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 'hie'. Sat, 03 Sep 2011 02:11:49 +0100 http://www.medworm.com/index.php?rid=5139951&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fannouncing-metadata-pilots-realize-pcast-vision Those of you keeping a close eye on the Office of the National Coordinator for Health Information Technology (ONC) and its activities might have noticed the advance notice of proposed rulemaking (ANPRM) that was published on Tuesday, August 9, 2011, requesting public input on a set of proposed metadata standards recommended to ONC by the HIT Standards Committee. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5139951 Thu, 18 Aug 2011 13:25:30 +0100 5139951 http://www.medworm.com/index.php?rid=5096465&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhealth-information-exchange-current-projects-inspiring-future-pathways There’s been a lot of talk lately about the future of health information exchange (HIE)—what it will mean 10, 15 or even 20 years down the road. There is no question that providers recognize the importance of HIE, and realize in combination with electronic health records (EHRs) that it will transform the practice of medicine. The question is whether providers are fully aware of the many HIE projects on the ground right now that already are beginning to impact patient care. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5096465 Thu, 04 Aug 2011 13:07:33 +0100 5096465 http://www.medworm.com/index.php?rid=5077816&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F07%2F27%2Femr-and-meaningful-use-books%2F I must admit that I’m not much of a book guy. Especially since there’s so much free information available on the internet about just about any subject you could want. However, I’ve been quite intrigued by the number of healthcare IT related books that I’ve seen coming out of late. Here’s a quick roundup of some of the ones I’ve seen. Getting to Meaningful Use and Beyond: A Guide for IT Staff in Health Care by Fred Trotter and David Uhlman – I’ve been a big fan of Fred Trotter for a while. So, I’m glad he’s working on this book. Turns out the book isn’t even published, but in Fred Trotter open source style fashion, the book is available for free online right now. Of course, they’re hoping you’ll provide feedback. ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5077816 Wed, 27 Jul 2011 18:46:01 +0100 5077816 http://www.medworm.com/index.php?rid=5008381&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Falaskan-healthcare-it-lessons-learned I'm back from Alaska and I'll post several blogs about my Healthcare IT and personal experiences in the 49th state. Alaska faces many healthcare challenges given its large area (663,268 sq mi) and population of 710,231 residents (as per the 2010 US Census), approximately half of which live in the Anchorage metropolitan area, making Alaska the least densely populated state. Roads are limited, making boat and small plane the only means of transportation to many locations, especially in the western portion of the state. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=5008381 Wed, 06 Jul 2011 13:13:46 +0100 5008381 http://www.medworm.com/index.php?rid=4934456&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Faco-development-provider-driver The proposed CMS regulations on Accountable Care Organizations (ACOs) took the first step in promoting discussions about lowering costs, but how to align these costs between each healthcare stakeholder is still an issue and obstacle, leaving most of us to wonder — how will this all actually work? read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4934456 Tue, 14 Jun 2011 19:50:36 +0100 4934456 http://www.medworm.com/index.php?rid=4911619&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fharmonizing-provider-directory-standards Two weeks ago, I wrote about a strawman for embracing internet-based standards to support the provider directory services needed by health information exchanges. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4911619 Wed, 08 Jun 2011 13:49:07 +0100 4911619 http://www.medworm.com/index.php?rid=4911621&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fnew-apple-developments-will-likely-spur-mobile-health-innovation If you’re reading this blog, you most likely saw the pop-up/interstitial Intel ad that asks “Is Cloud Computing Right for You?” Steve Jobs apparently thinks so. The Apple impresario announced the company’s most talked-about offering, iCloud, at its Worldwide Developers Conference this week, among a number of other new developments that have stirred Apple fans to new heights of evangelism. Mashable.com staffers have been keeping up with conference developments and announcements pretty well. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4911621 Tue, 07 Jun 2011 14:11:59 +0100 4911621 http://www.medworm.com/index.php?rid=4902527&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhit-lessons-learned-scotland My trip to Scotland provided a remarkable opportunity to exchange ideas and experiences. Scotland has nearly 100% adoption of electronic health records among general practioners and is making good progress in hospitals with innovative built/bought inpatient systems. As in most countries, health information exchange is still evolving, but novel databases supporting disease management at the community level and an emergency care summary exchange are already live. Here's what I learned while in Scotland: No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4902527 Wed, 01 Jun 2011 13:33:08 +0100 4902527 http://www.medworm.com/index.php?rid=4862676&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fspinning-rhio-story A recent publication in the Annals of Internal Medicine has gotten quite a bit of attention in Health IT related media: RHIOs struggling to meet Meaningful Use Few RHIOs Meet Basic Criteria for Meaningful Use, Researchers Find No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4862676 Tue, 24 May 2011 14:01:45 +0100 4862676 http://www.medworm.com/index.php?rid=4852987&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fsuperfreakonomics-healthcare-it I recently attended a conference at which Stephen Dubner, co-author of the best-selling books Freakonomics and Superfreakonomics, gave a keynote. Though he was speaking to a room full of email marketers, his story was peppered with anecdotes from the world of healthcare. He specifically, and quite humorously, told the story of Cedars-Sinai’s efforts to encourage doctors to wash their hands more often in an effort to reduce patients’ hospital-acquired infections. No sticky read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4852987 Mon, 23 May 2011 12:48:05 +0100 4852987 http://www.medworm.com/index.php?rid=4820952&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FD3BF4RAkszU%2F Healthcare and health IT are plagued by conundrums. Providers long have been the ones asked to make hefty investments in EMRs and other IT systems to help remove costs from the healthcare system, but payers and plan sponsors tend to enjoy most of the financial benefits. Clinicians wish their organizations would share data with others, but those in the executive suite have been reluctant to cooperate with competitors for fear of losing revenue. And, let’s face it, medical errors can be profitable if a routine procedure turns into an expensive inpatient admission. Portions of the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act are intended to address these problems by providing financial incentives for “meaningful use” of EMRs (incl... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4820952 Thu, 12 May 2011 21:45:30 +0100 4820952 http://www.medworm.com/index.php?rid=4789382&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Fneil%2F2011%2F04%2F28%2Fchicago-hospitals-embark-on-long-hie-journey%2F I live in Chicago, a highly competitive healthcare market with some world-class medical schools (Northwestern, University of Chicago, Loyola, Rush) and a pretty decent record of EMR adoption. At least four major institutions/health systems run similar Epic EMRs: University of Chicago Medical Center, Northwestern Memorial Hospital, Rush University Medical Center and, in the northern suburbs, NorthShore University HealthSystem (formerly Evanston-Northwestern Healthcare). Three NorthShore hospitals–Evanston Hospital, Glenbrook Hospital and Highland Park Hospital–were among the first in the country to reach Stage 7 on the HIMSS Analytics EMR Adoption Model.(NorthShore’s Skokie Hospital since has reached Stage 7). Several others, notably Rush, Advocate Lutheran General Hospita... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4789382 Thu, 28 Apr 2011 21:01:25 +0100 4789382 http://www.medworm.com/index.php?rid=4684485&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FsIIYXgtP5I8%2F Healthcare IT News just published its list of top issues for health plans in 2011: 1. Administrative Mandates (Compliance HIPAA 5010, ICD-10, etc.). 2. Care Management, Data Analytics, and Informatics. 3. Health Insurance Exchanges and Individual Markets. 4. New Provider Payment & Delivery Systems (ACOs, PCMHs, etc.). 5. Bend the Cost Trend. 6. Medicare and Medicaid. 7. Health Information Exchanges and EMRs. 8. Consumer’s Role in the Modernization of Healthcare. 9. Reform Uncertainties. 