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A Look at the Olympic EHR

Posted on August 23, 2016 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’ve always been interested in the United States Olympic Committee’s choice of GE as their EHR software. As part of the Olympics, GE put out this video where a bunch of the USOC support staff talk about how they use the GE Centricity Practice Solutions EHR with olympic athletes. Pretty cool to hear about some of the stuff they’re doing and the unique challenges they face as the doctors of these athletes.

My favorite part of the video is that they’re able to use the EHR to coordinate care of the athletes across 1000 doctors. Shows you that if there’s a desire to do so, it’s possible. Also, pretty interesting that they note that they take 45 minutes to get someone up to speed on the Centricity EHR.

Hospital Mergers Complicate EMR Transition

Posted on June 14, 2013 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.

Getting an EMR up and running in a hospital or health system is complicated enough. But managing EMR implementations in the midst of hospital mergers is even more difficult.

Like it or not, though, hospital CIOs are increasingly facing the likelihood that they’ll be facing a merger in the midst of their EMR rollout, notes a new piece in the Wall Street Journal. With reimbursements from both Medicare and private insurers falling, hospitals’ margins are growing perilously thin, and the pace of hospital mergers is likely to increase, according to a March report by Moody’s.

Right now, for example, two of New York’s biggest hospital chains — NYU Langone Medical Center and Continuum Health Partners — have agreed to discuss a possible merger. Continuum CIO Mark Moroses is in the process of moving his chain of hospitals to its GE Centricity EMR, in a move which will allow the chain to collect $20 million to $30 million in Meaningful Use incentives.

If the merger between Langone and Continuum goes through, Moroses will have to stitch together dozens of billing,  procurement and patient care systems over the next few years, the WSJ notes. But more than that, the hospital chains will have to synchronize their clinical information management, a formidable job which, as Moroses says, leaves no room for error.

It’s not just systems integration that merging systems will face, however. As the WSJ piece notes, when North Shore-Long Island Jewish Health System took over Lenox Hill Hospital in 2010, the systems’s CMIO Michael Oppenheim had to bring Lenox Hill’s data to a new version of its Allscripts EMR.  The system used currently by Lenox Hill is an old one which isn’t certified for Meaningful Use.

Ultimately, hospitals’ urge to merge makes sense on a lot of levels. Given their tremendous capital costs (including EMR spending) it only makes sense to achieve economies of scale.  Unfortunately, the commonsense desire to save money and be more efficient is going to subject HIT leaders to an even rougher ride then they might have expected.

Some Interesting Thoughts from the EHR Summit

Posted on November 17, 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.

I enjoyed all day at the EHR Summit that’s being held by HBMA in Phoenix. It’s been a really interesting event for me. I had some sound bites from the Ron Sterling keynote queued up, but it’s not connecting to Twitter. So, I’ll see if I can post those tomorrow. Today, I thought I’d post some of my other tweets from the other session. I think you’ll find them interesting, enlightening, thought provoking or some other adjective. I really look forward to the discussion on this post.

EMR software has many versions of the same data. #interesting #EHRSummit11 Think about an HIE as well. They have a version of the data too

HIE’s aren’t good at getting the receiving doctor the second version of a clinical document. #interesting #EHRSummit11

Think about the records retention issues when you switch EHR software companies. Good thought. #EHRSummit11

If you haven’t lost a client to a hospital this year….you will next year. #EHRSummit11 #HBMA

How many EHR companies are billing companies? They have 7 listed on screen. Do you know of others? #EHRSummit11
They have MED3000, Allscripts, Greenway, NextGen, Athena, GE Centricity, Ingenix. Any other EHR companies do billing as well? #EHRSummit11

Shame on you if you hire an EHR Company and don’t check the references. Ask for a list of 10 in that specialty and size. #EHRSummit11

Pre-existing conditions, No lifetime maximum and kids on parents plan for longer are going to increase our insurance costs. #EHRSummit11

Definitely interesting to consider how the healthcare billing industry will be affected by things like ACO’s and concierge. #EHRSummit11

Super bills are going to go away once we get ICD-10. #EHRSummit11 #HBMA

The healthcare billing sales cycle is 12-18 months. #EHRSummit11

Since I’m putting some of my tweets. I also enjoyed a number of the tweets coming out of the ONC Meeting today. Here’s one that really hit me:

RT @INHSbeacon If you’ve seen one CCD, you’ve seen one CCD. Everyone interprets different, we need to find a standard to succeed #ONCMeeting

Who Will Police EMRs and EHRs?

Posted on November 7, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

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.

Meaningful Use Attestation: GE Admits Problems with Two Centricity Products

Posted on October 24, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

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.

Patient Portal Meets Meaningful Use ONC-ATCB Certification Requirements

Posted on October 6, 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.

