Clinical Decision Support | Meaningful HIT News

Video: Live from HIMSS with Athenahealth CEO Jonathan Bush

NEW ORLEANS—I made my debut for the new Health Innovation Broadcast Consortium last night with a live webcast interview with Athenahealth CEO Jonathan Bush. As usual, I didn’t need to prepare much for the interview because Bush almost interviews himself, so I just decided to wing it. Also as usual, we kept it light, as each of us had a beer in our hand, since we were at the House of Blues in the French Quarter, where Athenahealth had its annual HIMSS party. (This year featured a jazz funeral marking the “death of software.”) But we did discuss some topics actually relevant to health IT, including meaningful use and Athenahealth’s recent acquisition of Epocrates. Enjoy.

Watch live streaming video from hibc at livestream.com

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March 4, 2013 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Tags:athenahealth Epocrates HIMSS13 Jonathan Bush meaningful use Medicare payers

Video: Dell Healthcare Think Tank at HIMSS12

The video from the Dell Healthcare Think Tank dinner at HIMSS12 last week, which I participated in, is now available. It’s long, but if you’re into health IT policy and healthcare reform, it probably is worth your time.

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February 26, 2012 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: Accountable Care Organizations Business intelligence clinical decision support cloud computing EMR/EHR health reform HIMSS interoperability meaningful use physicians regulations reimbursement video

Tags:Dell HIMSS12

Podcast: UPMC informatics leader Shrestha talks accountable care, business intelligence

Did you happen to catch my InformationWeek Healthcare story about how UPMC believes it has the roadmap in place to achieve true accountable care? Well, here’s the rest of the story.

Last week, Nuance Communications invited me to Pittsburgh for a tour of the Center for Connected Medicine, an impressive, high-tech showcase on the 60th floor of the U.S. Steel Tower. There, I interviewed, among others, Rasu Shrestha, M.D., UPMC’s vice president for medical information technology, medical director of interoperability & imaging informatics and division chief of radiology informatics. Here is that interview.

Podcast details: Interview with Rasu Shrestha, M.D., UPMC vice president for medical information technology, Feb. 7, 2012, at the Center for Connected Medicine, Pittsburgh. MP3, stereo, 128 kbps, 15.6 MB, running time 17:08.

1:10 “Clinical language understanding” and “bringing data to life”
3:05 Analytics beyond patient care
3:55 Computer-assisted coding
6:35 Business intelligence in the context of ACOs
7:45 UPMC striving to be an ACO
8:35 Aggregating data from payer and provider sides of the organization
10:30 Keeping medication lists up to date
11:45 Health information exchange among multiple vendor systems
13:00 What to watch for in the near future from UPMC
14:10 Overcoming cultural barriers to change

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February 14, 2012 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: Accountable Care Organizations Business intelligence clinical decision support coding health information exchange health IT health reform Healthcare IT Innovation interoperability podcast

Tags:Accountable Care Organizations Nuance Communications Rasu Shrestha UPMC

Podcast: IBM Distinguished Engineer Scott Schumacher envisions the ‘clinical hub’

In part two of my series from month’s IBM Exchange 2011, my guest is IBM Distinguished Engineer Scott Schumacher. In this lively podcast, Schumacher discusses Watson, disease management and the concept of the “clinical hub,” which envisions bringing together clinical decision support and case management.

As with my previous podcast with IBM’s Lorraine Fernandes, I set my mic too low. I boosted the level during editing, but that introduced more background noise than I’d like. Schumacher mostly comes through nice and clear, though.

Podcast details: Interview with IBM Distinguished Engineer Scott Schumacher, recorded Sept. 14, 2011, in Chicago. MP3, stereo, 128 kbps, 13.2 MB. Running time 14:25.

