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ONC Offers Guidance on EHR Safety

Posted on January 17, 2014 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.

ONCHIT has released a new set of guidelines and tools designed to help providers make safer use of EMRs and related technology. ONCHIT calls the set of nine toolkits SAFER, or Safety Assurance Factors for EHR Resilience. (Access the toolkit here.)

According to Healthcare IT News, the SAFER tools include checklists and recommended practices designed to optimize EHR safety.  ONC officials say that this suite follows up on, and forms an important part of, the Health IT Patient Safety Action and Surveillance Plan released by HHS this past July.

The toolkits, which include self-assessment checklists, practice worksheets and recommended practices, include the following topics:

  • High-priority practices
  • Organizational responsibilities
  • Patient identification
  • CPOE and decision support
  • Test results review and follow-up
  • Clinician communication
  • Contingency planning
  • System interfaces
  • System configuration

According to officials, the SAFER guides complement existing health IT safety tools already developed by ONC and the Agency for Healthcare Research and Quality.

The idea behind these guides, it seems, is to bring evidence-based practices to an area which is still evolving rapidly. As things stand, EHR use and workflow development is subject to a lot of guessing, especially as to what pathways work best in getting providers to use EHRs most effectively and safely.

All that being said, hospital executives are eyebrow deep in operational and IT issues related to their EHR, and may be simply too overwhelmed to shift their work processes to adopt these evidence-based tools.  It will be interesting to see, in other words, whether the industry considers these guidelines to be “nice to have” or necessary.

Vendors Way (Seriously, Way) Behind In ICD-10 Readiness

Posted on December 23, 2013 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.

While providers are well aware that the consequences of failing to be ready for ICD-10 in time can be dire, that hasn’t kept them on track. In fact, according to a new report, providers have fallen further behind with ICD-10 milestones that they did back in February, reports Healthcare IT News.

But as you will see, it’s not necessarily the providers’ fault. In fact, if I were a provider, and my vendor was as behind as some apparently are right now, I would be beside myself.

Research from the Workgroup for Electronic Data Interchange found that some 50 percent of providers have completed the ICD-10 impact assessments. And about 50 percent of providers expect to begin external testing in the first half of 2014, Healthcare IT News notes.

But the study concludes that about 80 percent of healthcare providers will fail to complete their business changes and testing ICD-10 before 2014.

This may not be their fault. According to WEDI, 20 percent of vendors surveyed said they were halfway there or less developing products to support ICD-10. Even worse, 40 percent indicated they wouldn’t even have a finished product available until sometime in mid-2014, a situation which could create enormous problems for providers. (Wondering vendors are addressing the changeover? Here’s how one vendor has been handling the  problem.)

According to WEDI, the top three barriers to vendors completing their ICD-10 upgrades were customer readiness, competing priorities and other regulatory mandates. Personally, I’d argue that vendors have had plenty of time to get the ICD-10 act together. And I wouldn’t find any of those excuses compelling given the impact these delays are likely to have on my operations – – specifically, that special part of operations known as getting paid.  (But hey, maybe you’re a more forgiving type than me.)

With vendors falling behind on ICD-10 software updates and patches, providers are left having to wait — way too long — to begin tests of the downstream functions to come after testing, Judy Comitto, CIO at Trinitas Regional Medical Center in New Jersey, told Healthcare IT News: “I’m a bit disappointed, having reached out to these vendors that they are certainly not there yet.”  Sadly, I think more disappointment is yet to come.

Study: Doctors Favor Integrated EMR, Practice Management System

Posted on September 13, 2013 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.

While large institutions may not be jumping onto cloud-based technologies — or admitting it, in any event — the majority of doctors in a new Black Book survey are gung-ho on cloud solutions to their revenue cycle management dilemmas, according to a new piece in Healthcare IT News.

A new Black Book study, “Top Physician Practice Management & Revenue Cycle Management: Ambulatory EHR Vendors,” surveyed more than 8,000 CFOs, CIOs, administrators and support staff for hospitals and medical practices.

The research has concluded that 87 percent of all medical practices agree that their billing and collections systems need to be upgraded, HIN reports. And the majority of those physicians are in favor of moving to an integrated practice management, EMR and medical software product, Black Book concluded.

