Hospital Impact

Health IT RECs are setting themselves up to fail

Wendy Johnson — 2010-09-09T14:20:28Z

by Joseph Ingemi Like most programs, the Health IT Regional Extension Centers (RECs) that are being established across the nation as mandated by the stimulus are a great idea in theory. Their intent was to encourage the adoption of EMRs by providers by disseminating best practices for adoption. But what is the reality on the ground? I think the RECs are setting themselves up for failure in two areas. First, they do not get around the issue of providers simply not wanting to adopt EMRs. For whatever reason, providers do not think that EMRs help them in any way. Many subscribe to the idea that if it isn't broken, don't fix it. Others feel that the effort and cost (even after subsidies) is not worth the benefit. Providers tend to focus on innovation that allows them to deliver more billable services and/or speed up payment. From the providers' perspective, EMRs do not facilitate this goal. RECs do not provide a solution to this psychological obstacle. Second, are RECs really providing best practices or integrated solution or are they becoming cattle calls for EMR providers? It seems that quite a few RECS are issuing Requests for Proposal geared toward EMR vendors. If the Office of the National Coordinator (ONC) is issuing the framework for EMRs through Meaningful Use, then what is the value-added of RECs? They will effectively become catalogues for preferred EMR vendors. This seems like another layer of bureaucracy rather than a tool for implementation. With such little interest in Health IT adoption, the federal government cannot create even perceived boondoggles for everyone. This only will lead to more misgivings about the federal government's role. My recommendation would be to spend REC resources in other areas such as funding greater bandwidth for providers. Joseph Ingemi is a blogger, Certified Information Systems Auditor, and certified Project Management Professional who writes about healthcare IT issues. He also consults on healthcare IT issues through his company, Pinarus Technologies.

Skirmishes over how to define mobile healthcare

Wendy Johnson — 2010-09-09T13:58:17Z

How do you define mobile health? Is it still emerging? And how broad is its scope? Does it include wireless sensors?

These questions are part of a debate that has played out on the 3G Doctor blog, according to FierceMobileHealthcare Editor Neil Versel. Several months ago, David Doherty, head of business development at the Ireland-based mobile healthcare software vendor 3G Doctor, took a stab at defining the field.

He took issue with a Wikipedia entry that cites the work of Robert Istepanian, a professor of data communications at Kingston University in London, who defined m-health as "emerging mobile communications and network technologies for healthcare." The entry, at least as it read six months ago, also mentioned "embedded wireless devices that track health-related parameters," Versel writes. FierceMobileHealthcare

How to bulletproof your data security now

Wendy Johnson — 2010-09-09T13:38:50Z

Financial institutions suffer more data breaches than healthcare organizations, right?

Wrong. It's healthcare--by a factor of three to one, writes Websense CIO Jim Haskin.

He cites a recent report from the Identity Theft Resource Center (ITRC) showed that compromised data stores from healthcare organizations outstrip those in other industries. According to the ITRC, healthcare organizations disclosed 119 breaches this year through early August, compared to 39 reported in the financial services industry. Why is this happening? FierceHealthIT

