Top 10 Things We Like About Meaningful Use Stage 2

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  […]


Good News Makes Bad Headlines

Sarasota ECCentrance

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, […]

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 […]


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 […]


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 […]

Do acute care Electronic Health Records always achieve their intended goals? The literature on “unintended consequences” has long warned of the potential downside of EHR implementations and the unique challenges associated with computerization in healthcare settings. Alert fatigue, for example, continues to frustrate clinicians overloaded with un-prioritized pop-ups that lead them to click past both inane and critical alerts.  The moral is that simply computerizing medical records and ordering electronically with CPOE does not lead effortlessly to the clinical, efficiency and organizational performance outcomes we seek. In fact, it often does harm.  I was on the phone recently with a physician friend who was driving home after seeing a patient in a hospital that uses a competitive EHR.  Abruptly he said, “I need to turn around and head back to the hospital – I apparently ordered a ten-fold over dose […]