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Disaster Planning and HIPAA

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When talk turns to HIPAA, most of us are focused on privacy compliance.  After all, privacy is a complex, expensive nightmare, and few hospitals or medical practices feel up to the task, so talking through those issues makes sense.

But as blogger Art Gross points out, the HIPAA Security General Rules require more than protecting a patient’s privacy. They also require that ePHI remains available even in the face of disaster. From the rules (courtesy of Gross, emphasis his):

§ 164.306 Security standards: General rules.
(a) General requirements. Covered entities must do the following:
(1) Ensure the confidentiality, integrity, and availability of all electronic protected health information the covered entity creates, receives, maintains, or transmits.

Apparently, far too few healthcare providers are paying enough attention to this part of the rules. Gross, who is a HIPAA security consultant, says that when he audits organizations, few have disaster recovery or emergency operations procedures in place.

Now, big enterprise IT departments aren’t going to leave disaster recovery out of their planning; it’s simplly part of the drill for any large installation. But the smaller the provider group gets — particularly when you zoom down to one to three-doctor practices — the story changes.

As people who read blogs like this one know, smaller practices aren’t likely to have so much as a single IT staffer on board. Keeping their EMR up and running is enough of a burden. I’m not at all surprised to hear that they aren’t prepared for disasters like Hurricane Sandy, which brought down even large medical centers.

But with HIPAA demanding immediate access to ePHI, doctors won’t have a choice much longer. And hospitals will want to make sure independent doctors aren’t the weak link in the availability chain.

Yes, it’s asking a lot of small practices to make intellligent disaster recovery plans for their EMR, and even more of their hospital partners if they want to keep access to disparate EMRs out there.  But there’s just no getting around the problem.

November 20, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Major EMR Vendor Consolidation On The Verge

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Note: This is a post by Katherine Rourke. Tomorrow watch for a post by John on EMR and EHR where he discusses some of his views on this discussion.

While it may not be immediately obvious, the EMR industry is at a major turning point in its history. Any day now, we’re going to see a bunch of mergers and acquisitions go off like a string of firecrackers, some of which may have a direct impact on your business.

Now, I don’t know how many EMR companies there are out there. In fact, I’m not sure anyone has a precise count. But can we agree that we’re looking at 1,000 or more, no?  And, heck, there’s probably thousands of companies pitching practice management + EMR,  medication management systems, clinical decision support, apps, mobile health plug-ins to EMRs and so on. Just visualize it all — you’ll get a headache but you’ll doubtless agree that we’re dealing with a raging flood of technology.

And most of it won’t stand alone forever. Every vendor likes to say that their product line has all the solutions, but even the most green sales rep doesn’t really believe that. Smart EMR tech firms and their natural allies are already beginning the mating dance, and quietly but inexorably, hooking up.

Since this isn’t the Wall Street Journal, I’m sure we don’t need to dig into deep financial discussion over this. And anyone who’s a regular reader of this site knows why software companies often buy rather than build the technologies they need to fill out their portfolio.

But I thought it was still worth noting that within, say, 18 months, the EMR world could look fairly different in the following ways:

* EMRs aimed at doctors are overabundant, to put it mildly. I predict that there will be a dozen or so well-publicized failures or buyouts in this space within the next year.

* Big vendors that pitch to both enterprises and medical practices will largely have to pick one,and it’s the enterprise side that will win. If you’re a doctor running a giant company’s EMR, stay in regular touch with your vendor and get their support promises in writing!

* There will be a flurry of mHealth activity, with EMRs that play nicely on tablets in center stage.  It’s possible the market will even support another IPO or two this year by EMR vendors if they’re offering a nifty mobile health aspect integrated with their core product.

* Doctors, in particular, risk finding that their product becomes abandonware this year as the market consolidates.  Have a Plan B available, and I mean a written plan developed by a consultant or tech-savvy senior member of your team.

So, what else do you think will happen as the market absorbs excess players and recombines relationships?

June 14, 2012 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Tricorder Devices, REC Numbers, and EHR Photo IDs: This Week in HealthCare Scene

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John’s Note: As regular readers know, I usually reserve the Sunday post to do a Twitter round up. The Sunday post on EMR and EHR has been a Healthcare Scene round up post written by Katie. I decided to mix things up a little bit. Each week I’ll swap which site does the Twitter round up and which site does the Around Healthcare Scene.