According to Black Book rankings, the revenue cycle management software and services industry just crossed the $12 billion mark, pushed up by reimbursement and payment reforms, accountable care trends, ICD-10 and declining revenues.

Forty-two percent of doctors surveyed said that they’re thinking about upgrading their RCM software within the next six to 12 months. And 92 percent of those seeking an RCM practice management upgrade are only planning to consider an app that includes an EMR, Healthcare IT News said.

It’s no coincidence that  doctors are trading up on financial tools. Doctors are playing catch-up financially in a big way, with 72 percent of  practices reporting that they anticipate declining to negative profitability in 2014 due to inefficient billing and records technology as well as diminishing reimbursements. (On the other hand, it’s not clear why doctors aren’t still seeking best-of-breed on both the EMR and PM side.)

While selecting an integrated PM/EMR system may work well for practices, it’s going to impose problems of its own, including but not limited to finding a system in which both sides are a tight fit with practice needs. It will be interesting to see whether doctors actually follow through with their PM/EMR buying plans once they dig in deep and really study their options.

URMC Faces Third HIPAA Breach

Posted on May 7, 2013 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.

The University of Rochester Medical Center has seen a third HIPAA breach, this one caused by the loss of an unencrypted USB drive by a physician, reports Healthcare IT News.  The drive, which belonged to a resident, contained protected health information on 537 patients.

Officials with URMC say they have notified the 537 former orthopedic patients whose information was lost on the drive.  Lost information included patients’ names, genders, ages, dates of birth, telephone numbers, medical record numbers, and more, though it didn’t include addresses, Social Security numbers or insurance information.

According to Healthcare IT News, the resident’s unencrypted, unprotected drive runs counter to URMC’s campus-wide policy. URMC requires physicians and staff to use only encrypted drives — the only kind which are stored in its on-campus computer center.  The latest URMC security policy also requires all mobile devices to be password protected, encrypted, and to have a time-out if unattended.

In an effort to make sure further security breaches don’t occur, the health organization is re-educating its faculty and staff on its security policy, and plans an annual education series to reinforce this training, a hospital spokesperson told Healthcare IT News.

This is URMC’s third data breach involving more than 500 patients reported to HHS, the magazine reports. The previous two breaches, which involved PHI for nearly 3,500 patients, both took place in 2010.  One of the two involved the loss of an encrypted portable electronic device.

Meaningful Use for Radiologists – Meaningful Use Monday RSNA12 Edition

Posted on November 26, 2012 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.

This week is the enormous RSNA conference in Chicago. I almost made the trip to the event, but wasn’t able to figure out the logistics. Plus, with a wife and kids the less travel the better. One day I’ll make it to RSNA. Until then, I thought I’d dedicate this edition of Meaningful Use Monday to the radiologists out there.

In short, meaningful use stage 1 was not good for radiologists. Most radiologists saw it as a non-starter for them. In fact, I think it’s safe to say that smaller radiologists couldn’t tell you much of anything about meaningful use stage 1. Meaningful Use stage 2 has made some progress for radiologists, but is unlikely to really get them off the bench and showing meaningful use.

Healthcare IT News has a good article on radiologists and MU where they point out some image centric updates to meaningful use per RSNA:

compliance exemptions for many hospital-based providers who are not involved in their facility’s information technology decisions, a discretionary menu set objective targeted toward diagnostic image accessibility in EHRs, recommendations for radiology-relevant clinical quality measures, more flexible definitions of what constitutes justified EHR, and a consolidation of the eligible hospital and eligible professional technology certification criteria.

Although, the article also points out two other very important points. First, radiology practices will likely forgo participation in the meaningful use program and avoid the EHR financial penalties by way of an exemption. If that exemption ever runs out, then radiologists might change their tune. Although, my guess is that the meaningful use penalties will never be enforced or that there will always be exemptions that radiologists can fall back on.

The second point is even more interesting. Lineage Consulting’s Nakhle suggests that all of the other ordering physicians that are adopting EHR and showing meaningful use might be the real driver for radiologists to get on board meaningful use. I agree that ordering physicians being meaningful users of an EHR is going to change imaging facility requirements. Certainly imaging facilities are going to have to work on new tech workflows, but that doesn’t mean they have to go so far as meet meaningful use. Plus, most imaging facilities are working on these workflows already, so I don’t expect meaningful use will cause much change.

