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Hospitals Sharing More Patient Data Than Ever, But Is It Having An Impact On Patient Care?

Posted on November 1, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Brace yourself for more happy talk in a positive interoperability spin, folks. Even if they aren’t exchanging as much health data as they might have hoped, hospitals are sharing more patient health data than they ever have before, according to a new report from the ONC.

The ONC, which recently analyzed 2017 data from the American Hospital Association’s Information Technology Supplement Survey, concluded that 93% of non-federal acute care hospitals have upgraded to the 2015 Edition Health IT Certification Criteria or plan to upgrade. These criteria include new technical capabilities that support health data interoperability.

Today, most hospitals (88%) can send patient summary of care records electronically, and receive them from outside sources (74%), ONC’s analysis concluded. In addition, last year the volume of hospitals reporting that they could query and integrate patient health data significantly increased.

Not only that, the volume of hospitals engaged in four key interoperability activities (electronically sending, receiving, finding and integrating health data) climbed 41% over 2016. On the downside, however, only four in 10 hospitals reported being able to find patient health information, send, receive and integrate patient summary of care records from outside sources into their data.

According to ONC, hospitals that work across these four key interoperability domains tend to be more sophisticated than their peers who don’t.

In fact, in 2017 83% of hospitals able to send, receive, find, and integrate outside health information also had health information electronic available at the point of care. This is a 20% higher level than hospitals engaging in just three domains, and a whopping seven times higher than hospitals that don’t engage in any domain.

Without a doubt, on its face this is good news. What’s not to like? Hospitals seem to be stepping up the interoperability game, and this can only be good for patients over time.

On the other hand, it’s hard for me to measure just how important it is in the near term. Yes, it seems like hospitals are getting more nimble, more motivated and more organized when it comes to data sharing, but it’s not clear what impact this may be having on patient care processes and outcomes.

Over time, most interoperability measures I’ve seen have focused more on receipt and transmission of patient health data far more than integration of that data into EHRs. I’d argue that it’s time to move beyond measuring back and forth of data and put more impact on how often physicians use that data in their work.

There’s certainly a compelling case to be made that health data interoperability matters. I’ve never disputed that. But I think it’s time we measure success a bit more stringently. In other words, if ONC can’t define the clinical benefits of health data exchange clearly, in terms that matter to physicians, it’s time to make it happen.

My MEDITECH MD and CIO Forum Experience

Posted on October 29, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently had the pleasure of attending the annual MEDITECH MD and CIO Forum. Not only was the venue and MEDITECH hospitality great, but they also ordered up beautiful fall weather for the event in Boston. Although, I have to admit that it must be intimidating to speak at an event hosted in the round. Luckily all of the keynotes really delivered (See my post about Ted James, MD’s keynote).

As long-time readers know, there’s almost nothing better to me than attending a user conference. At user conferences, you hear the “from the trenches” perspectives on what’s life really like on the front lines of healthcare and technology. In many cases, you listen to sessions and discussions at lunch that sounds like they’re speaking another language. For the most part, that’s basically what they’re doing. The language of an EMR user is really unique and different and it’s what makes an EHR user conference like this so special. Those attending speak the same language and are able to uniquely help each other.

Given users’ propensity to share the good, the bad, and the ugly, it was really great that MEDITECH invited me to attend their MD and CIO Forum. The good news for them is that I’ve been to enough EHR user forums that I’ve heard it all. Nothing really shocks me anymore and every EHR vendor has their challenges. In one session, someone commented on the 500 open tickets they had with support. I think it kind of scared MEDITECH that I was hearing this. However, I’d recently heard from someone using their competitor’s EHR who had 4000 open tickets. Only 500 tickets sounded quite good comparatively. Perspective and nuance really matter when you talk about problems. That’s something that’s often missed by many media these days.

While at the Forum, MEDITECH made a number of interesting announcements. Read on for details below and check out the 4 video interviews we live streamed from the conference on Facebook. The biggest announcement from my viewpoint was around voice enabling the MEDITECH EHR software. Together in partnership with Nuance, MEDITECH created a simple way for users to request information from the EHR using their voice and even to create orders. On the mobile side, they’re creating similar functionality in partnership with Google’s voice recognition. No doubt this is just the start of voice enabling the EHR.