10. Payer/Provider Interoperability. Dear health plan colleagues, Wake up! The order of this list is totally out of whack. #2: Care Management, Data Analytics, Informatics. Good…sounds about right. However, #2 can’t happen before you address: #7: HIEs and EMRs #10: Payer/Provider ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4684485 Tue, 05 Apr 2011 18:15:37 +0100 4684485 http://www.medworm.com/index.php?rid=4684482&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F4a7BPdYBVDY%2F John’s Note: The following is a guest post by Mark Segal talking about the recently announced ACO program and it’s relationship to EHR, meaningful use, and healthcare IT. I also love the insider look at rule making. The long-awaited proposed rule on Medicare’s Shared Savings Program (SSP)/Accountable Care Organization (ACO) program is out. These 429 pages outline how the Administration plans to transform U.S. health care delivery from fee-for-service to a value-based emphasis on accountability for quality and efficiency of care provided for populations. Following a final rule later this year, the program is to start January 1, 2012, with additional January 1 annual starts by ACOs, and a special optional start possible for July 1, 2012 given the tight timing this year. CMS so... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4684482 Tue, 05 Apr 2011 17:21:54 +0100 4684482 http://www.medworm.com/index.php?rid=4482846&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fn_8NskSrwx4%2F There’s a pretty fierce battle going on right now between all the various stakeholders interested in exchanging patient data. The stakeholders range from very large companies to government initiatives to startup companies. One of the major problems that I see is that it’s not completely clear which model of patient data exchange will win out. In fact, let’s not be surprised if a number of different options take hold. With this said, I found it interesting that my favorite open source healthcare IT advocate, Fred Trotter, has chosen to get behind the Direct Project. In Fred’s post describing the challenges with the IHE-protocol HIE model approach is flawed and that the direct exchange of healthcare information is the way to go. In fact, he provides the following two ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4482846 Tue, 15 Feb 2011 20:09:45 +0100 4482846 http://www.medworm.com/index.php?rid=4433159&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2F2011-predictions-mu-goes-tactical-aco-strategic In the Healthcare IT (HIT) market, 2010 was the year of meaningful use (MU). Healthcare organizations (HCOs) of all sizes developed plans, began making IT modifications and began adopting the technology they needed to meet Stage One MU requirements and subsequently receive incentive payments, some of which began being disbursed in late 2010. read more (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=4433159 Thu, 03 Feb 2011 18:53:35 +0100 4433159 http://www.medworm.com/index.php?rid=4318395&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2011%2F01%2F04%2F2011-emr-prognostications-and-predictions%2F While I admit that I’m much more suited to comment on other people’s prognostications and predictions for EMR and health care IT in 2011, I decided to throw caution to the wind and try and make some predictions for the EMR world in 2011. Few EMR Vendor Acquisitions – I predict that acquisitions of EMR vendors will actually slow down in 2011. Certainly there needs to be some EMR company consolidation with 300+ EMR companies out there right now (and it seems more coming every day). However, I think 2011 will be a wait and see period where companies want to see how the various EMR companies perform for their clients interested in getting the EMR incentive money. The only thing that might ruin this prediction is that if many of the 300+ EMR companies have issues selling produ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4318395 Tue, 04 Jan 2011 19:07:37 +0100 4318395 http://www.medworm.com/index.php?rid=4225429&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fwww.wvhin.org%2FPrivacy_and_Security%2FDocuments%2FPrivacy%2520and%2520Security%2520Policies%2520for%2520Public%2520Comment%2FPatient%2520Consent%2520-%2520General.pdf The West Virginia Health Information Network (WVHIN), West Virginia's health information exchange, has issued proposed privacy and security policies and is seeking public comments on the proposed policies from December 3, 2010 through January 3, 2011. The WVHIN is a public/private partnership created in 2006 under W.Va. Code 16-29G-1 et seq. and is charged with building a secure electronic health information system for the exchange of patient data among physicians, hospitals, diagnostic laboratories, other care providers, and other stakeholders.The proposed privacy and security policies that are available for review and comment are as follows:Patient Consent - GeneralPatient Consent - Permissible Purpose Patient Consent - Sensitive Health InformationUser AuthorizationUser AuthenticationPat... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=4225429 Thu, 02 Dec 2010 15:02:03 +0100 4225429 http://www.medworm.com/index.php?rid=4119190&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FvlXfojwrFQs%2F Yesterday Surescripts announced their new Clinical Interoperability Services: Extended Network Connectivity – As a network of networks, Surescripts will support and enable the exchange of all types of clinical messages between EHRs, HIEs and health systems that, today, are not connected with each other. Net2Net Connect – Allows health systems and technology vendors that already support clinical information sharing within their network to connect to Surescripts in order to receive and send clinical information outside their network (December 2010). Message Stream – Secure messaging tools for health systems and technology vendors to enable their physicians to electronically exchange clinical information (December 2010). Clinical Message Portal – Simple connectivity tools intended f... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4119190 Wed, 27 Oct 2010 00:04:26 +0100 4119190 http://www.medworm.com/index.php?rid=4098122&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FPhoA0bPGIvk%2F Tuesday, Oct. 26, 1-2 p.m. Eastern Time — Presented by the Care Continuum Alliance Federally supported “Beacon Communities” are at work now defining how health information technology will support accountable, evidence-based care in communities – especially for care of chronic conditions. Backed by $235 million in federal grants, 15 communities across the country are serving as Beacon Community pilots for eventual wide-scale, performance-based use of technology to improve our health care delivery system. The goal of the webinar is to address The fundamental nature and vision of the Beacon Community Program How the Beacon Program will influence nationwide delivery system reform and be a guide-path toward developing community infrastructures Other implications for the fu... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4098122 Fri, 22 Oct 2010 22:09:34 +0100 4098122 http://www.medworm.com/index.php?rid=3983449&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F09%2F15%2Fno-sign-for-healthcare%2F I recently heard Arien Malec from ONC summarize the biggest challenge of Healthcare Information Exchange (HIE) in one simple phrase: There’s no @ sign for healthcare It’s a really basic idea, but sadly cuts straight to one of the core reasons HIE isn’t happening. We don’t have a great way to authenticate, verify and address health information to another provider. Twitter has created this interesting concept of using @ to specify people. For example, you can find me @techguy and @ehrandhit. It’s amazing how quickly Twitter has created a whole new set of addresses where we can communicate with other people. Certainly it’s not designed for healthcare, but it’s amazing that they could create this whole new address system for people and organizations. A... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3983449 Wed, 15 Sep 2010 16:11:26 +0100 3983449 http://www.medworm.com/index.php?rid=3899484&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fassessment-ingenix-makes-hie-move-acquiring-axolotl Last week, Ingenix announced that it would be acquiring Axolotl. Probably no one was happier than the folks at Gilat Satellite Networks who had invested $4.5M in Axolotl over ten years ago, had written off that investment during the dot-com bust in 2001 and now is looking at getting some $24M in cash plus another $3M by year’s end. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3899484 Tue, 24 Aug 2010 13:20:29 +0100 3899484 http://www.medworm.com/index.php?rid=3876746&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F08%2F16%2Fingenix-acquires-hie-provider-axolotl%2F It seems like it’s the season of acquisitions for healthcare companies. I’ve been predicting the need for EMR consolidation for a while now, but we have yet to really see that happening. Instead this acquisition by Ingenix is entrance into the HIE space. Here’s a section of the press release: Ingenix, a leading health information technology and services company, today announced it is acquiring Axolotl, a leading provider of health information exchange (HIE) services. The combined company will enable health information to be shared effectively and securely for the benefit of patients and health care professionals. The Axolotl management team will remain in place and will lead Ingenix’s efforts in health care community connectivity. Seems like all the major EMR players ar... