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Hyperbole doesn’t work in health IT

I’m still rather slammed with work, but I might as well take a few minutes to post on a Friday afternoon to call out someone else who’s pumping up the health IT hype beyond reasonable levels.

A publicist for UnitedHealth Group wanted me to attend yesterday and today’s New York eHealth Collaborative Digital Health Conference in New York City. Never mind the fact that I live in Chicago and the invite came in two days ago. To be fair, though, I was offered phone interviews. I declined based on the second paragraph in the e-mail:

This event is the first and only national summit dedicated specifically to advancing the role of health information technology (HIT). Hundreds of leading stakeholders and thought leaders from across the HIT space will gather under the same roof to discuss the latest technologies, achievements and challenges impacting the industry. HHS Chief Technology Officer Todd Park is the keynote speaker.

This is the first and only national summit dedicated specifically to advancing the role of health information technology, huh? Other than HIMSS, AHIMA, AMIA, AMDIS, CHIME, ANIA-CARING, iHT2, Health Connect Partners, HL7 and a few more, that is absolutely a true statement. Let’s not leave out the dearly departed TEPR, either.

I hope others didn’t fall for that ridiculous statement.

December 2, 2011 I Written By

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

Rules for conference season

Fall is in the air. That means it’s conference season again in health IT. I’m at Health 2.0 in San Francisco right now, and I’ll be taking at least two more business trips to the Pacific time zone before Thanksgiving, plus at least one trip east. That means I’ll be seeing a lot of PowerPoint presentations in the near future.

Needless to say, some presentations are better than others. Some are more accurate than others. On my last trip to California back in July, I hit the AMDIS Physician-Computer Connection. There, one slide show contained a fairly serious factual error regarding mergers and acquisitions in the EHR market. I won’t repeat it because I don’t want to spread falsehoods. You could see the shock on the faces of several people in the audience.

An hour or so after that session, I was sitting a table where one particularly perturbed individual had been earlier. He left the following on a notepad: Read more..

September 26, 2011 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: Gartner’s Vi Shaffer on HIE, ACOs and meaningful use

Back in June, I covered the Wisconsin Technology Network’s Digital Healthcare Conference in Madison. That conference featured a panel with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner, Judy Murphy, vice president of information services at Aurora Health Care in Milwaukee, and Epic Systems CEO Judy Faulkner, based in nearby Verona, Wis.

The panel discussed the question, “Is meaningful use a floor or a ceiling?” as I reported for WTN News. The conference also featured several sessions on how business intelligence and health information exchange can support Accountable Care Organizations.

A month later, I saw Shaffer again at AMDIS Physician-Computer Connection meeting in Ojai, Calif. There, she presented preliminary data from Gartner’s annual survey of CMIOs. After the conference ended, I got a chance to sit down with Shaffer for this podcast. Since the fog and clouds finally lifted on the final day, we decided to record this outdoors at the beautiful Ojai Valley Inn, which is why you will hear some birds and other (human) creatures in the background. We don’t care, it was too nice to sit indoors.

We mostly discussed how HIE can support ACOs, but we also touched on meaningful use and health reform in this lively interview. Enjoy.

Podcast details: Interview with Vi Shaffer, research vice president and industry services director for healthcare providers at Gartner. Recorded July 15, 2011, in Ojai, Calif. MP3, mono, 64 kbps, 7.9 MB. Running time 17:14.

1:35 ACO as a business model and a fundamental change in the needs of patients (chronic disease)

3:00 Interoperability for care coordination 3:50 Will ACO model be better than disease management as it exists today?

4:50 Nature of proposed rules

7:30 Importance of innovation because “meeting the metrics is average.”

9:05 Is meaningful use a floor or a ceiling? Is an ACO a floor or a ceiling?

10:46 Ambulatory services growing faster than hospital services

12:38 “Oligopolies” in healthcare building interoperability and continuums of care

14:40 How far can you go with interoperability in this changing healthcare climate?

