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Health IT Stands Out In Health Technology Hazards List

The ECRI Institute has just released its annual list of top 10 health technology hazards, and this year, two of the hazards are health IT related. This probably isn’t a surprise to anyone who reads this blog, but it’s still worth noting, as it’s easy to get embroiled in abstract IT discussions and forget concrete patient risks, wouldn’t you agree?

For context, here’s ECRI’s list for 2013 in its entirety:

1.  Alarm hazards
2.  Medication administration errors using infusion pumps
3.  Unnecessary radiation exposures and radiation burns
during diagnostic radiology procedures
4.  Patient/data mismatches in EHRs and other health IT
(HIT) systems
5.  Interoperability failures with medical devices and health
IT systems
6.  Air embolism hazards
7.  Inattention to the needs of pediatric patients when using “adult”
techniques
8.  Inadequate reprocessing of endoscopic devices and surgical
instruments
9.  Caregiver distractions from smartphones and
other mobile devices
10. Surgical fires

As you can see, two of the top five are EMR-related, and perhaps more importantly, are risks that don’t get discussed that often in health IT watering holes such as this publication.  But it’s hard to argue that patient/data mismatches could pose severe risks up to including death, as could interoperability problems between medical devices and healtlh IT systems.

While ECRI doesn’t, I’d also count number nine, mobile device distractions, as I’m betting much of the distraction clinicians face comes from clinical communication, not idle chatter.  And while I don’t know how ECRI ranks its choices, I’d bet it actually belongs higher on the list.

I’m not going to sound like much of a prophet when I predict that health IT  problems will take over more slots on the list over time.  For example, when infusion pumps are linked with EMRs, interchange of data will almost certainly become a life or death issue.

In the mean time, dealing with mobile device distraction may be the lowest hanging fruit of the bunch. I don’t know how to do it, but if a vendor comes up with a solution that elegantly streamlines doctor communication on mobile devices, it’s likely to be a big hit.

November 30, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Patients Accessing Online Medical Records Use More Services

In previous postings, I’ve noted that for various reasons, doctors using EMRs are tending to bill for more E/M services.  This has CMS in a bit of a tizzy, and definitely deserves attention from the industry. (See also this post about EMR and Upcoding)

Now, a study appearing in the Journal of the American Medical Association seems to have identified another vector for increased use of services. According to the study, patients with online access to medical records and clinicians consume more clinical services than those without access.

The JAMA authors drew this conclusion after studying the consumption of clinical services by members of Kaiser Permanente Colorado, a group model IDS.  The Kaiser unit was studied from March 2005 through June 2010, reports Becker’s Hospital Report. 

What made the Kaiser unit a good choice was that not only did it have an EMR in place, it also launched a patient portal in May 2006 allowing patients secure access to health records details such as test results, care plans and active medications.

Researchers found that members who used the MyHealthManager portal, which gave access to the EMR, had increased rates of office visits, telephone encounters, after-hours clinic visits, emergency department encounters and hospitalizations during the study period.

I was surprised to find out that JAMA researchers generated this data, especially the ED and hospitalization rates, which seem to have to been markedly different between the two groups.

It did occur to me that perhaps the sickest patients are using the portal, or that those who aren’t using the portal aren’t very engaged in caring for their health, but such relationships are rarely that simple. Besides, the researchers did group patients by “propensity scores” which took patient age, sex, utilization frequencies and chronic illnesses, so we aren’t looking at populations that simply self-selected into the sicker and more healthy.

In any event, I’m glad I stumbled across this study and could share it with you. Knowing that these patterns exist, just in case they turn up in your health system. They’re certainly worth bearing in mind.

November 29, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Top Hospital EMR & EHR Posts

I was recently asked to identify some of the top blog posts from my websites. It was an interesting exercise to dive into the stats and see what was my top 2012 blog posts. I was actually surprised by what I found.

When I pulled up my stats for 2012, I found that the top Hospital EMR and EHR post was about The Pains of Becoming a Certified Epic Consultant. It’s a great post and there is a lot of interest in becoming a Certified Epic Consultant thanks to the stranglehold that Epic puts on becoming one. The surprising part is that this post was done back in the middle of 2011. However, the post is still getting a ton of traffic.

In fact, as I looked through the list of posts with the most traffic, I had to go all the way down to the 8th post on the list to fnd one from 2012. The top 2012 post was about CA Doctors Saying Their Epic Install Created Massive Turmoil. That’s a great post by Anne Zieger as well. I expect it will continue to do really well for a long time to come. Plus, it’s amazing that the top 2012 post was from only 2 months ago. I’d have thought that one of the early 2012 posts would have had more time to make it to the top of the list. I guess not.

As most of you probably know, I’m a stats addict so I love this stuff. It will be interesting to see which posts become the most enduring. It’s something that’s really hard for me to predict, but it’s always great when content you’ve written years ago is still providing value to readers.

