Hospital CIO | EMR and HIPAA

EMR Success Depends on Proper EMR Access

With all of the focus being on all the various regulatory requirements (meaningful use, ACOs, ICD-10, 5010), I think there’s a real issue brewing in healthcare IT because we’re not focusing on other IT issues. As a hospital works on their EHR implementation strategy, it’s easy for them to focus a lot of time and effort to make sure that they meet the meaningful use attestation requirements. This is important, because if they don’t focus on meaningful use, then they’ll never meet the meaningful use measures. However, in the process I’m starting to see many institutions that short change the IT part of the EMR equation.

This point was really driven home to me when I was reading “Tips for Ensuring EMR Access = Success” on the Point of Care Corner blog. Here’s a great paragraph from that blog that highlights the challenge:

An effective access-point strategy must also support a safe, ergonomic workplace that enables caregivers to focus on patients rather than “hunting and gathering” the tools and information they need. Most nurses walk many miles per shift. With good planning, they will not need to add to that total looking for an open computer to enter or view patient information.

Unfortunately, in the rush to implement meaningful use of a certified EHR by the deadlines, many institutions aren’t spending the time required to make sure that EMR access is available when and where it’s needed.

The good part of this story is that you can still correct this problem after the fact. Plus, it’s not that hard once a hospital CIO places focus on it. However, it does take a focused effort. Ideally you would have worked through the EMR access issues during your EMR implementation, but it shouldn’t be any surprise that you weren’t able to plan for all of your unseen EMR access needs. So making sure you plan a review after your EMR has been in place is essential.

There is nothing more demoralizing to a user of an EMR than to not be able to get into the EMR when they need it. Although, many times EMR users won’t know what they need until after they’ve been using the EMR for a little while. There’s nothing more valuable than experience to inform decisions. Plus, technology is constantly changing, so you’ll want to consider how new technologies can make your EMR users’ lives better.

This issue reminds me of a comment Will Weider, CIO of Ministry Health Care, made in this interview. When asked what project he thought didn’t get enough attention in the hospital, he answered that it was the need to abandon Windows XP by the time Microsoft ends support. Evaluating EMR access points is another issue that I think doesn’t get enough regular attention. It’s unfortunate, because it can make an extremely big difference in what your EMR users think about their EMR experience.

Full Disclosure: Metro is a sponsor of EMR and HIPAA

BYOD And HIPAA Compliance: Can You Have Both?

Written by: Katherine Rourke

With doctors among the biggest fans of smartphones around, hospitals and medical practices are having to face the reality that Bring Your Own Device is here to stay. The question is, is BYOD so hard to manage that it all but guarantees HIPAA breaches?

On the one hand, BYOD seems to have arrived to stay. According to a recent report by KLAS Research surveying 105 CIOs, IT specialits and physicians, 70 percent said they used mobile devices to access their EMRs. Even this small group was accessing virtually every major enterprise EMR via mobile, reports MobiHealthNews.

But the pressures on hospitals to corral BYOD security gaps are growing. Hospitals will soon have to provide increased protection of patient health information under Meaningful Use Stage 2. And the HHS Office of Civil Rights will be doing stepped up HIPAA-compliance audits, which gives hospitals even less leeway than they’d have had otherwise.

Of course, hospitals have been dealing with doctors bringing one device — a laptop — for quite some time. One might think this would have prepared hospitals for dealing with security-hole-ridden portable devices that staff and clinicians bring to work. But as we all know, laptops have proven to be major sources of security breaches, most typically by being stolen when loaded down with unencrypted data.

BYOD on the mobile side is if anything a riskier proposition. For one thing, doctors and executive staff are likely to own more than one device, such as a phone and a tablet, multiplying the risk that an unguarded device could be stolen and bled for information. And managing mobile devices calls for IT to support two additional operating systems (iOS and Android) configured in whatever way the user prefers.

Folks, I know I’m not saying anything crashingly original, but I’d argue it’s worth repeating: It’s time for hospitals to stop waffling and develop comprehensive protocols for BYOD use. It’s clear that left alone, the problem is going to get worse, not better.

