Electronic Medical Data Exchange in Denmark

Posted on June 5, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Used by 91% of doctors according to research2guidance

By Ralf Jahns

Denmark emerges as the number one country to start an mHealth business according to a survey conducted by research2guidance in partnership with HIMSS Europe. Over 5000 app developers, healthcare professionals and mHealth practitioners took part in the “European mHealth App Market Ranking” survey, where participants were asked to rank the mHealth App market readiness of the 28 EU member states. The results were recently revealed by Ralf Jahns, Managing Director at research2guidance, during the HIMSS Europe event in Riga, the mHealth Summit, on 12th May 2015.

The results, which establish Denmark as having the best market pre-requisites needed for an mHealth business, are based on the average of the scores in five categories: eHealth adoption, level of digitalisation, market potential, ease of starting an mHealth business and mHealth regulatory framework. Hans Erik Henriksen, CEO of Healthcare Denmark commented on the survey findings: “Denmark has a very digitalised society and is familiar with using technology in healthcare, supported by a regulatory framework. The research2gudiance and HIMSS Europe survey confirms the progress we are making. I sincerely hope that this will inspire the European countries and mHealth community in their efforts to progress mobile solutions, which will make a big difference for our citizens”. Denmark ranked top country for eHealth adoption being the only country where exchanging patients’ medical data electronically is used amongst 91% of doctors, whereas the average of other covered countries is only 34%

In terms of market attractiveness and healthcare investments, Denmark is at the top in the mHealth market potential category, together with Austria which also has one of the highest expenditures for health. The ease of starting mHealth business category describes how easy it is to start and maintain a new business based on the number of days needed to start business, the number of necessary start-up procedures to register a business and the level of tax and, in this case, Denmark also ranked extremely high, as the smaller countries – Ireland was also top in this category – tend to support new businesses better compared to larger countries. Rainer Herzog, General Manager at HIMSS Europe, added: “This year’s survey has revealed that the market conditions for mHealth which Denmark offers are truly remarkable. This has been the largest global mHealth research study to date and there are different learnings that could be drawn from the EU countries’ mHealth App Market Ranking. Ultimately though, although mHealth is still it is an emerging market, and a number of countries in Europe are currently in the process of defining their mHealth roadmaps, Denmark leads the way in all aspects”.

Download the full mHealth study report here.

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Forget FITBIT – Meet FEARBIT

Posted on May 27, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

New Sweat Sensors Will Sniff Out Fatigue, Stress and Even Fear

[By staff reporters]

Wearables TNTC ?

Bits

***

Sweat can be a smelly messenger, but one that also carries a trove of valuable information about how our bodies are feeling.

Scientists at several labs are now trying to pick its lock with nano-technology, including know-how transferred from GE’s jet engine research, to develop flexible, Band-Aid-like wireless sensors sensitive enough to detect a drop of biomolecules found in sweat in 2.5 million gallons of water.

***

Meet the Fearbit: New Sweat Sensors Will Sniff Out Fatigue, Stress and Even Fear

***

Channel Surfing

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Conclusion

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Arnold Spielberg and the Birth of Personal Computing

Posted on May 27, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

It’s BASIC*

[By staff reporters]

From Thomas Edison to former President Ronald Reagan and novelist Kurt Vonnegut, GE has employed a number of luminaries over the course of its 123-year history.

But, one famous last name that’s been missing from this list is Spielberg.

***

Enter Arnold Spielberg

In the late 1950s, Arnold Spielberg, the father of Hollywood director Steven Spielberg, helped revolutionize computing when he designed the GE-225 mainframe computer. The machine allowed a team of Dartmouth University students and researchers to develop the BASIC programing language, an easy-to-use coding tool that quickly spread and ushered in the era of personal computers.

(Young Bill Gates, Paul Allen, Steve Wozniak and Steve Jobs all used the language when they started building their digital empires.)

LINK: http://www.gereports.com/post/117791167040/its-basic-arnold-spielberg-and-the-birth-of

More:

Cyber-Security Considerations for “Mission-Critical” Medical Devices

Posted on May 24, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Understanding the balance between new regulations (almost none) and guidance (in the form of non-binding recommendations)

By Shahid N. Shah MS

THEN …

In 2013, the Food and Drug Administration (FDA) issued its first cybersecurity safety communication, followed in 2014 by final guidance.

It struck a reasonable balance between new regulations (almost none) and guidance (in the form of non-binding recommendations).

NOW …

In 2015, the Federal Trade Commission (FTC) released a staff report entitled Internet of Things: Privacy & Security in a Connected World, in which it recommend that Internet of Things (IoT) style devices, which of course include medical and clinical devices, need to maintain a good security posture. It’s worth noting that the FDA, FTC, and other government regulators are centering on a few key guidelines.

Six Recommendations

The following six recommendations come directly from the FTC report:

Companies should build security into their devices at the outset, rather than as an afterthought. As part of the security by design process, companies should consider:

Conducting a privacy or security risk assessment
Minimizing the data they collect and retain
Testing their security measures before launching their products

Companies should train all employees about good security, and ensure that security issues are addressed at the appropriate level of responsibility within the organization
Companies should retain service providers that are capable of maintaining reasonable security and provide reasonable oversight for these service providers.
When companies identify significant risks within their systems, they should implement a defense-in-depth approach, in which they consider implementing security measures at several levels.
Companies should consider implementing reasonable access control measures to limit the ability of an unauthorized person to access a consumer’s device, data, or even the consumer’s network.
Companies should continue to monitor products throughout the life cycle and, to the extent feasible, patch known vulnerabilities

The FTC report and FDA guidelines are remarkably consistent. When thinking of cybersecurity and data privacy, engineers tend to think about authentication, authorization, and encryption. Those are the relatively easy topics.

*** ***

Mission Critical Medical Devices

For “mission-critical” medical safety devices, however, things are much more difficult and need to encompass a larger surface of questions, including but not limited to:

Asset Inventory: Is the device discoverable, and can it associate itself with standard IT inventory systems so that revision management, software updates, and monitoring can be automated?
Cyber Insurance: Does the device have enough security documentation to allow it to be insured by standard cyber insurance riders?
Patching: How is the firmware, operating system (OS), or application going to be patched by IT staff within hospitals (or the home for remote devices)?
Internal Threats: Has the device been designed to circumvent insider (hospital staff, network participants, etc.) threats?
External Threats: Has the device been designed to lock down the device from external threats?
Embedded OS Security: Is the device sufficiently hardened at the operating system level, such that no extraneous software components, which increase the attack surface, are present?
Firmware and Hardware Security: Are the firmware and hardware components sourced from reputable suppliers and free of state-sponsored spying?
Application Security: Is the Microsoft Security Development Lifecycle (SDL) or similar software security assurance process integrated into the engineering process?
Network Security: Have all network protocols not in use by the device been turned off so that they are not broadcasting?
Data Privacy: What data segmentation, logging, and auditing is being done to ensure appropriate data privacy?
HIPAA Compliance: Have proper steps been followed to ensure Health Insurance Portability and Accountability Act (HIPAA) compliance?
FISMA Compliance: If you’re selling to the federal government, have proper steps, such as use of Federal Information Processing Standard (FIPS) certified encryption, been followed to ensure Federal Information Security Management Act (FISMA) compliance?
Data Loss Prevention (DLP): Is there monitoring in place to ensure data leakage outside of the device doesn’t occur?
Vulnerabilities: Have common vulnerabilities such as the Open Web Application Security Project (OWASP) Top 10 been reviewed?
Data Sharing: Are proper data sharing agreements in place to allow sharing of data across devices and networks?
Password Management: Are passwords hardcoded into the device or made configurable?
Configuration Protection: Are configuration files properly check-summed and protected against malicious changes?

Conclusion

ABOUT

Mr. Shahid N. Shah is an internationally recognized healthcare thought-leader across the Internet. He is a consultant to various federal agencies on technology matters and winner of Federal Computer Week’s coveted “Fed 100″ Award, in 2009. Over a twenty year career, he built multiple clinical solutions and helped design-deploy an electronic health record solution for the American Red Cross and two web-based eMRs used by hundreds of physicians with many large groupware and collaboration sites. As ex-CTO for a billion dollar division of CardinalHealth, he helped design advanced clinical interfaces for medical devices and hospitals. Mr. Shah is senior technology strategy advisor to NIH’s SBIR/STTR program helping small businesses commercialize healthcare applications. He runs four successful blogs: At http://shahid.shah.org he writes about architecture issues; at http://www.healthcareguy.com he provides valuable insights on applying technology in health care; at http://www.federalarchitect.com he advises senior federal technologists; and at http://www.hitsphere.com he gives a glimpse of HIT as an aggregator. Mr. Shah is a Microsoft MVP (Solutions Architect) Award Winner for 2007, and a Microsoft MVP (Solutions Architect) Award Winner for 2006. He also served as a HIMSS Enterprise IT Committee Member. Mr. Shah received a BS in computer science from the Pennsylvania State University and MS in Technology Management from the University of Maryland.

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How Do Medical Students See Future Technologies?

Posted on May 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Disruptive Technologies in Medicine

[By Dr. Bertalan Meskó]

Recently, I gave a talk to medical students about what kind of trends and technologies might shape the future and I was very curious what they think about these.

The Question

I asked them to give a score between 1 and 3 about how beneficial or advantageous those can be for society; and a score between 1 and 3 about how big threats they will pose to us.

They also gave a score between 1 and 10 about how much they look forward to using a technology in action. See the full size infographics here.

The Answer

So, I just wrote about how our Disruptive Technologies in Medicine university course prepares medical students for the coming waves of change. I also recently published an infographic related to new technologies in medicine.

***

Assessment

Preparing them for the future is a real challenge but I remain confident that we need to to that and it is still possible.

***

More:

***

FUTURISTIC MEDICAL INTERFACE

Interactive Touch Screen Application

***

This interactive touch screen presentation is an outstanding example for the importance of nice interfaces. With them you are able to show information in a whole new way and exploring data is an adventure every time!We created a vertical interactive touch screen presentation that was controlled by a mobile device. We only focused on the futuristic design and the beautiful interfaces . Our aim – the future is here and now!

Our touch screen presentations bring the future directly to your exhibition stand, shop, museum, hospital or even your tv show or movie! No prerendered elements!

It’s realtime!

LINK: https://www.behance.net/gallery/14374555/FUTURISTIC-MEDICAL-INTERFACE

***

Conclusion

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Largest global m-Health research study reveals top five m-Health countries in Europe

Posted on May 13, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

More than 5,000 participate in landmark study for m-health app companies

[By Ralf Jahns]

RIGA, Latvia, 12 May 2015:

Denmark, Finland, The Netherlands, Sweden and the UK are the top five countries offering the best market conditions for mobile health app companies in Europe, according to a survey conducted by research2guidance in collaboration with HIMSS Europe. As part of the largest global mHealth research programme, research2guidance and HIMSS Europe have come together to analyse the market readiness of the 28 EU member states through “The EU Countries’ mHealth App Market Ranking” survey.

Over 5,000 app developers, healthcare professionals and mHealth practitioners were asked to rank European countries based on their experience and provide reasons for their ranking. The practitioners view is combined with facts based evaluation for each country, based on five dimensions and 26 market condition criteria such as eHealth adoption, level of digitalization, market size and health expenditure, ease of starting a business and the mHealth regulatory framework.

