Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

What? In Some Cases, Additional IT Spending May Not Prevent Breaches

Posted on June 11, 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 research study has come to a sobering conclusion – that investing more in IT security doesn’t necessarily reduce the number of breaches.

The research, which appeared in the MIS Quarterly, looked at how many breaches hospitals experienced relative to their IT security spending. The study authors started with the assumption that hospitals spending more on security would enjoy better protection from breaches.

The researchers assumed that looked at broadly, some security investments were “symbolic,” making superficial improvements that don’t get to the root of their problem, while others were substantive investments which met well-defined security needs.

After reviewing their data, researchers noted that many classes of hospitals turned out to be symbolic security investors, including members of smaller health systems, older hospitals, smaller hospitals and for-profit hospitals. They also noted that faith-based and less-entrepreneurial hospitals were prone to such investments. The only category of hospitals routinely making substantive security investments was teaching hospitals.

But that’s far from all. Their more controversial conclusions focused on the role of IT security investments in preventing security breaches. In short, their conclusion was pretty counterintuitive.

First, they found that larger IT security investments did not in and of themselves lower the likelihood of security breaches. Not only that, researchers concluded that the benefits of substantive adoption wouldn’t generate greater breach protection over time.

Researchers also concluded that the benefits of substantive IT security adoption by hospitals would take time to be realized. If I’m reading this correctly, mature IT security systems should offer more advantages over time, but not necessarily better breach protection.

Meanwhile, researchers concluded that the negative consequences of symbolic adoption would grow worse over time.

I don’t know about you, but I was pretty surprised by these results. Why wouldn’t substantively increasing security spending reduce the occurrence of breaches within hospitals? It’s something of a head-scratcher.

Of course, the answer to this question may lie in what type of substantive security investment hospitals make. The current set of results suggests, to me at least, that current technologies may not be as good at preventing breaches as they should be. Or maybe hospitals are investing in good technology but not hiring enough IT security experts to get the installation done right. Plus, purchasing security infrastructure can only do so much to stop bad user behavior. The issue deserves further research.

Regardless, this study offers food for thought. The industry can’t afford to do a bad job with preventing breaches.

Investment in IT Infrastructure Needed to Power Healthcare Transformation

Posted on May 11, 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.

Genomics, artificial intelligence, chatbots and a host of other technologies are accelerating the transformation of healthcare from a paper-based system to a digital one. In order to power this transformation, IT infrastructure (storage, computational power, security, etc) needs to move from an implementation afterthought to the forefront of strategic planning. Windstream Enterprise is one company that is working closely with healthcare providers to ensure their IT infrastructure is ready for the challenges ahead and helping to put the infrastructure conversation front-and-center.

Windstream is part of the wave of companies that have successful track-records in other industries that are now bringing their solutions to healthcare. This wave is being led by technology giants like Amazon, Apple and Google. The moves they make in healthcare get a lot of attention and rightfully so. Check out the excellent coverage by Christina Farr over at MSNBC for more information.

Although I am intrigued by what the big tech companies are doing, what I truly find fascinating (and frankly inspiring) is the work of the hundreds of companies not named Amazon, Apple and Google. Windstream is one of the companies I have been interested in ever since I saw them at HIMSS17 and wondered “What is an Internet access provider doing in healthcare?”

Windstream was formed back in 2006 when Alltel spun off it’s landline business and merged it with VALOR Communications Group. Back then they provided 3.4 million access lines (telephone and internet connections) in 16 states. Over the years they have continued to grow through acquisition, expanding into fiber transport networks and fixed wireless. Windstream Enterprises, a division of Windstream, has had tremendous success helping clients in the retail and banking industries build and manage their technology infrastructure.

I recently had the chance to sit down with Windstream’s President and CEO, Tony Thomas and one of their clients, the University of Kentucky Healthcare (UK), to talk about why healthcare needs to continue to invest in good IT infrastructure.

