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Podcast: Scot Silverstein talks health IT safety risks

In a sidebar to the September cover story I did for Healthcare IT News, I reviewed some of the work of Scot Silverstein, M.D., who has long been chronicling problems with EHRs and other health IT systems. Unfortunately, he wasn’t available for an interview in time for that report, but he was last week, so I got him for a new podcast.

Silverstein, a professor of health informatics at Drexel University in Philadelphia, considers EHRs to be experimental and, sometimes, less safe than paper records and would like to see health IT subjected to the same kind of quality controls as aerospace software or medical devices. “Suboptimal system design could lead even careful users to make mistakes,” Silverstein said in this interview.

During this podcast, we refer to a couple of pages that I promise links to, so here they are. Silverstein writes regularly for the Health Care Renewal blog, a site founded by Roy Poses, M.D., a Brown University internist who runs the Foundation for Integrity in Research and Medicine. His definitions of good health IT and bad health IT appear on his Drexel Web page.

Podcast details: Scot Silverstein, M.D., on health IT safety risks. MP3, mono, 128 kbps, 33.8 MB. running time 36:59.

1:10 How this interest came about
3:05 His blogging
3:45 His 11 points demonstrating why he believes the FDA should be concerned about health IT risks
5:00 IOM, FDA and ECRI Institute statements on health IT safety
5:50 Comparing EHRs to medical devices and pharmaceuticals
8:35 Lack of safety testing in health IT
9:25 Issues with EHR certification
10:00 Safety validation of software
10:35 EHR’s role in Texas Health Presbyterian Hospital’s initial discharge of Ebola patient
11:50 EHR failure causing medical harm to a close relative
13:10 Poor design vs. poor implementation
14:35 Who should regulate?
15:55 Billions already spent on EHRs
16:45 Threat of litigation
17:40 “Postmarket surveillance” of “medical meta-devices”
18:50 EHRs now more like “command and control” systems
19:30 Movement to slow down Meaningful Use
20:17 Safety issues with interoperability
21:40 Importance of usability
22:30 His role at Drexel
24:18 “Critical thinking always, or your patient’s dead”
25:05 Lack of health/medical experience among “disruptors”
29:30 Training informatics professionals and leaders
31:15 Concept vs. reality of “experimental” technology
32:50 Advice for evaluating health IT
33:55 Guardians of the status quo
35:10 Health IT “bubble”
36:10 Good health IT vs. bad health IT

 

October 20, 2014 I Written By

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

Breaking: ONC’s Judy Murphy leaving for IBM job

Judy Murphy, R.N., Director of the Office of Clinical Quality and Safety in the Office of the National Coordinator for Health Information Technology, and the ONC’s chief nursing officer, is stepping down Oct. 17 to become CNO of IBM Healthcare Global Business Services.

Murphy has been with the ONC since December 2011 after 25 years as a nursing and informatics expert at Aurora Health Care in Wisconsin; she had led Aurora’s EHR program since 1995. Most importantly to those of us in the media, she has never been afraid to speak her mind and provide good quotes. Now that she’s moving back to the private sector, she won’t be hamstrung by political and considerations when she gives public presentations.

According to National Coordinator Karen DeSalvo, M.D., health IT specialist Jon White, M.D., will be on part-time detail from the Agency for Healthcare Research and Quality to serve as interim head of the Office of Clinical Quality and Safety and acting ONC chief medical officer until those positions get permanent replacements. (Former ONC CMO Jacob Reider, MD, is now deputy national coordinator.) Andy Gettinger, M.D., of Dartmouth Hitchcock Medical Center, will head up patient safety efforts at the ONC on an interim basis.

Judy’s CNO responsibilities will be entrusted to the other nurses at ONC until a replacement CNO can be named,” DeSalvo said in a memo to ONC staff.

