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Apparently, Hospital EHR Use Still Has A Long Way To Go

Posted on August 20, 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.

It’s fairly easy to look back at the progress hospitals have made with EHR use and be impressed. In less than 10 years, most hospitals have gone from largely paper-based processes to relying on EHRs to support a wide range of clinical processes. Even given that hospitals got meaningful use incentives for EHR adoption it’s still a big deal.

That being said, we’ve still got a long way to go before hospitals exploit EHRs fully, according to a new research study. The study, which appears in the Journal of Medical Internet Research, concludes that it will take until 2035 for the majority of hospitals to put a fully mature EHR infrastructure in place.

To conduct the study, researchers relied on the HIMSS Electronic Medical Record Adoption Model (EMRAM) dataset, which ranks a hospital’s adoption of varied EHR functions considered important to hospital care quality and efficiency. The researchers sifted through EMRAM data for 2006 to 2014 and then leveraged them to predict future adoption levels through the year 2035.

After analyzing the data, the research team found that the majority of US hospitals were in EMRAM Stages 0, 1 and 2 in 2006 and that by 2014, most hospitals had achieved Stages 3, 4 and 5. Having analyzed this data, researchers predicted that Stage 5 use should peak by 2019 and Stage 6 levels of use by 2026.

Where things really start to get interesting is the path from Stages 5, 6 or 7 EMRAM. The study concluded that while most hospitals would reach these stages by 2020, a “considerable” share of hospitals won’t achieve Stage 7 by 2035.

It’s no surprise to read that as the level of sophistication needed grows, the number of hospitals that have achieved it tails off, with just a few likely to hit the prized Stage 7 in the near future. Developing a mature infrastructure calls for an infusion of time, talent and funding, and even resource-rich health systems might not have all three at the same time.

Also, given that one of the key requirements of Stage 7 is having interoperability functionalities in place, it’s easy to see why many hospitals won’t get there anytime soon. Heck, there’s good reason to wonder whether the bulk of hospitals will ever achieve interoperability, at least as it’s currently defined.

But do we need to measure everything by EMRAM standards? I don’t know, but it does seem that the question worth asking after defaulting to these measures for many years.

Don’t get me wrong – I’m not an EMRAM critic. It certainly seems to have done a good job of tracking hospital EHR progress for quite some time and it can be used by leaders to create a common goal for a healthcare organization. On the other hand, if it predicts that it will take more than a decade for hospitals to develop a mature EHR ecosystem, despite their pouring endless resources into the game, maybe it’s worth reevaluating this model. Just a thought.

Is It Worth The Trouble To Drop Fax Use?

Posted on August 17, 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.

Not long ago, ONC held its 2nd Interoperability Forum in Washington, DC. One of the big ideas being kicked around at the event was killing the use of fax machines to share health data.

During her keynote address, CMS leader Seema Verma went so far as to say that she’d like to see all provider organizations go fax-free by 2020. Apparently, Verma wants providers to switch to other means of digital information sharing.

Sounds good, right?  Well, maybe not. Despite its flaws, faxing does have the advantage of being easy to use, available in virtually every provider office and fairly reliable. I’m not sure we can say that about most other forms of digital health data exchange. In fact, dropping faxing may leave doctors with bigger problems than they had before.

After all, before we stop faxing, we’ll have to find a digital document format that plays nicely with other systems and makes patient information easy to access. That, not surprisingly, may be tougher than it sounds.

I particularly like the way Jay Anders, MD, broke these issues down in a recent email message. Anders, chief medical officer of Medicomp Systems, makes the following observations:

  • E-paper may not be interoperable: In fact, it may create new barriers to data sharing, he suggests: “Electronic paper is not effective. It [can] create a data tsunami in healthcare – a flood of clinical data that physicians cannot access at the right time with the right patient.”
  • Free text is a burden: While e-documents may be easy to pass back and forth, making use of the data within can be really tough, he says. “When the EHRs receive these PDFs with mountains of free text, how do they interpret that data? How do they present that data to physicians? How do they make that data into actionable information?

His bottom line here is that while providers can use e-documents to share data, there’s no point in trying unless they can offer useful information at the point of care.

After taking in Anders’ questions, I have another one of my own. If providers will still need to go through contortions to extract data from e-documents, how is that better than using faxes? After all, if you run faxed documents through a sophisticated OCR process, you can capture and even format health data information.