You can watch the full recording of our conversation here:

Thomas sees a lot of similarity between the digital transformation happening in healthcare and the ones that swept through the financial services and retail sectors.

“When you look at the success we’ve had in retail and banking, and then you look at where healthcare is heading, the commonality is the push to technology,” explained Thomas. “You can see that technology is changing the way that healthcare gets done. There is a focus on the patient experience and cost transformation.” This same focus on improving customer experiences and reducing costs is what helped spur the adoption of cloud and other advanced technologies at banks and retailers.

One driver of technology adoption in healthcare is the higher expectations patients have of healthcare provider. These higher expectations are fueled by the prevalence of (and convenience of) consumer technologies that have made our lives so much easier: online shopping, online banking, booking appointments through our smartphones, etc.

In 2016, Deloitte released a study that compared consumer use of technology for health vs other aspects of their lives. Not surprisingly their findings showed that healthcare lagged behind.

I see the delta between the use of technology as a consumer vs as a patient as a demand gap. The more healthcare lags behind, the more demand patients will put on healthcare organizations to adopt technologies that mirror what they experience as consumers.

To close that gap, organizations have accelerated the implementation of technologies like chatbots, omni-channel communications, artificial intelligence and data analytics. However, when you couple these new technologies with the use electronic health records and advanced lab systems, the result is explosive data growth.

“Over the last two years we have generated over 1.2 Petabytes of pathology data,” noted Cody Bumgardner PhD, Assistant Professor of Pathology & Laboratory Medicine at the University of Kentucky Healthcare (a Windstream client). “Pathology is really the collection of different points of data: images, genomic & laboratory data. Digital Pathology is taking all that data, making it both operationally effective and ready for computational analysis – transforming it into something useful and actionable for clinicians. Pathology and pathological reports arguably provide the most actionable data in the patient record and it is relatively low-cost relative to other data sources.”

“As the number of health and wellness devices increases,” continued Bumgardner. “It means we will have to collect and analyze more and more data. You will need some solid infrastructure to allow that data to flow and you will need good computational power as close to the point of data generation as possible.”

Getting funds and resources to keep IT infrastructure up to date is not easy. Jan Bates, Director of Systems Operations at the University of Kentucky Healthcare summed it up succinctly: “It’s hard to get buy-in from executives because it’s not something they have a keen interest in discussing. In fact, many find it boring. You HAVE TO relate infrastructure back to the business. You have to answer the questions: What benefits will the organization realize? and What will the organization be able to do when the infrastructure is well maintained?”

The answer according to Windstream’s CEO Tony Thomas is nothing short of transforming the way healthcare is delivered: “We are really at an exciting time in healthcare. There are tons of new technologies emerging [like AI]. We’re going to need solid investments in the underlying infrastructure to support those technologies which will revolutionize the way healthcare is delivered.”

It gives me hope that companies like Windstream are bringing their extensive data and infrastructure management expertise from the banking sector to healthcare. Although healthcare is a unique industry, that doesn’t mean we are restricted to adopting solutions developed by healthcare insiders. We can (and should) leverage the best from other industries and adapt them to the unique aspects of healthcare.

“Given the opportunities we see in healthcare, we are increasing our investment here.” stated Thomas. “We think we can be a provider of choice for many healthcare organizations. In the end it’s all about the application of technology to solve problems in healthcare.”

Well said.

Henry Ford Rolling Out Analytics In Neuro ICU

Posted on April 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.

Not long ago, the chair of neurology at the sprawling Henry Ford Hospital decided it was time to bring his idea to life. Dr. Stephan Mayer, who had previously created a data analytics system at New York Columbia-Presbyterian Medical Center, felt he could bring what he learned to Henry Ford Hospital — and that it could save lives.

According to a story in Crain’s Detroit Business, Mayer was convinced that if the hospital analyzed data generated by patient monitors, it could reduce mortality and complications by predicting negative patient events.

