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More of the Siemens Healthcare Back Story

One of the things I love about blogging is the comments that I receive. Many of them come in the comments of the blog, but just as many get emailed to me privately in response to my posts being emailed to readers. Every once in a while I want to share the emails I receive with the readers (Note: You can now subscribe to all of the Healthcare Scene emails in one place). This is one such response that I got in response to my post about Siemens Selling its Health IT business.

I remember the good ol’ days of being a 25+ year SMS Unity customer. Siemens who had recently purchased SMS told us that Unity would be going away. They showed us Soarian (which at the time was not actually built) and said that they would move us there for free. Of course, since it didn’t yet exist we would have to transition to Invision first for about a year. That would also be free. However, they would have to expense us for professional fees which they estimated to be in excess of $1,000,000. This is how we became a Meditech customer.

This kind of back story is what makes healthcare IT so interesting and so challenging. Many who want to enter the healthcare space forget about all this history and they usually fail. The very best hospital health IT companies that I know usually do an amazing job pairing new innovations and technologies together with someone who understands and has been part of this history. Pairing the two together is a powerful combination.

July 10, 2014 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.

Siemens to Sell Hospital IT Business?

This is some interesting news for the hospital health IT world:

Siemens (SIE) AG is exploring a sale of its hospital database and information-technology unit to focus on energy and industrial businesses, according to two people familiar with the plans.

The German engineering company is evaluating options for the business, and no final decision has yet been made, said the people, who asked not to be identified because the considerations are private. The unit could be valued at more than 1 billion euros ($1.4 billion), said one of the people.

Siemens Chief Executive Officer Joe Kaeser is seeking to focus Siemens around “electrification, automation and digitalization” and has already sold off $2.3 billion euros since late 2012. It seems like Siemens healthcare product line fits great with the digitalization focus, so there’s likely more to the story. My guess is the Siemens healthcare business hasn’t been doing well (Thank you Cerner and Epic) and so he’s looking to get out while there’s still some value in the business.

If you’re a Siemens healthcare customer, you probably welcome this change as well. Hopefully a sale will infuse the company and the product with a new energy that will produce some better results for their customers. Maybe I’m talking to the wrong people, but those I’ve met on Sorian are basically ho-hum about the product. No doubt it will be interesting to watch.

July 9, 2014 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.

Balancing Operations with Strategic Thinking

One of the biggest challenges I see hospital CIOs facing is trying to balance the operational requirements of their organization with the high level strategic thinking that’s really needed to make an organization effective. I think we all underestimate the operational challenges that most hospital CIOs face. Most health IT organizations are relatively young and were put together at a break neck pace. This provides an exceptional challenge for hospital CIOs.

If all the hospital CIO was tasked with doing was meaningful use of a certified EHR, that could consume all of their time and it would still be a challenge to do it effectively. However, meaningful use is far from the only thing that hospital CIOs are dealing with in their organization.

Meaningful use gets all the press and so we often forget about all of the IT tasks that were originally associated with the office of the CIO. Things like managing the network, the computers, and all the other IT infrastructure has come a long way, but still requires a high quality leader to keep it up to date and working efficiently. A lot of us look at these things as commodities that every organization just has and does. This really discounts the effort and time that’s required to do this effectively.

When considering all these tasks that require the CIO’s attention, it’s no wonder that many don’t have (or don’t make) the time required to think about their organization in a strategic way. I’d suggest two ways that hospital CIOs can spend more time thinking strategically.

First, learn to delegate and trust the other leaders in your organization. This is much easier said than done. In some cases this means changing the leaders in your organization. However, more often it requires a shift in mentality as a leader. Trusting other people is hard, but absolutely necessary for you to make the most as a leader.

Second, schedule time into your calendar for strategic thinking. I assure you that you’ll feel a little odd doing this. It almost feels like you’re cheating your organization to schedule in time to work on the strategy of your organization. However, there’s definitely truth in scheduling. We do what we schedule. Just don’t cheat yourself during that time. It will be really easy for you to fudge that time and work on other things. Turn off the email. Turn off the cell phone if needed and spend the time focused on where you should take your organization.