It’s easy to see how voice will become really valuable if providers are able to get information and create orders while their hands are tied up examining the patient. MEDITECH was also smart about the voice created orders. It doesn’t just order things automatically but queues up those orders for the doctors to approve later. This is a common step we’ve seen smart vendors take when adding voice and other AI to the documentation process. We’ll see over time whether the accuracy and trust reach the point that this human verification process is no longer needed.

MEDITECH also announced a number of things around interoperability. First, outbound FHIR integrations are included in every MEDITECH EHR. Plus, they’re working on inbound FHIR integrations. They didn’t set a timeline on inbound integrations but they did say they’d be “coming soon.” MEDITECH also talked about their new API called MEDITECH Greenfield. If you want more information on Greenfield, be sure to read our interview with Niraj Chaudhry where we cover it in detail.

Another interesting announcement was MEDITECH’s new population health oriented integration with Arcadia.io. It’s great to see MEDITECH embracing outside third party data that can help their users provide better care to patients. Plus, the integration looked really seamless from a physician user perspective.

Another big takeaway for me came from a session on governance and end user buy-in. The takeaway was simple. Enduser buy-in and governance are a challenge regardless of what EHR system you choose. To get more specific insights into how to improve buy-in and governance in your organization, check out the live tweets I shared on the #MDCIO2018 hashtag on Twitter.

A few other observations from the event are that I don’t think most people appreciate what a huge step forward Expanse (their latest EHR platform) is for MEDITECH and their users. I’ve often written that there’s no one feature about EHR software that’s hard to implement. However, it’s the 1000 features you need to create a complete EHR that makes it such a challenge. It was a pretty brave thing for a 50-year-old company, MEDITECH, to go back and start nearly from scratch using the latest technology to create Expanse. That means that Expanse is still a work in progress where they’re adding features as fast as they can. However, it also is true that it might be the only EHR software that was built in the post-meaningful use era.

I was also surprised by a number of users I talked to who commented on how the price of MEDITECH really mattered to their organization. I’m not sure if these organizations had read the many stories of expensive EHR implementations damaging healthcare organizations financially or if they were just more fiscally conservative organizations. Either way, you could tell these users appreciated that MEDITECH charged a much lower price for their software than other EHR competitors out there.

All in all, I had a great experience at the MEDITECH MD and CIO Forum. Their users really reflect the culture of MEDITECH. They’re largely unassuming and just want to do what’s best for their patients. It was actually fascinating to see how the same cultures seemed to attract. No doubt, their users were still suffering from burnout like so many others. That’s common across all of healthcare. They also still had their long list of features and functions they wanted to be implemented. However, I have yet to attend an EHR user conference where that wasn’t the case.

Note: MEDITECH is a sponsor of Healthcare Scene.

AI Project Set To Offer Hospital $20 Million In Savings Over Three Years

Posted on October 4, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While they have great potential, healthcare AI technologies are still at the exploration stage in most healthcare organizations. However, here and there AI is already making a concrete difference for hospitals, and the following is one example.

According to an article in Internet Health Management, one community hospital located in St. Augustine, Florida expects to save $20 million dollars over the next the three years thanks to its AI investments.

Not long ago, 335-bed Flagler Hospital kicked off a $75,000 pilot project dedicated to improving the treatment of pneumonia, sepsis and other high mortality conditions, building on AI tools from vendor Ayasdi Inc.

Michael Sanders, a physician who serves as chief medical informatics officer for the hospital, told the publication that the idea was to “let the data guide us.” “Our ability to rapidly construct clinical pathways based on our own data and measure adherence by our staff to those standards provides us with the opportunity to deliver better care at a lower cost to our patients,” Sanders told IHM.

The pilot, which took place over just nine weeks, reviewed records dating back five years. Flagler’s IT team used Ayasdi’s tools to analyze data held in the hospital’s Allscripts EHR, including patient records, billing, and administrative data. Analysts looked at data on patterns of care, lengths of stay and patient outcomes, including the types of medications docs and for prescribing and when doctors were ordering CT scans.