Denmark, Finland, The Netherlands, Sweden and UK proved to have the highest market readiness and most mature market conditions, providing the best starting points for mHealth companies to succeed. Out of these five countries though, the UK emerged as the leader according to 55% of mHealth practitioners. The study revealed that this is primarily due to the openness and positive attitude many doctors in the UK have when it comes to new technology and integrating mHealth solutions into patient treatments.

***

[Click to enlarge]

***

Ralf Jahns, Managing Director at research2guidance, who announced the survey findings at the mHealth Summit Europe, said: “The survey is now in its sixth year and the response this time has been overwhelming becoming increasingly evident that the momentum around mHealth is growing at a rapid pace. The report is extremely valuable for anyone thinking about starting an mHealth company, as well as for government organisations in European countries that want to benefit from a flourishing mHealth ecosystem through creating highly qualified jobs, reducing national healthcare costs and ensuring high levels of quality of care.” Germany and France emerged with mixed results: on the one hand these two markets have enormous potential when it comes to the amount which has been invested in patients, doctors, hospitals and healthcare on a whole.

However, rankings for eHealth and mHealth adoption in Germany and France were extremely low, showing these countries are more reluctant to embrace the digitalisation of healthcare, thus classifying themselves as “average” countries to invest in mHealth. Rainer Herzog, General Manager at HIMSS Europe added: “The timing of the report is particularly important as it coincides with the mHealth Summit Europe which will bring together the most important stakeholders in the mHealth industry in Europe. The survey results will provide a great platform for discussion and give us an insight into how ready European countries really are to adopt mHealth and the challenges that some countries are yet to overcome, meanwhile giving entrepreneurs a head-start when deciding which country would be best to start an mHealth business.”

To view the full report please click here: About research2guidance:

ABOUT

Research2guidance is a strategy advisory and market research company. Research2guidance concentrates on the mobile app eco-system and are convinced that mobile health solutions will make a difference to people’s lives and that the impact on the healthcare industry will be significant. The organisation provides insights to make it happen and to successfully lead a business.

Link to full report Link to blog post Link to image

Conclusion

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What’s Fueling the Demand for Tele-Health Today?

Posted on May 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The Four Key Factors

By http://www.MCOL.com

Conclusion

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Using mHealth to facilitate end-of-life care

Posted on May 3, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

An Infographic

By Eric Wicklund

[Editor – mHealthNews]

Last week was National Healthcare Decisions Day (NHDD), “a day devoted to encouraging the completion of advance directives.”

When discussing end-of-life care, it’s a delicate issue that has to be handled carefully – and one in which mHealth can play an important role.

***

“There are serious communication challenges around advance care planning and they contribute to the emotional and financial burdens on patients, their families and their caretakers,” Geri Lynn Baumblatt, executive director of patient engagement for Emmi Solutions, said in a press release.

“Empowering people to make decisions about their own care before reaching a point where they can no longer speak for themselves can shift that experience from one of stress and confusion to one where everyone involved including the family and care team is readily prepared to follow the person’s wishes.”

“In a study of ICU patients with terminal conditions, only 12 percent of patients with an advance directive had received input from their physician in its development while another study showed that between 65 and 76 percent of physicians whose patients had an advance directive were not aware that it existed,” Nathan Kottkamp, founder of NHDD, in the release.

“These findings show that there is a huge communication gap between patients and their doctors around end of life care, NHDD’s mission is to help close that gap while Emmi Solutions’ program is a useful tool for doing so.”

For a closer look at how mHealth figures into advance directives, take a look at this infographic from Emmi Solutions.

***

[Click image to enlarge]

Conclusion

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Why Health Insurance Companies Fail To Generate Significant Reach with Their App Portfolio

Posted on May 2, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

The “Health Insurance App Benchmarking Report for 2015”

***

AN ME-P SPECIAL REPORT

By Ralf Gordon Jahns

rgj@research2guidance.com

The majority of health insurance companies can be described as hesitant in their app publishing activities, even those that have a larger app portfolio fail to have a significant impact. A new report from research2guidance analyses global app publishing activities of the leading health insurance companies.

***

Some of the reasons are that health insurance companies are not leveraging their assets, their apps are not compliant with state-of-the-art app publishing rules and missing cross promotion.

The vast majority of health insurance companies have failed to generate a significant reach with their app portfolio, with 67% of health insurance companies having achieved less than 100,000 downloads. The majority of apps in the portfolio of healthcare payers belong to the long-tail:

70% of health insurance companies can be described as hesitant publishing only 1 or 2 apps. However, if health insurance companies were to publish more apps they wouldn’t necessarily generate higher download numbers.
77% of health insurance companies belong to the low impact category having published less than average apps with less than average download numbers. Only 9% of health insurance app publishers could be described as active with above average impact.

AETNA

Aetna is the one health insurance company that stands out. Having published 28 apps across both iOS and Android Aetna have achieved more than 14million downloads, significantly more than any other health insurance company. That being said 85% of those download come from just on app within their app portfolio, iTriage. This is not uncommon amongst those health insurance companies that have generated a large number of downloads.

For example, 7 of the top 10 biggest health insurance companiesapp portfolios generate more than 50% of downloads from the top performing app. What are the reasons for the little impact the traditional payers of the healthcare systems have in the app economy?

RESULTS

These are some findings from research2guidance’s latest report “Health Insurance App Benchmarking 2015”. The report provides information on app categories health insurance companies concentrate on, the number of apps they have published, target user groups and the organization of their app business model.

***

The study results indicate that:

Most health insurance companies fail to produce ‘state of the art’ apps – Apps in most cases do not incorporate the 6 key elements of best practice: Tracking and coaching, automated input, remote consultation, secure use of mHealth data, integrating their solutions into the current IT healthcare infrastructure and beautiful design and usability.
Companies fail to realize the potential of app integrated incentive schemes – Health insurance companies are best positioned to link financial rewards via incentive schemes to healthy and cost saving behavior of their members. However, currently there are only a few companies that link healthy behavior to financial rewards with the help of an app.
Health insurance companies fail to successfully cross-promote their app portfolio– Companies do not successfully leverage their app portfolio through cross-promotion. Best practice mHealth app publishers manage to have almost equally successful apps in their portfolio by cross promotion using for example, “more apps” screens, pop-ups and push notifications. This is not being done at all by health insurance companies.

More:

http://www.research2guidance.com/shop/index.php/health-insurance-app-benchmarking-2015 http://research2guidance.com/wp-content/uploads/2015/03/HIC-Blog-Post-2-Slide-v.2.png

Conclusion

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How Secure Is Your Password – Doctor?

Posted on April 28, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Tips on using strong passwords

[Securing yourself from a world of hackers]

By Shahid N. Shah MS

What is at Risk?

Here are some specific tools, gadgets, cloud servers, EHRs and other reasons you should secure your PWs:

Fax Server – a fax server allows you to centrally manage all incoming and outgoing faxes. Since most medical practices live on fax, this is one of the fastest investments you can recoup.
Shared drives – start using shared drives either using your existing software or you can purchase inexpensive “network disks” for a few hundred dollars to share business forms, online directories, reports, scanned charts, and many other files.
Online backups and Internet PACS storage – there are online tools like JungleDisk.com that allow you to store gigabytes of encrypted data into the Internet “cloud” for just a few dollars a month.
E-mail (beware of HIPAA, though) – internal office messaging and email is a great place to start. If you haven’t started your office automation journey here you should. If you’re going to use it for patient communications you’ll need to make sure you have patient approvals and appropriate encryption. If you’re on Gmail today and you want to have customers immediately be able to communicate with you on Gmail, that’s generally HIPAA compliant because communications between two Gmail accounts stays within the Google data center and is not sent unencrypted over the Internet.
E-Prescribing – e-prescribing is a great place to start your automation journey because it’s a fast way to realize how much slower the digital process is in capturing clinical data. If e-prescribing alone makes you slower in your job, EMRs will likely affect you even more. If you’re productive with e-prescribing then EMRs in general will make you more productive too.
Office Online and Google Apps (scheduling, document sharing) – Google and Microsoft® have some very nice online tools for managing contacts (your patients are contacts), scheduling (appointments), dirt simple document management, and getting everyone in the office “on the same page”. Before you jump into full-fledged EMRs see if these basic free tools can do the job for you.
Modular clinical groupware – this is a new category of software that allows you to collaborate with colleagues on your most time-consuming or most-needy patients and leave the remainder of them as-is. By automating what’s taking the most of your time you don’t worry about the majority of patients who aren’t.
Patient registry and CCR bulletin boards – if you’re just looking for basic patient population management and not detailed office automation then patient registries and CCR databases are a great start. These don’t help with workflow but they do manage patient summaries.
Document imaging – scanning and storing your paper documents is something that affects everyone; all scanners come with some basic imaging software that you can use for free. Once you’re good at scanning and paper digitization you can move to “medical grade” document managements that can improve productivity even more.

Clinical content repository (CMS) – open source systems like DrupalModules.com and Joomla.org do a great job of content management and they can be adapted to do clinical content management.
Electronic lab reporting – if labs are taking up most of your time, you can automate that pretty easily with web-based lab reporting systems.
Electronic transcription – if clinical note taking is taking most of your time, you can automate that by using electronic transcribing.
Speech recognition – another “point solution” to helping with capturing clinical notes; you can get a system up and running for under $250.
Instant Messaging (IM) – IM gives you the ability to connect directly with multiple rooms within your office using free software; if you want, you can also connect with patients and other physicians during work hours.

How to avoid the most common and dangerous passwords?

***

More:

Conclusion

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Filed under: Information Technology | Tagged: clinical groupware, E-Prescribing, Electronic lab reporting, EMRs, HIPAA, Instant Messaging, Password, Speech recognition | 3 Comments »

Enter the ROBO Financial & Medical Advisors

Posted on April 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Machines will Rule … Soonest?

[By Dr. David Edward Marcinko MBA CMP™]

Machines beat humans at chess. Machines can pilot airplanes to land at O’Hare; or on Mars. There is now a machine that beats the best of us at Jeopardy.

And, many predict that an Artificial Intelligent medical clinician is ten years away.

Just think tele-medicine and tele-health.

And, no one will use a biological doctor in twenty five years. Then, of course, enter the singularity*.

Innovation

I’m not sure who said it first, but this quote has been floating around Twitter lately:

“In 2015 Uber, the world’s largest taxi company owns no vehicles, Facebook the world’s most popular media owner creates no content, Alibaba, the most valuable retailer has no inventory, and Airbnb, the world’s largest accommodation provider owns no real estate.”

Assessment

Fundamental assumptions about what is needed to be a successful doctor, financial advisor, or other business has changed in just the last few years.

So – I ask MD and FA colleagues – will you keep up professionally, or fall behind? What are the ethical implications of these technology innovations; if any?

***

[Vanguard’s “Robo Advisor” – Good for Clients but Bad for Advisors?]

***

More:

Even More:

Human–Cyborg Relations: Coming Soon to a Medical School Near You

Note: From Wikipedia, the free encyclopedia.