HIE Waste

Written by: John Lynn

In a post on LinkedIn, David Angove offered this comment on government HIE funding:

The biggest waste of the new program I’ve seen is the HIE (Health Information Exchange) part. It got much more money than the EHR/MU part (5-10 times) and much of it ended up in the pockets of universities who just absorbed it as personal funding. Just look to see how many HIEs are actually functional in the US now almost 4 years after the grants were awarded. Most of the working HIEs were done by private groups who got tired of waiting for the groups who got all the grant money to do something.

It should be clear that David’s comparing the money spent on HIE’s as compared with RECs (he refers to it as EHR/MU). If you take in the larger EHR incentive money that doctors will receive, then it blows the HIE portion of the funding away.

Instead of focusing on the comparable amounts, I think the question of whether the HIE money the government put out as part of ARRA and the HITECH Act has been generally a waste. I started to think through the successful HIE projects out there. David’s right that the most successful ones I know of (see Indiana’s HIE, Maine’s HIE, and Arizona’s HIE) would have happened regardless of whether the government money came. Does anyone know of government funded HIEs that are seeing success and wouldn’t have without the government money?

The hard part of this question is that we’re not likely to know exactly how well the HIE funding has gone until we see how many HIEs survive post government funding.

Related to this was how many hospital CIOs I’ve talked to that don’t believe that HIE is the future of health information exchange. As one hospital CIO told me, he didn’t think that the HIE was a viable model. Instead he suggested that point to point exchange of information is going to be the winner when it comes to exchanging health information. Considering the issues related to HIE, I have a hard time arguing against that thought.

Hospital CIO Jobs

Written by: John Lynn

The past couple days, I’ve been at the CHIME Fall CIO Forum in Palm Springs. This is my first time attending the event and it’s been an eye opening experience to say the least. It’s an amazing experience to have casual conversations with many in the healthcare IT industry and particularly with hospital CIOs.

While chatting with a former hospital CIO who now is on the vendor side, he made this fascinating observation:

I travel around and talk to a handful of CIOs every week as part of my job. When I meet with these hospital CIOs and hear about the challenges they face in their institution, I don’t get the feeling “That’s a really swell place to work. I want that job.”

In this current economic climate, it’s hard for anyone to feel really bad for a well paid hospital CIO (Yes, some are better paid than others). I acknowledge that many around the country would argue that a hospital CIO should be glad to have a job, and one that pays above the national average salary.

This general economic argument aside, I think it’s worth noting the challenging situation that many hospital CIOs face. Regardless of how much someone is paid, that doesn’t change the enormous challenge that most hospital CIOs confront every day.

Yes, we could start with the list of alphabet soup including: meaningful use, EHR, ACOs, 5010, HIE, and ICD-10 to name just a few. However, that’s just the beginning of what they’re dealing with in their jobs. Another major one worth mentioning is managing the budgets. It’s a complex, high pressure job whenever money is involved. Add in all the various maintenance, people management, process management, etc etc etc and the hospital CIO has a tough job.

This has never been more clear to me than at CHIME where the hospital CIOs all come and commiserate. I don’t think we should feel bad for these hospital CIOs and I don’t think they’re asking us to do that either. Although, it’s worth acknowledging that hospital CIOs face a tough and challenging job and I don’t see that changing any time soon. I appreciate those that are willing to take up the challenge and that perform so well in the face of such a changing environment.

Enterprise HIE vs Public HIE

Written by: John Lynn

I was recently listening to an interview with a hospital CIO talking about their move to becoming an ACO and the various ACO initiatives. As part of the interview the hospital CIO was asked about HIEs and how they were approaching the various HIE models. His answer focused on their internal efforts to create what he called an Enterprise HIE.

I think it’s telling that even within a hospital system they haven’t figured out how to exchange health information. They control the end points (at least in large part) and yet they still have a challenge of exchanging information between their own provider organization.

