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Monday Morning Update 7/18/11

July 17, 2011 News 7 Comments

From Brass Tacks: “Re: Danbury Hospital. They fired the CFO over this.” Former Danbury CFO William Roe is sentenced to 33 months in federal prison for embezzling $200,000 from Danbury Hospital (CT) and former employee St. Rita’s Medical Center (OH) by approving invoice payments to a fake software consulting company he had set up. Roe, who made $594K in 2009, blamed poor judgment and begged for a light sentence. The judge, unimpressed by his two court order violations, said, “Your primary concern is for yourself and your family, who have already benefited from the funds you’ve stolen.”

A New York Times article on usability of clinical systems highlights the usual arguments: usability experts say there’s no question that today’s systems are measurably poorly designed to the detriment of clinician users and patients, while vendors strongly resist the imposition of usability standards or mandatory usability testing.

7-17-2011 12-52-47 PM

Most poll respondents say the person running the company that employs them is honest and honorable. New poll to your right: should the federal government measure and report the usability of clinical systems?

Essentia Health (ND) goes live on Epic’s EHR July 31th.

Gartner positions mobile application development platform provider Kony in the “Visionaries” quadrant of the Magic Quadrant for mobile consumer application platforms.

David Roberts, HIMSS’s VP of government relations, says it is unlikely that Congress would vote to eliminate future funding for EHR Meaningful Use incentives, despite the current current stalemate in federal budget negotiations. To eliminate the incentives, Congress would need to specifically vote to narrow the scope of the program or eliminate the program entirely. Roberts believes that legislation lacks adequate support to be passed in either houses of Congress.

The weekly e-mails of Kaiser Chairman and CEO George Halvorson are often HIT-related, with this week’s no different. Kaiser researchers have published autism-related studies made possible by its extensive patient data warehouse. They found that pregnant woman who used certain drugs greatly increased the odds of having an autistic baby, but vaccines were not among those drugs. They also found that children are dying of whooping cough because they aren’t being given pertussis vaccine.

Here’s the latest installment of HIStory from Vince Ciotti, this time covering vendors of minicomputer systems.

Greenway Medical Technologies files registration to raise up to $100 million in an IPO. Underwriters include Morgan Securities, Morgan Stanley, William Blair, Piper Jaffray, and Raymond James.

7-17-2011 3-20-52 PM

Caristix is offering a free beta program for software that helps hospital integration analysts identify and document custom HL7 interface segments and values.

7-17-2011 1-28-26 PM

Indian River Medical Center (FL) hires as its first CIO Bill Neil, formerly IT director at Presbyterian Healthcare Services (NM).

Scripps Health (CA) chooses Meddius to provide Integration as a Service, replacing its Sybase integration engine.

7-17-2011 2-51-25 PM

Yale New Haven licenses the Rothman Index, which uses real-time clinical systems information to generate a patient score that helps clinicians identify patients whose condition is deteriorating.

UPMC’s living donor kidney transplant program was shut down in May because up to six transplant team members failed to notice a Cerner EMR lab result alert indicating that a donor had undiagnosed hepatitis C. Her kidney was transplanted into a patient who did not have the disease, resulting in the temporary shutdown of the program. The surgeon who did most of the procedures was removed from his position, joining his equally high profile colleague who was fired in an earlier UPMC transplant scandal. A highly regarded transplant nurse was suspended for two weeks. Outside experts blamed generally poor EMR design, saying that UPMC administrators had a “knee-jerk reaction” in removing the surgeon, who had been under pressure to increase procedure volume, instead of examining the system that allowed the error to occur.

7-17-2011 2-46-41 PM

Seven former nurses from Valley Regional Medical Center (TX) sue the hospital, alleging they were fired in retaliation for making good faith reports of unsafe patient conditions. The nurses were terminated for "insubordination" after opposing assignments they claimed endangered critically ill patients. One nurse explained the situation as follows:

"It’s about standing up for your patient. We got into this profession to advocate for our patients… Patients who can’t speak up for themselves… And that’s what we’re trying to do here."

