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Hospital EMR and EHR Recruiting

Late last year, I acquired the healthcare IT career website Healthcare IT Central. Since bringing Healthcare IT Central into the Healthcare Scene family, I’ve dove head first into the healthcare IT Recruiting and career space. It’s been quite an adventure with a lot of great learning for me along the way.

What I’ve learned most is that there are some really amazing people working in healthcare IT and some really amazing companies that are trying their best to make healthcare better. There are a lot of screwed up things in healthcare, but the people are generally good people and a real pleasure to work with.

Health IT Job Seekers
If you’re in the job market and looking for a healthcare IT job, take a few minutes to register as a job seeker where you can upload your resume and apply for jobs at some of the top healthcare IT companies. Also, be sure to check out some of these popular job searches:

Of course, you can always do your own health IT job search using the criteria that matter for you. All of this is all free for the job seeker.

Health IT Employers
If you’re a health IT company or a hospital organization looking to hire qualified healthcare IT professionals, you can register and post your jobs as well. We just passed over 20,000 registered job seekers and are getting close to 11,000 active health IT focused resumes.

We also have other options available to employers like eNewsletter sponsorships (almost 16,000 email subscribers), webinars, and resume database access where you can search for specific candidates.

We’re working really hard to be an amazing health IT career resource for both job seekers and employers. If you have any feedback on the site and what we’re doing, we’d love to hear it on our contact us page.

April 17, 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.

A Meaningful EHR Certification

In many ways this post could be considered a continuation of my previous post on data liberation. I’ve really loved the idea of a creating a meaningful EHR Certification and that could include data liberation. Let’s be honest for a minute. Do any of you find value in the current EHR certification?

You know that a certification is screwed up when it requires certain interoperability standards and then when you go to actually implement the sharing of data between two systems you find out that the two systems are working on two different standards. They are close standards, but close doesn’t count with standards. Many have asked the question, “What did the EHR certification do if it couldn’t test the standard?” I have no answer to that question.

Now imagine we created an EHR certification that actually did require a standard for interoperability. Not a flavor of a standard, or something that closely resembles a standard. I’m talking about a standard. Would hospitals find this useful? I think so.

Another example of a meaningful EHR certification could be certifying that an EHR vendor will not hold your EHR data hostage. Think about how beneficial that would be to the industry. Instead of EHR vendors trying to trap your data in their system, they could focus on providing the end user what they need so the end user never wants to leave that EHR. What a beautiful shift that would be for our industry.

There could be many more things that could be meaningfully certified. However, this would be a simple and good place to start. I have no doubt that some would be resistant to this certification. That’s why those who do become meaningfully certified need to get the proper boost in PR that a meaningful certification should deserve. No EHR vendor wants to be caste as the EHR vendor who can’t figure out the standard and that holds its customers hostage. Yet, that’s what they’re able to get away with today.

What do you think of this idea?

April 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.

Moving Hospital EHR to the Cloud

I’ve long been interested to see how hospitals were going to handle the shift to “the cloud.” Obviously, most hospitals have made a big infrastructure investment in huge data centers and so I’ve always known that the shift to the cloud would be slow. However, it also seemed like it was inevitable.

I was interested to hear Jason Mendenhall talk in our Healthcare Data Center Google Plus hangout about healthcare entities moving their technology infratructure into their data center. Plus, I pair that with the smaller rural hospital CIO I met who balked at the idea of having a data center or really even having any sys admin people on staff.

Plus, I’m reminded of this quote I heard Dr. Andy Litt tell me about when hospitals will start using Dell to host their Epic EHR:

The opportunity to host an Epic or other EHR is in first install, not for existing ones that have invested in a data center already. -Andy Litt, MD, Dell

I can’t imagine that many institutions really want to move their Epic EHR hosted locally into the cloud. That just doesn’t happen. At least it doesn’t right now. Will we see this change?

I think the answer to that is that we will see it change. There’s a really good argument to make that hospitals shouldn’t be building data centers and that there’s tremendous value to using an outside provider. Plus, many of these “data center” companies are becoming more than just a set of rails, power, and cooling. They are now working with a variety of cloud providers that can provide you more than just a place to put your own servers.

I’ll be interested to see how this plays out, but I think we’ll see fewer and fewer hospital data centers. The outside options and connectivity to those outside data centers is so good that there’s going to be no need to do it on your own.

March 24, 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.

Are We Using All the Data We Have?

Many of you might remember the post I wrote previously about the real cause of hospital readmissions. In that post, I quote Stuart Long, Chief Marketing and Sales Officer at CapsuleTech, who shared with me some internal survey results. While I found those survey results really interesting Stuart also offered me a number of insights that I thought other might find interesting as well.

First, in our conversation Stuart commented off hand that “even in the hospital today we have to throttle the data we send them.” For some context, Stuart is referring to how much data the medical devices that Capsule connects to the hospital can send. Basically, he’s saying that these medical devices have a lot more data that they could share with the hospital, but the hospital IT systems can’t handle all the extra data.