0:30 What the IBM Exchange is
1:38 The “clinical hub”
2:30 Population analytics and individual patient analysis
4:20 Applying Watson intelligence and other medical knowledge
5:40 Target customers for clinical hub
7:10 Technical challenges
8:15 Potential for the technology
9:00 Video/image mining
10:00 Plans for testing and deployment
11:35 Mining of clinical notes and patient history
12:30 Incorporation of genomics and predictive treatment plans

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October 23, 2011 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: clinical decision support data mining informatics podcast predictive modeling

Tags:analytics disease management IBM Watson

Announcing Health eVillages

I’m involved in this project that’s being announced right now. I’ll have my perspective in MobiHealthNews.

Physicians Interactive and the Robert F. Kennedy Center for Justice and Human Rights Launch Health eVillages mHealth Initiative

First-Ever Consortium of Healthcare and Human Rights Organizations Providing Mobile Medical Technology to Challenged Regions Worldwide

MARLBOROUGH, MA, Sep 26, 2011 (MARKETWIRE via COMTEX) — Today marks the official launch of a historic healthcare and human rights advocacy consortium, Health eVillages, which aims to bring mobile medical reference and decision support technology to clinicians fighting to save lives in underserved regions worldwide. Physician’s Interactive Holdings, with its subsidiary Skyscape.com, Inc., in partnership with the Robert F. Kennedy Center for Justice and Human Rights, will formally announce the creation of Health eVillages during this year’s Health 2.0 Conference. Health eVillages will be assisting healthcare professionals practicing medicine in the most challenged clinical environments, by providing them with mobile clinical reference and decision support tools for medical training, diagnostics and clinical references.

“Putting these devices in the hands of healthcare professionals who require access to current treatment guidelines and references for chronic diseases, drug interaction guidance and medical specialties will help save lives,” said Donato Tramuto, founding partner, CEO and vice chairman of Physicians Interactive Holdings. “Health eVillages will arm clinicians with a ‘gold standard’ medical reference tool-kit, so they are prepared for any situation and are able to properly treat even the most unique medical conditions.”

“For four decades, the RFK Center has been working on the cutting-edge of social change with human rights activists around the world,” said Kerry Kennedy, President of the RFK Center for Justice and Human Rights. “Article 25 of the Universal Declaration of Human Rights recognizes the right to healthcare. With this new program, we’re harnessing the capacity of cutting-edge technology to bring healthcare to the neediest people on this earth — people in Kenya, Haiti, Mexico and in the poorest places of the United States.”

Health eVillages is comprised of leading international healthcare advocacy organizations, mobile healthcare solution providers, health information technology companies, communication providers and public health foundations. They will provide healthcare professionals in disadvantaged areas with new and refurbished mobile phones and handheld devices that do not require Internet access and are preloaded with clinical decision support reference tools to ensure caregivers and patients have access to updated medical references in remote locations. All devices include drug guides, medical alerts, journal summaries and references from over 50 medical publisher resources powered by Skyscape.com, Inc.

To date, Health eVillages has conducted pilot projects in several regions, including Haiti, Kenya, Uganda and the Greater Gulf Coast. The Health eVillages advisory board is comprised of accomplished executives that have played a critical role in the healthcare industry throughout their careers and bring vast knowledge, dedication and insight to the Health eVillages program.

Members of the Health eVillages Advisory Board include:
        
        --  Kerry Kennedy, co-founding partner and president of the RFK Center for
            Justice and Human Rights
        --  Donato Tramuto, co-founding partner, CEO and vice chairman of
            Physicians Interactive Holdings
        --  John Boyer, chairman of the board of directors for Maximus Federal
            Services
        --  Glen Tullman, chief executive officer of Allscripts
        --  Steve Andrzejewski, former chief executive officer of NycoMed, Inc.
        --  Alexander Baker, chief operating officer of Partners Community
            Healthcare
        --  Dr. Mary Jane England, former president of Regis College
        --  Neil Versel, freelance healthcare journalist
For more information about Health eVillages, please visit www.HealtheVillages.org .

