Neil Versel | EMR and EHR

Escape the Fire – Healthcare Documentary Film

I first heard about the Escape the Fire film coming out when Neil Versel posted about it on Meaningful Health IT News. I was really intrigued by the things he mentioned about the film and now after seeing the film I wasn’t disappointed. The film does a good job describing some of the major challenges associated with healthcare today.

Here’s the trailer if you want to learn more about what Escape the Fire is about:

For those interested in just seeing the film, you can buy Escape Fire: Fight to Rescue American Healthcareon Amazon or you can watch the Escape the Fire video on CNN this Sunday, March 10 at 8:00pm & 11:00pm ET. It’s great that CNN has picked up the documentary and will be getting it out to a larger audience.

I also love that the Escape the Fire website has a place where you can “Engage the Issues” and do something in your sphere of influence to improve healthcare. The amazing thing is that we can all do something. Even if that something is as simple as living a healthier lifestyle. That will make a huge difference.

As you’ll see in this movie, the problems in healthcare aren’t simple. In fact, they are very complex and hard to overcome, but one of the first steps to solving the issues is understanding them. This film is a good start to helping a larger group of people understand the issues that plague healthcare.

One challenge I did have with the movie was that it felt like two videos pushed into one. On the one end was the current state of the healthcare system and the other was the military healthcare issues. While there’s certainly plenty of issue overlap, I think that this could have easily been divided into two films as opposed to cramming the two subjects into one.

While I think most of the issues presented in the film aren’t anything new for those of us in healthcare, it was nice to see them all laid out in one place. I’m sure I’ll be thinking a lot about what’s presented for many years to come.

My HIMSS 2012 Session List #HIMSS12

I’m sure that some of you might have seen me complaining on Twitter about the challenge of trying to sift through the 300+ educational sessions at HIMSS. I even tried to convince the HIMSS expert Neil Versel to offer up some suggestions on which HIMSS 2012 sessions to attend. He suggested just leaving all of the education times open and decide later. It’s a good idea, but I think I prefer meeting with people more than some of the available sessions. Neil enjoys the sessions a bit more than I do.

One of my favorite old Neil Versel posts was when he basically said, “HIMSS is more than just the exhibit hall.” With 300+ sessions at HIMSS 2012 there should be something you will find interesting, so HIMSS should be more than just the exhibit hall.

Today I started ripping through the HIMSS sessions to try and identify those I found interesting and worth putting on my schedule. While they might make it on the schedule, that doesn’t mean I’ll necessarily attend. I debate attending based on the flow of the conference, people I’m with at the time, and if I’d already heard enough on that subject for one HIMSS. Plus, I often put multiple sessions that are at the same time on my schedule. In those cases, I use the above criteria to decide which ones I should attend.

The other X Factor with this all is that I still have to schedule my meetings with vendors I find interesting during HIMSS as well. I’ll start doing that now that I know which HIMSS sessions are happening when. At least now I won’t schedule a meeting with a vendor during the Biz Stone keynote. That would be a travesty.

Below you’ll find my HIMSS 2012 schedule of sessions (which will likely continue to change), but for those interested here’s the process I did to find interesting sessions. First, I added the exhibit hall hours and keynotes. Next, I went through the HIMSS Specialty Programs and HIMSS Social Media Center schedule (My HIMSS Panel on Wed, 2/24 from 4-5 made it on my schedule from this list). Then, the HIMSS Education section has the sessions broken out into “Core Education” areas. I found the Federal Participation at HIMSS 12, Senior Executive sessions and EHR Best Practices sections quite interesting.

There you have it. I’m sure I missed some sessions I should attend, so if you know of some that you think are worthwhile do let me know and I’ll check them out. Now without further ado, my current schedule for HIMSS 2012:

As you can see it’s going to be a full and crazy week for me at HIMSS 2012, but as I said before HIMSS is great for me. Everyone goes there with a little different plan on what they want to accomplish and learn, but hopefully my list of sessions will be helpful to someone else navigating the HIMSS 2012 gauntlet.

Let me know if you have any questions about particular sessions and I’m happy to tell you why they made the list as well.