If all of this is confusing, don’t worry. Just subscribe to the emails for EMR and HIPAA & EMR and EHR and you’ll be all set. Now sit back and enjoy a look around the Healthcare Scene network.

EMR and EHR
The Shift From Expensive Technology to Cost Saving Technology

For years, medical technology came with a hefty price tag. While many of these investments were a miracle worker of sorts, it left hospitals and medical practices with a large bill. Fortunately, in recent years, the technology being released, such as EHR, are trying to make health care less expensive. While it is up for debate if software like EHR really is less expensive, there is a definite shift in the costs of medical technology.

Photo IDs as Part of the Patient Record — Flashy Trend or Future of Medicine?

Unfortunately, errors do occur in hospitals. However, putting photos on a patient record may help prevent some of these problems. Children’s Hospital in Colorado is currently trying this out. The number of mistaken orders dropped from 12 in 2010 to 3 in 2010 since the hospital started using photo IDs. So the question is, are photo IDs worth the time and effort?

Hospital EMR and EHR
Make Consumers Want Their PHR

More PHRs seem to be popping up, but are any of them really convincing people to use them? Anne Zeigler doesn’t think she. In this post, she lists several different ideas on how to get people “excited” about PHRs with tips such as good marketing and rewarding the user. If companies want consumers to use their PHR, many things should be taken into consideration.

EMR Thoughts

REC Numbers for REACH (Minnesota and North Dakota Doctors)

REACH is a nonprofit federal Health Information Technology Regional Extension Center that aims to help hospitals and medical practices through Minnesota and North Dakota implement EHR or optimize the current system. It had many goals in mind when it started, and recently, many of these goals have been met or surpassed. REACH serves 4,749 priority primary care providers across these two states.

EHR and EMR Videos

Dr. Eric Hartz’s EHR Story from the 2012 HIMSS Conference

At the recent HIMSS Conference, Dr. Eric Hartz shared his thoughts on EHR. He discussed the benefits of EHRs and gave tips on participating in incentive programs. He also talked about how to use EHR across a number of different hospitals.

Smart Phone Health Care

Is the Tricorder Device a Reality?

Is that rash on your child something serious, or nothing to worry about? Or is that fever from a UTI? Scanadu, a tricorder-like device, supposedly will use social media to help make healthcare more immediate and accessible. The machine will allow people to take a picture or sample of something worrisome, and immediately find out what action needs to be taken. The world of social medicine is quickly expanding, and a tricorder is becoming an actual possibility.

Pajamas Created to Monitor an Infant’s Vital Stats, Sends Mobile Alerts

Wearable monitors are popping up throughout the health care world. The latest? Pajamas for an infant to wear. It monitors an infant’s vital stats and sends mobile alerts to the parents. Great idea, or just another gimmick to sell to paranoid parents? Read more and decide for yourself.

June 10, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR is the Health Care ERP

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I know I’ve written about ERP and EMR before, but the more I think about the EMR selection and implementation process, the more I see the same issues that are experienced with an ERP implementation.

The one issue that is a bit different about EMR versus ERP is that there are only a small handful of ERP vendors to choose from. However, we have 300-600 to choose from in the EMR world. That’s an important and challenging difference.

However, the similarities to ERP are many. One of the most striking is how the EMR like the ERP is something that’s going to be used and have an effect on the entire organization. As such, the need to manage the participation of multiple stakeholders is so key.

The key to a successful ERP implementation is to have a great project leader.  Someone who is great at working with various departments. They are great listeners who hear and understand each departments needs. Then, they have to be great at making the case for each depaartment’s needs.

The same is true for EMR. You need an EMR implementation champion who is great at listening to all areas of the clinic: nurses, doctors, front desk, billing, medical records, etc. Sometimes this can be done well by a physician lead, but is more likely to be a practice manager, IT support (if they have project management skills), or an outside consultant. 

