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Here’s What Makes Henry Ford Health System’s Employee Innovation Program Tick

Posted on November 25, 2014 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.

Hospitals are increasingly launching efforts designed to leverage new technologies, be they working with healthcare accelerators, taking advantage of employee ideas or setting up onsite centers designed to support a culture of innovation. One institution which has gotten a little further down the road than many of its peers is Henry Ford Health System, whose innovations program has paid off handsomely, generating countless smart, useful inventions from its employees.

So serious is the health system about exploiting its employees’ great ideas that it’s made organized efforts to reward such thinking directly. For example, HFHS just completed the competition among employees to submit their best ideas in clinical applications for wearable technology. The institution not only encouraged employees to participate, but sweetened the pot by offering a total of $10,000 in prizes to winners of the contest.

Winning entries included:

*  A system designed to record and encourage mobility of acute care patients by using wearable activity trackers
*  A recovery tool for total hip replacement patients which monitors and limits range of motion to rehab by using wearable sensors
*  A health and wellness reminder system for elderly patients, leveraging location-based sensors and smart watches
*  A mobile game interface, powered by activity trackers, designed to encourage childhood exercise and fight obesity

Certainly, the employees must appreciate the cash prizes, but they told a Forbes reporter that they’d participate even if there were no prizes, because what they really enjoy is having the experience and access to the program. That’s a pretty telling indicator that simply appreciating their concepts goes a long way.

This contest comes as part of larger efforts to make the health system innovation friendly. “The most important word is yes,” said Nancy Schlichting, the system’s CEO in a Forbes interview. “It is difficult to create a culture of innovation. If you shut down one person to shut down everyone, because bad news travels fast. When it comes to innovation, my mantra is yes.”

Other efforts to encourage employee intrapreneurship include big rewards for success in product development. The HFHS intellectual property policy offers a 50% share of future revenues coming from product ideas that end up in the market. That’s a pretty impressive call to action for employees who might have a great idea in their hip pocket.

Yet a third way the health system encourages innovation is to bypass employees’ natural fear of failure by tapping into their desire to help people. By encouraging clinicians to focus on patient care improvements, for example, the system drew staff cardiologist Dr. Dee Dee Wang to create a breakthrough method for more accurately sizing artificial heart valves and planning trans-catheter surgeries using 3-D printed models from CT scans. (She worked with Dr. William O’Neill in this work.)

So if they can generate great innovations, why aren’t more health systems and hospitals launching programs like these?

I don’t think the direct cost of creating such a program is much of an obstacle, especially for a multi-hospital system. It may require hiring a senior exec to spearhead the effort, but that’s not a huge investment for entities that size.

My guess is that one reason they don’t move ahead is management bandwidth — that health leaders simply don’t feel they have the time, energy and focus to kick off such a program at the moment. But I also suspect that C-suite execs just haven’t given much thought to the untapped potential their employees have for creating incredible solutions to critical health care problems. Sadly, I suspect it’s more the latter than the former.

CFO Pleads Guilty To Meaningful Use Fraud

Posted on November 24, 2014 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.

It had to happen eventually — the money is just too good.  The former chief financial officer of a now-closed Texas hospital has plead guilty to charges that he defrauded the meaningful use program, in what may be the first prosecution of its kind.

According to Healthcare IT News the former CFO of Shelby Regional Medical Center in Center, TX, has been indicted on charges that he falsely attested that Shelby Regional met meaningful use requirements for fiscal year 2012. The alleged fraud garnered the medical center $783,655 in payments, according to the indictment.

It’s not that hospitals haven’t wrongly claimed large amounts of meaningful use cash before. In fact, Florida-based Health Management Associates seems to have wrongfully claimed $31 million in meaningful use payments last year prior to its acquisition by Community Health Systems, with 11 of 71 HMA hospitals failing to meet meaningful use criteria.

