Healthcare IT News: “The Healthcare Information and Management Systems Society’s EHR Usability Task Force has released a white paper focusing on the level of usability in electronic medical records and their implementation at healthcare organizations. “Defining and Testing EMR Usability: Principles and Proposed Methods of EMR Usability Evaluation and Rating” identifies usability of software in an EMR as “one of the major factors and possibly the most important factor hindering widespread adoption of EMRs.” – A copy of the white paper can be found here.
Cool Technology for Pharmacy
Healthcare IT Consultant Blog: “VeriChip Corporation Outlines Current Applications and Potential Future Applications for its First-of-a-Kind Implantable RFID Implantable Microchip - VeriChip Corporation, a provider of radio frequency identification (RFID) systems for healthcare and patient-related needs, today provided additional comments regarding its VeriMed™ Health Link patient identification system following the recent passage of a bill by the Pennsylvania House of Representatives banning forced microchip implantation in humans, and also outlined its current and potential future applications for its RFID implantable microchip. The VeriMed Health Link system was cleared by the FDA in 2004 as a Class II medical device and is the first and only implantable microchip cleared by the FDA for patient identification. “
Read more …
ASHP Makes Recommendations for Definition of “Meaningful Use”
ASHP.org: “In a recent letter to the Office of the National Coordinator for Health Information Technology, ASHP said the definition of meaningful use should include the following three elements: interoperability of medication orders and prescriptions; medication decision support and continuous improvement; and the ability to report and quantify improved patient safety, quality outcomes, and cost-effectiveness in the medication-use process.” – Kind of vague, don’t you think. I expected a little more aggressive stance.
Bye bye paper medical records
HIT Consultant: “N.Y. medical group to ditch paper records by 2010 – Rep. Chris Lee toured the Buffalo Medical Group’s offices Monday as part of what he calls his effort to bring local ideas about health-care reform to Congress. Buffalo Medical Group, which handles 415,000 outpatients per year, is in the process of updating its data systems and patient records to a paperless electronic format. CEO Daniel Scully said the electronic records will replace a warehouse full of 5,000 boxes of patient record. Scully said he expects the transition to be complete by the end of 2010.” – I love this idea. It’s aggressive, it’s green and it’s much more efficient. Searching through a well indexed electronic database is much faster than looking through hundreds (possibly thousands) of paper files, no matter how well organized you are. How many times have you seen this order in a chart: “have the patient’s old medical records sent over”, or some equivalent phrase. That would be a thing of the past with a paperless electronic medical record.
The patient centered medical home and pharmacy
From the Pharmacy Technology Resources (PTR) blog:
“Patient Centered Medical Home” (PCMH) – is likely to be the best opportunity for aligning physician and patient frustration, demonstrated models for improving care, and private and public payment systems to produce the most profound transformation of the health care system this far. Wait a second – what about the Family Pharmacist or Consultant Pharmacist? How does pharmacy play into this model? What relationships are being formed today between the community retail pharmacy and these home-care physicians? What active correlation or network can be established nationally to group together seamless health-care services between the home-patient, the physician, and the pharmacy?
First – we’ll say – its ePrescribing with all the industry attention this mode of communication brings between doctors and pharmacists – however – I say it takes more than an electronic network to ensure the proper care is given to the patient. This medical home based model sounds similar to the model from the 1990’s of managed care that was about decreasing costs. Is this system designed to help patients instead of insurers? The relationship between the “local” doctor and the “local” pharmacy is imperative. We have come full circle – where in the 1950’s the relationship between physician and pharmacist was much more prevalent. Today – the home-care doctor can grab his iPhone and digitize the necessary communications with pharmacy for a seamless and completed transaction for the patient. But what about the relationship between the doctor and pharmacist and the periodic medication review for the home-care patient?”
As I have mentioned before, the technology to provide real-time access to patient data is currently available. This provides a genuine opportunity for pharmacist involvement in the medical home model. The PTR blog recommends pharmacists partner with local physicians using the PCMH model, and I think this is a great idea. This is a golden opportunity for all you pharmacists that want to expand your practice setting. What are you waiting for? The time is now.
Deinstallation of EMRs
HealthcareITNews.com: “Physician groups in Phoenix are canceling their EMR contracts as a result of training, functionality or affordability issues. This is especially prevalent among smaller physician groups, the report says. ” – Software vendors take note. No matter how “cool” you think your product might be, people won’t use it if it is cumbersome and expensive. Unfortunately, this appears the be the rule in healthcare rather than the exception.