I’m sure this will be a huge topic of discussion at RSNA. If you’re there, we’d love to hear what’s being said on the show floor.

Meaningful Use Stage 3 Timeline – Meaningful Use Monday

Posted on November 19, 2012 I Written By

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

The big meaningful use news this week was the release of the meaningful use stage 3 recommendations (PDF) that the meaningful use workgroup released to the public. Some on Twitter thought that this was the meaningful use stage 3 rule that could be commented on. This is not open for public comment yet, but should be soon.

In fact, Healthcare IT News listed the following timeline for meaningful use stage 3:

  • Dec. 21, 2012 – RFC deadline
  • January 2013 – ONC to synthesize the RFC comments for HIT Policy committee workgroups to review
  • February 2013 – The workgroups will reconcile RFC comments
  • March 2013 – The workgroups will present a revised draft of Stage 3 requirements to ONC
  • April 2013 – ONC is expected to approve final Stage 3 recommendations
  • May 2013 – ONC will transmit final Stage 3 recommendations to HHS

That’s a pretty aggressive timeline to have meaningful use stage 3 published by May 2013. If my dates are right, meaningful use stage 3 won’t be effective until 2016. I like that ONC wants to get the MU stage 3 out soon so that no one can use not having the meaningful use details as an excuse for not complying. However, I also don’t think ONC should rush the process either. We have to live with meaningful use, good and bad, for a long time to come.

I’d love to hear what you notice in the meaningful use stage 3 proposal (PDF). We’ll be sure to cover it a lot more in the future.

Health IT List Season – A List of Lists

Posted on July 11, 2012 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.

Everyone on the internet loves a good list. I know that when I see a list tweeted by someone I feel that natural impulse to click and see who made the list. There’s something about a list that is captivating and fascinating. Plus, if there’s a potential that we could be on the list, then our interest in that list skyrockets. Most of the time the order of the list doesn’t matter. There’s little need to put any sort of rigor into who makes the list or not. People are naturally attracted to lists. I’m sure there’s some cultural reason for this, but regardless of the why it’s just the current state of affairs.

Over the past couple weeks, it seems like it’s the season of the Health IT lists. Every other day or so another health IT list comes out. I predictably click through to see who or what’s made the list. Every once in a while I even make a list and I must admit that it’s quite exciting. There’s something beautiful about having your name in lights. Add in the social media response that often accompanies making a list, and it’s really quite intoxicating. I of course try not to inhale.

I actually partially questioned one of the current list making efforts, the #HIT100, near the end of the #HITsm chat this week. I tweeted, “That’s the real problem with the #HIT100 It’s hard to really rank it and is easily gamed. #HITsm” Michael Planchart that puts together the #HIT100 replied, “I don’t understand why it would be easily gamed? #HIT100 #HITsm” Instead of sharing how people could game the ranking, I instead replied, “It’s not a large enough community to really do a ranking. The list is interesting regardless of how they are ranked #HIT100 #HITsm”

Interestingly enough, someone who saw our conversation privately sent me this message, “Here’s some reasons: New accounts created to vote. Non-industry people voting, staff voting en masse for boss, Mom voting, etc.” and then this follow up “We all have out pet projects and little ego things! :’) Thinking of a blog post about this – but don’t want to alienate #HIT100 friends :)” He was right about treading lightly (a challenge for me) so you don’t alienate others in the Health IT community. Although, by doing so we also miss out on some really meaningful conversations.

Michael also responded, “The purpose of the list is to introduce #HealthIT folks to each other. The ranking is just the fun part of it. #HIT100″

I agree with Michael that it’s a great way to learn about new #HealthIT people on Twitter. Although, I think Michael underestimates the power of the rankings. As I described above, being ranked and where you rank has a much bigger impact on people both consciously and unconsciously. To be honest, it’s part of the reason why I haven’t actually nominated anyone to the #HIT100….yet(?). I’d probably have to sit down and nominate 100 health IT people myself to do it justice. There’s just so many good ones, that I’m not sure where I’d start.

I actually like the way that Michelle McNickle (I’ve fallen in love with her work lately) handled her list of 10 Health IT bloggers on Healthcare IT News. Instead trying to rank them and instead of trying to be complete, she just said that these were “some of the best HIT bloggers actively using Twitter.” The ironic thing was that similar to that telephone game we’d play as kids, the list got tweeted as “Top 10 Health IT Bloggers.”

