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Health Wonk Review, post-HIMSS

While all the health IT reporters like myself were in Florida last week for HIMSS14, plenty of other things were going on in healthcare. David Harlow of HealthBlawg has a roundup of opinions in the latest edition of Health Wonk Review, entitled “In Like a Lion.”

Yes, HIMSS was a big deal, even for non-IT people, as I captured the top mention in a HWR for, I believe, the very first time, with my podcast interview with HIMSS President and CEO Steve Lieber.

(David, per your note, I only suffered superficial injuries this year, with a couple of scrapes on my face. No stitches needed, and no deaths in my family, though my uncle did lose his mother-in-law the day after I returned. I also broke a wine glass in a restaurant, though it was not my glass, it was empty and I was sober. The moral of this story: I need to avoid HIMSS in Orlando, which will be hard, since it’s on a three-year rotation. But next year, the conference is right here in Chicago, and it will be April 12-16 to avoid the dead of winter. The last time it was here, in 2009, I had bronchitis all week. Good times! The following HIMSS will be in Las Vegas, Feb. 29-March 4, 2016.)

Because it was HIMSS week, Harlow featured other IT posts prominently, including one from Lygeia Ricciardi and Adam Dole of the ONC—new national health IT coordinator Dr. Karen DeSalvo said they’re trying to call it “the ONC” instead of just “ONC” these days—about the recently launched Blue Button Connector. Harlow, an attorney, also referenced one of his own posts about HIPAA compliance audits.

Another section of this HWR examines something that I’ve been saying for a long time, that the mainstream media has been not telling the whole story about the Affordable Care Act, a.k.a., Obamacare. Later, Harlow talks about teamwork and collaboration for the purpose of patient safety. Kudos for highlighting those areas.

Click here to read Harlow’s rundown.

March 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.

‘Blue Button Plus is totally disruptive’

AURORA, Colo.—”Blue Button Plus is totally disruptive,” Frost & Sullivan health IT analyst Nancy Fabozzi just told me at the Healthcare Unbound conference. Why? Because the enhanced Blue Button Plus format can eliminate the need for healthcare providers to invest in patient portals in order to meet Meaningful Use Stage 2.

I tend to agree. The Stage 2 rules don’t require a portal, just the ability to transmit records securely from provider to patient. Providers, whether they be hospitals, clinics or even small physician practices, can just put a Blue Button widget on their Web site and give patients easy access to their medical records, transferred securely by the Direct protocol, itself a disruptive force for health information exchange.

Longtime readers might recall that I had dissed Blue Button in the past. More than once, in fact. That’s because the original Blue Button format was plain, unstructured text when it was an experiment at the VA. My opinion changed this week, when I realized that Blue Button Plus adds structure such as the Continuity of Care Document, and third-party vendors like Humetrix, make of the iBlueButton mobile app, provide additional context.

I don’t think this will kill the portal business because portals provide additional services such as secure messaging, appointment scheduling, refill requests and online bill payment. But it will make a lot of providers think twice about springing for an advanced portal when Blue Button Plus will fill the Meaningful Use need so easily.

July 12, 2013 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 first portal experience

Yes, after all these years of writing about EMRs, EHRs, PHRs, patient portals and the like, I have had my first real personal experience with a patient portal, courtesy of my internist.

He still has a small practice, with four other physicians, including one fresh out of residency. Those small practices are a dying breed, but this doctor is changing with the times, too. He recently offered a concierge option for a few hundred patients. I declined because I don’t need to reach him that urgently.

The portal has been in place for a couple of years, and I may have logged in once or twice before to set up an account, but didn’t really do anything other than look around. This time, prompted by an e-mail informing me of a new URL, I logged in and checked my medication list. I remembered that another doctor had changed the dosage of one of my medications a while back, so I fired off a secure message informing this practice of the change. (It was a new URL presumably because the EHR vendor formerly known as Sage Healthcare adopted the Vitera Healthcare Solutions name a year ago and was switching its customers to a common, white-labeled portal.)

