HHS’s Office of Inspector General spanks its fellow agency ONC for pushing interoperability without mandating security controls or encouraging standards. Examples of what it wants to see: requiring portable media to be encrypted, requiring two-factor authentication for remote access to PHI-containing systems, and mandating timely OS patch application and antivirus updates. OIG based this work on a previous project that looked at providers, in which it found unsecured wireless networks, lack of application vendor support for OS-level changes, poor antivirus practices, lack of event logging, allowing shared user accounts, and giving too many users administrative rights over their PCs.
ONC’s response to this report: (a) we turfed security work off to HITSP and incorporated some of its specs as HHS policy and in EHR certification requirements; (b) Stage 1 of Meaningful Use requires providers to fix their own security problems; (c) our job is to convince providers to use EHRs and we will worry about security later in the process; (d) our chief privacy officer is drafting a plan. It sounds to me like the typical external auditor’s report: their job is to find stuff to make sure you keep hiring them, while yours as the IT shop is to balance their sometimes ivory tower observations with your own realities. My only takeaway is that ONC should spend some of its billions to push security awareness, which you would think highly paid hospital and vendor IT people wouldn’t need, but apparently they do.
From Mia: “Re: CompuGroup. Big layoffs at Noteworthy Medical (last week, I think) and other of their companies. Will be interesting to see how many of the 420 ONC-ATCB certified EHR companies are around five years from now.” Unverified.
From CPOE Zealot: “Re: medication error. Incidents such as these give CPOE a bad rap.” The parents of a five-week-old premature baby who died after being given 60 times the ordered dose of IV sodium chloride sue Advocate Lutheran General Hospital (IL) for wrongful death. Like most fatal medication errors, CPOE was a non-factor here: — most in-hospital medication error deaths are caused by incorrect IV preparation or administration. In addition, the doctor ordered stat labs and then a re-test after getting a high sodium level back, but nobody drew it, leaving the baby on the hyper-concentrated fluid for 20 hours. There is one good reason CPOE gets a bad rap in cases like these, though: vendors sell and hospitals buy the seemingly logical argument that CPOE prevents patient harm, when what it mostly does is prevent lots of errors that were being caught anyway (like poor handwriting, in which somebody just calls the doctor for clarification). The risk of harm doesn’t change much unless you work at the sharp end of the stick where EHRs fear to tread – medication preparation and administration. The best IT systems in existence (including bedside bar-code checking) couldn’t have saved this baby’s life when hospital employees, despite experience and best intentions, are just as prone to distraction and carelessness as the rest of us humans, especially when they are overwhelmed and tired (sometimes because their peers were laid off to help pay for CPOE systems).
From Wireless Observer: “Re: Cerner. Word on the street is that Cerner is getting ready to announce some big organizational changes and these are not good kind of changes for the employees (may be good for Wall Street, however). This is supposed to hit the CareAware division pretty hard.” Unverified. CareAware is Cerner’s solution for connecting medical devices to EMRs (video above).
Acquisitions, Funding, Business, and Stock
FairWarning will hire 70 employees over the next 24 months.
Salt Lake City-based MediConnect Global announces plans to hire 100 employees across multiple departments.
Cerner names SenSage its “Accelerate Partner of the Year” for demonstrating speed to value for Cerner and its customers. SenSage also an expanded alliance with Cerner to offer a SaaS-based version of P2Sentinel, Cerner’s enterprise clinical system auditing program.
CareCloud partners with Xpress Technologies to launch a combined EMR/PM solution for urgent care facilities and hospital ERs.
Sharkey Issaquena Community Hospital (MS) selects Custom Software Systems ChartSmart EMR.
Onslow Memorial Hospital (FL) contracts with Language Access Network to provide hospital video language interpretation services.
Awarepoint names Ralph Keiser (MedeAnalytics) EVP of sales and Jaime Ojeda (PCTS) EVP of marketing and business development.
Government and Politics
CMS announces plans to release applications for “mature ACOs” interested in participating in its new Pioneer ACO Model and taking part in shared savings. CMS is also seeking input on the idea of an Advance Payment ACO Model, which would give certain ACOs access to their shared savings up front so they could build the required infrastructure. For providers wanting to learn more about ACOs, CMS is offering four free Accelerated Development Learning Sessions beginning in June.
Innovation and Research
Of the 75 operational RHIOs in the US, only 13 meet the basic criteria for Meaningful Use (e-prescribing, clinical data exchange, quality reporting) according to Harvard researchers. I don’t have access to the study, but apparently the findings are based on data from 2009 (so old they use the term RHIOs, apparently). Surely there’s been some improvement since 2009. If you’ve seen the full report, please share your insights.
JAMA reports that the use of telemedicine in ICUs reduces mortality rates and length of stay.
