Link: 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.
Link: 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.
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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.
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.
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.
Link: 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:
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!
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!
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.
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?
I just have three things to say. First of all, the word is pronounced PRE-scription not PER-scription.
Secondly, if we’re talking medicinal, you want to know something that is broken in the health care system? I’ll tell you: pharmacies. What value does a pharmacist add? None. They can be immediately replaced by vending machines and websites (thx, Zach.) I can read my own labels, thank you very much.
Finally, why are many non-addictive medications by prescription anyway? Here’s an example: ibuprofen. You can buy OTC ibuprofen, and they usually come in 200mg tablets. 200mg doesn’t do anything useful, so what do people do? They take 4-8 of them. If you go to a doctor with a bad headache, they’ll prescribe you ibuprofen in 800mg tablets. I’m sorry Mom, but that’s retarded. Ibuprofen doesn’t need to be by prescription. Here’s another: Liptor. Lipitor is used for reducing cholesterol. “But wait,” Mr. Wily protests, “what if a user bought Lipitor and decided to take more than the label suggested? That would be bad.” Indeed, but the side effects of Lipitor are headache and muscle soreness, hardly cause for alarm. On the other hand, too much of lots of OTC drugs can be harmful as well. For example, excessive Tylenol can hurt your liver, but Tylenol isn’t by prescription. Why?
While I’m at it, doctors themselves are close to obsolete. The Internet is making elite bearers of information unnecessary. When I last went to the doctor for a checkup, he GOOGLED a symptom during our visit. GOOGLED. I can google. Thanks for charging me for your web surfing.
That’s all.
What’s wrong with Medicine today?
Let’s design the most inefficient, error-prone, hackable system for transmitting medical information.
We’ll start by having persons with notorious handwriting, doctors, scribble in code onto a piece of paper.
Then, the afflicted person (the patient) jams that paper into their pants’ pocket and carries it down to a non-doctor (a pharmacy tech), who attempts to decipher the information and enter it into the computer.
If it’s a new pharmacy or a new doctor, they have NO IDEA what you’ve been prescribed before, or what you’re currently taking.
Why, why, why?
Actor George Clooney was admitted last month to the the Palisades Medical Center after a motorcycle accident. The temptation to look at Mr. Clooney’s medical file was just too much a couple dozen unauthorized employees to withstand. 27 people looked. 27 people are now suspended for a month without pay according to CNN.com. Sadly, the impetus for the investigation was not that they viewed Clooney’s records without cause, but that they leaked information to the press… HIPAA, it’s got (some) teeth now.
Microsoft, the megalithic, oft-hated vendor of only marginally-useful software, announced today in the Wall Street Journal that it would be offering free personal health records on the Web via its HealthVault system. Why *anyone* would trust the likes of Microsoft with their health information is beyond my comprehension. Still, proving once again that CEOs continue to make technology decisions instead of CIOs, Microsoft managed to signup an impressive roster of partners, including: American Heart Association, Johnson & Johnson LifeScan, NewYork-Presbyterian Hospital, the Mayo Clinic and MedStar Health, a network of seven hospitals in the Baltimore-Washington region.
On the upside, they did get the permissions model right, “Its privacy controls, the company said, are set entirely by the individual, including what information goes in and who gets to see it.” That said, the WSJ article goes on to mention that the data, stripped of some identifiers, will be data mined by third parties.
The news of this launch prompted a Slashdot reader to quip, “[this brings a] whole new meaning [to the blue screen of death.]
Would you trust Microsoft with your personal medical information?!?
It’s no secret that many doctors are, if not technophobic, at least VERY SLOW to implement new technologies. To wit, according to the report called “Health Information Technology in the United States: The Information Base for Progress,” only one in four doctors (24.9 percent) use EHRs to improve how they deliver care to patients.1 Fortunately, our Luddite physician friends are being joined by Gen X’ers, who, having grown up with computers, are not afraid to break out of the restraints of paper forms and charts.
One of these early adopters is Jay Parkinson, MD, MPH (from Penn State and Johns Hopkins.) Jay is an EMR-enabled, private physician practicing in Brooklyn. Jay prefers to “e-visit [his patients] by video chat, IM and Email for problems that don’t require an actual face-to-face visit. It’s the future of cost-effective medicine.” All of that, plus two home/work visits a year for $500.00. Jay also gives out his cellphone to his patients.
Can you video conference with your doctor?