I’m sure we could have a deep discussion of the value (or lack thereof) of the data that’s not being sent to the hospital systems. However, I think this is all part of a larger question we need to ask ourselves in healthcare. Are we using all the data that we have available to us? Maybe there is value in some of the data that the medical device is collecting and not transferring to the hospital IT system.

This topic also takes me to discussions around patient generated data. Millions of patients are tracking their health using hundreds of tracking devices. That’s a lot of data available for us to use. Are we using it? I can think of a few hospitals that have focused uses of this patient generated data. However, we certainly aren’t using the vast majority of this data.

Are We Using All the Data We Have? The answer is clearly no. The question then remains, should we be using more of the data that’s available to us? Should someone be responsible for making sure we’re using the data we have available to us the best way possible?

Another interesting insight that Stuart provided was that Capsule was looking to extend charting ability to point of care. For those who don’t know much background on Capsule, go and read medical device guru Tim Gee’s HIMSS 2014 blog post where he talks about them in some detail. When you think about the interfaces that Capsule has created for medical devices, they aren’t that much different than an interface between a charting application and the EHR. The big difference is that a medical device is capturing the data versus a human entering the data in the charting application. The method the data uses to become digital is irrelevant. After that it’s the same plumbing that gets that data to the EHR.

I’ll be interested to see how far they take this. One of my big topics of interest coming out of HIMSS 2014 was to dig deeper into the idea of external EHR interfaces. I heard about some huge teams that are creating generic EHR data interfaces that push the data to the EHR. I’ll be interested to see how far we go with this trend.

March 19, 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.

Every Hospital Should Adopt EHR

While I’m sure this tweet will rub many the wrong way, I found it incredibly thought provoking. I have no idea who this person is that tweeted it, but I think that his tweet represents the majority of Americans who know very little about EHR and Health IT.

From a layman’s perspective, in every industry the use of IT has benefited that industry. Those not living in the EHR world just automatically think that by applying IT to something that we’ll see a huge benefit. Those of us in the EHR industry no doubt have a much more nuanced feeling about the benefits of EHR. I’m sure the guy who tweeted above won’t be happy with the meaningful use hardship exemptions which will defer organizations from being #finedheavily.

While I agree with the idea that we need broad EHR adoption, I think we have to be careful trying to rush any EHR implementation. A rushed EHR implementation is far worse than no EHR.

March 13, 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.

Cerner Agrees To Pay $106M Over Allegedly Defective Software

After years of back and forth, Cerner has settled a dispute with a North Dakota hospital claiming that Cerner’s financial software was defective and didn’t deliver expected business benefits.

Back in April 2012, Trinity Health told the vendor that it was transitioning away from Cerner’s patient accounting software solution and certain IT services provided by Cerner. At the time, it alleged that the patient accounting solution didn’t work right.  Of course, Cerner disputed the allegations, according to its 10-K yearly report.

The two players began arbitration in December 2013, a move which allowed Cerner to collect some payments due from the hospital.  At the outset, Cerner was predicting liability you of up to $4 million, while Trinity anticipated damages totaling $240 million.

Ultimately, the two agreed upon a settlement under which Cerner would pay Trinity $106 million. Interestingly, Trinity is continuing as a client of Cerner for its clinical solutions, something you might not expect under the circumstances.

This is a particularly unusual outcome for a vendor/hospital dispute, because most vendor contracts contain clauses to eliminate “consequential damages,” which limit hospital’s ability to take legal action, notes Trinity attorney Michael Dagley. That being said, there are areas under state and common law provisions of consumer fraud statutes, under which manufacturers cannot misrepresent product capabilities and benefits.

Knowing how hard it is for a hospital to sue a vendor of IT services, it makes you wonder whether the growing number of hospitals dumping their current EMR are doing so because they’re not getting what they want but can’t sue to get their money back.  While it may be heinously expensive, buying a new EMR and installing it is certainly faster than going through years of court proceedings and then having to buy another EMR nonetheless.

March 12, 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.

Is IT The Reason CEO Turnover Is So High?

A new study from the American College of Healthcare Executives reports that hospital CEO turnover increased to 20 percent in 2013, the highest rate reported since ACHE began tracking these numbers in 1981.

There are several reasons one could identify as causes for high CEO turnover, including the retirement of baby boomers and the trend towards consolidation in the industry, which may eliminate jobs.

All that being said, I believe that the most likely reason for high CEO turnover of late is the turmoil around IT, including but not limited to evaluating and buying equipment from EMR vendors, managing process changes as the EMR is installed, seeing to it that the EMR doesn’t bankrupt the hospital and more.

And then, there is a need for management to be responsible for all of the systems that feed into the EMR, and to do something with the data that they produce.

Bottom line, it’s hardly surprising that there are a record number of CEOs struggling to stay on top of the crest where IT is concerned.  And it’s also not too surprising that some CEOs, who had done very well as the responsible leader with their hands on the wheel, might be less suited to the massive changes that can occur in the wake of IT transformation.

No, in reality it’s not very surprising that this is a time of high turnover for CEOs.  When you pile on the various revolutions taking place in healthcare IT, and the need to lead your staff through them, manage them and prepare for the future, you have what might be seen as an impossible job for some CEOs. It’s not a big surprise that particularly high number of hospital CEOs are calling it a day — or having it called for them.