In other words, given the issues inherent in using digital documents, putting faxing to bed may not be worth the trouble. I have to agree with Anders’ conclusion: “So, how does sending electronic communication of scanned PDFs rather than faxes enable interoperability? The answer is that it doesn’t.”

For another view on Seema’s comments and the fax machine in healthcare, check out John Lynn’s post on the real problem when it comes to replacing fax machines in healthcare.

Within Two Years, 20% Of Healthcare Orgs Will Be Using Blockchain

Posted on August 16, 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 don’t know about you, but to me, blockchain news seems to be all over the map. It’s like a bunch of shiny objects. Here! Look at the $199 zillion investment this blockchain company just picked up! Wow! Giant Hospital System is using blockchain to automate its cafeteria! And so on. It gets a bit tiring.

However, I’m happy to say that the latest piece of blockchain news to cross my desk seems boring (and practical) in comparison. The news is that according to a Computerworld piece, 20% of healthcare organizations should be using blockchain for operations management and patient identity by 2020, or in other words within two years. And to be clear, we’re talking about systems in day-to-day use, not pilot projects.

The stats come from a report by analyst firm IDC Health Insights, which takes a look at, obviously, blockchain use in the healthcare industry. In the report, researchers note that healthcare has been slower out of the blockchain gate than other industries for reasons that include regulatory and security concerns and blockchain resource availability. Oh, and while the story doesn’t spell this out, good ol’ conservative decision-making has played its part too.

But now things are changing. IDC predicts that in addition to supporting internal operations, blockchain could form the basis for a new health information exchange architecture. Specifically, blockchain could be used to create a mesh network capable of sharing information between stakeholders such as providers, pharmacies, insurance payers and clinical researchers, the report suggests. This architecture could be far more useful than the existing point-to-point approach HIEs use now, as it would be more flexible, more fault-tolerant and less prone to bottlenecks.

As part of the report, IDC offers some advice to healthcare organizations interested in taking on blockchain options. It includes recommendations that they:

  • See to it that any blockchain-related decisions are evidence-based and informed and that stakeholders share information about the pros and cons of blockchain interoperability freely
  • Develop a blockchain interoperability proof of concept which demonstrates how decentralized, distributed and immutable properties could make a contribution
  • Pitch the benefits of blockchain interoperability to providers and patients, letting them know that it could eliminate barriers to getting the data they need when and where they need it
  • Adopt blockchain interoperability early if at all, as this can offer benefits even prior to implementation, and gives leaders a chance to tackle concerns privately if need be

Of course, these suggestions and factoids barely scratch the surface of the blockchain discussion, which is why IDC gets $4,000 a copy for the full report. (Though I should note that the article goes into a lot more depth than I have here.)

Regardless, what came across to me from the article was nonetheless worth thinking about when kicking around possible blockchain strategies. Broadly speaking, providers should get in early, keep everyone involved (including patients and providers ), work out differences over its use privately and see to it that your rollout meets concrete needs. You may want to also read this article on 5 blockchain uses for healthcare. It may not be in places you’d have thought previously.

And now, back to silly blockchain news. I’ll let you know when another set of practical ideas shows up.

Healthcare Scene Meetup in Chicago

Posted on August 14, 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’m always amazed at the power of meeting up with people in the world of Healthcare IT. It’s a surprisingly small world and it’s always great to mix and mingle with colleagues who work in the field. Often this is at big conferences, but it’s also fun to bring the community together in more informal settings near their home.

That’s why I’m excited to share that Healthcare Scene will be doing an informal meetup next week in Chicago. The meetup is happening Thursday, August 23, 2018 at Vapiano. You can find all the details and register for the event here.

One of the amazing things about the Healthcare Scene community is that we include a wide cross section of people. This is particularly true when you include the various social media communities including the #HITsm, #hcldr, and #HITMC communities as well. If you live in or near Chicago, we hope you’ll join us for a fun night of networking and connecting with those in the community.

If you can’t join us in Chicago, be sure to keep an eye on our list of Healthcare IT Conferences and Events. We’re about to update it with our Fall schedule of conferences and events. No doubt we’ll be coming to a city near you. We love meeting readers in person, so please let us know if you’ll be at an event.

What events are you planning to attend this Fall 2018 and in 2019? Are there other events we don’t have on our list that we should include? Which events do you find most valuable and why? Share with us your thoughts and perspectives in the comments or on social media with @HealthcareScene.

