The HIPAA Privacy Rule regulates the use and disclosure of Protected Health Information (PHI) held by “covered entities.”These entities generally include healthcare clearinghouses, employer sponsored health plans, health insurers, and healthcare providers.
PHI is any information held by a covered entity concerning the health status, provision of healthcare, or payment for healthcare that can be linked to an individual.
Covered entities must disclose PHI to the individual within 30 days upon request. They also must disclose PHI when required to do so by law, such as reporting suspected child abuse to state child welfare agencies.
Every leader of a competing electronics health records vendor probably jumped for joy once they heard the news that Glen Tullman was ousted by Allscripts, the company that he made what it is. Or, maybe I’m wrong. Perhaps leaders of competitive companies would have liked to have kept him around because of what he did to the organization following the acquisition of Eclipsys.
The man, for the most part, has been considered a genius. Peers in the industry gave his performance praise, patted him on the back and showered him in adulation through the maneuvered takeover of the hospital health IT giant. At the time, in 2010, the move made by Allscripts was hailed as a magnificent effort.
It was the kind of move that was supposed to have turned the industry on its head. Many thought it would, and many eyed the effort with envy for such a move was powerful and assertive.
It did rock the industry. Competitors shook in slight fear with the announcement of the news, and many feared for their longevity. In this fact I am serious. I know. I was at a competitor. The whispers went something like this: “Will this new monster kill us all?”
Though all of we worked to secure our shores, many of us were fearful of the coming tide.
But, from the beginning, there was always a sense that Allscripts, and Tullman specifically, was positioned as too big to fail. Perhaps we should have seen a previous merger, the failed move to integrate Mysis, as a harbinger of things to come.
There was even a point in which I had dubbed him the king of health IT. I referred to him as such during internal meetings in my effort to create the queen of health IT, who was a president of another firm in which I worked.
There was a level of pomp and circumstance about everything he seemed to do through his promoted PR moves and image building to his constant appearances and associations with Washington’s power elite, including the president.
I can’t imagine Tullman saw this coming during his rise to the top. Just 18 months ago he was on top of the health IT world, seemingly unafraid of the world in which he lived, or so it seemed from my outside position.
Hindsight is 20/20, though, and it’s easy to question failed policy after decisions have been made.
When the recent takeover bids failed to take the Allscripts private, the company had but one choice and he and other leaders of the company had to go. It’s a common scenario in the world of politics, another world which Tullman is known to frequent. As things grew worse for the once mighty giant, everyone associated with the debacle had to go.
And, even in lands where great kings have ruled, even their glory days come to an end.
But, does it surprise me that he and others at the disheveled vendor are gone? Gone from the vendor that positioned itself as too big to fail? Gone from the vendor that asserted itself upon the market; that worked to take over a market in which its ambitions were bigger than its capabilities?
No, I’m not surprised.
In many ways Tullman died at the hand of his own sword.
And, as we’ve seen countless times and will see again, no company nor its mascot is too big to fail. No kingdom too vast to conquer, no land immune from the trials of the nations it builds.
And so, the king of health IT is no longer king, but neither is he a pauper. And, like most who have achieved his heights, it’s safe to say we probably haven’t seen the last of him.
In what appears to be an extension of yesterday’s post, today I want to examine some questions posed by Success EHS, which asks, “Should you replace your EHR?”
As you most likely know, most large enterprise ambulatory practices and hospital systems have well-established EHR systems in place. They are clearly recognized as among the early adopters of electronic health records, and, compared to their small counterparts, are also the most likely healthcare facilities to currently be in the market for an alternative EHR.
In the age of meaningful use, in a time where healthcare technology is also known as the electronic health record, the systems are being replaced with great frequency. The why and what fors are pretty simple to figure out if you’re familiar with the technology and the marketplace.
There are several prevailing reasons practices are jumping systems, though. They include (and I’m citing Success EHS here):
• Lack of strong vendor support
• Lagging product development
• Consolidation of disparate solutions
• Systems fail to live up to vendors claims
• EHR hinders efficiency and productivity
Given these hurdles – there may be others, of course – there are several questions practice administration must ask to determine whether it’s time to move.
Some of these questions include (feel free to grab a pen and paper and add to the list):
• Are issues able to be solved through remediation? No? Might be time to hit the road.
• Can the vendor’s technical improvements resolve any issues? If so, you need to ask that fixes be made in a reasonable timeframe. Obviously, telling said vendor that fixes need to be made “ASAP” won’t do; you must be reasonable. Consider negotiating a term of three to six months and get final terms in writing. Anything more than six months and it might be time to pack up and leave.
• Are you partially responsible for the EHR’s issues? If you’re partially or fully at fault for a botched EHR implementation or for poor usage, you owe it to yourself, your staff, your patients and, yes, to your vendor to work out a solution. If you’ve tried every solution and there’s no fix, you may be forced to move on. Some times it’s a matter of agreeing to disagree, let’s just agree on that.
• Do you have an opt-out clause? If so, you may wish to exercise it. If not, you’re going to pay, probably handsomely, to exit stage right.
• Are your current long-term goals going to be met using your current EHR? If not, you need to change your goals or change your system.
• Is your EHR negatively impacting practice efficiency? Success EMS says it best, “An EHR that hampers productivity now will only grow worse as the complexities of health reform initiatives increase in the future.”
If you decide it’s time to implement a new EHR system then it’s time to create an assessment plan. Assessments are designed to answer the “why” of implementing an EHR, and what is working and can be improved by installing one.