After analyzing the data, Sanders and his colleagues used the AI tools to build guidelines into the Allscripts EHR, which Sanders hoped would make it easy for physicians to use them.

The project generated some impressive results. For example, the publication reported, pathways for pneumonia treatment resulted in $1,336 in administrative savings for a typical hospital stay and cut down lengths of stay by two days. All told, the new approach cut administrative costs for pneumonia treatment by $800,000.

Now, Flagler plans to create pathways to improve care for sepsis, substance abuse, heart attacks, and other heart conditions, gastrointestinal disorders and chronic conditions such as diabetes.

Given the success of the project, the hospital expects to expand the scope of its future efforts. At the outset of the project, Sanders had expected to use AI tools to take on 12 conditions, but given the initial success with rolling out AI-based pathways, Sanders now plans to take on one condition each month, with an eye on meeting a goal of generating $20 million in savings over the new few years, he told IHM.

Flagler is not the first, nor will it be the last, hospital to streamline care using AI. For another example, check out the efforts underway at Montefiore Health, which seems to be transforming its entire data infrastructure to support AI-based analytics efforts.

New MEDITECH EHR API – An Interview with Niraj Chaudhry

Posted on October 2, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The EHR API has been a hot topic lately. Many healthcare organizations and startup companies are looking to EHR vendors in order to connect applications that exist outside the EHR with the EHR. Years ago (2012 to be exact), I wrote that the EHR is the database of healthcare and with all of these APIs coming out, we’re seeing that come to fruition.

The good news is that EHR vendors are finally starting to embrace this viewpoint as well. Many of you have probably read Colin Hung’s article that looks at 2 EHR vendors and their APIs. Many of you probably saw the announcement of MEDITECH’s new app development environment called MEDITECH Greenfield. It’s great to see MEDITECH launching an API for developers who want to engage with their Expanse platform. To learn more about this new platform, we sat down with Niraj Chaudhry, Director of Development Advanced Technology Division from MEDITECH.

What’s the motivation for MEDITECH to launch Greenfield?

Interoperable, open architecture EHR platforms that promote sharing resources for collective growth are critical for driving innovation and progress in today’s healthcare paradigm. By offering a space for mobile app development, MEDITECH is adding more capabilities and value to our customers’ EHRs and driving efficiencies for better community outcomes. Our customers will be able to enhance the EHR experiences of their providers, patients, and consumers with innovative apps available on any mobile device.

Greenfield is a natural extension of what we’ve done with MEDITECH Expanse and reinforces our commitment to a mobile, web-based EHR. We are excited about working with third-party developers and increasing our visibility with the creation of apps to augment Expanse.

What data will developers be able to access through Greenfield?  Is it a read-only environment or will developers be able to write back to MEDITECH using the Greenfield API as well?

Currently, our testing environment includes a list of available Common Clinical Data Set APIs and associated documentation. These APIs support GET methods and so give read-only access to the data. Developers can register now to get started. More APIs will be added to the Greenfield in future which will support other methods such as PUT and POST, and so will allow the ability to write data back to the Greenfield environment.

Will Greenfield only work with Expanse or will it work with other MEDITECH products?

Currently, MEDITECH Greenfield is available to MEDITECH Expanse customers.

Are there costs associated with companies participating in Greenfield (ie. signup and/or usage)?

There are no costs to sign up, access or use Greenfield.

What type of promotion will you do for companies who choose to leverage MEDITECH Greenfield in their application? What are you planning to do so MEDITECH users learn about new partners?

In the future, we plan on highlighting select (or “preferred”) mobile apps that we feel add significant value to the MEDITECH platform. This is still in the very early stages and business models for how we will list or promote apps are being discussed.

Will any company be able to sign up for Greenfield or will you restrict it to a certain number of companies or certain types of companies?

Any interested developers can sign up for access through a secure login process here.

Underwhelming Epic Patient Engagement Features from #UGM2018

Posted on August 30, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

John Moore has been live-tweeting the Epic User Group meeting happening this week in Wisconsin. John has shared a lot of interesting perspectives, but I was quite intrigued by this picture he shared of the “Really Cool Software In the Works.” Presumably, these are the big new patient experiences features that will be coming to an Epic EHR software near you.

