Requirements for bar code scan verification set too low in meaningful use guidelines

homer-simpson-dohOver the weekend I read an article at HealthBiz Decoded about bar code requirements and meaningful use (MU). I knew that there was some language in Stage 2, but never took the time to read through it carefully. The meaningful use documentation is exactly what you’d expect from years of bureaucrats sitting around trying to generate a document worthy of the governments typical high standard. Yeah, it’s a big ol’ pile of crap. One thing’s for sure, it’s going to create an entire generation of consulting business for a lot of people. I digress.

According to the article, “Hospitals will be required next year to use bar codes to verify 10 percent of medication orders under government health IT rules.”  That number seems pretty low, even for our low reaching federal bureaucracy. And some people have noticed.

The article quotes Mark Neuenschwander, a barcoding evangelist, as saying “We should be striving for a higher percentage because errors can happen in the other 90 percent as easily as they can happen in the 10 percent.” True enough. Anyone out there have a job where 10 percent accuracy, completion or participation is acceptable? If so please give me a jingle if/when you have an opening.

It’s hard for me to imagine what someone was thinking when they pulled 10 percent out of thin air. I’m not naïve enough to think we’ll ever get to 100 percent, but c’mon man, 10 percent! Really? Fifty percent would have been low, but 10 percent is comical.

I think bar coding technology has a place in healthcare. It offers up some real advantages when used appropriately, and I find it disturbing that the MU guidelines find 10 percent scan rates acceptable. That’s some serious weak sauce right there.

Saturday morning coffee [May 11 2013]

MUG_Talyst3So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

The coffee mug to the right is from the company I work for. Strange little story to go along with how I ended up working there, but that’s probably better saved for another time. I ended up with a mug from the company long before I came on board. It was part of a swag bag at one of the past user group meetings that I attended as a customer. I believe it was my first ASHP Summer meeting way back in June of 2009; can’t be sure though.

Iron Man 3 was #1 at the box office last weekend raking in a cool $174 million. No surprise there as Iron Man 3 was expected to be a blockbuster. I wasn’t able to see it over the weekend, but did manage to catch it Monday night. Was it good? Absolutely, it was a very good move. However, I was a bit disappointed. There was a lot going on in the movie, and some of it felt “off”. I’d still see it again. It’s a bummer that this is likely the end of the Iron Man franchise. Oh, just in case you were wondering Pain and Gain was a close second with $7.5 million in weekend gross; a mere 23 fold difference.
Continue reading Saturday morning coffee [May 11 2013]

Saturday morning coffee [April 6 2013]

MUG_AlienJerkySo much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

Welcome to April 2013 everyone. The year is flying by.

The coffee mug to the right comes straight from Alien Fresh Jerky in Baker, CA. Baker is small town located near the Nevada border. The population is less than a thousand people, but they do have the worlds tallest thermometer, and of course Alien Fresh Jerky. My family and I drive right past Baker, CA every time we head to Las Vegas. I’ve seen the Alien Fresh Jerky sign a hundred times, but for one reason or another had never pulled in for a visit. This time I decided to swing in and take a look. Turns out that it was a good decision. Not only did I pick up a coffee mug, but I purchased some seriously good jerky. I’m a traditional kind of guy so I stuck with the beef in two flavors: Honey Teriyaki and their Road Kill Original. Great tasting jerky. Oh, I’d recommend staying away from their “Invisible Jerky”, it just doesn’t fill you up like the others.
Continue reading Saturday morning coffee [April 6 2013]

“What’d I miss?” – Week of February 14th

As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
Continue reading “What’d I miss?” – Week of February 14th

“What’d I miss?” – Week of January 17th

As usual there were a lot of things that happened during the week, and not all of it was pharmacy or technology related. Here’s a quick look at some of the stuff I found interesting.
Continue reading “What’d I miss?” – Week of January 17th

The American Recovery and Reinvestment Act is not without risk

The American Recovery and Reinvestment Act (ARRA) has created quite a flutter of activity in healthcare during the past several months. I can’t remember a time when something was such a popular topic. Everywhere you look, Twitter, Facebook, personal blogs, professional blogs, and so on are talking about how to demonstrate “meaningful use” and get their hot little hands on some cash.