“This is all about lost opportunity and making the most of the data we have,” Mayer told Crain’s. “There is nothing unique about the data we have. We have EMRs connected to pharmacy, radiology, billing, this and that, but there is a doughnut hole. The empty spot is the ICU, where the sickest  of the people are.”

Acting on that belief, Mayer put together an initiative bringing such tools to the health system’s neuro ICU.

After searching for a partner that could make this happen, Mayer settled on Medical Informatics Corp.’s FDA-cleared clinical intelligence platform, Sickbay, which monitors real-time vital signs issued by any connected device. The Sickbay product also comes with related apps such as Multimon, which allows clinicians to view multiple patients remotely across units, the hospital or multiple facilities.

Once deployed, Sickbay collects patient monitor data, stores and organizes it in a manner making it easier for clinicians to predict future patient events. For example, it can produce data on patient alarms that fall within specified critical ranges. This allows clinicians to see and act on patterns more quickly, Mayer said.

Working with Henry Ford’s IT Department, Mayer is rolling out Sickbay. Starting in June, Henry Ford will launch Sickbay and begin storing patient data. Over the next six months, the neuro ICU should collect data on 600 patients. Hopefully, this data will offer clinicians the insight and context they need to help patients.

If Mayer gets the results he’s hoping for, this could be just the first in a series of rollouts, potentially across the 22 ICUs operating across the five-hospital system. “Our organization is eager to push boundaries,” he told the magazine. “What we are doing, if it works as planned…it will change the way we round in the ICU.”

This sounds great, but Mayer is still lucky he’s at Henry Ford rather than other less-entrepreneurial organizations. The health system has worked to promote technology innovation for many years. Its efforts include an innovations program rewarding employees for standout inventions in areas like clinical applications for wearable technology.

Is EMR Use Unfair To Patients?

Posted on April 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.

As we all know, clinicians have good reasons to be aggravated with their EMRs. While the list of grievances is long — and legitimate — perhaps the biggest complaint is loss of control. I have to say that I sympathize; if someone forced me to adopt awkward digital tools to do my work I would go nuts.

We seldom discuss, however, the possibility that these systems impose an unfair burden on patients as well. But that’s the argument one physician makes in a recent op-ed for the American Council on Science and Health.

The author, Jamie Wells, MD, calls the use of EMRs “an ethical disaster,” and suggests that forced implementation of EMRs may violate the basic tenets of bioethics.

Some of the arguments Dr. Wells makes apply exclusively to physicians. For one thing, she contends that penalizing doctors who don’t adapt successfully to EMR use is unfair. She also suggests that EMRs create needless challenges that can erode physicians’ ability to deliver quality care, add significant time to a physician’s workday and force doctors to participate in related continuing education whether or not they want to do so.

Unlike many essays critiquing this topic, Wells also contends that patients are harmed by EMR use.

For example, Wells argues that since patients are never asked whether they want physicians to use EMRs, they never get the chance to consider the risks and benefits associated with EHR data use in developing care plans. Also, they are never given a chance to weigh in on whether they are comfortable having less face time with their physicians, she notes.

In addition, she says that since EMRs prompt physicians to ask questions not relevant to that patient’s care, adding extra steps to the process, they create unfair delays in a patient’s getting relief from pain and suffering.

What’s more, she argues that since EMR systems typically aren’t interoperable, they create inconveniences which can ultimately interfere with the patient’s ability to choose a provider.

Folks, you don’t have to convince me that EMR implementations can unfairly rattle patients and caregivers. As I noted in a previous essay, my mother recently went to a terrifying experience when the hospital where my brother was being cared for went through an EMR implementation during the crucial point in his care. She was rightfully concerned that staff might be more concerned with adapting to the EMR and somewhat less focused on her extremely fragile son’s care.

As I noted in the linked article above. I believe that health executives should spend more time considering potentially negative effects of their health IT initiatives on patients. Maybe these execs will have to have a sick relative at the hospital during a rollout before they’ll make the effort.