*Yes, that is Judy at the bottom of the big screen presenting these changes and yes she is dressed up like a park ranger. This year’s Epic User Group theme was The Great Outdoors.

It’s nice to see Epic focusing efforts on the patient experience, but am I the only one that was totally underwhelmed by this graphic?

Let’s start with MyChart Bedside on smartphones. You can see a preview of this here. It’s interesting that Epic chose to create a product like this rather than partnering with companies like Oneview or TVR Communications who already have similar products that would work even better with a nice Epic integration. This is why Epic should embrace an open ecosystem for partners.

The announcements around “Get Rid of Clipboards” and “Skip the Waiting Room” are underwhelming as well. I’ve known companies that have had this solution for a decade or so. Epic is just getting them now?

I have a hard time judging the “Catch a Ride” and “Patient-Entered Social Determinants” features. I’m still not convinced how an Epic connection to Lyft and Uber is going to help patients. How many hospitals will really adopt this and will hospitals really start paying for patients rides with this? If they will, why didn’t hospitals just buy cab rides for patients in the past? Will an integration with Epic change that?

As far as patient-entered SDoH (Social Determinants of Health for those following along at home), are patients really going to do this? Once they do, what will the doctor do with this information? Nothing? On the less pessimistic side, as a fact-finding approach, this could be interesting. Assuming patients are willing to share this information (which may be possible in this world of over sharing) this could be a way to discover what SDoH are most prevalent in an area so that hospitals can then find ways to alleviate these challenges.

Finally, the “Talk to MyChart” feature. We’ve long heard that voice was coming to EHR software. Yes, I’m talking beyond the voice recognition that every EHR software has had forever. First, let me share that I’m a huge proponent of voice. It’s amazing the way Alexa has changed my and my family’s lives. I could be wrong, but the feature mentioned above feels like they’ve just voice enabled MyChart. Is it really that much easier to use voice in MyChart? Even if I enjoy the “pleasant voice”? Color me skeptical that this will really change any behavior. If Epic wanted a big voice empowered announcement it should have been being able to access MyChart through Alexa or Google Home (I’m pretty sure Epic would blame HIPAA on this one). That would be a really cool software.

Of course, here I’m just analyzing one slide in Judy’s presentation. I think John Moore commented that the analytics looked promising, but then he hedged the comment by saying that it was better than their competitors.

What can I say? Epic has made billions. I guess I just expect more from them.

Facebook Partners With Hospital On AI-based MRI Project

Posted on August 23, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

I’ve got to say I’m intrigued by the latest from Facebook, a company which has recently been outed as making questionable choices about data privacy. Despite the kerfuffle, or perhaps because of it, Facebook is investing in some face-saving data projects.

Most recently, Facebook has announced that it will collaborate with the NYU School of Medicine to see if it’s possible to speed up MRI scans.  The partners hope to make MRI scans 10 times faster using AI technology.

The NYU professors, who are part of the Center for Advanced Imaging Innovation and Research, will be working with the Facebook Artificial Intelligence Research group. Facebook won’t be bringing any of its data to the table, but NYU will share its imaging dataset, which consists of 10,000 clinical cases and roughly 3 million images of the knee, brain and liver. All of the imaging data will be anonymized.

In taking up this effort, the researchers are addressing a tough problem. As things stand, MRI scanners work by gathering raw numerical data and turning that data into cross-sectional images of internal body structures. As with any other computing platform, crunching those numbers takes time, and the larger the dataset to be gathered, the longer the scan takes.

Unfortunately, long scan times can have clinical consequences. While some patients can cope with being in the scanner for extended periods, children, those with claustrophobia and others for whom lying down is painful might have trouble finishing the scanning session.

But if MRI scanning times can be minimized, more patients might be candidates for such scans. Not only that, physicians may be able to use MRI scans in place of X-ray and CT scans, both of which generate potentially harmful ionizing radiation.

Researchers hope to speed up the scanning process by modifying it using AI. They believe it may be possible to capture less data, speeding up the process substantially, while preserving or even enhancing the rich content gathered by an MRI machine. To do this, they will train artificial neural networks to recognize the underlying structure of the images and fill in visual information left out of the faster scanning process.