One trend that is causing the above challenge has to do with hospitals acquiring medical practices. As you acquire a practice or even acquire a hospital there’s often a challenge associated with getting everyone on the same IT system. Plus, even within one hospital they use hundreds of different applications to capture clinical content. Thus the need to create an enterprise HIE.

I think that the idea of hospitals building enterprise HIEs puts some context on public HIE efforts. First, if hospital organizations are having a challenge putting together an internal enterprise HIE, it’s no wonder that public HIEs are having such a challenge. If hospitals don’t have their own houses in order, how could they export that to a public HIE?

In that same interview I mentioned above, the hospital CIO said that he was monitoring the other HIE initiatives in his area. However, he said that he believed that we were far from seeing HIEs really take off and be used widely. Obviously each HIE is very regional in nature since healthcare is mostly regional in nature. However, it was a telling message about the slow pace of HIE.

ACO Security Issues

Written by: John Lynn

Leave it to the people at Healthcare Info Security to take a look at the security issues that are associated with an ACO. They do so in an interview with Bill Spooner, CIO of Sharp Healthcare. Here are some of the quotes from the interview which really resonated with me:

To deliver more coordinated care, collaboration and data exchange among ACO participants are vital. And participants “need to ensure that patient privacy is honored, and that all security provisions are in place,” Spooner says in an interview with HealthcareInfoSecurity.

And this one about ACO Information Sharing needs and patient privacy:

“The ACO model tends to elevate the attention on information sharing. … And along with that comes the need to ensure patient privacy is honored so that records are only shared with providers that patients want their information shared with, and that security provisions are put in place,” Spooner says.

I think Bill Spooner elegantly describes how healthcare institutions should handle patient privacy in everything they do, including ACOs. I like the idea of honoring patient privacy.

Let me make a few suggestions on what healthcare institutions and ACOs can do to honor patient privacy. I think there are two things that patients fundamentally want in regards to the privacy of their health information. They want to be informed about its use and control.

Informing Patient Information Use
The reality for the large majority of patients is that they want their medical providers sharing their information. I don’t know anyone who wants their health information kept private when it could provide them better care. I imagine there are some outlier cases, but the majority of people actually assume that doctors are sharing their health information already.

What patients want from doctors and in this discussion ACOs is transparency on when and what information is being shared. Is that too much to ask? I don’t think so and it’s the right way to honor patient privacy is to provide a way for the patient to be informed on where and when their health information is being shared.

Controlling Health Information Sharing
Some might say that we’re becoming a nation of control freaks. I’d argue that we don’t all want to be control freaks, but we do want that option available to us if so desired. As I said in the previous point, most patients want their information shared because they realize that they’ll get better, lower cost, more effective patient care if their doctors have all of their health information. However, one thing we hate as Americans is not having the choice of whether that sharing happens or not.

What does this mean? It means that you’ll provide patients the opportunity to restrict their health information from being shared and then almost no patients will use that function. Patients want the knowledge that they can stop health information sharing more than they want for their information to not be shared. It’s a subtle difference, but is another key to honoring patient privacy.

What other things can ACOs and healthcare organizations do to ensure that they’re honoring patient privacy?

Health IT Q&A with Scott Joslyn, CIO and Senior Vice President, MemorialCare Health System

Written by: John Lynn

Tell us a little bit about yourself and your organization.
I’ve been the CIO at MemorialCare for about 16 years and with the organization for some 33 years. My training as a pharmacist has allowed me to bring a clinical background into my work as CIO. A subsequent MBA allows me to approach today’s challenges from both a clinical and business perspective.

MemorialCare, based in California, is a private, not-for-profit integrated delivery system that includes 1,500 beds across six hospitals, and a medical foundation with 400 physicians in an IPA model and 150 physicians in a staffing model. MemorialCare is listed among the top 20 percent of health systems nationwide by Thomson Reuters and in 2011 the organization was identified as one of the top 100 integrated healthcare networks nationwide.

