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NYC Health Systems Get $7M To Share Data

Seven New York City health systems have gotten a delayed Christmas present — a $7 million grant designed to encourage data sharing initiatives and improve patient recruitment for clinical trials. The primary goal of the project is to use evidence-based research to help patients make good decisions about their healthcare.

The funding comes from a group known as the Patient-Centered Outcomes Research Institute, or PCORI. PCORI, which will create a clinical data research network in NYC, has already created 29 such networks across the nation, according to Healthcare IT News.

These networks, collectively, will form PCORnet, a $93.5 million patient-centered research initiative. The New York City Clinical Data Research Network (NYC-CDRN), a  consortium of 22 regional organizations, will work together to develop systems supporting data networking efforts and advance patient-centered research, Healthcare IT News reports.

NYC-CDRN will kick off their efforts by identifying patients with diabetes, obesity and cystic fibrosis. It will then partner with patients and clinicians by creating disease-specific community groups.

The NYC-CDRN network will connect medical records for 6 million New York City residents, then anonymize the records, and over the next 18 months, will work to standardize the data. Ultimately, the goal is to allow patients and providers to have access to evidence-based information they can use to make smart healthcare choices.

This should be an interesting project to watch over the next year and a half. PCORI is doing a lot of forward-thinking work with its money, including $5 million to the NIH for a tool called PROMIS designed to help with comparative effectiveness research. PROMIS has existed since 2004, but PCORI is now helping it move forward, making the $5 million in funds available  in research grants up to $500,000 for projects up to two years in length.

January 29, 2014 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.

Do Hospitals Care About Blue Button?

Jennifer Dennard has been doing a series of blog posts detailing her “Blue Button Patient Journey.” It’s a really insightful look from the patients viewpoint about how Blue Button and patient engagement with their medical records is doing.

My gut reaction when I read that post by Jennifer was that is all felt way too complex with so little value to the patient. Which of course led me to the conclusion that patients aren’t going to do this.

If patients don’t care about Blue Button, is there any reason we should believe that hospitals are going to care about Blue Button? I think we all know the answer to that question.

It would be interesting to go around the hospital and ask people what they thought of Blue Button. I have a feeling hospital employees answers would be more like a Jay Leno “Jaywalking” video than an deep explanation of Blue Button.

Of course, I’m sure that hospitals will be adopting Blue Button more and more. However, most of the people in the hospital won’t know that it’s happening. They’ll just be Blue Button enabled by default when they implement their EHR’s patient portal. Maybe that’s not such a bad thing.

Think about how beautiful it will be to have all of your healthcare data Blue Button enabled. It could open up some really interesting possibilities. In fact, if those in the hospital knew about the data being available through Blue Button they might try and stop it from happening. Freeing healthcare data is a good thing and Blue Button is one step towards freeing the data.

Once those in the hospital realize the health data has been available to patients through blue button all along, then they’ll realize that giving patients their health data won’t cause the universe to implode. Hopefully by then we’ll have some really great applications doing beautiful things with all that blue button data.

January 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently 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.

Kaiser Permanente Branch Joins Epic Network

Though it apparently held out for a while, Kaiser Permanente Northern California has signed on to Epic Systems’ Care Everywhere, a network which allows Epic users to share various forms of clinical information, Modern Healthcare reports.

Care Everywhere allows participants to get a wide range of patient data, including real-time access to patient and family medical histories, medications, lab tests, physician notes and previous diagnoses. The Care Everywhere network debuted in California in 2008, and has since grown to a national roster of more than 200 Epic users.

Many of the state’s major healthcare players are involved, including Sutter Health, as well as prominent regional players such as Stanford Hospital and Clinics, USCF Medical Center and UC Davis Health System, according to Modern Healthcare. Kaiser Permanente Southern California also participates in the network.

According to Epic, the Care Everywhere system allows patients to take information with them between institutions whether or not both institutions use the Epic platform. Information can come from another Epic system, a non-Epic EMR that complies with industry standards, or directly from the patient.

But of course, the vendor likes to see Epic-to-Epic transmission best, as it notes on the corporate site: “When an Epic system is on both sides of the exchange, a richer data set is exchanged and additional conductivity options such as cross-organization referral management are available.”

