Top News

Politicians from Epic’s home state of Wisconsin urge the VA and DoD reconsider their plans to develop an open source replacement for VistA, asking for “appropriate consideration” for “commercial EHRs.” Epic admits it provided information to Wisconsin’s members of Congress as well as to those from other states, although a company spokesperson stresses that it does not hire lobbyists. Expert Tom Munnecke was quoted as saying, “The open-source VA VistA model was always under attack by those who wanted to lock the government in to their proprietary architecture. The VA showed repeatedly that an open model was superior.”

The Alembic Foundation announces its formation as a nonprofit that will build and manage open source technologies that empower citizens. Its first project is Aurion, which will extend the work of the CONNECT project as a private sector custodian. David Riley and Vanessa Manchester, Alembic’s president and COO, respectively, helped develop CONNECT for the Federal Health Architecture as independent contractors before starting Alembic. They also mention a keen interest in Personally Identifiable Information.

Reader Comments

From Frank Poggio: “Re: Medicare Payment Advisory Commission’s recommendation of a 1% physician pay increase. If a doc gets payments of $400k per year from Medicare, that means they will get a $4k increase in payment if volume and mix stay the same. But .. CMS has never accepted the MPAC recommendation without lowering it, so probably will be more like 0.5% (a $2,500 increase). Now if the doc does not do the EMR dance and misses MU, they will get hit with a 33% reduction in his/her Medicare adjustment, reducing the $2,500 by $800!! In other words, if I do not spend $40k+ on an ambulatory EMR (not including installation, training, etc.) it will cost me $800. Sounds like a no-brainer to me. Forget the $800 and do it when you are really prepared and ready to, not when the government says JUMP!”

From Nolan Smith: “Re: Duke CIO. Duke University Health System has picked a new CIO. Look for an announcement soon.”

From Lazlo Hollyfeld: “Re: NHIN Direct. I give the federal government credit. I never throught they would get this far. Gradually added vendors and now have almost every important ambulatory EMR vendor. I do wonder, though, why athenahealth is MIA, especially since Bush takes every chance he gets to bring up the ‘walled garden’ analogy of his EMR competitors?” ONC announces that 60 organizations (including the vendors on the list above) will support the Direct Project’s protocols, which will allow simple EHR-to-EHR messaging and secure e-mail (using the provider’s Direct Address) to replace paper and faxes.

HIStalk Announcements and Requests

Several readers suggested holding off a couple of weeks before deciding whether to make the “new” format (this one) permanent, so here’s your last chance to vote.

I wrote some pretty good editorials for Inside Healthcare IT over several years because I wasn’t as busy with HIStalk then and I have a desperate need to be loved (it must have been that because I worked cheap). I’ve reacquired the rights to the large collection (something like 175 editorials) and will start running them occasionally on HIStalk. They’re fun to read because they cover what was big news at the time (much of which still is), not to mention that I wrote them on a tight deadline that made me usually go way over the top in both subject and style (the title of one of my early ones: Just Back From HIMSS? Finish Implementing Yesterday’s Fads First.) I ran a few of them here years ago, but most haven’t seen the light of day unless you were a subscriber to that newsletter.

Cerner shares hit an all time-high this week, closing Tuesday at $107.80 and giving the company a market cap of $9 billion. Neal Patterson holds $459 million worth.

A Kaiser Health News article says that insurance companies are investing in less-regulated businesses to keep their profits high, potentially also giving them control over more of the healthcare system. Mentioned: UnitedHealth Group’s acquisitions (including Picis), Aetna’s purchase of Medicity, and Humana’s acquisition of clinic operator Concentra. Former ONC head David Brailer is quoted: “If you’re a health plan, you either become a care delivery system or an information services company. The traditional business is dead.” 

Apple sues Amazon, saying the company improperly used its trademarked “App Store” name. Some EHR vendors have used that name as well, so this is probably a good reason to stop.

A class action lawsuit trial against Tenet Healthcare starts Monday, brought by people inside Memorial Medical Center, a New Orleans hospital it owned in which 45 people died following Hurricane Katrina in 2005. The suit claims the hospital had inadequate backup electrical systems and wasn’t prepared to handle a disaster. Tenet is alleged to have initially turned down the hospital’s requests for supplies and evacuation helicopters. Doctors at the hospital have already admitted they intentionally killed suffering patients with drugs in the four days it took for help to arrive.

Sales

United Hospital (MN) chooses Isabel Healthcare’s diagnosis support system to integrate with its Epic EMR.

The Military Health System awards Evolvent seven new task orders, including a transition from ICD-9 to IDC-10 code sets and 5010 updates.

People

John Schrenker, former CIO of Lakeside Health System (NY), will run the new online master’s degree program in health information administration of Roberts Wesleyan College.

Announcements and Implementations

MidMichigan Health goes live on Cerner after spending 398,000 person-hours preparing, not including the time of Cerner employees or that of contractor Deloitte Consulting. The total project cost for MidMichigan’s four hospitals: $50.1 million.

Banner Health (AZ) will spend $200 million to upgrade its Cerner systems in 23 hospitals, expecting to recoup $125-$150 million from federal EHR incentives.

Henry Ford Health System (MI) goes live on its $100 million CarePlus Next Generation EHR at its Ann Arbor location. Henry Ford’s IT team, including six executives and 150 programmers, spent six years developing the system, which is sold commercially by Reliance Software System (RelWare) as EXR.

Innovation and Research

athenahealth VP John Lewis says that his company is “definitely considering” retooling its product to work on Safari and Mozilla browsers and not just Internet Explorer, but notes it would require “a big chunk of additional cost in research and development.”

Other

I mentioned Vince Ciotti’s HIS-tory presentation at HIMSS. He’s putting together a version for HIStalk, the first installment of which is above. Assuming SlideShare works, anyway, not a given since they seem determined to mess it up by grafting it onto Facebook and Twitter. My first choice was Microsoft’s Windows Live SkyDrive, but I couldn’t get it to work right.

The new $1 billion children’s hospital in Victoria, Australia will open in November using software applications it previously described as “old and outdated” and potentially dangerous to patients. The hospital had turned down the government’s HealthSMART system to go its own way and requested $24 million to buy an unnamed US system, but the new government forgot to budget for it.

Two New York men are arrested for selling oxycodone out of a Lickety Split ice cream truck. Kids would buy their frozen treats and grownup addicts would line up make their purchases, turning the truck into a $1 million a year business. They pair will be giving up their mobile freezer for a different kind of cooler.