Preparing for HIMSS 2012 – #HIMSS12

It seems like everyone I talk to or interact with in the Health IT world is in full on HIMSS 12 preparation mode. I only attended my first HIMSS 2 years ago in Atlanta. So, I’m mostly a newbie at HIMSS. I sometimes long for the days when I just went to HIMSS with little real planning. I just went and enjoyed myself.

As you can imagine, HIMSS is a perfect place for me and my business. I’ve often told people that the core of my business is great content and advertisers. Turns out that every booth and every person at HIMSS is possibly both. For me, it’s like being a kid in a candy store. So, many exciting things to try (and you might even say you get sick after “eating” too many as the flavors all run together). To be quite honest, I love the entire experience. I was meant for the system overload that happens at HIMSS. I love large crowds of people and being overstimulated. I guess that’s why I love living in Las Vegas (which is also convenient for this year’s HIMSS).

HIMSS Attendee and Exhibitor Count
Enough about me. What can we expect at this fantastic affair called HIMSS 2012? Last year there were 30,000 attendees and I wouldn’t be surprised if this year it’s somewhere in the neighborhood of 35,000 people attending HIMSS. During an #HITsm twitter chat about HIMSS, I said that there would be at least 1000 vendors exhibiting at HIMSS. If I remember right (I can’t find the tweet), one of the HIMSS staff corrected me and said there would be 1100 companies exhibiting at HIMSS this year.

What does all this mean? Well, as my mother always told me: You can’t do everything. I’d always look at her shaking my head saying, “You’re right….but I’m sure going to try.” I think this describes my approach to HIMSS as well. Although, each year I am getting more selective on what I spend my time doing.

Press at HIMSS
I’m sure that many reading this are wondering how they can get some coverage on the Healthcare Scene blog network at HIMSS. Considering the 40 or so emails from PR people that I have filed away already, I’m going to have to apply a pretty strict filter.

What then are my filters?

First, if you’re an EHR company, then I’m probably interested in connecting with you in some form. Although, if you’re an EHR company that’s just seen me and has nothing new to say, then I’ll probably pass at this HIMSS. To be honest, I could probably fill my entire schedule with just EHR companies considering how many EHR companies there are out there. Plus, I think I’m going to bring around my flip video and do an EHR series called “5 Questions with EHR Companies.” I’ll see how many EHR companies I can get to answer the same 5 questions.

However, an entire week of just EHR talk would be a little rough. Plus, I asked on Twitter if I should look at things outside of EHR and they all said I should. I’m a man for the people, so I must listen. How then could another healthcare IT company get me interested in meeting with them at HIMSS?

The best way to get me interested in talking with your company is to provide something that will be interesting, unique and insightful to my readers. Remember that my main goals are great content and advertising. If you provide me with great content that my readers will love, then I’ll love you and likely write about that content.

I didn’t realize this when I started blogging, but I’m not like a lot of journalists. I don’t go to any conference with stories in mind. I’m not digging around HIMSS to try and find an ACO story for example. Instead, every person that I talk to I’m trying to discover what stories are being told at HIMSS that are worth telling. I’m always happy when people help me find interesting stories.

Social Media at HIMSS 12
Speaking of finding stories. One of the most interesting ways I use to find stories and connect with people is through social media and in particular Twitter (see this post I did on EMR and HIPAA about Twitter). I guarantee you that Twitter usage at HIMSS 12 is going to be off the charts. There is going to literally be no way to keep up. I love the idea that Cari McLean had of the HIMSS Social Media Center summarizing the most important tweets during HIMSS. Granted, that’s an almost impossible task to ask anyone to do.

Of course, the HIMSS related hashtags will be another great way to filter through the various HIMSS related tweets that are happening. Here are some of the ones I’m sure I’ll be using:
#HIMSS12 — official hashtag for the event
#HSMC — HIMSS Social Media Center
#HITX0 — HIT X.0: Beyond the Edge specialty program
#LFTF12 — Leading from the Future specialty program
#eCollab12 — eCollaborative Forum
Here’s a bunch more HIMSS related social media hashtags you might want to consider:

HIMSS Social Media Center
If you love social media like I do, then you’re also going to love the HIMSS Social Media Center. They’re doing a number of Meet the Bloggers sessions again and I’ve been invited to participate in the Health IT Edition of Meet the Bloggers at HIMSS. I’m on the panel along with: Brian Ahier (Moderator) Health IT Evangelist, Mid-Columbia Medical Center, Jennifer Dennard, Social Marketing Director at Billian’s HealthDATA/Porter Research/HITR.com, Neil Versel, Freelance Journalist and Blogger, Carissa Caramanis O’Brien, Social Media Community and Content Director, Aetna. Should make for a pretty interesting conversation. Plus, you know I always like to mix it up a bit.

