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January-4-2012

8:54

CalendarLink: Thoughts on the Year Ahead

John Halamka presents his ideas about the major issues for 2012..

ICD10 - John predicts 25% of IT capacity will be consumed by ICD10 this year. Not good...

Meaningful Use Stage 2 including inpatient clinical documentation - now this is exciting. Potential criteria will likely include improvements to clinical records that improve care coordination and communication between providers. John suggested use of templates and social-networking like group documentation.   

ACO Planning - The reform changes for ACOs will include focus on prevention and wellness. New business intelligence (BI) and clinical decision support (CDS) capabilities will be helpful in meeting these goals.

Compliance - Compliance issues will include "conflict of interest tracking, learning management systems for compliance education, and enhanced revenue cycle systems that provide decision support."

Security - yes, the past year had a long list of data breaches, malware, and mobile devices so security of PHI must be improved, particularly if we intend to move clinical decision support to the bedside or engage in Health Information Exchanges.



January-3-2012

10:15

BinocularsLink: A New Year's Forecast For The Health Care Bill

NPR topics presents a summary of the impact to the Affordable Care Act in a discussion between Audie Cornish and Noam Levey of the Los Angeles Times.

 

 


HSGLogo Looking for best of breed HIPAA Training?

To stay current on the HITECH Act and its quickly changing regulatory scheme visit the HITECH Survival Guide website and/or sign up for our free monthly compliance newsletter. Also, check out our FREE EHR Checklist.

If you need tools that will help with your compliance initiatives then check out the HSG Store. Do you need an Internet Lawyer with HITECH /HIPAA experience?

 


December-29-2011

9:46

Link: Usability and Successful EHR Meaningful Use

Recently the ONC posted on the Health IT Buzz Blog about the "challenges providers face in achieving Meaningful Use of electronic health records (EHRs)."

The concept of "useability" has long been known in other industries where new technology or applications enter the workplace. Some time ago I wrote about usability of health IT, however I expanded the definition to include a few more "E-bilities" as shown in the following graphic contained in the post: Part 4 of The Value of the Internet for Improving Healthcare.

This is the last post in the series and it focuses on capabilities, or "e-bilities" of technology to improve healthcare. Regardless of the mode of use (e.g. email or internet), technology must be easy to use, secure, reliable, and accessible.

E-bilities

For the past year, the SHARPC-Project 1 has focused on making use of technology easier for clinicians. One ONC staff member, Jacob Reider, MD had some interesting comments that focused on "The User Experience." His comments spanned the continuum of User Experience with a framework for how tools and/or applications can/should evolve.

Quotefirebrick

 

Functional (it does what it is claimed to do)
Reliable (it works consistently)
Usable (it works in a way that is consistent with the user’s expectations)
Meaningful (it does something important or valuable)
Pleasurable (it is enjoyable to use)

So, I will end with one thought. Even if the system meets "Useability" standards for clinicians, achieving quality health data analytics still requires that accurate, timely and quality data is entered into the EHR avoiding the Garbage In-Garbage Out phenomenon. 



December-27-2011

15:35

KeysLink: 8 Key issues for population health management in 2012

This article in Healthcare IT News caught my eye. A white paper written by the Care Continuum Alliance described significant market movement toward accountability and value driven healthcare outcomes as a result of collaborative models, such as ACOs. However, there are 8 key issues that could affect population health management in 2012:

  1. Accountable care and the Medicare Shared Savings program
  2. Consumer use of mobile and eHealth technologies
  3. Reducing avoidable hospital readmissions in Medicare
  4. Quality improvement in Medicare advantage
  5. Opportunities to support insourced programs
  6. Improving care coordination for dual eligibles
  7. Federal support for prevention and wellness
  8. Development of ACA health insurance exchanges

Each of these items contains a plethora of complex issues that will require agreement, alignment, and cooperation between distinct parties. In order to simplify my thoughts on this topic, I offer the following.

Accountable care and collaborative models certainly provide the opportunity with electronic records to capture and disseminate research and/or de-identified clinical data for surveillance. The link to "accountability" also provides the impetus to develop predictive analytics, a personal favorite.

It is well known that mobile technology, including smart phones, are changing the nature of "computer use" and internet access. According to the article the author stated that "a patient-centered, consumer-empowered, pull-rather-than-push model will dominate, with social media in a position of importance."

Reducing re-admissions? Well, we should already be doing this, unfortunately the quality of healthcare in certain situations, or the variable factors in a patient's condition and care makes this a tough goal to reach all the time. However, Medicare tracking is looking a 3 conditions - heart failure, acute myocardial infarction and pneumonia.

