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Monday Morning Update 12/10/12

December 8, 2012 News 8 Comments

12-8-2012 10-47-35 AM

From HITEsq: “Re: Epic. It appears they aren’t happy with some consultant, suing two individuals and three similar sounding entities (KS Information Technologies). They were granted a motion to seal the complaint to protect sensitive information. Maybe someone knows more.”

12-8-2012 7-55-53 AM

The government should get more proof that providers have met Meaningful Use requirements before sending them a check, according to 72 percent of poll respondents. New poll to your right: should FDA create an Office of Wireless Health as proposed by Rep. Michael Honda (D-CA)? I’ve generously included a “don’t know/don’t care” option for those anxious to participate despite indifference to the topic.

My latest Spotify playlist includes the usual mix of music I like, including Villagers, This Providence, Gov’t Mule, Faith No More, and going back decades, Mountain, Throwing Muses, and even the virtually unknown 60s Detroit band Frijid Pink. I spend a fair amount of time choosing what I think is worth listening to and then play the list several times to make sure it makes sense, not that I’m in need of extra work. Give it a listen if you’re stuck in a musical rut.

12-8-2012 8-23-29 AM

I never look at (and in fact am annoyed by) infographics, those trendy, huge, multi-font pictures that fool short attention span Internet skimmers into thinking they understand a complex topic, often created by someone who hopes their agenda will be accepted as truth instead of opinion because it’s easier to stare at dumbed-down pictures instead of using your brain to read something more challenging and informative. If you don’t feel that way, cruise over to ONC’s EHR infographic for consumers. At least theirs is footnoted.

The secretaries of Veterans Affairs and Defense say they will present a plan in January to speed up the VA-DoD EHR integration. The planned go-live date of 2017 may be moved up. 

Manitoba’s eChart HIE  will allow users to hide their information even though they can’t opt out of the service. It will contain prescription information, immunization histories, demographics, and lab results.

The Jewish Healthcare Foundation, the Pittsburgh Regional Health Initiative, and Health Careers Futures form the Pittsburgh-based QIT training center, funded by the foundation and the County tourism office. It will offer training to healthcare executives and workers on emerging technology. ONC Deputy Director Jason Kunzman is former CFO of the foundation. Also announced was the QIT Health Innovators Fellowship program for graduate students in the health professions, who will submit IT solutions for judging in a 10-week program.

Healthcare provider CIOs on the 2013 Computerworld Premier 100 IT Leaders list:

  • Horace Blackman, Department of Veterans Affairs
  • George Brenckle, UMass Memorial Health Care
  • Thomas Bres, Sparrow Health System
  • Sonya Christian, West Georgia Health
  • Chad Eckes, Cancer Treatment Centers of America
  • Randall Gaboriault, Christiana Care Health System
  • Theresa Meadows, Cook Children’s Health Care System
  • Mark Moroses, Continuum Health Partners Inc.
  • Stephanie Reel, Johns Hopkins Health System
  • Kathleen Scheirman, Kaiser Permanente
  • Thomas Smith, NorthShore University HealthSystem

12-8-2012 9-11-37 AM

A new KLAS report on revenue cycle performance finds that Meaningful Use, reduced payments, and ICD-10 fears are forcing providers to examine their revenue cycles more closely for efficiency and effectiveness, with many of them engaging outside assistance.

RSNA attendance was down 9 percent this year, with possible reasons being lack of technology breakthroughs and a new policy that required guest attendees to pay.

12-8-2012 9-47-54 AM

A technical school in the Philippines creates a telenurse training program, preparing nurses to offer their patient consultation services via smart phones. ClickMedix, an online health company is participating, offering the nurses access to its smart phone application, doctors, and medical library in return for a percentage of their billings. Experts say it’s time to create business models for nurses to become online health consultants. I tracked down ClickMedix, which turns out to be a US-based company (Rockville, MD) formed by faculty and students of MIT and Carnegie Mellon to address global healthcare challenges. The company’s mHealth platform offers modules for delivery of medical services, patient management, administration, and healthcare services purchasing.

