The XY Files in an MT World : EHRs

A Call for Plug-and-Play EHRs

Jay Vance — Fri, 22 May 2009 14:37:00 GMT

Nothing like great timing. In my last blog post, I suggested that electronic health record (EHR) and personal health record (PHR) technology needs to become more like an iPhone in order to achieve widespread acceptance from technology-shy physicians and...(read more)

Lessons from an iPhone

Jay Vance — Tue, 19 May 2009 12:33:00 GMT

I admit it, I was suffering from iPhone envy. As an unabashed technophile (i.e., hard-core geek), I couldn't help but be intrigued by all the cool things the iPhone was supposedly capable of doing. When one of your colleagues says something to the effect...(read more)

Beth Israel/Google Health Fiasco--Is Technology Really the Problem?

Jay Vance — Tue, 28 Apr 2009 11:55:00 GMT

Recently the Boston Globe has been reporting on problems arising when Beth Israel Deaconess Medical Center sent insurance claims data (i.e., billing codes) to Google Health PHR as a means of summarizing patients' medical condition. As it turned out, this...(read more)

Bits & Pieces

Jay Vance — Tue, 17 Feb 2009 20:10:00 GMT

Here are a few items of information from the past week I thought you might be interested in.

1. Transcription Service Provider Runs Afoul of the VA

From a Department of Veterans Affairs press release: During a routine internal inspection, the Department of Veterans Affairs (VA) discovered a contractor providing medical transcription services who was not following the Department's rules for protecting medical information.

Although there is no evidence that any patient information was disclosed as a result of the violation, VA has suspended the contractor from receiving any sensitive information from the Department until the contractor guarantees compliance with VA's standards for information technology (IT) security.

"VA insists that contractors, as well as our own personnel, adhere to the highest standards for protecting personal information," said Secretary of Veterans Affairs Eric K. Shinseki. "When we detect a problem, as happened in this case, we will quickly fix it, and we will ensure such problems are not happening elsewhere."

The issue involves a contractor whose employees create written transcripts of recordings made by health care professionals while performing physical examinations, reporting on surgeries, and taking patients' histories. VA officials found the contractor's employees used computers that do not adhere to government policy on security.

Based on this incident, the Secretary has launched an intensive examination of all VA's contracts to ensure all contractors properly safeguard information about VA patients, Veterans and employees.

2. New PHR Requirements in Stimulus Bill

Health Data Management is reporting that the economic stimulus bill will impose new consumer protection requirements on vendors of personal health records.

The vendors must notify affected individuals following the discovery of a breach of unsecured identifiable health information in PHRs. Vendors also must notify the Federal Trade Commission.

Further, a third-party service provider that provides services to a PHR vendor or covered entities that offer PHRs must notify affected vendors or entities of a breach. "Such notice shall include the identification of each individual whose unsecured PHR identifiable health information has been, or is reasonably believed to have been, accessed, acquired or disclosed during such breach," according to the legislation.

The FTC shall treat violations as unfair and deceptive acts or practices under the Federal Trade Commission Act. The legislation requires the FTC to publish interim final regulations within 180 days of enactment.

The requirements will remain in effect unless Congress enacts new legislation governing PHR breach notifications.

3. Medpedia Opens Public Health Care Technology Platform

TechCrunch is reporting that Medpedia has unveiled a public version of its technology platform for the worldwide health community. Combining social networking with Web 2.0 health information, Medpedia's website offers consumers a Wikipedia for health information, a LinkedIn network for health professionals, and a Facebook-like platform where consumers and experts can have a medical dialogue about treatment and conditions.

Medpedia has developed partnerships with Harvard Medical School, Stanford School of Medicine, Berkeley School of Public Health, University of Michigan Medical School and other health organizations to help bring content and medical networks to the site. Many of the health institutions are offering the content free of copyright restrictions. Already, 25 medical and government institutions in both the U.S. and the U.K. have signed on to Medpedia to use its professional network.

4. U.S. Army Adopting Dragon Speech Recognition

According to FierceHealthIT, the U.S. Army Medical Department is adopting speech recognition technology in a big way as part of an effort to boost its clinicians' satisfaction with the military's electronic medical record system. The new system will allow physicians to speak their notes into the EMR at the patient's bedside, rather than enter them later when their memories aren't as fresh.

The Army is rolling out Dragon Medical speech recognition software to 90,000 clinicians worldwide. It's taking this step as part of a larger program, run by the U.S. Army Surgeon General, designed to help improve providers' experience with AHLTA, the military's EMR. The program, MEDCOM AHLTA Provider Satisfaction, has already invested in touch-screen laptop computers and wireless networks.

Society For Exorbitantly Expensive And Difficult To Implement EHRs (SEEDIE)

Jay Vance — Mon, 10 Nov 2008 16:58:00 GMT

Someone alerted me to this spoof website and I got a big kick out of it. It's a great followup to my last post regarding implementing an electronic health records (EHR) system in this country.

From the website's "SEEDIEspeak" page:

SEEDIE invites industry insiders to provide commentary on the value of certification on our blog. The following post is from Brantley Whittington, CEO of EHR vendor Extormity.

Much is made these days in healthcare IT circles about interoperability. This so-called "holy grail" has lulled many into believing that EHR systems should be able to easily and inexpensively exchange data using standard communication protocols.

Our company, Extormity, sells a suite of EMR software solutions, and we can't keep all the acronyms straight! I can't explain the difference between an HL7, a CCR and an XPHR, and I do this for a living! In fact, we tried to participate in some interoperability exhibitions at a few conferences, and we couldn't make our systems talk with those from other vendors. We also took a look at CCHITSM Certification, and quickly realized there was no way we could meet 263 criteria in 40 some categories. We're all for certification, but what's wrong with setting the bar low? Why does CCHIT have to make certification so rigorous?

We threw up our hands and decided to work with other like minded vendors to start our own organization - SEEDIE. This "take our ball and go home" approach puts the power where it belongs - in the hands of a few very large, very profitable companies who know how to build the complex, proprietary systems required to turn the EHR space into a multi-billion dollar market in a short period of time.

Is interoperability a pipe dream? Absolutely not.

Is interoperability expensive? We think it should be! We believe that true interoperability requires organizational will and a tremendous amount of money from customers to fund it. Given enough in custom integration fees, we can build an interface that will allow our EMR to exchange clinical data with a toaster oven. It all boils down to dollars and desire.

EHR vendors who tout plug and play interoperability are eroding the potential value of the healthcare IT market. Look for the SEEDIE seal when you select an EHR partner, and you will know with confidence that your added investment will support aggressive industry growth forecasts.

Whoever the author of this website is, I absolutely agree with him or her that we're making the whole EHR compatibility/interoperability issue much more complicated than it has to be. If we're really serious about cutting costs in health care, rejecting expensive proprietary systems in favor of open-source software and established file formats would be a logical place to start.