November 28, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

EMRs Snag Just One VC Investment Last Quarter

If you’re looking for signs that the EMR market is consolidating, especially on the small vendor/startup side, consider the following data and see what it tells you. To me, it suggests very clearly that the days of unbridled EMR startup growth are tailing off quickly.

According to a report by Mercom Capital Group, VC funding in the health IT sector was strong in Q3 2012, with $194 million going into 37 deals during the period.  This is the 5th quarter in a row that the dollars invested in HIT ventures has gone up, Mercom reports.

Health information management companies got the most funding in the sector ($101 million across 20 deals), dwarfing the $39 million sunk in mobile health and $26 million in social health networking companies.  That being said, EMRs only logged a single $1 million investment during the last quarter. Meanwhile, there were two EMR M&A transactions this quarter.

Far more interesting is the list of deals that were closed in other subsectors. For example, he top HIT VC funding deal in Q3 was $25.5 million raised by Telcare, a mobile health company using cellular machine-to-machine to manage chronic illnesses. Other deals included $20 million for Connecture, an online health insurance process automation company focused on health insurance exchanges and $13 million for eClinical technology provider Clinipace.

While it’s not exactly a set-game-match point to make, I’d argue that this data is instructive. VC money is migrating away to infrastructure plays, mHealth and social health networking, next-round investments which are likely to make the make the right investors a bundle.

Another way of putting this is that while we’re not seeing any signs that EMR vendors are outta luck, EMR startups aren’t the hot, sexy thing on the block any more. Could it be that we’re finally seeing the market mature and beginnings of M&A and business failures in some EMR sectors?  In a word I’d say, “yes.”

November 27, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Study: VistA Is Doctors’ Favorite EMR, Beating Epic

Despite more than a decade to work things out, discussions about open source vs. commercial enterprise software always seem to devolve into “religious wars” over the inherent goodness of one business model over the other.  EMR software seems to be no exception to this rule, a state of affairs which has done little to advance the industry as a whole.

Well, maybe the following will help move the discussion into more positive channels.  According to a new survey by Medscape, physicians prefer VistA over Epic, as well as Cerner, Meditech and McKesson, on characteristics which included ease of learning, reliability, value for the money, physician overall satisfaction and staff overall satisfaction.

According to the study, VistA came in at 3.89 out of 5 (five being “like most”), while Epic followed at 3.51, Cerner at 3.15, Meditech at 2.94 and McKesson at 2.91. (The pack was actually led by Amazing Charts (4.22) and Practice Fusion (4.04), both systems aimed at physician practices directly.)

Lest this seem like a flash in the pan, consider the results of a similar study done by the American Academy of Family Physicians in 2011. The AAFP, which asked physicians to compare 30 EMRs on 15 criteria. Of enterprise EMRs included in the study, Epic and VistA were neck at 5th and 6th, with McKesson 19th and Cerner 25th in line.

Now, in all fairness, it should be noted that the author of the blog item I mined for this piece is Edmund Billing, MD, CMO and EVP of Medsphere, whose product is OpenVista. But the stats outlined by Dr. Billing are worth considering nonetheless.

Perhaps we’re not ready for the religious wars to end, but throwing some relevant stats into the conversation couldn’t possibly hurt.  After all, there’s never a bad time to take physician perceptions seriously.

November 26, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Study: EMR ROI Stronger In Low-Income Setting

Well,  here’s some information which caught my eye right away. According to a new study published recently in the Journal of the American Medical Informatics Association, EMRs can provide a good return on investment for hospitals located in low-income areas.

In the study, researchers studied the what happened when a tertiary hospital in Malawi implemented an enterprise- wide EMR system.  The felt it was important to evaluate an EMR implementation in a low-income area such as this, the authors noted, because such hospitals face obstacles unlike those in more prosperous areas, such as marked supply and staff shortages, which might change the effect of such a system.

To examine the impact of the EMR, researchers looked at three areas: length of stay at the facility, transcription times and lab use.  The hospital saved an estimated $284,395 per year in U.S. dollars. By the third year of operation, the EMR  started generating a positive ROI, and by five years, it provided net benefit of $613,681, according to FierceEMR.

This is an inspiring study for those who hope to see EMR success stories, as until recently, there’s been little if any information to suggest that EMRs can offer a substantial savings on operations, much less help to generate a profit.

This doesn’t necessarily mean that hospitals aren’t generating savings or even profits by implementing an EMR.  As we noted in a previous story, few hospitals are planning for and implementing EMR ROI measures early in the game, according to a recent study from Beacon Partners.

If hospitals don’t dig in and integrate EMR ROI measurements into their strategic planning, it’s not surprising that they aren’t getting the fullest picture of what their systems are delivering. Backward-looking measurements aren’t likely to do as much as measurements built on a hospital’ls entire vision for success. Let’s see what happens when hospitals focus on ROI as a top-of-mind item going forward.

November 23, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Why Don’t We Groom the Next Generation of Health IT Leaders?