Mayo Clinic Creating Souped-Up Extension Of MyChart

Posted on March 19, 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.

As you probably know, MyChart is Epic’s patient portal. As portals go, it’s serviceable, but it’s a pretty basic tool. I’ve used it, and I’ve been underwhelmed by what its standard offering can do.

Apparently, though, it has more potential than I thought. Mayo Clinic is working with Epic to offer a souped-up version of MyChart that offers a wide range of additional services to patients.

The new version integrates Epic’s MyChart Virtual Care – a telemedicine tool – with the standard MyChart mobile app and portal. In doing so, it’s following the steps of many other health systems, including Henry Ford Health System, Allegheny Health Network and Lakeland Health.

However, Mayo is going well beyond telemedicine. In addition to offering access to standard data such as test results, it’s going to use MyChart to deliver care plans and patient-facing content. The care plans will integrate physician-vetted health information and patient education content.

The care plans, which also bring Mayo care teams into the mix, provide step-by-step directions and support. This support includes decision guidance which can include previsit, midtreatment and post-visit planning.

The app can also send care notifications and based on data provided by patients and connected devices, adapt the care plan dynamically. The care plan engine includes special content for conditions like asthma, type II diabetes chronic obstructive heart failure, orthopedic surgery and hip/knee joint replacement.

Not surprisingly, Mayo seems to be targeting high-risk patients in the hopes that the new tools can help them improve their chronic disease self-management. As with many other standard interventions related to population health, the idea here is to catch patients with small problems before the problems blossom into issues requiring emergency department visit or hospitalization.

This whole thing looks pretty neat. I do have a few questions, though. How does the care team work with the MyChart interface, and how does that affect its workflow? What type of data, specifically, triggers changes in the care plan, and does the data also include historical information from Mayo’s EMR? Does Mayo use AI technology to support care plan adaptions? Does the portal allow clinicians to track a patient’s progress, or is Mayo assuming that if patients get high high-quality educational materials and personalized care plan that the results will just come?

Regardless, it’s good to see a health system taking a more aggressive approach than simply presenting patient health data via a portal and hoping that this information will motivate the patient to better manage their health. This seems like a much more sophisticated option.

E-Patient Update:  Patients And Families Need Reassurance During EMR Rollouts

Posted on March 5, 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.

Sure, EMR rollouts are stressful for hospital staffers and clinicians. No matter how well you plan, there will still be some gritted teeth and slammed keyboards as they get used to the new system. Some will afraid that they can’t get their job done right and live in fear of making a clinical mistake. All that said, if your rollout is gradual and careful, and your training process is thorough, it’s likely everyone will adjust to the new platform quickly.

The thing is, these preparations leave out two very important groups: patients and their families. What’s more, the problem is widespread. As a chronically ill patient, I visit more hospitals than most people, and I’ve never seen any effective communication that educates patients about the role of the EMR in their care. I particularly remember one otherwise excellent hospital that decorated its walls with asinine posters reading “Epic is here!” I can’t see how that could possibly help staff members make the transition, much less patients and family members.

This has got to change. Hospital IT will always be evolving, but when patients are swept up in and confused by these changes, it distorts everything that’s important in healthcare.

Needless fear

A recent experience my mother had exemplifies this problem. She has been keeping watch over my brother Joseph, who is critically ill with the flu and in an induced coma. For the first few days, as my brother gradually improved, my mother felt very satisfied with the way the clinical staff was handling his case.

Not long after, however, someone informed her that the hospital’s new Epic system was being deployed that day. Apparently, nobody explained what that really meant for her or my brother, and she felt that the ICU nurses and doctors were moving a bit more slowly during the first day or two of the launch. I wasn’t there, but I suspect that she was right.

Of course, if things go well, over the long run the Epic system will fade into the background and have no importance to patients and their families. But that day or two when the rollout came and staff seemed a bit preoccupied, it scared the heck out of her.