The Singularity

The technological singularity is the hypothesis that accelerating progress in technologies will cause a runaway effect wherein artificial intelligence will exceed human intellectual capacity and control, thus radically changing civilization in an event called “the singularity”.^[1] Because the capabilities of such an intelligence may be impossible for a human to comprehend, the technological singularity is an occurrence beyond which events may become unpredictable, unfavorable, or even unfathomable.^[2]

The first use of the term “singularity” in this context was by mathematician John von Neumann. In 1958, regarding a summary of a conversation with von Neumann, Stanislaw Ulam described “ever accelerating progress of technology and changes in the mode of human life, which gives the appearance of approaching some essential singularity in the history of the race beyond which human affairs, as we know them, could not continue”.^[3] The term was popularized by science fiction writer Vernor Vinge, who argues that artificial intelligence, human biological enhancement, or brain–computer interfaces could be possible causes of the singularity.^[4] Futurist Ray Kurzweil cited von Neumann’s use of the term in a foreword to von Neumann’s classic The Computer and the Brain.

Proponents of the singularity typically postulate an “intelligence explosion”,^[5]^[6] where superintelligences design successive generations of increasingly powerful minds, that might occur very quickly and might not stop until the agent’s cognitive abilities greatly surpass that of any human.

Kurzweil predicts the singularity to occur around 2045^[7] whereas Vinge predicts some time before 2030.^[8] At the 2012 Singularity Summit, Stuart Armstrong did a study of artificial general intelligence (AGI) predictions by experts and found a wide range of predicted dates, with a median value of 2040. Discussing the level of uncertainty in AGI estimates, Armstrong said in 2012, “It’s not fully formalized, but my current 80% estimate is something like five to 100 years.”^[9]

***

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Career Development, Ethics, iMBA, Information Technology | Tagged: robo advisors | 16 Comments »

Curing By Numbers

Posted on April 5, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Taking Cloud Computing to a New Level

[By GE Healthcare IT]

American healthcare has by far the most expensive system in the world, but few would argue that it’s also the most efficient. A study published in the Journal of American Medical Association found that almost 40 percent of patients are misdiagnosed in primary care¹. Another report by the American College of Physicians discovered that unnecessary testing and medical procedures, and extra days in the hospital caused by wrong diagnosis could add up to $800 billion per year².

That’s close to a third of all U.S. healthcare costs. “There is a lot of waste in the system,” says Jeanine Banks, general manager of marketing at GE Healthcare IT. “We want to help rein in the costs and make the system far more efficient.”

That’s not just talk. Engineers at GE Healthcare IT are developing a new “cloud imaging” solution that will allow doctors to create a professional profile, store patient images and data together in one place, view 3D images from anywhere, and access intuitive analytics. “It’s like LinkedIn professional networking meets diagnostic imaging,” Banks says. “It’s all about virtually limitless computing, storage and collaboration on tough cases to help healthcare teams make more informed decisions.”

***

Banks says that the information physicians need to make diagnoses is often fragmented and sits in siloes. The new platform, GE’s Cloud Imaging solution, allows doctors to exchange images and use social digital tools to share cases with each other over a network instead of distributing CDs, as common practice now. “They can open their browser, click on a link and share quickly,” she says.

Banks says that GE intends to give hospitals the flexibility to host the system on their own servers, as a private cloud, or through GE’s public cloud environment. “We are committed to using industry standards to make it easy to connect medical devices, link with existing PACS (picture archiving and communication systems) and EMR (electronic medical records environments), and enable consistent access to a flourishing ecosystem of apps,” she says. “Providers don’t need more silos of data.” GE’s first Cloud Imaging pilot site is the Kadlec Health System in Washington State. Kadlec is helping evaluate the platform ahead of plans to demonstrate the new solution during the annual meeting of the Radiological Society of North America in December. “It’s an opportunity for them to use it inside their health system and give us feedback,” Banks says.

***

For Banks, this is the beginning of a new healthcare revolution. “What if together with industry we could help physicians reduce waste?” she asks. “We could process that information, learn from past diagnostic decisions and store the data all in the cloud to inform future decisions. One day, we could tap into knowledge based on cases from around the world.”

Assessment

That’s just brilliant.

Citations:

¹ Journal of American Medical Association 2012

² Reuter’s, citing study by American College of Physicians

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Economics, Information Technology | Tagged: Cloud Imaging, EMRs, GE Healthcare, Jeanine Banks, PACS, Taking Cloud Computing to a New Level | 1 Comment »

Emerging New-Wave Cloud Technology for HIPAA

Posted on April 4, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Securing Electronic Communication in the Cloud

[By Carol S. Miller BSN MBA PMP]

To help hospitals and health systems comply with burdens of the Health Insurance Portability and Accountability Act [HIPAA] regulations, best practices are emerging for securing all electronic communication – cloud, wireless, and texting – of protected health information.

These new technologies will continually be evolving with hospitals, providers and patients move to new means of communication.

And so, below is a very brief description of one: cloud solutions.

Cloud Solutions

Cloud solutions are becoming a needed commodity in treating patients today but also present a risk to privacy and security violation. Despite the advantages of cloud computing, organizations are often hesitant to use it because of concerns about security and compliance.

Specifically, they fear potential unauthorized access to patient data and the accompanying liability and reputation damage resulting from the need to report HIPAA breaches. While these concerns are understandable, a review of data on HIPAA breaches published by the HHS shows that these concerns are misplaced.

In fact, by using a cloud-based service with an appropriate security and compliance infrastructure, a facility can significantly reduce its compliance risk.

***

[A.I. and the “SINGULARITY”]*

***

Because HIPAA compliance involves stringent privacy and security protections for electronic protected health information (PHI), many cloud providers are balking at signing new Business-Associate agreements.

Most cloud-technology providers, such as Box and Dropbox, do not include the built-in privacy protections that guarantee HIPAA compliance. Because many cloud storage companies store plaintext data on their servers, PHI is especially vulnerable to breaches and compliance violations.

Note:

The SINGULARITY is that hypothetical moment in time when Artificial Intelligence [AI] will have progressed to the point of a greater-than-human intelligence.

Channel Surfing the ME-P

ABOUT THE AUTHOR

Carol S. Miller; BSN, MBA, PMP
ACT IAC Executive Committee Vice Chair at-Large
HIMSS NCA Board Member
President – Miller Consulting Group
7344 Hooking Road
McLean, VA 22101
Phone: 703-407-4704
Fax: 703-790-3257
email: millerconsultgroup@gmail.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Law & Policy, Information Technology, Risk Management | Tagged: Box, Carol Miller RN, cloud computing, Dropbox, HIPAA, PHI, protected health information | 1 Comment »

Meet Next-Gen Healthcare Powered by the Industrial Internet

Posted on March 24, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

This is Your Body Online

[By GE Healthcare IT]

A couple of years ago, the Kadlec Health System in Washington State started testing a new cloud-based technology that mashes up professional networking and diagnostics. The system allows doctors to create a professional profile, store patient images and data together in one place, view them from anywhere and access intuitive analytics.

“It’s like LinkedIn professional networking meets diagnostic imaging,” said Jeanine Banks, general manager of Commercial Cloud Solutions at GE Healthcare IT, which developed the technology. “There is a lot of waste in the system. We want to help rein in the costs and make the system far more efficient.”

A study published in the Journal of American Medical Association found that almost 40 percent of patients are misdiagnosed in primary care [1]. Another report by the American College of Physicians discovered that unnecessary testing and medical procedures, and extra days in the hospital caused by wrong diagnoses could add up to $800 billion per year, close to one-third of all U.S. healthcare costs [2].

***

At a panel of experts, John Dineen, president and CEO of GE Healthcare, Bill Ruh, who runs GE’s Global Software Center, and Michael Leavitt, the former secretary of U.S. Health and Human Services discussed the state of American healthcare and the ways to improve it with technology. Their panel, which was moderated by technology investor and philanthropist Esther Dyson, was part of GE’s conference focused on IT in healthcare.

Ruh and Dineen reminded everyone that over the last two decades many consumer-facing industries got thoroughly remade and that healthcare won’t be different. “There was an architectural shift of technology,” Ruh said. “We changed how we deliver and interact with music and books.”

Dineen said that the healthcare landscape was also changing “from cost plus to profit and loss. The consumer will start making buying decisions,” Dineen said. “There’s going to be transparency. There is going to be a real focus on productivity and customer satisfaction and that’s going to require tremendous investment …The industry will pivot over the next few years.”

Industrial Internet systems like the GE technology that’s now working at Kadlec will be one driver of change. But, former Sec. Leavitt said collaborative tools that bring together patients, insurers and providers will help distribute the risk associated with healthcare costs.

“Exchanges will allow consumers to make trade-offs,” Leavitt said. “If you stay with me and get your body in a better shape, I’ll give you a better [insurance] price.”

***

Next-generation healthcare will also focus on outcomes. Dineen said that engineers used to be concerned chiefly with building better machines and “taking the technology to the next level.” But, medical systems in the future will have to combine high quality and lower costs with results.

Dineen and Ruh stressed the need to focus on predictive analytics, which has started empowering other industries. Dineen said that in aviation, Industrial Internet systems can already see “a signature of a problem and get it fixed when [the aircraft] comes to a shop and not on a mountain top.”

“It’s not that you get this magic answer that something is going to break,” Ruh said. “You get early indicators. You still need to have experts in the loop.”

Dineen said that right now, the healthcare industry was going through “this clumsy period when the incentives have not kicked in” yet. He listed three stages of the IT revolution in healthcare that need to take place. They include connecting machines and digitizing data, getting data from siloes like primary care providers, as well as the “rich stage,” which involves analysis and learning from the data.

Assessment

Researchers estimate that the majority of healthcare costs stem from preventable chronic health conditions rather than disease prevention and early detection. Dineen called the status quo “unproductive.” The new system will have the rewards and the incentives to change that, he said.

Citations:

¹ Journal of American Medical Association 2012

² Reuter’s, citing study by American College of Physicians

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology | Tagged: Bill Ruh, Centricity LIVE, Esther Dyson, GE Healthcare IT, Jeanine Banks, John Dineen, Kadlec Health System, michael leavitt, Your Body Online | 3 Comments »

The Impact of Medical Identity Theft on Health Care

Posted on March 15, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Health Plan Related Breaches Since 2009

By http://www.MCOL.com

Channel Surfing the ME-P

More:

Conclusion

How does this relate to emails? Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Law & Policy, Information Technology, Risk Management | Tagged: health data breaches, HIPAA, identity theft, Medical Identity Theft | 3 Comments »

Is there a Migration of Patients to Paper-Based Dentists?

Posted on March 13, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Paper Medical Records Become Popular Again?

[By Kellus Pruitt DDS]

Starting long ago, I warned that as more dental patients are notified of data breaches – some more than once – we are likely to witness an event mandate stakeholders said would never happen: A migration of patients to paper-based dentists.

Now, because of the rapidly escalating costs and liabilities, defiant, slow adopters of electronic dental records [EDRs] can not only expect to provide dental care at a lower cost than “paperless practices,” but patients are on course to learn that some dentists do not put their patients at risk of medical identity theft by putting identities on computers.

Just sit back and watch!

The Ponemon Institute

In February, the Ponemon Institute published their “Fifth Annual Study on Medical Identity Theft.”

http://medidfraud.org/2014-fifth-annual-study-on-medical-identity-theft/

“Consumers expect healthcare providers to be proactive in preventing and detecting medical identity theft. Although many respondents are not confident in the security practices of their healthcare provider, 79 percent of respondents say it is important for healthcare providers to ensure the privacy of their health records. Forty-eight percent say they would consider changing healthcare providers if their medical records were lost or stolen. If such a breach occurred, 40 percent say prompt notification by the organization responsible for safeguarding this information is important.”