I also loved that Kristi Ellis (one of the @HealthyComms Twins) took the #HIT100 and made it into a blog post. I hope that the #HIT100 spawns more lists like this from people in the industry. One thing I would have loved to see in that blog post was a short description of why Kristi added that person to her list.

We need more blog interaction like Kristi is doing and now to some extent I’m doing with this post. I’ve discussed this a bit before, but I think in the age of Twitter were losing out on some of the deeper conversations. Instead of putting together a thoughtful blog post reply to someone else’s blog post we just post it on Twitter with 2 words or hit the retweet button and move on. Each of those has its place, but a part of me still yearns for those blog responses which add depth to the conversation.

There you have it. A few thoughts on the various health IT lists I’ve seen being passed around. What do you think? I know I can’t wait until I see the next list. Let me know if you know of others.

Radiologists, Meaningful Use and EHR Incentive Money – Meaningful Use Monday

Posted on December 5, 2011 I Written By

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

I recently had someone ask me about radiology and whether they needed to comply with meaningful use and if they qualified for EHR incentive money. Good thing is that I found this Healthcare IT news article that discusses radiology and the EHR incentive money.

Let’s start off with a stat about whether radiologists qualify for the government EHR money.

An estimated 90% of radiologists are eligible for incentive payments from the CMS, according to the American College of Radiology.

I was surprised that the number of radiologists that qualify is so high. So, I guess the simple answer is that yes, almost all radiologists qualify for the EHR stimulus money. Yes, that also means that radiologists will also be subject to the penalties for not being meaningful users of an EHR system.

Although, I guess there has been confusion around whether radiologists qualify for the EHR money. This quote illustrates how widespread this could be:

“Most radiologists seem to believe that they weren’t included in the meaningful use regulations, but the opposite is true,” said Murray Reicher, M.D., DR Systems co-founder and chairman. “The real challenge is meeting the requirements in time to get the largest bonuses — and just as important, to avoid future penalties.”

With that out of the way, the next question is how hard it is for radiologists to meet the meaningful use requirements. I’d love to hear from some radiologists who have either been through the meaningful use stage 1 attestation process or who have looked through the requirements and can point out the meaningful use measures that will be hard for radiologists to achieve. I’m sure there are a number of them that they won’t need to show.

Either way, it’s worth noting that radiologists do qualify for the EHR stimulus money and also could be subject to the future EHR penalties. I wonder how many EHR software vendors work with radiologists.

Great EMR and Healthcare IT Content

Posted on March 3, 2011 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.

Today I’m happy to officially introduce readers of EMR and HIPAA to my latest project: The Healthcare Scene blog network. If you follow me on twitter (@techguy and @ehrandhit), then you’ve probably already come across one or more of the great blogs in this new healthcare IT blog network. I’m really excited with the group of bloggers that I have working on the network and the amazing content they’ve been creating and will create.

Before I introduce you to the various websites on the network, here’s a little background in why I decided to do this. As I looked at the various healthcare IT and EMR bloggers producing content, I was disappointed that many of them were creating great content that wasn’t getting nearly as much attention and traffic as the content deserved. Plus, many hadn’t benefited financially from all the great content they were creating. Combine lack of traffic with lack of financial rewards and these independent voices often disappear.

I saw this as a real opportunity to leverage many of the marketing and advertising tools that I’d created for EMR and HIPAA to the benefit of many others in the EMR and healthcare IT world. Plus, a number of my current advertisers told me that there weren’t enough online healthcare IT advertising options out there. I see this network as a real win for everyone. Independent bloggers can have their voices magnified while making money doing so. Readers and the EMR and Healthcare IT industry get more independently created content (including content by doctors). Healthcare IT advertisers will have more opportunities to advertise next to great content. I get to expand my network and work with a bunch of really smart people.