What have been the benefits and challenges associated with EHR adoption to date?
Today, we live with Epic across five of six hospitals and 175 physicians. In addition, approximately 300 physicians use the NextGen EHR. Epic replaced an early-generation EHR (TDS, now Allscripts) installed in 1991. The experience with that system – CPOE, alerts, order sets, best practices, etc. – was immensely helpful as we configured, installed and supported the rollout of the Epic system. We know from that experience, for example, the critical role of physicians and nurses as the key leaders and champions of change, patient safety, and system design cannot be overemphasized. Apart from that experience, we also benefited from all that had been learned by other organizations that had gone before us with EHR rollouts, both successes and failures. We went live with Epic at our first hospital six years ago. We completed implementation of Epic’s clinical and revenue cycle systems over the ensuing four years.

We’ve learned that rather than being done with our EHR journey, we are actually just beginning. We are currently live with high levels of physician adoption and have largely eliminated paper-based records in our care for patients. Nevertheless, we find ourselves expanding the Epic system and exploiting its power in an environment where care process and healthcare financing are undergoing a revolution as a result of healthcare reform. Challenges included keeping pace with advances in the features and functions of Epic, increasing cost pressures, the anticipated organizational changes associated with accountable care, a transition from fee-for-service out outcomes focused financing, and the basic operational needs of accountable care.

Other challenges we faced were developing a system that would work well for everyone – from specialist to internist to hospitalist and beyond. Many different but interrelated workflows are involved, some that emphasize content while others are built for procedural speed. Another challenge is ensuring system reliability, speed, and near-constant availability. While we have “downtime” procedures, we are not terribly productive reverting to paper when the system is not available. We simply must take steps to minimize and protect against system failure.

What role has voice recognition played as it relates to your organization’s EHR adoption?
Today, we’re moving from an era of dictation and transcription to an era of voice recognition. As a result, the role of the transcriptionist is shifting from one focused on transcribing to one focused on editing the text captured by voice recognition.

Our EMR captures data in two forms – structured and narrative data. Increasingly, EMRs are incorporating functions and tools that help streamline the capture of both types of data. Voice recognition, specifically Dragon Medical 360 | Network Edition and Dragon Medical 360 | eScription, play a large and growing role in the capture of the patient narrative. Voice recognition helps make our physicians more productive, as the capture of narrative is integrated with structured data gathering tools such as forms and discrete data fields. This will be especially important and helpful as we shift to more elaborate coding under ICD-10.

How has meaningful use influenced your development roadmap? Have you found meaningful use to be very “meaningful”?
We invested in the Epic EHR well before the HITECH Act and Meaningful Use incentives and embraced MU along the way as part of our adoption and use of Epic. We have already attested for Stage 1 for MediCal (Medicaid in California). We believe in Meaningful Use and think it represents the best interests of patients, providers and payers. Currently, we’re in the process of digesting Stage 2. While we find it daunting as it relates to the breadth of the information provided, we’re confident that we’ll be able to tackle these new requirements over time. So yes, we do find Meaningful Use “meaningful” and generally the right thing to do.

What type of involvement do you see your organization having in Accountable Care Organizations (ACOs) and what role will technology play in it?
EMRs are a foundation of ACOs and increasingly taken for granted – table stakes for participation in an ACO. While we’re still ironing out the details of what an ACO means for our organization, the reality is we’re living in a post-EMR world. ACOs are the next frontier and, clearly, EMRs will play a major role in the making the ACO model a reality. Other technologies, such as analytics, interoperability and data warehousing will play an equally big part in this shift toward the focus on population health and outcomes-based care.

What’s are your thoughts on HIE? What will it take to have a truly successful HIE?
New policies and regulations need to be put in place at the Federal level for HIE to truly work. Today, providers are reluctant to consider or embrace HIE because of the financial and reputational risks associated with the idea of sharing patient information. Issues of patient consent management, opt-in vs. opt-out, and privacy create both real and imagined barriers. We need to create a legal and regulatory environment that is receptive and supportive of HIE rather than potentially risky and punitive. As an organization, we participate in local, public HIE efforts while we endeavor connect our systems to affiliated providers to safely and securely make available patient information as our physicians and patients currently demand and expect in the current environment. We’re encouraged by the progress and ongoing regional and national dialog with regard to HIE though we do think it will evolve slowly and unpredictably.

