UPDATE: See the comments from Randall Oates below where he explains that SOAPware is just one of the EMR/EHR options that will be connecting to the Collaborative Care Solution that IBM is offering. It seems the IBM offering amounts to more of an HIE specification that any and/or all EMR vendors can adopt. A little different idea than what I posted below.

I’m sure most people in the tech world remember the days when Big Blue ruled the tech world. In fact, there’s even a saying which I’ve been hearing more and more lately that basically goes that “no tech person ever got fired by choosing IBM.” Basically meaning that everyone was choosing IBM and so it was a safe bet. Kind of reminds me of Epic in the hospital IT space.

Well, last week IBM made an announcement about their new Collaborative Care Solution. The press release is honestly one of the worst I’ve seen. Usually amidst the PR speak you can at least summarize what they’re really doing in a couple sentences. Sadly, I can’t do that from the press release.

There was also a post about the IBM announcement on the SOAPware blog. Still not a very informative post, but it does provide the interesting connection between the solution IBM is offering that with the SOAPware EMR. A good announcement for SOAPware, especially after their release of the SOAPware PMS software.

I confirmed that the SOAPware EMR/PMS will be what IBM is offering with their Collaborative Care Solution. It will be interesting to see how this collaboration develops. Is it a real collaboration or just another marketing arm for SOAPware.

I know a good number of my readers are EHR vendors and so I thought it worthwhile to post the REACH REC’s Request for Information for EHR vendors. Here’s the information from the email I received:

The Regional Extension Assistance Center for Health Information Technology for Minnesota and North Dakota (REACH) is issuing a request for information to help fulfill our common mission to assist providers in their efforts to achieve meaningful EHR use in pursuit of healthcare quality and efficiency improvements.

This RFI is the first step in a process intended to select a group of primary care, ambulatory EHR vendors to be designated by REACH as “preferred.” Through the establishment of this preferred vendor program, REACH intends to maintain ongoing, healthy competition between  participating vendors but at the same time will establish a number of ground rules and standards that will make the vendor selection process more efficient and effective. The vendors that apply for this “preferred” designation should approach this project with a willingness to be judged based on accurate contract, functionality and price differentiation.

Please visit the REACH web site to download the full Request for Information.  The response to this RFI is required by 5:00 PM on Monday, August 23, 2010.  All questions should be directed tovendors@khareach.org at least one week prior to the RFI response date.

Check the web site often as answers to questions deemed useful to all respondents will be posted there.

Thank you in advance for your interest and participation in this important initiative!

Nice to see that at least one REC is trying to get the word out about their EHR selection process instead of the process that I’ve seen coming out of many RECs where EHR vendors don’t even know their doing an RFI.

In this post, Susan White looks at the real challenges that we face with integrating medical devices with EMR software. The lack of real industry wide standards is really at the crux of this issue and I don’t see a solution to this in sight. First, we probably need to narrow down the more than 300+ EMR vendors to something more manageable.

Technology is supposed to make our lives easier and more convenient, but when said technology makes us adopt roundabout ways to do work and takes up more of our time in the process, it is worse than useless. In such cases, it becomes a white elephant that costs more than it is worth, and it’s better to do without the technology than spend hundreds of thousands of dollars on something that’s not more than a showpiece. This is exactly what’s happening with EMR systems – they’re supposed to make medical history access, updates and management as easy as pie for hospitals and other healthcare facilities; instead, they’re becoming a headache because of integration problems.

In an ideal world (the one that the EMR was designed for), medical devices could be hooked to EMR systems which would automatically record readings for patients and store them in the right records. However, in reality, the machine spews out the values and nurses or technicians record them on paper and then feed them manually into the EMR. If this is the norm rather than the anomaly, why invest in EMRs? Why not just use a regular patient database that can be queried for patient records and updated manually?

The problem is not that the medical devices or the EMR are faulty – rather, it is the fact that there are serious integration issues between the two. Direct capture seems to be something that is destined to remain the stuff of dreams because different manufacturers adhere to varying standards and this means that the integration protocol changes. There is no industry-wide standard for the integration of medical devices and EMR systems and because of this, integration becomes a thorny issue.

The very purpose of using EMRs is to reduce medical errors, decrease the amount of paperwork, boost staff productivity, and deliver clinical results in an accurate and timely manner. When manual data entry is used as opposed to automatic data capture, all the above advantages are nullified, and this means that the healthcare facility has wasted money in the course of the EMR investment.