Why trust in doctors has eroded

Wendy Johnson — 2010-09-09T13:08:31Z

By Christopher Cornue In Canada last month, a newsstand magazine caught my eye. In bold letters on the cover of the August 23 edition of Maclean's Magazine were the words: "Crisis in Confidence: Do You Trust Your Doctor?" According to the article, an increasing number of Canadians don't. The article detailed some examples of medical errors (for example: misdiagnoses, misread pathology, and incorrect surgery) and the erosion of trust in medical professionals. The article cited surprising results from a recent poll they conducted that suggest trust in physicians has eroded over time: *Forty percent of respondents believe Canadian doctors care less about their patients than they did 10 years ago. *Twenty percent said they believe doctors are more likely to make mistakes than they were 10 years ago. *More than 50 percent of respondents believe doctors do not readily acknowledge their mistakes. *Thirty-nine percent believe physicians are more concerned with seeing patients quickly. The article suggests many reasons why this may have happened, such as the expansion of media and Internet which gives consumers/patients more information sources on health and physicians. One example they cited was the website www.rateMDs.com where over 85 percent of Canadian doctors are reviewed with user-submitted ratings. This website has seen significantly more activity over the past few years and close to half of the international readers are from Canada. The media has covered some high-profile medical error cases in Canada recently, which most likely gives rise to the perception that it's more prevalent than before. Given the rise of the Internet and more media outlets bringing attention to these issues in recent years, perhaps the results of this poll are to be expected. There have been some "landmark" studies about medical errors in Canada over the past decade. The first was a joint research project between the University of Calgary and the University of Toronto from 2004 suggesting that 2.5 million people in Canadian hospitals suffer from medical errors. Additionally, between 9,250 and 23,750 died in 2000 from "avoidable mistakes in treatment." The Health Care in Canada survey conducted in 2002, indicated that 20 percent of those surveyed experienced an "adverse event while receiving care" and a follow-up survey in 2007 suggested a similar finding. What's more, since 2005, the number of complaints about physician misconduct has climbed from 5,482 to almost 6,000. Physicians, and the organizations which represent them, are taking this information and public perceptions seriously. Recently, the Canadian Medical Association (CMA) has proactively supported key initiatives to help stem this perceived (or real) rise in medical errors, including pre-surgery checklists, the creation of health quality councils across the nation who focus on quality outcomes, and the establishment of "disclosure guidelines" to promote transparency in medical error reporting. Just last month, the CMA published the "Health Care Transformation in Canada: Change the Works. Care that Lasts" report which calls for a culture of patient-centered care, greater, and more timely,access to care, and greater accountability in the medical profession. Great efforts are being made by physicians to improve healthcare in Canada and, whether intentional or not, to address the perceptions that Canadians have about their physicians. Christopher Cornue is principal for slainte global partners and is the former CEO at McKee Medical Center in Northern Colorado. He has also served as vice president at Mount Sinai Hospital and Health System in Chicago, and has held leadership roles at University Health System Consortium and the University of Chicago Hospitals.

Why robot empathy won't go far

Wendy Johnson — 2010-09-01T21:17:25Z

By Anthony Cirillo I'm insulted and you should be too. I knew when I read this FierceHealthcare blurb that there was a blog lurking. But right after I read it I had to leave my desk for a doctor's appointment. Well that appointment sealed the deal. When you arrive at your 2 p.m. appointment and are not seen until 3 p.m. that is an insult. When you fly a certain airline and their idea of offering a better experience is to charge you thirty bucks to "upgrade" to, get this, "Economy Plus" that is an insult. (Sorry, I do a lot of flying in my consulting!) And then this: The featured hospital in the FH blurb announces it will lay off 140 employees by the end of October, despite ending the fiscal year nearly $37 million in the black. And then for salt in the wounds, the hospital has leased 19 robots to fulfill a range of tasks, from delivering medication and food to taking out trash. "Hiring as many humans to make deliveries would have cost the hospital more than $1 million a year," said the vice-president of facilities and support services. Leasing the robots from Aethon costs $350,000 a year. And this is all part of the hospital's "Accelerating Continuous Excellence" program. I don't know about you but I am sick of people putting pretty names on what essentially are cost cutting or revenue enhancement programs. People see through this stuff. And as a marketer I am embarrassed. Because many times the brand my colleagues promise is not the brand that is delivered. The programs above have little to do with your better experience or mine. Healthcare is just as much about human relations, empathy, comfort as it is about clinical care. I am sure robots are more efficient and cost less but what is the ultimate cost to the patient? I know MY experience would be enhanced when the robot is "speaking politely with workers and patients." Patient experience. Everyone's talking about it but few do anything about it. How do you enhance care with an unsympathetic robot? How do you enhance care when a patient in my doctor's office (an orthopedic practice) is in pain and need to be lying down in a room but is told the doctor is running behind and you have to wait in the seating area? Maybe the staff should ask themselves--"Would I be insulted by this behavior?"--and let that guide their actions. And please stop couching these programs as the best thing since Mother Teresa. The public is more intelligent than that. Look, maybe I am just irked from a few isolated examples. You tell me. But I am reminded of a television show from my youth called "Lost in Space." And I am beginning to believe that healthcare providers are lost in space given how they act sometimes. The robot in that movie was constantly shouting "that does not compute" and "Danger Will Robinson." Maybe it was on to something. Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities.