Update 7/1/10

Vendor News:

eClinicalWorks announced that Arizona Integrated Physicians, a physician-owned organization, has chosen eClinicalWorks unified electronic medical records and practice management system for its approximately 600 physicians.

McKesson Corporation and IASIS Healthcare LLC announced an extension of their strategic relationship as IASIS plans to expand its use of healthcare information technology by completing its suite of McKesson Horizon Clinicals solutions. This latest expansion of IASIS’ healthcare information system includes physician documentation as well as computerized provider order entry (CPOE) and will be deployed across all 16 of the IASIS hospitals over the next 12 months.

Picis announced that Bayonne Medical Center, Bayonne, NJ, has successfully deployed Picis ED PulseCheck, part of its CareSuite family of high-acuity solutions, two months ahead of schedule.

Hoag Memorial Presbyterian Hospital, Newport Beach, California, has selected Medicity, Inc. as its partner to build a secure community-wide health information exchange (HIE). Hoag Hospital will deploy Medicity’s full suite of technology services, including ProAccess Community, MediTrust Cloud Services and the Novo Grid.

In the 6/28/10 Issue of Inside Healthcare Computing:

Physicians Use EMR to Improve Patient Outcomes

After spending the last two decades searching for an EMR, physicians at a small Los Angeles, CA area practice discovered a simple, low-cost solution that not only helps the office run more smoothly, but more importantly, lets them focus on patient outcomes.

Customers Weigh In on Allscripts-Eclipsys Merger

While industry analysts and competitors were weighing in on the recently announced Allscripts-Eclipsys merger, at Inside Healthcare Computing we were interested in hearing opinions from Allscripts and Eclipsys customers. Several end-users gave us their optimistic impressions, as well as expressed concerns over product and company integrations, and worries about possible effects on support and software development.

Regional Extension Centers Begin Efforts to Reach out to Providers

As the government moves slowly but inevitably toward a final definition of Meaningful Use, Regional Extension Centers (REC) across the country are launching plans to support eligible providers in their efforts to meet the criteria, secure incentives, and avoid penalties in 2015.

California Hospitals’ Privacy Penalties Provide Wake-up Call to Other Healthcare Systems Nationwide

Last month five California hospitals learned firsthand the financial consequences of medical privacy violations. On June 10, the California Department of Public Health (CDPH) announced administrative penalties and fines totaling $675,000 after determining that the five facilities failed to prevent unauthorized access to confidential patient medical information.

Our Take: Having Your Vendor Acquired Is Rarely Good News

Click to purchase this issue

Update 6/16/10

News:

Apollo Health Street announced a second agreement with Mississippi County Hospital System (MCHS) which comprises two hospitals – SMC Regional Medical Center in Osceola, AR and Great River Medical Center in Blytheville, AR. MCHS will now use Apollo’s Patient Access Partnership to review and correct their patient accounts prior to bill drop.

GE Healthcare announced the launch of Centricity Advance, a Software as a Service EMR solution for small independent clinical practices.

eClinicalWorks announced that the non-profit NYC Regional Electronic Adoption Center for Health (NYC REACH), the federally-recognized Regional Extension Center (REC) for New York City, has selected eClinicalWorks unified electronic medical records (EMR) and practice management (PM) system as an option for providers located in New York City.

U.S. Department of Health and Human Services Secretary Kathleen Sebelius today announced a series of new investments worth $250 million to increase the number of health care providers and strengthen the primary care workforce. The new investments were made possible by the Affordable Care Act.

Inside Healthcare Computing’s 5 for ’10 – A Series of Valuable Quick Tips

Here are some excellent tips to keep in mind as you get ready for Meaningful Use — and the Inside Healthcare Computing articles in which they appeared.   1. ”We’re really not in it for the incentives – or to avoid the penalties. We’ve run the numbers and to be honest, we’ll spend more than we get back,” says Guy McAllister, CIO at Tift Regional Medical Center (GA). For McCallister, Meaningful Use is about more than the money.  It’s an opportunity for his hospital to improve outcomes — a point that may resonate with both clinicians and administrators who may be reluctant to invest in new technology.(“Meaningful Use and Patient Safety,” Inside Healthcare Computing , Vol. 20, #11)   2. “One of the mistakes we commonly see in traditional training sessions is that the lessons are focused on the system’s functionality, rather than how the system will help users in their daily work,” says Jon Roberts, a consultant with Rule 4 Consulting (OR). The key to successfully implementing a new HIT system is teaching people to use it in the context of their work. (“Keys to Successful IT Adoption,” Inside Healthcare Computing, Vol. 20, #10)   3. “The doctors realized that a lot of data has to be tracked and reported on and there’s no way you can do that manually. These physicians have started to see EMR as a necessity. They also see huge dollar signs if they’re successful,” says Chris Jordan, COO, Physicians Health (FL)“(“Physician Practice Sees Another Benefit of EHR: Competitive Edge in Recruiting Doctors,” Inside Healthcare Computing, Vol. 20, #9)   4. “The private practice environment cannot be equated to the outpatient environment of a hospital. If you plan to offer an EMR solution to your affiliated physicians, form a true partnership that will allow those practices to develop a flexible solution,” says David Levitt, assistant executive administrator, Cardiology Consultants (NY).  (“Physician Practice Shares EMR Implementation Best Practices,” Inside Healthcare Computing Vol. 20, #8)   5. “The most important thing to ensure [EHR] implementation success is to get the clinicians involved early on. And if you can swing it, hire a dedicated project manager who is able to concentrate all of his or her attention on the project,” says Terri Rini Barber, VP/CIO, Southwest General Health Center. (“CIO Credits Clinician Involvement with EHR Go-Live Success,” Inside Healthcare Computing, Vol 20, #5) Inside Healthcare Computing offers you best practices, in-depth news, and unbiased stories about how hospitals are leveraging technology to improve patient care and safety.

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Update 6/7/10

Health Information Technology News:

TELUS Health Solutions and Iatric Systems Inc. announced that pre-built Iatric Systems interface utilities for MEDITECH customers are now available with TELUS’ family of electronic health record (EHR) solutions – Oacis. Both companies see tremendous value in offering the MEDITECH customer base the ability to deploy components of a clinician-friendly, web-based EHR while at the same time leveraging existing investments in their MEDITECH installations.

MEDecision, Inc., announced that it has been awarded a contract by the State of Minnesota to provide the technology for a personal health record (PHR) program being developed for State employees and their dependents. The initiative is designed to give state workers and their families an additional tool to manage their health and help control medical costs.

3M Health Information Systems has released a breach notification tool available with new versions of 3M ChartRelease Software and 3M DisclosureTrac Software. The new functionality provides a template for creating breach notifications, making it possible to generate customized letters into which the patient name, address, and specific information about the breach incident can be inserted. The software records and saves all breach notifications and provides a reporting capability to track specific breach incidents by date or patient.

NextGen Healthcare announced that five critical access hospitals have signed on to implement NextGen Inpatient Clinicals: Caro Community Hospital, Caro, MI; Cedar County Memorial Hospital, El Dorado Springs, MO; St. Croix Regional Medical Center, St. Croix Falls, WI; Salem Township Hospital, Salem, IL; and Washington County Hospital, Nashville, IL. Several of these clients already use NextGen Inpatient Financials.

Five Tips As You Prepare for Meaningful Use

 

Here are some excellent tips to keep in mind as you get ready for Meaningful Use — and the Inside Healthcare Computing articles in which they appeared.

 

1. “It’s key that hospital systems take the time to understand how practices are run,” says Laurie Sicaeros, vice president for physician alignment for MemorialCare Health System (CA).  “It’s also important to identify leaders within the practice, particularly a physician, someone in billing, and someone in the front office who can be the go-to resource on site.”  (“Memorial Care: Connecting Physicians to Improve Patient Care,” Inside Healthcare Computing , Vol. 20, #12, April 19, 2010)
 
2. “It’s important to understand from the beginning what you want to do from a research perspective,” when it comes to selecting and implementing EHRs, says Subra Sripada, VP/CIO, Beaumont Hospitals (MI). “Knowing that can be a huge motivating factor from a physician perspective. They see that in order to do the things they’ve always wanted to do, they have to use the technology.” (“CIO: Our Role is to Help Clinicians See the Benefits of Technology,” Inside Healthcare Computing, Vol. 20, #13, May 3, 2010)
 
3. “Don’t assume anything about the functionality of the [EMR] product,” says Chris Jordan, COO of Physician Associates (FL). “It’s easy to get overly enthusiastic during a demo when you see your pet piece working, but take the time to test as much of the system as you can to make sure the functionality you need is there.” (“Physician Practice Sees Another Benefit of EHR: Competitive Edge in Recruiting Doctors,” Inside Healthcare Computing, Vol. 20, #9, March 8, 2010)
 
4. “We have a team of about 3-4 people which does a 90-day CPOE readiness assessment,” says Phil Smith, MD, VP and CMIO, Adventist Health (FL). “We develop a profile on each hospital, looking at things like whether there is a local business case, adequate infrastructure and physician support. During the process we identify in-house ‘champions’ among the different stakeholder groups.” The entire process, while smoothing the road for CPOE implementation, also builds senior leadership’s investment in the outcome. (“Adventist Health System’s Key to CPOE Success: Secure Senior Leadership’s Buy-In,” Inside Healthcare Computing Vol. 20, #6, January 25, 2010)
 
5. When implementing its EMR, “being able to make a case for patient safety was important,” says Marty Fattig, CEO of Nemaha County Hospital (NE). “I’ve always said that installing technology for technology’s sake is doomed to failure. If you’re doing it to improve patient care, to help you take care of a patient more quickly and more effectively, then you can work through whatever problems crop up.”  (“Rural Hospital’s EHR Implementation Provides Lessons for Larger Counterparts,” Inside Healthcare Computing, Vol 20, #3, December 14, 2009)

 

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Update 5/17/10

Health Information Technology News:

IntrinsiQ and eClinicalWorks announced a partnership to integrate IntelliDose, IntrinsiQ’s chemotherapy management solution, with the eClinicalWorks unified Electronic Medical Record and Practice Management solution to give oncology practices a complete, best-of-breed health information system.

InSight Health Services Holdings Corp. announced that it selected MobileMD as its exclusive provider of health information exchange services. MobileMD’s Health Information Exchange provides secure real-time electronic orders and results exchange for physicians.

maxIT Healthcare announced that it has entered into an agreement to become a Certified Consulting Partner with Eclipsys Corporation.

The National Quality Forum (NQF) has formed a new Health Information Technology Advisory Committee (HITAC). Members of the new advisory committee represent a wide range of healthcare stakeholders, including consumers, providers, clinicians, purchasers, suppliers, and public and community healthcare. The NQF Board of Directors approved the creation of HITAC, charging the body with developing a strategic plan and providing ongoing guidance for NQF’s HIT portfolio; pffering input on HIT projects, such as maintenance of the Quality Data Set and specification of testing requirements for eMeasures; reviewing electronic specifications for NQF-endorsed and candidate standards; and making recommendations on the endorsement and maintenance of HIT-related consensus standards.

SunCoast Health Partners has selected MedLink to deploy the MedLink Regional Health Information Organization Financial Stability Model. SunCoast Health Partners is a Joint Venture between the SunCoast RHIO, Inc. and for profit partners offering services to the healthcare community in the Southwest Region of Florida. The participation by SunCoast will include offering products and services to the more than five hundred Healthcare Providers in the SunCoast RHIO covered area of Florida.

