PPOC) will be able to swap data nicely despite their using different EMRs.

According to Mace, Boston Children’s runs a Cerner EMR, as well as an Epic installation to manage its revenue cycle. Meanwhile, PPOC is going live with Epic across its 80 practices and 400 providers. On the surface, the mix doesn’t sound too promising.

To add even more challenges to the mix, Boston Children’s also expects an exponential jump in the number of patients it will be caring for via its Medicaid ACO, the article notes.

Without some form of data sharing compatibility, the hospital and practice would have faced huge challenges, but now it has an option. Boston Children’s is joining CommonWell, and PPOC is joining Carequality, solving a problem the two have struggled with for a long time, Mace writes.

Previously, the story notes, the hospital tried unsuccessfully to work with a local HIE, the Mass Health Information HIway. According to hospital CIO Dan Nigrin, MD, who spoke with Mace, providers using Mass Health were usually asked to push patient data to their peers via Direct protocol, rather than pull data from other providers when they needed it.

Under the new regime, however, providers will have much more extensive access to data. Also, the two entities will face fewer data-sharing hassles, such as establishing point-to-point or bilateral exchange agreements with other providers, PPOC CIO Nael Hafez told HealthLeaders.

Even this step upwards does not perfect interoperability make. According to Micky Tripathi, president and CEO of the Massachusetts eHealth Collaborative, providers leveraging the CommonWell/Carequality data will probably customize their experience. He contends that even those who are big fans of the joint network may add, for example, additional record locator services such as one provided by Surescripts. But it does seem that Boston Children’s and PPOC are, well, pretty psyched to get started with data sharing as is.

Now, back to me as Queen Grump again. I have to admit that Mace paints a pretty attractive picture here, and I wish Boston Children’s and PPOC much success. But my guess is that there will still be plenty of difficult issues to work out before they have even the basic interoperability they’re after. Regardless, some hope of data sharing is better than none at all. Let’s just hope this new data sharing agreement between CommonWell and Carequality lives up to its billing.

Health IT Preserves Idaho Hospital’s Independence

Posted on February 1, 2017 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.

Most of the time, when I write about hospital IT adoption, I end up explaining why a well-capitalized organization is going into the red to implement its EMR. But I recently found a story in RevCycle Intelligence in which a struggling hospital actually seems to have benefitted financially from investing in IT infrastructure. According to the story, a 14-bed critical access hospital in Idaho recently managed to stave off a forced merger or even closure by rolling out an updated EMR and current revenue cycle management technology.

Only a few years ago, Arco, Idaho-based Lost Rivers Medical Center was facing serious financial hurdles, and its technology was very outdated. In particular, it was using an EMR from 1993, which was proving so inflexible that the claims stayed in accounts receivable for an average of 108 days. “We didn’t have wifi,” CEO Brad Huerta told the site. “We didn’t have fiber. We literally had copper wires for our phone system…we had an EMR in a technical sense, but nobody was using it. It was a proverbial paperweight.”

Not only was the cost of paying for upgrades daunting, the hospital’s location was as well. Arco is a “frontier” location, making it hard to recruit IT staffers to implement and maintain infrastructure, staff and servers, the story notes. Though “fiercely independent,” as Huerta put it, it was getting hard for Lost Rivers to succeed without merging with a larger organization.

That being said, Huerta and his team decided to stick it out. They feared diluting their impact, or losing the ability to offer services like trauma care and tele-pharmacy, if they were to merge with a bigger organization.

Instead of conceding defeat, Huerta decided to focus on improving the hospital’s revenue cycle performance, which would call for installing an up-to-date EMR and more advanced medical billing tools. After the hospital finished putting in fiber in its area, Lost Rivers invested in athenahealth’s cloud-based EMR and medical billing tools.

Once the hospital put its new systems in place, it was able to turn things around on the revenue cycle front. Total cash flow climbed rapidly, and days in accounts receivable fell from 108 to 52 days.

According to Huerta, part of the reason the hospital was able to make such significant improvements was that the new systems improved workflow. In the past, he told RevCycle Intelligence, providers and staff often failed to code services correctly or bill patients appropriately, which led to financial losses.

Now, doctors chart on laptops, tablets or even phones while at the patients’ bedside. Not only did this improve coding accuracy, it cut down on the amount of time doctors spend in administrative work, giving them time to generate revenue by seeing additional patients.

What’s more, the new system has given Lost Rivers access to some of the advantages of merging with other facilities without having to actually do so. According to the story, the system now connects the critical access hospital with larger health systems, as the athenahealth system captures rule changes made by the other organization and effectively shares the improvements with Lost Rivers. This means the coding proposed by the system gradually gets more accurate, without forcing Lost Rivers to spend big bucks on coding training, Huertas said.

While the story doesn’t say so specifically, I’m sure that Lost Rivers is spending a lot on its spiffy new EMR and billing tech, which must have been painful at least at first. But it’s always good to see the gamble pay off.