October 3, 2014 I Written By

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

Podcast: Care Innovations CEO Sean Slovenski on his company’s Validation Institute

PALO ALTO, Calif. — I’m out here in the Bay Area, in part because Intel-GE Care Innovations invited me to be one of six judges of its first-ever “hackathon” this past weekend. (Full disclosure: Care Innovations paid my travel expenses, but placed no editorial demands on me.)

On Saturday, I sat down with CI CEO Sean Slovenski to discuss a number of issues in digital health and health reform, but I found myself most curious about CI’s new Validation Institute, launched in late June, which looks to bring some truth to some outrageous claims made by entrepreneurs in the untamed world of digital health, telehealth and population health management. I turned on the voice recorder, and this short podcast is the result.

(Sorry for the bit of background noise. We both live in the Midwest, and just had to do this outside on a gorgeous California morning.)

Podcast details: Interview with Sean Slovenski, CEO of Intel-GE Care Innovations, on the company’s new Validation Institute. MP3, stereo, 192 kbps,  9.2 MB. Running time 6:38

September 22, 2014 I Written By

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

Infographics: Health IT leadership and salaries

It’s infographic time! In fact, it’s time for two infographics.

The first is from HIMSS, celebrating 25 years of the organization’s annual health IT leadership survey. Some interesting findings, as pointed out by a HIMSS publicist:

  • 1991- 75 percent say their institution’s financial health is helped by computers
  • 1994 – 14 percent predict that digital patient information will be shared nationwide in 1-3 years
  • 2000 – 70 percent of respondents say HIPAA is a top business issue.

 

The second infographic comes from HealthITJobs.com. Not surprisingly, the most lucrative jobs are in consulting, and those with experience get paid significantly more than newbies.

September 18, 2014 I Written By

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

More health IT comedy means the public is taking notice

I often share jokes and humorous videos here, sometimes because a product is worthy of ridicule, but also to illustrate how some health IT is going mainstream. I’m going to do it again today because two things happened in the last week that I had not seen before.

First, though Stephen Colbert has made fun of digital health and fitness products before, last week he took it upon himself to do so on consecutive nights.

On Sept. 8, he took down the forthcoming Pavlok fitness bracelet, a product that sends an electrical jolt to the wearer’s arm as a reminder to exercise. It also debits the user’s bank account and posts an embarrassing message on Facebook. No, really. “When you’re in a dark place, alone at home, out of shape and too tired, overweight or depressed to work out, it’s probably because you weren’t getting enough public humiliation,” Colbert said.

 

A night later, Colbert, like the rest of the world, was talking about the Apple Watch. After cheering wildly about the announcement, Colbert asked, “What does it do?” He then showed a picture of himself from high school and said it was finally cool to wear a calculator watch.

 

Then, on Friday, no less than America’s Finest News Source, The Onion, got into the act with its “American Voices” feature, in which common people (actually, the same five or six headshots recycled for years with different names and occupations) give their fake opinions on a newsworthy topic. That day, the subject was, “Patients Making Record Number Of Telehealth ‘E-Visits’ With Doctors,” with a reference to an actual Deloitte study on that very topic.

As one “commenter” said, “Until doctors can email me painkillers, I don’t see the point.”

 

September 16, 2014 I Written By

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

Podcast: Greenway Health CEO Tee Green on interoperability, consumerism and more

Health IT vendor Greenway Health recently finished its rollout of a cloud-based EHR to all 8,200 Walgreens stores in the U.S. When I was offered the chance to interview CEO Wyche T. “Tee” Green III about this, I decided to take it a step further.

In all my years of covering health IT, I’ve never met nor even spoken to Green, so I figured a podcast was in order. After all, I had written a piece for Health Data Management earlier this year about how pharmacies are reshaping themselves as true healthcare companies. (This interview also comes in the wake of CVS Caremark ending its sale of tobacco products and changing its name to CVS Health.)

I also had a lot of questions about interoperability issues in health IT and the many criticisms that lately have been heaped on both EHR vendors for perceived usability problems and the federal Meaningful Use EHR incentive program. The timing couldn’t have been better.