 From the Inside Healthcare Computing Best Practices Library: EMR-Using Solo Physician Says Hospitals Need to Understand the Small Practice Culture

As hospitals promote the use of electronic medical records in their communities, their leaders should consider the underlying cultural differences between small physician offices and larger entities.

“The people that hospitals put in charge of these projects need to understand the culture of these small practices,” advises Jeffrey Brenner, MD. Brenner is among the estimated four percent of the country’s solo physicians who fully utilize an EMR. “These practices are very mom-and-pop like.”

Small Practices Do It Themselves

Brenner notes that solo physicians have more of a “do it myself” attitude than those employed in larger groups.

“They have a small business mentality, so when something breaks, you fix it yourself,” the Camden, NJ-based Brenner tells Inside Healthcare Computing. “You can’t afford to call someone to fix every little thing.”

While this mindset is effective for many aspects of solo practice, lack of computer skills has hindered EMR adoption for many offices. “Many practices have older staff not comfortable with computers,” says Brenner. “The key to moving small offices forward is getting them computer literate as soon as possible so they can do things themselves, just like they do everything else.”

Brenner recommends that hospitals dedicate resources to teach employees basic computer skills rather than relying solely on hospital-supplied IT services.

“If your computer doesn’t work, how long will it take the hospital IT staff to service an office that is not one of their own practices?” asks Brenner. “These small offices need to know how to perform basic troubleshooting and installation on their own. The providers should start off with a ‘Networking for Dummies’ book.”

 Doctors in Small Practices Wary of Large Entities

 Cultural differences and past hospital interactions can cause solo practitioners to resist hospital assistance. “People who go into a small practice choose to do so because they don’t like interacting and working with large entities,” explains Brenner. “In the past, hospitals have not always done things in the best interest of the small practice, so they don’t trust them.”

As hospitals reach out to the small practice community physicians, leaders must acknowledge their underlying fears.

 “When doctors see this large entity that has never done anything to help your life suddenly coming out saying ‘I am going to help you and give you this and this and this,’ it’s a little scary,” says Brenner. “EMR adoption then becomes more of a cultural problem than an IT data problem.”

Hiring a small office practitioner to promote the hospital’s EMR initiatives can help alleviate fears.

“Just as if you were implementing EHR in a large system with super users and practitioner leaders, you need to find a small office provider to be part of the project, pay them, and they can become your advocate,” advises Brenner. “You need a leader from within that culture who understands these practices and is trusted to be at their side through the whole process.”

 Brenner, who also teaches part-time at Robert Wood Johnson Medical School in Camden, has personally experienced both EMR implementation successes and failures. “When I opened my private practice five years ago, I bought a product but couldn’t get it to work right,” says Brenner. “I am very computer-literate, but this product had an awful user interface and it ending up just sitting on the shelf.”

Two years later Brenner searched for a more suitable product and settled on SpringCharts from Houston, TX-based Spring Medical. “I needed something simple to use that allowed me to make quick notes,” says Brenner. “I did all the network set-up myself, my staff needed very little training, and it worked like a charm.”

Brenner claims the EMR’s impact has been tremendous. “Everything is paperless now. I see far more patients a day – at least one more patient an hour, I’ve been able to cut staff back and my overhead hasn’t increased,” says Brenner. “The huge stacks of charts are gone.”

 Simpler EHR Option Recommended

 Brenner’s experience has convinced him that small offices require different software alternatives to the systems of larger practices.

“When a tiny office is offered an enterprise EHR built for a big health system, I am not sure it is the best alternative,” says Brenner. “A big enterprise’s requirements are very different than what a small, busy, and high throughput office needs.”

Brenner suggests hospitals offer a range of products. “They need to find products designed for small offices,” says Brenner. “There are products out there that are cheaper and better suited for the complexity level of the smaller practices.”

For a hospital system to fully appreciate the small office environment, Brenner recommends leaders spend time in a small physician practice.

“Hospitals should get their CIO to spend a day at the smallest office they’d like to see adopt EHR and see what a difficult time they are having,” says Brenner. “Primary care is already on the ropes. Trying to do change management won’t be effective unless they understand the culture.”

— Correspondent Michelle R. Noteboom

 Sidebar: How Hospitals Can Encourage Small Practice EMR Adoption

1. Dedicate resources to teach employees in small practices basic computer skills so they can perform basic troubleshooting and installation on their own, instead of having to wait for your busy IT department to help them.

2. Consider hiring a small office practioner to promote the hospital’s EMR initiative. Having an advocate whom small practices see as “one of their own” can help facilitate adoption.

3. Acknowledge that small practices will have underlying reservations about becoming part of a larger system. Keep those reservations in mind when working with them.

4. Offer a range of EMR products that will meet the needs and budget of smaller practices.

5. Have IT leadership spend a day in a small practice and learn first-hand about the challenges it faces.

This article is from the 8/18/08 issue of Inside Healthcare Computing. Copyright 2010 Algonquin Professional Publishing.

Need more best practice tips on working with physician practices to implement EHR?   Take a look at some more recent articles from Inside Healthcare Computing:

MemorialCare: Connecting Physicians to Improve Patient Care (4/19/10)

Physician Practice Sees Another Benefit of EHR: Competitive Edge in Recruiting New Docs (3/8/10)

Physician Practice Shares EMR Implementation Best Practices (2/22/10)

Hospital Assists Community Physicians with EMR (10/5/09)

Hospital System Prepares for Increase in EMR Implementation Among Physicians (3/9/09)

Tips for Implementing EMRs in Physician Practices (3/9/09)

Update 5/3/10

Vendor News:

athenahealth, Inc announced that it will be providing its revenue cycle management services to Lourdes Medical Associates (LMA), a healthcare management association located throughout southern New Jersey. LMA will be deploying athenahealth’s web-based physician medical billing and practice management service, athenaCollector SM, for its more than 100 medical providers in their growing New Jersey health network.

