No matter where the Supreme Court lands on the Obama Administration’s health insurance mandate, there’s no question that the transformation underway in healthcare today will continue. One of the most striking changes in the last few years – consolidation and transformation within the hospital market – is the subject of a recent study by Moody’s Investors Service. As reported by the New York Times’ Reed Abelson, Moody’s says the arrival of value-based reimbursement will accelerate techtonic shifts already underway in the hospital market. Big hospital groups are getting even bigger as smaller, stand-alone hospitals and groups seek financially strong partners. Along the way, some hospitals are joining forces with former adversaries, health insurers and for-profit companies. Abelson calls out two notable examples of these trends: North Shore-LIJ health system in New York, and Pittsburg-based West Penn Alleghany Health System.   Both […]

Allscripts is taking a leading role in the delivery of best-practice care for patients with cardiovascular disease through sponsorship of the Allscripts Million Hearts Clinical Decision Support Challenge, which officially opens today.   The Challenge The Allscripts Million Hearts Clinical Decision Support Challenge offers a $50,000 prize to the person or group that creates a publicly available clinical decision support (CDS) resource to accelerate the delivery of optimal treatment for cardiovascular disease. Our goal is to accomplish this by facilitating the translation of the resulting CDS rules into an unambiguous, machine-readable format that can be “read” by any Electronic Health Record (EHR). Allscripts will provide materials, including an XML format that participants can use in the development of the solution. In line with our long-held commitment to interoperability and open systems, the Challenge is designed to make important elements of the winning solution available to the community […]

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Memorial Sloan-Kettering and IBM Watson

Memorial Sloan-Kettering Cancer Center and IBM today announced plans to develop advanced oncology decision support using IBM’s Watson supercomputer.  Researchers at IBM and the world-renowned hospital will input data from, among other sources, the cancer center’s Sunrise Electronic Health Record, to strengthen Watson’s capabilities as a medical resource.  Martin Kohn, chief medical scientist at IBM, told the AP/Washington Post that, after the completion of the oncology training in 2013, Watson should be able to quickly recommend cancer diagnoses and provide treatment options.   Larry Norton, deputy chief for breast cancer programs at Sloan-Kettering, told the Post that the data will add “wisdom” to the computer’s grasp of scientific literature. He said, “Because of our size and experience, we have super-specialized physicians in every field of cancer. And all of what they actually do is capturable in the language of our electronic medical records.” After […]

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Reducing Blood Transfusion Risk and Costs with Advanced CDS

  • Steven Shaha, Ph.D., DBA
  • 03/20/2012

  Healthcare isn’t broken, as some would have you believe.  In fact, healthcare has never been in better health than when clinical decision support (CDS) helps expert providers do the best thing, consistently.  Everyone wins – providers, patients and the healthcare organizations in which they co-operate.  Rather than criticize, perhaps we should promote more powerfully enabled models for helping. Here’s a great example. Few outside the inner circle of blood banks and surgeons know that the costs and risks associated with everyday blood transfusions are significant.  A recent study in the journal Transfusions pegged the cost at between $522 and $1,183 per unit of blood.  And despite the routine nature of transfusions, the procedure carries sobering and serious clinical risks.  According to The Strategic Healthcare Group, the leading causes of transfusion-related morbidity and mortality are unrelated to viral transmission and include bacterial […]

The other day, I was sitting in O’Hare International when I learned my plane was delayed. To take my mind off the prospect of arriving later than I’d planned, I watched the mechanics that were crawling over the plane outside the window. I wondered, has the plane been burning oil? If a warning light is not working, when was the last time it failed? How recently were the hydraulics checked? Since the American Super 80’s that I was looking at are older than many of the passengers who were waiting to board, I suspected there was a rich history on this particular airplane. Do you suppose that in the front of the plane somewhere, there is a file folder with this wealth of maintenance information enshrined within? If there is, what are the odds that all the mechanics who worked […]

