WSJ compares House and Senate bills

Posted by

0

This help clarify the situation.

http://ow.ly/pQhI

Certification may be of zero value to the healthcare provider

Posted by

0

HIT do-overs

Posted by

0

I read a very interesting and well-written post on the Healthcare Blog by MARGALIT GUR-ARIE.

http://www.thehealthcareblog.com/the_health_care_blog/2009/09/what-if-i-had-to-do-hit-all-over-again-.html

It reminds me of the conversation in the movie City Slickers when Billy Crystal tells his friend his life is a do-over. From where I sit, I think a do-over is exactly what’s needed on two fronts. On the provider side, EHR decisions need to be based on what business problems are being addressed and on an ROI, not on what DC may or may not do. On the interoperability or transport side of the record I do not believe much of what is being worked on today will exist in 3-5 years (which further compounds the difficulty of what the providers are doing.) I think Meaningful Use and Certification will cease to exist, and that the structure of hundreds of Rhios and HIEs will cease to exist because they will have failed to work.

saint

Don’t let DC drive your selection process

Posted by

0

The decision to do EMR/EHR should be made independently of Washington. There either is or isn’t a valid business reason for going forward.  ARRA funds and penalties are not valid business reasons unless perhaps you operate a very small practice.

I believe there are valid reasons. I also believe that without knowing which of those reasons suite your organization there is a strong possibility of selecting the wrong system.

021_18A

EHR Leadership–Who’s in charge?

Posted by

2

 

Nicely written.  I look at the need from the perspective of the path not traveled.  For most, the task of selecting the correct EHR and managing the effort would be like me buying a spaceship–never been there, never done that.
Providers are well-staffed on the clinical side, and on the IT side.  The problem is that none of them has the high cost, high risk, high visibility PMO (project management officer) skills that are required to buy something that can cost more than a new hospital wing.
So what do they do? They pull someone out of IT or clinical and hand her the keys.  Most large IT projects will fail.  MOre EHR projects will fail.

 

anonymous-leadership-5000373Here’s a nicely written piece by Elyse of AntiClue.  http://www.anticlue.net/archives/000970.htm 

I look at the need from the perspective of the path not traveled. For most, the task of selecting the correct EHR and managing the effort would be like me buying a spaceship–never been there, never done that.

Providers are well-staffed on the clinical side, and on the IT side. The problem is that none of them has the high cost, high risk, high visibility PMO (project management officer) skills that are required to buy something that can cost more than a new hospital wing.

So what do they do? They pull someone out of IT or clinical and hand her the keys. Most large IT projects will fail. MOre EHR projects will fail.

That’s my opinion, but nobody has talked me out of it.

021_18A

2011 lost it’s relevancy

Posted by

0

It’s time to quit tiptoeing around 2011 and HIT and Meaningful Use and Certification, acting like they are relevant. Since the unspoken general consensus is that their relevancy has passed shouldn’t we be using our efforts to formulate a plan to make them relevant?

EHR Integration-A good read

Posted by

0

Robert Connely in the HIE blog makes some bery sound points about how the enite EHR intergration could and should work.  Note, could and should are not closely aligned at this point.

http://infosite.medicity.com/thehieblog/post/The-Practical-Reality-of-Hospital-and-EHR-Integration-Challenges-in-the-Trenches.aspx#comment

He writes, :This is not to say that the “standards and stimulus” approach isn’t a good thing – it’s just that the day-to-day problems we really deal with may not be adequately addressed by the current approach.”

I think he’s being generous to the extent of the words, “may not be adequaltely addressed.”  I can’t prove my statement, however I think that the mere fact that more than one group are working on standards is not standard.

How much more difficult will interoperability be, my guess is at least one more order of magnitude that what’s planned.

And as for interfaces?  I think Jimmy Weeks recently wrote having 400 he needed to meet.

My best – Paul

saint

Solutions for individual doctors

Posted by

2

A nice piece by Mark McGraw regarding the move by large firms to build and deploy EHR systems and potentially deploy them on-line.

I think individual practitioners have little to lose by waiting for someone to shrink wrap the application.

sainttop5

Baucus: Math for librarians

Posted by

0

What part of this do I not understand? The poor, who can’t afford insurance, will have to buy the insurance they can’t afford or pay a fine which they can’t afford.

021_18A

Who was supposed to be watching the customer?

Posted by

0

customer_relationsSometimes it’s easier if I simply shoot myself in the foot rather than having to wait around for others to do it.  Permit me to begin with a disclaimer; my comments and questions almost always pertain to the non-clinical side of healthcare.

We’ve spent time discussing how we take an industry that in many respects functions on a 0.2 business model and transform it rather quickly to one comfortable operating in a 2.0 model—effective and efficient.

So, while that’s going on, what other things are underway which will impact that transformation?  Reform is one.  What will be the impact?  Nobody knows, but it may not be pretty.  One of the largest implications of reform is that the industry is being forced to integrate.  For example, it’s one thing to build a phone company.  There is a whole new order of magnitude of difficulty when one phone company has to integrate seamlessly with all of the other phone companies.

That integration is being driven by hundreds of different teams of vendors, standards setters, certifiers, and networkers, each having its own goals and working in their own vacuum chamber.

As I’ve studied this business problem for the past few years it becomes more and more apparent that something has been overlooked.  It gets it share of lip service, however unless it is addressed concurrently with reform and EHR, EHR will prove to be of such low value as to stymie people who later have to justify the expenditure.

It’s the missing link, the customer.  I know customer is not the politically correct term in healthcare because it sort of blemishes the notion that nobody is in this for the money.  We’d rather talk about patients.  Patients are on the clinical side, customers are on the business side.  Healthcare needs systems that work for both.

Where does customer care, customer relationship management (CRM), and customer equity management (CEM) fit within the realm of EHR?  The wrong answer to this question could set your EHR effort back years and millions.

The following link takes you to a presentation of mine on CRM and discusses the merits of looking at treating customers via CEM.

 http://www.slideshare.net/paulroemer/good-CEM-deck

I am curious to learn how you are incorporating the customer into your transition.

021_18A