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1.  Did you know that a Bill passed out of the NJ Legislative Committee (11-0) to make it Illegal in that State to buy or use any non-CCHIT certified EMR? Such a bill can be seen as a means to deny open source EMRs any chance. Interestingly, Dr. Conaway, the motivator of this bill, was specifically invited to our HIMSS booth by our Regional Sales Director for New England, Bill Hockstedler, for him to gain some insight into the open source world in general and OpenVista in particular. He declined. Hmmmmm!

 

     http://ehrdecisions.com/2009/06/08/legislating-health-it-beware-of-land-mines/comment-page-1/#comment-1548

 

2. Way to go AMA!!!  Here are a couple of snippets from the AMA regarding policies including open source software:

   

     "The policies concern physicians' responsibilities in case of computer security breaches and support of electronic health-record systems based on open-source code."

 

     "On open-source, delegates approved a resolution calling for the AMA to support law and public policy that makes open source EHR systems that meet certification and "meaningful use" requirements available to physicians at nominal cost."

 

3. Another posting on HITS suggests that EMR adopters may find more stringent regulations on "meaningful use" as they seek continuing stimulus bucks. The suggestion is that an EMR may meet the "meaningful use" criteria at the outset, but may have more and more goals to meet as the bar to obtain continuing stimulus dollars gets set higher and higher with time. Indeed, an EMR user may even face such increases in regulations between the time they decide on an EMR and the time their first stimulus dollars are released in 2011. So, will the EMR world now face an ever increasing "meaningful use" bar to hurdle as time goes on?  Surprising that there would be any suggestion of "raising the bar" when they haven't defined "meaningful use" as yet.

 

4. Since we are on the subject of "meaningful use", AHRQ has posted this: "HHS' Office of the National Coordinator for Health Information Technology (ONC) is seeking comments on the preliminary definition of “Meaningful Use” of electronic health records as presented to the HIT Policy Committee on June 16. Comments on the draft description of "Meaningful Use" are due by Friday, June 26, 5 p.m., EDT, and should be no more than 2,000 words in length. Select to access instructions for submitting comments." Might be time for us in the open source world to make our voices heard.

 

5. Have you read the "meaningful use" matrix yet?  Try this: http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872719_0_0_18/Meaningful%20Use%20Matrix.pdf

 

6. This article in "Advance" is a "Tidbit" and a good one at that. If you need to have, at your fingertips, an up to date review of open source and the stimulus package, here it is. Oh yes, our position is well stated by Rick Jung and Mike Doyle.  Read on:  http://health-information.advanceweb.com/editorial/content/editorial.aspx?cc=200988

 

7. Oh wait, did someone say that "meaningful use" is still not defined??? Nope, back to the drawing board boys and girls. Is 2011 still coming?

 

http://www.healthcareitnews.com/news/onc-goes-back-drawing-board-meaningful-use.

 

I am tired. Later.

 

Rob.

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There have been numbers of articles in the IT press pro and con to the effectiveness and value of migrating to an EHR. As this discussion continues, I find myself wondering if that resistance is a valuable learning experience for those of us who have some control over what we bring to market, or that these ongoing lengthy discussions and nit picking are just means of avoiding having to change. The following commentaries may be important to consider for if using an EHR is commonly viewed as interferring with patient care and not considering provider input, we may have a difficult task before us, despite all the cash that is being thrown our way.

 

 

Modern HealthCare.Com

 

Don't just throw money at EHRs

Posted: May 15, 2009 - 5:59 am EDT


Cheers for Dr. David Polaner’s response, which mirrors the critique of today’s electronic health records by a large number of practicing physicians, all of whom must be feeling like the boy in the crowd shouting "the Emperor has no clothes" since it appears no one is listening thus far. The same questions about the effectiveness of today’s EHRs are overwhelmingly supported by an extraordinarily blunt 2009 report from the National Research Council entitled Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions.”


The lengthy and detailed report concludes that "current efforts aimed at the nationwide deployment of healthcare IT will not be sufficient to achieve the vision of 21st century healthcare, and may even set back the cause if these efforts continue wholly without change from their present course.”


The report's core conclusion is that our current EHRs are "focused on individual transactions ... and virtually no attention being paid to helping the clinician understand how the voluminous data collected could relate to the overall healthcare status of any individual patient.” Most damning, it states that most of today’s healthcare information technology is “designed in ways that simply mimic existing paper-based forms" and are “designed primarily for transaction processing.”


The report concludes: “So that the nation can cross the healthcare IT chasm, the committee advocates rebalancing the portfolio of investments in healthcare IT to place a greater emphasis on providing cognitive support for healthcare providers, patients and family caregivers.”


The American Recovery and Reinvestment Act of 2009 is offering more than $30 billion of taxpayer-funded stimulus monies to create a nationwide health IT infrastructure that “improves healthcare quality, reduces medical errors, reduces health disparities and advances the delivery of patient-centered medical care.” That means that the stimulus law is focused on technology to improve patient care, not transactions.


Hopefully President Barack Obama and Congress will listen to clarion calls like those of Dr. Polaner and the National Research Council before they rush to spend the stimulus act’s $30 billion on merely perpetuating more of the current direction of EHRs, which have done little thus far to support the “patient-centered medical care” promised by the stimulus act. Healthcare in the U.S. is at a historical crossroads, and our president and Congress ought to consider carefully what can be, not what is, before merely throwing more money at current solutions.

Rick Kneipper
Chief administrative officer and co-founder
PHNS
Dallas

Modern HealthCare.Com

Understanding EHR workflow only way to ROI

Posted: May 14, 2009 - 11:00 am EDT


n response to reader commentary on Joseph Conn’s “Rush for EHRs could ‘stick docs with bad systems’ ":

My primary focus is on training and I have seen so many frustrated physicians. The information technology vendor does a whirlwind approach to training and then the clinicians are stuck trying to figure out how to make it work with their daily practice. I have seen double documentation because some physicians are still hand-writing notes and using an electronic health record.

We are still on a learning curve and even though the IT experts feel that they have great systems, it still isn't working with the flow. I am a firm believer that we need trained people, solid technology and complete understanding of the workflow process before there is a substantial return on investment.

Deresa Claybrook
Healthcare industry consultant
Positive Resource
Moore, Okla





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We have established a Blog entitled Tidbits & Outrages that might be of interest to our company as a whole. We will try to keep these posts short, informative and relevant. My sources for these items are simple: I have signed up to just about every e-thing in the world. If I have missed some important source, let me know and I will monitor that (those) source(s) as well.

We hope that this Blog will be an area for streamlined access to interesting tidbits that we may encounter as we wade through the HIT world. It can also be an important area where we can point out those issues in that HIT world that make no sense, are contradictory, or are just plain silly. Feel free to ferret out all such issues, come by and post them. We just might be able to ultimately make sense of this mad, mad, IT world in which we live.

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