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3876746 Mon, 16 Aug 2010 21:06:58 +0100 3876746 http://www.medworm.com/index.php?rid=3823005&cid=t_150880_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fhies-public-interest The Health Information Exchange (HIE) market is the Wild West right now.  Vendors are telling us that they are seeing an unprecedented level of activity both for private and public HIEs.  Private HIEs are being set-up by large and small healthcare organizations to more tightly align affiliated physicians to a hospital or IDN to drive referrals and longer term, better manage transitions in care in anticipation of payment reform.  Public HIEs are those state driven initiatives that have blossomed with the $560M+ of federal funding via the HITECH Act. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3823005 Wed, 04 Aug 2010 12:44:46 +0100 3823005 http://www.medworm.com/index.php?rid=3683730&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fwww.samhsa.gov%2FHealthPrivacy%2Fdocs%2FEHR-FAQs.pdf The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Office of the National Coordinator for Health Information Technology (ONC) announced last week the release of FAQs for Applying the Substance Abuse Confidentiality Regulations to Health Information Exchanges (HIEs). Cover letter regarding the FAQs by Pamela S. Hyde, the Administrator of SAMHSA, and David Blumenthal, National Coordinator for ONC. The letter describes that the the Substance Abuse Confidentiality Regulations under 42 CFR Part 2 were enacted years ago (circa 1975). Due to the age of the regulations SAMHSA and ONC created the FAQs to provide guidance and understanding of the scope of these regulations in the context of today's move toward an electronic health information system. The FAQs outline the ... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3683730 Mon, 21 Jun 2010 18:50:11 +0100 3683730 http://www.medworm.com/index.php?rid=3678591&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F06%2F10%2Fallscripts-acquisition-of-eclipsys%2F I’m going to be a little lazy today and just give you a couple links to the story of yesterday. I guess I get busy sometimes too. In case you missed it, the BIG news yesterday was Allscripts acquisition of Eclipsys. I posted most of the relevant links on EMR and EHR yesterday along with some interesting user comments about the deal. Also, if you like this stuff, you’ll enjoy this lengthy analysis that was done on HISTalk about the acquisition. Here’s my thoughts after reading the HISTalk analysis: “After this merger, the new company will be trying to support eight EMRs systems and five practice management solutions with a sprinkling of inpatient technology” Talk about an ugly situation. Plus, this quote doesn’t even highlight all the HIE software they’re dealing w... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3678591 Thu, 10 Jun 2010 17:52:28 +0100 3678591 http://www.medworm.com/index.php?rid=3545514&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F3_WFReWEtTc%2F In my reading, I heard someone bring up an interesting problem with meaningful use stages. As most of you are familiar, the stage 1 meaningful use criteria really focuses on EMR’s having the ability to share patient information, but doesn’t actually require them to share information. In stage 2 and stage 3, my understanding is that the requirements to start sharing this clinical information will be a major part of the criteria. With that understanding, let’s imagine a clinical office spends more than they should on a certified EHR and show stage 1 meaningful use. No doubt they spent a fair amount of time dealing with the reporting requirements of stage 1 meaningful use. As with any EMR implementation they made a lot of changes in their office and for the most part their s... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3545514 Thu, 06 May 2010 15:23:00 +0100 3545514 http://www.medworm.com/index.php?rid=3490710&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F19%2Femr-technology-exacerbates-problems%2F One thing that I’ve mentioned many times in the 4+ years of blogging about EMR is the impact of technology on a clinic. I’ve regularly mentioned that you shouldn’t implement an EMR to try and fix process problems in your clinic. Instead, you should first address the process problems in your clinic and then implement the EMR with the proper processes already in place. The reason for this is quite clear. Technology, in this case EMR, has a tendency to just exacerbate any problems that exist in a clinic. In fact, it will often bring to light problems that you didn’t know existed before EMR. A simple example is doctors who are behind on their charts. In the paper world, you might not know how far behind they are on their charting. In the electronic world many EMR softwa... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3490710 Mon, 19 Apr 2010 15:10:55 +0100 3490710 http://www.medworm.com/index.php?rid=3471884&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Flz5D9nw2Izc%2F We concluded our last post in this series with a blunt prediction that “key physicians will sit on the sidelines” and that clinician non-adoption of EHR technology is a potential “deal-breaker for the success of HITECH”. While this might sound like a criticism of the way HITECH has been implemented, it’s not intended that way — it’s a commentary on 1) the complexity and scope of change that will be required to make HITECH successful, and 2) the level of protective entrenchment existing American health care today. Rather, we believe that the Office of the National Coordinator (ONC) for Health IT – Dr. David Blumenthal and his staff — have done a superb job in interpreting and defining key aspects of HITECH legislation. We’re big fans. For those of you who have been fo... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3471884 Wed, 14 Apr 2010 23:56:39 +0100 3471884 http://www.medworm.com/index.php?rid=3460246&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F04%2F05%2Fhimss-public-policy-forum-quick-hits%2F Yes, I still have quite a bit of HIMSS content that I haven’t had a chance to post. Luckily most of the information is really timeless and so it doesn’t matter when it’s posted. One of those was some of the information I got at the public policy forum at HIMSS. Here’s some quick hits from it: Dr. Rhonda Medows from Georgia said, “Could extend benefits to Long Term care based on capital improvement benefits.” I wonder if she’ll still do this if it’s true that there will be some money for long term care in the current healthcare reform. At least Georgia was looking at some creative ways to get some money for healthcare IT in under served areas. State representative Rosenthall from NH-Representative said that 40-50 percent of doctors in NH have ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3460246 Mon, 05 Apr 2010 14:44:25 +0100 3460246 http://www.medworm.com/index.php?rid=3432994&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FXOreo-ruc8w%2F by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA  The rationale for hospitals having to play in the HITECH game is straightforward: the financial carrots through 2015 are helpful, and the financial sticks after 2015 will be very painful. We’ll discuss: Financial Impacts on Hospitals Survey Data Showing Hospitals Will Play Why Success is Not Guaranteed Financial Impacts on Hospitals Even prior to HITECH, most hospital executives already had passed the threshold decision and concluded that they need to implement EHR technology. Thus, the issue for most hospitals isn’t “whether” to implement EHR technology, but “when”, “at what cost”, and “how”. (more…) Article Series - Is HITECH Working?Is HITECH Working? #1: Hospitals are grumbling but are playing in th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3432994 Fri, 02 Apr 2010 14:00:53 +0100 3432994 http://www.medworm.com/index.php?rid=3370515&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FdqhFSjCaVoY%2F Well, as you might have noticed, I decided to take the weekend off from the blog. I figured it was reasonable to take a weekend off after the craziness of HIMSS. I still have a ton of content from HIMSS 10 that I’d like to post. So, watch for more of that over the next couple weeks as well. I thought a nice video to kick off the new week would be nice. This video is of Robin Daigh from MD-IT and Craig Mercure from MxSecure talking about their partnership with Verizon to create a really interesting health information exchange. I talked about this Medical Transcription Service Consortium previously, but it was really neat to talk about it in person with Robin and Craig (Full Disclosure: Both Robin and Craig advertise on EMR and HIPAA). I also talked with the CMO from Verizon about it a... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3370515 Mon, 15 Mar 2010 16:33:33 +0100 3370515 http://www.medworm.com/index.php?rid=3346543&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FdV8NiFM3Ynw%2F Just the Facts  Certification Programs NPRM (Notice of Proposed Rulemaking) Health IT, U. S. Department of Health and Human Services; March 2, 2010 Certification NPRM Facts-At-A-Glance FAQ   Bookmarked version of Certification NPRM (much easier to navigate) U. S. Department of Health and Human Services; March 2, 2010 Via OCCAM Practice Management blog, March 3, 2010   Commentary and Analysis   Proposed EHR Certification Rule Changes Game HDM Breaking News; March 2, 2010 “The rule mentions the Certification Commission for Health Information Technology, but does not grant it any grandfather status…. So, while CCHIT appears to be able to continue its operations under the proposed temporary certification program, its future isn’t clear in the proposed permanent program.”  ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3346543 Tue, 09 Mar 2010 01:48:54 +0100 3346543 http://www.medworm.com/index.php?rid=3335439&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2010%2F03%2F01%2Fhimss-10-day-2%2F I’ve survived my second day of HIMSS. This is my first time to HIMSS and so I must admit that I’m a bit overwhelmed. Plus, it’s the first time I’ve been to a conference as “media.” I must admit that it’s really nice to be media at HIMSS. You get access to some things that you don’t normally get to access. Plus, the media room with food and internet has been great since I haven’t had time to breathe, let alone eat. The problem I’ve had is that there just isn’t enough time while I’m there to write too much content. Plus, it gives me no time to really process the content. So, if you want my latest updates about HIMSS, you can find them on my EMR twitter page. I went to town on Twitter during the CCHIT town hall. It shoul... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3335439 Tue, 02 Mar 2010 05:46:10 +0100 3335439 http://www.medworm.com/index.php?rid=3272986&cid=t_150880_114_f&fid=34963&url=http%3A%2F%2Fsymtym.net%2F2010%2F02%2Fmeaningful-x%2F Should Doctors Reject the Government’s EHR Incentive Plan?—David Kibbe It’s a big hill to climb for a carrot that may not be there when you reach the top. Is health information technology (IT) being set up to fail? Might we be facing a lost generation of health IT investment? Will Kaiser Permanente and Mayo Clinic get windfall profits while small practices receive nothing but hassles? It’s beginning to seem that way. Valid questions in this excellent article by Kibbe. A physician must consider many factors in coming to a decision on whether and when to participate in the HITECH incentives program. HITECH Physician Incentives (carrots and sticks)   Adopt2011 Adopt2012 Adopt2013 Adopt2014 Fail toAdopt 2011 $18K         2012 $12K $18K &n... symtym blogs http://www.medworm.com/rss/comments.php?id=3272986 Mon, 15 Feb 2010 08:45:00 +0100 3272986 http://www.medworm.com/index.php?rid=3271095&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FHealthCareBlogLaw%2F%7E3%2FobK34RJ52Ss%2Fwv-hit-funding-under-hitech-wvhin-gets.html Health and Human Services Secretary Sebelius and the National Coordinator for Health Information Technology, David Blumenthal, announced the HITECH funding under the ARRA for State Health Information Exchanges (HIEs) and Regional Extension Center (RECs) across the country.The White House Press Release provides a detailed list of HIEs and RECs receiving grants. Inormation is also available via the HHS News Release, Sebelius, Solis Announce Nearly $1 Billion Recovery Act Investments in Advancing Use of Health IT, Training Works for Health Jobs of the Future.West Virginia will receive the following funding:West Virginia Department of Health and Human Resources in conjunction with the West Virginia Health Information Network HIE Award: $7,819,000West Virginia Health Improvement Institute, Inc.... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3271095 Sat, 13 Feb 2010 21:39:23 +0100 3271095 http://www.medworm.com/index.php?rid=3269760&cid=t_150880_114_f&fid=34963&url=http%3A%2F%2Fsymtym.net%2F2010%2F02%2Fhealth-information-startup-funding%2F Sebelius, Solis Announce Nearly $1 Billion Recovery Act Investment in Advancing Use of Health IT, Training Workers for Health Jobs of the Future Health and Human Services Secretary Kathleen Sebelius and Labor Secretary Hilda Solis today announced a total of nearly $1 billion in Recovery Act (ARRA) awards to help health care providers advance the adoption and meaningful use of health information technology (IT) and train workers for the health care jobs of the future. The awards will help make health IT available to over 100,000 hospitals and primary care physicians by 2014 and train thousands of people for careers in health care and information technology. This Recovery Act investment will help grow the emerging health IT industry which is expected to support tens of thousands of jobs ran... symtym blogs http://www.medworm.com/rss/comments.php?id=3269760 Sat, 13 Feb 2010 09:30:11 +0100 3269760 http://www.medworm.com/index.php?rid=3224905&cid=t_150880_114_f&fid=34963&url=http%3A%2F%2Fsymtym.net%2F2010%2F01%2Fhealth-information-commons%2F The commons refers to resources that are collectively owned. There are two tragedies that may befall a commons: The Tragedy of the Commons and The Tragedy of the Anticommons. Paraphrasing Michael Heller (Gridlock Economy): the tragedy of the commons is when too many people share a single resource, we tend to overuse it; and the tragedy of the anticommons is when too many people own a single resource, and anyone can block the use. Modifying this for healthcare, the tragedy of the healthcare anticommons is that too many people own portions of a patient’s health information (HI), and anyone at anytime can block a full rendering of the patient’s HI. A patient’s HI might be charcterized by those that have an interest in the HI, including the patient. This interest extends beyo... symtym blogs http://www.medworm.com/rss/comments.php?id=3224905 Sun, 31 Jan 2010 06:43:32 +0100 3224905 http://www.medworm.com/index.php?rid=3159819&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FkWsx2carqaU%2F * = highly recommended   Descriptive Summaries and Documents    *Dissecting the Meaningful Use Proposed Rule PowerPoint eHealth Initiative Policy Webinar; January 8, 2010   *What You Need to Know About the Meaningful Use Proposed Rule, Standards and Implementation Specification, and Interim Final Rule Certification Criteria PowerPoint HIMSS Webinar; January 6, 2010   *Meaningful Use, Certification Criteria and Standards, and HHS Certification Process HIMSS, frequently updated material, some members-only   Source Documents (Bookmarked) Notice of Proposed Rulemaking (NPRM), Medicare and Medicaid Programs; Electronic Health Record Incentive Program; December 30, 2009 Warning: 536 pages of barely intelligible gobbledygook; stay away from this unless you are a lawyer, accountant, actuary,... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3159819 Mon, 11 Jan 2010 01:38:30 +0100 3159819 http://www.medworm.com/index.php?rid=3129503&cid=t_150880_88_f&fid=38961&url=http%3A%2F%2Fsymtym.net%2F2009%2F12%2Frebooting-information%2F You need a Data Asset—not a Data Warehouse—Family Health Guy A data asset is a collection of all the information relevant to an organization, regardless of source and of type. We call it an “asset” because this data, not the systems that created it or that are used on any given day to interact with it, represents the true long-term capability of an organization to thrive. The potential of that organization to measure itself, to learn, to adapt to new situations and technologies, to predict future outcomes and improve operations, all rely on its ability to find, use and re-use data. This is what Amalga does – it captures all the information, and stores it in data atomic form. “Data atomic” means that rather than try to selectively normalize incomin... quanta vie blogs http://www.medworm.com/rss/comments.php?id=3129503 Tue, 29 Dec 2009 23:16:44 +0100 3129503 http://www.medworm.com/index.php?rid=3126607&cid=t_150880_88_f&fid=38961&url=http%3A%2F%2Fsymtym.net%2F2009%2F12%2Fstructuring-and-focusing-information%2F A few weeks ago I saw a 40 year old male patient in the ER for chest pain, episodic over 2 days. He had diabetes for 15 years, hypertension for 20 years, and hyperlipidemia for 7 years. Four months prior he had a NSTEMI, 5–way coronary bypass, and 2 stents placed. Since that hospitalization he has had one followup with a cardiologist (unknown name), continues to smoke in excess of one pack of cigarettes a day, continues to drink vodka daily, and ran out of “some” medicines last week. He received his heart surgery and stents in one health system in our community, sees a cardiologist within another health system, and comes to the ER of a third health system. This is not an uncommon presentation for the ER, and not an uncommon problem where health information is spread acros... quanta vie blogs http://www.medworm.com/rss/comments.php?id=3126607 Mon, 28 Dec 2009 23:38:43 +0100 3126607 http://www.medworm.com/index.php?rid=3092696&cid=t_150880_88_f&fid=38961&url=http%3A%2F%2Fsymtym.net%2F2009%2F12%2Fhealth-information-palliation%2F Cure v. Palliation For those that practice in emergency medicine or work in ERs, we share a common bond of enjoying both the excitement and diversity of medical conditions that find there way in. There is nothing as satisfying and rewarding as participating in a medical or trauma resuscitation where there is a good outcome. And there is nothing so important as helping family and friends deal with the loss of a loved one due to a medical or surgical emergency. Unfortunately, the realities of emergency medicine practice is not dealing with true emergency, but rather acute episodes of chronic illnesses, the failings and lack of primary care, and those suffering from psychiatric and other social ills. We find ourselves many times not treating actual diseases or disease states, but rather treat... quanta vie blogs http://www.medworm.com/rss/comments.php?id=3092696 Wed, 16 Dec 2009 03:34:31 +0100 3092696 