The Paper-Gold Standard?

So if your patients start asking you not to put their identities – including medical records – on your computers, what will you do, Doc?

Since encryption is a non-starter in dentistry for solid, business reasons, and will make paperless practices even less competitive with paper-based, would you consider employing staff which knows how to use pegboard, ledger cards and lots of carbon paper (The gold standard of security)?

Or, would you prefer not to give up computerization, yet keep your patients safe?

***

More:

Assessment

De-identification of primary electronic dental records is sounding better all the time. Am I right? If patients’ identities are not available, they cannot be hacked.

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Practice Management, Pruitt's Platform, Risk Management | Tagged: Are Dentists Satisfied with their EDRs?, D. Kellus Pruitt DDS, De-identification, digital medical records, eDRs | 5 Comments »

On Physicians Texting [SMS]

Posted on March 11, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Some Technical Considerations

By Carol Miller BSN RN MBA PMP [Miller Consulting]

Text (SMS = Short Message Service) Messaging has become nearly ubiquitous on mobile devices. According to one survey, approximately 72 percent of mobile phone users send text messages (TMs).

Clinical medical care is not immune from the trend, and in fact physicians appear to be embracing texting on par with the general population. Another survey found that 73 percent of physicians text other physicians about work.

(Source: Journal of AHIMA, “HIPAA Compliance for Clinician Texting”, by Adam Green, April 2012)

Advantages

Texting can offer providers numerous advantages for clinical care. It may be the fastest and most efficient means of sending information in a given situation, especially with factors such as background noise, spotty wireless network coverage, lack of access to a desktop or laptop, and a flood of e-mails clogging inboxes.

Further, texting is device neutral—it will work on personal or provider-supplied devices of all shapes and sizes. Because of these advantages, physicians may utilize texting to communicate clinical information, whether authorized to do so or not.

Risks

All forms of communication involve some level of risk. Text messaging merely represents a different set of risks that, like other communication technologies, needs to be managed appropriately to ensure both privacy and security of the information exchanged.

Text messages, like all digital data, may reside on a mobile device indefinitely, where the information can be exposed to unauthorized third parties due to theft, loss, or recycling of the device. Text messages often can be accessed without any level of authentication, meaning that anyone who has access to the mobile phone may have access to all text messages on the device without the need to enter a password.

***

Texts also are generally not subject to central monitoring by the IT department. Although text messages communicated wirelessly are usually encrypted by the carrier, interception and decryption of such messages can be done with inexpensive equipment and freely available software (although a substantial level of sophistication is needed.

If text messages are used to make decisions about patient care, then they may be subject to the rights of access and amendment. There is a risk of noncompliance with the privacy rule if the covered entity cannot provide patients with access to or amend such text messages.

The Wireless Association

According to 2012 data from CTIA–The Wireless Association, U.S. citizens alone exchange nearly 200 billion text messages every month. So it’s not surprising that an increasing number of clinicians are using text messaging to exchange clinical information, along with a wide range of other modes — smartphones, pagers, computerized physician order entry, emails, etc. Electronic communication is certainly faster, can be more efficient, enhances clinical collaboration and enables clinicians to focus on patient care. But with these benefits comes an increased risk of security breaches.

(Source: Clarifying the Confusion about HIPAA – Compliant Texting, by Megan Hardiman and Terry Edwards, May 2013)

Unfortunately, vendor hype about the Health Insurance Portability and Accountability Act [HIPAA] is causing many hospitals and health systems to implement stop-gap measures that address part — but not all — of a problem. To identify all vulnerabilities, health care leaders need to consider not only text messaging, but all mechanisms by which protected health information in electronic form is transmitted — as well as the security of those mechanisms.

Mobile device-to-mobile device SMS text messages are generally not secure because they lack encryption. The sender does not know with certainty that his or her message is indeed received by the intended recipient. In addition, telecommunications vendor/wireless carrier may store the text messages.

Recent HHS guidance indicates text messaging, as a means of communicating PHI, can be permissible under HIPAA depending in large part on the adequacy of the controls used. A hospital or provider may be approved for texting after performing a risk analysis or implementing a third-party messaging solution that incorporates measures to establish a secure communication platform that will allow texting on approved mobile devices.

***

The Ponemon Institute

A study reported in Computer World in May 2013 by the Ponemon Institute with 577 healthcare and It professional in facilities that ranged from fewer than 100 beds to over 500 beds stated that fifty-one percent of the respondents felt HIPAA compliance requirements can be a barrier to providing effective patient care.

Specifically HIPAA reduces time available for patient care (85% of the respondents), makes access to electronic patient information difficult (79% of the respondents) and restricts the use of electronic mobile communications (56% of the respondents).

The study stated “respondents agreed that the deficient communications tools currently in use decrease productivity and limit the time doctors have to spend with patients. “ They also stated “they recognized the value of implementing smartphones, text messaging and other modern forms of communications, but cited overly restrictive security policies as a primary reason why these technologies were not used.”

Clinicians in the survey stated that only 45% of each workday is spent with patients; the remaining 55% is spent communicating and collaborating with other clinicians and using the electronic medical record and other clinical IT systems.

Several other statements made were:

Because of the need for security, hospitals and other healthcare organizations continue to use older, outdate technology such as pagers, email and facsimile machines. The use of older technology can also delay patient discharges – now taking an average of 102 minutes.
The Ponemon Institute estimated that the lengthy discharge process costs the U.S. hospital industry more than $3.189 billion a year in lost revenue, with another $5 billion lost through decrease doctor productivity and use of outdated technology. Secure text messaging could cut discharge time by 50 minutes.

(Source: Computer World, “HIPAA rules, outdate tech cost U.S. hospitals $3.38 B a year”, by Lucas Mearian, May, 2013)

***

Assessment

Several suggestions offered for these preferred mobile devises are: 1) ensure encryption and access to individuals who need to have access; 2) use secure texting applications; and 3) even consider alerting employees with warnings before they send an email or share files that lets them know they are liable for the information sent

Channel Surfing the ME-P

ABOUT CAROL MILLER; BSN, MBA, PMP millerconsultgroup@gmail.com ACT IAC Executive Committee Vice Chairwoman at-Large HIMSS NCA Board Member [President – Miller Consulting Group] Phone: 703-407-4704 and Fax: 703-790-3257

Ms. Carol S. Miller has an extensive healthcare background in operations, business development and capture in both the public and private sector. Over the last 10 years she has provided management support to projects in the Department of Health and Human Services, Veterans Affairs, and Department of Defense medical programs. In most recent years, Carol has served as Vice President and Senior Account Executive for NCI Information Systems, Inc., Assistant Vice President at SAIC, and Program Manager at MITRE. She has led the successful capture of large IDIQ/GWAC programs, managed the operations of multiple government contracts, interacted with many government key executives, and increased the new account portfolios for each firm she supported. She earned her MBA from Marymount University; BS in Business from Saint Joseph’s College, and BS in Nursing from the University of Pittsburgh. She is a Certified PMI Project Management Professional (PMP) (PMI PMP) and a Certified HIPAA Professional (CHP), with Top Secret Security clearance issued by the DoD in 2006. Ms. Miller is also a HIMSS Fellow.

Conclusion

How does this relate to emails? Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Career Development, Information Technology, Risk Management | Tagged: Carol Miller RN, Computer World, HHS, HIPAA, PHI, Ponemon Institute, SMS, The Wireless Association | Leave a comment »

Mobile-Health or Global Economy?

Posted on March 9, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

Boom or Bust?

[By Edward Bukstel]

ME-P SPECIAL REPORT

***

mHealth or Global Economy, Boom or Bust?

***

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Experts Invited, Information Technology | Tagged: Edward Bukstel, mHealth; mobile Health, Mobile-Health or Global Economy? | 4 Comments »

On Digital Health Investments

Posted on March 4, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

258 Digital Health companies raised over $2 million in Venture Capital in 2014

By Edward Bukstel

ME-P SPECIAL REPORT

***

$4.1 Billion in Digital Health Investments in 258 Digital Health Investments 2014.

***

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Health Economics, Information Technology, Investing | Tagged: Digital Health Investments, Edward Bukstel | 4 Comments »

Health Data Breaches Multiplying

Posted on March 2, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

YET – Fines Remain Rare

By Charles Ornstein @charlesornstein

[ProPublica]

Federal health watchdogs say they are cracking down on organizations that don’t protect the privacy and security of patient records, but data suggests otherwise.

***

Fines Remain Rare Even As Health Data Breaches Multiply

***

Channel Surfing the ME-P

More:

Explore the app: Over 1,100 Health Data Breaches, but Few Fines
Get involved: Has your medical privacy been compromised? Help ProPublica Investigate

Even More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Risk Management | Tagged: Charles Ornstein, EHRs, Electronic Data Interchange, health data breaches, health information technology, HIE, PHI, ProPublica | 8 Comments »

Top Ten Most Innovative Healthcare Companies of 2015

Posted on February 26, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

World Class Innovation

[By Staff Reporters]

******

THE LIST

APRICOT FOREST: For seeking a cure to what ails Chinese health care
PERFINT HEALTHCARE: For attacking cancer with robotics
OMADA HEALTH: For improving health through coaching
ELMINDA: For changing the way we see our brains
CARDIOMEMS: For reducing heart failure hospitalizations
ORGANOVO: For getting one step closer to human drug trials—without harming actual humans
THERANOS: For introducing a better blood test
GOOGLE: For developing the next generation of health monitors
ZENEFITS: For helping small businesses provide health insurance
COHEALO: For bringing the sharing economy to the surgery room

Source: Fast Company, February 9, 2015

Channel Surfing the ME-P

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Recommended Books | Tagged: google, Innovative Companies | 5 Comments »

Hospital Data Does NOT Equal Community Health

Posted on February 20, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

More on Big Healthcare Data

[By Edward Bukstel]

ME-P SPECIAL REPORT

***

Hospital Data does not Equal Community Health.

***

Channel Surfing the ME-P

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology | Tagged: big medical data, Community Health, Edward Bukstel, EHRs, Hospital Data | 2 Comments »

The Social Media Shakeup in Healthcare

Posted on February 19, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

An Info-Graphic

By Matthew Smith [CDW]

Patients are increasingly turning to social media channels to seek health information and become more informed about their care, rate the quality of care they receive from providers, and communicate with their peers regarding health advice.

For their part, physicians are seeing increased value in social media for their own research discussions with colleagues — utilizing it to become more informed on patient care resources and for career development and networking.

Social media is slowly starting to foster meaningful results in the healthcare industry. This infographic from CDW Community IT claims social media enables:

Better knowledge of health conditions
Increased dialogue
Connected support
Improved patient engagement

Doctors and hospitals alike are tapping into social media. Consider these stats:

87 percent of physicians ages 26 to 55 use social media.
65 percent of physicians ages 56 to 75 are interacting online.
In 2012, four in five (79 percent) of hospitals were using social media. That number increased to 91 percent in 2013.

***

[To view a full-size version of the infographic, please click here and then click the image when it opens]

***

More:

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

* 8

Filed under: Information Technology | Tagged: medical socia media, Social Media Shakeup in Healthcare | 3 Comments »

Dentists for De-Identification

Posted on February 10, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A Start-Up Idea

[By Darrell K. Pruitt DDS]

An early, shoestring proposal for a non-profit dedicated to common sense security solutions.

