We’re back with our weekend round up of interesting tweets from the Twittersphere. We’ve got some really interesting ones to consider this week. So, much is happening in healthcare IT. Hopefully I can provide a good insight to some of the trends that are most interesting. No doubt this will be a challenge as we head into what is one of the most busy healthcare IT news cycles of the year around HIMSS.

Now, on to the various EHR and Healthcare IT tweets:

Just What the Doctor Ordered: Mobile Access to Your Kaiser EHR ow.ly/8KwkP – check out my latest blog for @ehrandhit

— Jennifer Dennard (@SmyrnaGirl) January 30, 2012

Kaiser Permanente just made 9 Million EHR records available on line to the patients. That’s definitely worth talking about. Go read about it in Jennifer’s post.

This tweet just made me laugh (although, if you’re experiencing it, it’s not that funny):

What’s the billing code for EHR Anxiety? ow.ly/8KAWx #EHR #HCSM

— Alicia C. Staley (@stales) January 30, 2012

I think they probably need a DSM-IV code.

What if the patient was the repository of their own data – perhapsQcode on my phone to my EHR? plug into me not my data #hitsm

— Sherry Reynolds (@Cascadia) January 27, 2012

I know there are a number of companies working on this. The problem isn’t the technology to get the Qcode to access your patient record. It’s aggregating your patient record in some place so that it’s accessible. That’s going to take a long time (if ever) to get it all connected.

This is a great idea! #EHR Accessibility Challenge scr.bi/wTOetz #cisummit

— Brian Ahier (@ahier) January 26, 2012

I’m fascinated by this idea as well. I hope some companies will take it really seriously. The interesting thing is that often by making software accessible, you also learn a lot about how you can simplify the software.

EHR Design Talk with Dr. Rick 1/23/12: Computer-Centered versus User-Centered Design Within the next few years, … bit.ly/yPqDOw

— histalk (@histalk) January 24, 2012

Dr. Rick does a great job starting the conversation around EHR usability. I can’t imagine the effort he put in just to create the first post. Of course, it is a first offering, but I’m really glad that he’s started a deeper discussion around EHR usability. My only disappointment is that he isn’t posting them on one of my sites instead of HIStalk. Regardless, by the looks of the discussion in that post it’s going to drive some really interesting conversation that will hopefully result in improved EHR design.

As you know on the weekend, I try to do my simple posts since most of you are enjoying the weekend like you should.

Today I thought it might be interesting to point to a few different EMR and healthcare IT blog recommendations. This is far from an inclusive list. In fact, I could probably do this every weekend and not repeat the same blog recommendations. Maybe I will! Especially since then as I read various other blogs I can remember to make note of it. So, for this post I’ll start with some popular ones that many people know about.

Fierce EMR – I really like the work that Neil Versel does and Fierce is lucky to have him working on their EMR content.

HIStalk – This is often a bit too hospital focused for my tastes. They do have HIStalk Practice which is more ambulatory focused and has gotten better as Inga’s focused on it more.

Chilmark Research – I really enjoy John’s blog. He does a good job analyzing HIE, EHR and mobile healthcare. The only complaint is that he doesn’t publish enough, but that’s ok. When he does publish it’s almost always an interesting read.

The Health Care Blog – My only complaint about The Health Care blog is that often times it has a lot of posts that aren’t related to health care IT. Although, it does have a strong group of health care IT bloggers that do some great IT and EMR related posts.

Like I said, there are dozens and dozens of other ones. These are a few of the ones that have been around for quite a while doing their thing. I’ll cover some more of the other blogs I enjoy next time. Or you could just keep reading this site and my other blogs (EMR and EHR & The Wired EMR Practice) where I try to write about a lot of the major happenings in the EMR and healthcare IT world.

I’m going to be a little lazy today and just give you a couple links to the story of yesterday. I guess I get busy sometimes too. In case you missed it, the BIG news yesterday was Allscripts acquisition of Eclipsys.

I posted most of the relevant links on EMR and EHR yesterday along with some interesting user comments about the deal. Also, if you like this stuff, you’ll enjoy this lengthy analysis that was done on HISTalk about the acquisition.

Here’s my thoughts after reading the HISTalk analysis:
“After this merger, the new company will be trying to support eight EMRs systems and five practice management solutions with a sprinkling of inpatient technology”

Talk about an ugly situation. Plus, this quote doesn’t even highlight all the HIE software they’re dealing with.

I ran into a number of unhappy Misys users who were angry for Allscripts making them change. Just wait for these Allscripts resellers who are going to have to deal with the MyWay fall out.

I’m always a fan of awards and I’m also a fan of HISTalk. So, it just makes sense for me to let you all know about the annual HISsies nominations being done by HISTalk. Here’s Mr. HIStalk’s description of the awards:

Tell me your thoughts about 2009’s best and worst vendors, the smartest and stupidest vendor moves, and of course the granddaddy of all HIT industry awards: your choice for “HIT industry figure in whose face you’d most like to throw a pie.”