Care Everywhere also comes with Lucy, a freestanding PHR not connected to any facility’s EMR system. According to Epic, Lucy follows patients wherever they receive care, and gathers data into a single source that’s readily accessible to clinicians and patients. Patients can enter health data directly into Lucy or upload Continuity of Care Documents from other facilities.

While connecting 200+ healthcare organizations together is a notable accomplishment, Care Everywhere is not going to end up as the default national HIE matter how hard Epic tries. As long as the vendor behind the HIE (Epic) has a strong incentive to favor one form of data exchange over another, it cuts down the likelihood that you’ll have true interoperability between these players. Still, I’ve got to admit it’s a pretty interesting development. Let’s see what healthcare organizations have to say that try to work with Care Everywhere without owning an Epic system.

P.S. It’ll also be interesting to see whether Epic is actually “best” for ACOs, as a KLAS study of a couple of years ago suggested. More recent data suggests that best-of-breed tools will be necessary to build an ACO, even if your organization has taken the massive Epic plunge.

December 26, 2013 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.

Common Misconceptions About HIEs

Health leaders are  interested in connecting up with other organizations — an interest documented by several studies — but many aren’t moving ahead. HIE expansion is proceeding slowly for a number of reasons, not the least of which are concerns about HIE costs and the great difficulty in establishing interoperable data streams.

But some of the reasons healthcare administrators cite for not moving ahead are actually myths, according to a story in Becker’s Hospital Review.  Becker’s spoke with Carol Parker, executive director of the East Lansing, Mich-based Great Lakes Health Information Exchange, who argued that at least three common beliefs about HIEs are myths.

1. HIEs are costly.  According to Parker, hospitals assume that HIE connections will prove to be as expensive as bringing an EMR on board, which naturally gives them pause.  But the truth is that HIE costs are “negligible” compared to EMR expenses, Parker says. For example, she estimates that a 300-bed hospital would pay less than $50,000 per year, a very small number when compared to EMR costs.

2. HIEs are less secure than current systems. Providers worry that HIEs aren’t going to offer strong enough data security to ensure HIPAA compliance. In fact, according to a HIMSS Analytics report, 39 percent of hospitals who are already on board with HIEs have privacy concerns. But according to Parker, HIEs like hers have tight security measures in place.  GLHIE even has a chief privacy and security officer who audits and monitors the data to make sure security meets government and industry standards.

3. HIEs don’t need to be a priority.  According to Parker, providers overwhelmed by EMR installs have “IT fatigue” and don’t feel they can add this one more thing to their efforts. But Parker argues that participation in an HIE is critical, particularly as hospitals take on population health management, and work under performance-based contracts. “It will be challenging to make that work without having information on care delivered to the patient outside of the health system’s network,” she says.

While Parker is obviously biased in favor of HIEs, I believe she makes some good points. It’s particularly interesting to hear that the annual cost of HIE participation, at least with GLHIE, is a relatively small number. Now, just because it’s inexpensive doesn’t mean joining an HIE isn’t a big deal. But it’s good to hear that the costs are probably doable for most hospitals.

October 30, 2013 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.

Ohio HIE Hits 101-Hospital Mark

This is a very busy time for HIE builders.  In recent months several states have either announced that they’d completed their preparations for a broad-based HIE or reached a new milestone in HIE participation.

For example, earlier this month the state of Wisconsin announced that it is gearing up to kick off a statewide HIE network that would embrace hospitals, clinics, nursing homes and other care facilities, powered by HIE technology vendor Medicity.

According to Health Affairs, this is part of a larger trend. A recent piece in the journal noted that health data exchanges between hospitals and other healthcare providers have climbed 41 percent between 2008 and 2012.

The latest in state HIE news comes from Ohio, where the state’s HIE has just announced that it had signed two hospitals, 25 bed Harrison Community Hospital in Cadiz as well as 91-bed Wilson Memorial Hospital in Sidney, reports Healthcare IT News.  With the new additions, Ohio’s CliniSync HIE now boasts 101 of the state’s hospitals.

CliniSync, which is run by the nonprofit Ohio Health Information Partnership, is based on Medicity technology as well.  With these new members, and the momentum it has underway, CliniSync might well be one of the largest public HIEs in the U.S. by 2014, Healthcare IT News reports.

According to Healthcare IT News, CliniSync makes it possible for physicians, hospitals, nurses and others who do patient care to share patient data electronically. What’s really neat, if true, is that CliniSync will allow doctors and hospitals with varied EMRs to share data. Previously, the HIE members could only share data regionally or within their own systems.