What’s the most beneficial IT program that your organization has implemented? What benefits were achieved?
Our EMR. It’s had the most dramatic impact on the patient care we provide and how we run our “business” efficiently with substantially higher levels of patient safety. It is a vital go-forward “platform” on which to build new tools and capabilities to survive and thrive in a rapidly-changing healthcare environment.

What are your biggest challenges as CIO?
Figuring out what it really means to be an ACO and what it means to manage the health of a population. I find myself constantly thinking about these questions:

What do we really mean by population health?
How do we restructure our business to provide population health services, and with which organizations will we need to affiliate to carry out population health initiatives?
What tools and technologies will we need beyond the EHR to make population health a reality?

Which IT project doesn’t get enough attention and why?
Establishing social media tools and technologies that can help facilitate internal collaboration – beyond email and our intranet.

Effectively engaging patients in their health care, likely using social media, apps, etc. I’m constantly wondering what patients really need from us in order to manage their health and wondering what role apps or other technology might play in making an effective connection between provider and patient.

BIDMC’s Encryption Program Tames BYOD Security Fears

Written by: Katherine Rourke

Beth Israel Deaconess Medical Center has begun what it calls an “aggressive” campaign to make sure every mobile device in use by its staff and students is encrypted. This is interesting in light of John’s recent post about encrypting devices to meet HIPAA. The following update comes from the GeekDoctor blog maintained by Halamka, a resource worth reading in its own right.

The initiative, spearheaded by the indefatigable CIO John Halamka, MD, MS, is massive in scope, affecting as it does 18,000 faculty members and 3,000 doctors, plus a large student population. Costly and time-consuming though it may be, I think it’s an object lesson in what needs to be done to make “bring your own device” a safe and sustainable part of hospital computing.

“It is no longer sufficient to rely on policy alone to secure personal mobile devices,” Halamka said. “Institutions must educate their staff, assist them with encryption, and in some cases purchase software/hardware for personal users to ensure compliance with Federal and State regulations.”

Halamka and his team already began training staff regarding smart phone devices connecting with the Exchange e-mail system using ActiveSync. Under the new regime, those devices must now have password protection.

Next, the Information Systems team is beginning the massive task of encrypting all mobile devices. They’re starting with company-owned laptops and iPad-type tablets, but expect to move out into encrypting other tablets later.

While the process is understandably complex, broadly speaking the IS department is going to take every device currently owned by the institution and give it a complete going over for malware and vulnerabilities, make sure the configuration meets security standards, then fully encrypt it to meet HIPAA/HITECH safe harbor criteria.

The next phase of the program will extend the checkup and encryption process to any personally owned computers and tablets used to access BIDMC data. I’ll be interested to see if people get squeamish about that. There’s a big difference, emotionally, between letting IS strip your work device naked and sharing your personal iPad. But clearly, if BYOD is to have a future, initiatives like this will need to go on at hospitals across the nation.

Hospital CIO Interview – Will Weider

Written by: John Lynn

When I first started blogging, I came across a hospital CIO blog called Candid CIO that is written by Will Wieder, CIO of Ministry Health Care. Six years later he’s still my favorite hospital CIO blogger out there. My only complaint is that he doesn’t blog enough (understandably so). I’ve never had a chance to meet Will in person, but I hope to one day have that opportunity.

Will recently commented on one of my posts. After seeing his comment I had the genius idea to ask him for an interview. I’m not sure why I hadn’t thought of it before since we go so far back, but when you see the content of the interview you’ll see why I’m planning to reach out to more CIOs. I hope you enjoy Will’s comments as much as I did.