But it does seem to be unusual, if not unprecedented, for CMS to catch providers in the act of willfully falsifying meaningful use attestations. Either the self-attestation honor system is working or CMS  is failing to catch a great deal of monkey business.

In Shelby Regional’s case, the hospital relied on paper records throughout fiscal year 2012 and only minimally used an EMR, according to the feds. To make sure the facility still captured its meaningful use payout, CFO Joe White instructed the software vendor and employees of the hospital to input data from paper records into the EMR, sometimes months after patients were discharged and after the fiscal year. (If convicted, White faces five years in prison).

What makes the purported fraud at Shelby Regional seem all the more egregious is that it was apparently part of a much larger scheme. Tariq Mahmood, MD, who owned Shelby Regional and five other Texas hospitals, is also being investigated by federal prosecutors for alleged healthcare fraud. The six hospitals owned by Mahmood collected a total of $16.8 million in meaningful use incentives for fiscal 2011 and 2012.

The truth is, there’s probably a lot more fraud going on in the meaningful use program that hasn’t been caught. After all, a report by the Office of the Inspector General for HHS issued early this year concluded that CMS fraud auditors such as the Recovery Audit Contractors weren’t doing a great job of reviewing EMR records, failing to take basic steps such as reviewing EMR audit logs to verify that medical records support a claim. It’s little wonder they haven’t caught more providers deliberately gaming the meaningful use system.

Hospitals can do more to avoid accidental problems with meaningful use claims, too. Observers have noted that few hospitals have sufficient safeguards in place to catch attestation problems before they happen.

ACOs Stuck In Limbo In Trying To Build HIT Infrastructure

Posted on September 26, 2014 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.

Though they try to present themselves differently, ACOs are paper tigers. While they may be bound together by the toughest contracts an army of lawyers can devise, they really aren’t integrated in a meaningful way.

After all, the hospitals and medical groups that make up the ACO still have their own leadership, they don’t generally hold assets in common other than funds to support the ACO’s operations, and they’re definitely not in a great position to integrate technically.

So it comes as no surprise that a recent study has found that ACOs are having a hard time with interoperability and rolling out advanced health IT functions.

The study, a joint effort by Premier and the eHealth Initative, surveyed 62 ACOs. It found that 86% had an EMR, 74% had a disease registry, 58% had a clinical decision support system, and 28% had the ability to build a master patient index.

Adding advanced IT functions is prohibitively difficult for many, researchers said. Of the group, 100% said accessing external data was difficult, 95% said it was too costly, 95% cite the lack of interoperability, 90% cite the lack of funding or return on investment and 88% said integration between various EMRs and other sources of data was a barrier to interoperability.

So what you’ve got here is groups of providers who are expected to deliver efficient, coordinated care or risk financial penalties, but don’t have the ability to track patients moving from provider to provider effectively. This is a recipe for disaster for ACOs, which are having trouble controlling risk even without the added problem of out of synch health IT systems.

By the way, if ACOs hope to make things easier by merging with some of the partners, that may not work either. The FTC — the government’s antitrust watchdog — has begun to take a hard look at many hospital and physician mergers. While hospitals say that they are acquiring their peers to meet care coordination goals, the FTC isn’t buying it, arguing that doctors and hospitals can generally achieve the benefits of coordinated care without a full merger.

This leaves ACOs in a very difficult position. If they risk the FTC’s ire by merging with other providers, but can’t achieve interoperability as separate entities, how are they going to meet the goals they are required to meet by health insurers? (I think there’s little doubt, at this point, that truly successful ACOs will have to find a way to integrate health IT systems smoothly.)  It’s an ugly situation that’s only likely to get uglier.

EMR Change Cuts Cardiac Telemetry Use Substantially

Posted on September 25, 2014 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.

Changing styles of medical practice can be really tough, even if major trade organization sticks its oar in to encourage new behavior from docs.

Such is the situation with cardiac telemetry, which is listed by the American Board of Internal Medicine Foundation as either unnecessary or overused in most cases. But a recent piece of research demonstrated that configuring an EMR to help doctors comply with the guideline can help hospitals lower needless cardiac monitoring substantially.