September 12, 2013 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.

Survey: CIO Pay Isn’t Keeping Up With Responsibilities

With EMRs, ICD-10, HIEs and countless additional technical responsibilities being heaped on the head of healthcare CIOs, one would think that they were paid well for their trouble.  And in most cases, they are.  But a new survey suggests that healthcare CIO pay isn’t keeping up as their responsibilities grow, according to Healthcare IT News.

The survey, by retained executive search firm SSI Search, points out that healthcare reform and the HITECH Act of 2009 have but previously unheard-of pressures on CIOs and IT teams to handle major technology changes and new requirements, “arguably some of the greatest changes to impact modern healthcare in America,” SSI said.

According to SSI Search’, which surveyed 178 respondents,, the typical healthcare CIO these days is a well-educated male who has served in the CIO role for 10 years.  Specifically, 82 percent of respondents were male, 97 percent have a college degree and 61 percent have a master’s degree, Healthcare IT News reports.

Total compensation for these CIOs ranged widely, from less than $125,000 to more than $724,000 per year, Healthcare IT News notes.  But that compensation didn’t track closely with the level of responsibility these CIOs are taking on, the study found. Thirty-eight percent of CIOs reported having an increase in compensation of 10 percent or less over the past four years, SSI concluded.

It’s not that we should feel sorry for these CIOs who, after all, make far more  than most average Americans. But it’s worth noting that their already overloaded plate is having even more piled on it these days.  Whether it’s reflected directly in their compensation or not, CIOs deserve acknowledgement that their very tough job is getting tougher.

For what it’s worth, CIOs seem more or less content with their pay, with more than half reporting that their current compensation is “good – in line with expectations.”

September 5, 2013 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.

Wisconsin Prepares For Statewide HIE

The state of Wisconsin is gearing up to kick off a statewide HIE network that would embrace hospitals, clinics, nursing homes and other care facilities, according to a piece appearing in the Milwaukee Journal Sentinel.

The network, known as the Wisconsin Statewide Health Information Network (WISHIN), is a private nonprofit organization. It expects to add several hospitals to its network this year, and most of the state’s major health systems have committed to participating over time. The health systems and other providers who participate in WISHIN will pay an annual subscription fee based on their size.

WISHIN expects to make a wide variety of information available securely to providers, including problem lists, prescriptions, radiology reports, physician notes and test results, the newspaper notes.

WISHIN will replace the Milwaukee area’s Wisconsin Health Information Exchange, a network which was formed in 2008 and included 13 hospitals in the area. The WHIE was shut down after the region’s health systems decided that being part of a statewide network would be more efficient than relying on a local organization.

WISHIN was created in December 2010, funded by the American Recovery and Reinvestment Act of 2009. Initial planning for the network was done by a body overseen by the state’s Department of Health.

Since then, WISHIN brought in Medicity Inc. to handle the design of the network. Medicity, which is owned by Aetna, is building HIEs in several states.

In kicking off its network, WISHIN is joining a rapidly-growing community of hospitals who have embraced HIEs. In fact, a recent study appearing in the journal Health Affairs concluded that health data exchanges between hospitals and other healthcare providers have climbed 41 percent between 2008 and 2012.

And WISHIN is one of a growing number of statewide efforts. For example, New Jersey’s State Department of Health just awarded $1.57 million to a coalition of HIE group to help them kick off a statewide HIE there.

What’s not clear, from the description of either HIE, is how they’re going to sustain their efforts over the medium and long term;  subscription-model based HIEs have failed in the past and, unless something new is afoot, are likely to fail again.  Let’s see if the ROI is enough to satisfy hospitals and providers this time around.

September 3, 2013 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.

Feds Plan EMR Certification For Specialty Facilities

Federal HIT leaders are planning to set up a voluntary program for testing and certification of EMRs used by behavioral health, long-term care and post-acute care, according to a story in Modern Healthcare. 

As things currently stand, they’re off the hook, as ARRA doesn’t require long-term or behavioral health facilities to buy certified EMRs.

These plans came to light last week at a webinar held by outgoing ONC head Farzad Mostashari, who said that his office is working on what the scope of such a program should be, MH reports. The webinar was held to discuss government officials’ reaction to public comments on how to improve interoperability.

