MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'clinical decision support'. Sat, 03 Sep 2011 02:36:16 +0100 http://www.medworm.com/index.php?rid=5139934&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FMRIneOML2vQ%2F As I heard at AHIMA’s Legal EHR Summit earlier this week, clinical decision support isn’t a perfect science. (Check InformationWeek Healthcare for coverage on Thursday or Friday.) This is especially true when doctors rely too much on Google and don’t actually verify what they find on the Internet. This may sound hard to believe, but not everything posted online is true. Now, the notion that doctors guess with Google has made its way onto the funny pages, specifically in the cartoon Sherman’s Lagoon. To wit:     Hopefully, your own doctor is more qualified than Hawthorne. Related posts:Tasteless joke, but kind of on the mark How doctors use Twitter RIP, Google Health, doomed to fail from the start (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=5139934 Thu, 18 Aug 2011 05:41:54 +0100 5139934 http://www.medworm.com/index.php?rid=5057722&cid=t_99668_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-new-details-about-the-fda-regulation-of-mhealth-apps%2F2011.07.23 Since the beginning of this year, there have been clues that the FDA will be heading toward clarification of the complex regulatory issues posed by mobile health devices and software. We have previously reported on testimony and public comments by Dr. Jeffrey Shuren, director of the  FDA’s Center for Devices and Radiological Health (CDRH) alluding to coming guidelines. Today, the FDA finally released a detailed draft guidance of how it intends to regulate this rapidly exploding sector of mobile medical devices and software. This is what the Emergo group, regulatory compliance consultants, has gleaned from today’s FDA press release: (more…) *This blog post was originally published at iMedicalApps* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=5057722 Sat, 23 Jul 2011 16:00:04 +0100 5057722 http://www.medworm.com/index.php?rid=4921557&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F06%2F05%2Femr-and-hipaa-quote-of-the-sunday%2F Lately I’ve been posting a number of tweets in a sort of Sunday Tweet roundup. I think it’s been fun to highlight some short Healthcare IT and EMR related tweets that people might find interesting. With a little bit of commentary of my own (let me know if you disagree). Today, I decided I’d just go with a small quote from a comment that Chris Paton made over on Neil Versel’s Meaningful Healthcare IT News. Here it is: We’re a long way from getting rid of doctors but they might find their role changes from being repository of all knowledge to being a trusted communicator and carer. I’d been trying to summarize this position in a coherent way and I think Chris hit it on the head. Not only the part about being a long way from getting rid of doctors, but his desc... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4921557 Mon, 06 Jun 2011 06:59:22 +0100 4921557 http://www.medworm.com/index.php?rid=4893605&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2F0g_GyIRAV-M%2F In just the last few hours, I’ve seen a huge wave of pushback and doubt about Watson, the IBM supercomputer, being used for clinical decision support. Yesterday, I covered a “healthcare leadership exchange” at IBM’s new Healthcare Innovation Lab in downtown Chicago. I posted some of my observations on the EMR and HIPAA blog, and made the case for diagnostic decision support. I also wrote a story for InformationWeek, but that hasn’t run. Instead of posting my story, InformationWeek healthcare editor Paul Cerrato wrote a column about Watson already being “beaten in the medical diagnostics race” by Isabel Healthcare, a diagnostic decision support tool that’s been available for years. I have to admit, he’s right. I first interviewed Isabel ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4893605 Sat, 04 Jun 2011 00:37:50 +0100 4893605 http://www.medworm.com/index.php?rid=4921559&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Fneil%2F2011%2F06%2F02%2F4742%2F I’m beginning to see a pattern here. Two weeks ago, I wrote about clinical decision support in context of Dr. Larry Weed’s new book. Two weeks before that, I commented about physicians worrying that patients would perceive them as being incompetent if they relied on CDS. Today, I’m back to the same topic. Deny the obvious all you want, physicians, but clinical decision support is coming, and once it’s here, it’s not going away. I just got back back from the new IBM Healthcare Innovation Lab in downtown Chicago, the company’s third such center in the U.S. and eighth worldwide. While kickoff included a “healthcare leadership exchange” with such thought leaders as HIMSS CEO Steve Lieber and Allscripts Healthcare Solutions Chief Innovation Office... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4921559 Thu, 02 Jun 2011 21:10:40 +0100 4921559 http://www.medworm.com/index.php?rid=4862665&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FJa0I4VDCMDE%2F I’m sure like many of you, I was completely intrigued by the demonstration of the Watson computer competing against the best Jeopardy! stars. It was amazing to watch not only how Watson was able to come up with the answer, but also how quickly it was able to reach the correct answer. The hype at the IBM booth at HIMSS was really strong since it had been announced that healthcare was one of the first places that IBM wanted to work on implementing the “Watson” technology (read more about the Watson Technology in Healthcare in this AP article). Although, I found the most interesting conversation about Watson in the Nuance booth when I was talking to Dr. Nick Van Terheyden. The idea of combining the Watson technology with the voice recognition and natural language processing ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4862665 Wed, 25 May 2011 15:59:50 +0100 4862665 http://www.medworm.com/index.php?rid=4848022&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2F2dCY8-XWSbI%2F It’s Friday afternoon, and I realize it’s been days since I’ve posted here. (Make sure you catch my posts on EMR and HIPAA every Thursday, including my latest on Dr. Larry Weed and his critiques of current health IT systems.) I think it’s time for a rundown of some interesting developments this week. Weed apparently is not the only one who’s disappointed in the pace of change in healthcare. Dr. Bill Crounse, senior director of worldwide health for Microsoft, was at the World of Health IT conference in Budapest, Hungary, to deliver some scathing remarks at about North American health IT. According to Canadian Healthcare Technology, Crounse called the U.S. and Canada the “worst of the worst in the industrialized world in the use of IT in healthcare.”... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4848022 Fri, 20 May 2011 19:32:13 +0100 4848022 http://www.medworm.com/index.php?rid=4848026&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F_97v-o6BSOE%2F Sometimes it’s better to be lucky than good. Last month, in my very first post for EMR and HIPAA, I mentioned Dr. Larry Weed in my commentary about the general public’s perception of clinical decision support. I referred to a 2007 study in the journal Medical Decision Making, which said, “Patients may surmise that a physician who uses a [decision support system] is not as capable as a physician who makes the diagnosis with no assistance from a DSS.” I then noted that Weed has been saying for more than 50 years that physicians shouldn’t have to rely on their memory to make clinical decisions when computers can help them process an increasingly voluminous knowledge base. As it turns out, Weed read my commentary. (I’m guessing that a computer, i.e., Google Aler... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4848026 Thu, 19 May 2011 21:24:27 +0100 4848026 http://www.medworm.com/index.php?rid=4813404&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FWNwZU_GkVps%2F Oh man, I’ve been busy. I filled in as writer of the Midwest edition of Payers and Providers the last two weeks because regular editor Duncan Moore, a former colleague, had been hospitalized. (Get well soon, Duncan.) I’ve been at the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla., since yesterday, and I’ve also had my regular deadlines for InformationWeek and MobiHealthNews. I moderated two IHT2 conference sessions yesterday, on how health IT underpins Accountable Care Organizations and how business intelligence can create a framework for health information exchange. I haven’t had time to blog about those, but several people seem to have tweeted during those sessions. I therefore present a rundown via Twitter. @narmi91 #iHT2... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4813404 Thu, 12 May 2011 00:13:28 +0100 4813404 http://www.medworm.com/index.php?rid=4794927&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FK8wwkSlT1Zg%2F Neils’ article about Unrealistic Expectations about Clinical Decision Support made me think of how important the ability to know where to find the information can be in so many different situations. In fact, memorization of where to search might be more valuable and useful than strict memorization of everything. The core point is that with very rare exception, the human mind can only store and recall so much information. However, if you only have to remember where to find a certain piece of information, it’s much easier to remember. For example, many of my readers probably don’t realize that I have a network of TV blogs. I get a lot of credit on those websites for listing out the music for those shows. Funny thing is that I’m not all that good at identifying songs. ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4794927 Fri, 06 May 2011 17:43:44 +0100 4794927 http://www.medworm.com/index.php?rid=4753798&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F0KFMueXj3ss%2F CPOE (Computerized Provider Order Entry), is the direct entering of orders into a computer (or mobile device), so that the order is documented in a digital, structured, and computable format. Meaningful Use Core Measure: CPOE More than 30% of unique patients with at least one medication in their medication list seen by the EP have at least one medication order entered using CPOE. Exclusion: providers who write fewer than 100 prescriptions during the reporting period. CPOE is one of the measures that elicited quite an animated response from the provider community. When initially proposed, this measure required 80% of all orders to be directly entered by the provider. To overcome objections to the scope of the requirement and the burden it would impose, CMS ultimately limited the measure to ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4753798 Mon, 25 Apr 2011 15:41:02 +0100 4753798 http://www.medworm.com/index.php?rid=4742491&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FIfPULHEeSYs%2F Since I’m starting to write a lot of daily/breaking news, I’m going to try something new today that might become a regular Friday feature: posting my week in review. It will consist of a quick rundown of stories I’ve written this week. Here goes: Monday “Patient Safety Initiative To Leverage Health IT: The $1 billion federal Partnership for Patients initiative aims to cut $35 billion in healthcare costs, save 60,000 lives, and decrease hospital-acquired conditions by 40% by 2013.” (InformationWeek) Tuesday “Medicare Opens EHR ‘Meaningful Use’ Attestation” (InformationWeek) “How mobile health can abide by HIPAA” (MobiHealthNews) “State of mobile and wireless healthcare” (video/slides of my recent presentation to M... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4742491 Fri, 22 Apr 2011 17:21:52 +0100 4742491 http://www.medworm.com/index.php?rid=4742492&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FekbeQ5dblLM%2F I’ve just written my first post for the well-established EMR and HIPAA blog, one of the flagship sites for the Healthcare Scene network. (This site belongs to Healthcare Scene as well.) My post is a commentary about public perceptions of clinical decision support and a critique of failures by health IT developers, the healthcare industry and the media to design easy-to-use technology and communicate the purpose of CDS to the public. I’ll be writing weekly for that site, usually on Thursdays. I quote Dr. Larry Weed in that post. If you want more on this pioneer in health informatics and healthcare quality, check out some of my previous posts and stories about him: A must-read from Dr. Weed (April 2009) ‘Isabel’ as a verb? (February 2007) “Realizing the Vision for IT i... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4742492 Thu, 21 Apr 2011 20:46:02 +0100 4742492 http://www.medworm.com/index.php?rid=4747723&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Fneil%2F2011%2F04%2F21%2Fmore-unrealistic-expectations-from-the-public-this-time-involving-cds%2F Yet again, someone needs to educate the general public about healthcare in general and health IT in particular. HealthLeaders last week asked the question, “Does Decision Support Make Docs Look Dumb?” The story, apparently based on a 2007 study (not 2008, as HealthLeaders reported) in the journal Medical Decision Making, says: “Most clinicians would agree that evidence-based decision support tools have the potential to improve clinical quality. But patients’ perception of the tools—and the physicians who use them—might be yet another barrier to their adoption. The problem is twofold: Some patients are skeptical of docs who need a computer to help them make a diagnosis. And some physicians don’t want to be seen as being too reliant on technology.” We’ve... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4747723 Thu, 21 Apr 2011 20:05:53 +0100 4747723 http://www.medworm.com/index.php?rid=4642726&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FB0_WsC3JVZ8%2F Just a reminder, the $3 million Heritage Health Prize competition will kick off on April 4. Sponsored by the Heritage Provider Network in Southern and Central California, the competition is meant to promote innovation in predictive modeling and clinical decision support, with the goal of helping physicians develop care plans to keep high-risk patients healthy and out of the hospital. In a story I wrote for Inside Healthcare IT (formerly Inside Healthcare Computing) in January, I explained that HPN will provide contestants with three years worth of de-identified claims data on 100,000 patients, from which they are expected to develop algorithms to identify high-risk patients. “We’re looking for an algorithm to allow us to predict, based on a person’s history, the likelihood of a perso... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4642726 Mon, 28 Mar 2011 02:29:54 +0100 4642726 http://www.medworm.com/index.php?rid=4626886&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FuP93TL-iZGE%2F The slams on Dr. Donald Berwick, frankly, are getting pathetic. Today, Fox News medical contributor Dr. Marc Siegel dismissed Berwick as a “basically a policy wonk” who “hasn’t really practiced since 1989.” Siegel tried to score points with sound bites. “This guy has more quotes than Yogi Berra, and let me tell you something, these quotes are an indictment on people that want clinicians to make decisions,” Siegel said on Fox this afternoon. Watch the latest video at video.foxnews.com According to Siegel, comparative effectiveness “doesn’t work in the real world.” Well, sure, that’s the point of clinical decision support. Best practices are for common conditions, and clinical decision support is to help physicians either foll... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4626886 Wed, 23 Mar 2011 22:11:49 +0100 4626886 http://www.medworm.com/index.php?rid=4399646&cid=t_99668_113_f&fid=34631&url=http%3A%2F%2Fehealth.johnwsharp.com%2F2011%2F01%2F25%2Fdo-emrs-improve-the-quality-of-healthcare%2F In conclusion, the editorial writers from the National Library of Medicine state, “Only when EHRs carry rich repositories can we expect EHRs to reach their promise and CDS to have measurable effects on a broad range of quality measures at the national level.” My conclusion is that the use of clinical decision support within EMRs can impact quality on a national level but that early implementation of EMRs may take time to demonstrate this impact. (Source: eHealth) eHealth blogs http://www.medworm.com/rss/comments.php?id=4399646 Wed, 26 Jan 2011 03:22:52 +0100 4399646 http://www.medworm.com/index.php?rid=3362454&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2010%2F03%2Fclinical-decision-support-and.html Before I forget, here's a link to a feature story I wrote for the March issue of CMIO. It's about how to decide on which rules to build clinical decision support for when going for meaningful use. (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=3362454 Sat, 13 Mar 2010 03:43:00 +0100 3362454 http://www.medworm.com/index.php?rid=3335441&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F03%2F01%2Fmedispan-clinical-expands-cds-offerings-by-wolters-kluwer-health%2F Since I know I have a number of EMR vendors that read this blog, I know they’ll be interested to learn the news coming out of Wolters Kluwer Health about a new clinical decision support (CDS) offering called Medi-Span Clinical. Here’s a part of the press release announcement: Wolters Kluwer Health, a leading global provider of information for healthcare professionals and students, today unveiled Medi-Span® Clinical, a robust clinical decision support (CDS) platform that delivers the functionality, interoperability and medication-related CDS necessary to advance the practice of evidence-based medicine and to achieve meaningful use of health IT. From the looks of their website page about Medi-Span Clinical, this looks like it’s the announcement of the features that they ha... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3335441 Mon, 01 Mar 2010 12:33:34 +0100 3335441 http://www.medworm.com/index.php?rid=3092778&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FnaQJ3skPWfE%2F “Physician order entry and decision support I believe offer the most chance of improving healthcare delivery. There are a lot of information systems with bells and whistles that don’t focus on physicians’ real needs.” – Neil R. Powe, MD, MPH, MBA, Chief of Medical Services, San Francisco General Hospital source I previously posted about the benefits of EMR interoperability. The above quote touts Physician order entry and clinical decision support as the most likely to improve healthcare. Are these the three most promising features of an EMR or is there something they’re missing? What’s the killer feature of an EMR that will make every doctor implement an EMR whether they like it or not? Related posts:Killer EMR Features According to EMR Vendors I... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3092778 Mon, 14 Dec 2009 16:25:34 +0100 3092778 http://www.medworm.com/index.php?rid=2511549&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F06%2Fanswering-mail.html I have to admit I'm shamefully behind on blogging this week. Between the AMA House of Delegates meeting, deadlines for FierceMobileHealthcare Tuesday and FierceEMR Thursday, plus a dentist's appointment thrown in for good measure, I've been too busy or too tired to post here. I also submitted an entry for the BNET Healthcare blog, but it hasn't been posted yet.Meantime, I've left some people hanging.While I was on the air with news anchor Andrea Darlas of WGN-AM 720 in Chicago to discuss President Obama's speech to the AMA, I promised this link to a story about a high-schooler in Washington state who correctly diagnosed herself in science class with Crohn's disease after doctors were stumped for years. Folks, this is why we need clinical decision support.Fellow blogger Lodewijk Bos of the ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2511549 Fri, 19 Jun 2009 04:17:00 +0100 2511549 http://www.medworm.com/index.php?rid=2405568&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F05%2F10%2Falert-fatigue-and-clinical-decision-support%2F Clinical Decision Support has been called out as an important part of an EMR system. You’ll get no argument from me on this. What I have been thinking a lot about is what people call “Alert Fatigue.” For those unfamiliar with the term, it basically means that a doctor gets so many alerts that they grow numb to the alerts and stop looking at them. For those that are married, it’s like your wife’s nagging. It happens so much that you stop listening (ok, that was a joke. I hope none of us do that or have reached that point. I’m just lucky to have a wife who doesn’t nag). I think this concept of “alert fatigue” is really important and I think it will be impossible to create an EMR that strikes the perfect balance. Some EMR offer too many al... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2405568 Sun, 10 May 2009 16:45:53 +0100 2405568 http://www.medworm.com/index.php?rid=2390015&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FlTTJzcTDQuQ%2F We’re all still sitting here waiting for the government to finally decide two key terms in regards to gaining access to the $18 billion in stimulus money in the HITECH act (ARRA). I’ve been interested in the subject myself since before it was even settled that we’d call it meaningful use as opposed to meaningful EMR user. From the looks of that post back in February, there was still a lot of confusion about “meaningful use” and “certified EHR.” Turns out that a few months later, we still have very little clarification about what these two terms mean. Certified EHR discussion has really revolved around CCHIT certification or some other alternative. We’ll try to leave that discussion for other posts. What has been interesting is in just the pas... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2390015 Tue, 05 May 2009 13:19:39 +0100 2390015 http://www.medworm.com/index.php?rid=2227094&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F03%2Fanother-take-on-clinical-decision.html I've been on a mini kick for clinical decision support since last fall's AMIA annual conference. If you recall, I said medical informatics needed a rock star to spread the word about the link between CDS and proper implementation of electronic health records. Today, while attempting to catch up on a massive backlog of e-mail, I came across a Jan. 26 post from Steve Beller, Ph.D., on the Trusted.MD blog network. Beller writes about including consumer-centric cognitive support in the next generation of CDS systems, and he has started to put together a PowerPoint presentation on defining his goal and thoughts on how to achieve it.I'd love to hear your thoughts. (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2227094 Mon, 02 Mar 2009 17:10:00 +0100 2227094 http://www.medworm.com/index.php?rid=2240786&cid=t_99668_113_f&fid=34621&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthcareGuy%2F%7E3%2FLoYGpik98o4%2F485 This article is the first in a series about the challenges of clinical interoperability in healthcare. The first thing we need to do is ask the question “What is clinical interoperability?” The Institute of Electrical and Electronics Engineers or IEEE defines the term interoperability as follows: The ability of two or more systems or components to exchange information and to use the information that has been exchanged. I like this definition because it is short and sweet, but to truly understand interoperability, we need to go a little further. The first thing we need to do is add that clinical interoperability is about exchanging a specific type of information.  