I also looked at some of my test results from a year and a half ago just to confirm that everything was more or less OK then, though I did see one abnormality with my HDL cholesterol. I last went for a physical in March 2011, about a month after I ungracefully cut my face open on a bathtub in Orlando during HIMSS11, so I was probably due. This practice lets patients request appointments — not actually choose open slots — online, so I sent my request. Tonight, about 24 hours later, I got my confirmation, and I’ll be seeing the doc in a couple of weeks.

It’s not a perfect system, but it was convenient enough for a night owl like myself who might not remember to call during business hours to make an appointment or simply not want to wait on hold or press a bunch of buttons to navigate a telephone menu. I did not see the Blue Button option to download my record that the federal government is pushing private vendors to adopt, but I’m sure that will be there by the time the practice is ready for “meaningful use” Stage 2 in a year or two. I don’t have a PHR anyway, so I wouldn’t be able to do anything with the data other than print it.

I suppose I should set up an emergency PHR at some point, even though I doubt any hospital or specialist I might get referred to would take the time to download my data from a USB drive or log into someone else’s portal. Untethered PHRs simply don’t fit physician workflow. That might change in MU Stage 2 when providers will have to send electronic discharge statements and patient summaries during transitions of care, but I’m still not convinced a patient-controlled PHR will be the right vehicle for these data transfers.

 

October 31, 2012 I Written By

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

Park defends plain-text format of ‘Blue Button’

Todd Park

Well, I guess everything else pales in comparison to the news late Sunday night that Osama bin Laden has been killed and that his body is in U.S. custody, but I had been meaning to bring you something from another part of the government. So now, nearly three hours after I sat down to start writing, here goes.

Remember back in February how I reported that the Blue Button Initiative that HHS, the VA and the Department of Defense had been touting was much ado about nothing because the add-on outputs data in plain, unstructured text that’s essentially useless when imported into an EHR? Well, government officials continue to defend it.

At the Microsoft Connected Health Conference last Wednesday in Chicago, HHS CTO Todd Park extolled the virtues of Blue Button, saying that it was a conscious decision on the part of the people behind the idea—particularly ex-Google and Microsoft star Adam Bosworth and author/Internet scholar Clay Shirky—to export patient information in untagged text format as a quick means of “liberating” data from proprietary systems. It then is up to the patient and his/her providers to decide what do do with the exported record.

“We decided that the burden shouldn’t have to be on the vendor to parse the data,” Park told me offstage.

Well, what do you think of that? Should Blue Button follow some established protocol that organizes data in discrete format like the Continuity of Care Record, Continuity of Care Document or Clinical Document Architecture, or is raw, unorganized text good enough?

UPDATE, 10:50 pm CDT: I found the rest of my notes and see that Park said 270,000 unique users have downloaded data through Blue Button, an average of three times each, even though the government hasn’t done much in the way of marketing. “Simplicity is the key,” he said.

 

May 1, 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.

Big health systems to promote connectivity

Geisinger Health System, Group Health Cooperative, Intermountain Healthcare, Kaiser Permanente and the Mayo Clinic will join together to promote sharing of electronic health data as part of a new organization called the Care Connectivity Consortium. The formal launch is set for 9 a.m. EDT Wednesday at the National Press Club in Washington, and the event will be webcast here.

According to a media advisory, the Care Connectivity Consortium is “a historic interoperability collaboration among five of the nation’s leading health systems to securely share electronic health information and best practices.” Executives from the organizations will be on hand to “will discuss the goals of the consortium, how sharing electronic health data supports high quality, patient-centered care, and the possibility of sharing electronic data in a secure environment.”

It sounds intriguing, but the five participants don’t have much geographic overlap, save for Kaiser’s reciprocal care agreement with Group Health in the Seattle area. Don’t expect any overnight miracles.

That aside, I’d really like to know the standards they’ll be using for data sharing. If they pick something that’s unformatted text, à la Blue Button, this initiative might be doomed to failure.

UPDATE 12:30 p.m. CDT: A publicist for the consortium tells me that the health systems will be following NHIN protocols for data sharing.

April 4, 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.