http://www.medworm.com/index.php?rid=3036990&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FeXeiCoqQKS0%2F Everyone seems to love talking about RHIO, HIE and all of the other various initiatives happening around sharing patient health information amongst doctors. This weekend, I want to open it up to you the readers to get an idea of what type of participation you’ve had in an RHIO, HIE or other clinical data exchange. Are you participating in one now? Do you like it? Do you hate it? In fact, what do you like and what do you hate? Do you use an EMR to interface with the exchange? What’s the interface like? How much work is it to manage the interface? I’d also be interested in hearing about people who are working through the process now. Where are you at in the process? What’s holding you up from making this happen? Let’s help educate each other on what’s happ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3036990 Sat, 28 Nov 2009 16:11:30 +0100 3036990 http://www.medworm.com/index.php?rid=3023246&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fwww.wvhin.org%2Findex.php%3Foption%3Dcom_docman%26amp%3Btask%3Ddoc_download%26amp%3Bgid%3D151%26amp%3BItemid%3D Today the West Virginia Health Information Network released a Request for Proposal (RFP) for a statewide Health Information Exchange. More information, including the deadlines, bidder worksheets and a full copy of the RFP are available on the WVHIN website.Following are sections from the RFP that provide a general overview of the proposed West Virginia Health Information Exchange and a general scope of the RFP:The West Virginia Health Information Network (WVHIN) is soliciting proposals to provide a statewide Health Information Exchange (HIE) infrastructure platform for physicians, hospitals, other health care organizations, and consumers. The purpose of this Request for Proposal (RFP) is to obtain vendor services and expertise in support of the WVHIN. Details on the scope of work, requirem... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=3023246 Tue, 24 Nov 2009 07:19:04 +0100 3023246 http://www.medworm.com/index.php?rid=3012474&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FmQyPb5p5cGU%2F Medicare announced today that it is extending its Personal Health Record (PHR) pilot project for residents of Utah and Arizona. This is a waste of time and taxpayer dollars. Those of you who read my blog know that I’m a big fan of PHRs, but you have to know when you’re backing the wrong approach. What’s wrong with this pilot project? A lot: (more…) Tags: business model, EHRs/PHRs, HIE, Medicare, platform (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3012474 Fri, 20 Nov 2009 05:09:35 +0100 3012474 http://www.medworm.com/index.php?rid=3003871&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FE-Jk96eOPWk%2F Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks.  I’d like to expand a bit today… So, why is Medicare’s participation in MAPCI  and other regional collaboratives such a big deal? Here’s my hypothesis: Medicare’s non-participation (to-date) in regional payer/provider collaboratives has been a rate... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3003871 Wed, 18 Nov 2009 00:53:23 +0100 3003871 http://www.medworm.com/index.php?rid=3023229&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F11%2F16%2Fproblems-with-arra-emr-stimulus-money%2F I recently read a Healthcare IT article that talks about some of the challenges with the EMR stimulus money. Here’s a couple of the challenges discussed with my commentary. Albert L. Strunk, MD, representing the American College of Obstetricians and Gynecologists, said ACOG is concerned that the measures, while clinical in nature, are not related to adoption of electronic medical records. “The meaningful use measures for ARRA should determine whether a physician has met the objectives shown in the meaningful use matrix, not whether the EMR is being used to report clinical quality measures that rarely apply to that physician’s patients,” he said. I think this is an interesting analysis. Clinical quality measures are one of the main goals of having an EMR. However, ve... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3023229 Tue, 17 Nov 2009 01:13:48 +0100 3023229 http://www.medworm.com/index.php?rid=2981183&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FaeujPdqyGRU%2F The King of the Cats has just acknowledged that indeed cats and dogs should co-exist peacefully. Dr. John Halamka — Vice Chair of the HIT Standards Committee of the ONC and one of the most vocal and influential figures in health IT — writes a blog post this morning entitled “The Genius of AND”. Halamka reasonably summarizes the essence of the debate about standards and interoperability as being between “the healthcare informatics crowd” (cats) and the “Internet crowd” (dogs): He notes that the debate shouldn’t be about one or the other POV prevailing (“either/or”), but about integrating both points of view (“and”): ..we need to embrace both approaches – the right tool for the right job depending on what you want to achieve. For provider to provider communi... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2981183 Tue, 10 Nov 2009 17:39:16 +0100 2981183 http://www.medworm.com/index.php?rid=2943908&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fsny5F8u6dgs%2F Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?” Today’s blog post will tackle: Medicare’s biggest change in 40 years? The rise of MAPCI The fall of MMHD Implications/discussion Medicare’s Biggest Change in 40 Years? (more…) Tags: business model, care coordination, care management, conference, EHR, health plan, health reform, HIE, hospital, meaningful use, medical home, Medicare, Medicare Medical Home Demonstration, multipayer, network effect, primary care, readmission (Source: e-C... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2943908 Fri, 30 Oct 2009 00:35:37 +0100 2943908 http://www.medworm.com/index.php?rid=2931085&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5FVQDknxCBw%2F I just received an email from CMS announcing the latest official word on the Medicare Medical Home Demonstration (MMHD): 10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of House Bill 3200 contains a provision to repeal this demonstration and replace it with an independent practitioner-based medical home pilot described further in the bill. In addition, the House bill includes a second medical home pilot to evaluate community-based medical home models... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2931085 Tue, 27 Oct 2009 15:59:21 +0100 2931085 http://www.medworm.com/index.php?rid=2883078&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F10%2F11%2Fhhs-connect-program-for-healthcare-data-interoperability%2F I’ll admit to not being the most expert person on HIE, RHIO, NHIN, and all of the other acronyms associated what really is just creating systems and structures for sharing healthcare data between various doctors and systems. However, I do have some knowledge in the area since I believe all of these things will be important for those using an EMR. So, I was surprised when I’d never heard of HHS’ health connect software. Here’s a short bit from Government Health IT of the government’s connect software’s latest update: The Health & Human Services Department (HHS) has updated the government’s Connect software to improve information security and enterprise services for organizations that want to use it to exchange health data, said its senior architect... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2883078 Sun, 11 Oct 2009 15:15:16 +0100 2883078 http://www.medworm.com/index.php?rid=2862604&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FNHWsxnws2mA%2F Here’s the big idea: accountable care organizations (ACOs) are about creating accountability. ACOs of various types are being proposed in national health reform legislation. For all you ever wanted to know about ACOs, read How to Create Accountable Care Organizations from the Center for Healthcare Quality and Payment Reform.   I spent an hour and a half poring over the details of this excellent report written by Harold Miller. My mistaken impression has been to focus on the organizational form of ACOs, rather than their objectives.  Organizational form is relevant in understanding ACOs, but primarily as a means toward creating accountability, not the end in itself.  Thus, expect to see many varying types of ACOs emerging based on local needs and characteristics. I initially a... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2862604 Mon, 05 Oct 2009 18:26:29 +0100 2862604 http://www.medworm.com/index.php?rid=2796539&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fp5se2G_011g%2F Updated 6:10 pm, September 14, 2009 One bad deal can ruin your day. Today, LifeMasters filed for Chapter 11 bankruptcy protection.  According to its press release: “The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for Medicare and Medicaid Services (CMS), ” said George D. Pillari, President of LifeMasters. Mr. Pillari, named President of LifeMasters today, is a Managing Director of Alvarez & Marsal Healthcare Industry Group, LLC and had been working with the company and its board as a restructuring advisor prior to the filing. During the last four years, LifeMasters participated in three CMS Demonstration Projects aimed at testing ce... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2796539 Mon, 14 Sep 2009 23:43:51 +0100 2796539 http://www.medworm.com/index.php?rid=2790321&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fqn6AlRE1xgg%2F By Vince Kuraitis and Steven Waldren MD, MS.  