Sponsor Updates

• Cumberland Consulting group promotes Elizabeth Durst to executive consultant.
• Sage Healthcare finalizes a uniform community health center contract with the Texas Association of Community Health Centers.
• California Health Information Partnership and Services Organizations (CalHIPSO) identifies eight vendors to participate in a Stage 1 contract negotiation process: Allscripts, eClinicalWorks, GE (Practice and Advanced Systems), Greenway, NextGen, athenahealth, McKesson (Practice Partner), and e-MDs.
• Quest Diagnostics launches a 12-week, 10-city Care360 EHR Road Test tour to provide live demonstrations of the Care360 EHR software.
• Fujifilm Medical Systems and Nuance Communications partner to sell Nuance’s PowerScribe 360 dictation system to Fujifilm’s base of radiology customers.
• MD-IT posts a product video to YouTube.
• Consulting firm asquaredm offers a free guide called The Physician Compensation RVU Fallacy: Part 2.
• Health Assocation of New York State (HANYS) expands its relationship with RelayHealth as its preferred partner for revenue cycle management solutions for its member hospitals and health systems.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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It’s officially spring and there was a full moon over the weekend to boot. I’m not sure what I was thinking when I decided to work this one.

One of the downsides of being a CMIO type is that I’ve had to give up any semblance of a “normal” practice. Most of what I do these days is emergency department coverage or urgent care. One of the things I enjoy doing, though, is Locum Tenens work. If you haven’t heard of that, basically it means that you’re for hire to anyone who’s willing to meet your terms. Sometimes Locum work is fun, because you can take an assignment at an exotic location or practice in a way you normally don’t, like with the Indian Health Service or the military.

In my case, though, I usually Locum in my own metropolitan area. Folks like to hire me because I’m proficient in several EHR systems and can hit the ground running. (Thank you, moonlighting shifts during residency! Thank you, best of breed strategy!) In addition to the variety, this lets me see under the hood of other systems and experience for myself how other practices are using technology to perform patient care.

You might think it would be a competitive intelligence issue — that practices would be reluctant to use someone like me because I might steal their secrets. Frankly, they’re just happy to get someone who can jump right in and they don’t have to pay extra hours for training time. Most of the time it’s fun, but sometimes it’s very humbling.

Musings of a Mercenary Doctor

Training and staff proficiency makes a huge difference. There’s one group where I cover acute/sick visits. The physician shift splits two nursing shifts, so each physician works with two different nurses. I only work there once a quarter and it’s a large group with multiple locations, so I haven’t met everyone.

Recently I had the Jekyll and Hyde day. My morning nurse was spectacular – every patient history was nearly 100% complete, all medications were reconciled, and needed labs and diagnostic studies were pre-ordered based on standing orders. We rocked through 38 patients, too good to be true.

Remember that scene in Titanic where the crew in the crow’s nest shouts, “Iceberg! Dead ahead!”? Well, someone should have shouted that during shift change.

I spent the next couple of hours absolutely treading water and gasping for air. The semi-retired nurse who was staffing me apparently thought free-texting everything was a good idea, effectively sabotaging any smartness of the EHR workflow to select the right documentation forms or to share information between today’s symptoms and the patient’s previous notes.

Instead of reconciling medications she just entered new medications, creating duplicates. No tests were pre-ordered, making for a backup in radiology after I sent three patients simultaneously just to get the exam rooms clear for new patients. Although the volume had slowed significantly, it felt like we couldn’t get ahead. I kept focusing on the fact that at least I got to get in my lifeboat and go home at the end of the day.

Shirley is super-nice and does phone triage better than anyone I’ve worked with in a long time. She knows exactly how to counsel patients and is excellent with procedures. By late afternoon, the other physicians were gone except the two of us doing evening coverage.

According to my colleague, because she’s well-liked and is close to retirement, no one has the heart to either tell her that her misuse of the EHR is sabotaging the docs or that she needs retraining. Although they grouse about her at every provider meeting, they’ve decided they’re OK with it because they don’t want to hurt her feelings or rock the boat. The younger nurses don’t want to work nights and weekends and they can’t afford to lose her.

One of the great things about being a mercenary is not having to deal with office politics and being able to push the limits a bit. I decided to ask her how she thought the shift was going. She admitted being aggravated because she’s “not good with computers” and said she’d been frustrated since their go-live last year. I decided to dig a little deeper and see what I could do to help.

Turns out she’s semi-retired and works evenings and weekends because she helps care for her grandchild during the week. It also turns out that the practice did all the staff training last year during the morning, while many physicians were on hospital rounds, so they wouldn’t have to cancel patients. She never had formal training on the system. They asked one of the 21 year-old medical assistants to let her “shadow” and “learn the system” one afternoon.

Are you kidding me? I can only imagine what that was like for Shirley, trying to catch up after the fact and trying to learn from someone a third her age who was also learning the system.

I asked her if I could show her a couple of small things that might make her life (and selfishly, mine) easier. In just a couple of minutes between patients, I taught her how to reconcile medications and worked with her 1:1 on the next few patients. By the end of the shift, I had fantastic med lists and she felt like she had accomplished something. We spent a few minutes talking about how the logic of the system works and what happens downstream when you free-text. She honestly had no idea the havoc she was causing.

I cornered the other physician when we hit a lull. He was surprised. He had no idea Shirley hadn’t been trained. The docs had abdicated any responsibility during the EHR implementation, leaving it up to the office manager. He didn’t know about her work situation or what was behind it. I could tell he felt bad for complaining about Shirley rather than figuring out a solution. I told him what I showed her and what Shirley was now able to do.

In short, I spent about thirty minutes training/mentoring her rather than doing her job for the rest of the shift. I was happy, she was happy, and you can bet the next physician she staffs will be happy. As I finished my notes and the last few patients were trickling out, the other doc was showing her how to access his medication favorites list so she could use it to enter medications on new patients.

I hope he’s able to help his partners understand the situation and get her the training she needs (and deserves). I ended up seeing over 60 patients that shift, but the most important “care” I delivered didn’t have an ICD-9 code attached to it. Even on hectic days with systems that don’t always work the way we want, remember to look out for each other.

E-mail Dr. Jayne.