New Media Meetup at HIMSS
More details coming soon. We’ll have to work on Neil Versel’s idea of starting a Twitter storm to get Biz Stone to come to the HIMSS meetup.

Dates of HIMSS
Be sure to check the dates of HIMSS. As Neil Versel noted, it’s a little different days than it’s been in the past. I personally like these dates better than the other ones.

There you have it. I thought I’d do a short post on HIMSS and I guess I had a lot more to say. I’d love to hear if you’re going to HIMSS. If you know of any events, sessions, parties, announcements, technologies etc. that I should know about at HIMSS, let me know.

And the most exciting part of HIMSS…seeing old friends and making new friends. I can’t wait.

Who Will Police EMRs and EHRs?

Amid all the dog-bites-man type health IT news, here are some not-so-positive EMR/EHR stories that have been reported:

- An EMR in Lifespan hospital group gave incorrect prescriptions to some 2000 patients. The article in the Providence Journal says that

The hospitals have placed calls to nearly all the affected patients, although not all have called back, Cooper said. Most patients reached had already obtained the correct medication because the error was noticed by someone at the hospital, or a pharmacist or doctor outside, she said. So far, Cooper said, there is no evidence that any- one was harmed.

Thank goodness for that.

- Incorrectly calculated MU thresholds (GE Centricity). I’m not going to rehash the story, but you can check out Neil Versel’s article in InformationWeek, the spirited discussion on my previous EMR and EHR blog post and John’s EMR and HIPAA blog post.

It might be just be my skewed viewpoint, but GE Centricity related issues are nowhere on par with people being prescribed the wrong prescription. In one case, a few practices may not be able to demonstrate Meaningful Use. Wrong medication could actually be life-threatening to you. So if I had to rank my problems, I’d rather be short by 44K than worry about my EMR inadvertently killing my patients off.

What we need is a governing body, similar to the National Transportation Safety Board, to police EMRs, says Paul Cerrato in a recent InformationWeek Healthcare article.

Cerrato writes:

“An NTSB-like organization for EHRs would at the very least provide a reporting mechanism to keep track of incidents and life-threatening consequences of misusing e-records. More importantly, it could police vendors and healthcare providers who repeatedly ignore these dangers.”

Cerrato goes on to say there are only 120 EHR-specific problems reported to the FDA over the last 18 years. That figure, if correct, to me shows:

EMR users don’t know how/where they can report EMR related errors or don’t expect any action to be taken – this certainly is credible, because from all quarters, it seems as if the focus is just to get the healthcare field into electronic data capture, not on whether the experience delivers any tangible and useful benefits
Maybe they’re willing to give EMRs a pass assuming the healthcare IT to be in infancy
They’re too overwhelmed with the EMRs’ capabilities/inabilities to really see what’s going on

For a national database of EMR problems to be truly relevant, here’s the information I would look for, on problems I’m facing:

How critical was the error? How many people did it affect, and in what ways – medically, financially?
How was it handled?
How common is it – are there others who’ve faced similar problems?
If the problem was not sorted, what raps on the fingers did the vendors face?

Read the article here.

An Interesting MGMA Observation

Lately I’ve been traveling to more and more EMR and Healthcare IT related conferences. The past couple days I’ve been enjoying my time at the MGMA conference in Las Vegas (although, I didn’t have to travel to this one since I live in Las Vegas). This is my first time attending the MGMA conference. From what I can tell the attendance and exhibit hall have done very well. In fact, I just asked and they’ve had 3500 conference attendees and a total of 5700 people in Las Vegas for the MGMA conference. They tell me that’s a 19% growth over last year.

