May 2007

Salt and TEPR

The 2007 TEPR (Towards and Electronic Patient Record) awards were announced last week.
  
Mobile Applications for Healthcare

First-PatientKeeper
Second-Medical Communication Systems
Third-e-MDs

Stand-alone e-Prescribing Systems

First-Purkinje
Second-Misys Healthcare Systems
Third-Allscripts

Personal Health Records

First-CapMed
Second-Waiting Room Solutions
Third-Medical Communication Systems

Document Imaging in Healthcare

First-Medical Communication Systems
Second-BlueWare
Third-e-MedRec by Holt Systems

Hot Products in HIT

First-Phytel
Second-Sage Software

Continuity of Care Awards for Vendors

First-e-MDs and Medical Communication Systems (tie)
Second-Solventus
Third-Allscripts

Continuity of Care Awards for Implementers

First-New Orleans Health Department
Second-Pediatric Health Care at Newton-Wellesley, Newton, Mass.
Third-Northern Illinois Physicians for Connectivity, Glen Elyn, Ill. and Yuil Medical Center, Lawrence, Mass. (tie)

For a show that is all about EMRs, it was odd to see them discontinue the EMR category award. I guess they bowed to vendor pressure, not wanting to offend the hands that feed them. The award was replaced with an EMR usability demonstration at the show.  Hospitals and doctors wanting third-party opinion on the best EMR systems can check KLAS, AC Group EHR Report, the annual EHR systems review conducted by Andrew & Associates, and the leadership quadrant of Gartner.

Posted by Shawn Whalen on May 29, 2007 at 11:06 AM
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Try Again

Robert Kolodner gave a big thumbs down to Accenture, CSC, IBM and Northrop Gumman. After reviewing proposals submitted in January by these leaders in IT integration, the Office of the National Coordinator for Health Information declared them insufficient.

When I hear something like this I wonder if the government knew what they wanted in the first place.  Anyway, new RFPs were issued and the agency will give the contract this summer. Moving forward, Kolodner will also tap state and local health information exchanges that will be the networks that will help make up the NHIN, instead of relying solely on the vendors.
 
In other government news, Senator and presidential hopeful Hillary Clinton proposed spending $3 billion annually to help doctors implement healthcare IT.  In a speech yesterday at George Washington University, she also called for an incentive system for doctors to actually use this technology, among other proposals for disease management. She said the reduction in healthcare costs from using technology could be used to provide health coverage for all Americans.

Posted by Shawn Whalen on May 25, 2007 at 2:27 PM
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Ka-Ching

A quick agency self-congratulatory note on Scwhartz Communications largest client acquisition ever.  Client Cytyc, a medical device company that treats excessive menstrual bleeding, will be acquired by Hologic for $6.2 billion.  That is a "b" for billion. Hologic is paying $46.46 per share of Cyctyc, a premium of 33%.

Over the course of nine years Schwartz Communications drove market awareness and adoption for Cytyc's ThinPrep Pap Test among women to detect cervical cancer.  Schwartz' public relations efforts created a push-pull effect, raising awareness among consumers while driving physician adoption. These in turn pressured insurance companies to reimburse members for the test. Today the ThinPrep Pap Test is considered by most to be the gold standard test. Just ask Hologic.

Posted by Shawn Whalen on May 21, 2007 at 11:09 AM
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CHIMING In On Stark Law

Continuing this week the Stark Law reform topic, the College of Healthcare Information Management Executives (CHIME) recent survey showed that most hospital execs won't be taking advantage of the change that allows donation of EMRs to private physicians.

The survey found that 62% of respondents do not plan to take advantage of the new Stark exception and anti-kickback safe harbor laws. CIOs (read lawyers) are apparently concerned that the reform could be overturned and that exact interpretation of the law is not black-and-white. CHIME said that the 38% who do plan to take advantage of the reformed laws are planning on donating software, implementation support, training and help-desk support.

Posted by Shawn Whalen on May 15, 2007 at 4:20 PM
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Stark Implications

This week brings a guest blog post from Joel Andersen, VP at client Purkinje, on the dark side of Stark law reform. The piece originally appeared in Advance magazine.

The Stark Truth

While the Stark Law reforms have been hailed as a positive development for health care, a closer look at who is singing its praises may show an ulterior motive. Small and medium sized physician practices, which deliver 70 percent of the health care in America, could be force-fit with software from large acute care software vendors, many of which are ill-equipped to understand and service the needs of today's busy medical practices.

Ambulatory care is a very different world than acute care. In Stark law "reform," EMRs could likely become a loss leader for acute care technology vendors and hospitals. Many acute care vendors will practically give away their ambulatory solutions in order to secure millions of dollars in acute care software business from hospitals. As often discussed in the media and rankings from industry research groups, their ambulatory-specific technology is often dated, cumbersome to implement and use, difficult (or impossible) to integrate, and serviced by vendors who "just don't get it." 

Hospitals are often complicit in their own way. Hospitals, like any business, are looking for ways to grow business and want to drive admissions and use of ancillary services. The potential lure of free or low-cost EMRs that are integrated with hospital systems and data generated within their facility such as transcription, lab, radiology, and ADT may do just that. However, EMRs in this arrangement will likely become glorified order-and-result systems tied directly to the hospital.

Continue reading "Stark Implications" »

Posted by Shawn Whalen on May 8, 2007 at 12:51 PM
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Our Hidden Health Crisis: Misdiagnosis

Jerome Groopman's widely reviewed book "How Doctors Think" highlights the problem of misdiagnosis in America's healthcare system. Misdiagnosis and incorrect treatment are critical to quality healthcare but are often overlooked, despite misdiagnoses happening almost 20 percent of the time and wrong treatment plans 60 percent.

Is the current emphasis on EMR, transparency, health plan and cost efficiencies to improve quality misplaced? No, but to think these are the big answers to achieving quality misses the point. Healthcare is the right diagnosis, the correct treatment, a condition/illness healed the first time. Consumers want healthcare delivered correctly the first time, not having the system experiment on them.

Quality improvement impacts not just consumers, but also employer group and health plans costs. Three to five percent of cases represent 30-50 percent of healthcare premium costs and increases. Focusing on this critical segment of the medical population can improve healthcare quality while lowering costs for employers and health plans.

Companies like Best Doctors, Isabel Healthcare, ParadigmHealth, Health Dialog, ActiveHealth Management and Quantum Healthcare are addressing the problem from different angles.  Isabel Healthcare offers a diagnosis reminder system for hospitals. In the employer and payor world, Best Doctors' medical intervention service brings medical expertise to bear on individual complex cases. ActiveHealth's automated, evidence-based Care Considerations alert patients and their doctors about medical issues and treatments.

More attention should be put on the issue of misdiagnosis, which is far and away a problem whose solution impacts quality and cost more than any health IT issue.

Posted by Shawn Whalen on May 1, 2007 at 4:24 PM
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