Podcast details: Interview with Greenway Health CEO Tee Green, recorded Sept. 8, 2014. MP3, mono, 128 kbps, 25.5 MB. Running time 27:51

1:00 Walgreens rollout and EHRs for “retail health”
3:20 Future expansion to Walgreens Healthcare Clinic locations
4:15 My own experience with lack of interoperability at a CVS MinuteClinic
5:30 Achieving EHR interoperability
7:30 Frustration with slow progress on Meaningful Use
10:30 Data liquidity
12:30 Update on CommonWell Health Alliance
14:25 Addressing criticisms that vendors are hindering interoperability
16:30 EHR usability
18:10 Greenway Marketplace app store
22:15 Patient engagement and slow start to Stage 2 Meaningful Use
24:10 Dealing with the rise of consumerism in healthcare

I’ve been kicking around in my mind the idea of hosting a regular podcast, perhaps as frequently as weekly. If so, what day of the week would you prefer to hear a new episode?

September 12, 2014 I Written By

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

EHRs and patient safety

If you wonder where I’ve been, I’ve, for one thing, been blogging a bit for (very little) pay over at Forbes.com and writing a lengthy cover story for the September issue of Healthcare IT News.

The Healthcare IT News piece actually breaks down into a fairly short lead story and several sidebars, which aren’t all that evident from the traditional Web version. (The digital edition has everything.) For the sake of convenience, here are links to all elements of the cover package:

Main story: “Patient safety in the balance: Questions mount about EHRs and a wide range of patient safety concerns”

Sidebars:

The issue also contains a reprint of my May 2012 blog post, written just a week after my father’s death: “Medical errors hit home.”

Happy reading, and happy Labor Day weekend.

August 29, 2014 I Written By

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

Cerner to buy Siemens health IT business for $1.3B

The next round of health IT consolidation is on. Today, Cerner confirmed the rumor that had been swirling for a couple of weeks, that it will acquire Siemens Health Services, the health IT business of Siemens AG, for $1.3 billion in cash.

Cerner and Siemens also announced a strategic alliance to, according to the press release, ” jointly invest in innovative projects that integrate health IT with medical technologies for the purpose of enhancing workflows and improving clinical outcomes.” Each company will commit as much as $50 million to the alliance over the next three years, with an initial focus on integrating images and medical devices with EHR data in cardiology, Cerner says.

The device integration should come as no surprise. In healthcare, Siemens has always been, first and foremost, a medical device company. Health IT came later, by virtue of Siemens’ acquisition of Shared Medical Systems in 2000 for 2.1 billion. (Adjusting for inflation, that deal would cost $2.9 billion today, meaning that either Siemens overpaid in 2000 or the health IT assets lost more than half their value in the past 14 years.) Cerner has been selling medical devices for integration with its EHR products for several years, but nobody has confused Cerner for a device company. The two companies should complement each other well in this regard.

It’s no surprise that Siemens wanted out of the health IT business, either. Cerner and Epic have been dominating the enterprise EHR market in recent years, winning all kinds of replacement and upgrade business from health systems that previously had used Siemens, GE Healthcare, Meditech and Eclipsys technology.

Eclipsys, of course, merged with Allscripts in 2010, in a deal also worth $1.3 billion, and the combined company struggled to the point that the board forced out several top executives two years later. That was the last major acquisition in enterprise health IT until today. I don’t expect it to be the last, though I won’t predict anything other than that Epic will continue its strategy of growing organically and that many companies, particularly ambulatory vendors, will drop out rather than pursuing federal certification to the 2014 standards.

The market has been shaping up to be a battle between Cerner and Epic for a while, though the formation of the CommonWell Health Alliance a year and a half ago — now including Cerner, Allscripts, Athenahealth, Greenway Health, McKesson, Sunquest and CPSI — shows that Epic is everybody else’s No. 1 competitor.

Cerner and Siemens say the deal should close early next year.

 

August 5, 2014 I Written By

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

Colbert pokes fun at Fitbit and other digital trackers

“We live in a golden era of digital toys,” noted comedian Stephen Colbert on “The Colbert Report” last Monday.

