This week I’ve taken vacation time to help my colleagues in Japan and New Zealand with national IT planning. As I often say, the healthcare IT challenges are the same all over the world, but the cultural context is different. In Japan, I spent 2 days in Tokyo and 1 day in Kyoto, lecturing, meeting, and listening to stakeholders. There is a great desire to share data for care coordination and clinical trials/clinical research. Telemedicine/telehealth is increasingly important in an aging Japanese society that has increasing healthcare needs but a limited number of caregivers and few opportunities to increase healthcare budgets. Here are a few of the current issues we discussed...
Meaningful Use
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Does Healthcare Need a More Modern Way to Define and Measure EHR Interoperability?
Industry experts and the federal government are divided on the best way to assess the state of the nation’s health IT interoperability. The Office for the National Coordinator for Health IT, for instance, has proposed using CIO surveys to gauge the status of interoperability among and between healthcare organizations. To that end, ONC posted a Request for Information (RFI) on how to best assess interoperability that closed last month — just not before drawing some sharp comments from across the industry...
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Does Healthcare Need a More Modern Way to Define and Measure EHR Interoperability?
KLAS executive vice president Taylor Davis said that measuring interoperability can get messy because the EHR market is currently immature. Industry experts and the federal government are divided on the best way to assess the state of the nation’s health IT interoperability. The Office for the National Coordinator for Health IT, for instance, has proposed using CIO surveys to gauge the status of interoperability among and between healthcare organizations...
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Don’t forget Obamacare’s electronic medical records wreck
The White House finally acknowledged the spectacular public disaster of Obamacare’s Internet exchange infrastructure during Monday’s Rose Garden infomercial. But President Shamwow and his sales team are AWOL on the bureaucratic ravages of the federal electronic medical records mandate. Modernized data collection is a worthy goal, of course. But distracted doctors are seeing “more pixels than patients,” Dr. DiNubile observes, and the EMR edict is foisting “dangerous user-unfriendly technology” on physicians and patients.
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DSS and First Databank Collaborate to Enhance Patient Care and Outcomes
Document Storage Systems, Inc. (DSS), the leading provider of health information technology (HIT) solutions for federal, private and public healthcare organizations, today announced a collaboration with FDB (First Databank), the leading provider of clinical drug knowledge that helps improve medication-related decisions and patient outcomes. DSS will incorporate FDB’s MedsTracker® MedRec and e-Prescribing solutions within its open source EHR system, vxVistA, to enhance patient care transitions and help healthcare organizations achieve Meaningful Use compliance...
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EHR Certification Criteria Under Fire
Complaints rolling in to the ONC-The hits keep on coming as two industry groups spoke out against voluntary 2015 EHR certification under meaningful use...
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Electronic Case Reporting (eCR) Takes Front Stage at PHI2018 Conference
But the real buzz at the conference seemed to be about electronic case reporting (eCR). This refers to the national effort to replace the current paper and FAX process of submitting reportable conditions from clinical care sites to state and local public health agencies with a more automated electronic process fed from electronic health records (EHRs)...HLN demonstrated the workflow for eCR at the HIMSS18 Interoperability Showcase. However, we did not see a lot of interest on eCR at the HIMSS conference. At PHI2018 we had significant interest, both among public health officials who were anxious to see how they could initiate eCR in their jurisdictions, and other vendor and stakeholder groups who seemed to feel eCR was becoming viable and more “real.”
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Game Review: EPIC Systems EHR
EPIC has banned my use of the screenshots. The original post follows, considerably damaged by the lack of screenshots. Thanks a lot, EPIC!...
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Halamka Discusses Three Disruptive Care Coordination Innovations In Use at Beth Israel
Would you buy an iPhone if the only apps that ran on it were written by Apple? Maybe, but the functionality would not be very diverse. The same can be said of EHRs. Athena, Cerner, Epic, Meditech, and self developed EHRs such as BIDMC’s webOMR are purpose-built transaction engines for capturing data. However, it is impossible for any single vendor to provide all the innovation required by the marketplace to support new models of care I’m a strong believer in the concept of third party modules that layer on top of traditional EHRs in the same way that apps run in the iPhone ecosystem...
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Halamka Explains Background to athenahealth/BIDMC Collaboration
BIDMC and athenahealth announced a new and unique collaboration. The collaboration between the two organizations provides athenahealth the chance to take BIDMC’s experience to a much larger audience, hopefully making a difference to providers, patients, and payers across the country. athenahealth will also accelerate its ability to develop expanded functionality more rapidly than doing it alone. Read More »
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Halamka Pays a Visit to Oscar Health
Today I’m in New York City visiting Oscar Health, on my continuing quest to determine how best to integrate digital platforms, patient-family engagement, and care coordination in preparation for MACRA/MIPS and the transformation from fee for service to alternative payment models. At the moment, there is no single magic bullet, but there are early innovations that hold promise. At BIDMC we’ve thought the best approach to care management is to identify a cohort with a disease, then enroll that cohort in a program which involves tracking progress against guidelines/protocols, deploying telemedicine/visiting nurses, and measuring data from home-based devices...
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Halamka's Health IT Observations from Japan and New Zealand
Halamka's Reflections on US Health IT Policy Trajectory
I’m in China this week, meeting with government, academia, and industry leaders in Guangzhou, Shenzhen, Beijing, Shanghai, and Suzhou. The twelve hour time difference means that I can work a day in China, followed by a day in Boston. For the next 7 days, I’ll truly be living on both sides of the planet. I recently delivered this policy update about the key developments in healthcare IT policy and sentiment over the past 90 days. I’ve not written a specific summary of the recently released Quality Patient Program proposed rule which provides the detailed regulatory guidance for implementation of MACRA/MIPS, but here’s the excellent 26 page synopsis created by CMS which provides an overview of the 1058 page rule...
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Halamka's Report on The April 2015 HIT Standards Committee Meeting
The April 2015 HITSC meeting focused on the Certification Rule NPRM and a comprehensive review of the Federal Interoperability Roadmap. I suggested that a guiding principle for the committee’s work is to emphasize the enablers in the proposals while reducing those aspects that create substantial burden/slow innovation. As a federal advisory committee our job is to temper regulatory ambition with operational reality.
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Harvard Docs: Time Is Right for Patient-Centered Health Repositories, Not Portals
A number of public and private initiatives have been launched over the years in the name of a personal health record for patients. But one way or another, they've all failed to gain traction, according to Drs. Isaac Kohane and Kenneth Mandl of the Harvard-affiliated Boston Children's Hospital, who published an editorial in the New England Journal of Medicine last week. The authors believe now might be the time to finally realize that ambition...
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Health IT Execs Have a New Favorite Dirty Word
Cerner President Zane Burke, athenahealth CEO Jonathan Bush and eClinicalWorks CEO Girish Navani. When eClinicalWorks rechristened its flagship electronic health record software as the cloud-based 10e, CEO Girish Navani said something curious: “I don’t want to call it an electronic health record anymore.”...
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