Hospitals That Share Patients Don’t Share Patient Data

Posted on August 7, 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.

If anyone in healthcare needs to catch up on your records, it’s another provider who is treating mutual patients. In this day and age, there’s no good reason why clinicians at one hospital should be guessing what the other would get (or not get as the case is far too often).

Over the last few years, we’ve certainly seen signs of data sharing progress. For example, in early August the marriage between health data sharing networks CommonWell and Carequality was consummated, with providers using Cerner and Greenway Health going live with their connections.

Still, health data exchange is far more difficult than it should be. Despite many years of trying, hospitals still don’t share data with each other routinely, even when they’re treating the same patient.

To learn more about this issue, researchers surveyed pairs of hospitals likely to share patients across the United States. The teams chose pairs which referred the largest volume of patients to each other in a given hospital referral region.

After reaching out to many facilities, the researchers ended up with 63 pairs of hospitals. Researchers then asked them how likely they were to share patient health information with nearby institutions with whom they share patients.

The results, which appeared in the Journal of the American Medical Informatics Association, suggest that while virtually all of the hospitals they studied could be classified as routinely sharing data by federal definitions, that didn’t tell the whole story.

For one thing, while 97% of respondents met the federal guidelines, only 63% shared data routinely with hospitals with the highest shared patient (HSP) volume.

In fact, 23% of respondents reported that information sharing with their HSP hospital was worse than with other hospitals, and 48% said there was no difference. Just 17% said they enjoyed better sharing of patient health data with their HSP volume hospital.

It’s not clear how to fix the problem highlighted in the JAMIA study. While HIEs have been lumbering along for well more than a decade, only a few regional players seem to have developed a trusted relationship with the providers in their area.

The techniques HIEs use to foster such loyalty, which include high-touch methods such as personal check-ins with end users, don’t seem to work as well for some HIE they do for others. Not only that, HIE funding models still vary, which can have a meaningful impact on how successful they’ll be overall.

Regardless, it would be churlish to gloss over the fact that almost two-thirds of hospitals are getting the right data to their peers. I don’t know about you, but this seems like a hopeful development.

Hospitals Struggle To Get Users On Board With Mobile Policies

Posted on August 6, 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.

A new survey has found that hospitals are having a hard time managing and tracking user compliance with mobile communications policies.

The survey, which was conducted in early 2018 by communications vendor Spok, collected information on mobile device communications strategies from approximately 300 healthcare professionals. Forty-four percent of respondents were clinicians, 10% were IT and telecom staff, 6% were executive leaders, and another 40% had a wide variety of healthcare roles.

Spok found that hospitals who do have a mobile strategy in place have had one for a long time, with 42% having had such a strategy for either 3 to 5 years or more than five years. Another 46% have had a formal mobile strategy for one to three years. Only 12% have had a strategy in place for one year or less.

Reasons they cited for creating mobile device strategies included the launch of a communication initiative (46%); a clinical initiative (25%); or a technology initiative (24%). Five percent of responses were “other.” Top areas of focus for these strategies included mobile management and security (56%), mobile device selection (52%) and integration with the EHR (48%).

Other reasons for mobile initiatives included clinical workflow evaluation (43%), device ownership strategy/BYOD (34%), mobile apps strategy (29%), mobile app catalog (16%), mobile strategy governance (14%) and business intelligence and reporting strategy (12%).

However, there’s little agreement as to which hospital department should monitor compliance. Forty-three percent of respondents said the security team was monitoring policies for the hospital or system, 43% rely on a telecommunications team, 43% said a clinical informatics team played that role, and 26% had monitoring done by a mobile team. Twenty-one percent said individual departments enforce mobile policies and 9% said they don’t have an enforcement method in place. Another 9% of responses fell into the “other” category.

Given the degree to which monitoring varies between institutions, it’s little wonder to learn that policies aren’t enforced effectively in many cases. On the one hand, 39% respondents said the policies were enforced extremely well most of the time, and one-third said they were enforced well most the time. However, 4% said the policies were being enforced poorly and inconsistently, and 44% said they are not sure about how well the policies are being enforced.

Hospitals are aware of this problem, though, and many are taking steps to ensure that users understand and comply with mobile policies. According to the survey, 48% offer educational programs on the subject, 42% use technology or data gathered from devices to measure and track compliance, 37% leverage direct feedback from users and 23% use surveys.

Still, 21% said they don’t have a way to validate compliance — which suggests that hospitals have a lot more work to do.