Finally, the other items tout the value of competitive forces in healthcare resulting from support of "insourced programs," development of health insurance exchanges in 2014, and the single idea that is near and dear to a nurse - support for prevention and wellness!

Prevention and wellness has not been a priority for most clinicians due to its non-reimbursable status. Let's hope that changes. Since the Prevention and Public Health Fund is under discussion, Medicare added annual wellness visits and expanded coverage of obesity and cardiovascular disease prevention services.

2012 brings a year of great change and challenge. Best wishes to all for a safe, happy, and prosperous new year!

 


December-14-2011

14:52

As clinicians, do we ever wonder how excellent patient care can be achieved? Do we become too involved in our deadlines, our tasks, or our own needs and lack the time to reflect and to improve? It is certainly an issue in today's healthcare environment as the delivery of care changes in the path to Meaningful Use...

Well, I watched this video today, posted by Brian Ahier. It is an epic portrait of how one individual came up with an idea that would provide quality care/experience to customers.

Click this link to watch the video - a moving and heart-felt story.

The Simple Truths of Service: Inspired by Johnny the Bagger 

May you have a Happy and Safe Holiday Season!


December-10-2011

8:48

The HIPAA Survival Guide's Privacy Rule Under HITECH Webinar will help get you up to speed on how the HITECH Act has impacted the HIPAA Privacy Rule and how marketplace trends are impacting it as well. The webinar will walk you through the Privacy Rule and discuss the effect that the HITECH Act has had under three major sections: 1) uses and disclosures of PHI contained in sections §164.502 through §164.514; 2) the Patient's Bill of Rights contained in sections §164.520 through §164.528; and 3) the Administrative Requirements contained in Section §164.530.

Date: December 13, 2011. 

Time: 2:00 to 3:30 EST. 

To register CLICK HERE

 


HSGLogo Looking for best of breed HIPAA Training?

To stay current on the HITECH Act and its quickly changing regulatory scheme visit the HITECH Survival Guide website and/or sign up for our free monthly compliance newsletter. Also, check out our FREE EHR Checklist.

If you need tools that will help with your compliance initiatives then check out the HSG Store. Are you for an Internet Lawyer with HITECH /HIPAA experience? 


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Technical
MedTech and Devices

Future Health IT

January-7-2012

5:53

DNAI remember vividly reading about DNA and its mechanisms in James Watson's Double Helix. The unzipping of the two reversed strands interlocked by the strict pairing of nucleotides--adenine to thymine and guanine to cytosine. The complex and choreographed interactions with other molecules leading to the construction of proteins. The systematic beauty at the nucleus of life. It was all engaging enough for me to decide to study Biochemistry at university.

When I finished my degree I worked in international marketing and travelled the world. I was always proud (and grateful!) that English is the most widely spoken language with about 80 percent of the world being able to speak it. But it is not the real lingua franca any more. The most popular language comprises 0s and 1s--the binary language of computers. GB Shaw said America and England were 'separated by the same language,' but the binary language unites the world.

What's more, the two binary languages of DNA nucleotide pairing and computer coding are set dominate the coming decades in a combination of genomics and computer science. David Baltimore said that Biology is today an information science. Indeed, Bioinformatics combines life and computer science so that they are as interlocked as the strands of DNA.

We will see if genomics lives up to its promise, of course. As another scientist, Neils Bohr, said: 'Prediction is difficult, especially about the future.' Even the exquisite DNA translation process sometimes gets it wrong and proteins end up with the wrong amino acids, impairing their function. Indeed the majority of DNA itself is regarded as 'junk', because it seems to have no function. All of this all sounds a bit like computer code and its creation, another systematic human process.

I have been fascinated by interface between man and machine for more than 30 years. Now it seems more alluring than ever.

December-28-2011

11:21

Last week BBC's Click programme showed (6m 38s) a one year old iPad user confused by a print magazine where she couldn't 'flick' the pages: a sign of the times.

November-2-2011

3:19

Picture of pillsA few years ago there was a kerfuffle in healthcare IT. A study at the Childrens Hospital of Pittsburgh concluded that mortality rates had increased with the implementation of Computerised Physician Order Entry System (CPOE). Despite being rebutted almost immediately after publication, the study gained wide credibility. It was still being quoted without qualification by a prominent academic at a UK healthcare IT conference a couple of years ago.

October-11-2011

4:55

A former Apple CEO says healthcare missed the PC and Internet revolutions. He loads the blame squarely on the shoulders of reluctant doctors.

September-29-2011

14:49

'Bots are back. It's a while since I wrote about them--for example, see here for a collection of musings--and in the interim they seem to be moving into the mainstream.