Ergonomics researchers warn that the increased use of EMRs and other keyboard-based technologies for long periods of time raises the risk that providers will sustain repetitive stress injuries as happened when offices computerized in the 1980s. A small study found that more than a third of doctors reported RSI-related pain in their neck, shoulders, back, or wrists. In what could be an indirect measure of the uptake of EMRs, another small provider study found that more than 90 percent use a computer, averaging more than five hours a day.

12-8-2012 10-07-12 AM

An article in the Rochester paper describes the use of contracted scribes in the ED of Rochester General Hospital, which says its 60 ED scribes cost $1 million annually but save the health system $1.6 million per year. According to the associate ED chief, “When you come to see the doctor, you want to see the doctor. You want eye contact. You don’t want us standing at a computer screen. I care for people. I’ve never been trained to be a good typist or a data entry specialist.”

An Atlanta nephrologist serving as the medical director of a clinic owned by dialysis provider DaVita files a whistleblower lawsuit against the company under the False Claims Act after noticing that its computer systems showed large amounts of wasted drugs. His suit claims DaVita overcharged Medicare for up to $800 million over eight years by intentionally using oversized vials of medication and discarding the remainder, billing Medicare for unavoidable waste. The doctor was noticed by his fellow whistleblower, a nurse who says the company was pushing employees to increase their drug revenue. The company says CMS approved all of its practices.

12-8-2012 10-22-02 AM

Scheurer Hospital (MI) renovates its patient rooms to include technology improvements, placing a computer in each room to allow nurses to document at the bedside. They also added a new patient call system that alerts nurses on cell phones.

The former executive director of Syringa General Hospital Foundation (ID) is sentenced to six months in prison and is ordered to pay $115,000 in restitution after pleading guilty to using the hospital’s computer system to transfer money to her personal accounts.

Aetna will pay $120 million to settle lawsuits claiming that it used databases from UnitedHealth Group’s former Ingenix unit to intentionally underpay insurance claims for members using out-of-network medical services. UnitedHealth paid $350 million in 2009 to settle a similar lawsuit in New York, at which time Aetna also settled by agreeing to stop using the Ingenix database and paying $20 million to help create an independently developed replacement for it.

Weird News Andy says he now knows how your mom always knew what you were thinking. Researchers find that a mother’s brain often hosts living cells from her children born decades earlier. WNA also digests new medical research as being an explanation for crazy cat ladies: a common cat parasite is found to have the ability to enter the human brain and to possibly cause behavioral changes.

More on CPSI in this week’s HIS-tory from Vince, putting it into current perspective by reviewing the MU success of its customers and how its practices parallel those of Meditech and Epic. Next up is NextGen’s inpatient division, so connect with Vince if you can help him out with background information.


Contacts

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

More news: HIStalk Practice, HIStalk Mobile.

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8 Responses to “Monday Morning Update 12/10/12”

  1. 1
    Minnie Schwartz Says:

    From CFO of a wealthy foundation to the ONC, Kunzman does not escape scrutiny. What a coincidence that QIT was spawned!!

    The Jewish Healthcare Foundation came about from the funds UPMC Presbyterian paid for the purchase of the then Montefiore Hospital. The use of the funds for this purpose is in violation of the original charitable patient oriented specifications for this charitable body.

    There just may be a financial conflict for Kunzman that should be vetted. This in addition to fact that several employees and BOD members from UPMC are on the BOD of the Foundation.

    They threw in the scholarship to give the illusion that it is charitable, when in fact, it will provide the IT education for UPMC employees and executives as if it were charity.

  2. 2
    Not Tired of Suzy, RN Says:

    From your reference on QIT: “‘HIT [health information technology] is here and it’s here to stay,’ said Jason Kunzman, deputy director of the Office of the National Coordinator for Health Information Technology with the U.S. Department of Health and Human Services in Washington, D.C. Mr. Kunzman also is the former CFO of the Jewish Healthcare Foundation.”

    I just love that mantra that I read and hear so often: “HIT is here to stay”.

    Sooooo, who are they trying to convince, and why, exactly?

    It sort of gives a sense that they are worried, and with good reason, when one studies what happened in the UK.