Indeed, some of the digital health and fitness products out there are rather ridiculous, even the popular ones, and we’re hearing just that at some actual health IT events. At last month’s WTN Media Digital Healthcare Conference in Madison, Wis., Adam Pellegrini, vice president of digital health at Walgreens, poked fun at programs that reward people for allegedly exercising. “You could put a pedometer on your dog and get 10,000 steps while watching TV,” Pellegrini joked.

Colbert, who certainly was not present at that Madison meeting, got the same idea about the Fitbit activity tracker. “Last week, I wanted to run a marathon, so I strapped this bad boy to a paint shaker for about 20 minutes,” he said.

Colbert then addressed the Vessyl digital cup, which records data on the beverages each user consumes. “That level of information was previously available only on the can you just poured it out of,” he said. He then pointed out that Vessyl only tracks half of the hydration equation, the input, so he announced the pre-release of his own “product,” Toylyt.

Watch the clip below.

 

 

July 20, 2014 I Written By

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

Health eVillages, Qualcomm ‘move the needle’ on global health

I’m back from an extended break, though hardly a vacation. I spent 11 days this month cycling from Chicago to Washington to raise awareness of multiple system atrophy, the rare neurodegenerative disease that killed my father in 2012. For my first post in more than two weeks, I’ll keep it simple but important, namely with an update on Health eVillages, the program I sit on the advisory board of, as well as some vaguely related news from Qualcomm.

First off, Health eVillages this week officially welcomed five new board members: Brad Fluegel, Spencer Warden, Mike Hamilton, Lorri L. Jean and Ulya Khan. Here’s the press release in full:

FOR IMMEDIATE RELEASE

Health eVillages Welcomes Five Renowned Executives to Advisory Board
Will Provide Strategic Guidance to Bring Quality Healthcare to People in Underserved Areas

READING, MA – (July 16, 2014) -Health eVillages , a program founded by Donato Tramuto andPhysicians Interactive in partnership with the not-for-profit Robert F. Kennedy Center for Justice & Human Rights (RFK Center), has appointed five new members to its Advisory Board.

Health eVillages provides iPod®, iPad® and other handheld devices equipped with specialized reference and clinical decision support tools to improve primary and preventive healthcare in underserved areas around the world.

“We are proud to announce the addition of these five fantastic non-profit and corporate executives to our Advisory Board,” said Donato Tramuto, the Founder of Health eVillages. “As HealtheVillages continues to grow its presence across the globe, we are excited to be able to mine the breadth and depth of experience that Brad Fluegel, Spencer Warden, Mike Hamilton, Lorri L. Jean and Ulya Khan bring to the table. We look forward to using their guidance to help shape innovative, strategic approaches to bringing quality healthcare to people in some of the most underserved areas around the world.”

Since its inception in 2011, Health eVillages has made a significant impact in improving access to critical, live-saving medical information worldwide, launching programs in Africa, Central America, Pacific nations, the Caribbean and areas of Louisiana affected by the Gulf oil spill.

The most recent additions to the Health eVillages Advisory Board include:

Brad Fluegel is the Senior Vice President and Chief Strategy Officer at Walgreens Co. Prior to coming to Walgreens in 2012, Fluegel was an executive at several prominent healthcare companies, including Wellpoint, Aetna, Inc., United Health Group and Tillinghast-Towers Perrin. He also serves on the Board of Directors of Metropolitan Jewish Health System in New York City,Health Integrated, Inc., and Performant Financial Corp.

Spencer Warden is the Provider Engagement Lead at Dabo Health Inc., which provides a community healthcare platform to view and track improvement in key performance metrics and allows for collaboration across hospitals and healthcare systems. Spencer’s responsibilities at Dabo Health include business development, corporate strategy, and strategic partnerships in the Hospital and Payer marketplace. He previously worked for Eli Lilly as a Sales Representative in San Francisco’s Neuroscience sleeve.