The following are suggested tweets announcing the news. For more information regarding Health eVillages via Twitter, please follow along at @PI_Posts and at @SkyscapeInc.
        
        --  New healthcare consortium to provide clinicians w/ Internet-free

http://ow.ly/6C2RQ                (5 Characters)
        --  RT @SkyscapeInc Breaking from #health2con: @rfkcenter & @PI_Posts

http://ow.ly/6C2RQ                Characters)
        --  @HealtheVillages announced at #health2con to bring vital #mHealth

http://ow.ly/6C2RQ                Characters)
About Physicians Interactive Holdings Physicians Interactive Holdings, with its subsidiary Skyscape.com, Inc., is the leading resource for healthcare information, medication samples and mobile decision support tools to medical professionals everywhere. We use the full power of our network to bring clinicians and Life Sciences Companies together in ways that will change the practice and business of medicine, for the better. Physicians Interactive Holdings has developed a foundation of user-generated, proprietary and public data that powers a networked suite of transactional applications, including eSampling, interactive learning programs and mobile solutions. Physicians Interactive Holdings is owned by Perseus LLC, a merchant bank and private equity fund management company. For more information about PIH, visit http://www.physiciansinteractive.com

About the Robert F. Kennedy Center for Justice and Human Rights The Robert F. Kennedy Center for Justice and Human Rights was founded in 1968 by Robert Kennedy’s family and friends as a living memorial to carry forward his vision of a more just and peaceful world. Through long-term partnerships and cutting-edge methods at the Center for Human Rights, we engage in long-term partnerships with human rights activists who have won the Robert F. Kennedy Human Rights Award to initiate and support sustainable social justice movements. We support authors and investigative journalists who bring light to injustice through the RFK Book and Journalism Awards. Our Speak Truth To Power program educates the public and provides students with a toolkit for action to create change in the classroom, the community, nationally, and internationally. The RFK Compass Program works with institutional investors to advance a discussion of the connections among investment performance, fiduciary duty, and public interest issues to optimize risk-adjusted rates of returns and address current and future global challenges. Partnering with RFK Europe, we provide human rights education advocacy programs to schools and communities across the continent. With RFK Children’s Action Corps, we urge legislative reform of juvenile justice systems. The Robert F. Kennedy Center for Justice and Human Rights is a 501 (c) (3) nonprofit charitable organization.

So, now, doctors guessing with Google has become a joke

As I heard at AHIMA’s Legal EHR Summit earlier this week, clinical decision support isn’t a perfect science. (Check InformationWeek Healthcare for coverage on Thursday or Friday.) This is especially true when doctors rely too much on Google and don’t actually verify what they find on the Internet. This may sound hard to believe, but not everything posted online is true.

Now, the notion that doctors guess with Google has made its way onto the funny pages, specifically in the cartoon Sherman’s Lagoon. To wit:

Hopefully, your own doctor is more qualified than Hawthorne.

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August 17, 2011 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: clinical decision support humor patient safety

Tags:AHIMA Google Internet

Not so elementary, my dear Watson

In just the last few hours, I’ve seen a huge wave of pushback and doubt about Watson, the IBM supercomputer, being used for clinical decision support.

Yesterday, I covered a “healthcare leadership exchange” at IBM’s new Healthcare Innovation Lab in downtown Chicago. I posted some of my observations on the EMR and HIPAA blog, and made the case for diagnostic decision support.

I also wrote a story for InformationWeek, but that hasn’t run. Instead of posting my story, InformationWeek healthcare editor Paul Cerrato wrote a column about Watson already being “beaten in the medical diagnostics race” by Isabel Healthcare, a diagnostic decision support tool that’s been available for years. I have to admit, he’s right. I first interviewed Isabel founder Jason Maude probably in 2002 or so, and I first blogged about the company in 2005. I mentioned Isabel in a 2007 post that, interestingly, also alluded to the work of Don Berwick and Larry Weed.