What’s really interesting about my tweet above is that the person that asked me why their weren’t young people at CHIME was actually the wife of someone attending CHIME. She was a healthcare IT outsider that was just observing the situation from the outside.

It’s a very good question and all that I could tell this nice lady was, I don’t know. The reality is that CHIME and all the other major health IT conferences should be embracing and facilitating the next generation of health IT leaders. If they don’t then healthcare will be in a bad position. The next generation of hospital CIOs need to learn from the current crop of hospital CIOs.

I know that I ruffled some feathers with my previous post about the “Old Boys Club” of Healthcare IT, but this is another example of it. I was amazed that I was the youngest person at CHIME and by a long shot. The only people that came close in age were some of the vendors participating in the event.

What are we doing in healthcare IT to groom the next generation of leaders? From my view, not very much. It’s unfortunate, because your hospital CIO won’t live forever (as hard as he may try).

November 21, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 14 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus.

Video: The Horrors Of Generic HIT Training

Everyone knows training is a big burden, and tricky to pull off under the best of circumstances. Let’s hope things don’t go as badly for you as they do for the doctor and trainer in the following video.

The video, brought to us by HIT training vendor OptimizeHIT, offers a wry take on what happens when EMR training isn’t relevant for the doctor who’s getting the training. In this case, we witness the plight of a heart surgeon who’s forced through a discussion on primary care functions that she neither wants nor needs.

I recommend you give it a look. I think some of you will find this quite amusing. If the dialogue sounds familiar, my sympathies.

November 20, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

Contest Offers Prizes For CCD Redesign

When EMRs are the gossip of the week at TechCrunch (a popular tech startup website), you know our little EMR thang has gone mainstream. And TechCrunch is indeed one of a series of sites trumpeting the news of a design challenge intended to make the Continuity of Care Document more usable.

The White House’s Health Design Challenge, working with a community of philanthropic angels and mentors known as Designer Fund, asks designers to transform the CCD (and by extension the Blue Button output) from a consumer-hostile mess into something easily used by the following groups:

  • An underserved inner-city parent with lower health literacy
  • A senior citizen that has a hard time reading
  • A young adult who is engaged with technology and mobile devices
  • An adult whose first language is not English
  • A patient with breast cancer receiving care from multiple providers
  • A busy mom managing her kids’ health and helping her aging parents

The ONC and VA, which seem to be spearheading the effort, are providing for twelve winners. First place for best overall design gets $16K, second place $6K and third place $4K. They’re also distributing $8K per category across winners for best medical/problem history section, best medication section and best lab summaries.

The design is expected to not only improve the visual layout of the record, it’s also supposed to make it easier for a patient to manage their health, enable medical professionals to digest information more efficiently and help caregivers support patients. Tall order for a messed-up text file?  Well, we’ll see what design superbrains can do.

In part because the VA hopes to use the new designs to support its Blue Button initiative and its MyHealtheVet patient portal, all entries have to be submitted under a Creative Commons license.   Curators will select a final design — which may include elements from various winning entries — and open source the code on code-sharing commuity Github.

November 19, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.

What HIMSS Told Congress

This week, a House subcommittee held a hearing entitled “Is ‘Meaningful Use’ Delivering Meaningful Results?: An Examination of Health  Information Technology Standards and Interoperability.”  The hearing follows a recent furor over Meaningful Use’s benefits, in which HHS head Kathleen Sebelius was written a stinging letter by a quartet of Congressman arguing that the program might not be pulling its weight.

Lots of interesting discussion took place at the hearing — see a report from the indefatigable HIT blogger and expert Brian Ahier for more background — but for the purposes of this item, I’m focusing on what HIMSS had to say.

HIMSS, which obviously has a massive stake in the topic discussed, is a big Meaningful Use fan. The trade group argues that “Meaningful Use and the Stage 2 regulations allow the healthcare community to continue the necessary steps to ensure health information technology will support the transformation of healthcare delivery in the United States.”

Not surprisingly, HIMSS showed up in full color at the hearing, ready to defend MU and the progress of health IT generally. HIMSS offered Congress seven recommendations as to how to keep the MU train moving, Ahier reports. Here’s my favorites:

  1. Direct the administration to initiate an appropriate study of a nationwide patient data matching strategy with a report back to Congress.
  2. Support harmonization of federal and state privacy laws and regulations to encourage the exchange of health information across health systems, payers, and vendor systems.
  3. Continue to support and sponsor pilot programs addressing the collection, analysis and management of clinical data for quality reporting purposes to assist providers and provider organizations make informed decisions for public health, patient care and business purposes.
  4. Preclude any additional delay in the nationwide implementation of ICD-10, International Classification of Diseases beyond the current October 1, 2014 deadline.

Other than the ICD-10 recommendation, which will probably be battled down to the last millisecond by some groups, I’m betting most readers would consider these to be reasonable steps. But I could be wrong. And I don’t see a lot here on the nitty-gritty of interoperability, which was the focus of the Congressmen’s ire in the first  place.  Folks, what would you add to/subtract from this list?

November 16, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 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.