The Health IT industry is abuzz with a recent Wall Street Journal op-ed by Professor Stephen Soumerai of Harvard Medical School and Professor Ross Koppel of the University of Pennsylvania.   The opinion piece, “A Major Glitch for Digitized Health Care Records” (subscription required), transforms a timid literature review on the value of information technology for medication management into the final word on IT’s ability to deliver savings in healthcare. The authors not only make sweeping pronouncements about the much-discussed ability of Electronic Health Records (EHR) to contain costs but go on to make equally questionable claims such as that the Meaningful Use program will cost $1 trillion – a figure they attribute to “installation, training and maintenance costs.” They also contend that the effort to share patient records between organizations has already been proven a failure, even as the industry […]

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The Infobutton: ONC Gets it Right

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, […]

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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  […]

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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 […]

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Meaningful Use: One Health System’s Journey

While most hospitals are focused on CMS’s release of the draft Stage 2 rules for Meaningful Use last week, now seems a good time to take a look back at how one health system managed to succeed with Stage 1. After all, more than half of all hospitals have yet to attest to Stage 1. Summa Health System, where I work as lead quality and clinical analyst, is one of the largest integrated healthcare delivery systems in Ohio, serving more than 1 million patients each year in comprehensive acute, critical, emergency, outpatient and long-term/home-care settings. Summa includes eight hospitals, more than 1,500 physicians and 11,000 employees overall. Nationally renowned for excellence in patient care, Summa implemented the Sunrise Acute Care Electronic Health Record (EHR) from Allscripts in 2003.  (Editor’s Note: Steve Shaha, Ph.D. wrote last week about Summa’s success using Sunrise […]

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Stage Two: Let the Debate Begin!

Many of us who are close to healthcare IT regulation will soon be heads-down reviewing, analyzing and generally mulling over the Proposed Rule on Stage 2 of the Meaningful Use program, now that CMS is set to release it.  On top of late nights and a headache or two, there is one other thing we’re bracing for: the Great Debate as to whether CMS – with significant input from others – did a good job or missed the mark.  No matter what is in the Rule, some will argue that the proposed measures are too difficult, while others will insist CMS didn’t go far enough.  It’s clear we can expect significant back-and-forth on the appropriate balance of the Rule’s many elements – the thresholds, the quality measures, the requirements for data connectivity, privacy elements, and how best to measure patient engagement in […]