Cerrato mentioned Jerome Groopman’s 2007 book, “How Doctors Think,” which discussed, in part, how IT could help doctors avoid many types of cognitive errors. “[D]octors tend to lean toward diagnoses that are most available to them in their day-to-day routine,” Cerrato wrote (emphasis in original). That’s exactly what Weed has said for decades, and exactly what Atul Gawande talked about in his groundbreaking book, “Complications.” Computers should not make decisions for physicians, but rather should help them reach the right conclusions, particularly when they see rare cases.

Wouldn’t you know, “e-Patient” Dave deBronkart commented on my EMR and HIPAA post to say he just finished reading Groopman’s book. He tweeted a link to my post, which a few of his 6,500 other Twitter followers noticed. They also noticed EMR and HIPAA grand poobah John Lynn’s comment that the example in yesterday’s Watson demo, a 29-year-old pregnant woman being prescribed doxycyline was “pretty weak.” (He’s right, by the way.) Aurelia Cotta, who blogs about issues such as infertility and adoption, started this thread that also got South Carolina nurse Sunny Perkins Stokes interested:

@sunnystill @ePatientDave @nversel I can see great uses for this, but I find it funny the example they give of doxy in pg is wrong.

June 3, 2011 3:19 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

@sunnystill @ePatientDave @nversel because it's still using the FDA's pg categories, which are 30 years out of date. GIGO anyone. Heh

June 3, 2011 3:20 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

RT @AureliaCotta: @sunnystill @ePatientDave @nversel find it funny the example they give of doxy in pg is wrong.| How so?

June 3, 2011 3:25 pm via TweetDeck ReplyRetweetFavorite

@sunnystill

Sunny Perkins Stokes

@sunnystill @ePatientDave @nversel sorry to reply late--but FDA is binary, and Motherisk is risk vs reward ratio. Critical difference

June 3, 2011 3:49 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

@sunnystill @ePatientDave @nversel doxy is an excellent drug, and cheap. Lyme disease can cause m/c + stillbirth. What if pt needs it?

June 3, 2011 3:50 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

@sunnystill @ePatientDave @nversel baby teeth that have a line on them as a remote chance, might be worth the risk to a pt with no $

June 3, 2011 3:52 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

RT @AureliaCotta: @sunnystill @ePatientDave @nversel baby teeth might be worth the risk to a pt with no $ ?Amoxicillin not just as good?

June 3, 2011 3:54 pm via TweetDeck ReplyRetweetFavorite

@sunnystill

Sunny Perkins Stokes

@sunnystill @ePatientDave @nversel maybe to you, but what if the pt is allergic? Or they've already tried amoxicillin, and it didn't work?

June 3, 2011 3:58 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

@sunnystill @ePatientDave @nversel context matters is all, and I just think any sources used should be good, not "lawyer endorsed"

June 3, 2011 3:59 pm via UberSocial ReplyRetweetFavorite

@AureliaCotta

Aurelia Cotta

Well, there’s a reason why I call myself a “healthcare” reporter and not a “medical” reporter. I don’t know the science, and I do occasionally get myself in trouble when I start talking about things like whether doxycycline is contraindicated during pregnancy. (To my credit, I did attribute the statement to IBM’s chief medical scientist, Dr. Marty Kohn.)

As I was reading the above tweets and contemplating this blog post, I came across a link to some tongue-in-cheek pushback against Watson in healthcare. An anonymous radiologist who blogs about PACS as “Dr. Dalai” compared Watson to HAL, the diabolical mainframe in “2001: A Space Odyssey.” Dr. Dalai wrote: “Watch out, boys and girls, Watson is headed to a hospital near you, and he (it?) may challenge you as much as he did Ken Jennings.” Jennings, of course, is the Jeopardy! champion whom Watson beat earlier this year.