Phishing Attack On Hospital Could Impact 1.4 Million Patients

Posted on August 3, 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.

A hospital in West Des Moines, Iowa has entered its third month of public disclosure after experiencing a data breach which could impact 1.4 million patients.

On May 31st, UnityPoint Health discovered that a phishing attack on its business email system had created a breach. Its investigation found that the company got a series of fraudulent emails pretending to have come from an executive within UnityPoint. After contacting law enforcement and beginning to research the situation, UnityPoint disclosed the existence of the breach to the public.

The patient information exposed includes names, addresses, dates of birth, medical record numbers and insurance information. Cyber attackers may also have gotten access to patient Social Security numbers and/or drivers’ license numbers. In a limited number of cases, attackers might even have been able to access patients’ payment card or bank account numbers.

Since then, UnityPoint has continued to keep its patients aware of any news on the situation, a painful yet necessary process which can help it rebuild its credibility. After all, it’s likely that the news of UnityPoint’s breach will get consumers very upset.

In fact, a new survey by SCOUT in partnership with The Harris Poll found that 49% of America adults are extremely or very concerned about the security of their personal health information. Given the fact that they’ve been hit with news of such breaches very regularly in recent years, it’s little wonder.

It’s worth noting that many consumers aren’t using online healthcare tools very often. For example, while 39% of those aged 18 to 34 used online portals to access their health information, all told only 36% of Americans overall use this technology.

As their health information knowledge increases, though, most patients become more concerned with what providers do to protect the privacy and security of their healthcare data. They learn how valuable this data is to potential buyers, and how there’s a ready market for their data in clandestine, impossible-to-track sites on the Dark Web.

Also, as the tenor of news coverage shifts from technical terms like “data breach” to tales of what happened to specific consumers, it’s likely that consumers will develop a more realistic view of what’s at stake here. If they’re freaked out at that point, they’ve probably figured out how a breach could impact their lives.

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.

Patient Safety Market Heating Up with Mergers and New Product Announcements

Posted on July 26, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

For the past few years the patient safety software market has been stable with little in the way of new products and company activity. That has changed with a flurry of recent announcements:

  1. The merger of two market leaders: Datix and RL Solutions
  2. Health Catalyst entering with their new Patient Safety Monitor™ Suite: Surveillance Module
  3. VigiLanz expanding their platform to include Dynamic Safety Surveillance

When something goes wrong in a healthcare facility it is referred to as an adverse event or a medical error. According to a recent study by Johns Hopkins, 250,000 Americans die each year from medical errors making it the third leading cause of death in the United States. The Journal of Patient Safety estimates that non-lethal adverse events happen 10-20 times more frequently than lethal events. This puts the total number of adverse events somewhere between 2.5 – 5 million per year. The financial cost of these events is enormous. Frost & Sullivan estimates that the financial cost of adverse events in the US and Europe will reach $383.7 Billion by 2022.

Traditionally, adverse events have been recorded and logged in incident reporting systems (sometimes called risk management software) – like those offered by Datix and RL Solutions. These systems rely on voluntary reporting of events by staff members and patients. Once entered, these events are reviewed and analyzed by specially trained risk managers to determine root causes. When patterns emerge, changes are made to policies, procedures and physical environments to prevent similar events from happening in the future.

The most recent Research and Markets report estimates the global patient safety and risk management software market is poised to grow at a CAGR of 10.9% over the next decade to reach $2.22 Billion by the year 2025. I believe there are three key drivers for this this growth:

  1. Hospitals transitioning away from traditional after-the-fact adverse event reporting systems to real-time surveillance platforms that take advantage of the data being collected in EHRs and other electronic repositories
  2. The movement towards value-based care where a focus on patient safety has meaningful impact on reimbursements
  3. Realignment of patient safety as part of overall patient experience vs a function of compliance and legal.

According to a report by the Agency for Healthcare Research and Quality (AHRQ), it is estimated that less than 6% of adverse events are reported voluntarily. This means that healthcare organizations are potentially missing out on 94% of events that are happening within their four walls. In addition, very few organizations have effective ways to capture near misses – adverse events that did not occur because they were stopped BEFORE someone was harmed. There is a better way.