Often, it takes a very long time to get doctors to embrace new guidelines like these, despite pressure from payers, employers and even peers. (Physicians may turn on a dime and try out a new drug when the right pharmaceutical rep shows up, but that’s another story.) Doctors say they stick to their habits because of patient, institutional or personal preferences, as well as fear of lawsuits.

But according to a recent study appearing in JAMA Internal Medicine, reprogramming its Centricity EMR did the trick for Wilmington, Del.-based Christiana Care Health System.

To curb the use of cardiac telemetry that was unnecessary, Christiana Care removed the standard option for doctors to order cardiac monitoring outside of AHA guidelines, and required them to take an extra step to order this type of test.

Meanwhile, when the cardiac monitoring order did fall within AHA guidelines, Christiana Care added an AHA-recommended time frame for the monitoring. After that time passed, the EMR notified nurses to stop the monitoring or ask physicians if they believed it would be unsafe to stop.

The results were striking. After implementing the changes in the EMR, the health systems average daily not intensive care unit patients with cardiac monitoring fell by 70%. What’s more, Christiana Care’s average daily cost of administering  non-ICU cardiac monitoring held by 70%, from $18,971 to $5,772.

Christiana Care’s health IT presence is already well ahead of many hospitals — it’s reached Stage 6 of the HIMSS EMRAM scale — so it’s not surprising to see it leading the way in shaping physician behavior.

The question now is how the system builds on what it’s learned. Having survived a politically-sensitive transition without creating a revolution in its ranks, I’d argue the time is now to jump in and work on compliance with other clinical guidelines. With pressure mounting to deliver efficient care, it’d be smart to keep the ball rolling.

Epic Hires DC Lobbying Firm To Fight Closed-System Reputation

Posted on September 15, 2014 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.

For quite some time, everybody’s favorite EMR giant has a “no marketing, no government relations” policy. (In fact, Epic staffers really seem to hate journalists, but maybe they just don’t like me — who knows?)

Anyway, a few weeks ago, reports the ever-watchful HISTalk, it came out that Epic has broken its rule, hiring on DC lobbying firm Card & Associates. While you might think Epic would hire a billion-dollar behemoth, Card is a smallish firm with seven modest accounts and only one healthcare client. It must help, however, that Card is run by the brother of the former White House Chief of Staff under Pres. George W. Bush.

So what made Epic change its standard operating procedure and begin lobbying The Hill? In its federal lobbying disclosure, the EMR firm says that it’s begun lobbying to “educate members of Congress on the interoperability of Epic’s healthcare information technology.”

The timing of the outreach effort isn’t a coincidence, Modern Healthcare astutely notes. As you read this, a team made up of Epic, IBM and a handful of other technology giants are fighting other equally ferocious IT firms to win the roughly $11 billion contract to update the Department of Defense’s clinical systems.

While none of its contract competitors have a strong reputation for interoperability, Epic is seen as much worse, with a RAND Corp. study released in July calling Epic’s systems “closed records.” That had to hurt.

Unless Epic plans to hold health IT classes for Congress over the next several years, I doubt they’ll be able to make their point with largely Luddite Senators and Representatives in Washington on a technical basis. That is, Epic’s lobbyists won’t be able to convince legislators that Epic is interoperable on the merits.

But lobbyists may very well be able to break the ice on The Hill, and sell the idea that those mean, bad old health IT competitors haven’t been telling the truth about Epic. The pitch can include the somewhat matronly CEO, Judith Faulkner, who doesn’t look like the most powerful woman in healthcare or a competitor that would gladly bite your head off and spit it down your neck. Then they can roll out Epic’s pitch that its systems actually are interoperable (between other Epic installs at least). If it sticks even a little bit, whatever the $1.7 billion company spent will have been worth it.

