IT for Healthcare

RE/MAX Legacy Grand Opening

To prove were no one-trick pony (that's right, we can do things besides healthcare IT!), we recently installed and networked a turnkey SMB office solution for a start-up realty office in Hudson, Ohio.  Jeff Swiecicki and George Daher, the principals of RE/MAX Legacy, will celebrate their grand opening this weekend with a two-day open house featuring $5 rides in the world famous RE/MAX balloon (weather permitting, of course).  We'll be there.  If you're in the market or you just want a bird's eye view of the wonderful Western Reserve region, we recommend checking them out.

RE/MAX Legacy
84 Village Way
Hudson, Ohio 44236
330.656.1081

Rides will go from 1p-5p on Sunday, September 3rd and 12p-4p on Monday, September 4th.  Proceeds will go to charity.

Time: How VA hospitals became the best

There is no direct discussion of EMR in this piece but many of the efficiencies that the VA has created are a function of their commitment to IT.

The VA runs the largest integrated health-care system in the country, with more than 1,400 hospitals, clinics and nursing homes employing 14,800 doctors and 61,000 nurses. And by a number of measures, this government-managed health-care program--socialized medicine on a small scale--is beating the marketplace. For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan's American Customer Satisfaction Index, based on patient surveys on the quality of care received. The VA scored 83 out of 100; private institutions, 71.

Some examples of the VA's increasingly sophisticated technologies and how they impact quality and cost of healthcare are cited.

When a veteran is treated, the doctor has the vet's complete medical history on a laptop. In the private sector, 20% of all lab tests are needlessly repeated because the doctor doesn't have handy the results of the same test performed earlier, according to a 2004 report by the President's information technology advisory committee.

Another innovation at the VA was a bar-code system, as in the supermarket, for prescriptions--a system used in fewer than 5% of private hospitals. With a hand-held laser reader, a nurse scans the bar code on a patient's wristband, then the one on the bottle of pills. If the pills don't match the prescription the doctor typed into the computer, the laptop alerts the nurse.

It seems strange to see the word innovation used in a story about a government program but there you have it.

Link to more information on the transformation of VA hospitals.
Thanks to FierceHealthCare for the original link to the Time piece.

Brewed Fresh Daily: RRR 3.0

Doug Craver at BFD shares his take on the latest incarnation of the Red Room Revolution, TechSync, and the state of the Cleveland Technology Community.

tech.sync kicks off with Guy Kawasaki who in this blog post about kicking Silicon Valley’s butt recommends, “Don’t pat yourself on the back too soon.” Yikes, I wonder what he’ll think about our cheerleaders? Hopefully some of the cheerleaders won’t spook him out too much and he’ll give us an honest eval of tech.sync on his blog.

Yeah, there's more.  Check out the whole post and the comments here.

FutureHIT

We've been active in the blogosphere this week.  A post at FutureHIT on CPOE and a comment exchange with author Dale Hunscher precipitated adding his insightful blog to Recommended Reading.  Please check him out.

EMR Musings

We've entered into a good-spirited debate with EMR and HIPAA this week about the nature of the "Best EMR" and what features set the best apart from the rest.  This originally came about after a favorable post regarding our blog and the information we're putting out there.  In that post, the question was posed as to why we chose to align with Misys when so many folks out there seem disenchanted with them.  Our response, in brief, was that Misys is dedicated to development and has recently improved upon its previous iterations of EMR with the release of EMR 8.0.

In addition to implementing Continuity of Care Record (CCR) funcitionality in 8.0, Misys has been recognized with the following honors in the past 12 months:

Misys EMR 8.0

• CCHIT Certified Ambulatory EHR (One of 18 charter certifications)
• Top 20: 2005 Year-End Best in KLAS - #6 Ambulatory EMR
• 2006 AC Group Five-Star Rating: EMR & Multi-Specialty EHR
• DOQ-IT Certified

Misys Vision

• 2006 AC Group Five-Star Rating: Fully-integrated PMS
• Top 20: 2006 Mid-Year Best in KLAS - #2 PMS - 100+ Physicians

Misys Tiger

• 2006 AC Group Five-Star Rating: Fully-integrated PMS
  Top 20: 2006 Mid-Year Best in KLAS - #6 PMS - 25+ Physicians

And while we don't believe that honors and accolades alone ensure quality, we do take exception with the notion that it's all marketing.  The best marketing in the world isn't going to help earn the above honors if the product doesn't do what it's supposed to do.

In the course of the debate, it was pointed out that we hadn't really addressed the question of what features put Misys "ahead of the pack."  True.  And we won't bother trying.  Here's why.