Keeping patients in the loop

Don’t get me wrong: I understand why this hospital didn’t do more to educate and reassure my mother. I suspect administrators wouldn’t know how to go about it, and probably feel they don’t they have time to do it. The idea is foreign. After all, communicating with patients about enterprise health IT certainly isn’t standard operating procedure.

But isn’t it time to involve patients in the game? I’m not just talking about consumer-facing technology, but any technology that could reasonably affect their experience and sense of comfort with the care they’re receiving.

Yes, educating patients and families about enterprise IT changes that affect them is probably out of most health IT leaders’ comfort zones. But truthfully, that’s no excuse for inaction. Launching an Epic system isn’t inside-baseball process — it affects everyone who visits the hospital. Come on, folks, let’s get this right.

Yale New Haven Hospital Partners With Epic On Centralized Operations Center

Posted on February 5, 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.

Info, info, all around, and not a place to manage it all. That’s the dilemma faced by most hospitals as they work to leverage the massive data stores they’re accumulating in their health IT systems.

Yale New Haven Hospital’s solution to the problem is to create a centralized operations center which connects the right people to real-time data analytics. Its Capacity Command Center (nifty alliteration, folks!) was created by YNHH, Epic and the YNHH Clinical Redesign Initiative.

The Command Center project comes five years into YNHH’s long-term High Reliability project, which is designed to prepare the institution for future challenges. These efforts are focused not only on care quality and patient safety but also managing what YNHH says are the highest patient volumes in Connecticut. Its statement also notes that with transfers from other hospitals increasing, the hospital is seeing a growth in patient acuity, which is obviously another challenge it must address.

The Capacity Command Center’s functions are fairly straightforward, though they have to have been a beast to develop.

On the one hand, the Center offers technology which sorts through the flood of operational data generated by and stored in its Epic system, generating dashboards which change in real time and drive process changes. These dashboards present real-time metrics such as bed capacity, delays for procedures and tests and ambulatory utilization, which are made available on Center screens as well as within Epic.

In addition, YNHH has brought representatives from all of the relevant operational areas into a single physical location, including bed management, the Emergency Department, nursing staffing, environmental services and patient transport. Not only is this a good approach overall, it’s particularly helpful when patient admissions levels climb precipitously, the hospital notes.

This model is already having a positive impact on the care process, according to YNHH’s statement. For example, it notes, infection prevention staffers can now identify all patients with Foley catheters and review their charts. With this knowledge in hand, these staffers can discuss whether the patient is ready to have the catheter removed and avoid related urinary tract infections associated with prolonged use.

I don’t know about you, but I was excited to read about this initiative. It sounds like YNHH is doing exactly what it should do to get more out of patient data. For example, I was glad to read that the dashboard offered real-time analytics options rather than one-off projections from old data. Bringing key operational players together in one place makes great sense as well.

Of course, not all hospitals will have the resources to pull something off something like this. YNHH is a 1,541-bed giant which had the cash to take on a command center project. Few community hospitals would have the staff or money to make such a thing happen. Still, it’s good to see somebody at the cutting edge.

Amazon May Soon Announce Major Cloud Deal With Cerner

Posted on November 27, 2017 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.

As I’ve previously noted, Amazon is making increasingly aggressive moves into the healthcare space of late. While it hasn’t been terribly public with its plans—and why should it, honestly?— there been some talk of its going into the healthcare technology space. There’s also much talk about angles from which Amazon could attack healthcare sectors, including its well-publicized interest in the pharmacy business.

Though interesting, all of this has been vaguely defined it best. However, a new deal may be in the works which could have a very concrete effect. It could change not only the future of Amazon’s healthcare industry efforts but also, potentially, have an impact on the entire health IT world.