Market Center Management Company announced an alliance with HIMSS, the Healthcare Information and Management Systems Society. .The alliance includes an agreement for space inside the Nashville Medical Trade Center, exclusive education partnership programming, creation of new trade events, and broad-based opportunities to showcase HIMSS partners. HIMSS will establish a flexible, permanent home for the HIMSS Interoperability Showcase on the premier healthcare information technology (HIT) floor of the Nashville Medical Trade Center.

NextGen Healthcare Information Systems, Inc announced it has executed an agreement with Sinai Medical Group to deploy NextGen EHR (Electronic Health Record) and NextGen Practice Management. Implementation of the integrated technology platform began in January 2010, with the first clinic expected to go live in August 2010.

The Chesapeake Regional Information System for our Patients, or “CRISP,” the state-designated entity for Maryland’s health information exchange, or “HIE,” has selected Axolotl’s technology as the core infrastructure for the state’s health information exchange.

Since achieving Meaningful Use seems to be at the forefront of everyone’s mind these days, we’ve reprinted a recent article from the Nov. 2, 2009 issue of Inside Healthcare Computing that offers some best practices for achieving CPOE.  Published biweekly, Inside Healthcare Computing is the HIT industry’s only advertising-free, independent source of news and information. For additional information, visit us at http://insidehealth.com.

Hospital’s Approach to Achieving CPOE Adoption: Involve Physicians in a Step-by-Step Plan

Achieving 100 percent CPOE adoption by physicians takes a deliberate, step-by-step approach, according to James Keel III, MD, chief medical officer at Asheville, NC-based Mission Hospital.

“You don’t just start off one day and decide to launch CPOE,” he tells Inside Healthcare Computing. “You have to make sure the building blocks are in place and working extremely well.” Keel contends that an organization must look closely at both clinical and business processes, including the implementation of standard protocols, procedures and order sets prior to launching a CPOE initiative.

As one of the few hospitals in the country that has achieved 100 percent CPOE adoption by its physicians, Mission Hospital began its multi-year CPOE journey in 2000 by easing physicians into an electronic environment. The hospital worked with Cerner, its vendor of choice, to implement a document imaging application, which enabled staff to scan in documents at discharge. Post-discharge records were only available electronically, thus forcing a transition from paper to computer for results viewing and chart completion.

“This was a big deal for our end users for two reasons,” Keel explains. “First, when patients would come back to the hospital, end users could access their records quickly. Second, it meant that our doctors got a lot of experience using a keyboard, a mouse, and navigating the software. As their comfort level increased, it was no time before they gravitated to the computer in daily rounds instead of looking for paper results, which frequently weren’t as up-to-date.”

The second step in the process was to implement both nursing documentation software and PowerOrders, both from Cerner. Nursing documentation included results reviewing while PowerOrders gave unit clerks, nurses, and pharmacists the ability to electronically enter orders.

“That was an important step for us in migrating to CPOE in that we got an assembly of orders in the system that was both useful and available,” says Keel.

The next step was working with Cerner to implement an eMAR, which Keel says was a fundamental piece of getting the medication orders processed correctly.

From the beginning of the process, Keel says that Mission Hospital’s key to successful implementation was that it was truly physician-led. The hospital’s Physician Information Group (PIG), a voluntary group of physicians that met weekly when the process began and continues to meet biweekly, was instrumental in selecting software, laying out the development of the process, and dealing with governance issues. “For example, the PIG voted to make CPOE mandatory,” Keel explains. “That really forced even the staunchest naysayers to realize that if they didn’t get involved to develop their order sets and get their people educated that they would suffer.”

Taking the time to carefully develop orderables and order sets was also critical to CPOE success. Early on, Mission began to define what eventually ended up as approximately 62,000 orderables. Each individual orderable contains a set of detail options and values that allow each order to be easily modified to suit individual patient needs. Physicians from all specialties then developed more than 500 order sets in preparation for CPOE.

“We had a very deliberate effort beginning in 1995-2002 to promulgate order sets. We encouraged their use and made sure they were evidence-based where possible, and we got physicians to agree by consensus about how the order sets were constructed, that they would have a common systems appearance and structure, and that there would be significant restrictions on allowing redundant or personalized construction of order sets,” says Keel.

Mission Hospital drew on its existing partnership with Cerner once the decision was made to move to CPOE, and Keel credits the partnership as one of the keys to its success. “All those order sets had to be converted to an electronic environment. Our vendor and our physicians had to work closely together to determine the best way to leverage the electronic medium to improve the usability and availability of those order sets,” Keel explains.

Keel says he can’t emphasize enough the importance of testing and retesting in preparing for CPOE. “With 62,000 orderables and 550 order sets, there are so many opportuntieis to miss things.” In addition to basic unit testing, application testing, and integration testing that needed to occur, the hospital also performed an additional category of testing, referred to as usability testing.

During usability testing, which began one year prior to go-live, thousands of handwritten paper orders were scanned and stored on compact discs to be viewed exactly as they had been written by physicians. Users converted those handwritten orders into computer order entry and recorded any difficulty they came across when entering those orders. Order defects were reviewed by a committee and action was taken to amend and improve the order.

Two months before go-live, only 2 percent of orders tested had some form of defect, a decrease of 70 percent in ten months. Keel is convinced that this testing was a critical factor in CPOE adoption, given the hospital physicians’ low tolerance for defects in the system.

Not surprisingly, there were some bumps in the road during the ten year process. As Keel explains, at the same time the hospital went live with results viewing in 2002, it also implemented a physician inbox.

“Initially, there were lots of problems with that product and the physicians became highly frustrated with it. There were also challenges and issues as we made improvements which led to quite an effort on our part to try and solve the problem and educate physicians about the changes. Eventually, we did get those problems ironed out and the physicians fully utilize and leverage the inbox function now and would be distraught if we took it away from them.”

