Building a Smarter EHR with Data Analytics

Building a Smarter EHR with Data Analytics
Jonathan Bertman

Guest post by Jonathan Bertman, founder and president of Amazing Charts.

The big news out of HIMSS13 was no surprise to those of us who work in the electronic health record (EHR) industry. The results of a two-year (2010-2012) survey from American EHR revealed that user satisfaction levels with EHRs are dropping in multiple areas – very bad news for EHR vendors.

The results didn’t surprise me at all. I talk to hundreds of EHR users each year about their concerns, and have divided the sources of their satisfaction into three broad areas. Users talk about their dissatisfaction with unusable systems because of poor design; unaffordable prices; and the inherent unfairness of the purchase process, often requiring multi-year contracts committing clinicians to a system they have never had a chance to use in the real world.

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Healthcare Records: A Hacker’s Roadmap to your Life

Healthcare Records: A Hacker’s Roadmap to your Life
Alex Horan

Guest post by Alex Horan is the senior product manager at CORE Security.

In 2012 we saw an increasing number of health breaches across the country – and across continents. We saw an employee’s lost laptop turn into a healthcare records breach of more than 2,000 sensitive medical records of Boston Children’s Hospital patients. We heard how one weak password allowed a hacker to access the Utah Department of Technology Services’ server and steal approximately 780,000 patients’ health and personal information. We even read about Russian hackers encrypting thousands of patient health records and holding the information for ransom for thousands of dollars.

Healthcare fraud or medical identity theft put both individuals and healthcare organizations at huge and severe risk. Since 2010, Ponemon Institute has annually benchmarked the progressing and evolving issues of patient privacy and security. The third annual study, released in December 2012, found that healthcare organizations still face an uphill battle in their efforts to stop and reduce the loss or theft of protected health information (PHI) and patient records. What’s more, data breaches can have severe economic consequences – and the repercussion costs are only climbing. The study estimates the average price tag for dealing with breaches has increased from $2.1 million in 2010 to $2.4 million in 2012. The report projects that the economic impact of continuous breaches and medical identity theft could be as high as $7 billion annually, for the healthcare industry alone.

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Dog Sledding and ACOs: What Do Health IT Leaders Do When the Lead Dogs Fail?

Ken Perez

Guest post by Ken Perez, Director of Healthcare Policy and Senior Vice President of Marketing, MedeAnalytics, Inc.

Recently, Mitch Seavey, 53, became the oldest winner of the Iditarod, the most famous dog sledding race in the world. At a distance of 1,600 kilometers, the Iditarod constitutes a race of supreme endurance. In dog sledding, the dogs that are chosen to lead the sled are usually the smartest, as well as the fastest, and they are appropriately called lead dogs.

The lead dogs in the realm of Medicare ACOs are the 32 pioneer ACOs, the selection of which was announced in December 2011 with great fanfare and optimism. With the greater risks (and rewards) of the pioneer ACO Model, the pioneers were widely considered the best and the brightest, the organizations most likely to succeed as ACOs.

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Office of the National Coordinator’s PlanningRoom.org Needs More Planning; Until then Move On

I’m a cynic and I’m snarky. They are character traits earned from my days as a reporter at the newspaper. Constantly being pitched the greatest new thing meant to change the world when rarely these things lived up to their promise made me this way.

It takes a lot to impress me.

This, of course, won’t do it.

By “this” I mean the PlanningRoom.org.

The latest offering from the Office of the National Coordinator for Health Information Technology (ONC), the site is being billed as a place for public input to update the Federal Health IT Strategic Plan.

According to the site, the plan outlines goals and strategies for the nationwide shift to electronic health records and information exchange, and for creation and spread of new health information technologies. “On this site, you can learn about these issues and be part of the public discussion that will shape the new plan. Whether you’re a patient, consumer, provider, insurer or IT developer, you should have a voice in this process.”

The rest of the site focuses on a variety of topics in discussion board fashion (think late ‘90s comment-based webpage) where consumers, the general public and anyone else with an opinion of any kind can respond to the seeded ONC topic.

Some of the topics include:

The list goes on, with a few sparse comments to support the topics addressed, and some questions and responses.

The rest of the site features some meager announcements and a bit more info about PlanningRoom.org.

I’ve been a supporter of many of HealthIt.gov’s work and have featured it multiple times on this site for the availability of their information and the organization’s outreach to the public and the HIT community, but PlanningRoom.org is a limp attempt at a public information movement.

I’ve got to hand it to ONC for trying to engage the public in an information and educational campaign, but this effort wreaks of propaganda. For the most part, the comments are thin and generic and the “conversation” here seems someone staged.

This sure seems to resemble the acts of a start up site looking to generate page views and buzz. Certainly, there are people interacting with the site, but it comes off as fluff; a bit too polished if you will.

Call it the cynic in me, but at present, this effort just isn’t enough to make me think it’s going to drive any real change. Perhaps as it grows and evolves it will be worth a lot more, but in its current, state, not so much.


Patient Access to Electronic Health Records: Should More Control Be Handed Over?

According to a recent Accenture survey, “Patient Access to Electronic Health Records: What Does the Doctor Order?” published on iHealthBeat, 79 percent of surveyed U.S. doctors say that patients should be able to update all demographic information in their electronic health record.

The report suggests that 16 percent of surveyed U.S. doctors say that patients should be able to update some demographic information in their EHR and 5 percent say that patients should not have the ability to update any demographic data.

“Sixty-seven percent of surveyed U.S. doctors say that patients should be able to update all family history information in their EHR, while 21 percent say that patients should be able update some family history data and 12 percent say that patients should not have the ability to update any family history information,” according to the study.

Twenty-five percent of surveyed U.S. doctors say that patients should be able to update all of their laboratory test results in their EHR, while 28 percent say that patients should be able to update some lab test results and 47 percent say that patients should not have the ability to update any lab test data.

On behalf of Accenture, Harris Interactive conducted the online survey of 500 U.S. physicians between November 2012 and December 2012.

This is an interesting topic that seems to have many foes and fans, and I can see the perspective from each side. On one hand, allowing access to a personal record may allow for breeches of information, HIPAA violations and may create a slippery slope to a movement for patients to have full editorial access to their records. Obviously, doing so creates more many more problems than it solves.

The benefits to such a move – allowing patients to input their demographic data into their personal health record – may lead to greater patient engagement, which seems to be healthcare’s sticky wicket, and it may help practices struggling with being overwhelmed administratively to streamline some of their intake and the management of their information and “pass along the cost,” so to say.

It seems as new solutions come to pass and as we as an industry seek ways to moderate, streamline and create new efficiencies, questions such as the one raised by this survey will be asked more and more. As the questions become more well circulated and discussed, the issues they address will move toward the acceptable and standard practice as they gain ground within the society we have created.

As such, though there may be initial resistance, like all cultures built to change, what was once unacceptable will become standard practice.

Given the issue raised by these questions, I wonder what level of change we’ll see in regard to this in the near term. My hunch is that in an effort to include more people in the process, to streamline and to offload some of the administrative responsibility, we’ll see tactics such as these be incorporated more often, and more “power” given to the patients.

I wonder what your thoughts are on this subject, and what your perspectives are. Do you agree with the survey results? Should patients be allowed to change any of the data in their records or does it make sense to include them in the administrative management of the record?

HIT Thought Leader Highlight: David Finn, Symantec