It’s easy to underestimate the challenge of “herding sheep.” Done right, it can work very well. Done wrong and your clinic is likely going to have the opportunity to try again after the failed EMR implementation.

There are other comparisons worth considering, but this one was striking me today. I’ll be interested to hear stories and experiences from those who have implemented an EMR. Did you have a strong leader to help pacify the different stakeholders in your clinic? 

June 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Helping doctors adapt to EMRs

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Much ink has been spilled discussing why physicians are resistant to adopting EMRs.

The thing is, it’s really no mystery.  Researchers have arrived at what seem like sensible answers to the question, including a) problems changing their work habits, b) fear of the unknown and c) struggles with kludgy interfaces.

So, why not take these problems on directly? While we can’t get inside clinicians’ heads and tell them how to think, we can address their issues concretely.

If the anecdotes I hear are accurate, many are pushed into EMR use and forced to do all the adapting, rather than getting the help they need.

So how can we help?

Obviously, physicians and other clinical staffers need access to accessible, intelligent training — ideally, both Web-based and live — as well as easy-to-use documentation that’s written in very simple language.

But that’s not all. While many institutions breeze by this step, IT departments (or consultants) should do everything they can to customize the EMR experience for individual clinicians. (If your EMR is too rigid to allow for this, that’s another story, but let’s pray you have one with some flexibility built in.)

It’s also important to pinpoint what other frustrations clinicians may have. For example, some doctors who type poorly are immensely frustrated by using EMRs, something keyboard-savvy techs might never consider.  A good old-fashioned typing course might work wonders in those cases.

In the rush to deal with the complex technical issues involved in EMR integration, it’s easy to blow by the needs of individual users.  It’s even easier to throw some fragmentary training at clinicians and assume they have a bad attitude if it doesn’t “take.”

The truth is, though, that nobody can afford to be short-sighted about getting users connected to EMRs.  Let’s hope everyone bears this in mind as the main wave of rollouts begins.

May 8, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

HIMSS Attire Day 2 – Top 10 Real Reasons I’m at HIMSS11

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image
Today I have a special shirt made just for HIMSS, thanks to the great people at Enterprise Software Deployment.

If you see me at HIMSS, check out my shirt. It has the top 10 real reasons I’m at HIMSS listed on the back of the shirt. My favorite is #4 Booth babes. I’ll post the full top 10 later tonight.

Also, be sure to check out Enterprise Software Deployment at HIMSS if you need a great EMR consultant or if you’re looking for a position doing EMR consulting. You can find them at Booth #2777.

Here’s their HIMSS exhibitor description:
At ESD, our goal is to ensure successful implementation of a new EHR system or upgrade from start to finish in healthcare organizations around the globe. Our services include Clinical Transformation, Legacy System Support, Training, Supplemental Staff Augmentations, Clinical and System Transformation, as well as education and training in all aspects of Cerner®, Siemens®, Epic®, Eclipsys®, MEDITECH, and McKesson systems.

Thanks for ESD for sponsoring such a cool shirt for me.

February 21, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Convincing Doctors to Do EMR

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Yesterday I was attending a conference that had almost nothing to do with EMR. However, in one of my conversations a young girl told me that her dad was a doctor. She went on to tell me how it is all that her dad can talk about her.  He was trying to convince himself why he should ignore the stimulus money and not do EMR.

Of course, this part isn’t that interesting since I think we all know many doctors who are doing something similar. What was very interesting was that the daughter of this doctor explained how she was trying to convince her dad why he should do EMR. In fact, she suggested that she might have read my EMR site before because she’d done searches to learn more about EMR so that she could convince her doctor father to use an EMR.

This discussion of why you should or shouldn’t use an EMR is really nothing new. My challenge with the discussion is that I’ve seen first hand the benefits of EMR. However, I’ve also heard many stories of EMR implementations which utterly failed.

I don’t know all the answers to this situation, but it is something I want to think about more.

I do think that selecting the right EMR is the first step in the process. The other challenge is finding the right person or people to support your implementation.   Now, how do we simplify and improve those two objectives?