Think I’m exaggerating? Check this out. According to a story on the CNBC site, Amazon is about to announce a “huge” deal with Cerner under which the two will work together on building a major presence in enterprise health IT for Amazon Web Services. Put that way, this sounds a bit hyperbolic, but let me lay this out a bit further.

As things stand, the online retailer’s Amazon Web Services is already generating almost $20 billion a year, boasting clients across major industries such as technology, energy and financial services. Its only stumbling point to date is that it’s had trouble cracking the healthcare market.

Apparently, at the re:Invent conference in Las Vegas next week, AWS’s CEO will announce that Amazon is teaming up with Cerner to convince senior healthcare leaders to use AWS for key initiatives like population health management.

Sources who spoke to CNBC that the partnership will initially focus on Cerner’s HealtheIntent population health product, presumably as a door into convincing hospitals shift more of the cloud-based business to AWS.

Now why, you ask, is this deal bigger than the average bear?  is it one of those vaporware partnerships that fly a flag and promise a lot but don’t really go anywhere?

Yes, I admit that’s always possible, but in this case, I don’t think it’s going to turn out that way. The fit simply seems to work too well for this to be one of those much-ballyhooed deals that fade away quietly. (In fact, I could visualize a Cerner/Amazon merger in the future, as crazy as that might sound. It’s certainly less risky than the Whole Foods deal.)

For one thing, both Amazon and Cerner have significant benefits they can realize. For example, as the story notes, Amazon hasn’t gotten far in the healthcare market, and given its talent for doing the impossible, it must be really stuck at this point. Cerner, meanwhile, will never pull together the kind of cloud options AWS can offer, and I doubt Epic could either, which gives Cerner a boost in the always next-and-neck competition with its top rival.

If this agreement goes through, the ripples could be felt throughout the healthcare industry, if for no other reason than the impact it will have on the enterprise EHR market. This one should be fun to watch. I’m pulling out the popcorn.

Epic Mounts Clumsy Public Defense On False Claims Lawsuit

Posted on November 6, 2017 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 former employee of a health system using Epic filed a False Claims Act whistleblower suit claiming that the vendor’s platform overbills for anesthesia services by default. The suit claims that Epic’s billing software double-bills both Medicare and Medicaid for anesthesia, as well as commercial payers.

At this point, let me be clear that I’m not accusing anyone of anything, but in theory, this could be a very big deal. One could certainly imagine a scenario in which multiple Epic customers colluded to permit this level of overbilling, which could generate staggering levels of overpayment. If so, one could imagine hospitals and health systems paying out judgments that add up to billions of dollars. To date, though, nobody’s made such a suggestion. In fact, Epic has said essentially the opposite and pointed to the need to understand how medical billing works, but we’ll get to that.

In the suit, which was filed in 2015 but unsealed this month, Geraldine Petrowski contended that Epic’s software was billing for both the base units of anesthesia for procedures and the time the procedure took.

Petrowski, a former employee with the compliance team at Raleigh, N.C.-based WakeMed Health & Hospitals, alleges that setting the billing to these defaults has resulted in “hundreds of millions of dollars in fraudulent bills” submitted to Medicare, Medicaid and other payers. (WakeMed is an Epic customer.)

According to an article appearing in Modern Healthcare, Petrowski developed these concerns when she worked with Epic as the provider’s liaison for its software implementation between 2012 and 2014. In the complaint, she says that she raised these concerns with Epic, but got a dismissive response. Eventually, after Petrowski kept up the pressure for a while, Epic fixed the billing issue — but only for WakeMed.

Apparently, the U.S. Department of Justice reviewed Petrowski’s case and decided not to intervene, a fact which Epic has not-surprisingly mentioned every chance it gets. Perhaps more tellingly, the vendor has suggested that Petrowski filed the suit largely because she’s clueless. “The plaintiff’s assertions represent a fundamental misunderstanding of how claims software works,” Epic spokesperson Meghan Roh told the magazine.