Frankly, I find the idea of portraying Epic as an underdog in any way as downright laughable, and I bet you do too. But I simply can’t imagine another pitch that would work.

Large Health Facilities Have Major Patient Data Security Issues

Posted on July 2, 2014 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.

Many healthcare organizations have security holes that leave not only their systems, but their equipment susceptible to cyberattacks, according to two recent studies.

The researchers included Scott Erven, head of information security for multi-state hospital and clinic chain Essentia Health, and Shawn Merdinger, an independent consultant. According to iHealthBeat, the two presented their findings last week at the Shakacon conference.

Erven and his colleagues conducted a two-year study addressing the security of Essentia’s medical equipment. As part of their study they found that hackers could manipulate dosages of drugs provided by drug infusion pumps, deliver random defibrillator shock to patients or prevent medically needed shocks from taking place, and change the temperature settings in refrigerators holding blood and drugs.

The research team also looked for exposed equipment within other healthcare organizations, and the results were appalling. Within only 30 minutes, iHealthBeat notes, they found one healthcare organization which had 68,000 devices that exposed data.  Across all of the health systems they studied, they found 488 exposed cardiology systems, 323 PACS systems, 32 pacemaker systems, 21 anesthesiology systems and and several telemetry systems used to monitor elderly patients and prevent infant abductions.

Both Erven and Merdinger found that the organizations are leaking data because an Internet-connected computer had not been configured securely. Typically, data leaks occurred because sys admins had allowed Server Message Block –a protocol used to help admins find and communicate with computers internally — and allowed it to broadcast information turning private data into publicly-accessible data.

According to Erven, these issues are “global” and impact thousands of healthcare organizations. He suggests that too often, healthcare organizations focus on HIPAA compliance and don’t put enough effort into penetration testing and vulnerability protection.

This should come as no surprise. After all, Proficio’s Takeshi Suganuma notes, HIPAA was developed to protect PHI for a wide range of organizations, and as he puts it, “one size seldom fits all.”  While HIPAA compliance is important, collection, analysis and monitoring of security events are also critical activities for medium- to large-sized organizations, Suganuma suggests.

He also warns that healthcare organizations should be aware that cyberattackers are exploiting not only traditional network vulnerabilities, but also vulnerabilities in printers and medical devices. Networked medical devices are a particularly significant issue, since provider IT teams can’t upgrade the underlying operating system embedded in these devices — and too many of the devices are using older versions of Windows and Linux with known security holes.

The key point Suganuma, Erven and Merdinger are making is that while HIPAA compliance is good, healthcare organizations must pay greater attention to new attack vectors, or they face high odds of security compromise.  Seems like there’s a lot of work (and investment) afoot.

UPMC Kicks Off Mobility Program

Posted on July 1, 2014 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.

If you’re going to look at how physicians use health IT in hospitals, it doesn’t hurt to go to doctors at the University of Pittsburgh Medical Center, a $10 billion collosus with a history of HIT innovation. UPMC spans 21 hospitals and employs more than 3,500 physicians, and it’s smack in the middle of a mobile rollout.

Recently, Intel Health & Life Sciences blogger Ben Wilson reached to three UPMC doctors responsible for substantial health IT work, including Dr. Rasu Shrestha, Vice President of Medical Information for all of UPMC, Dr. Oscar Marroquin, a cardiologist responsible for clinical analytics and new care model initiatives, and Dr. Shivdev Rao, an academic cardiologist.

We don’t have space to recap all of the stuff Wilson captured in his interview, but here’s a few ideas worth taking away from the doctors’ responses:

Healthcare organizations are “data rich and information poor”: UPMC, for its part, has 5.4 petabytes of data on hand, and that store of data is doubling every 18 months. According to Dr. Shrestha, hospitals must find ways to find patterns and condense data in a useful, intelligent, actionable manner, such as figuring out whether there are specific times you must alert clinicians, and determine whether there are specific sensors tracking to specific types of metrics that are important from a HIM perspective.