You have a great CIO blog at CandidCIO.com, what made you start blogging and why do you continue blogging today?
Thanks. I originally started the blog for two reasons. Firstly, I follow tech trends and like to try anything that is emerging. So, I started this blog a long time ago. Secondly, I always desired an outlet where I could express my views of healthcare IT. At the time I started the blog a lot of the HIT press was driving me crazy with superficial stories that didn’t explore difficult questions. One would get the impression that every single IT project ever started was a worthwhile success. So, I wanted to be able to challenge conventional wisdom.

Today there are many great blogs and thousands of voices on Twitter.

Do you think other CIO’s should blog?
I hope that they do, because we have a lot to learn from each other. But it does take time, I have found it impossible to post consistently these days. I am big fan of tech blogger, John Gruber. His posts are almost always two or three sentences. I used to always write long posts. Recently I am mostly writing shorter posts that matches what I would like to read, given my attention span.

How do you deal with the challenge of a blog and Twitter account making you “too” accessible as a CIO?
People generally respect boundaries. Part of my life is to ignore cold callers (unless they are serendipitously offering something on my priority list), I would love to get back to every person that wants to meet me for lunch and talk about my organization’s prioirites, but there isn’t enough time in the day to respond – let alone have all those meetings. I have met a lot of great people on Twitter and I have hired a few, all of those have turned out great.

What’s the biggest issue on your plate as a hospital CIO today?
Managing demand. The best part of being a health care CIO is that there are so many great new solutions that solve business problems, especially in the clinical arena. The worst part is that everybody wants those solutions and they want them now. Even if senior management makes some hard decisions about priorities, the managers that submitted projects that didn’t make the priority list are disappointed and frustrated. I would feel the same way (and do feel the same way when my projects don’t make the cut).

What are the top 3 hospital CIO issues you can see on the horizon?
1. Hone project management so projects are done more quickly and successfully (see above)
2. Security
3. IT Operations – as our doctors and nurses become increasingly more dependent on IT we need to improve our processes that drive system availability and response time.
4. Consumerization of enterprise IT (rise of the iPads)

How has meaningful use impacted your hospital for good and bad?
I have heard a lot of people state that Meaningful Use was a clinical project and that they expected the results to be really meaningful. That wasn’t our experience. We were already working on meaningful clinical IT projects. Much of the objectives were things we had done or started. Our focus was to stay the course and make a few modifications so we hit every objective as written.

Our internal customers (our management team, physicians, nurses, etc.) would probably say that Stage 1 Meaningful Use has been a non-event for them. I like to think that is a testament to the many things that we were doing right. For example, our hospital in Weston, WI is all-digital. There are no charts on the floor; there is not even a file room. It is the only Wisconsin hospital (except a Children’s Hospital) recognized by Leapfrog Group as having fully met the CPOE leap. So, Meaningful Use was mostly about taking the time to properly measure everything and create quality measures to the appropriate specification.

Do you follow the All in One or Best of Breed software approach and why?
I would have to describe us as a Best of Breed IT organization. Many of our admissions come from Marshfield Clinic doctors. The Marshfield Clinic developed their own EHR and have been perfecting it over the last 20 years. About 5 years ago we made the decision to use the Marshfield Clinic EHR in our Ministry clinics and to interface that EHR to our hospitals.

Sharing that EHR was in the best interest of our patients. Our primary care doctors, our hospitals and Marshfield Clinic specialists are all contributing to a common patient record. Once we made that decision for our patients, it was no longer possible to have an All in One solution (Marshfield Clinic does not have a Hospital Information System).

If you could snap your fingers and change one thing about healthcare, what would it be?
Reduce costs. Quality improves year over year as medical knowledge increases, processes improve and new technologies (including information technologies) evolve. But the cost here in the US continues to skyrocket (18% of GDP, double that of the second most expensive industrialized nation). Frustratingly, there isn’t even agreement on why the cost is increasing. I want healthcare to be affordable to the working families here in Wisconsin.

Are you seeing and experience an experienced health IT staff shortage? How do you suggest people without healthcare experience get a health IT job?
More so in the technical areas where we are competing with all industries. We are able to recruit and/or develop applications analyst.