My favorite category is “HIT industry figure with whom you’d most like to have a few beers.” Ok, now go and nominate your favorite people in the HIS world. I’ll try to remember to publish a link to the voting once it starts as well. Maybe Mr. HIStalk can send me a note when it’s up if I miss it.

HISTalk nailed it on the head in this post when they said:
“Some of the most frustrated employees I’ve seen were clinical people who went to work for vendors — they had always thought the problem was lack of company knowledge, not lack of company interest in doing anything beyond the minimum required to sell systems.”

Now that’s the real problem with most EMR companies.

You should also go check out Dr. Jeff’s answer to the question “When will Doctors Enthusiastically Get and Use EMR Software and EMR Systems?“

In a really thoughtful post on HISTalk, Dewey Howell MD, PhD, Founder, CEO Design Clinicals, Inc. wrote a n article called “The Real Problem with CCHIT Certification.” In it, Dr. Howell basically makes the case against CCHIT, because it doesn’t take into account all of the various specialized EHR which only need to do a few things really well. His example was an EMR for “ambulatory, inpatient, and emergency settings.”

These arguments remind me when near the beginning of the CCHIT certification process it included such things as growth charts. Sure, growth charts are essential to a pediatric EMR, but not so much so for other EMR companies. Luckily, the vetting process did remove this criteria and what CCHIT ended up with was much better than what they started to create. Unfortunately, it’s still an onerous process for a specialized EHR to be CCHIT certified.

Dr. Howell also provides this really interesting insight:

Another deficiency of the current certification process is the lack of requirement for certification of results or outcomes. How do we certify and validate that the system actually delivers the outcomes that we are trying to achieve? The current process encourages vendors to throw a button or screen into their application that produces a specific action or display. But, there is no accountability to the patient and quality of care delivered with the tool. It encourages technology for technology’s sake, presuming that outcomes will be “better” just because a product is certified, instead of really validating results. Maybe this is a much tougher nut to crack, but it is considerably more important than things like, “The system shall provide the ability to allow users to search for order sets by name.”

I like how he described the need to measure results or outcomes. We’ve often mentioned on this blog CCHIT’s biggest problem is actually measuring usability, but results and outcomes are another way to look at the challenge of certification.

If you’ve read much of this blog at all, then you know that I’m not a big fan of CCHIT. The basis of my feeling is that it’s expensive, doesn’t measure EHR usability (despite the impression that it does), and really feels like a coalition of big EHR companies trying to secure their position in the EHR world despite having often inferior products.

All of that aside, the health care IT blogosphere has been posting some amazing accusations about CCHIT. I’ll admit that I don’t have any inside information on the organization and structure of CCHIT. So, I’ll just post all of the various information being posted about CCHIT and let you decide what might be true and what might be conjecture.

Remember that the things below may be rumors, misinformation, politically motivated, flat our wrong, mostly correct, or from disgruntled individuals.  Read everything below and judge for yourself.

See the full coverage of the CCHIT drama after the break
Read more…

UPDATE: Check out more specific details on Obama’s EMR stimulus package.

UPDATE 2: Many of you will find my presentation on the ARRA EMR Simulus money of interest.

Details about Obama’s health care stimulus package are out. I prefer to call it Obama funds EMRs for medical practices. Here’s a summary of some proposed changes via HISTalk and John Glaser, VP and CIO at Partners HealthCare System (and thanks to Chris Paton for linking me there).

• Provision of $40,000 in incentives (beginning in 2011) for physicians to use an EHR
• Creation of HIT Extension Programs that would facilitate regional adoption efforts
• Provision of funds to states to coordinate and promote interoperable EHRs
• Development of education programs to train clinicians in EHR use and increase the number of healthcare IT professionals
• Creation of HIT grant and loan programs
• Acceleration of the construction of the National Health Information Network (NHIN)

He also adds. “All of these changes (and more) are accompanied by the infusion of $20B into the healthcare sector. To put this in perspective, in 2007 the HIT industry in the US was $26B (Gartner).”

It’s also important to note like John did that this is still just proposed legislation. In the next 30 days it will be turned upside down. However, what we can guarantee is that the government is going to make a huge investment in health care IT and in particular EMR and EHR software. Man, big EHR and EMR vendors must be licking their chops right now.

The funny thing is that I mentioned this investment in EMR to my wife’s OB/Gyn and she started to laugh. She said, “Like the government’s ever done anything to help the provider.” While I think the response was a bit jaded, you could tell that she sincerely felt like the government wasn’t going to help her get an EMR and honestly I don’t see her ever changing to one.

However, the perspective that the health care IT industry was $26B in 2007 and they’re looking at investing $20B really jumps out at me. It goes back to my thought that there aren’t enough health care IT, EMR, and EHR professionals out there right now. Can the health care IT market really support an infusion of $20B right now? I have my doubts. Of course, I don’t think that’s going to stop anyone in Washington. Plus, I find the possibilities for someone like myself who has experience incredibly exciting.

I’ll save my details response to these points for posts of their own, but it’s going to be a really interesting next couple months as we watch Obama’s investment in health care come to fruition. Of course, this assumes that the money doesn’t just get stuck in the political process and never actually makes it to the doctors who need the money to implement an EMR and EHR.