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A Culture of Patient Safety

One of the challenges with some health IT organizations is that they weren’t built from the ground up with a culture of patient safety in mind. There are certain aspects of an organization that need to become embedded in their culture for them to be a reality. Patient Safety is one of them. Privacy and security are another example.

The beautiful part is that once patient safety, privacy, security, etc become an embedded part of your culture, then amazing results happen.

Today I came across this incredibly compelling blog post on the Virginia Mason blog titled, “Terrible tragedy – and powerful legacy – of preventable death.” I love when hospitals are open and transparent like Virginia Mason is in that blog post. Ironically, their blog post is about transparency at an organization and the benefit to the organization. However, this line from the blog post struck me:

“Our board said that if we cannot ensure safety of our patients we shouldn’t be in business.”

-Cathie Furman, RN

This is a powerful question that makes me wonder how many companies shouldn’t be in business.

March 27, 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 HIPAA Compliance Dashboard

One of the interesting announcements coming out of HIMSS was a HIPAA Compliance Dashboard that was announced by INetU. The concept of a dashboard that shows you your HIPAA compliance is fascinating for me. The key question I’ve asked myself is can HIPAA compliance be automated into a dashboard?

Here’s a look at the HIPAA Compliance Dashboard they’ve created:

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INetU claims that the dashboard will keep track of both the business associate’s (in this case INetU’s) HIPAA compliance and the covered entities compliance with HIPAA. I need to dig into it some more, but I’d love to hear from some other HIPAA experts out there. Aren’t there pieces of HIPAA compliance that can’t be automated to a dashboard? I’d love to be proven wrong.

I also think the Dashboard is a nice building block to doing security beyond just HIPAA. It reminds me of this post titled, “Why HIPAA isn’t Enough to Keep Patient Data Secure.” This dashboard could provide a deeper look into security beyond just HIPAA. Although, it makes sense why they’re leading with HIPAA since organizations don’t mind coughing up money to ensure their HIPAA compliant.

What do you think of this idea? Can HIPAA Compliance benefit from a dashboard like this? Of course, this can be taken too far as well. We don’t need CIO’s that become complacent, because the dashboard says “HIPAA Compliant.”

March 26, 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.

Interview with Shahid Shah About HealthIMPACT Conference

The following is an interview with Shahid Shah about the upcoming HealthIMPACTconferences he’s helping to organize. The next one is in Houston on April 3rd and a few discount seats for HealthcareScene readers remain open. Register here using IMPACT10 as the code.

It seems like there is a health IT conference every day.  What will make this conference unique?

The first thing unique about HealthIMPACT is the length and locations – we’re choosing single day and “local” to many areas of the country (southeast, southwest, etc.) because busy people can’t take more than 1 day and probably can’t afford to travel. The second unique aspect is that we’re focused on “actionable intelligence” coming not from pontificators but those “in the trenches” doing the grunt work of health IT every day. The third, and perhaps the most unique, is that we teach audiences what kinds of tech to buy, what not buy, how to spot real trends from hype, and how not to fall prey to prevailing myths. This is going to be a no-nonsense, no fluff, no hype, “just answers” event. It’s not so much a “conference” but an educational event – audience members can even earn CME credits if they’d like. The fourth, and something useful for software and technology vendors and buyers alike, is a customized meeting with one or more CIOs or other tech-focused buyers that developers can use as a mini “focus group” to test ideas and ask buyers questions that will help improve products and sales.

What’s special about the format of the conferences?

The format is “no long speeches, no PowerPoint-centric presentations, all panels and interviews with high interactivity”. By making sure that there are no speeches we don’t have to worry about “death by PowerPoint” or folks presenting a viewpoint that audiences can’t easily interact with. The panels topics are focused on problems that audience members are regularly facing in their daily work environments. The panel members are all working “in the trenches” and coming prepared to interact with the audience. That’s why we say “no fluff, just answers”.

What kind of audience attends your conferences?

We have a list of attending organizations and their titles available here. We get CIOs, CFOs, CTOs, HIM, architects, engineers, consultants, and product vendors from both hospital / health system and ambulatory physician practices. It’s a mixed audience but I think what’s in common is that they’re all “in the trenches” folks solving hard technical problems every day.

What are some of the main topics that will be discussed at these conferences?

  • How IT can support the overarching financial, operational, and clinical goals of your organization
  • HIEs in your region and provider participation in them
  • Technologies that support value driven care and population health management
  • Cloud based systems in healthcare
  • Programs that drive patient engagement
  • Leadership strategies that drive innovation
  • Predictive analytics that improve care delivery
  • EHR implementation and meaningful use
  • ICD10 compliance, readiness and physician training

Where can people go to learn more about the conferences?
You can find more information on the HealthIMPACT website and if you use the discount code IMPACT10, you’ll receive a 10% discount for being a Healthcare Scene reader.

March 25, 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.

