I was recently sent an Information Week article on the “Steady Bleed: State of HealthCare Data Breaches.” The article basically tries to list out all of the data breaches that are happening in healthcare and how healthcare companies aren’t doing what they need to do to protect patient data.

Now, I’ll be the first to acknowledge that more can always be done. I even agree that more can and needs to be done to protect patient information. However, I don’t agree with the article’s assertion that the use of an electronic health record (EHR) is the reason why health care providers are so poorly securing patient information.

Many of you might remember my post on EMR and EHR about HIPAA Breaches related to EMR. In that post, I discuss how it’s unfair for someone to automatically assume that if there was a breach, then it was the electronic medical record software’s fault. In the analysis I did in the above post, I found that most of the HHS list had nothing to do with EMR software. In fact, many of the HIPAA breaches were lost devices which contained lists of insurance information. EHR had nothing to do with that.

I’m not saying that breaches don’t happen with an EMR. They do. However, most of the examples given in the Information Week article could have happened just as easily in the paper world. It didn’t take an electronic health record for people to start looking up famous sports stars health information.

Maybe the real difference with an EHR is that now we can know and track who accesses each patient record. That just means that now we actually know about all the violations whereas with paper charts they’d just happen and we’d likely never know about it or have a way to prove that it happened. So, yes, the number of reported HIPAA breaches should be going up. We have more information to report on.

The good thing long term is that with an EHR we now have tracking mechanisms that allow us to hold someone accountable for their breaches of HIPAA. If this accountability is taken seriously, the number of breaches will go down. That’s a much better long term solution than the naive ignorance of not knowing about breaches in the paper chart world.

Sure not all EHR software is secure. They need to fix that and improve that. However, the numbers and reports I’ve seen don’t seem to indicate that breaching an EHR software’s security is the real problem. There are far easier ways to take patient data than trying to breach an EHR’s security system. Let’s focus on those other ways that people take patient data and punish it appropriately. That’s far more productive than saying that we’re rushing too quickly into an unsecured EHR world.

I’m interested to know what topics my readers would like me to blog about on EMR and HIPAA. I don’t ask because I don’t have plenty of topics already. I have 200+ draft posts that I could choose from. Not to mention the 20+ blog posts that I bet I can do based on the topics I heard discussed and thought of during the Las Vegas EMR conference I attended last week.

The reason I’m interested is that I prefer to write about topics that interest my readers. So, if you have a favorite topic I should cover, let me know. I’ll grease the tires by providing some common general topics that I’ve been writing about and you can let me know in the comments which ones you’d like to learn more about or even specific questions or topics I can use for future blog posts.

Ok, here goes (each topic is linked to posts I’ve done related to that topic):

EMR Stimulus (ARRA-HITECH)
Meaningful Use
Certified EHR
EMR Selection
EMR Consulting
EMR Vendors
EMR Consulting
EMR Implementation
EMR Backlog
Regional Extension Centers (RECs)
EMR Technology
Social Media
EMR Interoperability
Open Source EMR
SaaS EMR

Ok, make your voices heard. I love input!!

Many of you have likely noticed that I like to use the terms EMR and EHR almost synonymously. In fact, it’s kind of a game for me now. I generally try to stick with one term for a certain blog post, but I even break that rule on occasion. I guess the thing is that it really doesn’t matter to me at all.

I don’t like to debate the meanings and definitions of words since it doesn’t matter how you define a term. Instead, I just try and communicate the substance of the issues. Words matter as part of that communication, but whether I call it an EMR or an EHR doesn’t change the value of what I’m trying to communicate (at least 99% of the time).

There are a few rare cases when I do differentiate. For example, I would likely never say that you need a “certifed EMR” to get the available HITECH Act stimulus money. I wouldn’t do so because the legislation specifically says “certified EHR” and so I’d respect the verbiage. Although, these cases are few and far between.

Plus, I try to be the voice of the physician. I’d bet if you asked most physicians the difference between an EMR and EHR they’d likely laugh, walk away or know what an EMR was but ask you to define the term EHR. I, like most physicians, don’t care what you call it. They (and I) care more about the substance of selecting, implementing, using, maximizing, enjoying and even sometimes enduring an EMR or EHR.

I imagine that many of my readers use Twitter to find EMR information. Twitter is an interesting beast. It takes a little getting used to, but can be used in a whole number of ways. However, what people don’t realize is that you don’t have to be on Twitter and have a Twitter account to enjoy many of the benefits of Twitter.

I especially like Twitter during conferences. For example, during the HIMSS 2010 conference I would just search for the tag HIMSS2010 and found all sorts of interesting information about what was happening at HIMSS. Here’s a simple search for people talking about EMR on Twitter.