Why? if patients’ identities are unavailable, they cannot be hacked.

Recently, I’ve considered starting a non-profit dedicated to keeping patients’ identities off of dentists’ computers where they are far too easily fumbled thousands at a time. I think I might call it “Dentists for De-identification.” What do you think?

My son Ryan and I have discussed putting together an educational YouTube cartoon – comparing the cost, convenience and security of encrypted Protected Health Information (PHI), to storing PHI, including medical information, only on paper in bulky metal filing cabinets – leaving only nameless, unencrypted dental records on the computer. De-identification is the “other” HIPAA Safe Harbor, meaning if patients’ de-identified dental information is stolen or hacked, nobody has to be notified. And, since the patients’ nameless dental records remain unencrypted, de-ID should not slow down work flow like encryption does.

***

One could call employing in-house reference numbers to re-connect patients’ digital dental information to paper-based PHI a hybrid solution to an otherwise intractable security problem. The solution is nothing new, and has a long history of success. For decades, police departments have been substituting in-house reference numbers for citizens’ names to protect the owners. I see no reason it cannot work for dental radiographs as well.

Depending on staff’s familiarity with the alphabet, pulling a patient’s thin paper record from a loud filing cabinet might even take less time than correctly typing in an encryption key (on the first try). What’s more, since there is a limit to the number of patients even the fastest dentists can treat in one day, 4000 or so active patients per dentist is a reasonable estimate of the number of records in a busy dental practice – which is probably one third of the records in the average physician’s practice. Since the dental information remains digital and only a couple of sheets of paper are needed to reveal the patients’ reference number along with a brief medical history, very little filing space should be needed.

The problems with encryption don’t end with correctly entering the key. Once permitted access to encrypted ePHI, it will take much more time to de-crypt one radiograph than it takes to open a manila folder. Depending on the number of radiographs and other digital images – including complex cone-beam radiographs – a patients’ encrypted diagnostic history could require several minutes to view.

I would want to witness the De-ID non-profit professionally investigate whether de-identification indeed offers a cheaper and more secure solution to data breaches from dental offices. I think we all know by now that full disk encryption will never be the answer.

***

Assessment

Still too soon? Give it time. The FBI assures us that more massive data breaches are just around the corner.

Channel Surfing the ME-P

More:

Encrypt or De-identify PHI

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Practice Management, Pruitt's Platform | Tagged: Darrell Pruitt DDS, de-ID, dental eHRs, Dentists for De-Identification, ePHI, HIPAA, PHI | 3 Comments »

The Initial [Estimated] Costs of Electronic Health Records Systems

Posted on January 30, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

A Decade Look-Back Analysis

[By Richard Mata MD MIS]

Studies by the Organization for Economic Cooperation and Development (OECD) showed that healthcare spending in the U.S. accounted for 15.3% of GDP, which is more than six percentage points higher than the average of 8.9% in other OECD countries. This translates into per capita health spending of $5,635 in the U.S. compared with median costs of $2,280 in other OECD countries.[1]

Suggestions as to the economic drivers of U.S. health spending include excessive service use, administrative complexity, population aging, threats of malpractice litigation, defensive medicine practices, and the lack of patient waiting lists. In further comparisons with the OECD countries, it appears the U.S. overpays for physician visits, hospital stays, and pharmaceuticals.

In 2004

A 2004 OECD paper suggested that one way of improving performance would be to move towards EHR:

Health systems should invest in automated health-data systems, including electronic medical records and systems to automate medication orders in hospitals. Better systems for recording and tracking data on patients, health and health care are needed to make major improvements in the quality of care. [2]

In the U.S., possible savings from the adoption of EHR have been projected to reach $142 billion in physician office visits, and $371 billion in hospital costs over a 15-year period. These projections have not been validated by the experience in other OECD countries where the adoption movement is ahead of U.S. efforts by anything from four to thirteen years.

Nevertheless, the U.S. began its quest to move towards EHR in 2004 as medical software companies began actively marketing their systems, although funding for this endeavor did not come through until 2006.

In spite of this effort, the U.S. has the lowest percentage of physician providers using any EHR compared to Germany, Canada, United Kingdom, and Australia. The U. S. physicians’ low adoption rate involves fear of the loss of productivity, lack of financial incentives, and high startup costs of as high as $40,000 per physician EHR adoption.

When spending on IT implementation in the healthcare system is compared on an international level, the U.S. lags dramatically behind the major OECD countries. The U.S. spends $0.43 per capita compared to a high of $193 in the U.K. This difference is even more dramatic when compared with the German experience, where IT adoption in the healthcare system is almost universal. In thirteen years, Germany has spent $1.88 billion. Their annual per capita cost has been $1.63. The U.S. has reached only 25% of that expenditure so far.

The greatest barrier to adoption of EHR in most OECD countries has been the need to simplify the health insurance contracts payment structures with standard nomenclatures that can be adapted to EHR. The major OECD countries also report that there must be a national adoption of IT standards in the healthcare system as well as a national effort to focus on privacy and confidentiality standards. This assures better coordination of implementation and provides better strategies for adoptions through public incentives and grants.

In the U.S., the five-year costs for a national IT healthcare network have been estimated to be as high as $103 billion in capital and $53 billion in interoperability. Hospital costs for functionality were estimated to be $51 billion, skilled nursing facilities would bear $31 billion of costs, and physician offices would bear $18 billion of the costs. (Anderson, 2006) EHR systems that have been implemented have been used mainly for administrative rather than clinical purposes.

***

In 2005

A 2005 study by Richard Hillestad and colleagues at RAND [3] estimates that implementation of a nationwide EHR network would take about 15 years and cost hospitals about $98 billion and physicians about $17 billion. Over the 15-year period, the average annual cost to hospitals would be $6.5 billion and the average annual cost to physicians would be $1.1 billion (CQ HealthBeat [1], 9/14).

However, if 90% of providers adopted such a network, annual savings would total $81 billion, including $77 billion from improved efficiency and $4 billion from reduced medical errors, the RAND study found. The study estimates that an EHR network would reduce adverse drug events in inpatient hospital settings by 200,000 annually and reduce such events in ambulatory settings by two million annually, saving $1 billion annually in hospitals and $3.5 billion in ambulatory settings.

For hospitals, about 60% of these savings would be from reduced adverse drug events in patients ages 65 and older, while 40% of savings to ambulatory practices from reduced medication errors would be in patients 65 and older (CQ HealthBeat [1], 9/14).

In addition, the study estimates that a national EHR network would save Medicare about $23 billion annually and save private insurers about $31 billion annually. The study projects that the estimated total annual savings of $81 billion would double if providers followed all checkup reminders and other prompts from the system (AP/Las Vegas Sun, 9/14). Currently, about 20% to 25% of hospitals and 15% to 20% of physician offices have EHR systems, according to the study (CQ HealthBeat [1], 9/14).

Assessment

What about today in 2015? How close have these estimates been?

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

[1] For details of the report, see http://www.oecd.org/dataoecd/29/52/36960035.pdf.

[2] OECD, Towards High-Performing Health Systems, see http://www.oecd.org/document/26/0,2340,en_2649_37407_31734042_1_1_1_37407,00.htm.

[3] See http://www.rand.org/health/feature/2006/060414_shekelle.html. The report is also discussed in some detail in Neergaard, AP/Las Vegas Sun, 9/14/05. See http://www.ihealthbeat.org/index.cfm?Action=dspItem&itemID=114707.

Filed under: Information Technology | Tagged: Cost of EHRs, EHRs, Richard Mata MD | 1 Comment »

Overview of Hospital Information Systems Architecture

Posted on January 22, 2015 by Dr. David Edward Marcinko MBA MEd CMP™

On Configurations and Varieties

[By Brent Metfessel MD MIS]

Hospitals can use a variety of configurations for HIS implementation depending on business needs and budgetary constraints.

Staffing needed for these systems can range from a few full-time equivalents (FTEs) per 100 beds for very basic off-site processing systems to 15 or more FTEs per 100 beds for sophisticated systems that attempt to combine several architectures into one system (e.g., combination of client-server systems with mainframe processing). Resource use and customizability tend to vary in tandem; the greater the flexibility of the system to meet unique user needs, the greater the cost outlay for capital and/or additional FTEs.

***

Relationship of Resource Use and Customizability Based on System Architecture Selected

Values range from one (low) to four (high) stars
Architecture	Hospital resource use	Customizability
Off-site processing	*	*
Turnkey systems	**	**
Mainframe systems	***	***
Client-server	***	****

***

The Possibilities

The basic system architecture possibilities are as follows:

Off-site (remote) processing: In this case the hospital contracts with a vendor external to the hospital. The hospital sends data over to the vendor site where the actual processing takes place. When processing is complete, the vendor sends the data back to the hospital, usually in electronic form.

Turnkey systems: A vendor provides the hospital with systems that are “pre-packaged” so that hospital-based system development is minimal. Limited customization of the system is possible using systems analysts or programmers.

Mainframe systems: Most applicable to large hospitals, this configuration is highly centralized. A large and powerful computer performs basically all the information processing for the institution and connects to multiple terminals that communicate with the mainframe to display the information at the user sites. Hospital IT departments usually use in-house programmers to modify the core operating systems or applications programs such as billing and scheduling programs.

Client-server systems: In this configuration one or more “repository” computers exist, known as “servers,” that store large amounts of data and perform limited processing. Communicating with the server(s) are client workstations that perform much of the data processing and often have graphical user interfaces (GUIs) for ease of use. Both customizability and resource use is high, depending on the desired sophistication.

Many clinical information systems that process data directly related to patient care use this configuration. For instance, the Veterans Health Administration, which has implemented what is likely the largest integrated healthcare information system in the United States, uses client-server architecture. Known as the Veterans Health Information Systems and Technology Architecture (VistA), this system provides technology infrastructure to about 1,300 care facilities, including hospitals and medical centers, outpatient facilities, and long-term care centers. VistA utilizes a client-server architecture that links together workstations and personal computers using software that is accessed via a graphical user interface.

Overall, for hospitals that have the financial and manpower resources for a significant investment in IT, client-server architectures are the fastest-growing and typically the most preferred of the system architectures, due in large part to their local adaptability and flexibility to meet changing hospital and medical center needs.

Broad Categories

The above architectures are broad categories. Modifications and combinations of the above also exist, such as the use of client-server technology with mainframe systems and the addition of wireless technology, smart phones, laptop PCs and tablets, and various personal digital assistants (PDAs) to supplement the core computing functionality.

In considering the optimal architecture for a hospital, management needs to take into account factors such as size of the institution, desired sophistication of the application, IT budget, and anticipated level of user community involvement.

Assessment

Another important aspect of HIS is the need for integration. Often, different hospital departments have their own stand-alone systems — such as a Laboratory Information System (LIS) and pharmacy systems — that do not communicate with each other. Duplicate data may be kept in separate systems, creating additional work to enter the data multiple times.

In an integrated system, each departmental system communicates with the other systems through either a centralized or decentralized. A computerized physician order entry (CPOE) system, for example, would be much less effective if it did not communicate electronically with the pharmacy system that would process the medication orders.

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

NOTES: Resource use refers to the need for FTEs and hospital capital expenditure. Customizability refers to the ability for users to alter the system structure or function to meet the unique needs of the institution.