January 11, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Measuring Success or Failure of an EMR Implementation

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A reader of EMR and HIPAA asked the following interesting question:

I was wondering if you had or heard of anyone coming up with a way to measure if the EHR implementation was successful. Other than “its in!”. Im trying to help some clients define this but cant seem to find anyone who has done this. Im thinking something like:
Were all staff trained prior to go live?
Were project goals achieved? etc

Here’s my response that I hope you’ll find useful as well:
It’s an interesting question. I’d suggest you download my free EMR Selection e-Book.

In the book, I cover the various areas where a practice can get benefit from implementing an EMR. I suggest that each practice evaluate which of the benefits they are looking to achieve with their EMR implementation. Then, it works out nicely that it’s the criteria you can use for selecting an EMR and also for measuring how successful the EMR implementation has been.

That’s how I’d approach measuring the success or failure of an EMR implementation. Of course, you could also add in any unforeseen events (good and bad) that happened during the EMR implementation too.

The real key is to establish a set of goals or expectations for what you want to get out of the EMR implementation so you have a way to evaluate the EMR software and the EMR implementation. Then, it’s good to actually look at this criteria after the implementation to see if you fell short of those goals and what you could do to actually achieve them.

Implementing an EMR is a living, breathing thing. The best EMR implementations are evolving and improving as you continue to roll out more features of an EMR or better utilize the existing features. Not to mention all the new features that an EMR vendor will roll out as they upgrade their software.

December 14, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

EMR Consulting Business Model

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I’ve been thinking about the EMR consulting business model for a long time (check out my first post on EMR consulting back on October 27, 2006). My personal career path has taken me a different direction. I do some occasional consulting for people, but it’s not really my core business. Unfortunately, I don’t scale very well.

With that said, I think there’s definitely a business model for a company that does EMR consulting. In fact, today I learned that one of my advertisers and also an EMR consulting company, Enterprise Software Deployment, was ranked #561 out of the 5000 fastest growing companies in America (see press release).

That’s right. I guess EMR consulting is a good enough business that they can use an EMR consulting business to become one of the fast growing American companies. Plus, I agree with the press release that this next year we’re likely to see EMR consulting grow even more.

While I ABHOR EMR sales people who like to call themselves EMR consultants, I think there’s definitely a place in the EMR industry for qualified EMR consultants. In fact, check out this series of EMR consultant posts where I talk about the possible advantages of using an EMR consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in
NOTE: I wrote all these in early 2008. I don’t think too much has changed since then. Although, there are likely more EMR consultant opportunities.

September 3, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Looking Back: Meaningful Use Consultant Lies, EMR Conversions, EMR Backlog and Sunday Funnies

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This weekend I decided to look back at some random posts. Yes, call it my deep dive into the over 800 different EMR blog posts I’ve done on EMR and HIPAA. No sense in good quality posts not being seen.

Lies from Meaningful Use Consultants – Yes, the title is a bit sensational, but I was (and still am) aghast at the amount of misinformation (and lies) that are out there misleading the unsuspecting. Expect this to increase in 2011 as the EMR stimulus money starts rolling out. I’d love to post the first picture of someone getting their EMR stimulus check. Too bad it will be part of their Medicare reimbursement. Word of Caution: Be Careful with what you hear!

Converting Data from Old EMR to New EMR – I loved this email. The way he describes the difficult process of converting data from an old EMR to a new one is spot on. I expect in about 5 years, we’re going to have thousands of more stories like this one.

Plus, the comments on the cultural change of switching EMR software is beautiful to read also. This is something that Allscripts and Eclipsys EMR users are going to have to think about after Allscripts acquisition of Eclipsys.

EMR Backlog – I can’t believe I haven’t written about this for a while. It was such a hot topic back when I wrote this post in August of 2009. It’s still in the back of people’s minds. However, so far I haven’t seen any real major EMR backlog. Have you? We’ll see if that changes once the final Meaningful Use rule is out. Or maybe the checks need to start rolling in first. Either way, I’m not too worried. I think a backlog would be a good thing.

Kathleen Sebelius on The Daily Show with Jon Stewart – Just a little something to make you laugh. I should post more things like this. Maybe Saturday will become the Saturday Funnies. If you have healthcare or technology related jokes let me know on my Contact Us page. I’d love to publish them.

July 11, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.