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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 and Responsibility in 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.

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.

All my HIMSS coverage in one place

The last of my 10 MedCity News stories from HIMSS14 has been posted. It’s a nice mix of news, features, analysis and commentary. Here are links to all of them, in chronological order.
NantHealth launches Clinical Operating System – biggest of big data startups – with $1B (Feb. 25)

Body + biology + behavior: Intel exec explains how technology is making N=1 care possible (Feb. 26)

Tavenner: 2014 is your last chance for a hardship exemption for Meaningful Use 2 (Feb. 27)

HIMSS crowd skeptical of promise for flexibility on MU2 hardship requests (Feb. 27)

Google Glass startup expecting third healthcare client in less than 6 months (Feb. 27)

DeSalvo: True EHR interoperability – and a national HIE – is possible by 2017 (Feb. 28)

DeSalvo meets and greets – briefly – while Tavenner keeps her distance at HIMSS (March 3)

HIMSS Intelligent Hospital tracks patients, pills and clinicians in completely connected loop (March 5)

Interoperability Showcase uses car crash to show how connected data really can improve patient care (March 5)

Athenahealth’s first inpatient product isn’t quite an EHR, but a ‘Trojan horse’ into hospitals (March 10)

 

March 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.

Transcript from Leslie Saxon’s appearance on CNN’s ‘The Next List’

LOS ANGELES—Yesterday, I covered the seventh annual Body Computing Conference at the University of Southern California, hosted by Dr. Leslie Saxon, chief of cardiovascular medicine at USC’s Keck School of Medicine. That got me thinking: Whatever happened to the video from Saxon’s appearance on CNN’s “The Next List” back in March?

I’m pretty sure CNN never actually posted the full video anywhere online, though the network did share a short teaser clip a couple days before the show, hosted by CNN Chief Medical Correspondent Dr. Sanjay Gupta, first aired. However, I did find a full, albeit unverified, transcript of the episode on CNN’s Web site if you care to imagine what the pictures might look like.

Several of the people who were on the show also appeared at USC yesterday, including AliveCor’s Dr. Dave Albert, Zephyr Technologies CEO Brian Russell, Misfit Wearables CEO Sonny Vu and product designer Stuart Karten, as, of course, did Saxon and her Oscar-winning film producer-brother, Ed. I’ll have more coverage Monday in MobiHealthNews.

In the meantime, here’s Friday’s news about AliveCor earning FDA 510(k) clearance for the universal, Android-compatible version of its smartphone ECG, the newly dubbed AliveCor Heart Monitor. I’ll see you next week at CHIME’s Fall CIO Forum in Scottsdale, Ariz.

October 5, 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.

Podcast: HIMSS CEO Steve Lieber: 2013 edition

Once again, as has become custom, I sat down with HIMSS CEO Steve Lieber at the organization’s Chicago headquarters the week before the annual HIMSS conference to discuss the conference as well as important trends and issues in the health IT industry. I did the interview Monday.

Here it is late Friday and I’m finally getting around to posting the interview, but it’s still in plenty of time for you to listen before you get on your flight to New Orleans for HIMSS13, which starts Monday but which really gets going with pre-conference activities on Sunday. At the very least, you have time to download the podcast and listen on the plane or even in the car on the way to the airport. As a bonus, the audio quality is better than usual.

Podcast details: Interview with HIMSS CEO Steve Lieber about HIMSS13 and the state of health IT. Recorded Feb. 25, 2013, at HIMSS HQ in Chicago. MP3, stereo, 128 kbps, 46.0 MB. Running time: 50:17.

1:00        Industry growth and industry consolidation
2:50        mHIMSS
3:45        Why Dr. Eric Topol is keynoting
6:00        New Orleans as a HIMSS venue
6:50        Changes at HIMSS13, including integration of HIT X.0 into the main conference
8:55        Focus on the patient experience
9:35        Global Health Forum and other “conferences within a conference”
13:00     Criticisms of meaningful use, EHRs and health IT in general
17:00     Progress in the last five years
20:45     Healthcare reform, including payment reform
22:30     Why private payers haven’t demanded EHR usage since meaningful use came along
23:50     Payers and data
26:28     Potential for delay of 2015 penalties for not meeting meaningful use
29:15     Benefits of EHRs
30:40     Progress on interoperability between EHRs and medical devices
32:52     Efficiency gains from health IT
35:27     Home-based monitoring in the framework of accountable care
36:55     Consumerism in healthcare
39:40     Accelerating pace of change
41:10     Entrepreneurs, free markets and the economics of healthcare
43:25     Informed, empowered patients and consumer outreach
46:30     Fundamental change in care delivery

March 1, 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.

Catching up

It’s been a while since I’ve blogged, but being busy means I’m working. Usually.

In this case, I certainly have been working hard for the last few weeks, but I’ve also been toying with the idea of going to Australia for the triennial MedInfo conference, which takes place next week in Brisbane. After much contemplation, story pitching and even a preliminary discussion with someone who may have been able to cover the considerable expenses until the boss said no, I will indeed be departing for Australia this weekend.

With 17.5 hours of flying time each way—not counting connection time—and the need to do a whole lot of work to pay for the trip, this could be the last blog post for a while. It probably won’t, however, since I have something else to write tonight or tomorrow that I believe warrants its own post.

As I finish up some lingering assignments and prepare for my latest junket, here are a couple of items of interest that I’ve been sitting on for a bit.

This week, Alaska became the final state to legalize e-prescribing, meaning that electronic prescribing is now legal nationwide, including in the District of Columbia and Puerto Rico. Pharmacy connectivity network SureScripts has a map of e-prescribing status by state at http://www.surescripts.com/participant.aspx?ptype=pharmacy. At the right of the screen is a link to a high-resolution map showing where e-Rx laws have changed since 2004.

Then there’s this: A planned high-rise in New York would have 1 million square feet of space to showcase medical devices and other technology, with the goal of “making New York City the prime center of commerce and innovation for the US$260 billion global market for medical devices and diagnostics,” according to the press release.

The proposed World Product Centre would be at 11th Avenue and 34th Street in Manhattan, on the former site of the Copacabana nightclub, across the street from the Jacob Javits Convention Center. Is someone perhaps trying to lure the Radiological Society of North America annual conference to New York?

August 15, 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.