15:19 Targeted panel management rather than population health

August 12, 2011 I Written By

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

Deep thought on medical information for a Friday

From HL7 International‘s Chuck Jaffe, M.D., at the AMDIS conference in Ojai, Calif., this morning:

July 15, 2011 I Written By

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

CMIOs wanted in the UK

I’m getting ready to head west for, among other things, the annual AMDIS Physician-Computer Connection in Ojai, Calif., a high-level gathering of chief medical information officers. After years of fighting for a seat at the table, CMIOs now are being held up as a model, at least overseas.

Specifically, my friends at E-Health Insider in the UK have embarked on a mission to have every NHS hospital hire a chief clinical information officer, the British equivalent of the CMIO. Read more about the British perspective on the American CMIO here.

July 10, 2011 I Written By

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

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!

 

April 22, 2011 I Written By

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

A modest proposal

Medical informatics needs a rock star. Not a David Brailer-esque figure who could excite people in the technology sphere, but perhaps a Don Berwick type who can reach every level and constituency of healthcare, and even capture the imagination of the general public.

I had this thought yesterday during a highly engaging session at the American Medical Informatics Association‘s annual symposium in Washington, a session with the mouthful of a title, “Harnessing Mass Collaboration to Synthesize and Disseminate Successful CDS Implementation Practices.” In English, that means panelists were discussing the forthcoming “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide” and related feedback mechanisms, including a wiki.

During the session, panelists discussed the difficulties they’ve had in getting clinical decision support integrated into EMR and quality-improvement projects, as well as into medical practice itself. One commenter from the audience, a Veterans Affairs doctor, noted that to too many people in healthcare, CDS sounds like an IT issue, not something related to quality.

To this, Dr. Bill Bria, chairman of the Association of Medical Directors of Information Systems, said, “Our profession has really stumbled on this one.”

Then, AMIA CEO Dr. Don Detmer asked if the informatics community could identify perhaps the top five serious preventable outcomes and create “poster children” for quality improvement via CDS. He said much of the problem with low adoption of clinical IT is related to communications, though there are some scientific and technology issues as well.

I immediately thought of Berwick and his 5 Million Lives Campaign, a nationwide initiative to help prevent 5 million harmful incidents in healthcare from December 2006 to December 2008 by encouraging hospitals to commit to a series of proven interventions. This, of course, grew out of the 100,000 Lives Campaign, which Berwick’s Institute for Healthcare Improvement says successfully prevented more than 100,000 deaths in U.S. hospitals over a year and a half.

I was at Washington Hospital Center in D.C. just a week ago because my dad had surgery there. Everywhere I looked were signs reminding staff to take action to prevent errors and complications, particularly methicillin-resistant staphylococcus aureus infections. At just about every turn in the hospital corridors, wards, waiting rooms and cafeteria were hand sanitizers.

I’m fairly certain this high level of awareness is directly related to the IHI campaign. In fact, my dad picked Washington Hospital Center over another hospital much closer to his suburban Maryland home because the other place had been in the news of late for its high rate of MRSA. Yes, the public is very aware of the danger of hospital-acquired infections, and Berwick has had a lot to do with raising the issue.

Healthcare needs someone similar to take the lead in communicating the benefits of clinical decision support to the masses. Does informatics have a rock star out there? It’s time to come forward.

November 13, 2008 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: Dr. Robert Kolodner on the national HIT strategy

I love the annual Association of Medical Directors of Information Systems (AMDIS) Physician-Computer Connection. It’s a chance to hear some of the smartest and most accomplished people in healthcare, namely medical informaticists, in a small, informal setting. This year’s event, held last week in beautiful, laid-back Ojai, Calif., featured an appearance by Robert Kolodner, M.D., the national coordinator for health information technology.

After Dr. Kolodner’s presentation—more of a Q&A with his peers in medical informatics—he graciously sat down for an audio interview with me. Here is the result.

Podcast details: Robert Kolodner, M.D., on the national health IT strategy. Recorded July 16, 2008, in Ojai, Calif. MP3, stereo, 64 kbps, 14.3 MB, running time 31:24.