It’s been really interesting to see all the companies that are going after the ONC-ATCB EHR Certification. As one person mentioned to me this weekend, an EHR vendor that isn’t an ONC-ATCB certified EHR is dead in the water. With a few minor exceptions, that’s absolutely true. So far though, every EHR vendor that I know of has or will be an ONC-ATCB certified EHR.

Something that I’ve found really intriguing is all the modular EHR certified software products that have come out. Often these modular EHR certifications represent interesting companies or product lines for large companies that I never knew about.

I previously posted about a data warehouse product achieving the modular EHR certification. Today I saw that GE Centricity’s Patient Portal has achieved modular EHR certification as well. In many cases it makes a lot of sense to have the patient portal from a separate company. Particularly when you have multiple EHR software. So, it’s nice you can use it without worrying about the EHR certification since they are now certified.

I’ll be interested to see what other modular EHR certifications come out.

Finding Jobs for ONC Workforce Program Participants

Posted on August 25, 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.

In response to my post about the ONC Workforce program, I got sent the following message:

I have also completed the ONC Workforce Program. Ms. Feldman is not exaggerating about its difficulty, though my program did not have assignment deadlines. Her comments prove to be another verification that the programs present the standard materials differently. We were told that the course work would take 15-20 hrs/wk, but found we had to double that to complete within 6 months (and work around the high attrition from instructors). When she mentions spelling errors, and missing or duplicated material, it may sound trivial until one sees the extent of the errors. In May, a “corrected” version of the material was released, however. I don’t know the extent of improvement because I completed the program with the beta version.

Perhaps worth discussion is the fact that there are few internships and NO positions that want HITECH graduates without Epic, NextGen, Allscripts, or GE Centricity experience. These vendors do not have classes/seminars on their software, except for facilities who have purchased their product.

When added together, I believe the Workforce Development Program has put people through an enormous amount of pressure, lost many capable people along the way (7000 entered, 2280 completed, according to ONC) and, because back-end gaps for transitioning into entry-level HIT positions exist, we are unable to gain entry to the fastest growing segment for the labor force. That helps nobody.

My heart definitely goes out to these people who’ve gone through the courses and can’t find the jobs. I was particularly taken back by the comment in the middle about there being no positions that want HITECH graduates without the specific EHR experience. Although, I think that might be location specific. Or maybe I just got lucky getting my first job in the EMR world without any EMR experience. I still remember when they asked me to tell them about my experience in healthcare and I responded, “I’ve been to a doctor.” So, there are exceptions, but you have to find them.

I took a few looks at the jobs listed on my EMR and EHR jobs board. Based on past postings, I can definitely say that it’s competitive to apply for an EMR job. Even if there’s a real need for a well trained healthcare IT workforce. I’m not sure if that’s a function of a down economy shifting many workers into healthcare or what.

I welcome other ONC Workforce Program participants to share their experiences in the comments. What have you found that works? Where can other graduates look for EMR and healthcare IT related jobs? I’ll be interested to hear your stories and suggestions.

Another Example: Astronomically Expensive EMR in Place, Paper Use At the Bedside

Posted on April 15, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Just the other day, I went on sort of a rant complaining about the excessive hype around iPad use in healthcare. I wasn’t suggesting that using iPads is a bad idea,  but I was venting about the hyperbole around Apple’s latest darling.

That being said, I’ve just had a chance to be reminded why putting iPads into the hands of clinicians, or at least smart tablets, is long overdue.

Just a few days ago, a relative was in a large suburban hospital which has sunk big bucks into GE’s  Centricity (one of those big gun EMRs our illustrious publisher John Lynn calls “Jabba the Hutt” products).  While I sat in the room with my friend for a while, nurses came in and out a few times to take vital signs, document medication allergies and check in on my friend’s level of pain.

Do I even need to say that despite the frighteningly powerful engine sitting there rumbling within the desktops at the nurses’ stations, every one of these interactions was documented on paper?

I can only imagine a few ways that these nursing notes could get into Centricity, and none of them fill me with confidence:

*  Nurses may be scanning in their documentation as they create it, then they or someone else double-checks the OCR results

*  Transcriptionists could be entering data from paper notes into the Centricity system, with all the attendant potential for error this creates

*  The hospital — which is otherwise extremely automated and seemingly very efficient — has just decided to create a “church and state” environment where some forms of data get into the EMR immediately and some stay on paper

Don’t get me wrong: I realize some of you reading this may already have or be developing  solutions to solve just this problem.  The systems I’ve seen to date, however, seem to be aimed at smaller doctors’ offices and probably wouldn’t scale to a huge tertiary care facility.

I do wish there were better point of care data collection options out there. If, in fact, tablets like the iPad are the best fit, I swear I’ll buy a few for physician friends myself.  But shouldn’t hospitals and practices be doing that?