What I’ve found most interesting is that unlike many conferences I’ve been at, the sessions at MGMA have been incredibly full. In fact, many of them have been standing room only. This is in contrast to the exhibit floor which has felt rather empty. There are a few short periods that were busy in the exhibit hall, but overall it seems like MGMA attendees prefer to go to the educational session as opposed to being in the exhibit hall.

I asked professional conference attender (otherwise known as Healthcare IT journalist) Neil Versel who blogs at Meaningful Health IT News why this might be the case. He said that maybe those attending MGMA have already made their EHR selection, so they’re more interested in hearing from experts as opposed to browsing products. Of course, he did highlight that it was those that attended had already implemented an EHR since we know that the majority have not yet implemented an EHR.

While I think this could be part of the reason, I wonder if there’s not something more at work. If I’d done better at taking notes during the Marcus Buckingham keynote, I could maybe look at the profiles he found in the MGMA audience to explain it. A part of me wonders how many of the MGMA attendees are decision makers as opposed to operational leaders. I’m sure they’re all over the spectrum, but sessions are likely more interesting for operations and compliance people.

As a first time attendee, I’ve been really impressed with MGMA. They’re well organized and brought together a lot of interesting vendors and attendees.

Meaningful Use Attestation: GE Admits Problems with Two Centricity Products

If you have been using GE Healthcare’s Centricity Practice Solution or Centricity Electronic Medical Record solution to demonstrate Meaningful Use, you might be in for something of a rude shock. According to an InformationWeek Healthcare story by Neil Versel,

“Some customers of GE Healthcare may not be able to achieve Meaningful Use with their current electronic health records (EMR) systems, as the vendor has discovered “inaccuracies” in its software’s reporting functions.”

According to Versel, GE admitted the problem in a letter that went out to users of the two Centricity products on Thursday and promised a solution by end-November. At the time the InformationWeek story was written, this GE link was not working, but is now. In the document, GE details exactly where its reporting was going wrong. It appears as if the problems lay in the following areas:
- the default race and ethnicity provided by GE’s Centricity products didn’t always map exactly to OMB’s race and ethnicity categories (as an example, GE’s Centricity provided for a single Multi-Racial category, whereas OMB requires that a multiracial person be allowed to select as many races as s/he wants)
- inaccurate recording of smoking status
- inadequate training of doctors on educating their patients about medications
[Link]

Among the recommendations put forward by GE:

- If you’ve already attested for 2011, run reports again for attestation period once GE issues its software update. If the results don’t match up,
a) check if you clear all applicable Meaningful Use thresholds for the original period
b) check if you meet thresholds for all applicable measures

- If you haven’t attested for 2011, hold off on attesting till GE issues its updates.

- Prospectively follow GE’s recommendations for the rest of the year

While the GE letter points out there is still time till Feb 29, 2012 for 2011 attestations, these were my first reactions to reading this piece of news:
- Even a Stage 1 Meaningful Use certified software from a well-known company is not immune to inaccuracies in reporting

- It might seem like a trivial change to move from “Multi-racial” to allowing multiple check-boxes for races, but it could mean the difference between demonstrating MU and not being able to. From GE’s perspective, I would want to know why these small-seeming errors were not caught at the time these Centricity products were Stage 1 MU certified

- How many/what percentage of Centricity EMR and Practice Solution users were affected? It’s not very clear/GE doesn’t say.

- The letter and recommendations don’t show up on GE Healthcare website, and to me it’s also quite interesting that a story like this doesn’t have any hits beyond the InformationWeek article.

- Are there any recourses apart from following GE directives? Maybe if you have softwares other than GE’s Centricity, maybe you can cross-check your results. But I don’t know how many practices actually can afford two or more EMRs. So this really might be a worthless suggestion, unless you can press one of those free EMRs into service!

Full Disclosure: GE is an advertiser on this site, but I’m not sure Priya Ramachandran knew that when she wrote this article.

EMR and Healthcare IT Article Run Down

I imagine most of my readers know that I’ve launched the Healthcare Scene blog network. EMR and EHR is one member of the blog network along with 7 other blogs that have been announced with 6 more blogs that will be announced shortly (Have you found them already?). We’re growing rapidly and expanding the number of people that are sharing great content with the world of healthcare IT and in particular EMR and EHR. The goal of providing a platform for the independent Healthcare IT voice is becoming a reality.