At first glance, I thought Dr. Dalai was yet another whiny physician clinging to the status quo. But he hit on the real issue: application of knowledge. Quoting from an interview with one of Watson’s programmers, Dr. Dalai noted that the supercomputer is being loaded with all kinds of medical reference material in preparation for “learning” human physiology and ultimately gathering experience in medicine. “This isn’t fair! If I could just take a text book, stick it up my, ummmm, brain, and have it instantly memorized, I would be whiz, too!” he wrote.

Yeah, isn’t that the whole point of clinical decision support?

News and notes: Cool healthcare tech, telemed pushback and more

It’s Friday afternoon, and I realize it’s been days since I’ve posted here. (Make sure you catch my posts on EMR and HIPAA every Thursday, including my latest on Dr. Larry Weed and his critiques of current health IT systems.) I think it’s time for a rundown of some interesting developments this week.

Weed apparently is not the only one who’s disappointed in the pace of change in healthcare. Dr. Bill Crounse, senior director of worldwide health for Microsoft, was at the World of Health IT conference in Budapest, Hungary, to deliver some scathing remarks at about North American health IT. According to Canadian Healthcare Technology, Crounse called the U.S. and Canada the “worst of the worst in the industrialized world in the use of IT in healthcare.”

He explained: “I see physicians in perhaps less developed countries bypassing all that legacy technology and using commodity off-the-shelf contemporary solutions, using tablets and speech recognition and doing their discharges, all with technology that costs pennies on the dollar, and then I come home to America and look at these $150 million systems and say, ‘wouldn’t we be better spending that on patient care instead of IT?’”

EMRs just store health information, Crounse said. “It’s really what you do next that counts. Once we have information digitized, that doesn’t buy you value. It’s what you do with the information, how you use it to manage care, and to collaborate.”

While we’re talking about overseas events, Hello Doctor, a telemedicine service in South Africa, apparently is on hold less than a month after its April 17 launch. In an e-mail newsletter (not available on the Web, as far as I can tell), Telemedicine & E-Health reported:

Under fire from South Africa’s healthcare bureaucracy, Hello Doctor has suspended its telemedicine services, pending a meeting between representatives of the company and the Health Professions Council of South Africa (HPCSA). The council referred to its undesirable business practice committee Hello Doctor and two companies that have announced plans to offer a joint telemedicine service later this year, MTN Group and Sanlam. HPCSA has alleged that the companies violated rules that require a healthcare practitioner to do a physical examination and assess a patient before a diagnosis can be made. [News Alert, May 6 ]. HPCSA is drafting its own guidelines for telemedicine, an emerging competitor to nationally-licensed doctors.

The South African Medical Association also is fighting the service. “”It is no different from blind-dating. How sure are you whether you are getting the real doctor or not?” SAMA Chairman Dr. Norman Mabasa told Independent Online. Hmm, aren’t these the same kinds of objections we see in America? When will the medical establishment wake up and see that telemedicine is not a threat to their authority?

Well, at least some physicians are embracing new technologies. That’s the subject of a feature I just had published on Medscape, “10 Totally Cool and Incredibly Useful Medical Gadgets: Technology That’s Changing Medical Care.” Feel free to argue with me and add your own.

And speaking about telehealth and arguing with me, I was the victim of intimidation of the media this week. A certain story I wrote about a telemedicine technology vendor was pulled from the Web yesterday after the company threatened to sue the small company that published it. The company accused me of writing a “defamatory” story and wondered if a competitor didn’t actually help me write the piece. Sorry, but I have a lot more integrity than that. I also was accused of mischaracterizing the state of the deactivated ambulance telemedicine service in Tucson, Ariz., which I said was “failed.”

The accuser referred to an April article in Telemedicine & E-Health written by Dr. Rifat Latifi, one of the driving forces behind Tucson ER-Link, and several colleagues that showed the efficacy of ER-Link in performing remote intubation. That’s great, but there needs to be a working network to support the “videolaryngoscope.” Tucson, unfortunately, no longer has one.

