Honoring All Veterans on Memorial Day

Both of my parents served in and survived World War II. Continue reading

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October 1st is coming….will you be ready?

The Go-Live date for ICD-10 is fast approaching.  Although there continue to be isolated attempts to delay, amend or completely eliminate the transition all indications are that effective Oct. 1,  the U.S. will move from the use of ICD-9 codes to ICD-10.  While the majority of the health care industry has been preparing for the transition for years and expects to be ready for the change, there are some who have delayed implementation efforts on the off-chance that the effective date would continue to move or never happen at all.

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HIE inPractice Blog Series:Using Standards for Nationwide Health Information Exchange and Interoperability

by: Rick Edwards, Director, Integration Strategy, Iatric Systems, Inc and Stacey Lee, MS, Workflow Redesign and HER Implementation Specialist. 

Looking back over the last several decades, it appears that healthcare in the US has had a lack of interest and incentives surrounding interoperability. For clinics and hospitals – are we still worried that health information exchange (HIE) will make it easier for patients to switch to our competitors? We could deduce that many healthcare IT vendors have lacked the motivation to properly support interoperability standards. For these healthcare IT vendors – do we still claim that we are interoperable, yet we only provide tools in order to import data into our EHR system while intentionally charging extra for functionality designed to export data?

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How Close Are We to Consumer-Mediated Exchange?

by Sri Bharadwaj,  president-elect, Southern California chapter of HIMSS; member, HIMSS Value of Provider-Patient Engagement Task Force; and director, information services, UC Irvine Health

If you don’t know about an  app that allows you to securely integrate multiple banking accounts into one view, it does exist. Simple to sign up for and the directions step you through the process. Once set up, you can view your accounts through various charts that display expenses versus income and pay bills from the app. The app works seamlessly on personal computers, tablets and smart phones.

The analogous app for healthcare consumers would have similar functionality. Many patients, particularly those with complex chronic or life-threatening conditions (e.g., transplant, advanced cancer), often have multiple portals from multiple provider organizations and specialists. Five portals may not be uncommon; the record I have heard so far is 15.

To make a complex illness less complex,

  • Can data from these portals be imported into one app?
  • Can that app be easy to use, displaying data from multiple portals and using helpful charts, graphs and alerts that simplify understanding of complex health data?
  • Can the data be kept secure and updated regularly?

The good news is:  progress is underway. Under Meaningful Use Stage 3 proposed rules, there is an option for providers to create an Application Programming Interface (API) as an alternative to, or as another, stand-alone patient portal. HL7, a standards development organization, is developing the  FIHR® (Fast Healthcare Interoperability Resources) Specification. This creates a way to “simplify implementation without sacrificing information integrity.”

Another encouraging trend is that some companies are already developing apps that will make it possible to combine data from a single vendor or multiple vendors. Some EHR vendors are creating app stores. Start-ups that know how to use APIs are eager to develop secure apps for patients. Some healthcare providers, like Duke and Oschner, are using APIs to develop apps for Apple HealthKit. More will follow.

The Transmit function continues as a weak link in the process of View, Download, Transmit (VDT). Although some regions and states have well-developed health information exchanges (HIEs), this is not consistent across the country. Also, many of the patients mentioned above with complex conditions and multiple providers across states, are blocked from having their data transmitted or transmitting that data themselves to coordinate their care and seek second opinions.

Another challenge is correcting errors in EHRs. If patients have multiple EHRs, they may have different medication lists, lab results and problem lists. Patients should be able to request changes in a portal and harmonize their record to prevent errors.

According to Susannah Fox, “We are unfortunately at a very awkward stage where we have a lot of technology at our fingertips, and health care has not quite figured out how to use it.” We are optimistic about moving out of this awkward stage into a “patient-friendly” application environment that is both interoperable and intuitive across devices.

So what do patients need?

Patients over their lifetime accumulate a ton of healthcare data; however, they are unable to aggregate, correlate and keep it all in one single place. Data hidden in EHRs, doctors office files, and in laboratory records prevent them to adapt lifestyles and develop a care plan with the knowledge of demographic and genomic factors.

For example, some companies have attempted – through their initiatives – to develop this type of app, but their efforts have not received the deserved attention. Why? They have tried to maintain this information in their own cordoned marketplace and not use interoperability to become the community where both physicians and patients reach out and seek a common platform for a broader healthcare experience.

It is time we bridge data islands and bring together a cohesive rules-based playground to share between the cared-for and the caring.

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Not Just Another Patient Questionnaire

By: Deborah Wells, MS, CPHIMS, Senior Strategy Consultant, The Children’s Hospital of Philadelphia, Co-chair HIMSS Connected Patient Community, and member of HIMSS Patient-Generated Health Data Task Force.

A year ago, I posted a blog titled “Electronic Pre-Visit Questionnaires Improve Workflow and Encourage Engagement”about a pilot which The Children’s Hospital of Philadelphia  (CHOP)had just completed, using patient portal and kiosk technology to deliver developmental questionnaires in primary care. The project was extremely successful and the questionnaires have since been rolled out to all of CHOP’s 31 primary care practices. The project was so successful that there have been numerous requests for the development of additional types of questionnaires in both the primary care and specialty care areas.

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New Technology Task Force Seeking Members

by: Pam Jodock, Senior Director, Health Business Solutions, HIMSS

The new Health Business Solutions Technology Task Force will review existing and proposed legislative and administrative initiatives through the eyes of the technology needed to support the activity required by the language of the initiatives.

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Importance of Planning

By failing to prepare, you are preparing to fail. ~Benjamin Franklin

Planning is the process of determining goals and deciding how best to achieve them.  It provides direction, helps us make difficult decisions, keeps us on track and assists in overcoming obstacles and surprises.  When transitioning from military service to a civilian career, the earlier you begin planning, the better off you will be.  One way to start the career planning process is by utilizing a planning process model.

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Turning Data Into Direction

by: Ralph Williams, Director, Access Management

DATA.  This four letter word has created just as many opportunities as it has destroyed, much like the other popular, albeit more profane, four letter words.  In the realm of Health Information Exchanges (HIE), “data” is a buzzword like no other.  If you don’t have data, you definitely don’t have an HIE.

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National Healthcare Innovation Summit – 2015

by: Karan Singh, Co-founder, Ginger.io

Why is innovation crucial for improving the delivery of healthcare and fulfilling the Triple Aim?

Since the 1950s, the majority of innovations in mental health have been largely focused on the development of pharmaceuticals. Drugs that may or not work, but definitely come with a laundry list of side effects.

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Why is nursing informatics important in healthcare?

By: Robin Hoover, RN, MSN-HCI, Clinical Informaticist, Merit Health River Region and Susan A. Matney, MSN, RN-C, PhD, FAAN, Medical Informaticist, HDD Team, 3M Health Information Systems

A patient walks into the clinician’s office and the clinician reviews the patient’s medical history and current medication that is in the electronic health record (EHR) with him. The patient’s daughter is a nurse and he wonders how nurses are involved in these new EHRs.

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