Keel says that there were also some performance problems in the past, including downtime problems, but that the hospital has moved past nearly all of that. “We still have some downtime issues, and Cerner has developed a remote hosting system that we’re currently considering but we haven’t moved forward with yet. The performance problems we had early on are pretty much straightened out.”

The hospital continues to move forward, according to Keel, focusing on bringing up physician documentation, expanding decision support, completing the medication automated electronic process with positive patient identification, and expanding the electronic capability of its ambulatory systems. “I think that’s going to keep me plenty busy for the near future,” he says. n

Copyright 2010 Algonquin Professional Publishing, LLC.

Interested in receiving more best practices advice from your colleagues on implementing EMR, CPOE, and clinical documentation? Want to learn how they’re achieving Meaningful Use? If so, click here for a special subscription offer from Inside Healthcare Computing.

Update 4/15/10

Coming in the April 19 issue of Inside Healthcare Computing:

• Newly announced CCHIT Chair Dr. Karen Bell shares her thoughts about the Certification Commission’s current focus and future direction
• A EHR/HIE initiative in a remote region of Hawaii that boasts a physician EMR adoption of over 90 percent provides some valuable best practices for the rest of the country
• California-based MemorialCare continues its plan to roll out an EMR to its affiliated physicians while simultaneously building third-party interfaces to enable information sharing
• A pilot project that uses technology to ease patients’ transitions from hospital to home

 

Vendor News:

Eclipsys Corporation announces the availability of Sunrise Enterprise5.5.

RelayHealth announced today that Denver, CO-based Catholic Health Initiatives, the nation’s second-largest Catholic healthcare system, has chosen RelayHealth RevRunner to verify patient eligibility for healthcare benefits.

PositiveID Corporation announced that it has partnered with the International Maritime Medical Association, a trade association that promotes the health and medical interests of seafarers, port workers and cruise passengers worldwide, to offer PositiveID’s Health Link personal health record to approximately one and a half million seafarers per year on a paid subscription basis. The Company will launch the partnership with a pilot program for up to 1,000 seafarers in Antwerp, Belgium and Manila, Philippines.

OR International LLC, a hospital development and management company, announces the opening of Bokamoso Private Hospital, a new state-of-the-art specialty hospital located in Botswana, Africa. The fully-networked and paperless facility was designed to meet the highest international standards and is currently serving patients in Botswana who were previously obliged to travel to South Africa or further for quality care. The physicians and nurses, who come from all over the world, follow US protocols for care and provide care for trauma, cancer, cardiac and orthopedic patients. The hospital also has a full service labor and delivery unit using an LDRP room model.

Update 4/12/10

Vendor News:

Clarian Health Partners, Indiana’s largest healthcare system, has selected MedVentive as a technology partner for its clinically-integrated network, Clarian Quality Partners.

Management Health Solutions, Inc. (MHS), a provider of clinical inventory solutions to the nation’s hospitals and healthcare providers, announced its acquisition of AtPar Inc., a developer of mobile supply chain software. The terms of the deal were not disclosed.

Saint Michael’s Medical Center in Newark, New Jersey, will use IBM’s real-time tracking of medical equipment to ensure that life saving medical devices are instantly available and expertly maintained. The new system will initially track more than 2,000 pieces of equipment such as heart monitors, infusion pumps and ventilators across Saint Michael’s using ultrasound receivers and tagging technology from Sonitor Technologies.

HealthPort announcedit is launching a new Web page and blog (www.healthport.com/HIPAA ) devoted exclusively to HIPAA news and updates. Authored by Jan McDavid, HealthPort’s resident HIPAA expert, General Counsel and Compliance Officer, the HIPAA blog comprises news, tips and updates for the healthcare community and will serve as an educational resource surrounding privacy and security issues.

QuadraMed Corporation announced the general availability of the industry’s first ICD-10 Simulator developed to help coders prepare for the transition to ICD-10. Summit Health in Chambersburg, Pa., is the first to implement QuadraMed’s ICD-10 Simulator.

—-

From Inside Healthcare Computing: Best Practice Tips for CIO Management – Strategic Governance

If you’re a CIO who wants a voice in your hospital’s top-level policy formation, leave your propeller cap at the door.

“At a CIO level, it’s not so much a conversation about the number of servers your hospital needs, but how technology can move your organization forward to meet its strategic goals,” says Pam Arlotto, president and CEO of Maestro Strategies, Inc, a Roswell, GA-based healthcare strategy consulting firm.

Models abound for the way the boards of healthcare organizations engage in IT and technology issues, Arlotto says.

Sometimes IT issues are handled through the finance committee. Sometimes they’re handled through an IT committee of the board.

There may be a board member who has expertise in IT who will work with executive staff and report back to the board.

Or perhaps the CIO is invited to a board meeting once a year to give an update or make recommendations.

Or the CIO comes to all board meetings and is a full partner in developing health IT policy and strategy.

Whatever model an organization uses, it’s vital that board members grasp how the IT function is related to the strategic goals of the organization.

 

Arlotto suggests that CIOs take time to educate board members about the issues surrounding IT, acquainting them with the industry lingo, and sharing information about how technology can impact specific strategic goals. This focus on the “big picture” will go a long way in helping board members become valuable partners in the decision-making process as well as serving as a constant reminder that their role lies in policy formation, not implementation.

“Bring board members into hospital planning meetings. Let them see what goes on. An educated board member who understands the issues and their role in the context of the organization and can ask the right questions can be a strong advocate for you,” Arlotto says.

Joan Roscoe, vice president/CIO at Winchester,VA-based Valley Health System, explains, “Our board is very astute about IT computing in healthcare. They know the market and the players. They know the market caps of the major vendors and the volatility of the industry.”

At Valley Health, the board’s contextual understanding aids in the decision-making process. Roscoe will present proposals above $1 million to the board for discussion and then return the following month for final approval.