The NYU research team admits that meeting its goal will be very difficult. These neural networks would have to generate absolutely accurate images, and it’s not clear how possible this is as of yet. However, if the researchers can reconstruct high-value images in a new way, their work could have an impact on medicine as a whole.

Who is the Real EHR Customer?

Posted on August 2, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

What a fascinating question from Clay Forsberg. In my experience writing about the EHR space, the EHR customer is the healthcare provider and not the patient. In fact, I think the impact on patients played a very small role in most EHR implementations. I don’t remember ever seeing an EHR RFP that had much of any focus on the patient. The closest you might come is that the EHR would need to have a patient portal or something along those lines. Have you seen patient focused sections of EHR RFPs? If so, I’d love to see them. If not, I’d love to see it too.

When EHR software was first being purchased (technically it was EMR at the time), the decision was largely around how they could better handle things like E/M coding and being able to use the automation in the EHR to be able to bill for higher levels of care (ie. more money). This is what’s led us to EHR note bloat.

Following this EHR era was what I call the golden age of EHR adoption fueled by $36 billion of meaningful use money. I was shocked at how irrational the market became as doctors chased EHR software that would get them access to the meaningful use dollars and avoid any penalties. There was no time for doctors that purchased EHR software in this era to really think about patients. They were too focused on the government handouts.

Long story short, the patient has generally been far from the thoughts of those purchasing EHR software. Don’t get me wrong. I don’t think most people purchasing EHR wanted to recklessly damage the patient. In fact, EHR benefits the patients in a lot of ways (access to the records is one example). However, it’s not any stretch to say that those selecting and implementing EHR software weren’t trying to improve the patient experience. If it was, they would have made different choices.

The question is will this change in the future. Or maybe even more importantly is will EHR vendors be able to evolve in a way that patients will benefit. I think we will see some evolution in this regard, but I don’t expect to see a sea change when it comes to EHR software’s focus on the patient. I think instead we’ll see 3rd party software that will change the patient experience. Some of them will integrate with EHR software which is why EHR APIs are so important, but I’m not looking for the EHR to make the patient their customer. Maybe they should, but I don’t see it happening.

Switch From Epic To Cerner Comes With Patient Safety Questions

Posted on July 25, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s a story in which no health system hopes to take a lead role — the tale of a Cerner installation that didn’t go well and the blowback the system faced afterward.

On October 1 of last year, Phoenix, Az.-based Banner Health switched its Tucson hospitals from Epic to a Cerner system, a move which reportedly cost the health system $45 million.

No doubt, the hospitals’ staff and physicians were trained up and prepared for a few bumps in the road, particularly given that the rest of its peers had already gone to the process. The Phoenix-based not-for-profit, which owns, leases or manages 28 acute-care hospitals in six states, had already put the Cerner system in place elsewhere, apparently without experiencing any major problems.

But this time it wasn’t so lucky, according to an article in the Arizona Daily Star. According to the news item, there were “numerous” reports of medical errors filed with the Arizona Department of Health Services after Tucson-area hospitals in the Banner chain were cut over to Cerner.

The complaints included claims that errors were creating patient safety and patient harm risks, according to one filing. “Many of the staff are in tears and frustrated because of the lack of support and empathy [for] the consequences [to] patient care,” one stated.

Not only did the conversion lead to patient safety accusations, it also seems to have lowered physician productivity and shrunk revenue as doctors learned to use the Cerner interface. While predictable, this has to have added insult to injury.

Meanwhile, according to the paper, the state seems to come down on the side of the complainants. While hospital leaders denied there were any incidents resulting in a negative outcome for patients, “the hospital’s occurrence log for October 2017 showed numerous incidents of medical errors reported to be a result of the conversion,” state investigators reportedly concluded.

While the state didn’t fine Banner or issue a citation, it did substantiate two allegations about the conversion, the Star reported. The allegations were related to computer/printer glitches impacting patient care and an inability to reliably deliver medications and order tests as part of care for critically ill patients.