1. http://answers.google.com/answers/threadview?id=785923
Recently a number of websites have been offering “real age” calculators which, upon asking a number of health/lifestyle questions, attempt to predict how long you will live. The difference between how long you are going to live and how long people live on average determines your “real age.” If, for example, you are a heavy smoker with a family history of heart disease, you might have been born 28 years ago, but your real age could be closer to 35. As a measure of its popularity, even Oprah and her ilk have been jumping on the real age bandwagon.
These real age calculators are not without their faults however.
After seeing the calculator at http://www.poodwaddle.com/realage.htm, I spent a few hours reverse engineering it. healthtech’s real age calculator is an attempt to rectify the aforementioned deficits.
RemedyMD’s tagline is “Better Data, Better Decisions, Better Outcomes,” and you might be tempted to think that better data leads automatically to better decisions, but that is not always the case. More often, it is the application of intelligent analytic algorithms (predictive informatics, if you will) which transforms the raw data into actionable information. A lot of EHR systems collect medical history, for example, but how many of them process that information to produce actionable knowledge?
For too many physicians, that conversation is hard to have, and families, too, are reluctant to initiate a discussion about what Mom or Dad might want until they're in a crisis, which isn't the best time to make these kinds of decisions. Ideally, that conversation should begin at the kitchen table with family members, rather than in a doctor's office.It's a conversation you need to have wherever and whenever you can, and the more people you can rope into it, the better! Make this conversation a part of your Thanksgiving weekend, there will be a right moment, you just might not realize how right it was until you begin the conversation.
The audit program serves as a new part of OCR’s health information privacy and security compliance program. OCR will use the audit program to assess HIPAA compliance efforts by a range of covered entities, Audits present a new opportunity to examine mechanisms for compliance, identify best practices and discover risks and vulnerabilities that may not have come to light through OCR’s ongoing complaint investigations and compliance reviews. OCR will broadly share best practices gleaned through the audit process and guidance targeted to observed compliance challenges via this web site and other outreach portals.The OCR HIPAA Audit Program page also provides detail on when the audits will begin, who will be audited, how the audit process will work, and what will happen after the audit. The information indicates that they will select a broad range of covered entities for the first round of audits and that business associates will be included in future audits.
On June 5, 2009 and June 30, 2009, HHS began investigations of two separate complaints alleging that the Covered Entity was in violation of the Privacy and/or Security Rules. The investigations indicated that the following conduct occurred (“Covered Conduct”):
(i) During the period from August 31, 2005 to November 16, 2005, numerous Covered Entity workforce members repeatedly and without a permissible reason examined the electronic protected health information of Covered Entity patients, and during the period from January 31, 2008 to February 2, 2008, numerous Covered Entity workforce members repeatedly and without a permissible reason examined the electronic protected health information of a Covered Entity patient.More information and background can be found in the iHealthBeat article, UCLA Health System Agrees to Pay $865K over Privacy Breaches, including a link to a statement on the settlement issued by UCLH Health System.
(ii) During the period 2005-2008, a workforce member of Covered Entity employed in the office of the Director of Nursing repeatedly and without a permissible reason examined the electronic protected health information of many patients.
(iii) During the period 2005-2008, Covered Entity did not provide and/or did not document the provision of necessary and appropriate Privacy and/or Security Rule training for all members of its workforce to carry out their function within the Covered Entity.
(iv) During the period 2005-2008, Covered Entity failed to apply appropriate sanctions and/or document sanctions on workforce members who impermissibly examined electronic protected health information.
(v) During the period from 2005-2009, Covered Entity failed to implement security measures sufficient to reduce the risks of impermissible access to electronic protected health information by unauthorized users to a reasonable and appropriate level.
During today’s broadcast of The McLaughlin Group [1], there was a statistic tossed out about how $16
A Cincinnati newspaper, citing state public access to documents, successfully argued that HIPAA does
The 2006 HIMSS convention took place in San Diego, and I was able to spend two days seeing everythin
Popular Mechanics is reporting a “top 15 new technology concept for 2006″ implanted medical devices| Healthcare IT, also known by the acronym HIT, is all about using information technology solutions such as hardware, networking, and software to help improve healthcare, save lives, reduce costs, and improve profit margins for healthcare organizations. Healthcare IT has always been important but recently it has been receiving more attention because the government and consumers (patients) | are demanding better service from care providers and healthcare IT is a good way to improve service.The healthcare system, especially in the USA, has some critical problems such as nurse and physician shortages, spiraling costs, poor consumer (patient) service, and lower revenues which lead to mergers | or acquisitions. Healthcare IT is in even worse shape because outdated infrastructure, legacy architectures, and monolithic applications prevent positive change from occurring. Healthcare IT can, if used properly, help reduce costs, improve care provider productivity (which can then alleviate some of the shortages), and significantly improve customer service to patients. |