 

George Conklin, CIO of CHRISTUS Health, a Catholic-based, not-for-profit health system including more than 40 hospitals and facilities in six American states and Mexico, sees his value in the ability to offer a combination of broad business knowledge and technical knowledge.

Each year, Conklin conducts an annual educational event for CHRISTUS board members during which they discuss technology decisions and how they support the organization’s strategic plan.

“We have a very disciplined approach to how we invest in technology. My responsibility is technology, but I’m also expected to bring a knowledge of the social, environmental and market forces at play in our regions and how they will impact us now and in the future.”

At CHRISTUS Health, Conklin, a clinical psychologist by training, has numerous opportunities for engagement with the board. “I’m fortunate to be in an organization where there’s a very strong engagement by the senior level executive team, or what we call our SLT, with the board. We attend board meetings on a regular basis, we participate on committees.”

Conklin and other C-level executives are expected to interact with board members, both formally and informally. In the informal interactions, Conklin says, both staff and board are careful to keep their respective roles in mind at all times.

“I think all of us are very aware of not blurring the lines, but that interaction does create a deeper sense of what our board members are thinking, and where they’re coming from and that knowledge is invaluable.”

Six Tips for Broadening Your Role

1. Assess your odds of success. If you’re not in an organization where IT is viewed as a strategic asset, Conklin’s advice is to begin looking for someplace that does value IT’s contribution.

“If you don’t want to leave your present job though, at the very least, take a good hard look at how big a climb it will be to move the leadership team and the board to the position where IT is seen as an integral part of the organization. Then hang in there and keep pushing,” he says.

2. Be proactive. “A lot of CIOs sit back and wait to be invited to board meetings,” Arlotto says. “CIOs need to take the initiative to figure out the steps to take to be viewed as a key player.”

3. Enlist your CEO in pushing the IT agenda. The CEO plays a pivotal role in helping the board understand how technology can reinvent the organization, especially if the CIO doesn’t appear regularly in front of the board, says Arlotto. “The really successful CEOs that I’ve seen are evangelists about IT and how it can change the organization.”

4. Identify additional C-suite advocates. Conklin recommends taht CIOs start by finding one or two members of the executive leadership team who are power users or who have the potential to understand the value IT plays in the hospital.

“The CFO is often a good place to start,” he suggests. “Work with the CFO or whoever you identify on educating the other team members that information is a strategic resource that has considerable value as well as considerable implications if it’s not well-managed. You as a CIO can offer invaluable insight into that issue.”

“Just talking about a CIO-board relationship implies enlightened leadership in the organization,” Conklin adds. “A CIO’s presence at board meeting implies support from the C-suite. Politically, it’s probably not a good idea for you to be at those meetings until you have the support of the others on the team. With that support, you’ll be able to be more effective.”

5. Find a mentor. As the CIOs role evolves, Conklin stresses the importance of a mentor. “There are those of us out there who have struggled with all the same issues many of our colleagues are struggling with now. Look at who’s doing the things that you aspire to and call them up and ask them to mentor you. CHIME can be a resource, as could be the Scottsdale Institute. Most people in the industry would love to be asked.”

6.Find out what the board’s learning about governance. Arlotto suggests that CIOs take the time to educate themselves about the information that their boards are getting. “It’s really helpful for CIOs to take a quick walk in the board’s shoes. Look at what they’re reading and hearing about governance. Read Trustee magazine. Take a look at what the Center for Healthcare Governance and the Governance Institute are putting out.”

This article originally appeared in the 11/24/08 issue of Inside Healthcare Computing and may not be reproduced or distributed without the permission of the publisher. For reprint information, please go to http://insidehealth.com

Copyright 2010 Algonquin Professional Publishing.

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Update 4/8/10

In the 4/5/10 issue of Inside Healthcare Computing:

In early March, the Office of the National Coordinator (ONC) released long-awaited details of its proposed certification programs for testing and certifying EHRs. Find out what the Drummond Group, EHR certification’s “new kid on the block,” has to say about the process, its competitive edge, and its future plans.

Concerned that unplanned power outages and server downtime could pose a threat to patient safety and care, Tift Regional Medical Center (TRMC), a 191-bed hospital serving 12 counties in south central Georgia, opted to buck the current trend toward outsourcing and recently announced plans to begin construction on a $9.3 million data center. TRMC’s CIO gives readers the inside track on the decision-making process.

If you’re a small healthcare provider with simple exchange needs who wants to qualify for Stage 1 Meaningful Use incentives, you may benefit from NHIN Direct, a project recently announced by the Office of the National Coordinator. The project is on a fast track for implementation; by May, potential users will see a set of draft standards and a final set of core specifications and standards are expected by October of this year.

Participants at the Medical Users Software Exchange (MUSE) EMR adoption summit share their thoughts about interface solutions and Meaningful Use.

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Vendor News:

The University of Medicine & Dentistry of New Jersey–University Behavioral HealthCare announced that it has selected Document Storage Systems, Inc. (DSS) to provide the vxVistA electronic health records (EHR) system and integrated clinical mental health technology in addition to other modules that will enhance the performance of vxVistA.

NextGen Healthcare Information Systems, Inc. announced an agreement with Mercy Health System to deploy NextGen and NextGensm Health Information Exchange.

Unity Medical, Inc. announced that Florida Hospital for Children and St. Luke’s Health System will pilot the company’s new Medical Video jLog for the Apple iPad, an innovative application that utilizes short form interactive video to explain common medical procedures such as CT scans, cardiac stent placements, and physical rehabilitation treatment.

Eclipsys Corporation announced that The Methodist Hospital of Houston (Methodist), TX, has selected Eclipsys HealthXchange to support it in connecting its local care community. The scalable and secure platform, powered by Medicity, will connect Methodist’s acute care electronic health record (EHR) with a network of disparate EHRs in use at local affiliated physician offices throughout the region/local area.