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From Holly: “Re: Patrick Soon-Shiong. Maybe his healthcare announcement, if there really is one, will involve his recent investment in online game developer Fourth Wall Studios. He mentioned healthcare in his statement about that investment. ‘As I work with new technologies for healthcare and medicine, I see more and more parallels with what’s happening in entertainment; for example, the rapidly accelerating use of mobile devices and social media platforms, and the use of novel algorithms to create machine vision.’” Machine vision means applying computer algorithms to extract information from images that can be used to measure or control a process. It’s usually mentioned in a manufacturing context, but it sounds like PSS has something different in mind. That doesn’t sound like technology that would interest a wireless conference crowd, though.

From Kittery: “Re: Allscripts. Notified employees this afternoon that product strategy will move under President Lee Shapiro. It previously reported to John Gomez. Rumors abound that Gomez’s departure is imminent and the company is enticing his direct reports to stay. The e-mail also said that Lee Shapiro will lead its international business, which will focus on English-speaking countries where it maintains a footprint. It did not include the Middle East, where the company recently walked way from the largest deal where they were vendor of choice.” Unverified. I’ve heard the Gomez rumors over several weeks, but that’s all they are so far.

From The PACS Designer: “Re: Apple’s iOS 4.2 Personal Hotspot. Another feature of Apple’s iOS 4.2 is the availability of a Personal Hotspot that others nearby can use to connect to the Web. With this iOS 4.2 feature, the iPad was capable of averaging just over 1 Mbps on downloads and uploads using a 3G network. InformationWeek has an evaluation of the pluses and minuses of this feature.”

From Swedish Meatball: “Re: Swedish. See attached regarding planned affiliation between Swedish Medical Center in Seattle and hospitals on the Olympic Peninsula in Washington State. As affiliates, the hospitals will be using Swedish’s existing Epic EMR. Swedish already has a contract in place with The Polyclinic to share its Epic EMR.” Internal documents from Olympic Medical Center suggest that the EMR was an important part of the decision, along with clinical integration, collaboration on support services, and ACO.

From An HIStalk Fan: “Re: my MBA class’s Google survey. I had a dismal 38 respondents, but due to your efforts, I exceeded my goal with 551 respondents. Thank you. I do want to share that I have a better appreciation for the work you, Inga, and Dr. Jayne do for us readers. As a nurse, I know what it means to have a thankless job and your HIStalk work is definitely right up there in my book. The negative comments to my one open response survey question flabbergasted me. I’m sure you have had your share and I hope the naysayers never distract you from the truth, which is, WE ALL LOVE YOU, MR. H! I also wanted to provide you the results of the survey.” I’m occasionally amazed at how ill-mannered some people get over something trivial (like getting a second e-mail blast in one day or my mentioning my out-of-work friend). It used to bother me, but I’ve distilled my reaction as follows: (a) if I’m not getting readers worked up in ways both good and bad, then I’m not doing my job; (b) I don’t know the commenter and they don’t know me, so it’s not really as personal and hopefully it’s just Internet rudeness they wouldn’t exhibit in person; and (c) a few people in any given subset of the population have serious issues, and if blasting me by e-mail keeps them from expressing their inner rage in more harmful ways, then that’s OK, I can take it (although I always ask myself why they’re reading if it bothers them all that much). It’s also not a thankless job – I get thanks all the time and appreciate that. I uploaded the PDF results of your survey here.

From Dale Sanders: “Re: from The Onion. You are going to love this!” Dale’s right – I love The Onion and I’ve previously observed, as they do here, that oil change places keep better records about your car than most hospitals keep about its driver.

Quick-Lube Shop Masters Electronic Record Keeping Six Years Before Medical Industry

KETTERING, OH—A comprehensive digital cataloging system that keeps track of its customers’ car maintenance history, oil-change needs, and past fuel-filter replacements puts Karl’s Lube & Go’s computerized record- keeping an estimated six years ahead of the medical industry’s, sources confirmed Friday. "We figured that a basic database would help us with everything from scheduling regular appointments to predicting future lubrication requirements," said the proprietor of the local oil-change shop, Karl Lemke, who has no special logistical or programming skills, and who described his organizational methods, which are far more advanced than those of any hospital emergency room, as "basic, common-sense stuff." "We can even contact your insurance provider for you to see if you’re covered and for how much, which means we can get to work on what’s wrong without bothering you about it. The system not only saves me hundreds of thousands of dollars per year, but it saves my customers a bundle, too." Lemke added that he also routinely and politely inquires about his customers’ health and well-being, which puts him roughly 145 years ahead of the medical industry

We still can’t collectively decide whether free government money has too many strings attached. New poll to your right: who owns patient information in EHRs and other provider systems? A simple question that I suspect does not have a simple answer.

We already mentioned that the press release touting a $3,500 EMR report fails to mention Epic. It also misspells Eclipsys, which for some reason is as vexing to writers as Misys was (Mysis, anyone?) The report may be amazing, but I’d have a tough time writing that check based on what I’m reading here.

Speaking of lame press releases, here’s one from Avaya, touting the results of its booth survey at the HIMSS conference (one could argue that the survey itself was lame considering it was conducted at the Avaya booth with no respondent pre-qualification or demographics noted and only 130 responses received). Not only are the results startlingly mundane (hospitals buy IT to improve patient care, clinicians are busy) but the press release segues directly to a product pitch, ruining the perception of the 1% of readers who might have thought they spotted a tiny glimmer of objectivity by virtue of squinting their eyes and reading really fast. Not surprisingly, some of the rags and sites dutifully reported the results as though they were meaningful. I’m hoping we weren’t one of them since Inga loves writing about surveys and I usually limit her to one per post or I just edit them out. Companies do self-serving, statistically unsound surveys because they know lazy writers will run the company-friendly results unchallenged, adding their own catchy headline and dramatic summary in hopes of being mistaken as having commanding industry analytical skill.

Welcome to new HIStalk Platinum Sponsor Logical Progression and its flagship product, Logical Ink. The Cary, NC company has offered mobile documentation solutions for years, leveraging tablets, digital ink, and a pen-based interface to give clinicians a user interface that’s as natural and easy to use as paper. They convert paper forms to mobile applications that physicians and even patients themselves complete just like they would on paper, adding their own free-form notes, drawings, or signatures (data capture from handwriting recognition is supported). The resulting documentation is validated, digitally signed, and sent to clinical or enterprise content management systems. Sample solutions include admissions, informed consent, progress notes, radiology, and anesthesia record. The company owns all of the technology it uses, so it provides total system support and OEMs its technology. Refreshingly, it offers detailed and complete pricing information in the clear on its Web site. Thanks to Logical Progression / Logical Ink for supporting HIStalk.