Dr Waldren is Director of the Center for Health Information Technology at the American Academy of Family Practice (AAFP). Two issues have rightfully surfaced front and center in the public’s understanding of HITECH Act implementation: ” definition of “Meaningful Use” of EHRs, and ” definition of “certification” process for EHRs …and we applaud the progress of the workgroups and the HIT Policy Committee in addressing these issues constructively. However…a THIRD issue lurks – “Data harmonization at the expense of data liquidity“, or put another way – “misplaced pursuit of one (and only one) language at the expense of practical communication.” On August 20, the HI... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2790321 Sat, 12 Sep 2009 18:18:03 +0100 2790321 http://www.medworm.com/index.php?rid=2782124&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FrzJiYQ9ydd4%2F by Glen Laffel MD, PhD Many of us have enjoyed a few good minutes of fun having our fortunes told by soothsayers who claim they can predict our future based on patterns of tea leaves in a cup or the playing cards we’ve pulled from a deck. We pay a few dollars for the entertainment and if the fortune teller is skilled, we are temporarily impressed by his “insight.” But once we leave the carnival, we come back to our senses. Fortune-tellers can’t predict the future. With its latest announcement, the Certification Commission for Healthcare Information Technology (CCHIT) appears to have entered the fortune telling business. And if information provided on blogs published by its founders is to be believed, some EHR vendors plan to have their fortunes told by the former EHR certification... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2782124 Wed, 09 Sep 2009 21:43:16 +0100 2782124 http://www.medworm.com/index.php?rid=2761973&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FcUFc7zNwVKs%2F In Part I of my guest post on The Collaborative Forum blog, I wrote that the Medicare Medical Home Demo is in BIG Trouble. Here’s a recap: Political reality dictates that the MMHD must save costs. As currently structured, the MMHD cannot achieve cost savings In any given year, only a small percentage of patients account for the vast majority of costs Lessons from previous Medicare disease/care management demonstrations has shown that effective care coordination interventions must be targeted at this population Medicare has structured the MMHD so that any patient with one or more chronic condition is eligible; this includes 86% of all Medicare patients. Physicians will be paid risk-adjusted care coordination fees for this entire population — the 86% of patients with one or more chron... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2761973 Thu, 03 Sep 2009 17:39:20 +0100 2761973 http://www.medworm.com/index.php?rid=2788596&cid=t_150880_88_f&fid=38961&url=http%3A%2F%2Fquantavie.net%2F2009%2F09%2Fhealth-information-calculus%2F What’s needed…the goal Joe (patient) and all those that encounter Joe in the context of healthcare have only one true need—all the information about Joe’s health (broadly construed) integrated over time and from all instances—right here, right now. Old school…both problem/solution The present problem with Joe’s healthcare information is that it’s fragmented across his lifespan and across innumerable instances of care. Joe wants the whole picture at any moment in time, but knows that can only happen if there is true interoperability connecting all instances of his care. This would require that every instance of Joe’s care, stored in various data silos, be connected by a health information exchange (HIE) or regionalized in regio... quanta vie blogs http://www.medworm.com/rss/comments.php?id=2788596 Wed, 02 Sep 2009 06:38:42 +0100 2788596 http://www.medworm.com/index.php?rid=2751993&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FbffcvkNpO3k%2F One of my readers pointed out that NaviNet was offering their Health Information Exchange (HIE) solution to state governments for free. Here’s a short part of the press release: NaviNet (formerly NaviMedix), America’s largest real-time healthcare communications network, today announced the NaviNet Health Information Exchange (HIE), a solution that combines the NaviNet Provider Network of more than 770,000 providers nationwide, and NaviNet technology and services. The NaviNet HIE is now available to all state governments and U.S. territories at no cost, enabling more efficient implementation and expansion of local health data exchange. Adoption of NaviNet HIE minimizes technology investment requirements, providing states and territories a rapid and cost-effective way to offer their ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2751993 Mon, 31 Aug 2009 18:27:53 +0100 2751993 http://www.medworm.com/index.php?rid=2751994&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FDIluPSWQkxQ%2F I recently got the following email which highlights my point that the EHR stimulus money should have been focused on things like interoperability standards and not funding EMR adoption the way it is doing it. He also makes some interesting comparisons worth considering: I see an uncoordinated money pot out there, attracting uncoordinated work on EMR. — about as effective technically as HDTV (since mid-80’s), W3C, the space station. Non-profit efforts seem to generally fail, or to work so slowly as to be irrelevant. EMR standardization would likely benefit from an authoritative organization (similar to IEEE) that would work with existing systems as provided by Kaiser, Walmart, GE, etc. and grind out a solution acceptable to these and other major (and minor) players. Then a de fa... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2751994 Sun, 30 Aug 2009 17:33:22 +0100 2751994 http://www.medworm.com/index.php?rid=2741456&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FJVbaWzgJhJI%2F These guys really don’t get it, and they need to be called on the carpet, taken to the woodshed, or pick your own favorite cliche. The Federation of American Hospitals (FAH) sent a letter to Dr. David Blumenthal (National Coordinator for Health IT) arguing that “Meaningful Use” funding should not be tied to achievement of quality measures.  The FAH is the trade association for for-profit hospitals; the letter is dated August 26 and a copy is available on the HealthHombre website, with a deserved hat tip. First, let me concede that they make a reasonable point on p. 3 when they say “Under it’s framework, the Policy Committee has recommended that HHS should adopt a measure for 2013 requiring a 10 percent reduction in preventable admissions from 2012 to qualify as a meani... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2741456 Thu, 27 Aug 2009 20:16:29 +0100 2741456 http://www.medworm.com/index.php?rid=2705195&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fu4izsd-pnv0%2F At last Friday’s meeting, the HIT Policy Committee adopted the recommendations of the Certification and Adoption Workgroup. Between the initial recommendations in July and the adopted recommendations in August, one critical word was added to the definition of “certification”.  That one word is “minimum” — and this one word expresses the correct approach and philosophy for the government’s role in the certification process for EHRs. In this post I’ll address why a “minimum” approach toward certification makes sense:  Why “Minimum” Certification is Right: More Like UL Why Current CCHIT Certification Based on Functionality Risks Irrelevance or Lock-in to Outdated Technology Why “Minimum” Certification is Right: More Like Underwriters Laboratories (more&... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2705195 Sun, 16 Aug 2009 23:46:43 +0100 2705195 http://www.medworm.com/index.php?rid=2699695&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fno1LFrhNDCM%2F by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system.  We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included: Patient Centered Medical Homes (PCMHs) Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs) Payer Disease/Care Management Programs Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come State/Regional Chronic Care Programs (e.g., Colorado, Pennsylvania, Improving Performance in Practice) Accountable Care Organizations — the n... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2699695 Thu, 13 Aug 2009 20:41:48 +0100 2699695 http://www.medworm.com/index.php?rid=2641350&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FsdbX7BfA2F8%2F “Qualcomm pulls the plug on LifeComm”  announced Brian Dolan of mobihealthnews recently.  As demonstrated by e-CareManagement blog readership, there has been a lot of interest in LifeCOMM.  My first blog post on LifeCOMM in 2007 has been single the most commented on post and the second most widely read blog post. It’s taken me a while to sift through my thoughts and feelings about saying “Goodbye” to LifeCOMM. At first I was deeply disappointed, but after further reflection think that LifeCOMM wasn’t the right type of platform for today’s consumer mobile health market. Disappointment My first reaction was one of disappointment. (more…) Tags: business model, Google Health, HealthVault, HIE, HITECH, interoperability, LifeCOMM, network effect, platform, wireless (So... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2641350 Sun, 26 Jul 2009 16:44:23 +0100 2641350 http://www.medworm.com/index.php?rid=2639627&cid=t_150880_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FL62uVsfWwlE%2F A subtle but profound shift is occurring in the world of RHIOs/HIEs (Regional Health Information Organizations/Health Information Exchanges). …and the title of the eHealth Initiative’s Sixth Annual Survey of Health Information Exchange says it all: Migrating Toward Meaningful Use What’s happening here? (more…) Article Series - The Dog Manifesto: A Disruptive Innovator's Guide to Health ITWill HITECH Lead to Innovation? The Continuing Cat/Dog DialogueDogged Optimism: Five Innovative Aspects of HITECHFeline Foot-Dragging: Three Non-Innovative Aspects of HITECHWait and See: What’s Unclear or To-Be-Determined (TBD) About HITECH.Can Cats Think Outside the Box? Here’s a Role Model.Stand for Quality Group: “Link HIT Investment to Quality Improvement”EHR 2.0: ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2639627 Sat, 25 Jul 2009 18:15:48 +0100 2639627 http://www.medworm.com/index.php?rid=2598311&cid=t_150880_113_f&fid=38130&url=http%3A%2F%2Fwww.tempdev.net%2Fblog%2F%3Fp%3D841 Over the past year, I’ve heard the frequent comment that banks successfully deployed interoperability over 10 years ago, but the healthcare industry lags far behind. Often the comment is followed up with a statement that we can go to any bank and they can instantly access our financial information, but each physician I go to has to manually fax documentation back and forth. The banking industry is one of the most conservative in our society; healthcare can do better than banks, right? However, what these commentators fail to remember is we cannot deduce healthcare conditions into one simplem standard currency. For example, my back pain caused by poor posture and too much time in the car is different from someone else’s back pain caused by their scoliosis, which is different from anothe... Implementing EMRs blogs http://www.medworm.com/rss/comments.php?id=2598311 Tue, 14 Jul 2009 08:01:24 +0100 2598311 http://www.medworm.com/index.php?rid=2469657&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F06%2F10%2Fthe-move-to-ehr-adoption%2F Considering most people put current EHR adoption somewhere in the 10-20% range, I found this part of the article on Healthcare IT news pretty interesting: Fifty-nine percent of providers surveyed said they have already implemented or plan to implement EHRs in the next 12 months but only 17 percent are participating or planning to participate in a health information exchange. These survey results are really interesting to me since it seems to show a huge shift in people’s plans for EHR adoption. It’s the shift from asking the question “Should I adopt an EHR?” to the question “How and when should I adopt an EHR?” Of course, it’s one thing for people to say that they are planning to implement an EHR and actually meaningfully using an EHR. I still thin... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2469657 Wed, 10 Jun 2009 15:24:51 +0100 2469657 http://www.medworm.com/index.php?rid=2390014&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FohS0R02MYQ0%2F I’m not sure how many of my readers have heard about the Virginia Prescription Monitoring Program being hacked yesterday. The Prescription Monitoring Program is used by pharmacists and others to discover prescription drug abuse. The story gets really interesting since it looks like the hackers encrypted over 8 million patient records and over 35 million prescriptions. Then, the hackers posted the following note on the Virginia Prescription Monitoring Program website (according to wikileaks): “I have your [expletive] In *my* possession, right now, are 8,257,378 patient records and a total of 35,548,087 prescriptions. Also, I made an encrypted backup and deleted the original. Unfortunately for Virginia, their backups seem to have gone missing, too. Uhoh :(For $10 million, I will ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2390014 Tue, 05 May 2009 20:06:26 +0100 2390014 http://www.medworm.com/index.php?rid=2365201&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F04%2F23%2Fstill-far-from-healthcare-interoperability%2F I think that anyone that is in this industry had to be struck by the story of ePatientDave pulling his medical history into Google Health (see my previous ePatientDave post). It’s not that we didn’t already know that it was a problem. I think that most in the medical industry know the problems associated with our data right now. However, I feel like we’re all (including myself) in a little bit of denial about this fact. The story of ePatientDave just painted a picture of how bad the data really is going to be. The takeaway I have from ePatientDave’s experience is that we’re still a long way from having interoperable patient records. In fact, it makes my previous post about ICD-10 and EHR interoperability even more significant. Not to mention the need to simpli... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2365201 Thu, 23 Apr 2009 20:06:13 +0100 2365201 http://www.medworm.com/index.php?rid=2353921&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F08nCQqKnxoE%2F I’ve been hearing a bit of discussion about ICD-10 really helping to solve some of the problems of interoperability. Their contention is basically that ICD-10 is more precise in its description of the diagnosis and so therefore the information that is coded using ICD-10 will then provide more specific codified information that can then be rather easily shared. If you haven’t read about the transition from ICD-9 to ICD-10, here’s a good article about the transition. In theory, this is completely accurate. If everything went as outlined, we could really get a lot of interesting information for studies and for interoperability of health data out of our ICD-10 codes. The problem is that in reality ICD-10 is just going to cause even more problems for sharing quality data. Not ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2353921 Tue, 21 Apr 2009 15:55:05 +0100 2353921 http://www.medworm.com/index.php?rid=2314666&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F-eFyoyxwg6I%2F A lot of talk has been done lately on the importance of interoperability of EHR software. Many people point to health information exchanges when talking about this EHR interoperability. I must admit that almost all of the interoperability and health information exchange discussions I’ve seen recently leave me lost. Maybe I’m just not that smart, but I also think it’s possible that people are trying to bite off more than they can chew. I’d like to see a simplified method for exchanging health information. Let’s break it down into bite size increments where we can actually have achievable goals and solvable problems. For example, let’s start with something like prescriptions, allergies or labs. Let’s get those right and then add on top of those funct... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2314666 Wed, 08 Apr 2009 13:36:04 +0100 2314666 http://www.medworm.com/index.php?rid=2314669&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F7NXjyfU9GGI%2F I recently read a nice article comparing EHR interoperability to the Transcontinental Railroad. They hit the key point when they said, “Just as standardizing the railroad gauge created a uniform distance between tracks so that track the came from the East and West would fit together, health care IT standards will create a seamless and interoperable IT infrastructure that will benefit the entire nation.” I find the comparison incredibly intriguing and thought provoking. The only problem I have with the comparison is that the transcontinental railroad was merging essentially 2 standards (east and west) and standardizing the gauge was the only standard needed. In health care IT we have far more stakeholders in the game and far more standards that need to be established (allergies,... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2314669 Tue, 07 Apr 2009 21:29:28 +0100 2314669 http://www.medworm.com/index.php?rid=2314609&cid=t_150880_113_f&fid=38130&url=http%3A%2F%2Fwww.tempdev.net%2Fblog%2F%3Fp%3D771 John Halamka, CIO of Harvard Business School and Beth Israel Deaconess Medical Center (plus a myriad of other titles) and author of the popular Life as a Healthcare CIO blog, lead an interesting session on HIE and the ARRA/HITECH stimulus. There is about $2 billion available for HIE in the stimulus with much of the coordination being done by to be created Regional Healthcare IT Extension Centers. The make-up and number of the centers is a complete unknown at this point, but Halamka has heard numbers ranging from 10 to 60. Halamka also discussed some of attributes of the stimulus that will have great influence over HIT for the next few years: The new Federal IT Policy Committee will act as the Board of Directors and provide direction for the movement The HIT Standards Committee will implem... Implementing EMRs blogs http://www.medworm.com/rss/comments.php?id=2314609 Tue, 07 Apr 2009 17:50:11 +0100 2314609 http://www.medworm.com/index.php?rid=2314610&cid=t_150880_113_f&fid=38130&url=http%3A%2F%2Fwww.tempdev.net%2Fblog%2F%3Fp%3D767 I don’t know if it’s the size of the conference hall, the constant shuttling back and forth to the hotels, or the length of the conference, but I am exhausted! I don’t mean this as a criticism of HIMSS at all, but more of a forewarning for any snippy posts that come up today. This morning I attended a session on Maine’s HIE. Devore Culver, CEO of HealthInfoNet (winner of a 2009 Davie’s Award), has founded a 501(c)(3) to provide an HIE for Maine. The unique characteristic with Maine’s providers is they decided to stop competing over health data back in 2006. In addition, Maine has an all claims database containing all claims on all patients , including government payers. Participation in the HIE is completely volunteering and any patient or organization can withdraw at any time.... Implementing EMRs blogs http://www.medworm.com/rss/comments.php?id=2314610 Tue, 07 Apr 2009 14:12:50 +0100 2314610 http://www.medworm.com/index.php?rid=2200357&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Fwww.emrandhipaa.com%2Femr-and-hipaa%2F2009%2F02%2F20%2Fhitech-act-gives-hhs-2-billion-of-discretionary-funds%2F The HITECH Act gives Health and Human Services (HHS) 90 days to develop a plan to allocate $2 Billion of discretionary funds. Talk about a nice infusion of funding for HHS. HHS does have a set of core areas of focus for the money (per an Allscripts presentation on HITECH). The area of focus that interests me most is the “Regional Health IT Resource Centers.” Seriously, what is a regional health IT resource center? Can any of you imagine a doctor visiting a health IT resource center? I don’t understand how this will work at all. I have a better idea. Why not take a cool million and give it to me? I’ll create a killer online platform for sharing of health care IT resources where people can share information nationally or within their region. Could be a killer applicat... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2200357 Fri, 20 Feb 2009 08:51:52 +0100 2200357 http://www.medworm.com/index.php?rid=2348877&cid=t_150880_114_f&fid=34963&url=http%3A%2F%2Fsymtym.com%2F2009%2F02%2Ftethers-pipes-and-cloud%2F Doing some three Rs today: reading, ’rithmatic, and ’riting… Just got HIMSS’s Personal Health Records the other day and working my way through the text. Also read an excellent post by John Moore on HIEs, SaaS, and EHRs. Healthcare on many levels is nothing more than a transactional relationship between a clinician and a patient. The currency is information. What would our present economy look like if currency was still physically married to paper–form. Absurd! Yet we readily accept this absurdity when it comes to the currency of healthcare—marriage to a structural form no less dissimilar from paper. Compounding this conceptual disconnect from modern economies is the equivalent of stuffing one’s money in a mattress—the file, the office, the h... symtym blogs http://www.medworm.com/rss/comments.php?id=2348877 Sun, 08 Feb 2009 03:48:41 +0100 2348877 http://www.medworm.com/index.php?rid=2152809&cid=t_150880_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=2097776&cid=t_150880_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2Fxcnq9-HcJ8c%2F If you’ve been reading my blog, then you know that I’ve started a pretty interesting and complicated discussion about EHR and EMR sharing of patient data. I first posted an example of sharing data with an EHR and then followed it up with some challenges associated with sharing of EHR data. In my interoperability challenges post, Bjorn from Health Xcel posted a lengthy comment discussing some challenges of data sharing and made the case for RHIO (Regional Health Information Organizations) and HIE (Health Information Exchanges) as a means for sharing patient data between hospitals and doctors offices. His comment was so well done that I’m copying it below for more people to see and read it. I don’t personally agree with everything that was said. I also think he didn&#... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=2097776 Mon, 12 Jan 2009 05:10:40 +0100 2097776 http://www.medworm.com/index.php?rid=2039869&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fwww.hhs.gov%2Fhealthit%2Fdocuments%2FNationwidePS_Framework.pdf Today the Office of the National Coordinator for Health Information Technology (ONCHIT) issued The Nationwide Privacy and Security Framework for Electronic Exchange of Individually Identifiable Health Information. The summary states that the framework creates a set of consistent principles to:". . .address the privacy and security challenges related to electronic health information exchange through a network for all persons, regardless of the legal framework that may apply to a particular organization. The goal of this effort is to establish a policy framework for electronic health information exchange that can help guide the Nation's adoption of health information technologies and help improve the availability of health information and health care quality. The principles have been designe... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=2039869 Tue, 16 Dec 2008 06:26:13 +0100 2039869 http://www.medworm.com/index.php?rid=1794318&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fhealthcarebloglaw.blogspot.com%2F2008%2F09%2Fehealth-initiative-state-of-hies.html EHealth Initiative has released the results of the 2008 Fifth Annual Survey of Health Information Exchanges (HIE) at the State and Local Level.The survey included responses from 130 community based initiatives from 48 states. Here is a summary of the key findings. (Source: Health Care Law Blog) Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1794318 Mon, 15 Sep 2008 21:15:00 +0100 1794318 http://www.medworm.com/index.php?rid=1729335&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fhealthcarebloglaw.blogspot.com%2F2008%2F08%2Fehealthwv-west-virginia-ehr-public.html As a part of West Virginia's participation in the Health Information Security and Privacy Collaborative (HISPC), West Virginia Medical Institute and its partners launch the eHealthWV website focused on educating consumers about electronic health records and health information exchange.West Virginia was one of a number of states awarded a grant by RTI International to participate in the HISPC, a national collaborative effort to study health information security and privacy. To learn more about EHRs and HIEs check out the website. They also have a toolkit of brochures for physician practices to use.Project Director, Patty Ruddick, notified me last week that they had filmed a new EHR/HIT public service announcement that will start airing across West Virginia over the next few months. I though... Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1729335 Sat, 23 Aug 2008 19:21:00 +0100 1729335 http://www.medworm.com/index.php?rid=1460893&cid=t_150880_114_f&fid=34646&url=http%3A%2F%2Fhealthcarebloglaw.blogspot.com%2F2008%2F05%2Fhational-alliance-for-health.html On April 28, 2008, the National Alliance for Health Information Technology released its Report, "Defining Key Health Information Technology Terms," to the Office of the National Coordinator for Health Information Technology.The report is an effort to get everyone working in health information technology to have a common understanding of and differences between EMRs, EHRs, PHRs, HIEs, HIOs and RHIOs. If you don't know what each of these are or are interested in better understanding these key health tech terms check out the report.An article by Health Data Management indicates that the Report will be "presented on June 3 to the American Health Information Community, a Department of Health and Human Services advisory body, for final approval." (Source: Health Care Law Blog) Health Care Law Blog blogs http://www.medworm.com/rss/comments.php?id=1460893 Wed, 21 May 2008 18:20:00 +0100 1460893 http://www.medworm.com/index.php?rid=933063&cid=t_150880_113_f&fid=36347&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fblogspot%2FyjsX%2F%7E3%2F165019346%2Fleraning-from-past-hie-rhio-mistakes.html I just received an eHealth SmartBrief which contained a great editorial from Health Data Management, "Learning From Mistakes" which discusses how we must learn from mistakes of past HIE and RHIOs. The author highlight several points that I also have been making. This did not surprise me when I read that the author, too, like my self, is a practicing physician dealing with the day-to-day chores of clinical data management,Here a few quotes from the article:"pioneers in this emerging field concentrated on creating entities, not functionality. " "... they set out to build an organization like a RHIO, rather than advance the attainment of information exchange. " I have been commenting on this point of how RHIO have been all about setting up large organizations rather then entities that actuall... RHIOs, Health Information Exchange & Healthcare IT blogs http://www.medworm.com/rss/comments.php?id=933063 Sat, 06 Oct 2007 05:14:22 +0100 933063 http://www.medworm.com/index.php?rid=463423&cid=t_150880_113_f&fid=34624&url=http%3A%2F%2Fblogs.bsti.com%2Fhealthcare%2F%3Fp%3D519 CalRHIO will pick a contractor by mid March. The resulting HIE will be a “service-oriented architecture framework, Web services platform, application components and operational support services for an exchange within and across health care organizations statewide.” The eight prospective contractors are: Accenture Covisint Computer Sciences Corp. (CSC) IBM, partnering with Axolotl McKesson Medicity Sun Microsystems Wellogic Why this matters: It’s always interesting to see a lot of money being spent. By following CalRHIO, we should also get an understanding of what will happen when we build a NHIN. I think it is great that Sun is a contender; I don’t think they will get it. I haven’t read through the recent NHIN presentations, so I don’t have an educated guess for who wil... Healthcare IT blogs http://www.medworm.com/rss/comments.php?id=463423 Wed, 31 Jan 2007 15:45:10 +0100 463423