What’s your most important IT project today?
Ministry Health Care was traditionally a less consolidated organization that had 7 or 8 different IT departments. As a result of that we still have a lot of fragmented systems, 740 different applications running on 1,500 servers. Our environment is too complex and it makes us too inefficient. We have plans to greatly simplify that environment. But, it will take us several years and scores of projects to get there. This is paramount to our competitiveness.

From a more short-term perspective this ICD-10 thing is a complicated beast that must go well. After looking at the cost for our organization, and then extrapolating that to the entire industry, I don’t see how the money spent will be worth the value received.

Which IT project doesn’t get enough attention and why?
The need to abandon Windows XP by the time Microsoft ends support in April of 2014 is a ticking time bomb and I am not hearing anyone talk about it. We will spend more time and money (about $5M) on this than we spent working on Stage 1 of Meaningful Use.

Any final thoughts?
Two things: Firstly, I have a great job and I work with incredible people in IT and throughout Ministry. Secondly, the Packers are going to win the Super Bowl this year.

John’s Note: I’ll forgive him for his Packer fandom which is understandable for where he lives. Personally I just hope my Dolphins can turn things around.

EMR Only Doctors, Average EMR Price, Most Wired Hospitals, and Healthcare Social Media

Written by: John Lynn

Before I get to my Twitter round up of EMR and Health IT tweets, I thought at least a few of you would be interested in a short update on my previous post.

Mom and baby are home and doing really well. We’re still adapting to life with 4 children, but we feel really blessed. Thanks to everyone for the kind words on social media. Of course, how could I mention my new baby boy and not provide a picture of Gianluca:

Now on to some interesting EMR and Health IT tweets:

Internet connection at work went down today. For a while I went back to pen and paper for writing notes. It felt nice.

— Alex Zaphiris, MD (@Dr_Zaphiris) July 16, 2012

This wasn’t the tweet I meant to embed, but it seems that Dr. Zaphiris must have deleted the one I was going to embed. It talked about how Dr. Zaphiris had used EMR for so long she didn’t remember paper (or something like that). It made me wonder how many doctors today have only known EMR charting. Certainly it’s not a majority or even close, but I bet the number is higher than most would realize. If you add in doctors that don’t really remember paper charting, the number is even higher. This is the shift that’s occurring. We’ll call them EMR natives.

Not cheap. Larger physicians’ offices spent $30,000 per physician per EHR, smaller organizations spent $20,000. #EHR #EMR…

— par8o (@par8o) July 9, 2012

Where on earth did they get these numbers? These numbers remind me of when I started posting about EHR software on this blog 6+ years ago. That can’t be the average, can it?

3 years in a row, we’ve been named one of “America’s Most Wired Hospitals” by H&HN bit.ly/O68lsk #HITsm #HealthIT

— Montefiore Medical (@MontefioreNews) July 11, 2012

The Twittersphere has been abuzz with the “Most Wired Hospitals” list that was put out last week. This tweet is one hospital that’s making the most of the list. I made my thoughts clear on lists. I think I heard someone say that those that make the most wired hospital list are better at PR than they are at tech. Those that love the tech don’t worry about some list. Although, I’m sure many at the hospitals on the list are enjoying the pat on the back.

“Anything an organization wants to do; there’s some aspect of social media that can benefit: bit.ly/McSoGA #healthIT #HITsm

— Harry Greenspun, MD (@harrygreenspun) July 9, 2012

I’d only change the would can to could. I think social media can benefit anything an organization wants to do. The real question is should you use social media to accomplish that purpose. In many cases the answer is no. Often it’s no because it’s not the right tool. Often it’s no because the company culture isn’t amenable to it.

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EMR Success Depends on Proper EMR Access

BYOD And HIPAA Compliance: Can You Have Both?

HIE Waste

Hospital CIO Jobs

Enterprise HIE vs Public HIE

Health IT Q&A with Scott Joslyn, CIO and Senior Vice President, MemorialCare Health System

BIDMC’s Encryption Program Tames BYOD Security Fears

Hospital CIO Interview – Will Weider

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