The goal of certifications like CCHIT and organizations like KLAS and AC Group is to provide an outline of the functionality and features of each product to help physicians compare it with its peers.  Moreover, the function of CCHIT cerification is widely accepted as winnowing the field from the 400+ applications on the market to a more manageable number that share certain features in common.  Good.  Once we've established that EMR A, B, & C do in fact have an e-prescribing function (necessary for CCHIT certification) then we can discuss the far more important questions of how that function works, how it fits into your workflow, whether it's simple, secure, and reliable, and any number of other very personal considerations that each physician should ponder before deciding on any EMR.

We used the analogy of your favorite brand of jeans.  The point being, once we establish that the parts are all the same you're left with a question of comfort, of subjective like or dislike.  And as long as humans practice medicine, there will always be questions of personal feel, of subjective like or dislike (EMR and HIPAA used the equally good analogy of "best" movie).  To answer those questions you don't need marketing slicks with bullet-pointed lists of features, you need to get your hands on the application and see what it can do.  You need a technology partner that spends time learning about your practice's unique needs.   You need a solutions provider that asks the right questions to help you get the most out of your technology investment.  In short, you need to feel comfortable knowing that the technology you implement in your practice is a tool that helps you to be a better, more responsive, more efficient physician.  And frankly, they don't code that into the software; you get that from working with folks that have passion, integrity, and know-how and who think being the best means helping you to be your best.  I know some folks like that. . . I work with them everyday.

So if you want to see the feature set, please do go to the website.  If you want to get your hands on it, see what it can do, and find out if you feel comfortable with Misys and Calyx, let us know.  We'd be happy to find out together if Misys is right for you.

Here she comes. . .

I feel like Miss America today!  We keep hearing such nice things from the blogosphere, this time from Brewed Fresh Daily.  Please don't be afraid to let all these glowing reviews convince you to pick up the phone and find out how we can apply all that know-how to your IT environment!

Thanks Doug and George!

HITSphere

We're moving up in the world!  Our latest mention of note in the HIT Blogosphere was from EMR and HIPAA, a blog we read regularly, quote often, and look to respectfully as a pioneer in the EMR blogging community.  It's nice to see good reviews out there.  So, emboldened by our increased traffic and the kind words, we requested a place at the table with some of the premium HIT bloggers in the business at a great site called HITSphere.  HITSphere is a network of the best HIT blogs on the web, all in one location.  We look forward to reaching a wider audience and learning & teaching more about the potential and the reality of Healthcare Information Technology.

Why Docs Don't Say Sorry

Medical culture and the training doctors receive is cited as the number one reason patients are not informed of medical errors as often as they should be.

"We think doctors' attitudes about disclosure come much more from the culture of medicine -- attitudes derived from training -- than the external malpractice environment," said Thomas Gallagher, associate professor of medicine at the University of Washington and lead author of a study appearing this week in the Archives of Internal Medicine.

Link

Doctor-Patient Communication: Making Sure the Doctor Really Hears You

Brief but interesting article in The New York Times on communicating effectively during medical consultation.  As EHR become more ubiquitous, folks will have a greater role in their own healthcare.  That is, in fact, what many consider to be among the greatest advantages of e-Healthcare.  As that happens, however, the dynamic between physician and patient will need to change significantly:

Some patients show up to a scheduled appointment with a fistful of questions, “and that’s fine, that’s very good,” Dr. Gill said.

“But,” she continued, “to get them answered, write the questions down beforehand, and say at the outset of the office visit: ‘I’ve got some questions. When would be the best time for me to ask them?’ ”

That alerts the doctor — who has to keep an eye on the time — to what the patient’s agenda is, so that the two can prioritize what to cover and decide whether they’ll need a follow-up meeting, Dr. Gill said.

Technology will empower people to a more active role in their own healthcare by enabling access to a vast store of information but without a sound doctor-patient relationship and open communication, that seeming boon can be the source of more problems than solutions.  As Carma Bylund notes in the article, "Anyone who treats a doctor as a dispensary instead of a trusted medical guide loses the advantages of the physician’s experience.  Negotiating to win, in this case, may get you what you want, but not what you need."

Link
 

Insurance Providers & "Corporate Medicine"

This article (link from fiercehealthcare.com) was good but I wasn't going to link to it until I read the last paragraph - then I couldn't resist.

Beatty blames much of the trend toward corporate medical practices on the influence of the insurance industry, which encourages their formation to enlarge their networks. And often the HMOs second-guess these practices and deny coverage to patients. But for doctors, the corporate practice has become necessary for their survival. For the insurance industry, Beatty says, "it's a matter of greed."

He has a point: Ronald A. Williams, chairman of Aetna, earned $6.1 million, plus $18.2 million in stock options last year. Dale B. Wolf, chief of Coventry Health Care, earned $13 million in 2004, including stock options. And William W. McGuire, CEO of UnitedHealth, raked in nearly $37 million in 2004.

Wow.  That would pay for a lot of small practices to implement EMR and ancillary IT solutions.