EMR? What’s that?

Need more proof that true interoperability remains a distant goal in healthcare? You should have been at the Radiological Society of North America show here in Chicago this week.

I was meeting with a provider of remote radiology services that has developed its own workflow-management software, when I asked a fairly obvious question: Can the remote physician’s notes be incorporated into the host site’s EMR?

The response? “EMR? I’m not sure what that is.”

“Electronic medical record,” I said.

“Oh, you mean like a RIS or a HIS?” this puzzled vendor rep asked me.

Kind of, I suppose.

A radiology information system usually contains clinical information, but I’ve always thought that a hospital information system was something more on the administrative side of the house. Am I wrong, or do people in radiology speak a totally different language than everyone else in health information management?

RSNA is a founding member of Integrating the Healthcare Enterprise, so interoperability definitely is on the agenda. I guess it’s hard to get the message out to the more than 60,000 attendees and 740 exhibitors, but I would expect a vendor salesperson to be a little more in-the-know.

The RSNA show always is a curious event for me. For one thing, it takes up all three buildings of McCormick Place. (I never thought I would ever have to consult the exhibitor map to find Cerner‘s booth at any conference of any kind, but when Philips has a display the length of two city blocks, other companies tend to get lost.)

Vendors apparently don’t realize the scope of this show. I got meeting invitations from a couple dozen companies I’ve never heard of, thinking that I and other journalists would find them more important than 700-some other exhibitors. If you think the HIMSS annual conference is big, you should check out RSNA.

How RSNA gets that many people to come to Chicago this time of year—and likely pass through O’Hare International Airport at the tail end of the Thanksgiving long weekend—astounds me. I live here and I won’t go near O’Hare the Sunday after Thanksgiving.

Hopefully everyone got out of town before the first snowstorm of the year hit Thursday night, and hopefully people start to figure out what an EMR is. Maybe Thursday’s news that Intel, Wal-Mart Stores and other large American companies will begin offering EMRs to their employees will accelerate the process.

By the way, regular readers of this blog should not be surprised. Here’s the link again to my exclusive interview with Intel and Wal-Mart executives about health IT.

The McKesson/Per-Sé merger, and the latest government freebie

In case you were wondering about last week’s announcement that McKesson would take over Per-Sé Technologies for $1.8 billion, the story broke last Monday. I put together a story for Digital HealthCare & Productivity (f.k.a. Health-IT World), but e-mail problems on both ends kept the story out of Tuesday’s newsletter. It has since been posted on the Web, so click here to read what I wrote.

In other news, late last month, the federal Agency for Healthcare Research and Quality introduced an electronic reference tool for primary care—essentially, free clinical decision support. Called the Electronic Preventive Services Selector, it is available for Palm or Windows-based PDAs or for desktop/laptop/tablet computers.

I don’t know if it interfaces with any EMRs, but I will be talking to some AHRQ people this week for a publication outside the HIT universe. At first glance, however, it seems more reality than vaporware, unlike the allegedly “free” VistA Office EHR that we’re still waiting for.

Podcast: Malcolm Costello of Kryptiq on interoperability

At the recent Medical Group Management Association annual conference in Las Vegas, I sat down with Malcolm Costello, vice president of marketing for Kryptiq Corp., a healthcare communication and integration company in Portland, Ore. We talked about secure messaging and other means of electronic communication that are helping to improve healthcare workflows and link providers to patients.

I was surprisingly alert for 9:30 in the morning, when we recorded this, and the sound quality is better than normal because I used an actual hand-held microphone rather than the built-in mic on my digital recorder. What a concept!

Podcast details: Interview with Malcolm Costello, VP marketing, Kryptiq Corp., recorded Oct. 24, 2006 at MGMA annual conference in Las Vegas. MP3, 64 kbps, 9.0 MB, running time 19:41.

00:22 What Kryptiq does
01:20 Online communications as a way to interest physicians in IT
02:25 Michigan State case study on messaging
03:15 Memorial-Hermann case study on prescription refills
04:15 Nursing burnout from administrative inefficiency
05:05 Coordination of care from electronic messaging
06:27 Standards in messaging vs. standards in EHR
07:30 Different formats of physician portals
08:40 Where messaging fits in the RHIO discussion
09:24 No good, sustainable financial model for RHIOs
10:00 Peer-to-peer messaging is a better idea
10:58 E-mail works in other industries as a standardized communication platform
11:53 Potential of smart medical devices and other future communication technologies
14:02 E-mail for disease management
14:55 Integration of inputs from patients
16:15 Outlook for interoperability in the future
18:25 Adoption without standardization

A little bit of humor

My head is spinning from all the travel, deadlines, interviews, email backlogs and massive piles of paper that I have had to deal with in the past few weeks, including the loss of my precious notes somewhere between the final session of the World of Health IT at the Geneva Palexpo and the nearby train station, perhaps at the grocery store in the station pavilion. I have a podcast from last week’s MGMA meeting in to post, but that’s on my other computer and I don’t feel like dealing right now.

In its place, here are some random bits of wit and whimsy.

For those who think the Internet is going to help people manage their own care, we get this buzzkill from Stephen Colbert: “Unfortunately, Google Surgery is still in beta.” If you really must know, he said this on Oct. 18 in the context of elephant vasectomies. The proof is right here. Yes, the truthiness hurts.

The midterm elections are next Tuesday, and I’m devastated to learn that Texas gubernatorial candidate Kinky Friedman somehow left IT out of his wide-ranging healthcare plan. He always was a man of the people, and if he’s right about 6 million Texans being uninsured, the people rightfully are more concerned about coverage than EMRs.

Maybe the healthcare community also is more concerned about things other than EMRs, if the MGMA exhibit hall was any indication. Perhaps it was the venue, namely Las Vegas, but the over-the-top displays that seemed to have disappeared from the healthcare expo circuit the last couple of years were back. Case in point, this tiki bar at the Workflow EHR booth. Yes, that’s a surfboard on the outside wall and yes, those are real flames coming from the tiki torches inside. I don’t know how much the display cost, but I do know Workflow does not currently have CCHIT certification.