I think one of the main uses of Twitter is a way to share some of my favorite EMR links. I use this EHR and HIT twitter account to do that for some of my favorite bloggers. It’s also fun to see people’s reactions to the various items I post on that account. I guess people like what I’ve done since that account has 4232 followers of it.

At the end of the day, Twitter for me is a way for me to connect with lots of interesting people. Tomorrow, I’m going to lunch with a local CPA and blogger that I met on Twitter. It’s timely, since I’ve been looking around for a CPA. So, we’ll share lunch, I’ll teach him about blogging and we’ll see if his CPA services are a good fit for my needs.

Beyond that I’ve connected with so many people on Twitter. I’ve gotten free tickets to shows in Las Vegas. I’ve gotten free graphic design work. I’ve seen some of the latest breaking news before CNN and the likes are broadcasting it. I’ve found side work on Twitter. Plus, I’ve gotten hundreds of questions answered by my smart twitter friends.

Obviously, I’m a pretty big fan of Twitter. In fact, many of you likely found this blog through Twitter. I love Twitter because it can be used in so many ways. How do you use Twitter?

Also, if you want to connect to my personal twitter account (which also does quite a bit of EMR related content), I’m @techguy.

In my previous post about the benefits of inter operable EMR software, Russ Reese left the following comment about the benefits of CPOE and whether CPOE will make it into the ARRA EMR stimulus requirements or not. Plus, he ends with an interesting thought about the EMR stimulus program. I thought it was interesting and more people should read it and comment.

Here is a link to a study that showed some positive results for EMR use – http://jamia.bmj.com/content/17/1/78.full

“Conclusions: A basic CPOE system in a community setting was associated with a significant reduction in medication errors of most types and severity levels.”

Note, this study is about CPOE which is not featured in all EMRs and I think that HIMMS has even been trying to get HHS to back off on making CPOE required for the stimulus $.

But here is real data that shows real benefits. This study is about error rates and not dollars – but if errors are reduced then lawsuits are reduced and hopefully malpractice insurance premiums follow.

IMO, we never needed the tax payer funded stimulus to begin with. Malpractice insurance companies should offer radically reduced rates to physicians that use CPOE and that would be all the “stimulus” that is needed to move doctors toward EHR.

This week I have a chance to do a lecture about EMR to a bunch of med students at a local medical school. There are so many facets to EMR, that I’m really trying to figure out which EMR concepts would be most valuable to a med student. I’d love to get some feedback from my readers on what they think would be most valuable. I’d especially like to hear from any doctors about what they wish they’d known about EMR when they were in medical school.

If you have ideas and suggestions, please leave them in the comments or if you prefer to keep your comments private, you can fill out my contact form. I’d really like to provide these students the most valuable information possible so your feedback is really appreciated.

Many people know that I’m quite fascinated by Twitter. I love it and I love connecting with people on Twitter. However, today I came across a clearly fake twitter account. At least to me it was easy to see it was fake. It was a twitter account supposedly for Dr. David Blumenthal. Yes, the name might be familiar to many people here. How did I know it was fake? It linked to some awful news site. Plus, the tweets were just odd and so you could tell it wasn’t really Blumenthal at all.

What scares me is that many people in IT and healthcare won’t know that it’s not him. In fact, that’s why I’m not going to add a link to the fake account. I guess there’s no harm in someone following a fake account. Some of the fake accounts on twitter are really funny. In this case it was someone just promoting their waste of a website. That’s not something I like.

I’ve posted my personal twitter account on here before, but I recently just started a general EMR, EHR and HIT twitter account. It’s currently aggregating some of my favorite HIT and EMR bloggers. We’ll see how it evolves over time. I know I’ve used it to keep track of a bunch of great content that’s being created.

Also, thanks for those who have signed up for the EMR and HIPAA email subscription. It’s been growing like crazy. Nice to think that people enjoy the content I’ve created.

I recently became aware of a new open source tablet EMR that was going to be offered by Medscribbler. Everyone that reads this blog should know that I’m a huge fan of open source (see my previous posts about open source EMR). It’s about time that a really strong tablet based EMR software was available as open source software.

Open source EMR purists will probably be a little disgruntled that Medscribbler is built on top of other technologies which are not completely open source. However, I give them a pass for now since the open source community has so far failed to deliver very good tablet based software.

You can find more information about the free Medscribbler EMR software here or at their sourceforge page. The following is the official press release announcement:

Medscribbler is released as an Open Source electronic medical record

Scriptnetics, the leader in Tablet PC mobile healthcare applications, will announce Monday its release of the proprietary source code for Medscribbler electronic medical record, EMR, to the open source community. Installable components and the code for programmers are available at the globally recognized open source portal, Sourceforge.net.