  3. 3
    Bill Rieger Says:

    Do scribes = savings? I think it is arguable. ED systems should be designed to create and support efficiency, not require transcription like services to keep up. #wehavealongwaytogo

  4. 4
    Randall Oates, M.D. Says:

    The only thing more wasteful than dictation-transcription is turning physicians into distracted data trolls or giving them 2-3 hours of homework per work shift. It takes physicians an average of 9 times longer to create documentation if they are the ones filling in structured templates. However, many EHR systems can be designed to throw in piles of cloned/templated information and the doctor as data clerks can get the waste down to probably 4-5 minutes per encounter. Designing systems so that the physicians can be doctors and not overpriced clerks will be a key to success. In-the-room scribes can sometimes be a step in the right direction, but redesigned EHR interfaces that move the structured data management to the care team, patients, and real-time remote super-scribes will soon liberate docs from the tecnology and leave no doctor behind.

  5. 5
    Johnny B Says:

    @Randall
    Where is your data coming from on these points? While I don’t completely disagree with you, is it really 2-3 hours of homework that each ED provider is doing? With the generalizations that you’ve included, it’s hard to get your point about super-scribes.

  6. 6
    CPSI Employee Says:

    Thank you for a very accurate story on CPSI. They have always been successful by hiring the inexperienced, indoctrinating them, and working them until they burn out completely (I think we’re all familiar with who that sounds like). While that works from a business perspective, it happens at the expense of the employees, and more importantly, the customers. Because they expect and budget for 60 – 80% turnover of new hires within the first 2 years, the supporters and installers who actually know something are few and far between. Furthermore, CPSI doesn’t want their customers to know the majority of these employees are brand new; they actually require their employees to tell clients they have been there at least one year, more if they are comfortable with lying.

    CPSI truly was a great place to work until they decided to go public, which was when the primary objective of “making more money” superseded “treat the customers and employees fairly.” Now maintaining the status quo and doing as little as possible to the system is standard (including not fixing long-known bugs and flaws, because programming resources are expensive and the shareholders expect a dividend this quarter). For their employees, they have gone from giving bonuses and throwing elaborate holiday parties, to donating the money they would have spent on those things to charity, to simply pocketing the money without a word. Last year they made the decision to close the corporate office on Christmas Eve and New Year’s Eve (which they typically don’t do), but instead of giving their employees those days off, they mandated that employees use their personal time off, with no choice otherwise. Overtime is paid at a declining rate (starting with your normal hourly rate, the more you work the more it declines). Travel is done on weekends. System flaws are ignored. Travelling employees must use their own personal laptops during installs, because they don’t want to spend the money to issue them.

    Upper management stays insulated and paints a nice picture for their shareholders, but in the meantime customers and employees are footing the bill for this success (and I have been both). Of course every company has its pros and cons. You can label me a bitter dissenter, and that may be true to a point, but look at employee reviews on websites like Glassdoor.com to get an accurate picture of employee satisfaction.

  7. 7
    Randall Oates, M.D. Says:

    @Johnny B
    Many published studies have shown that physicians are now averaging 2-3 house of typing/pointing/clicking/navigating/frustrating that they were not doing back in the dictation days. The Anderson Group did a survey that reveals that documentation with structured templates takes an average of 9 times longer than dictation. If a one minute dictation is turned into 9 minutes x 25 patients, then there goes about 3 hours. Of course, the docs can “text” while seeing patients with the same risks as texting while driving, or they can throw in a bunch of cloned data to get the time waste down a bit. While this may always be validated information, it does keeps a whole industry of EHR customizers employed. It’s too bad as a clinician trying to take care of patients that there is often only a paragraph of unique and useful information buried somewhere within the equivalent of 5-6 pages if printed. And this is how we are improving care?
    Fortunately, new methodologies and user interfaces allowing for real time, remote super scribes to take care of the data entry/navigation are now available so that all the doc needs to do is carry around an iPad to review and sign off on information created and entered elseware. They can actually see more patients with less distraction and less total work. Everyone wins with this, but obsolete systems and old habits die hard.

  8. 8
    MIMD Says:

    Re: CPSI Employee – “Thank you for a very accurate story on CPSI. They have always been successful by hiring the inexperienced, indoctrinating them, and working them until they burn out completely…System flaws are ignored….etc.etc.”

    I have asked for the slideshow and additional comments to be passed to the medical malpractice plaintiffs’ attorney listserv.

    After all, they are probably the only ones representing patient’s rights and interests in the current health IT mania.

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