Here’s a demo of the Logical Ink consent app for the iPad.

I’m still working on the idea of giving small, innovative companies exposure on HIStalk. I have experts in place to do the vetting and ideas of how that exposure will look. We’re working out the details and will be taking submissions soon. I think it’s going to be tremendously fun, so stay tuned.

Canadian surgeons are using Microsoft’s Xbox Kinect in surgery to allow them to manipulate medical images via gestures without breaking scrub. They say it can save up an an hour in complex surgeries that would otherwise require leaving the sterile field and scrubbing in again, saying it works like a car GPS in allowing you to keep driving while you get oriented.

Montana governor Brian Schweitzer urges state lawmakers to reconsider their decision to make Montana the only state to reject HITECH EHR money. The legislature has voted four times to deny the state’s HHS department the authority to accept an estimated $35 million in federal money to distribute to hospitals in the state. The governor, a Democrat, says the money would reduce healthcare costs and increase jobs. Republican lawmakers say they’re drawing the line on out-of-control federal spending, with one saying, “Every one of those federal dollars that we spend, a taxpayer somewhere has to come up with.”

Thomson Reuters is helping out folks in Japan by providing free access to the radiation exposure content in its Micromedex Poisindex. All clinicians in Japan and everywhere else, whether they are Micromedex subscribers or not, can review information on evaluating and treating radiation exposure.

Speaking of the situation in Japan, hospitals are struggling. Some are without utilities, one has 10% of its staff missing, another used the last of its rice and limited patients to two meals per day, and physicians and employees can’t get to work because of fuel shortages. “It’s as if some enemy is starving us out,” one hospital official said.

Cooper University Hospital (NJ) is using iSirona’s solution to send monitor data directly to Epic, which the hospital says saves each nurse about an hour per shift.

I mentioned that only one of the educational sessions I attended at HIMSS was any good, that one being about bedside barcoding. It was excellent and very well received. I didn’t have presenter information, but it turns out it was Charles Still of Southwest Vermont Medical Center. He e-mailed me to let me know that he offers a more in-depth Webinar version of the same presentation a few times a year for $149 per attending site to offset some of his conference expense. The next session for Technical Device Considerations for EMAR/BMV Systems Implementation is April 14, with a limit of 24 participants for the 90-minute class.

A research study published in JAMIA finds that electronic medical records systems improve quality of care of HIV/AIDS patients in developing countries by sending clinicians automated reminders of overdue CD4 blood tests. The system used was the open source OpenMRS.

GhostExodus, the 26-year-old who who posted a YouTube video of himself hacking into computers and the HVAC system at W.B. Carrell Memorial Clinic in Texas, is sentenced to nine years in federal prison. He seems more stupid than dangerous.

E-mail Mr. HIStalk.

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Omar Hussain is president and CEO of Imprivata.

Tell me about yourself and about Imprivata.

I’ve been in the software business since 1985. I was introduced to Imprivata by the investors in 2002 when they were looking at it as a company to invest in. I met up with the founder, David Ting, and have since then had the fortunate privilege of being with Imprivata as we’ve grown the company and the business.

I’ve done a bunch of tech jobs: CTO, CEO, marketing, including all the usual career paths that you have.

UPDATE: in reviewing the recording, I found that I cut Omar off before he described Imprivata’s business. Just to clarify, the company offers user access solutions that include single sign-on, authentication, virtual session security, and privacy auditing tools.

The company is in markets other than healthcare, correct?

About 65-70% of our business is healthcare. We have financial services and public sector. Public sector covers everything from police departments to parole boards to departments of transportation, etc.

How was the HIMSS conference for the company?

It went very well. It was a great conference.

I thought it was good for us. In the last year, we’ve set up a healthcare division that really started to focus on healthcare as an industry for us. It’s good to now reach that stage where you have enough size and enough presence and enough customers that it’s a real show. You’re not just floundering around trying to meet with everybody. People like to come and meet with you, so that’s good.

CPOE utilization in hospitals is really low. How much of that relates to convenient physical access to systems?

Probably the number one problematic issue is physician convenience. If you think about it, this industry was paper based 10 years ago. Now, whether it’s in the US, UK, Benelux, or France, everybody globally is moving toward some kind of electronic record system. Because of patient privacy and patient safety concerns, there are all these government regulations around access controls.

Those access controls add minutes to a basic interaction that takes very little time. I joke about it, but if a physician or a clinician is spending two minutes logging in, logging off, and doing all the various things they need to do to access the records and they’re only spending eight minutes with the patient, that’s a lot of time as a percentage.

I think that’s where the big difference comes in. People have been so used to just signing a prescription using pen and paper, and in some cases not signing it … a nurse can sign it, you know?

People always think that clinician workflow is driven mostly by the applications that they use and how those applications are designed. What you’re saying is that how they log in and interact with those applications is equally important?

I don’t come from healthcare. I had to come from different technology companies that have been in different industries. The one thing you notice is that when we talk about workflow in any other industry, the user or the employee is constant and the work moves around them in the supply chain. Here, the user or the doctor is the one who walks, who changes around, and the service they provides stays constant. The workflow is very, very unique in healthcare.

I think when you look at what physicians are trying to do, missions are focused on the ultimate result — improving patient care as an outcome. Everything else is either an encumbrance or part of the problem, not part of the solution. Systems that can alleviate those encumbrances, make things smoother and easier, and streamline them have a lot of value to physicians.

It seems as though mobile device growth has changed the physician tolerance level.  Do you see that having access to iPads or iPhones and using applications on the fly is changing the expectation for readily available applications that aren’t inconvenient to use?

Absolutely. The net of it is that they provide benefit to the physician. Any technology, particularly when it comes to certain markets or certain temperaments of users — if they can get benefit out of it, then they’re going to use it a lot more. 

The benefit of a mobile device like the iPad or any other tablet or a mobile phone is that if you need to really access some information, now you can get some basic patient vitals, basic patient record information without having to go find a computer, dial in, log in. Hugely convenient. That’s why the adoption is going up, that it’s accessible the way they want it, when they want it. 

One of the reasons our customers like what we do is … great, you have stronger security or you have better security, but it’s not security they’re buying. They’re buying the fact that nobody has to remember a password. It’s all automated. They can log in and move from one terminal to another terminal.  

The doctor doesn’t care about security one iota. In healthcare, the structure is very different. There’s God, there’s the doctor, there’s the patient, then there’s physicians, then there’s the human race, then there’s IT. At the end of the day, all the doctors care about is taking care of the patient.