“Releasing a Medscribbler Open Source EMR is the next logical step to drive the innovation that is needed to get to a point where the majority of physicians and other health care providers take up electronic medical records,” said Michael Milne, Chief Executive Officer of Scriptnetics. “We hope to encourage a stable, widely available and affordable entry level EMR that uses cutting edge technology with the mobility of the Tablet PC,” he continued.

To provide focus and stability to move the project forward Scriptnetics has assigned programmers to manage and contribute new programming code on a regular basis. Other programmers wanting to contribute but needing help in understanding the considerable amount of code that already exists can access live help and support. For programmers looking to maximize their skills, project suggestions are posted in a forum.

The new Open Source EMR is called Medscribbler Community and is the first vertical, enterprise level open source project to be designed specifically for handwriting recognition on the Tablet PC. Medscribbler Community is already being used by many healthcare providers both in stand alone computer situations and client server multi computer offices. This cutting edge EMR is also being used in Internet WAN mobile remote access situations.

Scriptnetics is the largest vendor of penable Tablet PC designed medical software in the world. The company’s flagship product, Medscribbler, has been distributed since 2003 and is being used by healthcare providers in the United States and Canada. Its offices are located in Wilmington, Delaware and Moncton, New Brunswick. www.scriptnetics.com and www.medscribbler.com

SourceForge’s web sites connect millions of technology professionals and enthusiasts each day. Combining user-developed content, online marketplaces and e-commerce, SourceForge is the global technology community’s information exchange network and the world’s largest open source software development and distribution environment. Its offices are located in Mountainview, California.

For more information on Medscribbler Community see: www.emrfreesoftware.com and sourceforge.net/projects/medscribbler/

Press Contacts:
Michael Ferguson
Scriptnetics
(506) 859-9271
prnews@scriptnetics.com

Full Disclosure: Medscribbler is a an advertiser on EMR and HIPAA.

If you’ve been reading this blog for a little while, you might have noticed that I’m really struggling with whether I should use the term EMR or EHR. You can read about the difference between EMR and EHR on the wiki.

The problem I have is that for all practical purposes, EMR and EHR are being used synonymously. Yes, if we get to the nitty gritty there is a difference. However, if a doctor says they use an EMR or EHR in their office they’d mean the exact same thing. If I say I’m helping someone select an EMR or EHR in their office it would mean the same thing.

Basically, every EMR software could be called an EHR software. It’s really just branding. My problem is that I prefer the term EMR. It’s what I first used (thus the name of the website) and it’s what I used exclusively on this website for a couple years.

Now it’s en vogue to use the term EHR. I’m not very fond of the term EHR, but I almost feel like I have to use it since it’s the term people are starting to use more and more.

What kills me even more is that I want to be at the top of Google for EHR and EMR. However, Google doesn’t have common sense to realize that they’re essentially the same thing and should be ranked in similar ways. So, I walk this balance of using both terms and mastering neither of them on Google.

Since I’m on Google, I also want to openly tell Google to stop messing around with my Google Rank for the term EMR. Google keeps bouncing this website from the first page to the second page. Obviously the first page sends a lot more traffic this way and so you can imagine which I prefer. More importantly, Google should realize that this website is easily in the top 10 websites talking about EMR. If someone can show me 10 websites about EMR that are better than mine, then I’ll take it back. Until then, Google please place EMR and HIPAA permanently on the first page of results for the term EMR. Thanks!

I recently posted about CCHIT joining Twitter. Seems like a decent number of EMR and HIPAA readers are also on Twitter, because I’ve been getting a pretty good number of new followers in the HIT and EMR field.

As my 1423 followers and 2302 updates prove, I like Twitter a lot and really enjoy the way it can help people to connect (I’m techguy if you want to follow me). It’s really quite amazing how 140 characters could turn out to be so valuable and to a wide variety of markets too.

What was really interesting is I recently saw 2 EMR companies join the Twitter revolution: eMDs and NextGen. I think that it’s really smart for an EMR company to join the conversation. At least if it’s done right. So far they only have 8 tweets and 41 tweets respectively. It will be interesting to see how these 2 EMR vendors use twitter over time.

I tweeted one of these companies the following tweet, “How do you plan on using Twitter? Do you have a plan or are you just testing the waters?”

Their response was, “We’re just getting started, but hope to expand communication w/ customers & others in the industry & connect w/ the EHR community”

One thing is certain, we’re just seeing the beginning of what’s possible with Twitter. It’s going to be really fun to see what creative people are able to do with twitter and healthcare.

If you know of other EHR vendors or other important HIT people on twitter, please let me know in the comments.