Filed under: iMBA, Inc., Information Technology | Tagged: graphical user interfaces, GUI, health information technolgy, HIT, hospital information systems, Mainframe systems, Veterans Health Information Systems and Technology Architecture, VistA | 4 Comments »

Pitfalls with Health Care Provider Data

Posted on December 16, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Physician Licensure and Medical Care Quality?

By http://www.MCOL.com

More:

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Quality Initiatives | Tagged: medical data security?, Pitfalls with Health Care Provider Data, www.MCOL.com | 2 Comments »

Understanding “Meaningful Use” Attestation Numbers for 2014

Posted on December 13, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Providers versus Hospitals

By CMS

Assessment

So, what do the hospitals know – that the doctors do not?

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology | Tagged: CMS, EHRs, HIPAA, HIT, meaningful use | 6 Comments »

On Health Care Fraud Detection Analytics

Posted on December 7, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

On the Intersection of Data and Linking Analytics

By http://www.MCOL.com

More:

Channel Surfing the ME-P

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
Dictionary of Health Economics and Finance
Dictionary of Health Information Technology and Security
Dictionary of Health Insurance and Managed Care

Filed under: Information Technology, Risk Management | Tagged: health fraud, medical data analytics | 2 Comments »

Handling Protected [Cyber] Health Information [PHI]

Posted on October 30, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

More on Medical Cyber-Security

[By The Doctors Company]

***

NOTE

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants

Filed under: Information Technology, Risk Management | Tagged: Cyber Security, EHR risks, protected health information, The Doctors Company | 5 Comments »

Saving Private Medical Practice?

Posted on October 14, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Can the EHR Save this Business Model?

[Dr. David Edward Marcinko MBA]

Healthcare insurance reform from the Obama Administration – as incremental as it will be on both the Federal Medicare and State Medicaid levels from 2014 to 2018 – forces medical providers to look for more efficient ways to provide services, as well as additional sources of revenue in a margin-diminishing business model.

Total federal spending for both programs, under current Office of Management and Budget [OMB] assumptions, are growing. Skepticism is prevalent throughout the healthcare industry about the benefits and the role of market competition in the provision of healthcare services, despite pronouncements by the Federal Trade Commission (FTC) and Department of Justice (DOJ) that competition has positively affected healthcare quality and cost-effectiveness, and recommendations that many of the barriers to competition that prevent it from fully benefiting consumers be removed.

And so, according to Cimasi, Alexander and Zigrang of Health Capital Consultants LLC, and others; this growing economic tension has threatened the traditional private medical practice business model.

[Private communication: http://www.HealthCapital.com]

***

Link: http://www.medicalpracticeinsider.com/news/infographic-can-ehr-save-private-practice

Assessment

The “tipping point” has been reached, according to some experts, as the private practice model falls below 50/50.

Rhetorical Questions

What will save private medical practice as we know it.
Does it need to be saved, at all?
Will EHRs be the salvation?

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: EHRs, Saving Private Medical Practice? | 4 Comments »

Acknowledging Ada Lovelace Day [“Mother” of HIT?]

Posted on October 9, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Today is Ada Lovelace Day 2014

[By Dr. David Edward Marcinko MBA CMP™]

Ada Lovelace Day was created to celebrate one of the first female computer programmers. As the daughter of the poet Lord Byron, Augusta Ada Byron, was brought up by her mother, Annabella, after he passed.

Her mother feared that she would inherit her father’s poetic temperament, and gave Ada a strict upbringing of logic, science and mathematics. Ada became fascinated with mechanisms and designed steam flying machines, poring over the scientific magazines of the time and embracing the British Industrial revolution.

The Analytical Engine

In 1833, Ada Lovelace was introduced to Charles Babbage whom she helped to develop a device called The Analytical Engine; an early predecessor of the modern computer. Lovelace and Babbage worked together closely for many years in order to refine the Engine. Ada found relative fame in 1842 when she expanded on an article by an Italian mathematician, in which she elaborated on the use of machines through the manipulation of symbols. Although Babbage had sketched out programs before, Lovelace’s were the most elaborate and complete, and the first to be published; so she is often referred to as “the first computer programmer”.

***

Death

Ada Lovelace died of cancer at the age of 36 a few short years after the publication of “Sketch of the Analytical Engine, with Notes from the Translator”. The Analytical Engine remained a vision for many but until Ada’s notes inspired Alan Turing to work on the first modern computers in the 1940’s.

Assessment

Her passion and vision for technology have made her a powerful symbol for women in the modern world of technology. But, was she the “mother” of Health Information Technology? You decide.

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology, LifeStyle | Tagged: Ada Lovelace, Alan Turing, Analytical Engine, Charles Babbage, Steve Jobs | 6 Comments »

EHRs – AMA versus ADA

Posted on October 5, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Will Electronic Health Records Ever Be Usable?

[By Darrell K. Pruitt DDS]

The American Medical Association

The AMA attempts to address the frustration EHRs create, especially for doctors and other healthcare workers. ‘It’s easy to use, once you know where everything is,’ the instructor said during an EHR training session I recently attended.

Most EHR companies seem to believe this is an acceptable way to design software. EHR usability has been greatly ignored by vendors, and last week the American Medical Association issued eight usability priorities in an attempt to address the issue.

This directive comes as a result of a joint study by the RAND Corporation and the AMA highlighting EHRs as a significant detractor from physicians’ professional satisfaction.” Commentary by Stephanie Kreml for InformationWeek, September 26, 2014.

http://www.informationweek.com/healthcare/electronic-health-records/will-electronic-health-records-ever-be-usable/a/d-id/1316071

The American Dental Association

On the other hand, “EHRs provide long-term savings and convenience,” no byline, ADA News, December 6, 2013.

http://www.ada.org/en/publications/ada-news/2013-archive/december/ehrs-provide-long-term-savings-convenience

[POW – SPLAT – BIFF – UGH]

More:

EHRs versus the Federal Government

Government mandated EHRs – what a waste!

“Doctors, Hospitals Went Digital, But Still Can’t Share Records – After spending billions to switch from paper to digital records — much of it taxpayer subsidized through the economic stimulus package — providers say the systems often do not share information with competitors.”

[Kaiser Health News, October 1, 2014]

http://www.kaiserhealthnews.org/Daily-Reports/2014/October/01/marketplace.aspx

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology, Op-Editorials, Pruitt's Platform | Tagged: ADA, AMA, Darrell K. Pruitt DDS, EHRs, electronic medical records | 16 Comments »

Divorcing your EHR Sytem [A How to Approach]

Posted on September 28, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Planning for an Escape Hatch

[By Shahid N. Shah MS]

As a doctor, or physician executive, you will spend weeks or months in the “sales and demo cycle” for selecting an EMR. If you’re lucky you will have time to consider all workflows; if you’re even luckier you will test drive the UI and make sure training goes smoothly.

You will also try to ensure that deployment will be easy.

However, another thing not to forget is to plan how to get out of an application or system after it’s been installed for a while.

It’s Harder to Get Out – Than Get in

Why is getting out important? Every application looks better in a demo than in a working environment and every solution becomes “legacy” sooner or later. Every system will be replaced or augmented at some point in time. The cost of acquisition (“barrier to entry”) is well understood now as something we need to calculate. But the “barrier to exit” or switching cost is something you must calculate at the time you decide what systems to purchase.

If you can’t answer the “how, in 6, 18, or 24 months, will I be able to move on to the next-better technology or system?” question then you’ve not completed your due diligence in the sales cycle. Vendor sales staff are quite reticent to answer the “how do I leave your system” question; you will need to press hard and ask for a plan before signing any contracts.

Some Vendor Queries

When preparing an RFI or RFP, ask vendors specific questions about how easy it is to get out of their technology (rather than just how easy to it is to deploy and interoperate). Put in specific test cases and have your folks consider this fact when they are looking at all new purchases.

Here are some specific factors to consider:

Do you own your data or does the vendor? If you don’t have crystal clear statements in writing that the data is yours and that you can do whatever you want with it, don’t sign the contract. Look for a new vendor.
Is the database structure and all data easily accessible to you without involving the vendor? If only your vendor can see the data, you’re locked in so be very wary. Find out what database the vendor is using and make sure you can get to the database directly without needing their permission.
Are the data formats that the system uses to communicate with other vendors open? If not, you don’t own your data. Be sure that at least CCR and CCD formats are available and that all document data is accessible in standard PDF or MS Office friendly formats. Discrete data should be extractable in XML or HL7.
How much of the technology stack is based on industry standards? The more proprietary the tech, the more you’re locked in.
Are all the programming APIs open, documented, and available without paying royalties or license costs? If not, when you try to get out you’ll pay dearly.

***

More:

Book Chapter:

Chapter 13: IT, eMRs & GroupWare

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
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HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Chapter 13: IT, eMRs & GroupWare

Filed under: Information Technology, Practice Management | Tagged: Divorcing your EHR Sytem, EHRs, electronic medical recrods, HI-TECH Act, HIT, Shahid N. Shah MS | 3 Comments »

ICD-10 Could Bolster Ebola Bio-Surveillance?

Posted on September 23, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Forgetting ICD-9 … Moving on to ICD-10

[By Staff Reporters]

According to Tom Sullivan, there is no specific code for the Ebola virus under ICD-9?

And no, this is not a joke: There isn’t a specific one. Instead code number # 078.89 refers to multiple viral diseases. Under ICD-10, however, there is one. It’s A98.4.

***

The Proponent

That’s according to the Coalition for ICD-10 which, of course, is a proponent of moving to the new code set without further delay.

Assessment

The coalition’s main point is that specific codes can help public health officials better manage bio-surveillance. Do you agree?

Link: Infographic: ICD-10 could bolster Ebola biosurveillance

More: Ascel Bio on Forecasting Infectious Disease Outbreaks

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Ethics, Information Technology | Tagged: Ebola virus, ICD-10 | 4 Comments »

On Mobile Health App Privacy Policies

Posted on September 18, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

About Availability and Quality

By http://www.MCOL.com

More:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: EHR privacy, m-Health, m-Health Apps, Mobile Health, mobile health privacy | 7 Comments »

Site HACKED – HealthCare.Gov

Posted on September 5, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Site Breached

[By Staff Reporters]

Hackers successfully breached HealthCare.gov, but no consumer information was taken from the health insurance website that serves more than 5 million Americans, the Obama administration just disclosed earlier today.

Assessment

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Insurance, Information Technology | Tagged: HACKED-HealthCare.Gov, HealthCare.Gov | 10 Comments »

The Medical Industry is Going Mobile?

Posted on August 21, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

m-Health is Taking Off!

By Apollo Matrix

More: Co mprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: m-Health Apps, mHealth, Mobile Health | 5 Comments »

On Healthcare Provider’s Use of Technology

Posted on August 7, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Most Important Tool for Effective Communications in ACO

By http://www.MCOL.com

Assessment

Are your patient health records vulnerable to hackers?

The problem with EHR templates

EHRs may make patients leery of sharing information

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: Accountable Care Organizations, ACOs, Dictionary of Health Information Technology and Security, health information technology, HIT, Mobile Health | 1 Comment »

Consumer Satisfaction Levels with Public Health Insurance

Posted on August 3, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Selected HIE Shopping

By http://www.MCOL.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: Health Insurance Exchanges, HIE's | 2 Comments »

Prevalence Rates of Healthcare Access?

