From Don Money: “Re: West Michigan HIE article.” Here’s the link, but you have to be a subscriber (the reader sent me a PDF). The Grand Rapids Business Journal covers an HIE created by three hospitals, all of which are using technology from the former Novo Innovations (now Medicity). Medicity’s Robert Connely: “It’s not designed to create the next generation of applications. It’s designed mostly to solve work and save tons of money, and that’s the reason they’re willing to pay for it.” The hospitals’ HIE is replacing the community-based model advocated by Alliance for Health, which found providers unwilling to pay third-party usage fees. Trinity Health will use the Medicity approach for all 45 of its hospitals, according to the article. Medicity says its technology and business models can be adapted to any connectivity scenario: a hospital-owned HIE servicing its doctors, a RHIO/HIE with third-party governance, and (as in this case) a RHIO/HIE without third-party governance.
From Stan Pacifica: “Re: PROMIS pain scale. This is an adaptive testing methodology that contains 120 items in the item bank, but far fewer than 120 are used to assess pain.” That makes sense, although the reporter specifically said “asks patients 120 pain-specific questions, as well as hundreds more that probe the physical and mental effects of pain.”
Here’s the layoff letter from Philips Healthcare, citing lower profitability and “risk of further deterioration in several of our markets.” The usual “simpler, leaner, more flexible organization” mantra is recited, oddly enough by the same CEO who originally oversaw its regrettable transformation to more complex, fatter, and more rigid organization in the first place. He’s making $2.5 million a year for 20-20 business vision, which would value it at $5 million if it worked in foresight and not just in hindsight.
It’s clear from Friday’s excellent recommendations to HHS by the Certification and Adoption Workgroup of the HIT Policy Committee that they want major changes made to EHR certification. Some of the high points:
- HHS certification (notice they didn’t call it CCHIT certification) is not intended to be a seal of approval.
- A new certification process should be developed that focuses on Meaningful Use rather than specific functionality points (that change will let specialty EMR vendors certify their products).
- Certification should include all privacy and security policies that are in ARRA and HIPAA.
- New highly detailed interoperability and data exchange specs should be created.
- “Test harnesses” should be created so that providers can test their own software.
- Multiple certification organizations should be allowed, with NIST accrediting them.
- ONC should define certification criteria, not the organizations performing the certification testing.
- Certification criteria will be updated no more frequently than once every two years and certification should be good for four years.
- “Lock down” requirements should be eliminated to level the playing field for open source systems.
- Since Meaningful Use definition is imminent, HHS should create a preliminary certification that would be valid through 2011.
- Interesting quotes: “There has been criticism that CCHIT is too closely aligned with HIMSS or with vendors. While we did not see any evidence that vendors were exerting undue influence on CCHIT, we also understand that the appearance of a conflict is important to address … Most vendors advocated for a minimal approach to certification, complaining that CCHIT has ‘hijacked their development effort’ and that they are developing features/functions that nobody will use.”
The takeaway: if the recommendations are accepted, CCHIT’s role will be diminished and shared with other certification bodies, none of which will be allowed to create certification criteria; certification will move away from a detailed product design to focus instead of how EHR products are used; and CCHIT cannot shake its reputation for being controlled by a few big vendors and HIMSS. It’s pretty clear that CCHIT may well have an ongoing role in the government’s HIT policies, but not at the level of influence it has enjoyed until now. Finally, someone says no to HIMSS.
The Colorado Hospital Association and the Colorado Behavioral Healthcare Council select Qwest Communications to provide broadband services to create one of the largest health information networks in the country, connecting 400 providers and supporting telemedicine initiatives. The Colorado Telehealth Network will focus on rural areas, giving them 100-megabit connectivity via Qwest’s fiber-optic network.
Ross Koppel pointed out that hospitals probably can’t sign software vendor contracts containing non-disclosure language without running afoul of the Joint Commission’s accreditation requirements, which require hospitals and providers to share information about known patient safety risks. Here’s my challenge to you providers: send me a copy (scanned or copied and pasted) of the non-disclosure language in your contracts and the vendor involved. I’d like to run some of them here anonymously (nothing but the wording and the vendor) so new customers will recognize those terms and insist they be removed.
Recondo Technology announces EligibilityPlus, a SaaS insurance eligibility application. I mentioned the defunct (well, acquired by Sybase, which is pretty much the same thing) New Era of Networks the other day and, what do you know, founder Rick Adam is now chairman and CEO of Recondo. It’s a small world, this healthcare IT stuff.
A Florida medical magazine covers the history of EMR vendor DoctorsPartner, which says its PM offering was Best in KLAS 2007 and its EMR #2.
A London Times article compares US healthcare to the NHS, quoting a patient who moved from Britain to the US. “Every time you go for any treatment here, they want to see your insurance card and check every detail they have about you and that is wearisome. But I’ve had some terrific treatment. There are all sorts of things you have to be aware of: some treatments you part-pay for and you have to choose a doctor who is approved by your insurer. But it’s not all about money here. The doctors are doctors – they really want to help you.” Another insightful comment from a UK cancer patient who sought treatment here: “Most doctors in Britain, if they’ve worked overseas, will admit that somewhere like America has the best of the best. What it doesn’t have is the breadth of coverage. Ours is an equitable, morally cogent way of doing things. But looking at the amount and quality of research into my cancer, there was a clear difference between Britain and the United States.”
A pharmacist who didn’t catch a technician’s IV mixing mistake that killed a child at Rainbow Babies & Children’s Hospital (OH) is sentenced to six months in jail for involuntary manslaughter, to be followed by six months of house arrest, three years of probation, a $5,000 fine, and 400 hours of community service. His pharmacy license was also revoked. It appears from the newspaper’s description that the technician mixing the chemo IV used sodium chloride concentrate 23.4% instead of sodium chloride 0.9%, related to the fact that the hospital’s computer system had been down for some time. The tech was charged, but not indicted. I don’t know that putting healthcare providers in jail for making an honest mistake is a good idea, especially if you want to keep enough providers providing.