I’m telling you, nobody has ever bought our system because it’s secure. They’re buying it because makes their life easy, they don’t have to remember the passwords, they don’t have to log in multiple times, they go from one workstation to another workstation and the session is still hot and live, they don’t have to find the patient again. That’s why they buy it.

I wanted to ask you about the OneSign Anywhere product. Describe how that works, especially the mobile device part of it

Essentially, it’s the same thing as what we provide on a desktop or on a COW or on a workstation, but it’s from a kiosk environment or a mobile workplace. If you have an iPad, another mobile device, or a monitor sitting somewhere and you’re on vacation and and you want to go access information, you can authenticate, you can get in, and you don’t have to know your user names and passwords and all the access is provided. 

It’s basically fulfilling our vision to provide streamlined, simplified access securely from anywhere and from any device. Another step in that direction. It’s taking inside-the-firewall  or inside-the-building access to outside. You’re just eliminating the need to go through VPNs and log-ons and all that. Minimize clicks — that’s the secret to success.

What are your thoughts about biometrics?

Biometrics is an interesting technology … works in some cases, doesn’t work in other cases. If it fits the needs of what people want to do, and then it’s got high value. If it’s for additive security, well, the hospital is not the Department of Defense. They don’t really care.

A lot of our customers who use biometrics actually use the identification capability where they don’t even have to type a user name in. They just put their finger down and it recognizes who you are. It’s interesting. When we first started rolling it out, we thought people wanted authentication. No, no, no — they want the least, the easiest, the simplest way to access information and yet comply with all the regulations and be able to say it was secure and protected and traceable.

With the new requirements under HITECH to raise the bar of knowing who’s on the system, are you seeing higher demand for products like yours? There have been several recent cases where privacy was breached because of a technical flaw of having a user walk away from a logged-in session.

What I think is naturally happening is just the evolution of the market. HITECH is just one of many mechanisms because we see this globally. We have customers all over the world and we see this. Wherever EMR adoption starts to take off, there is some level of regulation that says you got to know who accessed what information, who could have access to it, who saw it, who did what, who monitored it. 

You have to be able to have some level of protection around that. That’s just basic, whether it’s financial information, whether it’s health information … it doesn’t matter. Banks have been deploying this for years. It’s just that in healthcare, it’s slightly different. 

If you’re a bank teller, you’re going to log in once in the morning and you’re stuck with it all day. If you’re a doctor, you’re going to log in maybe 30, 40 times in an hour based on the number of patients you might see. You have to streamline that. 

What we’re finding now more and more is that as systems are getting rolled out and deployed, you have concerns by patients. You have government regulations to ensure that there are some level of patient privacy and patient safety being enforced. That’s where authentication becomes important. That’s where you have access controls. That’s where sort of monitoring becomes really important. You see these cases all over where people have accessed information and you don’t know who saw the record or who let go of the information. The normal problems of technology.

What’s the status of proximity-based security and your Secure Walk-Away product?

Proximity can be used two ways. One is a simple prox card, where in lieu of your finger or your user name and password, you can tap a card and instantly you’re in. That card could also be used to access your building systems, but also be leverage to be a factor of authentication into your technology systems. People love that because it’s really fast. Whichever user comes taps on the RFID device and instantly their session is alive and well. It’s very convenient, and yet secure, and it has authentication around it.

The Secure Walk-Away problem was really around the fact that in healthcare, nearly everybody uses a shared workstation. Very often, people are called away from that workstation. In order to secure it, they actually have to do some act to secure it. They have to hit a key, a hot key, an F1 key, or hit Control-Alt-Delete. They have to do something to lock that system.

Secure Walk-Away deals with the problem on unattended desktops. Where someone walks away from that desktop, there’s a little camera that knows, due to heuristic algorithms, that there’s no one in front of that camera, or that the user that originally logged in to the camera is no longer in front of it. It shuts the screen down or puts up a block. The information is still live. If I come back to it and I was the original user, I don’t have to re-log in, retype in anything. I left it exactly where I was. But if a new user comes up, they have to shut it down and re-authenticate.

The problem that’s trying to solve is not just around patient privacy, but a lot of it around patient safety, where I could have been entering information on patient A, I got called away, you came into the same workstation and you changed it to patient B. You’re entering the information. I come back two minutes later thinking that it’s still the patient I was working on, patient A, and I enter in some information that’s wrong. I’m entering the wrong information against the wrong patient. This helps protect against that.

It’s a very, very complicated problem. We’ve been working on it for many years. We launched it and it has been a great success. A lot of hospitals are looking into it right now. We have a bunch of pilots going on right now with a bunch of customers, and it’s been a big success. But again, it’s one of those unique technological problems that you have to solve for a very unique environment — a hospital and the shared workstation in it.

Some of the earlier attempts to fix that problem were based on a badge tag. How is the camera better?

There’s been the sonar, which is like the system that is used in flushing systems, where you walk away and then it automatically flushes. There were the mats that came out at one point, pressure-sensitive mats where you were stepping on, and then there was the other RFID situation. People have been trying to solve this problem for a very long time.

We think we have created enough innovation to truly take a different approach that removes the authentication and the access from just doing one task, which is securing an unattended desktop. When you’re logging in, the camera sitting on top doesn’t know it’s you. It’s not authenticating you; it’s not doing anything. All it’s doing is taking a snapshot of you and associating it with your authentication. It has a set of algorithms that say, you know, if you turn your face to the side, you’re in a zone. If you walk away from that zone, it’s going to lock it up. When you come back, it’s going to recognize the characteristics and let you back in.

We have to continue to make innovations to it.  We’ve already had lots of ideas that people have asked for us to add to it, so we’re pretty confident it’s going to be a big success. But at the end of the day, it’s a problem that’s existed for a long time, ever since they started to introduce workstations in healthcare. We’ll keep innovating until we can solve it.

How are hospitals are using Privacy Alert?

Privacy Alert is patient access monitoring. If someone comes in and says they didn’t have access to these records or if some celebrity or patient comes in and says, “I don’t want my records seen by anybody who’s not on my care team,” then you can monitor access. You can put in controls that raise the flag that says, “OK, this nurse is not on your team and has been accessing your records.”

This is directly as a result of some of the provisions that some state laws have passed, that has been in the recent HITECH Act that you mentioned. All around the fact that they have to be able to monitor who has access to which patient’s records.