Posted on July 18, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Household Telephone Status

By http://www.MCOL.com

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: Mobile Health Apps, Prevalence Rate of Healthcare Access, teleHealth, telephone health access | 1 Comment »

Six groups that will shape mHealth apps of the future

Posted on July 16, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A Special ME-P Report

The Distinct Segment Publishers

By Ralf-Gordon Jahns and Markus Pohl

Introduction

Dr. Marcinko and ME-P Readers and Subscribers,

Did you know that mHealth app publishers can be grouped into 6 distinct segments?

Segments differ mainly by goals, business approaches and performance. Their desire to help others distinguishes them from the rest of the app community. Knowing these segments is a pre-requisite for all those who wish to successfully participate in the new mHealth app ecosystem.

The Publishers

So, who is behind the 100,000 mHealth apps published in today’s app stores? How do the publishers differ in terms of motivation, development tool usage and satisfaction about goals achieved? The mHealth app publisher segmentation distinguishes 6 groups of current mHealth app publishers. This segmentation is based on the results of themHealth App Developer Economics 2014study.

A deeper knowledge about the mHealth app publishers is essential to all health market participants who wish to successfully navigate inside the newly emerging mHealth app ecosystem.

mHealth app publishers are not like game or tool app developers. 46% publish apps, because they want to help others. They also have objectives like revenue generation or raising brand awareness, but this “altruistic” attitude clearly distinguishes them from the rest of the app economy.

Within the six mHealth app companies, publishers with a strong medical background and those who leverage existing app development tools & APIs seem to accomplish their goals better than those who do that to a lesser extent.

Traditional healthcare players like Pharma, Med-tech or insurance companies have not been able to define their role in the market yet. Established Healthcare Players are the only segment “mainly not” satisfied with their goal achievement.

These are the profiles of the 6 distinct mHealth app publisher segments:

1) Established healthcare players:

This group includes Pharma, hospitals, health insurance and Med-tech companies, representing 3.4% of the total number of app publishers. These players usually belong to the mHealth app publishers with > 5,000 employees. Their primary objective for being in the market is to raise brand awareness and they have published the largest number of mHealth apps. Nevertheless, average reach in terms of downloads is far below the market’s average. App publishers in this group are so far the least satisfied with the achievements in the mHealth app market. The usage of tools and APIs to improve the efficiency of the app development process and app monitoring as well as the value of the app is below its competitors.

2) App specialists:

App specialists are small companies, which typically hire 3-10 employees. They have entered the mHealth app market in order to benefit from its potential. They have an app developer background and are familiar with available development and support tools. The share of medical experts on board is relatively low. This group constitutes 14% of the mHealth app publisher community.

3) Helpers:

Helpers’ primary motivation for publishing apps is to help others and they are usually organized into small companies of 3-10 employees. Revenue generation is only a minor factor. Typically Helpers have already achieved or over-achieved their goals. In terms of downloads, they have the highest share of companies (61%) that achieved less than 5,000 downloads last year. Helpers represent 32% of the market.

4) Medical specialists:

Medical specialists leverage their medical know-how to develop mobile apps. Similar to the Helper group, Medical specialist have a large share of members who publish apps to help others. By far they have partly reached their goals. They have the highest share of companies, which in 2013 earned more than USD 1m with their mHealth app portfolio. They represent 20% of the market.

5) Fitness specialists:

This group of app developers represents around 10% of the total mHealth app developer community. They primarily develop fitness apps with a clear objective to generate revenue. They connect more often to medical databases and sensors and use app development tools above average. The usual company size is 11-100 employees.

6) Connecters:

This group of mHealth app publishers represents 18% of the total mHealth app developer community. Their strategy is to create value rich apps by enabling connection to other apps, sensors and databases. This group generates the highest average revenue and has the highest goal achievement level.

Assessment

The mHealth app publisher segmentation is a snapshot of the current state of the market. It will change as segments become more important (medical specialists) or new groups appear. One of the main questions will be if and how traditional healthcare players will be able to compete with these small and agile companies that are driving the market today.

More:

mHealth Collaboration Delivers Ground-Breaking Approach to COPD Management
Select Science, June 16, 2014
Smartphone Innovation Is About Seniors and mHealth
Medical Marketing & Media, June 13, 2014
mHealth Apps Should Be Reviewed and Certified, Experts Argue
MedScape, June 10, 2014
Over a Third of Docs Recommend mHealth Apps, Survey Shows
Manhattan Research, June 10, 2014
Kaiser Permanente Flagship App Surpasses 1 Million Downloads
Kaiser Permanante, June 4, 2014
New Medicast® App Brings Doctors To Doorsteps In Los Angeles And Orange County
Medicast, June 4, 2014

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

References:

Link to blog post:

http://mhealtheconomics.com/mhealth-segmentation-of-app-publishers-business-approaches/

Link to graph:

http://mhealtheconomics.com/wp-content/uploads/2014/05/research2guidance_mHealth_6_segments_business_approaches.jpg

Link to free report:

http://mhealtheconomics.com/mhealth-developer-economics-report/

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Health Economics, Information Technology | Tagged: Markus Pohl, mHealth, mHealth apps, mobile health applications, Ralf-Gordon Jahns | 7 Comments »

FOR SALE: Physician E-mail Lists with NPI Numbers

Posted on June 23, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Sensitive Data for Sale

[By Dr. David Edward Marcinko MBA]

I received this email recently. Are you as incensed over it, as I? OR, am I being overly sensitive? Feel free to call or email John Edward, the sender, to tell him what you think: pro or con?

Hi ME-P,

I’m writing to check if you would be interested in reaching Physicians or Healthcare Executives?

We at AccurateB2Blist maintain a permission passed email list for physician practitioners with NPI numbers.

Our Lists

Below given are few additional lists we maintain within Medical Industry

Nurses
Dentists
Veterinarians
Healthcare Executives Email List
Physicians – Offices and Clinics of Doctors of Medicine
Physicians – Offices and Clinics of Doctors of Osteopathy
Doctors, Physicians and Surgeons Email List with NPI Number

Healthcare executives: 518,900 out of which 123,200 contacts are senior management level contacts.

Assessment

Please let me know if you would like to discuss further on your target audience? Looking forward to hearing from you. And, please do not print this email unless it is absolutely necessary. To opt out reply with ‘Leave out’ in the subject line!

By John Edward [Business Development Executive] AccurateB2Blist

+1951-373-6718

Conclusion

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BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology, Risk Management | Tagged: AccurateB2Blist, HIPAA, John Edward, NPI Numbers, Physicians Email Lists, Risk Management | 1 Comment »

On m-Health App Therapeutic Business Potential

Posted on June 17, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Top Ranked Therapy Areas

By http://www.MCOL.com

Related:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: mHealth; mobile Health | 1 Comment »

How EMR Vendors Mis-Lead Doctors [Part 2 of 2]

Posted on June 16, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A SPECIAL ME-P REPORT

Practical “Tips and Pearls” from the Trenches

[Part Two]

By Shahid Shah MS http://www.healthcareguy.com

As your practice’s CIO it’s your job to challenge the vendors’ assertions about why you need an EMR, especially during the selection and production demonstration phase.

The most important reason for the digitization of medical records is to make patient information available when the physician needs that information to either care for the patient or supply information to another caregiver.

Electronic medical records are not about the technology but about whether or not information is more readily available at the point of need. In no particular order, the major reasons given for the business case of EMRs by vendors include:

Increase in staff productivity
Increase of practice revenue and profit
Reduce costs outright or control cost increases
Improve clinical decision making
Enhance documentation
Improve patient care
Reduce medical errors

Let’s tackle each potential benefit and see how they can be realized or left unfulfilled based on how a practice uses the technology solutions available to it. While thinking of the benefits, keep in mind that all automation solutions have voracious appetites for data entry and information. If you do not enter the data (either manually, through scanners, or integration with external systems) the value of the solutions cannot be realized. That’s why it’s crucial to consider how much time and effort you’d like to invest in data entry and if you’re not willing or able to take the time to enter the data into the system then the system is not going to work for you.

Increase in staff productivity

The first benefit often cited by vendors is improvement of your staff’s productivity. In a well-designed and properly implemented solution, an EMR can reduce the amount of time it takes for staff to locate records and find particular information about patients as well as generally conduct their tasks in a more efficient manner. However, actually achieving productivity improvement is much more difficult than vendors often make it sound. This is because the actual improvement in productivity is directly related to the amount of detailed data that is collected for patients across the entire practice workflow. Unless your practice has identified all or at least most major workflow steps and has created appropriate automation steps is unlikely that your productivity improvement will match what the vendor promises.

Ask your vendors specifically where the staff productivity improvements come from; in a demonstration have the sales person show you how specific functions of their software can improve staff effectiveness at particular tasks. Instead of citing just studies performed in large institutions, have the vendor show you how their benefits apply to your smaller setting. Ask specifically what happens if certain data is not entered in the way the vendor requires it; does it break the software, reduce the staff productivity benefits, or something else?

Increase of practice revenue and profit

Most physician practices make money by seeing patients and charging fees for services; but when a vendor promises an improvement in revenue or an increase in profit, you must be very reluctant to believe the claims without specific evidence. An increase in revenue can only come when the number of patients seen per day per physician can be increased. An increase in profit can only be achieved if the costs associated with seeing patients can be reduced. Unless an EMR actually reduces the number of steps involved in seeing a patient and reducing the time associated with the non-clinical aspects of patient care there is no way that the introduction of the technology itself will increase revenue. Likewise, unless an EMR is designed to significantly remove staff burden and reduce the number of people in your office that you need to perform tasks associated with patient care, realizing an increase in profits will be tough.

During the software demonstration, ask the vendor about how the revenues increases come because of specific features. Dubious responses like studies performed in academic medical institutions or a reference to another client shouldn’t be enough – they should be able to demonstrate methodically how revenues will go up in your practice.

Reduce costs outright or control cost increases

In some fairly sophisticated implementations the reduction of costs has been proven to be possible; however outright cost reduction is still tough to gain. Controlling cost increases, however, is quite possible and is usually easier to attain because as your staff becomes familiar with their technology solutions they become more efficient over time and they are able to do more work with the same resources and staff therefore you may be able to increase the number of patients that you can see over time without increasing costs. Again, while immediate cost reductions are tough in a medical practice given that a large portion of your costs are associated with personnel, long-term cost reduction through either attrition or not having to hire new staff while still being able to increase their workload allows you to control costs better.

During the software demonstration, make sure you see how specific software features will reduce costs. You will get plenty of softballs being thrown your way about how other customers saw their costs go down or studies showing that large companies have seen the benefits. Your job as the CIO will be to force the vendor to tie cost savings specifically to use of their software, not computers in general.

Improve clinical decision making

Improving clinical decision-making is often a dubious endeavor and should not typically be the first reason you choose to implement an EMR; this is because clinical decision-making is and will remain a knowledge –based activity requiring significant training and teaching of computers before they can actually begin to improve clinical decisions. Physicians are some of the worlds’ best trained knowledge workers and they honed their clinical decision-making skills over a long period of time in very specialized training regimens that cannot easily at this time be duplicated by computers. When a vendor promises that an implementation of any EMR will improve decision-making from a clinical standpoint remain very skeptical.