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May 20, 2011 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: clinical decision support EMR/EHR media

Tags:Arizona Bill Crounse Canada Hello Doctor Larry Weed Microsoft Rifat Latifi South Africa

Blogging by Twitter?

Oh man, I’ve been busy. I filled in as writer of the Midwest edition of Payers and Providers the last two weeks because regular editor Duncan Moore, a former colleague, had been hospitalized. (Get well soon, Duncan.) I’ve been at the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla., since yesterday, and I’ve also had my regular deadlines for InformationWeek and MobiHealthNews.

I moderated two IHT2 conference sessions yesterday, on how health IT underpins Accountable Care Organizations and how business intelligence can create a framework for health information exchange. I haven’t had time to blog about those, but several people seem to have tweeted during those sessions. I therefore present a rundown via Twitter.

@narmi91 #iHT2 FMA #HIE strategy: Simple HIE gives physicians instant value, allows them to dip their tow in the water.

@narmi91 #iHT2 #HIE strategy: Adopt exchange before adopting #EHR. Which would you choose Internet (HIE) or PC (EHR)?

@narmi91 #iHT2 #HIT for #ACO: Primary care medical home is a must for ACO. Paying patients to perform. Also focus on medical assistants & nurses.

@narmi91 #iHT2 #HIT for #ACO: Changing patient behavior: need to engage patients. BCBS has new benefit plan $300-700 cash for manage health and qual.

@narmi91 #iHT2 #HIT for #ACO: Fed/state gov are more on the side of privacy but security always comes down to human behavior.

@narmi91 #iHT2 #HIT for #ACO: Pace of tech adoption in healthcare is much slower than other industries: Privacy & security, care coord, social sci.

@ICALeader Dr Freeman says healthcare is more focused on quality assurance than quality improvement, need multi-disciplinary groups to achieve QI #iHT2

@narmi91 #iHT2 #HIT for #ACO: Quality improvement process can help identify clinical decision support.

@narmi91 #iHT2 #HIT for #ACO: Victor from HRSA – HIE challenges include security issues and not enough discrete data. Most #EHR not designed for qual

@ICALeader Kevin Mather says upside & downside risk must be high & metrics must be measured for quality & cost monthly for ACO success #iHT2 #HIE #ACO

@ICALeader Dr. Freeman reminds #ACO & #HIE not to forget federal healthcare DOD, VA & IHS agencies in effort to coordinate care @ #iHT2 FTL

@bhparrish: Patient-centered #HIE with secure communication will be essential infrastructure for #ACO development. <RT @ICALeader> #iHT2

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May 11, 2011 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Filed Under: Accountable Care Organizations Business intelligence clinical decision support EMR/EHR health information exchange Healthcare IT privacy security

Tags:Institute for Health Technology Transformation patient-centered medical home

My week in review

Since I’m starting to write a lot of daily/breaking news, I’m going to try something new today that might become a regular Friday feature: posting my week in review. It will consist of a quick rundown of stories I’ve written this week. Here goes:

Monday

“Patient Safety Initiative To Leverage Health IT: The $1 billion federal Partnership for Patients initiative aims to cut $35 billion in healthcare costs, save 60,000 lives, and decrease hospital-acquired conditions by 40% by 2013.” (InformationWeek)

Tuesday

“Medicare Opens EHR ‘Meaningful Use’ Attestation” (InformationWeek)

“How mobile health can abide by HIPAA” (MobiHealthNews)

“State of mobile and wireless healthcare” (video/slides of my recent presentation to Meharry Medical College)

Wednesday

“CMIOs to begin testing BlackBerry PlayBook” (MobiHealthNews)

Thursday

“More Unrealistic Expectations From the Public, This Time Involving CDS” (EMR and HIPAA)

I’ve got another InformationWeek story to crank out this afternoon that may or may not get posted until Monday, and a podcast in the works, too. Bring on the weekend!

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April 22, 2011 I Written By Neil Versel

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.