The New Zealand government awards a $252K grant to Vensa Health to conduct further research related to its mobile health reminder system. The company recites an impressive list of technology features, but like just about every mobile health vendor, they have no evidence showing that their product is effective in improving health. Like Bill Gates told me at lunch once (well, OK, me and a huge ballroom full of people at the mHealth Summit), reminders and education don’t necessarily work when it comes to wellness – plenty of fat people own bathroom scales.
I got another “urgent news” e-mail blast today from one of the rags that reinforces my argument that most industry publications either (a) can’t distinguish real news from press releases, or (b) don’t care as long as it draws readers and advertisers. Today’s hot news: a bond rating agency issued a press release claiming their study correlated use of advanced IT to hospital profitability and quality. I downloaded the “special report” from Fitch Ratings and it was, as I expected, not worth the excitement, being even less methodical (and therefore even less useful) than the Most Wired survey. Here’s a summary.
- The bond ratings company looked at only the 291 hospitals that use its services. That’s out of maybe 6,000 US hospitals – a tiny, non-randomized, non-representative sample that excludes for-profit and government facilities.
- They checked Leapfrog, Baldrige, and Healthgrades and found that 75 of their clients had won a quality award (all awards are created equal in drawing room studies like this that just match Readily Available Data Set A with Readily Available Data Set B).
- They checked with HIMSS Analytics and found that 24 were at EMRAM Stages 6/7 (ignoring all other forms of IT except inpatient clinical).
- Apparently disappointed to find that only 12 of the 24 EMRAM 6/7 hospitals had won quality awards, they invented an excuse related to “the evolution and maturation of how quality is measured.” (maybe that should have been the headline – that half the hospitals who reached IT Nirvana haven’t won even one major quality award as a result).
- They found that richer hospitals won more quality awards and had more IT (neither of which necessarily has anything to do with patient outcomes).
- They looked at utilization trends and concluded that higher IT hospitals (meaning richer ones) are improving, although they did not look at their absolute performance (meaning a hospital could still be terrible as long as it’s less terrible than before).
- The bottom line: even if the bond ratings firm had conclusively proved any kind of relevant correlation (which they most definitely did not), that still wouldn’t have proved causation. The implicit message in running this yawner of a study as real news is that everybody now has the justification to buy more IT, which is an absurd conclusion for an industry that somewhere down deep is supposedly based on science.
Speaking of questionable studies, here’s another one: do seven percent of doctors really use video chat in patient care? I’m not interested enough to buy the company’s report to evaluate its methodology, but I would have to bet that they surveyed a disproportionate number of telemedicine physicians or tele-ICU intensivists. Most docs won’t even e-mail patients, much less fire up a Skype session for a leisurely and probably unreimbursed Webcam chat.
Quality IT Partners, Inc. announces its Facebook launch featuring a dedication to the Scott Hamilton Cares Initiative, including a song and video written and produced by the company.
- Sonoma Valley Hospital (CA) picks ProVation Order Sets.
- BridgeHead Software will exhibit at the 2011 International MUSE Conference May 31-June 3 in Nashville.
- Emdeon introduces Emdeon Audit Advantage, which will provide real-time prescriber eligibility and patient coverage alerts to pharmacies. The company also wins a five-year GSA contract that allows it to offer products to over 90 government entities.
- Healthwise Patient Education EMR module earns ONC-ATCB certification.
- Imprivata announces GA of OneSign Anywhere for authentication and single sign-on for remote and mobile users.
- Delta Health Alliance, one of the country’s 17 Beacon Health communities, collaborates with Medicity to connect participating physicians and hospitals.
- Daughters of Charity Health System (CA) expands its partnership with Passport Health Communications and adds three additional RCM solutions from Passport’s eCare Patient Access Suite.
- McKesson medical director David K. Nace, MD is named first vice chairman of the board of directors of the Patient-Centered Primary Care Collaborative.
- Practice Fusion says it has grown from a team of four in 2007 to 75 today. The company is expects to reach 150 employees by the end of the year and is seeking new office space.
- MyHealthDirect assumes a silver-level sponsorship for the 19th Annual Medicaid Managed Care Congress this week in Baltimore. CEO Jay Mason will also participate in a panel discussion on ACOs and patient-centered medical homes.
- API Healthcare publishes a whitepaper entitled Achieving Quality of Care and Controlling Costs, which includes best practices for workforce automation.
- Concerro creates a Mac versus PC parody that compares healthcare scheduling solutions with paper-based systems.
- The City of Philadelphia selects eClinicalWorks to provide an EHR/PM solution for the Department of Public Health, which includes 230 providers and 20 primary care and correctional clinics.
- JEMS Technology announces a rental program that allows hospitals to provide smart phone video consultation capabilities (JEMS Consults) to their physicians starting at under $1,000 per month.