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A flawed approach to studying EHR cost-effectiveness

  • Steven Shaha, Ph.D., DBA
  • 03/08/2012

A study published this week in Health Affairs purports to call into question the ability of Electronic Health Records to reduce imaging and lab tests and therefore save money.  The study has been reported in the New York Times and elsewhere but generally with little insight into the substance of the authors’ argument.   A closer look reveals that, far from proving that EHRs cannot deliver their promised cost savings, the study provides compelling evidence that EHRs armed with advanced Clinical Decision Support (CDS) are what is most needed to cut costs while improving quality.  The size of datasets analyzed by the researchers is rock solid, as are the results quoted. But the conclusions in the study raise as many questions as they answer. Most notably, the final sentence in the authors’ abstract reads: “We conclude that use of these health […]

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The Path to EHR Interoperability

The long-anticipated interoperability of Electronic Health Records has at last been codified (or nearly) by CMS’s proposed Meaningful Use Stage 2 requirements. As veteran healthcare IT journalist Ken Terry writes in Information Week, interoperability is the “linchpin of MU Stage 2” as well as CMS’s proposed rule on 2014 certification of EHRs. How difficult will it be to achieve CMS’s interoperability goals? According to the proposed rule, to be certified as meeting Stage 2 requirements, EHRs will need to exchange Continuity of Care Documents (CCD) with the EHRs of other vendors; use Direct secure messaging to exchange patient data across enterprises; use certain standard medical terminologies such as SNOMED CT; and use the HL7 2.51 messaging format to submit reportable lab data, immunizations, and syndromic surveillance to public health agencies. While many providers will struggle to meet the new requirements for […]

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Call me crazy … A Stage 2 Perspective

When I tell people that part of my job is to read regulations that were written by the government, the reactions I get vary from blank looks to sympathy to “better you than me.”  And when I tell them that I actually enjoy that part of my responsibilities, most think I’m joking.  The truth is, I love the process of healthcare regulatory promulgation.  As all of us who waited anxiously for the Meaningful Use Stage 2 NPRM can attest (pun intended), there is an awful lot of conversation that takes place as regulations are written. I find the back-and-forth invigorating.  Before a regulation is written, there are numerous Federal Advisory Committee (FACA) meetings to listen to, carefully scripted presentations by ONC and CMS, and private meetings requested by various stakeholders and industry associations.  It’s really a constant opportunity to learn […]

Dr. Mostashari’s Last-Minute Interoperability Challenge Allscripts, by partnering with Albany Medical Center, MedAllies and NextGen, handily won an interoperability challenge issued by Dr. Farzad Mostashari, National Coordinator for Health Information Technology, at HIMSS last week.  Read Dr. Doug Fridsma’s post on ONC’s Health IT Buzz blog describing the event.  Mostashari’s surprise challenge was this: Send a document via protocols established by the ONC Direct Project along a pathway that has never been used. In other words, prove that Direct (a public/private collaborative focused on developing a scalable, secure, standards-based means of sending authenticated health information via the Internet) is live and working in general, and is not just a set of hard-coded demonstration systems working together. Allscripts and its team not only completed the task successfully but did so with time to spare. Important to note: “This used the test systems of […]

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Four Steps to Physician Revenue Cycle Transformation

Amid all the talk of Stage 2 Meaningful Use, Value-Based Care and ACOs at the HIMSS conference in Las Vegas last week, it was easy to overlook the dominance of the longest lasting trend of all in healthcare IT. Revenue cycle management doesn’t generate as much buzz as health reform but it’s still priority No. 1 for hospitals and physician practices nationwide. It’s easy to see why. As the latest Obama Administration budget indicates, reimbursement from payers including Medicare and Medicaid continues to decline. As a result, self-pay is on the rise, even as it is becoming harder to collect payment from patients, many of whom are struggling just to hold onto health coverage for their families. In this environment, effective revenue cycle management has become more important than ever. For help, many leading medical groups are turning to a […]