The ONC’s proposed rule for Electronic Health Record certification under Stage 2 Meaningful Use includes one requirement that will be good for clinicians and good for patients – the Infobutton.  Under the rule, EHRs certified for Stage 2 would be required to support the HL7 Infobutton standard for two distinct use cases: Providing a context-sensitive link to reference information to support clinical decision making Providing links to patient-specific education resources So what is an Infobutton?  Infobuttons link an EHR to an outside knowledge source.   Importantly, Infobuttons are context sensitive.   For example, if the patient has a diagnosis of multiple sclerosis on his or her problem list, an Infobutton next to that problem would link the user to one or more knowledge sources about multiple sclerosis.  The user can access the information immediately without opening a new application or web page, [...]

Where’s Paul Shaffer when you need some theme music? Now that the comments on the Meaningful Use Stage 2 Notice of Proposed Rulemaking (NPRM) have been submitted by anyone with an opinion and Internet access, the media is making hay of all the negative feedback from industry stakeholders.  There have clearly been some provocative conversations. There’s even a protest planned in response to one organization’s suggestions! But there are also plenty of people who actually liked elements of the proposed Stage 2 program, including the leadership of Allscripts.  It may not be as sexy to point out what we like, but even federal bureaucrats deserve kudos on occasion – especially when their proposals benefit patients and providers.  So here we go … The Top Ten Things We Like About Meaningful Use Stage 2 10. There’s so much more for specialists  [...]

“Sepsis is preventable, and at Orlando Health we have set a high priority on infection control as our quality initiative. (Allscripts) Sunrise EHR is an essential part of our initiative to eradicate central line-associated bloodstream infection and catheter-related urinary tract infection. The capabilities of Sunrise significantly help with these efforts.” – Michael L. Cheatham, MD, FACS, FCCM, Director, Surgical Intensive Care Units, Orlando Health Most of us are familiar with sepsis — a serious medical condition caused by an overwhelming immune response to basically a whole body infection. It’s one of the leading causes of death in hospital ICUs. Every year, severe sepsis strikes about 750,000 Americans. Somewhere between 28 and 50 percent of these people die—far more than the number of U.S. deaths from prostate cancer, breast cancer and AIDS combined. MLMs are the key The key to beating sepsis [...]

    We recently interviewed Michael Dowling, President and Chief Executive Officer of North Shore-LIJ Health System.  Based in Great Neck, NY with facilities across the New York City region, North Shore-LIJ is the nation’s third largest non-profit secular healthcare system with 14 hospitals and 9,000 physicians. The health system is a winner of the National Quality Forum’s National Quality Healthcare Award. Dowling, a long-time advocate of healthcare information technology, was the 2011 HIMSS/Modern Healthcare CEO IT Leader of the Year.  Here are a few quick highlights from the interview.  To hear the entire podcast, please click on the link at the bottom of this post. What is the biggest challenge facing healthcare leaders today? “I think it’s the necessity to completely transform how we do business. The future is going to require a lot more accountability, both to the public and to the actual [...]

As CMIO of United Hospital System in Wisconsin, I try to make it easy for our physicians to get the information they need to make the best clinical decision. Recently we deployed a Medical Logic Module (MLM) for all 40 of our employed physicians so they can do just that.  Using the MLM, they can view, with one click in their Sunrise Ambulatory EHR, everything they need to manage a patient with chronic disease – and they can do it in less time, with improved accuracy and better outcomes. Before I go on, though, a little history might be in order.  If you’re not familiar with MLMs, you should be.  An MLM is a bit of computer wizardry that’s designed to find all the information within an EHR database pertinent to a single question and alert doctors when the right [...]

The Centers for Medicare and Medicaid Services (CMS) announced last week that it selected 27 accountable care organizations (ACOs) to participate in its Shared Savings Program, which rewards organizations for meeting quality benchmarks and reducing costs.  The announcement followed the earlier selection of 32 Pioneer Model ACOs and six Physician Group Practice Transition Demonstration organizations.  Altogether, CMS says more than 1.1 million patients receive care from providers participating in Medicare shared savings initiatives. Yet the nation’s biggest commercial ACO isn’t on the CMS list. AdvocateCare, an ACO with 350,000 covered lives and 3,900 participating physicians, is the largest of a growing number of private ACOs across the US.  Launched in late 2010, the ACO is a joint venture between Advocate Health Care, a $4.5 billion IDN based in Chicago, and BCBS of Illinois. Building on Advocate’s 8-year-old clinical integration program, the [...]

Usability is the key to getting physicians to adopt voice recognition technology with an EHR.  That’s the conclusion of Mary Griskewicz of HIMSS, according to a story in today’s USA Today. The newspaper noted that the University of California-Irvine Medical Center, among others, is testing the technology for use with their inpatient (Sunrise) EHR, initially on desktop and later on iPad.  Meanwhile, many physician practices are already using voice recognition for dictation and to accomplish everyday tasks like prescribing medications. Stanley Crane, Allscripts Chief Innovation Officer, calls the confluence of iPad and voice recognition “a marriage made in heaven.” Voice recognition not only is an easy way to get information into the EHR but it lets doctors take more complete notes for themselves and for the next doctor who picks up the case. Crane, who was interviewed by USA Today for technical background [...]

Today’s Forbes.com features the latest guest column by Allscripts CEO Glen Tullman: “Face Time MD: How Consumer Tech Can Deliver Care That’s Better, Faster, Cheaper.”  Glen looks into the future by describing existing innovations that are already making a difference.  Like live consults with your physician on the iPhone . . . using Xbox Kinect to monitor compliance with physical therapy . . . and devices that let heart patients, diabetic patients and their doctors monitor vitals in real-time, all linked to the Electronic Health Record.   “Now, with a bit of innovation, and an open approach to both how we care for patients and the systems we use, we can put them together and create the future—a better future not just for health care but for health, which is what we really want anyway,” Glen writes. Speaking of which, if you missed last week’s announcement you [...]

Recruitment is at or near the top of every CIO’s list of headaches. The demand for trained informaticists far exceeds the supply.  Moreover, it’s expensive to recruit and relocate people from outside organizations, especially when there’s no guarantee they’ll work out.  The video above captures an innovative solution by UC Irvine Healthcare, a major academic medical center in the Los Angeles area that has been ranked among the nation’s top hospitals for 11 consecutive years by U.S. News & World Report.  Rather than recruit for open positions, UCI’s IT leaders decided to look inward — to the nurses who are the biggest users of the most strategic and important applications in a health system.  “We decided that, rather than trying to recruit and bring people in and not meeting our staffing requirements, to go out to our nursing population at large within UCI and grab [...]

Sometimes it seems as if the only news you read about computerizing healthcare is bad news.  Errors, alert fatigue, unintended consequences . . . it’s almost as if people enjoy hearing what’s not working  and can’t wait for the next installment.  Meanwhile, healthcare organizations that have invested in high-performance Electronic Health Records (EHR) and other advanced IT systems continue, often without fanfare, to make major advances in patient safety, quality of care, cost-effectiveness and efficiency.  One such organization is Sarasota Memorial Health Care System, an 806-bed regional medical center on Florida’s Gulf Coast.  Literature and industry experts such as the Institute of Medicine (IOM) have described the risks associated with patients who, as their condition worsens, remain unnoticed, and therefore un-rescued.  Patients who “crash” are among the most costly to care for.  Sepsis alone costs the U.S. healthcare system an estimated $17 billion a year, [...]