EHRs provide more comprehensive information on health services received than do Medicaid, according to a study published in the Annals of Family Medicine.

Mayo Clinic announces it is close to completing the development of tools that can identify and sort digital health information from any EMR, regardless of file format and data organization. Mayo’s project is funded by the HHS through its $60 million Strategic Health IT Advanced Research Projects (SHARP) program.

Next month CMS will roll out a pilot program for the electronic transmission of documents to support claims. Designated “health care handles” will serve as intermediaries between CMS and providers.

Strange: a city-employed nurse is fired for inappropriately accessing the electronic medical records of hospital patients. She says the real issue is her part-time job as a psychic, where she told patients they were about to experience heart attacks and claimed to be speaking to deceased co-workers from beyond the grave.


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

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Currently there are "7 comments" on this Article:

  1. “A New York Times article on usability of clinical systems highlights the usual arguments: usability experts say…”

    I’d take the “usual arguments” of the guy who wrote the book on human computer interaction (http://www.amazon.com/Designing-User-Interface-Ben-Shneiderman/dp/0201694972), the National Research Council, NIST and the Chair of AMIA / one of the founders of informatics…over the claims of self-interested vendors any day. Just sayin’


  2. Well, you know then but this usability is meaningfullies relavent to my abilities for when poor usabilities, my work as doctor embarrasses me with well, so manymany mistakes. Bad for patients and my reputations for vendors to makes EMRs with user unfriendliness and they do not ever listen.

    And then but, they argue about innovations stymied if they are watched which has become overused and stale, well you know then but, vapid.

    Well you know then but, I read of PUMC hepatitis transplantation and have they been using absent usabilities of their EMR to make such a stupid mistake? Smart transplant users using unusables EMR make to look like idiots by their unusables EMRs. Maybe reporter for NY Times would use hepatitis transplantation as examples of unusabilities and dangers you know then but?

    Thank yous for listening to me.

  3. The report in the Times is interesting. The incidence of my cognitive function has deteriorated since my hospitals have become totally wired. Nuisance and serious mistakes are on the rise, yet, there is not any wheres to report and record them. There is something about the brain, clicker, and computer screeen interaction that stifles my creativity to figure out what is wrong with my patient. When I write and speak (dictate) and verbally communicate with docs and floor nurses, rather than cut and paste progress notes, I am a better clinician. What I would like to see is the establishment of an FDA like (or the FDA itself) as a place to send in reports of my mistakes nd unusable features of the EMRs because companies do not respond and CIOs are helpless.

  4. Re: GinnyR, CRNP

    Actually there already is reporting that can be done using the FDA MAUDE reporting system (Manufacturer and User Facility Device Experience)

    See here: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfmaude/Search.cfm

    If you search by Manufacturer using some of the big EMR companies you will see examples of other reports filed over the years that have been filed by clinical practitioners. Interesting results if you select for example a certain company based in Kansas City for example!

  5. Usability is key for efficiency and adoption, but should be driven by the market and purchase decisions.

    There is no doubt a lack of usability forethought in 98% of healthcare applications. I recommend everyone to try and get a utilization report out of Lawson, PeopleSoft, or Oracle without being medicated.

    There are a couple problems with the current process though, vendors build software for every customer possible, so you end up with features that cloud the path of 90% of the users and most RFP’s do not include usability as a major decision making factor.

    I don’t recommend the government doing this, but an independent third party with no ties to vendors would be helpful.

  6. Agree with MH, Government ratings could turn messy with political pressures.

    Usability is such a key attribute of systems today because of all the choices out there. If vendors want your business they must build user obvious systems.

    By the way Mr. H, it took me 5 seconds more than it should have to submit this comment because I could not find your submit comment button. I would recommend changing the button color to stand out more and move it to the standard right side of the comment field….

  7. Should the FDA drop its regulatory requirements with regard to human factors/usability of medical devices and medical device software?

    Leave it to “the market” and purchases to each assess whether medical devices are leading to critical “use errors” that could harm or kill people?

    Caveat emptor…


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