Mobility has had a positive impact on patient care:  These doctors are enthusiastic about the benefits of mobility.  Dr. Marroquin notes that not only do mobile devices put patient care information at his finger tips and allow for intelligent solutions, it also allows him to share information with patients, making it easier to explain why he’s doing a give test or treatment.

BYOD can work if sensitive information is protected:  UPMC has been supporting varied mobile devices that physicians bring into its facilities, but has struggled with security and access. Dr. Shrestha notes that he and his colleagues have been very careful to evaluate all of the devices and different operating systems, making sure data doesn’t reside on a mobile device without some form of security.

On the self-promotion front, Wilson asks the doctors about a pilot  project (an Intel and Microsoft effort dubbed Convergence) in which clinicians use Surface tablets powered by Windows 8. Given that this is an Intel blog, you won’t be surprised to read that Dr. Shrestha is quite happy with the Surface tablet, particularly the form factor which allows doctors to flip the screen over and actually show patients trends.

Regardless, it’s interesting to hear from doctors who are gradually changing how they practice due to mobile tech. Clearly, UPMC has solved neither its big data problems nor phone/tablet security issues completely, but it seems that its management is deeply engaged in addressing these issues.

Meanwhile, it will be interesting to see how far Convergence gets. Right now, Convergence just involves giving heart doctors at UPMC’s Presbyterian Hospital a couple dozen Microsoft Surface Pro 3 tablets, but HIT leaders plan to eventually roll out 2,000 of the tablets.

Sutter Health Ready To Deploy HIE, But Can It Succeed?

Posted on June 30, 2014 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.

Sutter Health doesn’t have a great reputation when it comes to EMR implementation. Late last year, when we reported that Sutter’s Epic EMR crashed for an entire day, comments came pouring in about the company’s questionable approach to training its staff on using the system.

According to Epic consultants who’d been involved in the project, Sutter leaders decided that Epic experts were there to “facilitate” training done by inexperienced in-house teams, rather than actually teach key users what they need to know. The result was strife, disorder and anxiety, according to several consultants who’d been involved. Since then, Sutter has connected its EMR to five medical foundations and 17 hospital campuses; by next year, it expects the EMR to connect to information on 3 million patients. But there’s no reason to think it’s changed its training strategy, which could cast a bit of a pall over the new project.

Now, Sutter Health is building out a health information exchange, working with Orion Health, which will tie together hospitals and doctors both inside and outside of its network across northern California. Sutter plans to begin deploying the HIE in phases this summer, starting with data integration with the Epic EMR and extending to testing exchange of inbound and outbound data. If the project works out, it seems likely that it will be a plus for every provider that does business with Sutter.

The question is, will Sutter do a better job of managing this process than it did in rolling out its EMR? While it’s easy to boast that your plans are going to be a “gamechanger” for the market, it’s hard to take that claim at face value when your EMR implementation hasn’t gone so splendidly.

Certainly, Orion is a reputable HIE vendor which has been praised for having strong products and service. And Sutter certainly has the financial wherewithal to see such an effort through. The thing is, if Sutter leaders (seemingly) took a wrongheaded approach to the all-important issue of EMR training, who knows what curveballs they might throw into the process of rolling out an HIE? Even if its EMR has stabilized and Sutter has somehow gotten past its training hurdles, its past missteps don’t inspire confidence.

If I were with Orion, I’d draw a firm line where training was concerned, as Sutter’s past strategy only seems to have cast its last major HIT vendor in a bad light. If not, I’d make sure the contract had a workable bailout clause…or be prepared for some serious headaches.

AHA urges agencies to speed up EMR choice expansion

Posted on June 23, 2014 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.

In a move that shouldn’t surprise anybody, the American Hospital Association is urging CMS and the ONC to hurry up and finalize new rules which would expand choice for certified EMRs.