It’s a really exciting thing to be a part of. The most exciting part of it all is the amazing people that I get to work with and the content they create. Here’s a quick glimpse at some of their content with my thoughts on their posts.

EMR and HIPAA
Neil Versel recently started posting a regular weekly column on EMR and HIPAA. Check out his latest post on clinical decision support and an update on Dr. Larry Weed. Reading articles like that from Neil help me to appreciate more fully the history of healthcare IT. I’ve admittedly showed up late to the party, but Neil provides some interesting perspectives based on his knowledge and experience in healthcare IT. Here’s my favorite quote from his article:

“Patients may surmise that a physician who uses a [decision support system] is not as capable as a physician who makes the diagnosis with no assistance from a DSS.” I then noted that Weed has been saying for more than 50 years that physicians shouldn’t have to rely on their memory to make clinical decisions when computers can help them process an increasingly voluminous knowledge base.

Meaningful HIT News
Neil’s blog Meaningful Healthcare IT News is also a member of the Healthcare Scene blog network. How can you not enjoy a post entitled Skype for “Redneck Telehealth”? Sometimes, you’ve got to do what you’ve got to do.

Happy EMR Doctor
What doctor isn’t interested in reading another doctor’s perspective on “Getting a Life with Electronic Medical Records,” “Gag Orders and Bad EMR Systems,” and a Doctor’s issues with PQRI Incentive Money? Those are the latest topics from Dr. West over on Happy EMR Doctor. Of course, now that Dr. West has gotten the blogging bug, his EMR gave him a life and his new blog has taken it back. I always appreciate a practicing doctor’s perspective.

Smart Phone Health Care
I’d been covering a number of mobile health care and mHealth related topics on this and my EMR and HIPAA blog, but the topic has become so popular that I knew it was time to start a mobile health care related site of its very own. I’m now doing it in partnership with David. He’s been churning out some interesting posts about Cell Phones Saving Lives in Africa and a Mobile App that Could Detect an Acute Stroke. I’ve always seen one of the major developments of mobile health happening in the developing world where the IT networks aren’t yet in place. Mobile phones can have such a tremendous impact for good. It’s beautiful to learn about. Although, mobile health is still in its infancy in the developed world as well. Personally, I’ve been trying to kick around some mobile gaming app that would encourage activity (ie. movement). Far too many of us sit in front of our computers all day. Healthcare would be so much better if more people just moved (written as I sit in front of my computer).

EMR, EHR and Healthcare IT News
This site is still very young, but just hit it’s 100,000 pageview mark. That’s a result that I would have never been able to predict. Although, news like the one posted today about the First Medicare EHR Stimulus Checks is something that many find interesting. If you know of other news we should be posting, let us know.

EMR and EHR Screenshots
The most recently announced member of the Healthcare Scene blog network is a website called EMR and EHR Screenshots. There’s still a lot I want to do to improve the interface for viewing the various EMR and EHR screenshots, but I think the concept is really interesting. My goal is to aggregate as many of the EMR and EHR screenshots as I can get. Hopefully that will mean even screenshots from the same EMR and EHR software as it releases new versions of the software. I’d love to have screenshots of CPOE, ePrescribing, scheduling, charting, diagnosing, etc. Basically if you’re interested in knowing what an EMR looks like or what it looked like previously, we’re hoping to provide you that view into an EMR’s development. A lofty vision. We’ll see how many EMR and EHR vendors, doctors, and other users will support it.

See what I mean when I talk about the amazing content that’s being generated. This doesn’t even include the great posts that Katherine Rourke is doing on this blog and my own posts (which could be classified as good or bad).

As I mentioned, I have 6 more blogs to be announced shortly. So, keep an eye on Healthcare Scene to see what will be announced next.

Adopt an EHR or Lose Your Medical License

I was glancing through my draft posts today and found this article by Neil Versel, now blogging at Meaningful Healthcare IT News, about State Medical Boards considering making EHR user a condition of medical licensor. That’s right. To renew your medical license using an EHR could be part of the clinical competence test.

On face value, it’s a kind of crazy idea to consider. Although, couple that with a post on EMR Thoughts that talks about a Doctor Quiting His Practice Over EHR Use. Makes you think for a second the value of EHR knowledge for a doctor practicing medicine.