With the exponential growth in the quantity of healthcare data and the rapid increase in computing power, it is now possible to mine medical data to detect adverse events and near misses in real-time. For example, it is possible to look at EHR data to determine if the wrong medication was given to a patient based on their diagnosis. It is also possible to track the number of times the drug-drug interaction warning message is displayed to clinicians (each being a near miss). Justin Campbell of Galen Healthcare Solutions recently wrote an article about mining EHR audit log data to uncover workflow bottlenecks that touches on this same approach – commonly referred to as “real-time surveillance”.

Stanley Pestotnik, MS, RPh, Vice President of Patient Safety Products at Health Catalyst had this to say about this detection methodology: “The current approach to patient safety is like doing archaeology – digging through ancient safety events to identify the causes of harm, which does nothing to help with the patient in the bed right now. Our patient safety suite, along with our quality-improvement services and the Health Catalyst PSO, turns the current paradigm on its head. Unlike other approaches to using analytics within a PSO to identify and address episodes of patient harm, we monitor triggers in near real-time to reveal whether a patient is currently at risk for a safety event, so clinicians can intervene to prevent it. And we provide constant vigilance; no patient encounter goes unnoticed.”

Real-time surveillance of adverse events is the approach that Health Catalyst and VigiLanz have incorporated in their product offerings.

“The RL+Datix merger comes at a time when patient safety events are surging,” states Erik Johnson, Vice President of Marketing at VigiLanz. “It is not surprising that consolidation is happening as companies try to address the needs of the market.”

Johnson points to a recent Frost & Sullivan report that predicts further market consolidation. The report states that by 2022, adverse patient events will lead to 92 million hospital admissions and 1.95 million deaths in the US and western Europe. These avoidable hospital admissions will be a drag on financial performance – especially as we move to a value-based system.

Under the value-based models, healthcare organizations are reimbursed based on patient outcomes and satisfaction scores, not on treatment volume. This means organizations are no longer compensated for patients that are re-admitted or stay longer due to an adverse event experienced at the facility. This has put a spotlight on patient safety initiatives and is a key reason why healthcare organizations are once again investing in this aspect of their operations.

“We are seeing organizations take the opportunity, as they transition from volume to value, to renew their patient safety protocols and technologies to ensure they are capitalizing on the lessons learned from incident data,” continues Johnson. “It’s not just patient incident data either. Adverse events can happen to guests and employees as well. Hospitals are looking to get a better handle on all their events – not only to capture them, but to derive deeper insights on root cause and even further to automate the detection of events through surveillance technology.”

A request for comment from Datix and RL Solutions on their recent merger was politely declined. A company spokesperson pointed back to the press release announcing the merger which states: “the combined company will contain the largest repository of patient safety data in the world, enabling the creation of data-driven insights for healthcare stakeholders across the continuum of care.”

The final driver for growth is the recognition that patient safety is closely linked to patient experience. In the past, adverse event tracking fell to the Risk Management team inside a hospital which typically reported up through the CFO or legal counsel. It was seen as a compliance and back-office function. In recent years, however, there has been a realization that the patient safety function is a better fit under the umbrella of patient experience since the two are closely linked.

“From our perspective at The Beryl Institute, if we approach healthcare from the lenses of those that use the system not only safety, but also quality, service, cost and more are all part of the experience someone has within healthcare,” says Jason A. Wolf PhD CPXP, President of The Beryl Institute – the world’s leading community of practice for patient experience. “To differentiate safety from experience diminishes both, relegating safety to processes and checklists and experience to satisfaction or amenities. Rather, experience is the integration of all the above.”

Wolf cites the recent State of Patient Experience from The Beryl Institute where healthcare leaders acknowledged quality and safety as essential to overall experience. A parallel study, the Consumer Perspectives on Patient Experience mirrored the provider result with 68% of global healthcare consumers agreeing that safety is part of the healthcare experience.

“I see the movement towards aligning patient safety and patient experience as acknowledgement of all that impacts the overall experience,” adds Wolf. “That first and foremost to consumers, their health matters to them and how they are treated both clinically and as a person is essential to their healthcare experience. This too reinforces the expectations patients and families have always had, that their care will be delivered in a safe and reliable manner.”

lt will be exciting to watch the patient safety space as the three drivers of (1) changing technology, (2) value-based care and (3) realignment under patient experience, continue to push investments in this market. I’m curious to see if the Datix + RL merger is a one-off or if other players like QuantrosRiskonnect, Origami Risk, Ventiv, Policy Medical and The Patient Safety Company will merge or be acquired. This market is definitely heating up!

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.