The AHA letter argues that its members are on the verge of walking away from Meaningful Use. But if CMS and the ONC speed ahead with with the new proposed rules — which would offer more choice in specific meaningful use requirements they must meet this year — hospitals will be much better equipped to proceed.

Why the rush? Well, for one thing, the letter argues, time is of the essence for hospitals, which have to decide their meaningful use strategy for fiscal 2014. If they must make choices before the new rule is finalized, it could cause them “significant financial and operational harm,” the AHA contends.

Meanwhile, if the agencies don’t push these rules through quickly, “many providers are likely to conclude that they cannot meet meaningful use this year and abandon the program,” wrote Linda Fishman, AHA senior vice president of public policy analysis and development, in a letter to CMS Administrator Marilyn Tavenner and National Coordinator Karen DeSalvo, MD.

The letter also takes on other issues. It asks that CMS and ONC clarify the rules implementation, offer more flexibility in the reporting of clinical quality measures, shorten the MU reporting period for 2015 in analyze lessons learned from Stage 2 before finalizing Stage 3’s start date, according to HealthcareITNews.

The AHA’s letter comes at a challenging time for the meaningful use program generally, which has of late attracted broader attention than it has in the past.

Not only are industry groups pressuring ONC, legislators are too. For example, at a recent health IT conference, U.S. Rep Tom Price, MD, R-GA, argued that meaningful use is “maybe not even doing what needs to be done as it relates to patients and physicians.”

In his remarks, Price argued that meaningful use could be improved by keeping the patient front and center, making sure patients know they own their health data and establishing an interoperability standard.  But he suggests that because the MU program roadmap was laid out in the HITECH Act, it’s not as fluid as it should be and doesn’t accommodate such concerns.

The reality, however, is that there is no simple way to get interoperability; right now, we’re lucky if individual EMRs meet providers’ needs.  Despite the demands from other stakeholders, health IT vendors still have a lot more to gain by creating islands rather than interoperable products.

Georgia EMR Disaster: Was IT Department Responsible?

Posted on June 18, 2014 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.

A few weeks ago, heads began to roll at Georgia’s Athens Regional Health System when its $31 million Cerner rollout began to fall apart. After clinicians complained that a rushed rollout process was generating a host of medication errors and other mistakes, President and CEO James Thaw resigned, and less than a week later, SVP and CIO Gretchen Tegethoff left as well.

Since then, however, the political landscape there has changed, with the facility’s chief medical officer, as well as Cerner executives, contending that the disaster was due to mistakes by the health systems IT team, according to HealthcareITNews. The Cerner execs, CMO and others are arguing that IT leaders made strategic decisions that should’ve been made by clinicians, the publication says.

A local paper, the Athens Banner Herald, notes that the Cerner rollout was done largely by the hospital’s IT team, and that few end-users were involved. That, at least, is what Cerner VP Michael Robin told the paper.  And a different Cerner VP, Ben Himes, took another shot at the IT department, arguing that this implementation seems to have come out on the IT side of things, rather than stressing clinical involvement.

The bottom line seems to be that regardless of what actually happened, the clinicians at the hospital seem to of felt left out of the process, never good thing when we’re dealing with a tool that they’ll need to use everyday.  Regardless of what actually happened, it seems the hospital’s IT department didn’t do a good job of engaging clinicians and getting their feedback; under those circumstances, the likelihood of kicked up a fuss even if implementation was otherwise smooth.

On the other hand, I’m always a little skeptical when vendors point fingers at their customers and say it was their fault when things go wrong. OK, I realize that there may be some truth to their accusations, and that Cerner has a right to defend itself, but it’s hardly a good PR move to dump problems with the implementation completely in the customer’s lap.

The truth is, will probably never know exactly what happened with this EMR implementation. Considering the scale of the project, and the number of people involved, it’s inevitable that this will go down in a blaze of finger-pointing. But it never hurts to be reminded that EMR implementations which leads physicians feeling as though they’re on the sidelines are politically risky at best, and potentially disastrous at worst.