Update 4/1/10

MEDSEEK announced plans to the expansion of its relationship with long-time partner Frederick Memorial with its engagement to develop Frederick Memorial Hospital’s (MD) eHealth ecoSystem.

Computer Programs and Systems, Inc. announced that the Computerized Physician Order Entry (CPOE), Electronic Medication Administration Record (E-MAR) and Pharmacy applications of the CPSI System have achieved “approvable” status from the Ohio Board of Pharmacy.

Clearfield Hospital recently received a $69,000 grant for its Electronic Health Records Project from Highmark Inc. The funding is through Highmark’s Health Information Technology Grant Program. Originally known as the Highmark eHealth Initiative, the $29 million grant program is designed to help physicians acquire health information technology for their practices to improve patient safety and quality. The grant Clearfield Hospital received will be used to offset costs of implementing electronic health records in the hospital’s physician clinics.

Adoption of healthcare IT is on a steady incline in the small physician practice, reveals a survey by NaviNet. Survey results showed that the percentage of provider offices with plans to implement EMRs is growing. The two leading drivers for IT adoption are Centers for Medicare and Medicaid Services (CMS) mandates and administrative overhead reduction, with pending Federal incentives coming in a distant third.

Inside Healthcare Computing Editorial: The Next Stage of IT Maturity Requires Marketing Expertise

IT people have learned that big implementations are change projects, not IT projects. The heavy lifting must be done by respected leaders who understand the big organizational picture and who can paint a compelling vision beyond bits and bytes. Every IT project requires people to change. Most of the time, IT people aren’t ideally suited to do that.

We think the “IT shouldn’t own IT projects” concept should be taken a step further. Hospital IT departments should use the services of a marketing expert.That sounds heretical to fact-based IT people. Marketing is viewed as a black art, slick trickery to fool people in a dishonest way. It’s a lack of appreciation for marketing, however, that causes big IT and change projects to fail, especially those “turn the battleship” ones that redefine roles and seem threatening to the inadvertent participants. A small group of people huddled in an IT conference room have a nearly zero chance of getting the word out to the masses and getting them to participate.

Technology gets blamed when IT projects fail, but it’s usually poor communication that killed them. No technology is good enough to overcome that.

Marketing concepts apply to everyday IT work as well. Executives don’t always understand the IT budget and accomplishments. Can the lowest level hospital employees explain how the IT department benefits them? If not, the IT people are failing to get their message out. They need help from the experts, not to spin the truth, but to understand and meet the information needs of the large IT audience.

Marketing involves identifying those audiences, understanding how to communicate with them, and sending consistent messages that get their attention above the cacaphony of competing messages that engulf them. It is equally applicable to CPOE and closed loop medication administration as it is to selling laundry detergent.

Marketers know better than to try to change the behavior of individuals and groups by simply sending an occasional e-mail status message or doing a quick stand-up at a medical staff meeting. The message won’t work unless it’s carefully crafted to meet the needs of the intended audience, repeated regularly, and delivered by multiple methods.

Everybody wants physicians to change: healthcare reformers, EMR visionaries, and data sharing pioneers. They should be looking at the one group whose success at changing physician behaviors is unquestionable: drug companies. They don’t just send out dense studies that prove how good their drugs are; they market to doctors using a wealth of information and methods. Good drugs get trounced all the time by mediocre ones that were marketed better.

Our advice, then, to anyone like IT departments whose success depends on changing the behaviors of doctors or employees: bring in the marketing experts early. The next plateau of maturity after embracing the “IT projects are change projects that happen to involve technology” concept is that “change projects are marketing projects because they involve people”.

Copyright 2010 Algonquin Professional Publishing

Update 3/25/10

ONC’s Proposed Rule for Establishing Certification Programs: What You Need to Know

Reprinted from the 3/22/10 issue of Inside Healthcare Computing

 When the Office of the National Coordinator (ONC) released its proposed rule on the establishment of certification programs for HIT earlier this month, it may have raised more questions than it answered. Below we give you a quick look at what you need to know about the proposed ruling and how it will affect incentive payments.

What it’s About

 In order to qualify for incentive payments under the Medicare and Medicaid EHR incentive programs, eligible professionals and hospitals are required by statute to use Certified EHR Technology.

If a system is “certified”, it means that it offers the necessary technological capability, functionality, and security to help eligible providers and hospitals meet the meaningful use criteria established for a given phase. Once certified, Complete EHRs and EHR Modules can to be used by eligible professionals and eligible hospitals, or be combined, to meet the statutory requirement for Certified EHR Technology.

What the Rule Says:

The Proposed Rule outlines the process that organizations must undergo to offer certification. There are two parts to the proposed process:

1. A temporary certification program to assure the availability of Certified EHR Technology prior to the date on which health care providers seeking the incentive payments would begin to report demonstrable meaningful use of Certified EHR Technology. An organization able to offer certification under this program is referred to as an ONC-Authorized Testing and Certification Body (ONC-ATCB)

2. A permanent certification program to replace the temporary certification program. An organization able to offer certification under this program is referred to as an ONC-Authorized Certification Body (ONC-ACB).

The main difference between the two programs is that in the temporary certification program, organizations are required to perform both the testing and certification of Complete EHRs and/or EHR Modules.

The permanent certification program would separate the responsibilities for performing testing and certification, introduce accreditation requirements, establish requirements for certification bodies authorized by the National Coordinator related to the surveillance of Certified EHR Technology, and would include the potential for certification bodies authorized by the National Coordinator to certify other types of health informatino technology besides Complete EHRs and EHR Modules.

Secondly, in the temporary certification program, ONC will serve in a role similar to an accreditation body. Under the permanent program, the National Coordinator would approve a private sector accreditor to fulfill this responsibility.

ONC has stated its intention to use NIST’s National Voluntary Laboratory Accreditation Program (NVLAP) to perform the accreditation of testing laboratories.

