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Health IT Q&A, Speciality EMRs, and Secure Messaging: Around Health Care Scene.

Posted on September 16, 2012 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

EMR and HIPAA

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

This post features Scott Joslyn from MemorialCare Health System. He talks about a few different Health IT topics, including benefits and disadvantages to EHR and voice recognition. Joslyn is definitely an expert on Health IT, so this is a post you don’t want to miss.

Verizon Hopes To Be Secure Healthcare Network For All

Verizon is more than just switches, routers, and cables. Katherine Rourke discovered what the company has in store in the future with mHealth. She talked with Dr. Tippett from Verizon, who said Verizon’s Connected Health Division is “aiming to set the bar higher.” The company is hard at work, so expect some great things coming from Verizon.

Hospital EMR and EHR

Specialty EMRs: Behind the Curve? 

Are specialty EMRs worth investing in? There is debate on both sides of the issue, and a general consensus doesn’t appear to be developing anytime soon. Anne talks about assertions made in a statement recently about specialty EMRs, and offers her own two cents on the topic.

Study Suggests Most HIEs Aren’t Sustainable

HIEs are very expensive. Unfortunately, according to a recent study, the investment in them don’t seem to have any financial or clinical payback. There’s so much time and effort being put toward HIEs — would money be better spent elsewhere? Likely, but Anne Zieger doesn’t see things changing anytime soon.

Smart Phone Health Care

App Developers Urged to Consider Older Generations

There are apps developed that could make managing diseases like diabetes so much easier. However, these apps may not be designed with all age groups in mind. Researchers from North Carolina State are urging app developers to keep older generations in mind, who aren’t able to use certain apps as they are currently designed.

Happy EMR Doctor

EMRs’ Big Gaping Hole of Secure Messaging

This post is the first in a series from Dr. West, highlighting insights from his recent participating at a breakfast panel in Washington D.C. He talks about issues with secure messaging, including the lack of EMRs that have secure messaging included in their system. In the end, he discusses how secure messaging could impact patients and doctors positively.

Building — But Not Overbuilding — Next Gen HIEs

Posted on July 2, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today I’m delighted to bring you some thoughts from Micky Tripathi, founding president and CEO of the Massachusetts eHealth Collaborative.  In a write-up for the useful iHealthBeat.org blog, Tripathi argues that the HIT world is in danger of seriously overbuilding the next generation of HIEs.

As he notes, a generation of private HIEs (known as CHINs at the time) failed or struggled in the early to mid-1990s. He also reminds us that the failures — such as the demise of Tennessee’s CareSpark and the Minnesota Health Information Exchange — are far from over. In his mind, this is mostly because these groups tried to create over-architected HIEs.

Now, we’re at the heart of the matter. What is an over-architected HIE?  I’ll let Tripathi speak:

Put simply, it’s one that tries to do too much for too many with not enough money and time. It tries to establish an all-encompassing infrastructure and service to meet multiple, heterogeneous current and future requirements of multiple, heterogeneous current and future customers. It tries to do all of this with a shoestring budget and staff. And worst of all, it focuses more on long-term potential “big-bang” value at the expense of short-term, realizable, incremental value. Or as one HIE organization’s promotional material put it, the value proposition is to be a “one-stop shop for Clinical and Administrative Information.”  (Editor’s note: They actually made that claim? Wow.)

What’s wrong with trying to build a Holy Grail of HIEs that solves everyone’s problems?  His analysis:

1.   HIEs can only develop so fast no matter how much money and people you throw at them, given that moving clinical documents around, searching and retrieving clinical info and getting everything into a big database requires a lot of manual labor, legal and technical judgement, cultural and clinical change.

2. While HIEs can only move so fast, business and technology can move at breathtaking speed. Building out an infrastructure which is supposed to work five years from now may turn out to be a massive waste of resources. As he points out, remember that the game-changing iPad is only two years old.

3. CIOs are, let us say, a little overwhelmed at the moment. Asking them to build out a huge infrastructure for the HIE doesn’t exactly make things better. “Better to proceed with achievable steps that deliver incremental value along the way,” he says.

Well, all I can say is that I agree with him completely. Incremental moves and technologies like the Direct Project seem infinitely smarter than a “Big Bang” approach. HIEs are going to be part of our future like it or not, for many reasons, so why not get it right a little bit at a time?

Are EMRs As Great For ACOs As People Say?

Posted on March 13, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For quite some time, talking heads have noted that EMRs will be an essential part of ACOs, so much so that most doubt you can have a successful ACO organization without one.  What I don’t see asked as often, however, is whether EMRs are shaping the future of the ACO movement, both negatively and positively.

What would an ACO look like, if it could exist at all, without an electronic record or HIE in place?

* There would even more mistakes and delays in sharing patient records, as one can hardly expect a larger group of institutions to make *less* mistakes

*  ACOs could launch without having to spend millions of dollars on EMR software, hardware, training and support

*  Clinical workflow would remain the same, generally, even if doctors were forced to include larger numbers of co-workers in their network

And how are ACOs working with EMRs in place?

*  Aside from limited case studies in individual institutions , it’s not clear whether EMRs are turning large, newly assembled care organizations into safer places to get care.

*  ACOs are forming more slowly than they might be, arguably, because a comprehensive EMR is part of t he cost of doing business

* New clinical workflow patterns are being forced upon clinicians, cutting across multiple institutions. While this might ultimately increase efficiency, it’s hard to ignore how many human hours are being invested (or wasted, depending on your position) on new technology.

As you can see, I come down on the “EMRs may not be all they’re cracked up to be for ACOs” side of things. Now, I’d concede that I haven’t been completely fair — I know EMRs have yielded great benefits for some groups of institutions– but I’d say the jury’s still out overall.