Now, I don’t want to go off on a rant here, but if the best public defense Epic can mount in this case is to offer some mixture of “everybody’s doing it” and “you’re a big dummy,” you’ve got to wonder what it’s got to hide.

Not only that, trying to brush off the suit as the product of ignorance or inexperience makes no sense given what’s involved. While False Claims whistleblowers can collect a very large payoff, getting there can take many years of grueling work, and their odds of prevailing aren’t great even if they make it through the torturous litigation process.

No, I’m more inclined to think that Epic has tipped its hand already. I’d argue that fixing only the WakeMed billing system shows what the legal folks call mens rea – a guilty mind — or at least a willingness to ignore potential wrongdoing. Not only that, if the system was operating as expected, why would Epic have gotten involved in the first place? Its consulting services don’t come cheap, and I’m guessing that Petrowski didn’t have the authority to pay for them.

It doesn’t look good, people…it just doesn’t look good.

Sure, the hospitals and health systems using Epic’s billing solution are ultimately responsible for the results. Maybe Epic is completely blameless in the matter this case. Regardless, if Epic’s hands are clean, it could do a better job of acting like it.

Predictive Analytics Will Save Hospitals, Not IT Investment

Posted on October 27, 2017 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.

Most hospitals run on very slim operating margins. In fact, not-for-profit hospitals’ mean operating margins fell from 3.4% in fiscal year 2015 to 2.7% in fiscal year 2016, according to Moody’s Investors Service.

To turn this around, many seem to be pinning their hopes on better technology, spending between 25% and 35% of their capital budget on IT infrastructure investment. But that strategy might backfire, suggests an article appearing in the Harvard Business Review.

Author Sanjeev Agrawal, who serves as president of healthcare and chief marketing officer at healthcare predictive analytics company LeanTaaS, argues that throwing more money at IT won’t help hospitals become more profitable. “Healthcare providers can’t keep spending their way out of trouble by investing in more and more infrastructure,” he writes. “Instead, they must optimize the use of the assets currently in place.”

Instead, he suggests, hospitals need to go the way of retail, transportation and airlines, industries which also manage complex operations and work on narrow margins. Those industries have improved their performance by improving their data science capabilities.

“[Hospitals] need to create an operational ‘air traffic control’ for their hospitals — a centralized command-and-control capability that is predictive, learns continually, and uses optimization algorithms and artificial intelligence to deliver prescriptive recommendations throughout the system,” Agrawal says.

Agrawal predicts that hospitals will use predictive analytics to refine their key care-delivery processes, including resource utilization, staff schedules, and patient admits and discharges. If they get it right, they’ll meet many of their goals, including better patient throughput, lower costs and more efficient asset utilization.

For example, he notes, hospitals can optimize OR utilization, which brings in 65% of revenue at most hospitals. Rather than relying on current block-scheduling techniques, which have been proven to be inefficient, hospitals can use predictive analytics and mobile apps to give surgeons more control of OR scheduling.

Another area ripe for process improvements is the emergency department. As Agrawal notes, hospitals can avoid bottlenecks by using analytics to define the most efficient order for ED activities. Not only can this improve hospital finances, it can improve patient satisfaction, he says.

Of course, Agrawal works for a predictive analytics vendor, which makes him more than a little bit biased. But on the other hand, I doubt any of us would disagree that adopting predictive analytics strategies is the next frontier for hospitals.

After all, having spent many billions collectively to implement EMRs, hospitals have created enormous data stores, and few would argue that it’s high time to leverage them. For example, if they want to adopt population health management – and it’s a question of when, not if — they’ve got to use these tools to reduce outcome variations and improve quality of cost across populations. Also, while the deep-pocketed hospitals are doing it first, it seems likely that over time, virtually every hospital will use EMR data to streamline operations as well.

The question is, will vendors like LeanTaaS take a leading role in this transition, or will hospital IT leaders know what they want to do?  At this stage, it’s anyone’s guess.