Mike Hamilton , President of Engagement at Blood: Water Mission, has received numerous honors for his work with youth and children, especially for orphan crisis issues and healthcare needs in Africa. Hamilton came to Blood: Water after 26 years in intercollegiate athletics at Clemson University, Wake Forest University, and the University of Tennessee. He also served on the board for Show Hope and chaired the Knoxville Chamber Partnership and the local United Way Chapter in Knoxville.

Lorri L. Jean is a nationally recognized leader in the lesbian, gay, bisexual and transgender (“LGBT”) civil rights movement.  She serves as CEO of the L.A. Gay & Lesbian Center, the world’s largest LGBT organization.  Previously, Jean served as the Executive Director of the National Gay and Lesbian Task Force.  Jean was the first openly gay or lesbian person to receive a top secret security clearance from the Central Intelligence Agency, and with her appointment in 1989 as Deputy Regional Director of the Federal Emergency Management Agency (“FEMA”), she became the highest-ranking openly gay or lesbian person in the Federal government. OUT Magazine has twice named her one of the 50 most powerful gay people in the nation and Los Angeles Magazine named her one of the 100 most influential people in Los Angeles.

Ulya Khan, the Chief Operating Officer at Physicians Interactive, has more than 20 years of experience in technology, data and operations. Prior to joining Physicians Interactive, Khan held several leadership positions including Chief Operating Officer and Chief Of Staff at Thomson Reuters in London and New York City, where she was instrumental in building and exponentially growing several businesses and managing global teams across Asia, Europe and the Americas.

Additional members of the Health eVillages Advisory Board include:

Donato Tramuto, Founder, CEO and Vice Chairman of Physicians Interactive

Steve Andrzejewski, Chief Executive Officer of Spiritus Pharmaceuticals

John Boyer, President and General Manager of MAXIMUS Federal Services

Dr. Tim Bristol, Nurse Educator

Caleb DesRosiers, Healthcare Counsel at Foley Hoag LLP

Greg Divis, President and CEO of KV Pharmaceutical

Dr. Mary Jane England , Professor at Boston University School of Public Health

Mark Friess, CEO and Founder, WelVU, Inc.

Dr. Antoinette Hays, President, Regis College

Kerry Kennedy, President of the RFK Center for Justice and Human Rights

Devin Paullin, Executive Vice President of Corporate Business Development of Physicians Interactive

Derek Rago, Vice President of Marketing & Strategy, McKesson Patient Relationship Solutions

Glen Tullman, Managing Director, 7Wire Ventures

Neil Versel , Freelance Healthcare Journalist

About Health eVillages
Health eVillages, a program of the not-for-profit Robert F. Kennedy Center for Justice & Human Rights and Physicians Interactive, provides state-of-the-art mobile health technology including medical reference and clinical decision support resources to medical professionals in the most challenging clinical environments around the world. For more information about Health eVillages, please visit http://www.healthevillages.org/.

About Physicians Interactive
Headquartered in Reading, MA, PI aspires to use the power of worldwide networks of healthcare professionals and life sciences companies together in ways that will change the practice and business of medicine for the better. PI’s value proposition is to offer the life science industry a low-cost, virtual, multi-channel marketing approach that can be used to supplement currently promoted products, as well as non-promoted and orphaned products, that deliver benefits to physicians and patients. A key focus is providing services that fit into physicians’ and healthcare professionals’ daily workflow at the point-of-care when they make diagnosis, treatment and prescribing decisions. More information can be found at www.PhysiciansInteractive.com.

# # #

 

Interested in seeing the kind of difference Health eVillages is making in remote parts of the world? Check out this short video about “moving the needle on global health.”

In somewhat related news, Qualcomm Wireless Reach and Trice Imaging reported last week how their mobile ultrasound technology saved significant amounts of money, time and, ultimately, lives in prenatal care, at three small, rural health clinics in Morocco. Click here to read the case study.

July 16, 2014 I Written By

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