The temporary program would end once the permanent certification program is established and at least one certification body has been authorized by the National Coordinator. ONC is proposing that an ONC-ACB would be required to renew its status every two years under the permanent certification program.

ONC does not anticipate putting any limit on the number of eligible certification organizations and the certification standards are the same, regardless of who does the testing.

 What does this mean for providers and hospitals?

 The temporary certification program enables eligible providers and hospitals to begin meeting Meaningful Use requirements as soon as possible so that they can be eligible for incentive payments in 2011. It also buys some time for ONC to develop a more rigorous permanent certification program.

ONC would begin accepting applications as soon as a final rule for the temporary certification program is published. ONC anticipates issuing a final rule for the temporary certification program around the same time as the Department issues final rules for Meaningful Use Stage 1 and Standards and Certification criteria.

Once products are certified, ONC plans to keep a list of those products on their website which will be available to the public.

 Who’s Going to Apply?

 So far, two organizations have announced their plans to throw their hats in the certification ring. The Certification Commission announced earlier this month that it plans on filing an application with ONC as soon as it opens the process.

 The Drummond Group, an interoperability test lab that works with standards groups, software/firmware vendors and industry groups to drive adoption of standards by offering global interoperability and conformance testing, and certification, also announced its plans to apply to be a certifier this year as well.

To comment on the proposed ruling, go to http://www.regulations.gov/search/Regs/home.html#submitComment?R=0900006480ab9d0e

Copyright 2010 Algonquin Professional Publishing, LLC

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In a Nutshell: The HIT Standards Committee Meeting 3/24/10:

In addition to the usual workgroup reports, the HIT Standards Committee meeting on 3/24 focused on the new NHIN Direct program, a project which Chair John Halamka described as a “learning lab” to test out the transport of patient information.  There’s a lot of information about the project to synthesize so we’ll be taking a more in-depth look at it in the April 5 issue of Inside Healthcare Computing.

The committee also heard about plans for an interoperability framework design which builds on bottom-up use case development within a top-down coordination framework.  The proposed framework is designed to engage and involve a wide community of users and in order to “harmonize” core concepts, will use a process developed by National Information Exchange Model (NIEM). NIEM was originally developed by the Department of Justice, but has been used by HHS and state and local governments.  The framework involves a common core of concepts, explicitly defined, that are shared across different use cases or domains;  naming and modeling conventions that allow different groups to work independently but harmonize the work together; and is based on the ISO-11179 metadata standard used by the NCI, NLM, and standards organizations.

David Blumenthal, National Coordinator for HIT, took the opportunity to refute the rumor that NIEM was a “Trojan Horse” for government control over health information. “The question has come up about whether NIEM will make it possible for health information to be transmitted to DOJ, the CIA, Homeland Security or other government agencies. The answer is ‘No.’ The ONC would not participate in a process that would lead to that.”

 The Privacy and Security Workgroup will hold a series of educational sessions to discuss standardardization efforts relating to consent management. The first will be held April 1.

The Clinical Quality Workgroup reported that the retooling efforts for the 2011 measures is well underway and the group expects that its work will be completed by early Fall.  It will begin working on 2013 and 2015 measures as soon as the HIT Policy Committee completes its work.

The Implementation Workgroup reported on its findings from a hearing held earlier this month. Participants overwhelmingly asked for greater clarity and interpretation of Meaningful Use, greater transparency and easy-to-access federal resources, understandable and simple interoperability standards, and a forum for vendors to participate in a non-competitive environment to share information and exchange ideas.

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Other ONC News

 A whitepaper on consumer consent options for Electronic Health Information exchange is now available at ONC’s website. http://healthit.hhs.gov/portal/server.pt?open=512&objID=1147&parentname=CommunityPage&parentid=32&mode=2&in_hi_userid=11113&cached=true

The whitepaper examines issues regarding whether, to what extent, and how individuals should have the ability to exercise control over their health information in an electronic health information exchange environment.  It looks at existing approaches and details policy options, considerations, and analysis.  The whitepaper is the first in a series of privacy and security reports developed by George Washington University under contract with ONC.

The Strategic Plan Workgroup of the HIT Policy Committee will hold a public listening session on April 6, 2010, to obtain feedback on the Health IT Strategic Framework. This Framework will be a key input to the Federal Health IT Strategic Plan. The objective of the listening session is to obtain feedback from the healthcare community regarding the Health IT Strategic Framework which will become foundation for the updates to the Federal Health IT Strategic Plan. The Health IT Strategic Plan will focus on 2011 through 2015 time period as well as lay the ground work for the period beyond 2015 to create a learning health system through the effective use of HIT.

Registration for this event will be required in order to accommodate the number of interested parties. Visit http://events.signup4.com/hitstrategicto register to attend the session.  Meeting materials will be posted at http://healthit.hhs.gov/StrategicPlanWG as they become available.

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Vendor News:

Simply Healthcare Plans, Inc. (SHP), a Florida based HMO, announced it has entered into a collaboration agreement with Biometric Technologies, Inc. Biometric Technologies will assist SHP with its efforts to reduce and prevent healthcare fraud in Florida through BioClaim. BioClaim uses biometrics to authenticate a patient at the point of service and interfaces the patient and claims information with the HMO claims system. SHP anticipates launching BioClaim with a select group of Medicaid providers in the next 90 days.

University Physicians & Surgeons, Inc., the faculty practice of Marshall University’s Joan C. Edwards School of Medicine, has chosen McKesson to manage its medical billing and practice management processes. McKesson’s Revenue Management Solutions (RMS) group will provide services including patient billing, accounts receivable management and reporting to assist the Huntington, W.Va., group.

The Alaska Native Medical Center (ANMC) has chosen Cerner Corporation  to implement healthcare information technology (HIT) solutions throughout their campus. The Cerner(R) solutions being deployed will assist in automating paper processes in nearly every area of the ANMC and will be available in October 2011.