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New Fujitsu Smart Scanner Combined with CDA Clinical Document Standard Make for Interesting HIE

Posted on October 24, 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 at MGMA, Fujitsu together with Osmosyz announced a new scanner that supports the relatively new CDA “Unstructured Document” HL7 standard at MGMA 2011. I must admit that the press release is a little intense. However, I find what they’re doing with a hardware product to support HIE is quite interesting.

I don’t want the title of this post to be misleading. While certainly HIE has generally become synonymous with some large health information exchange entity, in this case I’m describing a hardware device (a smart scanner if you will) that acts as a small health information exchange. Basically, it’s more along the lines of Direct Project as opposed to NHIN. Although, I imagine that it could send the documents to some larger health information exchange if someone wanted to do so.

The larger application I see of this technology is as a replacement for the fax machine. In some ways, it’s like a second generation fax machine. The major differentiation I see between a document sent using the CDA “Unstructured Document” HL7 standard and a fax is all the meta data that comes with the CDA document.

The fax or scanning workflow for most EHR software consists of receiving faxed documents or scanning documents into what amounts to basically a bucket of all the scanned documents. Then, it’s up to the user to go in and sort through all the various faxes that have been received or documents that have been scanned. At this point, the user can assign the document to a patient in the EHR. You can imagine the challenges that this can pose. I wonder how many documents scanned or faxed into an EHR have been assigned to the wrong patient accidentally.

That’s what makes this new Fujitsu scanner quite interesting. If it’s receiving the document from an outside source, it will come with the meta information for the document as part of the CDA standard. That can then be leveraged to more quickly assign that document to the patient. Not to mention, then all of that CDA information is available for other uses within the EHR.

For inside documents that are scanned in through the Fujitsu device you can actually assign the document to a patient on the scanner itself. That’s right, you can identify which patient a scanned document belongs to while you’re holding the document in your hand. A much better way to ensure that the document you scanned gets attached to the right patient in your EHR.

I’m just touching on a few of the features of what’s possible with this new Smart Scanner from Fujitsu and smart documents. You can do other things on the scanner like dividing document scans between multiple patients.

Meaningful Use Monday Angle
Of course, as most of you know, on Monday we usually do our regular Meaningful Use Monday series. Turns out that the CDA Clinical Document standard that I discuss above is being adopted by ONC as part of meaningful use. I’ll be interested to see how this plays out over time, but don’t be surprised if EHR software has to support this standard in the future.

What I find more intriguing is that the above scanner could be used by someone who doesn’t have an EHR, but wants to exchange patient information. I still think that the long term solution to interoperability of patient information has got to come from connections with EHR software. However, this does illustrate that technology solutions can and will be created to exchange health information. In fact, some combination of these solutions could be a way to meet some of the meaningful use requirements around exchange of health information. You still can’t get the EHR stimulus money without an EHR, but technologies like this could help you achieve meaningful use.

I’ll keep an eye on how this technology progresses. I wonder how many EHR vendors will integrate with this type of technology. Whether we like it or not, documents are going to be a major part of healthcare for the foreseeable future. We’ll see if smart documents and smart scanners are an intermediate step to the health information exchange nirvana (whatever that might be).

No @ Sign for Healthcare

Posted on September 15, 2010 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 heard Arien Malec from ONC summarize the biggest challenge of Healthcare Information Exchange (HIE) in one simple phrase:

There’s no @ sign for healthcare

It’s a really basic idea, but sadly cuts straight to one of the core reasons HIE isn’t happening. We don’t have a great way to authenticate, verify and address health information to another provider.

Twitter has created this interesting concept of using @ to specify people. For example, you can find me @techguy and @ehrandhit. It’s amazing how quickly Twitter has created a whole new set of addresses where we can communicate with other people. Certainly it’s not designed for healthcare, but it’s amazing that they could create this whole new address system for people and organizations. And trust me when I say that Twitter is a great communication and collaboration mechanism.

One of the main reasons the fax machine is so successful in healthcare is that each clinic has a unique identifier, their fax phone number. I’ll be writing more about the fax machine in the future, but HIE needs to solve the problem of a verifiable address that’s unique to each healthcare provider if we want to move beyond the fax machine.

It seems like the people behind NHIN are trying to address this challenge, but they still have a ways to go. Does anyone else know of other ways people are trying to address the missing @ sign in healthcare?

First Day of HIMSS 10

Posted on February 28, 2010 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.

Well, I must admit that I’m a bit overwhelmed by everything I’ve seen and heard at HIMSS 10 in Atlanta. This thing is enormous. Although, I think I’m also trying to overcome the lack of sleep. Taking the Red-Eye from Las Vegas was the right choice, but I’m paying the price today for not having much sleep. Not that any of you really care.