I think that this all started with California, where they had issues around people seeing Octo Mom’s records and you had issues people seeing Maria Shriver’s records. There were a lot of celebrities that would go in and then the information would come out and then the hospital would deal with lawsuits. I think that spread. I think California was the first state to pass a law around this. Over the last few years, it’s become more and more widespread and adopted nationally. It makes good sense. Anywhere else, you’d be able to tell that.

As I said earlier, this is a logical evolution of an industry that is taking a lot of sensitive information and is now making it accessible in order to improve its own efficiency. The problem is that you are in an industry where it’s very difficult to do that, because the primary motive is not producing a product, but saving someone’s life or taking care of a patient. 

If you can’t find mechanisms by which you can embed security into the workflow, streamline it, and eliminate the encumbrance that security brings to the process, then that’s where utilization doesn’t happen. That’s why you have all these CPOE systems that clinicians aren’t using because it’s a pain. You have the EMR system that people don’t log in to because they don’t want to use it.

One of our customers found that the average nurse was logging in 70 times a day. Each log in was taking them about two minutes and sixteen seconds. After they bought our solution and had it deployed, they had it down to seconds. This IT guy was telling me he’s never the CNO praising him on anything, and now it’s like a little love-fest going on because it’s convenience.

They have a job to do. They want to do their job and now you’ve rolled out a system that adds another layer of steps. Instead of me seeing 100 patients, I’m going to see how many patients less because I’m spending two hours just getting in and getting out of systems? I think that’s where the value of what we do comes in front and center.

My last question reflects on that. If you look at the big picture of getting physicians or other clinicians to use technology, what strikes you as being the most important factors over the next few years?

I think it has to become simple, easy, and intuitive into their workflow. One of the reasons why Epic has been so successful and some of the new vendors that are coming into the spaces are innovating is they’re not taking a traditional approach. They’re saying, “Hmm, this problem is a lot more complicated. How can I truly make technology an integral and simple part of the clinician’s day-to-day work life?”

The more those innovations happen, the more you’ll see the utilization go up. Everybody at the end of the day wants to see and needs to see more patients, not just for business or productivity reasons, but because globally we have an aging population. Only so many physicians in the world, right? There are only so many resources, so you need to make things more efficient.

I think if there’s any industry that’s going to benefit by technological adoption, it’s going to be healthcare, dramatically. What’s going to drive it is easy, simple, and integrated solutions. People are not going to buy just raw technology. They’re going to need something that really offers a benefit. Otherwise, they could just use paper. It’s much easier to take the vitals, write them down, have a doctor come up, read them, sign off, and go.

Any final thoughts?

Love HIStalk. You’re a great writer. It’s fun to read.

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Top News

A lawsuit against Walgreens focuses on the selling of medical information gleaned from patient prescriptions. Previous lawsuits focused on patient privacy violations, but this one charges Walgreens with depriving patients of the commercial value of their own prescriptions by selling their de-identified information to drug companies for marketing purposes and keeping the money for itself. The plaintiff argues that Walgreens doesn’t own the information, so it shouldn’t be selling it. The suit cites a 2010 SEC filing by Walgreens that lists “purchased prescription files" as an intangible asset worth $749 million.

Senator Sheldon Whitehouse (D-RI) introduces legislation that would expand EHR stimulus incentives to include eligibility for behavioral health, mental health, and substance abuse treatment professionals and facilities.

Harris Corporation and Johns Hopkins Medicine announce a joint venture in which Harris will develop medical image management solutions for Hopkins that it will then commercialize.

Reader Comments

From Stephen Yoder: “Re: appointment scheduling. I’m an applications specialist with Cerner and Epic experience and have also worked with a Mammo RIS from a small company called PenRad. It does something that Cerner and Epic can’t – it allows scheduling two or more successive appointments ordered by one provider from different locations (or organizations) and then correctly routes the signed results via fax back to the location from which they were ordered. Those other systems send everything to one location, or require entering dummy doctors. Faxing isn’t going away and neither is FNPs, PAs, and MDs working on multiple locations. Comments welcome, even statements that I’m silly for expecting the big dawg HISs to perform as well at a specific task.” Unverified. PenRad is the #1 KLAS-rated mammography information system, according to the company’s site.

From Lamprey: “Re: CTIA. The wireless conference is hyping the conference in saying that healthcare billionaire Patrick Soon-Shiong will make some kind of major announcement during his keynote.” He’s buying lots of companies (and a chunk of the LA Lakers) so that could be the case, although I don’t know why he’d tip his hand to a conference organizer in advance. He’s made other big announcements about healthcare, society, etc. that haven’t amounted to much so far. We’ll seen next Wednesday.

From Mr. Sandman: “Re: Qatar. Two big deals are going down, with Sidra and Hamad Medical Corporation choosing systems. These are right up there with Cerner winning Abu Dhabi awhile back and the Dubai meltdown where Epic won and then had the contract cancelled. Eclipsys won the Hamad bake-off, but last month Allscripts told Hamad they were withdrawing. That’s walking away from possibly the biggest deal Eclipsys ever had as vendor of choice, essentially giving Cerner the business and a major foothold in the Middle East. I don’t know if Epic will jump back in due to the huge expense involved and their experience with Dubai.” Unverified.  

From Former Eclipsi: “Re: new Allscripts India-based offices. Not sure why they are referred to as new. Eclipsys was doing development and support for Sunrise at that same Pune location and Allscripts has been in Bangalore for almost that long.” I wondered that, but I assumed they were moving additional services there. I heard from someone who should know that the offshoring works well to eliminate the US-based resources from doing drudge work, but things go downhill fast when problems go off script (this person swore that a senior Windows engineer in India had to be walked through finding the Windows Start button). Eclipsys had apparently replaced all of its American remote hosting help desk analysts with India-based staff, resulting in some clients demanding that their calls not be routed there after service problems (not unheard of with offshoring in general, sometimes for good reason, sometimes not).

From Perry Natal: “Re: Inova Fairfax. Any idea why they de-installed GE Centricity and switched to Epic?” Here’s the much-appreciated response from Inova SVP/CIO Geoff Brown:

We have not deinstalled GE Centricity and switched to EPIC. As of 3/16/11 we do not have an agreement with anyone other than GE and McKesson as our core HIS vendors. We did conduct an assessment of our current and future state requirements which led us to issue an RFP to GE, EPIC and other vendors. The catalyst for this centered on our 10 year projected business plan goals and objectives. Drivers included health reform / mu, aco, enhanced analytics requirement, 5010 / icd-10, ambulatory & inpatient system interoperability, physician, patient care and patient experience requirements. I won’t hood wink you because we are strongly considering our options but as of today while rumors are swirling nothing has been finalized. If something should happen I’ll be happy to update you.  Obviously I’m a fan of HIStalk and have found it viable as a useful source for information and insight relative to industry activity.    

From Will Weider: “Re: Ministry Health Care. In response to the earlier post, we are running a system selection process to choose a single HIS with a single patient database. Today our hospitals run eight HIS instances, and we want to simplify this environment and improve the patient experience. Thus far the selection is limited to our two incumbent partners, Meditech and GE. We have not made a decision and we have not made a commitment to upgrade to GE Centricity Enterprise 6.9. Regarding HITECH EHR Incentives, our current plan is to certify ourselves using our combination of EHR technologies, rather than rely on a single certified EHR.” I’ll call this “verified” since Will is the CIO.

HIStalk Announcements and Requests

Listening: I can’t get enough of Deer Tick (goofy name aside), which I know I just mentioned, but I’m hooked. It’s the best thing I’ve heard in months and I’m playing it constantly. This song is amazingly good and world-weary considering the band is made up of kids in their early 20s (and a little Googling raises the strong possibility that the hard-miles singer is the son of Rep. John McCauley Jr. of the Rhode Island House of Representatives). I’ll be shocked if they don’t blow SXSW away this week.

The first day of spring is Sunday, just so you know. I’m definitely spring feverish.

On the Job Board: Regional Sales VP- West Coast, Account Manager, Content Writer/Media Specialist. On Healthcare IT Jobs: Physician Informaticists, RN Systems Analyst, Marketing Technology Programming Analyst, Implementation Consultant.

Acquisitions, Funding, Business, and Stock

Document management vendor Accentus acquires speech-to-text technology vendor Mrecord. Accentus acquired two transcription-related companies in December.

Sales

Franciscan Health System chooses TeleHealth Services to provide interaction patient education and entertainment services at its new St. Elizabeth hospital in Enumclaw, WA.

The board of directors for Sharon Regional Health System (OH) approves a five-year, $13 million Cerner purchase. The health system also hires Donna M. Walters as senior director of IT to lead the EMR project and other IT efforts.

Also choosing Cerner: Sheridan Memorial Hospital (WY), in a $9.8 million deal. The hospital’s CFO anticipates receiving $3.1 million in stimulus funds after its August 2012 go-live.

The William W. Backus Hospital (CT) will use a charitable foundation’s donation to fund a two-year extension of its subscription to MyHealthDIRECT, which allows referring non-emergent ED patients to the appropriate level of care by searching the open appointments of community-based providers.

St. John Providence Health System (MI) selects Intuit Health to provide a patient portal to its physician practices.

St. Peter’s Hospital (MT) picks SeeMyRadiology.com for the sharing of images with patients and physicians.

Georgia Hospital Association signs a purchasing agreement with Prognosis Health Information Systems that gives members special pricing for the ChartAccess Comprehensive EHR. The solution includes hosting on a shared server at Georgia Hospital Health Services.

NextGen reseller TSI Healthcare partners with The Center for Arthritis and Rheumatic Diseases (TX) for the NextGen EHR, PM, and Patient Portal solution.

Creative Testing Solutions (FL) picks Mediware Information Systems’ LifeTrak software to manage blood testing procedures.

Pine Rest Christian Mental Health Services (MI) chooses CareLogic Enterprise EHR for its 18 behavioral health facilities.

UMass Memorial Health Care (MA) selects Informatica EMR Data Migration Foundation as a key component of its five-year, $140 million upgrade of core clinical and financial systems. UMass is implementing Siemens Soarian clinicals and financials.

People

Healthcare portal company Omedix hires former IntraNexus VP Tom S. Visotsky as VP of sales and marketing.

Insurance industry business intelligence vendor Intelimedix names Michael A. Newman as chief informatics officer. He was previously VP of medical informatics at BCBS Florida and was already on the board of Intelimedix.

Announcements and Implementations

Orlando Regional Medical Center and MD Anderson Cancer Center Orlando go live with PerfectServe’s clinical communication system.

EChart Manitoba, the first province-wide EHR system in Canada, goes live on the first stage of its $22.5 million EHR sharing project. IBM is the project manager for the initiative and dbMotion is providing the software platform.

A data review by Curaspan Health Group finds that 168 eDischarge customers studied in 2010 saved an average of $1.5 million each by having a preventable readmission rate of 14% vs. the national average of 20% .

Evangelical Lutheran Good Samaritan Society will collaborate with WellAWARE Systems, Phillips Lifeline, and Honeywell HomMed in offering wireless sensor technologies to help senior citizens live independently at home. They will study the effectiveness and cost benefit of sensor technology, personal emergency response systems, and telehealth applications.

Baltimore’s technology incubator and its graduate company WellDoc are named finalists for incubator and incubator graduate, respectively, of the year. WellDoc develops chronic disease management applications.

Government and Politics

The second most highly paid local government official in California is the CEO of Palomar Pomerado Health at $1.15 million, according to a review. Eight of the top 20 mostly highly paid employees are hospital executives. At number one was an administrator from Bell, California, population 37,000, whose exorbitant employee salaries triggered the salary review in the first place. The former Bell administrator (now facing charges) made $1.25 million. A similarly outraged article in the New York Post lists the salaries of state hospital executives, with the top end exceeding $3 million.

Technology

Doximity launches its smart phone application for physician collaboration and networking (text messages, photos, telephone dialing, physician locator, provider lookup).

The Toronto paper mentions Ottawa-based Epiphan Systems, which sells a video “frame grabber” used for remote medical image viewing, but also distance education, security monitoring, and navigation. Henry Ford Health System is named as a customer, which uses the company’s $700 device to capture 30 frames per second video from a laparoscopic tower on a standard laptop via USB, where it’s converted to MPEG-4 video and e-mailed as an attachment.

Other

The EMR market was valued at $15.7 billion in 2010, but no single company dominates the market, according to Kalorama Information. It calls Cerner, GE Healthcare, McKesson, and Siemens “established hospital IT giants” and says Allscripts will build share this year. The press release does not mention Epic as one of the big players. Buy your copy for only $3,500 and maybe you can find out why.