The Hospital CIO Is a Salesperson

When you look at the job of a hospital CIO, I think their number one job is as a salesperson. A hospital CIO’s day is full of sales meetings. I’m sure that many won’t like to see it that way, but it’s true.

Think about the hospital CIO budget. The hospital CIO’s job is to sale the budget to the other hospital executives. If they don’t do a good job selling the budget to the executives, then you might not get the budget you need and then you’ve got other issues. In fact, the biggest issue you have to face is how you’re going to sell the smaller budget to the people who work for you.

Another important job of a hospital CIO is to set the vision for the organization. Making sure everyone in the organization is proverbially “paddling in the same direction” is fundamental to leadership in general and particularly to a hospital IT organization. How do you make sure that your vision is understood and executed by your organization? That’s right, you have to sell it to them.

Hiring the right people is also crucial to the success of a hospital CIO. Convincing the best people to come and work for you instead of someone else is a sales job of the highest degree. Ok, you get the point. A hospital CIO is a salesperson.

If you haven’t brushed up on your sales skills lately, you might want to expand your reading and consider some reading focused on selling techniques. The dynamics of what a hospital CIO sells are different and maybe no money changes hands in the transaction. However, you can be sure that every successful CIO is a good salesperson.

March 21, 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.

Healthcare Analytics is a Big Privacy Issue

Coming out of HIMSS, everyone said that healthcare analytics was a major discussion. I talked to someone from Allscripts today and they quoted me that something like 42% of their business is coming from population health (analytics, patient portal, and HIE) functionality. Today someone else told me that the future of healthcare IT is going to really be around analytics and how we use the data. When you think about future revenue streams, the data is likely going to be the center of most business models.

Analytics is going to play a major role in the future of health IT and I believe will lead to really important improves in the care patients receive. My guess is that one day we’ll look back on the EHR of today and wonder how we saw patients with such limited data and intelligence built into the EHR.

However, Sheri Stoltenberg from Stoltenberg Consulting made a great comment to me at HIMSS which is the title of this blog post: Healthcare Analytics is a Big Privacy Issue.

While we love to talk about the benefits of big healthcare data and the value of healthcare analytics, it’s also got a lot of big privacy issues that I think we’re going to need to address. Many will argue that we already have HIPAA and that should be enough. Certainly it will provide the framework for privacy and security of healthcare data and analytics. However, that’s likely going to need to evolve as the healthcare analytics involves. I’m not sure we even know the issues that healthcare analytics will pose to privacy in 5 years. Unfortunately, I don’t see HIPAA being able to keep up with it.

If the healthcare IT industry were smart, it would start working together and appropriate privacy and security within healthcare analytics. If they don’t, be ready for the government to step in and impose it on them. We know how that usually works out.

Hopefully this blog post will be inspiration for every organization to consider the privacy and security issues associated with their healthcare analytics.

March 18, 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.

Will TouphPads Finally Replace Computers on Wheels (COWS)?

I know that everyone hates the term COWS (Computer on Wheels). Feel free to call them some other variation, but we all know what we’re talking about (just like if you say EHR or EMR). Either way, they’re a mainstay of so many hospitals and they are some of the most beloved and hated devices by those who use them.

They love having everything available to them. They hate pushing, pulling, cajoling around the unit. It’s a true love-hate relationship for so many.

Many have called for the demise of COWS for a long time and most point to mobile devices as their obvious replacement. However, those that realize how many non-computer peripherals are attached and used on a COW know that the COW is still going to be a mainstay in many organizations for years to come.

I was recently talking with the people at Panasonic about their new ToughPad Tablets(pictured below).
Panasonic-ToughpadFZM1-1

There’s a whole lot to like about the Panasonic ToughPad tablets. At the event I saw the tablets, I literally saw a journalist from India throw it to the ground and then step on it. To the Panasonic reps delight, he picked it up and the tablet was still ticking with no issues. Pretty amazing demo of the toughness of the device. I’m sure healthcare would test it similarly. I’ve also written previously about the iPad Lifecycle versus Other Tablets so I won’t cover those benefits of the Windows 8 O/S on the ToughPad. However, they are a really important consideration.

Instead, I was intrigued by the idea that the ToughPad could essentially be the brain of the COW. So, you could plug it into the COW whenever needed, but if you needed the mobility of the tablet you could use it that way as well.

The reason this was never done before is that the Windows 8 tablets never had enough processing power, RAM, etc to handle the health IT applications that hospitals wanted to place on them (We’ll save the discussion of processor and memory hungry health IT applications for a future post). The ToughPad could change that since they’ve finally put enough into the device to make this a possibility.

I’ll be interested to hear from others working on this problem. Does this seem like a reasonable alternative? Will the ToughPad just get left in the COW and never be taken out? If so, then you’re at least making the COW lighter, but it might not be worth the added expense. Unless you ask the nurse after a long day pushing around a COW.

I don’t see the tablet being a replacement for that many COW, but I could see this interesting tweak in the computer on wheels implementation.

March 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.

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.