Blog url: 
http://www.futurehealthit.com/
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Influential
MedTech and Devices

eHealth

January-11-2012

22:13

This is the topic of my new blog post on HealthWorks Collective. Already received lots of traffic on Twitter and lots of views. Would like to see more about mobile standards in health care from Motorcycle Guy and others.

January-7-2012

23:22

DeliciousI am glad that Delicious is still around and being enhanced. I have used it for years to organize and tag my bookmarks. Now with almost 1200 bookmarks and several hundred tags, I often search my links to find a resource for a presentation or article. Recent links include:

So while links may be low on the priority list in social media with many more dynamic and “sexy” like Twitter and Facebook, Delicious has its place and does allow followers, RSS feeds and other social media features.
So if you are interested in what I am working on, my Delicious  may give you a clue.

January-2-2012

11:13

Like others (see Daniel Kraft) , I have my own opinions about what trends will be most influential for health IT in 2012.

  • Big Data and real-time analytics and decision support – IBM Watson and Explorys are in this space, others will follow and adoption will grow enabled by cloud computing, NOSQL/Hadoop and natural language processing
  • Continued focus on EMR adoption as more health systems pursue meaningful use. This will again be the main focus at HIMSS as well as other conferences
  • Social media in health care will continue to grow among patients as the e-Patient movement continues to gain in strength and public awareness and as advocates like the Reshape Innovation Center find creative uses to influence the future of health
  • Mobile health and apps usage will expand but what is needed is a way to integrate personal health information, such as, PHRs and apps that promote wellness and disease management. For health care professionals, apps and mobile devices need to be integrated into clinical workflow rather than being an adjunct or distraction
  • Research will be further enabled by EMR data as more academic medical centers develop data warehouses for research and quality studies and as initiatives like QueryHealth make it possible to combine data across systems and states using health information exchange and other tools

There are many more but these are the primary one’s I will be following.

December-29-2011

14:14

There are many top 10 predictions for 2012 out there. I could probably add my own for eHealth and mHealth.
These 10 Business Intelligence Trends for 2012 from Tableau Software apply to healthcare as much as any business.

 

December-27-2011

22:23

In addition to having a great year traveling and presenting, I had additional accomplishments:

  • Appointed as the Co-director for Biomedical Research Informatics for the Clinical and Translational Science Collaborative, an NIH funded program through the Case Medical School
  • Joined the Editorial Board of Tech Now Briefs of the American Association of Medical Colleges
  • Invited to contribute to a theme issue on social media for Frontiers from the American College of Healthcare Executives
  • Became a featured blogger for HealthWorks Collective
  • Appointed as a reviewer for HIMSS 2012 abstracts – a new role for me
  • Authored chapter on eResearch to a book on medical informatics to be ePublished in 2012
  • Celebrated 30 years as an employee at Cleveland Clinic
  • Leading a project to develop a clinical data warehouse for research
  • Approaching 1000 connections on LinkedIn (969)
  • 2881 followers on Twitter
  • Klout score hovering around 42
  • Invited to be on the advisory board of a health related startup
Looking forward to more great opportunities in 2012.

December-26-2011

23:31

It was a big year for traveling to conferences:

  • February – HIMSS Annual Conference in Orlando – spoke at the Social Media center twice and presented on a panel on social media
  • March – AMIA Clinical Research Informatics Summit in San Francisco. Two podium presentations (CKD Registry and REDCap business model) and two posters
  • April – attended TEDx Maastricht in the Netherlands and a side trip to UMC Radboud in Nimegen.
  • April – ACRT meeting (Association for Clinical Research Training) in Washington, DC – panel presentation on REDCap.
  • May – Patient Experience Summit at Cleveland Clinic with Enoch Choi presenting
  • June – consulting at a hospital in Michigan on data warehousing
  • September – Medicine 2.0 Congress in Palo Alto, CA. Poster presentation
  • October – American Association of Medical Colleges meeting on Big Data in Washington, DC
  • October – Clinical and Translational Science Awards Informatics meeting at the National Institutes of Health. Bethesda, MD – poster presentation
  • October – Panel at Case Medical School, Cleveland on Social Media in Clinical Trials
  • November – Senior Workers Conference in Minneapolis, MN – presentation on Social Media and Electronic Medical Records
  • December – Center for Health Services Research and Policy at MetroHealth Medical Center, Cleveland, on Disease Registries using EMR Data
Most of these are posted on SlideShare. Looking forward to many opportunities in 2012 as well.
Next post – Accomplishments in 2011
Blog url: 
http://ehealth.johnwsharp.com

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