0:40 Background on
national health IT strategic plan toward interoperable electronic health records
3:35 Goals of the plan
4:08 Distinction between “health” and “healthcare”
5:25 Explanation of “patient centeredness”
6:20 Physicians’ role in promoting patient centeredness
7:30 IT’s role
8:50 Population health
10:40 Why physicians should care about national IT strategy
12:55 Making the issue personal
13:35 Financial incentives for technology adoption
14:37 Incremental advances
16:18 Medicare e-prescribing incentives as one step in a series of improvements
17:30 Convincing healthcare organizations to cooperate
18:08 Greater public awareness about electronic health information
18:32 Privacy and security concerns, and coming framework
20:50 Convincing doctors to share data
22:10 Trial National Health Implementation Network implementations
22:55 Where physician IT leaders can make a difference
24:06
AHIC successor
25:25 Complexity of healthcare in the U.S. and abroad
27:18 Profound workflow changes from IT and maximizing skills of healthcare professionals
29:06 Possible effects of 2009 administration change
30:15 Health IT’s fundamental role in healthcare reform

July 22, 2008 I Written By

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

AMDIS notes

OJAI, Calif.—I’m at the Physician-Computer Connection, the annual symposium of the Association of Medical Directors of Information Systems (AMDIS), a high-level meeting of chief medical information officers and other leading medical informatics specialists. I’ll have a bunch on a couple of surveys on the attitudes, job functions and salary ranges of CMIOs and physician executives in IT, most likely in Digital HealthCare & Productivity in the next couple of weeks. (I need to pay for this trip, after all, and the recent run-ups in airfares, car rental costs and, of course, gasoline, are not helping my cause. But I digress.) Let’s just say a need for leadership skills is prominent.

I have plenty of other news and notes that are worthy of posting here, however.

For one, look out this fall for “Improving Medication Use and Outcomes with Clinical Decision Support: A Step-by-step Guide,” an update to the 2005 “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide.” According to lead author Jerry Osheroff, M.D., chief clinical informatics officer of Thomson Reuters Healthcare (formerly Micromedex), this one defines CDS as “providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care.” The guide will follow a modified set of the “five rights” for safe healthcare: The right information to the right person in the right intervention format through the right channel at the right point in the workflow, Osheroff says.

The new volume also involves many more industry stakeholders than the previous edition. It will carry the names of HIMSS, AMDIS, AMIA, the Institute for Safe Medication Practices and the Scottsdale Institute, and is sponsored by the Agency for Healthcare Research and Quality, two clinical IT vendors and two health systems. Osheroff didn’t name the vendors or health systems, but it’s a safe bet Thomson Reuters is involved.

Contrary to rumors, healthcare executive recruiter Betsy Hersher is not retiring, but she is shutting down her Hersher Associates firm and moving into consulting. At least a couple of her employees have taken jobs at Witt/Kieffer.

Earlier this week, I reported in Digital HealthCare & Productivity about the recent reorganization at Sage Software Healthcare. I since have learned that the company will be hiring a new, permanent CEO sooner rather than later. I’m guessing that means within a few weeks. I have no idea about who the candidates might be.

While I’ve been out here on the West Coast, the Medical Records Institute published a scathing critique of the national EMR strategy. That organization is working hard to market itself and stay relevant after a poorly attended TEPR conference a couple of months ago. This article certainly is an attention-grabber, listing the optimism about meeting the goal of getting interoperable EHRs to most Americans by 2014 among a number of “health informatics myths.”

If you want an impassioned defense of the national health IT strategy, check this space in the next 24 hours for my podcast with national health IT coordinator Robert Kolodner, M.D., who spoke at this conference yesterday. This might be my biggest podcast “get” to date.

July 17, 2008 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: Dr. Bill Bria on CMIOs and medical informatics

WASHINGTON—Live from the World Health Care Congress, here’s an interview with Dr. Bill Bria, chief medical information officer of Shriners Hospitals for Children and president of the Association of Medical Directors of Information Systems. We talk about the increasing importance of CMIOs as hospitals align their IT strategies with overall institutional goals, including quality improvement, and we discuss the similar growth of AMDIS. Bria also plugs the annual AMDIS Physician-Computer Connection, which is OK with me since I’ve been shameless in plugging my article in Red Herring.

Podcast details: Interview with Dr. Bill Bria on CMIOs and medical informatics. Recorded April 23, 2007, in Washington, D.C. MP3, mono, 64kbps, 8.6 MB, running time 18:56.

April 23, 2007 I Written By

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