Finding time and making an effort to not be overwhelmed by operations and think strategically is the very best thing you can do. Don’t cheat yourself or your organization by focusing on the wrong things.

July 7, 2014 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.

Large Health Facilities Have Major Patient Data Security Issues

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.

July 2, 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.

UPMC Kicks Off Mobility Program

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.

July 1, 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.

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

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.

June 30, 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.

Drop in ED Visits Post-Obamacare?

Dan Munro posted an interesting chart from Gallup that shows the percentage of uninsured in the US since 2008:
Uninsured Americans Since 2008 - Gallup
The chart clearly shows a drop in those that are uninsured. I think we can quite confidently say that this is the result of Obamacare where many uninsured Americans could get free health insurance. While many are proclaiming this data illustrates that this means that Obamacare is a success, I think the jury is still out.

In fact, this reminds me of those who consider the EHR incentive money and meaningful use a success because EHR adoption has increased. This might be true, but it might also be true that the wrong EHRs were adopted and so we wasted a lot of money encouraging the adoption of the wrong EHR. That’s just one example. It’s good that there’s been a change, but change does not always mean that we changed for the better.

Going back to the rise of the insured population in the US, I wonder if those newly insured have stopped going to the ED. That was one of the arguments that were made by proponents of ACA. Basically, the uninsured knew they could go to the ED anytime they wanted and not be turned away. Now that many of those people have health insurance, are they now going to a doctor’s office instead of the ED?

I haven’t seen any numbers that indicate this is the case. Plus, I fear that those who do switch from the ED to the doctors office will learn about deductibles and head right back to the ED.

If you have data on this trend, I’d love to see it. No doubt how this goes will have a tremendous impact on the bottom line of hospitals.

June 27, 2014 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.

The Connection of Sports and Healthcare

It seems like the soccer tide has hit the US as more and more as ESPN finally decided to broadcast the entire World Cup. The viewer numbers have been great. I expect many in healthcare will be tied to their computers or a TV in their hospital watching the US play Germany today. While not totally universal, it’s amazing the way sports can bring people together.

I was reminded of this when I saw this tweet from Mass General Hospital in Boston:

I’m a Dolphins fan, but understand why many would love to see Gronk and other Patriot players at their hospital. Pretty cool. Plus, so many hospitals are non-profits, so I guess this is considered charity work for the players. No doubt sports can be a great way for a team to bond together.

Of course, what does this have to do with healthcare IT? Nothing really. Unless you’re the IT director at a hospital that’s watching your bandwidth consumption during the 2 hours of the World Cup go through the roof. That would be interesting to see.

I guess it’s fair to say I have a bit of World Cup fever as well.

June 26, 2014 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.

A Hospital CFO Perspective on EHR Expense

The past couple days I’ve been able to enjoy a couple days sitting down with hospital CFO’s at HFMA’s ANI conference in Las Vegas. I think this is the third time I’ve attended the event and it’s always a really interesting conference since hospital CFOs have a great financial perspective into the running of a hospital.

While at the big dinner celebration they had last night at the event, I asked a hospital CFO what she thought of the event and what she’d learned. She responded:

The sessions really helped me feel good about the small investments we’ve been making in population health and analytics. I think were going in the right direction.

Then she added this after thought that was telling:

Not to mention justifying the insane amount of money we’re spending on our EHR.

I think we’ve done a really poor job of explaining why the EHR is worth the investment. Let’s be honest though. Most of the EHR implementations haven’t been about leveraging the EHR to improve the organization. They’ve been focused on the meaningful use regulatory requirements, getting the EHR incentive money, and avoiding the EHR penalties.

Going forward we’re going to have to shift our thinking. We’re going to have to do a much better job justifying the EHR expense by showing the benefits an EHR provides a hospital organization.

June 25, 2014 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.

AHA urges agencies to speed up EMR choice expansion

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.

June 23, 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.