Now here’s a look at the websites that will be part of the Healthcare Scene blog network:

  • Meaningful HIT News – This blog written by Neil Versel started in May 2004 and has over 500 posts. Neil is one of the only pure healthcare IT journalists out there and has been doing it for the past 15 years across more publishers than you can count, but most recently at Fierce Healthcare. I’m excited that Neil has chosen to move his blog to the HealthcareScene.com blog network. He’s a must read journalist for anyone in EMR and healthcare IT. I borrowed much of my writing style from Neil and so if you like this site, go and subscribe to Meaningful HIT News email list and you won’t be disappointed.
  • EMR and Healthcare IT News – The firehose of EMR and Healthcare IT news sent out by vendors. A great way for vendors to get their word out and for industry people to see the latest developments in EMR and healthcare IT. I’m looking to partner with healthcare IT PR firms on the site, so hit my Contact Us page if you’re interested.
  • Happy EMR Doctor – This blog first started out as a Doctor’s Blog guest post on EMR and EHR, but the content from Dr. West was too good. So, I rolled it off onto its own blog. Dr. West has been through a failed EHR implementation and now is using one of the Free EHR vendors. So, he has some interesting stories to tell.
  • Smartphone Health Care – I recently heard that there were something like 30+ mobile health conferences or conferences with a mobile health track in the past year. That seems like far too many, but it is quite clear that Smart Phones and other mobile devices are going to play a huge role in the future of healthcare. Consider this my foray into the mHealth world.
  • Wired EMR Practice – Many of you might remember that I already introduced Dr. Koriwchak’s blog on EMR and HIPAA earlier. Many of you subscribed to his blog and have seen the type of quality content he’s creating. I love doctor’s perspectives on EMR.
  • nextHospital – We’ll see how this blog evolves, but it’s the Healthcare Scene’s first blog that isn’t really IT focused. Written by Katherine Rourke (mentioned above), nextHospital will focus on the business of healthcare in hospitals.
  • EMR, EHR and HIPAA Wiki – Not a blog, but a pretty cool part of the network nonetheless. Be sure to add your EHR vendor if it’s not on there already.
  • EMR and EHR Job Board – Not a blog either, but this job board will be syndicated across all the HealthcareScene.com websites. So, it’s a great places to post or look for a job.
  • EMR and HIPAA – Hopefully it needs no intro if you’re reading this post. Let’s just say, 1000 posts, 4713 comments, and over 4 million pageviews.
  • EMR and EHR – Very similar to EMR and HIPAA, but only about 2 years old. 300 posts, 1092 comments and 700,000+ pagevies. Katherine Rourke, a healthcare IT journalist with 15+ years of experience, recently started posting on EMR and EHR and is a welcome addition to the site.

I’d say that’s a pretty good start. I’m in talks with a few more bloggers that may or may not join the network. I think there’s still some interesting niches that haven’t been filled. For example, a blog tracking publicly traded healthcare IT stock movements and other healthcare IT investment opportunities could be interesting. Either way, I’m excited to see all the great content that will be created on these sites. Much like this site, each site encourages you to respectfully comment, share the content, and join the conversation. Please let your voice be heard in the comments.

Yes, right now each site looks very much like the rest, but we’re just getting started. Over time I’ll work to give each blogger it’s own brand while also building up the HealthcareScene.com domain to better represent all the activity that’s happening on the network. I see it becoming a virtual hub of the best and brightest conversations happening in and around healthcare IT and EMR.

Let me know what you think of these additions in the comments or drop me a note on my Contact Us page.

EMR News Site and Foursquare at HIMSS (#HIMSS11)

Posted on February 18, 2011 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 was going to officially launch my new Healthcare IT blog network today, but got a little bit busy. Plus, it’s Friday, so I think I’ll wait until next week or after HIMSS to officially launch it. It’s going to be really cool and bring out some interesting independent voices in Healthcare IT.

Until then, if you want to see the latest news coming out of HIMSS, you should head over to our recently launched EMR and Healthcare IT news site. It’s been hopping and with my wife’s help it will stay well updated during and after HIMSS with the latest news.

Also, I came across the idea of using Foursquare at HIMSS. I thought that sounded like a good way to start using Foursquare. Plus, then more people will be able to find me in order to win a Free HD TV at HIMSS. So, if you’re on Foursquare, then follow @techguy on Foursquare and you’ll know where to find me. Become my friend so we can connect at HIMSS. I’ll be interested to see how my Foursquare experience could translate to healthcare. Should be interesting.

My flight leaves tomorrow. I can’t wait!!