It is about exchanging clinical information about a patient that allows our ‘partner’ to leverage what we alread... The Healthcare IT Guy blogs http://www.medworm.com/rss/comments.php?id=2240786 Tue, 24 Feb 2009 12:55:37 +0100 2240786 http://www.medworm.com/index.php?rid=2152809&cid=t_99668_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F02%2F02%2Fcchit-certification-thoughts%2F I just came upon a blog post on the TempDev blog that talks about the expansion of CCHIT certification into a number of new specialty categories. It’s really interesting to look at the list of new categories: Behavioral Health Clinical Research Dermatology Oncology Advanced Interoperability Advanced Quality (in reference to Quality Measures) Advanced Clinical Decision Support Long Term Care OB/GYN As noted by Ben, these are in addition to the HIE and PHR categories added for 2009. Well, I never back away from a discussion about CCHIT. I just wonder why the Senate hasn’t called me up to a hearing to talk about CCHIT certification. Of course, my friend Al Borges would do much better than I, but I digress. After reading through Ben’s post about the expansion of CCHIT I had... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2152809 Tue, 03 Feb 2009 07:35:07 +0100 2152809 http://www.medworm.com/index.php?rid=2110496&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F01%2Fits-officially-epidemic.html From Urban Dictionary:academic bulemia [sic]The process of learning or memorizing by rote, subsequently followed by the regurgitation of that knowledge onto an exam answer sheet. Just as with the serious eating disorder, this form of bulemia [sic] results in no real retention of substance.This term is frequently applied to describe a common practice of young medical students.I can't remember anything that I learned last night. It's like I grabbed the answer sheet, puked out all the answers and forgot everything immediately. I'd say that's academic bulemia [sic].As of this writing, the "score" for this definition was 6757 up and 833 down, so I'd say it's pretty well accepted, even if the spelling of "bulimia" is wrong.Anyone care to guess now why there are so many medical errors in teaching... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2110496 Sat, 17 Jan 2009 04:36:00 +0100 2110496 http://www.medworm.com/index.php?rid=2086801&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F01%2Fmodest-feedback.html A couple of months ago, I posted, "A modest proposal," my observations about a session on clinical decision support from the American Medical Informatics Association annual meeting. In it, I argued that medical informatics needed a rock star of sorts to help humanize the issue of clinical decision support and communicate the benefits of such technology to the general public.I got three comments on that post—actually pretty high for this blog—as well as several e-mails. One correspondent said we need more than a rock star, we need the whole band. I passed that comment on to Dr. Bill Bria, CMIO of Shriners Hospitals for Children, who was part of the panel at the AMIA meeting, who told me that he once led an all-physician rock band called the Straight Caths. It still may take the Rolling ... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2086801 Wed, 07 Jan 2009 07:25:00 +0100 2086801 http://www.medworm.com/index.php?rid=1960479&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F11%2Fmodest-proposal.html Medical informatics needs a rock star. Not a David Brailer-esque figure who could excite people in the technology sphere, but perhaps a Don Berwick type who can reach every level and constituency of healthcare, and even capture the imagination of the general public.I had this thought yesterday during a highly engaging session at the American Medical Informatics Association's annual symposium in Washington, a session with the mouthful of a title, "Harnessing Mass Collaboration to Synthesize and Disseminate Successful CDS Implementation Practices." In English, that means panelists were discussing the forthcoming "Improving Outcomes with Clinical Decision Support: An Implementer’s Guide" and related feedback mechanisms, including a wiki.During the session, panelists discussed the difficulti... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1960479 Fri, 14 Nov 2008 00:47:00 +0100 1960479 http://www.medworm.com/index.php?rid=1634782&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F07%2Famdis-notes.html This article certainly is an attention-grabber, listing the optimism about meeting the goal of getting interoperable EHRs to most Americans by 2014 among a number of "health informatics myths."If you want an impassioned defense of the national health IT strategy, check this space in the next 24 hours for my podcast with national health IT coordinator Robert Kolodner, M.D., who spoke at this conference yesterday. This might be my biggest podcast "get" to date. (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1634782 Thu, 17 Jul 2008 16:41:00 +0100 1634782 http://www.medworm.com/index.php?rid=1207163&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F02%2Fpriorities.html What would be my blog without a random item from weeks ago? On Tuesday I discovered a news story from Dec. 31 about an e-health strategy in Rwanda. The U.S. Centers for Disease Control and Prevention reportedly is helping to fund the installation of Internet links between the three major hospitals in the Central African country, known in these parts mostly for its 1990s civil war and genocide.According to the story, lack of high-speed Internet is holding back a national e-health strategy, "meant to help Rwandan medical experts exchange health information with their overseas counterparts." Those overseas counterparts included "two U.S. universities of George Washington and New Jersey." So George Washington University in Washington, and, I presume, the University of Medicine and Dentistry of... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1207163 Wed, 06 Feb 2008 06:35:00 +0100 1207163 http://www.medworm.com/index.php?rid=1045032&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2007%2F11%2Ftasteless-joke-but-kind-of-on-mark.html Since it's Thanksgiving here in the states, you'd rather laugh than work, right? In case anyone was wondering if the Wal-Mart retail clinic idea is getting any traction, here's a joke from an e-mail recently forwarded to me. (File this under clinical decision support.):One day, in line at the company cafeteria, Joe says to Mike behind him, "My elbow hurts like hell. I guess I'd better see a doctor." "Listen, you don't have to spend that kind of money," Mike replies. "There's a diagnostic computer down at Wal-Mart. Just give it a urine sample and the computer will tell you what's wrong and what to do about it. It takes 10 seconds and costs $10 — A lot cheaper than a doctor." So, Joe deposits a urine sample in a small jar and takes it to Wal-Mart. He deposits $10, and the computer lights u... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1045032 Thu, 22 Nov 2007 06:59:00 +0100 1045032 http://www.medworm.com/index.php?rid=760352&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2007%2F07%2Fcdscat-decision-support.html I'm sure the national media is jumping all over a "Perspective" essay in the July 26 New England Journal of Medicine about a cat named Oscar (at right) at Steere House Nursing and Rehabilitation Center who has "an uncanny ability to predict when residents are about to die," the report says."His mere presence at the bedside is viewed by physicians and nursing home staff as an almost absolute indicator of impending death, allowing staff members to adequately notify families," writes David M. Dosa, M.D, a geriatrician at Rhode Island Hospital in Providence.According to an Associated Press/Yahoo story, Oscar recently received a wall plaque publicly commending his "compassionate hospice care."I guess if you don't have advanced information systems with full clinical decision support, you rely on... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=760352 Thu, 26 Jul 2007 16:27:00 +0100 760352 http://www.medworm.com/index.php?rid=462246&cid=t_99668_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2007%2F02%2Fisabel-as-verb.html Will "Isabel" become a verb, much in the way "Google" has? A Fox News story from December on Isabel Healthcare, developer of a diagnostic decision support engine, suggested that it already has. The correspondent, Dr. Christine Dumas, says that clinicians in some hospitals routinely ask, "Did you Isabel this?" Unfortunately, the 2-minute piece does not include an interview with anyone at Isabel, nor does it mention any other clinical decision support companies. (Insert "fair and balanced" joke here.) I'll be speaking with the company at HIMSS in a couple of weeks.A much more in-depth piece of TV reportage on healthcare quality comes from none other than Katie Couric. The CBS Evening News anchor interviewed safety guru Dr. Don Berwick in a report that aired last week. The link takes you to a... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=462246 Tue, 13 Feb 2007 05:28:00 +0100 462246