Article – CHIME seeks Stage 2 delay, defends MU

So, the U.S. government—CMS/ONC and some Senators—and CHIME (College of Healthcare Information Management Executives) are “discussing” the merits and best timing of HITECH and Meaningful Use.

This article provides a good summary of the questions and recommendations posed.

Some key points from the article and my thoughts…

  • The Senators are fairly looking for evidence of results from the significant investment of taxpayer dollars. The reality is that this change is large and multifaceted. It will take time to reap the benefits once operations are normalized and productivity is enhanced.
  • CHIME believe that there are merits to the government’s programs, but wants to slow the pace of change. I know from personal conversations with smart, effective folks working for respected providers that they are reeling from the number of implementation projects driven by ACO, MU and other initiatives that they have going right now. The troops may indeed need a short break and to reflect on lessons learned from the initial change.
  • “CHIME also urged Congress to request an update from ONC regarding what technologies, architectures and strategies exist to mitigate patient matching errors” …it is interesting that CHIME is looking for this, as MPI (Master Patient Index)—also known as PIX (Patient Identifier Cross-Referencing) in the IHE Technical Framework—has been around for years and used in many projects to enable sharing of patient records across patient ID domains

Article – Outpatient services will dominate 2013, survey says

Healthcare providers are shifting their focus from providing inpatient services to providing outpatient services—and their investment priorities reflect this, according to a survey.

Some key stats from this article

  • 69% of survey respondents projected an increase in outpatient volume for 2013, while only 35% predicted an increase in inpatient volume
  • 43% of respondents plan to make health IT their biggest capital investment in 2013, up from 21% two years ago
  • 22% of respondents were part of an Accountable Care Organization, and 55% planned to be part of one by 2014

Article – EHR part of MaineHealth’s financial woes

This article describes a “perfect storm” of factors that lead to the health system’s financial loss…

…”the operating loss is due to declines in inpatient and outpatient volumes because of the hospital’s efforts to reduce readmissions and infections; “unintended financial consequences” due to the roll out of the health system’s Epic electronic health record and problems associated with being unable to accurately charge for services provided; an increase in free care and bad debt cases; and continued declining reimbursement from Medicare and MaineCare, the state’s Medicaid program”

Article – Creating a Clearer Picture of Patient Flow

This is cool.

It would be interesting to see the convergence of the output of SIIM‘s SWIM initiative and this application to understand real-time metrics of a Radiology department. The dashboard could show the actual location of patients, their spot in the prescribed workflow, and the comparison to statistical norms and/or KPIs.

Layered on top of a BI (business intelligence) platform for historic data analysis, and you would have something special.

Article – At Healthcare Experience Design conference, designers rethink ‘broken processes’

In this article, the topic of user experience design in Electronic Medical Record (EMR) applications is explored. They also briefly discuss the use of EMR technology by patients.

Some thoughts…

  • The fact that EMR user interfaces are often hard-to-use, and are undesirable by the user community they are intended to serve, is not news. EMRs are often, at their core, records management systems, presenting medical records generated by other systems, or by users typing data into the EMR. It is no surprise that information is presented like a big electronic filing cabinet. Niche players are trying to layer solutions on top of the EMR to present the information relevant for a given interaction in a more meaningful way. Often, if the EMR is not built with an open architecture (with APIs for external applications to discover and access information), a copy of (some of) the data is kept in a secondary system. Hopefully, IHE FHIR succeeds and enables an integration ecosystem for EMR add-ons that is tantamount to the platform needed to have an “App Store”.
  • Designing applications for trained medical professionals is hard enough. Trying to build a user interface that makes sense to, and it optimized for the use by, both an Oncologist and my grandmother is near impossible. Medical terminology alone is enough to confuse most patients. Then consider the questions and concerns of the patient as they start to review their CT images and wonder what that little whitish spot might be. In this article, many of the docs surveyed expressed concern over patient access to their own electronic medical records (which is why Personal Health Records were created, friends).

SIIM Blog: Part 2 – Organizing Concepts to Focus Learning Efforts

Part 2 of 2 of a SIIM blog post. Enjoy.

I have been discussing what it would take to create a “check list” of sorts (a scorecard?) to assess ones facility’s capabilities and strategies along the proposed themes listed. Would be fun to work on, but would need lots of help from people with bigger brains than mine. Stay tuned for a bonus Part 3, maybe? 🙂

P.S. Part 1 is here.

Survey: Doc dissatisfaction with EHRs grows

I enjoy articles like this because so much focus is on the expected benefits of healthcare IT, but as the old marketing tale goes, sometimes ‘the dogs just don’t like the dogfood’. If users won’t use the tools, the outcomes won’t be realized. As is often the case with products, the specialist is not well understood or served. The same applies for imaging consumers–the average imaging consumer using an EHR is quite different than the specialist that needs advanced visualization, navigation and measurement tools. Niche vendors will attempt to fill the gaps.

Most EHR user interfaces resemble an electronic filing cabinet, organizing information by type or service / organizational unit that created the data. Vendors could learn a lot from the design of social networking platforms, which are quite adept at coordinating activities in complex interactions among disparate users.

Article: How Not to Engage Patients in Stage 2

Some interesting observations in this article. We always need to consider the right moment to get users (patients, in this case) to engage when rolling out a new program and trying to get adoption. It can be the right application with the right value to the right people, but presented to them at the wrong time.