Turns out that Massachusetts has already put this requirement in place starting in 2015. Here’s a quote about that doctor that closed his practice thanks to his inability to use the EHR.

Like all Massachusetts doctors, the physician also was required to comply with the state’s Section 305 law. It mandates that physicians demonstrate competency in EHR use by 2015 to maintain licensure.

I must admit that this is a hard pill to swallow for me. Do we really need to make this a requirement? Does making it a requirement add any value? In Massachusetts it says they’re using CME’s to show a person’s EHR proficiency. A really powerful measure of proficiency < end sarcasm font>. Therein lies the problem. How do you measure EHR proficiency?

Although, the doctor leaving the practice, which is an issue in itself, also illustrates why EHR proficiency shouldn’t be a requirement for a medical license. In the not so distant future, it will be hard to practice medicine without EHR proficiency whether the medical boards require EHR knowledge or not.

Healthcare Contests to Drive Innovation in Health IT

I’ve been really intrigued with the large number of “challenges” or “contests” that have been coming out in the healthcare space. I love the ideas of a contest with a nice prize as a way to motivate smart people to work on something interesting.

The government has created an entire website devoted to these challenges called Challenge.gov. I first found this website when I found this Healthy People 2020 application developer challenge. They offered $4000 in prize money to work on a project that could help with health promotion and disease prevention. Looks like this is done in partnership with the Health 2.0 developer challenge. Although, before you get too excited the submission deadline has passed. In fact, the winner of that challenge was the Healthy Communities Institute. However, a quick search for health on Challenge.gov turns up 23 more challenges. For example, check out this SMART Apps for Health challenge.

It’s not only the government though that’s using these online contests to try and tap the wisdom of America to solve health problems. Neil Versel of Meaningful Healthcare IT News recently wrote an article about the $3 million Heritage Health Prize. That’s an impressive prize. I’d be interested to know who is competing for that prize.

I’m not sure what it is that is so motivating about these type of competitions. Maybe it’s that we’ve been so trained since we were little to win contests. Either way, it’s interesting to see these type of contests being put to use in healthcare.

IBM Medical Social Network – Patient Portal

I found an interesting article on Fast Company talking about the Facebook for Patients. Of course, I’m a sucker for anything that says Facebook and patients, so I had to check it out.

Turns out the article talks about a new Medical Social Network from IBM. Officially it’s being called the IBM Patient Empowerment System. From the description, it’s an interesting mix of PHR functions where you record your health information, patient to patient interaction like PatientsLikeMe, patient to doctor interaction, and even FDA alerts and drug checking.

Of course, I wanted to try this IBM patient empowerment system out myself, but the article didn’t have a link to it. So, I headed to Google and found no website, but the first result was this video about the IBM PHR along with some press releases:

Pretty hard to judge a system if you can’t use it. Plus, it’s hard to interact with other patients if patients can’t find the portal.

I suspect that the reason I can’t find the portal is that it seems like they’re doing a beta test of the website with Gacheon University Gil Hospital in Korea. It doesn’t seem like they’ve opened up the system to everyone yet. It will be interesting to see if they continue to do a partner based approach for rolling out the IBM PHR or if they choose to open it up to anyone and everyone that wants to join.

I’d say the most controversial part of what they’re doing is probably the FDA alerts and drug checking. This tweet by Neil Versel, blogger at Meaningful Health IT news, describes why these types of alerts and information is going to require a change:

Attitude adjustment needed, stat! RT @amednews: Only 8% of doctors say online research done by patients is helpful http://bit.ly/g5Yrzq

March 12, 2011 8:15 am via ÜberSocial ReplyRetweetFavorite

@nversel

Neil Versel

The challenge to doctors is whether IBM does it or someone else, the empowered patient is already happening. IBM’s Facebook for Patients is just one piece in the puzzle.

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Escape the Fire – Healthcare Documentary Film

Who Will Police EMRs and EHRs?

An Interesting MGMA Observation

Meaningful Use Attestation: GE Admits Problems with Two Centricity Products

EMR and Healthcare IT Article Run Down

Adopt an EHR or Lose Your Medical License

Healthcare Contests to Drive Innovation in Health IT

IBM Medical Social Network – Patient Portal

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