March 11, 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.

Eyes Wide Shut Meaningful Use Series

For those of you who read Hospital EMR and EHR but don’t read EMR and HIPAA (which from our latest survey is far too many of you), I wanted to highlight a series of blog posts by Mandi Bishop that I believe will be of extreme interest to those reading this site.

In this series called Eyes Wide Shut, Mandi gives some really amazing in the trenches views into how a large organization is dealing with the challenges of meaningful use and meaningful use stage 2 in particular.

Here’s a small sample from the latest entry in the series titled “Eyes Wide Shut: Meaningful Use Stage 2 Incentive Program Hardships“:

In my January update on Meaningful Use Stage 2 readiness, I painted a dismal picture of a large IDN’s journey towards attestation, and expressed concern for patient safety resulting from the rush to implement and adopt what equates to, at best, beta-release health IT. Given the resounding cries for help from the healthcare provider community, including this February 2014 letter to HHS Secretary Kathleen Sebelius, I know my experience isn’t unique. So, when rumors ran rampant at HIMSS 2014 that CMS and the ONC would make a Meaningful Use announcement, I was hopeful that relief may be in sight.

Like AHA , I was disappointed in CMS Administrator Marilyn Tavenner’s announcement. The new Stage 2 hardship exemptions will now include an explicit criteria for “difficulty implementing 2014-certified EHR technology” – a claim which will be evaluated on a case-by-case basis, and may result in a delay of the penalty phase of the Stage 2 mandate. But it does nothing to extend the incentive phase of Stage 2 – without which, many healthcare providers would not have budgeted for participation in the program, at all, including the IDN profiled in this series. So how does this help providers like mine?

In that post, Mandi also tries to not just complain about the challenges they face, but also offer some solutions. You can see her full list of ideas in the post, but I especially like the simplicity of her last line “Consider applying the hardship exemption deadline extension to the incentive program participants.”

We need more in the trenches people like Mandi sharing their stories and solutions for others to see. Otherwise, the regulators sit in their office in DC and don’t know the details of why they should adjust. If you’re someone reading this that would like to tell your story as well, I’d be happy to give you the platform. Just drop me a note on our contact us page.

March 6, 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.

Stanford Team Builds EMR Automated Checklist Solution

A Stanford team has built an automated checklist that pulls data out of EMRs and pushes patient-specific alerts to caregivers.  The checklist, along with the dashboard style interface clinicians use to work with it, has caused a threefold drop in the rates of a serious type of hospital acquired infection, according to a study of the solution published in Pediatrics.

The study, conducted by researchers in the pediatric intensive care unit at the Stanford University School of Medicine and the Lucile Packard Children’s Hospital Stanford, was focused on preventing bloodstream infections that begin in central lines.

To create the automated checklist, the research team collaborated with engineers from HP Labs, who programmed the checklist and displayed real-time alerts a large LCD screen in the nurses’ station.  Alerts from the system were generated in three different colors, red, yellow and green, each with a specific action to be taken in response to the dot. For example one dot might indicate that it was time for patients central line to be changed, and another if it was time for caregivers to reevaluate whether medications given in the line could be switched to oral meds instead.

Using the checklists created from EMR data it was much easier for clinicians to follow national guidelines in keeping central lines infection free. During the study, researchers reported, the rate of central line infections in the hospital’s PICU fell from 2.6 to 0.7 per 1000 days of central line use.

According to Natalie Pageler, MD, the study’s lead author, these are the kinds of solutions that can transform the use of EMRs  by digging into their deeper capabilities. “Electronic medical records are data rich of information poor,” Dr. Pageler said. “Often, the data in electronic medical records is cumbersome for caregivers using real-time, but this study showed a way to change that.”

March 5, 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.

Large Health Systems May Miss Stage 2 Deadline

Usually, it’s the small institutions that are having fits when an IT program deadline is approaching. This time around, it’s the big boys that are struggling.

Intermountain Healthcare has announced that the organization will probably not attest to Stage 2 of the Meaningful Use program this year over concerns about patient safety, according to iHealthBeat

In an interview with HealthLeaders Media, CIO Marc Probst said that with the organization transitioning from its own EMR to EMR software from Cerner, all the software will not be running at all of the locations by the end of this year. This isn’t surprising after the relatively recent announcement that Intermountain would be switching to Cerner.

It’s not clear what it says about the success of the Meaningful Use Stage 2 program, other than that Intermountain has other priorities, but it does make you wonder what other large health systems will take a similar posture.

After all, ONC Chief Medical Officer Jacob Rieder (who also spoke with HealthLeaders) said that other large institutions are reporting similar situations. As amazing as it sounds considering the money involved, I won’t be surprised if we see more institutions following similar paths. There are a decent number of hospitals that haven’t even selected an EHR software.

According to Reider, it will be easier for small providers to meet Stage 2 requirements, given that they generally don’t have to plan as far into the future. But when it comes to large health systems, it seems that achieving this year’s Meaningful Use goal is a bridge too far.

March 4, 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.