A rose by any other name….
HealthBlog: “Monday evening, I was invited to attend a dinner with my fellow panelists (Dr. David Kibbe, Ravi Sharma, Steve Adams, Martin Pellinat) and others to discuss the idea of clinical groupware. If you are not familiar with that term, clinical groupware is described as a set of practice management, electronic medical record, decision support, prescription writing and other solutions that could be delivered to clinical practices as services over the Internet.” – Hold the phone. Isn’t that the same thing as SaaS or clound computing or simply and extension of EMR/EHR? Sounds like it to me. Maybe we should all agree on a standard naming convention as different names for the same thing is more confusing than helpful. I’m just sayin’…
Physician’s stolen laptop contains patient information
EMR and HIPPA: “This story made me think of two things:
1. Why is PHI being stored on the laptop in the first place? I wish I could find out if there was an EMR involved. If there was, then the EMR should be storing all of the patient information on the server and none of that data should be stored on the laptop. So, if it gets stolen there’s no breach. That’s the beauty of an EMR these days. There should be no need for this to happen.
2. There’s some really cool technology that’s been coming out in recent laptops that will allow you to remotely wipe out the laptop if it ever gets connected to a network. Basically, once your laptop is stolen you report it stolen and they start tracking it down kind of like they do with stolen cars (same people from what I understand).” – The story associated with this blog goes on to say that “Patient names, treatment dates, short medical treatment summaries and medical record numbers were stored on the computer.“ This wouldn’t have been an issue if all the patient information was stored in the “cloud” and viewed and updated via a secure connection when necessary. Security aside, data stored on a local hard drive increases the chance for lost or duplicate data. Anyway you slice it, this was a bonehead move.
Not everyone is happy with the idea of ePrescribing
The Angry Pharmacist: “Don’t say that your pharmacy associations don’t do anything for you! Now GNP pharmacies get [$%#@] by their own for the low-low cost of only $0.30/eRx. Here’s something about “quality, safety, and efficiency”: I have seen more errors, decimal point, and unit [$%#@] via SureScript eRx in one week than YEARS OF PAPER PRESCRIPTIONS. In fact, I keep a file of all of the eRx [$%#@] that I get (it gets about 2-3 a day, that’s 15 a week) so when doctors say how WONDERFUL it is, I show them how many lives I have saved. I’ve seen injection dose written instead of an oral dose, blatant overdoses, everything you can imagine. I’ve even had controlled substances faxed to 2 different pharmacies 1 min apart for a cash paying patient MULTIPLE TIMES. Hows that for safety and quality! …Now here’s the dirty secret of eRx’s … You see, the “old fashioned way”, doctors had to sign each Rx they gave out to the patient. However those days are long gone thanks to ePrescribing. Now all some idiot has to know is the doctors password and ANYONE IN THE OFFICE CAN SEND OFF PRESCRIPTIONS. That’s right, this bullshit doesn’t save the pharmacies any time, but it saves the doctor a bunch because its pretty much giving anyone who works in the office the power to sign and give patients legit prescriptions (even for controlled substances!) Before, you had to steal the doctors pad and write out phonies, now anyone in the office with access to the eRx terminal can splatter out narcotics to every pharmacy that takes eRx’s and nobody would be the wiser.” - The author has some pretty interesting things to say about ePrescribing in general. I guess the process isn’t exactly ready for prime time. Take a minute to read the entire article, but only if you don’t have sensitive ears.
Call to slow down EMR development for better security.
HIT Consultant Blog: “The law [HITECH, the law gives incentives to healthcare organizations to digitize personal health information before 2020], which also updates parts of HIPAA, gives the Secretary of Health and Human Services until mid-August to define what constitutes an electronic medical record. In Schmidt’s view initial requirements should start with strong authentication and encryption, and so far, the Secretary has done just that. Citing existing NIST and FIPS standards, HHS guidance includes healthcare data at rest, data in motion, as well as the proper destruction of Protected Health Information. Unfortunately, some health practitioners have begun purchasing e-health systems before the full complement of standards is known.” - No matter how you slice it, security is always going to be a problem. Even now, security is a primary concern for any healthcare facility in the United States. As you expand outside the walls of your existing system it is only going to get worse. I agree that practitioners should slow down and wait until some of this gets worked out. There’s nothing worse than investing in a system that has to be scrapped secondary to jumping the gun.