While the idea is sound, the implementation has something to be desired. The overwhelming attention to the definition of “meaningful use” and the looming 2011 timeline has created some unwanted side effects to the ARRA. Hospitals have started throwing project plans in reverse for significant revision or throwing them out the window and starting over all together. Projects that may have been in the pipeline for months, or years, are now taking a back seat to the ARRA requirements. Project development and timelines are involved processes that are designed to work around several variables such as capital budgets, current software and hardware specs, and available human resources.

Many healthcare systems have yet to develop a plan to implement many of the requirements necessary to meet the ARRA “meaningful use” criteria. If a healthcare systems wasn’t ready to begin the process at any time over the past several years what makes the US government think they’ll be ready just because they say so? Is the infrastructure in place? Do they have the resources to not only implement, but support the new systems as well? These are all questions that people should be asking. I for one am disappointed in our facility as we have decided to immediately move forward with projects that weren’t slated for another 18-24 months. To make this happen other projects have been placed lower in the priority queue, creating a lack of resources that risk jeopardizing the quality of both implementations.

Healthcare systems should not be directed down a path that they feel unprepared to face. Doing so will only invite failure.

Siemens Innovations ’09 – The End

Siemens Innovations has officially come to an end. My time in Philadelphia was good, but I will be happy to get home to the “dry heat”. The information I picked up was very valuable and I made some great contacts. I’m excited to get back to work and see what damage I can cause with my newly acquired knowledge.

As I wrap up my time here at Innovations ’09 a few thoughts come to mind:
Continue reading Siemens Innovations ’09 – The End

Length of time to implement CPOE

Ok, I’ve taken a little heat since claiming that a “meaningful use” goal of 10% CPOE was weak, so I did a little digging. While collecting ammunition for my defense I came across a little blurb addressing this very issue.

CHIME070909.ashxiHealthBeat: Thirty-five percent of hospital CIOs surveyed said it would take their facilities three years to achieve 100% adoption of computerized physician order entry, according to a new survey from the College of Healthcare Information Management Executives. Twenty-seven percent of CIOs surveyed said it would take their hospitals two years to achieve 100% CPOE adoption, while 17% of respondents said complete CPOE adoption would take four years and 13% estimated a five-year time frame to achieve 100% adoption. Only 9% of CIOs surveyed said full CPOE adoption could be achieved in one year.”  – Remember that the “adoption year” timeframe is 18 months away (2011) with a 2012 start date qualifying you for the full incentive potential. This means you could actually wait as late as 2013 for full adoption and still qualify for funding. I realize CPOE is a major project; we’re struggling with it right now. Bu I still think hospitals have enough time to do this right and still get 100% usage. As the saying goes, “nothing worth having comes easy”.

ASHP Makes Recommendations for Definition of “Meaningful Use” “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.

Talking “meaningful use” with our CIO.

The American Recovery and Reinvestment Act of 2009 (ARRA) is an $850 billion stimulus package passed by Congress aimed at encouraging economic growth in various industries through government spending. If you’re in healthcare, then you may be able to take advantage of $51 billion that has been allocated to the healthcare industry, $19 billion of which is aimed at the adoption and implementation of Electronic Health Records (EHRs), also known as Electronic Medical Records (EMRs). The only way to get your share of the money is to demonstrate that you are a “meaningful user” of an EHR system. The problem is figuring out what a “meaningful user” is.

My curiosity about being a “meaningful user” led me to the office of our CIO, where I casually asked him if we were going to qualify for any of the funds allocated by the ARRA. He informed me that “meaningful user” had not been completely defined, and is currently a hot topic of discussion.

Continue reading Talking “meaningful use” with our CIO.