The trouble here is that connectivity to and integration with medical devices is an afterthought for EMR manufacturers. Besides, with each company following its own standards for connectivity hubs, there is no way that all EMRs can be uniformly hooked up to all medical devices. There are ways to resolve this issue, but it has to be consciously addressed by the healthcare facility that is investing in an EMR. They have to ensure that their devices are connected to the EMR to facilitate automatic data capture, and if they are not, they must work with the EMR provider or the device manufacturer or a third party vendor to provide a suitable connectivity interface.

But with cost being a substantial factor, most healthcare facilities are averse to such extra efforts; this leaves the future of EMR systems in a limbo – how long will people continue to invest in elephants if they know that they are white and so prone to expenditure without proving their worth? Only time will tell!

This article is contributed by Susan White, who regularly writes on the subject of surgical technician schools. She invites your questions, comments at her email address:susan.white33@gmail.com.

The people over at FierceIT recently reported that a hospital employee was recently fired for comments the employee made on Facebook. Here’s the story:

An employee at Oakwood Hospital in Michigan was fired after she posted negative comments about a patient on Facebook, WJBK Fox 2 reports.

In her post, Cheryl James said she came face-to-face with a cop killer and hoped he rotted in hell. She also posted another remark WJBK would not repeat.

The hospital gave the following reasons for the firing:

A statement released by the hospital referred to HIPAA rules and noted that “we all have a legal and ethical responsibility to put our personal opinions aside and provide the care required for any patient who has entrusted us with their health.”

James plans to fight her termination, claiming she did not share the patient’s name, his condition, or the name of the hospital.

Doesn’t seem like a HIPAA violation to me. Although, it is poor discretion and in poor taste. I am often amazed at what people post to Facebook. Some people just don’t realize how public it really is. I guess after things like this, the idea of a Facebook PHR isn’t very likely either.

I must admit that I’m also amazed that the hospital worker had access to Facebook. Hospital computers are some of the most guarded computers I’ve ever seen. Unless of course she posted from her phone. We’re bound to see a lot more of this. In fact, at some point we’ll see pictures and/or video of patients posted to Facebook.

I wrote previously about the Signapore government accepting proposals for a national EHR. Today I got the news that Accenture has been contracted to implement the Singapore National Electronic Health Record (EHR) system. Obviously Accenture is a big name and a big group. I’ll be interested to learn which EHR software system they plan to implement to create the national EHR system. International EMR movement like this is very interesting.

Here’s the press release from Accenture about the announcement.

Accenture Wins Contract to Implement Singapore’s National Electronic Health Record System

SINGAPORE; Aug. 2, 2010 – The Singapore Ministry of Health has awarded Accenture (NYSE: ACN) a contract to implement the National Electronic Health Record (NEHR) system, a key enabler of Singapore’s vision toward a national, integrated health care system. The NEHR is designed to improve the quality of healthcare for citizens, lower the costs of health services, and promote more effective health policies.

Under the NEHR, key medical information such as patient demographics, allergies, clinical diagnoses, medication history, radiology reports, laboratory investigations and discharge summaries will be exchangeable among healthcare providers. Patients also may benefit from proper, right-sited disease management and cost savings, as duplicate or unnecessary tests are eliminated and medication errors are reduced.

“As the centerpiece of Singapore’s connected health vision, the NEHR is intended to provide a holistic view of a patient’s health information. With this market-leading offering, health care providers can have the right information at the right time to make the best care decisions,” said Stephen J. Rohleder, group chief executive of Accenture’s Health & Public Service operating group. “We congratulate the Ministry of Health for taking this bold step to create a new foundation to help support meaningful advances to Singapore’s health care system.”

The National Electronic Health Record vision – “One Singaporean, One Health Record” – was previously announced by Singapore Health Minister Khaw Boon Wan. With the initial system release in April 2011, Singapore will be one of the first countries in the world to implement a national electronic health record system.

The Accenture team includes Oracle, Orion Health, Initiate Systems, Inc., and Hewlett-Packard.

UPDATE:
Mark told us who will be providing the software for the Singapore EHR in the comments. EHR Software is being delivered by 3 Partners;

Oracle’s HTB is the core Clinical Data Repository
Initiate is providing the Master Patient Index; and
Orion Health the Clinical Viewer & Messaging fabric using their Concerto & Rhapsody products.