Now for something completely non-HIT related: the average women owns 17 pairs of shoes, yet only wears three of those on a regular basis. She also purchases (only) three pairs of shoes a year. I can confirm that I am well above the mean. The editor-in-chief of ShopSmart provides an excellent analysis of why women love shoes:

Shoes never make your butt look big, you don’t have to worry about squeezing into them if you’ve put on a couple of pounds, and they can instantly make you feel sexier.

The photos above, by the way, were sent by readers who support my shoe fetish.

The former CEO of closed Parkway Hospital (NY) is charged with bribing a state senator to help him acquire to other hospitals. He was working with John Krall, CEO of HIT vendor Pegasus Health Restoration, to re-open Parkway. Krall says he has $70 million of capital to reopen the hospital and will serve as its CIO. A community board member wasn’t impressed that Krall declined to name his funding source, saying, “He just came out of the blue. You can’t just come and open a hospital.”

I don’t usually do this, but I thought I’d mention a friend of HIStalk who happens to be a marketing executive looking for a gig. She’s got senior-level HIT experience in working with brand image, brand awareness, social media, PR, product launches, etc. She got our attention as a sponsor contact and definitely raised the visibility of the company she worked for. I offered to forward to her any inquiries sent my way.  

VisualDX diagnostic decision support software outperformed ED docs in diagnosing cellulitis, according to a research study that also found that 28% of admitted patients with cellulitis were misdiagnosed in two hospitals.  
 

Sponsor Updates

• United Medical Centers (TX) will implement Sage Intergy for its eight-practice community health centers.
• Desert Sun Gastroenterology (AZ) selects ProVation MD software from Wolters Kluwer Health for its gastroenterology procedure documentation and coding.
• ProHealth Solutions, a new ACO formed by ProHealth Care hospital system (WI) and the Waukesha Elmbrook Health Care IPA, selects MedVentive Population Manager and Risk Manager.
• Microsoft says that since its purchase of Sentillion in February 2010, deployment of Sentillion products has expanded to 575,000 total users across 220 organizations. Over 50 new customers signed up for Sentillion products in 2010 and Microsoft is now distributing Sentillion solutions in the Asia Pacific market.
• Medworxx will distribute perioperative and critical care systems from iMDsoft’s MetaVision suite in Canada and iMDsoft will offer the Medworxx patient flow, compliance, and education systems outside of Canada in a just-announced reciprocal distribution agreement.
• Several applications of 3M’s eHealth Documentation Solutions are awarded certification as EHR Modules.
• MedAssets announces that it will market the PatientSecure palm vein biometric system from HT Systems to customers of its Access Integrity suite, giving patients faster check-in and more accurate medical records retrieval.
• CEO Jennifer Lyle of Software Testing Solutions will participate on the Meaningful Use panel of the iHT2 Health IT Summit in Atlanta next month.
• Workforce and incident management systems vendor Concerro announces a joint marketing agreement with Sydion LLC, which offers tracking technologies for emergency response organizations.
• Healthcare Management Systems earns ONC-ATCB certification for its HMS Ambulatory EHR, following the recent certification of its inpatient EHR and EDIS.

EPtalk by Dr. Jayne

Despite the spring flowers peeking through after the long winter, my week started with more snow. A bit depressing until the FedEx driver appeared with a package destined to lift my spirits.

The RelayHealth “gift basket to welcome Dr. Jayne” contest goodies had arrived! Chocolate, red wine, great hand cream, and fuzzy slippers. What more could an overworked CMIO want? As an added bonus, the “basket” is a waterproof nylon cooler/tote with an integrated bottle opener which will be great for my local Concert in the Park series this summer. (Yes, dear readers, I do have a life outside health IT, although sometimes it doesn’t feel like I do).

Mr. H alerted me over the weekend to an article by David Blumenthal in Health Affairs. I’m not sure he ever sleeps, but I’m glad when he makes sure I don’t miss interesting things in my ever-expanding inboxes, whether electronic or paper. After snuggling up with the aforementioned red wine and fuzzy slippers, it was an interesting read.

The subtitle is a little underwhelming: “The Benefits of Health Information Technology: A Review of the Recent Literature Shows Predominantly Positive Results.” Where’s the flash and bang? I’d love to see something more like “A Review of the Recent Literature Shows HIT is kicking ass and taking names.” But then again, that kind of concrete statement would require a lot more data than what we have here.

The first thing you note is that all four authors are currently or formerly with the Office of the National Coordinator (although they did list Blumenthal last). Nothing like a little potential author bias to start an article out right. I’d have been more impressed if the same data and conclusions were arrived at by someone independent, such as a university. Although the authors state that over 92% of recent HIT articles were positive, they recognize the cold hard reality that providers are unhappy with EHRs and adoption is a significant barrier.

Building on two previous studies which looked at data from 1994-2007, they examined the months between July 2007 and February 2010 using the same methods and selection criteria. Ultimately they looked at 154 studies (with 100 of those studies being from the United States). Outcomes were ranked as positive, neutral, mixed-positive, and negative based on the proportion of improvement in at least one aspect of care vs. whether any aspects were negatively impacted.

I give them full credit for noting their limitations. The first is publication bias, where negative findings aren’t published as often. The second is weighting all studies equally – independent of study design or sample size. These are very real concerns when performing a meta analysis, whether looking at EHR outcomes or some other parameter.

Reaching the lengthy section on statistical hypothesis testing, I felt myself slipping and had to self-medicate with some of the RelayHealth chocolates, STAT! That got me through to the Discussion section, which was more relevant for most of us. The authors validate what some IT departments seem to forget: “that the ‘human element’ is critical to health IT implementation.” One tidbit that most of us already know is how strongly correlated provider satisfaction is with negative findings.

One key finding is that the data hasn’t changed much from the previous reviews. There’s no real benefit to being an early adopter and slow-moving groups are seeing the same outcomes. For those of us that live every day on the bleeding edge, that’s not a big comfort. Maybe we need to remember The Tortoise vs. The Hare.

I think the best thing they clearly stated that I wish I could make required reading for every CIO, CMIO, CMO, and physician champion: negative findings can be a good thing if they’re used to figure out how to do health IT better / faster / stronger / safer. My spin: don’t take criticism personally – use it to do your job better.

If we’re ever going to get to that “Healthcare IT is kicking ass and taking names” article (which I will happily co-author under my real name with any of you) we need more studies on how to address the challenges we all face and what training and implementation strategies make for the most successful outcomes.

Have questions about CPOE, clinical decision support, or which shapes of chocolate candies have the best middles? E-mail me.

Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg.

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