In its original request for input, federal regulators noted that 4 in 10 hospitals were sending lab and radiology information to outside providers, though only one in four were  exchanging medication lists and clinical summaries, Modern Healthcare said.

Meanwhile, only 6 percent of long-term acute-care hospitals, 4 percent of rehab hospitals and 2 percent of psychiatric hospitals had even a basic EMR, the feds reported.

Launching these specialty-focused options seems like a logical next step for the certification program, and a long-delayed one at that. EMR certification has been a fact of life for several years, since then-ONC chief David Brailer kicked off the formation of the CCHIT.

Over the long haul, however, such new certification options may not be worth much unless they’re better matched to provider needs. My colleague John, for one, thinks the certification will have to change to actually offer value to doctors and healthcare organizations.

What do you think, readers?  Do you think certification programs for EMRs are a waste of time, or do you see them doing anything meaningful to improve care?

August 13, 2013 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.

Hospital Data Exchange Climbs Over Four Years

A new study appearing in Health Affairs concludes that health data exchanges between hospitals and other healthcare providers have climbed 41 percent between 2008 to 2012, according to a report in iHealthBeat.

The study, which was led by soon-to-be-ex ONCHIT head Farzad Mostashari, analyzed data sharing outputs and the type of information exchanged by more than 2,800 hospitals over the four-year period, iHealthBeat said.

According to iHealthBeat, the study found that in 2012, 58 percent of hospitals routinely exchanged health data with providers and health systems outside their organization, and that data exchange with outside hospitals actually doubled.

It also found that 84 percent of hospitals adopting a basic EMR and participating  in a RHIO shared information with providers outside of their organization during the period studied.

In addition, the proportion of hospitals adopting at least a basic EMR and participated in an  HIE shot up more than 500 percent during the four years studied.   And hospitals with a basic EHR participating in an HIEs had the highest rates of hospital data exchange, iHealthBeat reports.

Along with tracking the growth of health information exchange, the study tracked specific kinds of data exchanged.  It found that there were large increases in the percentage of hospitals sharing clinical care summaries, lab results, medication lists and radiology reports.

This data should be music to the ears of groups coming together into large HIEs, as it suggests that hospitals are becoming engaged users of networked data. Any sign that health information exchange is becoming a mission-critical activity is a good omen.

That being said, the study doesn’t seem to get into the issue of who will sustain and pay for the HIEs in question. It could be that the hospitals are perfectly happy to take advantage of a service supported by grant money — as is very frequently the case — but won’t be up for ponying up real money when the grants expire.  We’ll just have to see how deeply HIEs become ingrained into the hospitals’ workflow to see whether active HIEs are worth real money to them.

August 12, 2013 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.

NJ Groups Come Together For Statewide HIE

A group of regional organizations have come together to create a statewide HIE in New Jersey. As with most other large HIE efforts, the project is backed by a grant, in this case from ONCHIT.

New Jersey’s State Department of Health has awarded $1.57 million to a coalition of HIE groups, including the Camden Health Information Exchange, Virtua and Jersey Health Connect.  The project is dedicated to turning the patchwork of existing organizations into a true statewide, interoperable network.

The new HIE, known as the New Jersey Health Information (NJHIN) will begin by connecting regional health information that currently exchange data between local health providers, reports Healthcare Technology Online. The first wave of connectivity, which will link together various regional health information organizations, will bring together about 2,000 providers.

The program selected regional NJHIN coalition members through a competitive Request for Applications process. Those chosen had to demonstrate commitment to the success of the state’s HIE efforts; technical capability to deliver the needed technology services; and demonstrated experience bringing together diverse stakeholders to accomplish a shared goal.

This announcement follows on the heels of the an announcement by an HIE in Colorado (CORHIO), which has managed to connect the half of the state’s hospitals to its network as well as about 1,800 office-based physicians, 100 long-term and post-acute facilities, 13 behavioral health centers and five national/regional labs.

In both of these cases, it’s easy to see a lot of hope for sustained interoperability. But I’ve been watching HIEs/HINs/RHIOs for several years, and I’ve yet to see a really sound business model emerge for running an HIE successfully over time.

Perhaps with large, visible efforts like these coming into the spotlight, someone will come up with a solution — other than relying on grants — to fund long-term HIE growth, but as of this moment I’m skeptical these efforts can sustain themselves. For the sake of our healthcare system, I hope I’m wrong this time.

August 1, 2013 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.