The article says that Banner responded by pointing out that it has made more than 100 improvements to the Cerner system, resulting in better workflows and greater information access for physicians and staff. But the damage to its reputation seems to have been done.

No, perhaps Banner didn’t do anything particularly wrong when it installed the Cerner platform. However, if its leaders did, in fact, lie to the state about problems it actually had, it was not a smart move. On the other hand, one of the biggest problems you can have during an EHR implementation is users who don’t want to cooperate and make it a success. It’s not hard to see users who were happy with Epic dragging their feet as they shifted to Cerner. Either way, this is an important lesson as hospitals continue to consolidate and they consider switching the EHR of the acquired hospitals.

“We’re Goin’ Live with Epic Now” – An EHR Go-live Parody Video

Posted on May 25, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Many of you may remember the Hamilton parody video that Mary Washington Healthcare did back when they selected Epic as their new EHR. Well, Mary Washington Healthcare’ CEO, Mike McDermott, and his Epic team are back again with another Hamilton parody video as they go live on Epic. Check out the video below:

I’m sure many people wonder why a healthcare leader would engage their employees in a video like this. Many underestimate the value of bringing a team together to create a project like this. It’s an extremely valuable team building experience. Plus, it’s nice to have a little fun together when dealing with something as grueling as an Epic EHR implementation.

Furthermore, one of the keys to effectively implementing an EHR is creating a deep relationship with your EHR vendor. There are always problems that come up where you need your EHR vendors support to solve the problems. What better way to get noticed and appreciated by your EHR vendor than to create a video like the one above?

Nice work to the team at Mary Washington Healthcare for creating such a great video. I especially like the drone shots and the shout out to the Epic employees not dressed in the period clothes like everyone else.

In The Aftermath Of Sutter Health EMR Crash, Nurses Raise Safety Questions

Posted on May 24, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In mid-May, Sutter Health’s Epic EMR crashed, accompanied by other technical problems. Officials said the system failures were caused by the activation of the fire suppression system in one of their IT buildings.

As you might expect, employees at locations affected by the downtime weren’t able to access patient medical records. On top of that, they didn’t have access to email or even use their phones. In addition, the system had to contact some patients to reschedule appointments.

On the whole, this sounds like the kind of routine issue which, though embarrassing, can be brought to heel if an organization does the disaster planning and employee training on how to react to the situations.

According to some nurses, however, Sutter Medical Center may not have handled things so well. The nurses, who spoke on condition of anonymity with The Sacrament Bee, told the newspaper that the hospital moved ahead with some forms of care before the outage was completely resolved.

The nurses told that when some patients were admitted after the systems failure, clinicians still didn’t have access to critical patient information. For example, a surgical nurse noted that the surgical team relies upon EMR access to review patient histories and physicals performed within the previous 30 days. According to Sutter protocols, these results need to be certified by the physician as still being valid on the date of surgery.

Instead, patients were arriving with their histories and physical exam records on paper, and those documents didn’t include the doctor’s certification that the patient’s condition hadn’t changed. If something went wrong during elective surgery, the team would’ve had to rely on paper documents to determine the cause, the nurses said.

They argue that Sutter Medical Center shouldn’t have taken those cases until the EMR was fully online. “Other Sutter hospitals canceled elective surgeries,” one nurse told a reporter. “Why did Sutter Medical Center feel like they needed to do elective surgeries?”

Also, they say that at least one surgical procedure was affected by the outage, when a surgeon needed a particular instrument to proceed. Normally, they said, operating room telephones display a directory of numbers to supply rooms or nurse stations, but these weren’t available and it forced the surgical team to break its process. Under standard conditions, the team tries not to leave the operating room because a patient’s condition can deteriorate in seconds. In this case, however, a nurse had to hurry out of the room to get instruments the surgeon needed.

While it’s hard to tell from the outside, this sounds a bit, well, unseemly at best. Let’s hope Sutter’s decision-making in this case was based on thoughtful decisions rather than a need to maintain cash flow.

Let this also be an important reminder to every healthcare organization to make sure you have well thought out disaster plans that have been communicated to everyone in your organization. You don’t want to be caught liable when disaster strikes and your staff start free wheeling without having thought through all of the potential consequences.