What I’ve quickly realized is that I’ve over scheduled my time at HIMSS. This really isn’t too much of a problem for me since I LOVE being busy. The only problem with it is that it means that I won’t be able to create nearly as much content from the show as I’d like to create.

No worries though, I’m taking good notes and I’ll have plenty of great content to share with you over the next few weeks after HIMSS as well as during HIMSS. I have posted quite a few updates on my twitter account, @ehrandhit, and plan to do a lot more. Take a look through my updates to see some interesting items I heard during a briefing.

As I’ve talked with people at the conference, as expected, the EMR stimulus, meaningful use, certified EHR and everything related to those subjects is the main focus of discussion. I think that’s actually exciting. It’s a topic that everyone is kind of unified around. It creates a nice energy at the conference and is a topic that you can talk about with anyone.

Interoperability is also a really major discussion at this conference. I’m not sure how much real progress has been made, but there’s a lot of talk. I know I’m interested in a meeting I have setup with a person at ONC that works on the NHIN and CONNECT. I’m looking forward to hearing what he has to say.

Another interesting thing will be all the false information related to the EMR stimulus. It’s amazing how many professionals in the industry don’t even understand the details of the EMR stimulus. This is a problem and could have some ugly consequences down the road.

Watch for some more specific coverage of the conference tomorrow. Tomorrow is a very full day for me with some really exciting events including: the CCHIT town hall meeting, my Meet the Bloggers Session, an interview with one of my favorite EMR CEO bloggers, Evan Steele, and then of course the New Media Kick Off Event tomorrow night.

The CCHIT town hall should be quite lively since you know how much I love them. I’m thinking I might try and live blog it, or at least lots of tweets about the event.

HHS Connect Program For Healthcare Data Interoperability

Posted on October 11, 2009 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’ll admit to not being the most expert person on HIE, RHIO, NHIN, and all of the other acronyms associated what really is just creating systems and structures for sharing healthcare data between various doctors and systems. However, I do have some knowledge in the area since I believe all of these things will be important for those using an EMR. So, I was surprised when I’d never heard of HHS’ health connect software.

Here’s a short bit from Government Health IT of the government’s connect software’s latest update:

The Health & Human Services Department (HHS) has updated the government’s Connect software to improve information security and enterprise services for organizations that want to use it to exchange health data, said its senior architect.

Connect is federally developed software that lets agencies and healthcare organizations share health data by using the protocols, agreements and core services that make up the nationwide health information network (NHIN).

HHS is trying to develop improvements in the Connect gateway quickly so it can serve as an early model of the NHIN, executives said yesterday.

“The intent of the plan is that Connect will be a reference implementation of NHIN and provide a mechanism for organizations that are building gateways to have the ability to test against it and to provide for feedback to the NHIN specification group,” said Les Westberg, Connect technical lead in the Federal Health Architecture program and an executive with Agilex.

Is there anyone that knows more about this program that can give us a review of what’s going on. I’d love to hear about how far it’s come, the challenges its overcome and the challenges it still faces.

In fact, if you are someone working on one of the acronyms listed at the top that are trying to provide the all to elusive healthcare data interoperability I’d love to learn more about what’s going on in the comments or through a guest post if you have a lot to say.

HITECH Act Gives HHS $2 Billion of Discretionary Funds

Posted on February 20, 2009 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 HITECH Act gives Health and Human Services (HHS) 90 days to develop a plan to allocate $2 Billion of discretionary funds. Talk about a nice infusion of funding for HHS. HHS does have a set of core areas of focus for the money (per an Allscripts presentation on HITECH).

The area of focus that interests me most is the “Regional Health IT Resource Centers.” Seriously, what is a regional health IT resource center? Can any of you imagine a doctor visiting a health IT resource center? I don’t understand how this will work at all.

I have a better idea. Why not take a cool million and give it to me? I’ll create a killer online platform for sharing of health care IT resources where people can share information nationally or within their region. Could be a killer application for sharing information quickly and could be available to every state in the country (and for that matter the world). Unless you think that training health care IT staff is better done without using IT.

Here’s a look at the full list of core areas of focus:

  • Standards requirements due before the end of this year
  • HIE Infastructure, National Health Information Network (NHIN)
  • Regional Health IT Resource Centers
  • Federal grants through AHRQ, HRSA, CMS
  • Grants to the states in 2010
  • Promote advanced EHR

Detail’s of Obama’s EMR Stimulus Package

Posted on January 24, 2009 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.

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.