Enhance documentation

Many vendors claim that their EMR’s will help improve and enhance clinical documentation. While this is very true for lead-based EMR is they are often creating much more documentation as far as quantity is concerned while likely reducing the actual quality of the information contained in the documentation. When implementing a template-based solution keep in mind that what a physician could normally easily write down in a couple of sentences will turn into many paragraphs in many pages of boilerplate text and boilerplate documentation that must then be stored red and understood by colleagues. So the promise of enhanced documentation is actually usually easy to achieve because you will get more pages of documents that are automatically generated but those pages that are generated may not necessarily be the most favorable from a clinical usefulness perspective.

Improve patient care

Many vendors proclaim that the installation of an EMR sometimes by itself will improve patient care; if by improvement of patient care they mean actually moving patients through the different steps associated with patient care in your office in a faster and more customer friendly manner then there is some truth to that. However if by improvement of patient care the promise is to actually make people’s healthcare better or truly improve a patient’s health itself then those claims must also be seen with a skeptical eye. This is similar to the clinical decision making enhancement promises that are often made; just like clinical decisions, patient care is a very human activity and simply introducing a better record keeping system will not improve people’s health. We are an improvement in health can occur however is in the tracking of clinical goals and helping patients meet those goals by reminding patients for regular tasks.

Reduce medical errors

Reduction of medical errors is a laudable goal; and in fact many EMR’s and the use of computerized physician order entry systems can help reduce medical errors by ensuring that common clerical types of errors do not occur. When looking at medical and clinical errors those errors that can easily fit well established and known rules can be automated in a somewhat friendly and easy manner and by using such automated tools error reduction is possible.

Assessment

However, when rules become difficult to define or are not widely agreed-upon then errors associated with such rules would not be caught.

PART ONE: How to Demo and Buy an EMR Office System [Part 1 of 2]

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: electronic medical records, EMRs, Shahid Shah MS | 3 Comments »

How to Demo and Buy an EMR Office System [Part 1 of 2]

Posted on June 14, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A SPECIAL ME-P REPORT

Practical “Tips and Pearls” from the Trenches

[Part One]

By Shahid Shah MS http://www.healthcareguy.com

When getting demonstrations from vendors, the only way to understand the value for the money being spent or invested is to measure and communicate the productivity improvements that IT is supposed to deliver.

If you cannot measure how much time something takes before technology is implemented you will never know whether or not the purchase of any technology was a wise investment.

Some of the measurements you should consider are:

how long it takes to pull up a patient chart
how long it takes to update common data elements within a chart (meds, problems, etc.)
how long an appointment takes to schedule
how many patients are seen on a daily basis
how much data is being captured per patient visit
how long the check in and check out processes take
how much time spent on non-essential phone calls (better handled by automated email?)
how much time a physician spends on non-clinical activities

The actual items that you measure will depend on the tasks that you would like to automate; the simple listing of the tasks that you would like to automate often provides enough basic measurement metrics that you can perform a before and after comparison.

Vendor Demonstrations

When bringing vendors and for demonstrations or discussions you should lay out your workflow and your processes and share with them the kinds of tasks you would like to automate and the kind of staff productivity you are looking to improve and make your vendors focus on what’s important to you and not what features and functions they have in their solutions. Just remember the rule if you don’t measure you will never know whether you made an investment or simply spent money on something you didn’t need. If you don’t know how well you’re doing and where you want to improve vendors can give you any numbers and they will sound good to you.

Here are some general tips for making sure you get good demo’s:

Demonstrations from vendors should not be about their software, but about how their solution benefits you. Make sure they spend most of their time talking about you, your practice, how their solution matches your practice, why each feature they are showing is important to your specialty and staff, and why they won’t fail in your office. Each time they talk about a general feature or function, bring them back to your practice.
When vendors talk about saving money and increasing productivity keep in mind that some money comes in the form of hard cash for the purchase of equipment and software but even more money will be spent in terms of early loss of productivity as new solutions are installed and staff becomes acclimated to it and potential loss in productivity forever if the wrong processes and steps are automated.
Force vendors in their demonstrations to talk about their failures in past installations – how many times were they removed/deinstalled, why did failures occur in the past, how did they recover from inevitable problems? The more a vendor can talk about why things go wrong and how they can help right the ship, the more likely they can help you out the jams you will get into.

To save you time, take 30 minutes and create a document that will tell vendors what you want them to show you in a demo and make the follow your script, not theirs.

Here are some tips for helping vendors demo to you:

See if you can do the first demo over the phone and web meeting software like WebEx or GotoMeeting. Remote demonstrations make more efficient use of time – the second or third demonstrations when you’re narrowing down selections are better in person.
Tell them there is no need for detailed company introductions and that you have no desire to hear that the vendor’s founders have found the secret sauce to healthcare technology that will save the healthcare industry. Vendors think you care about that stuff and will waste much of your time unless you make sure your wishes to not hear that are known in advance. They will not think you’re rude, they will thank you.
All medical records software do generally the same thing, they just do them in sometimes different ways and that’s what you care about – how they’re different. You’ll want to tell them to focus on how they different from other EMRs but not let them focus on competitors early on. Do this towards the end when you better understand their product and can ask more specific questions.
If the sales person wants to talk about the company, ask him to focus on the size of their service staff relative to their R&D staff, whether they provide in person phone support, do they have web-based support with screen sharing, and how much it will cost you to get support when you need it. While you’ll never talk to the CEO or founders of a vendor, you’ll definitely talk to their service staff so do ask about it.
Take the keyboard from the sales person. Never let a sales person drive the keyboard in a demo, you should do it yourself or have a computer-proficient staff member drive it.
Within the first 30 seconds of the demo, make sure you are shown how to lookup a patient by name and date of birth. If it takes more than 30 seconds to launch the app, log in, and type in a patient name or date of birth, and get to a chart then you should be disappointed.
Once you’re at the demo patient screen, try to make sense of it without letting the sales person talk and show you around. If there are too many fields and you’re getting confused, it’s probably not intuitive and you should be cautious. Again, don’t let the sales person show you what you don’t understand – try to figure it out yourself.
In the demo patient screen, can you find the face sheet, meds, problem lists, procedures, past documents, faxes, lab results, and other documents without help from the vendor?
Within the first three minutes of the demo, make sure you see how to add meds, problems, and procedures to an existing patient. These are common tasks and shouldn’t take long.
Within the first seven minutes of the demo, make sure you see how to add a note to the chart. This is how you’ll start to interact and input data into the system.
Within the first fifteen minutes of the demo, create a new patient record and try to reproduce a sample patient chart in the system. Use an anonymized patient chart and try to recreate it during the vendor’s demo.
Now is the time to ask about all the other features that you care about and want to see demonstrated. Try not to ask about features just to see if they have it; tie it to one of your metrics and tell them why you need it.
If you liked what you saw, now is the time to ask them what other customers they have and their recent customer wins, how they compare with competitors, how much they cost, and related questions. You’ll understand the vendor better once you’ve tried the software.

Key focus areas for your demonstrations

Sales people for vendors give demo’s hundreds of times and each demo is the same for almost everyone and it focuses on their product. Your job is to focus them into the following key areas that are of concern to you:

Chart access. You will want to know how patient charts indexed, searched, and stored. Ask how they handle lost charts and multi-user access to the same chart (meaning can multiple people simultaneously view and update a chart). Inquire about how charts can be accessed on a mobile phone, on a web browser at your house, on a workstation at a hospital you have privileges at, or on your laptop while you’re in CME training. An EMR that doesn’t give you fast access to your charts from everywhere on any kind of device is going to limit you. Ask them to allow you to point your iPhone to a sample chart and see how it will look.
Data entry and document creation. Ask over and over again how data gets into the system; will it be a model that allows you to dictate into a phone and have the results show up in the EMR or will it be through voice recognition where the computer is trained and tries to understand what you say and automatically and immediately converts your speech into text for the EMR? Be sure to ask to what extent your voice can create notes in their system. The most common input mechanism outside of voice dictation is “point and click” templating where you choose between many options by pointing and choosing patient symptoms, observations, and other details and the computer creates the notes for you. For all normal findings the software can create the standard notes but for all abnormal findings you either enter free text or dictate. The point and click model is very popular but is a time-consuming activity. Another technique is handwriting recognition on a tablet – if you can write fast enough on touch screen device or can point and click fast it can be something that you can use. All these techniques are important to cover in a demo so you can decide what’s best for you.
Data backups. If they are a cloud provider, ask them during the demo to show you how you can easily get access to the database behind the user interface to get your data out anytime you want to. Ask the cloud vendor their disaster recovery strategy – what happens if their primary site is inaccessible, how do you access the data? If your EMR is on-premises on a server, ask them about how they help you perform backups of the server either locally or over the Internet. If the EMR vendor says backups are your problem and doesn’t give you a strategy or guidance you’ll have more to worry about.
Patient portals and personal health records (PHRs). Patient engagement and ability for patients to directly connect with you and view their records through your EMR is an important capability. During the decision-making process be sure that for no extra cost patients should be able to see their personal health record (PHR) as another view of your EMR.

Other considerations for your demonstrations

When you are looking to capture metrics and figure out which areas of your practice needs to be automated, take a look at the following general areas and make sure that when you are getting a demonstration you do so in a manner that fits the actual needs of your practice rather than what the software developers and consultants might think you need. If you don’t focus on your business problems than the vendors and consultants will focus you on what they think is important rather than what actually might be important to you. You’re better off reducing the number of areas you get demonstrated versus expanding.

PART TWO: How EMR Vendors Mis-Lead Doctors [Part 2 of 2]

RELATED:

Conclusion

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: electronic health records, EMRs, Shahid Shah | 2 Comments »

Why Hospitals Must Look to the Cloud?

Posted on May 29, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

A Key Solution to Meeting the Healthcare Mandates

By http://www.Innotas.com

Assessment

Healthcare and Insurance Partial Client List:

Adventist Health
RelayHealth
SCAN Health Plan
University of Missouri Health System
Johns Hopkins Healthcare LLC
Maxim Healthcare Services, Inc.
Catholic Health System
Noven Pharmaceuticals, Inc.
Nyack Hospital

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: Hospitals Must Look to the Cloud? | 3 Comments »

Beware the WET heartBLEED Bug!

Posted on April 12, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Hacking – Web Encryption Technology [WET]

[By Staff Reporters]

A newly discovered bug in widely used Web Encryption Technology [WET] has made data on many of the world’s major websites vulnerable to theft by hackers.

BEWARE!

[An OpenSSL Hack]

LINK: http://money.msn.com/business-news/article.aspx?feed=OBR&date=20140408&id=17508701&ocid=ansmony11

More:

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
ADVISORS: www.CertifiedMedicalPlanner.org
BLOG: www.MedicalExecutivePost.com
FINANCE:Financial Planning for Physicians and Advisors
INSURANCE:Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology | Tagged: computer bugs, hack, heartBLEED bug, SSL, virus, Web Encryption Technology | 10 Comments »

Can Politically-Correct Names Save Obamacare?

Posted on March 19, 2014 by Dr. David Edward Marcinko MBA MEd CMP™

Saving Electronic Health Record Interoperability?

By D. Kellus Pruitt DDS

If HHS successfully persuades Americans to use happy names for its bad ideas, will the cheap trick save electronic health record interoperability which is critical to the success of Obamacare?

Healthcare Lexicon

According to the government’s modernized healthcare lexicon, doctors have been demoted to “providers,” insurance companies, including Medicare/Medicaid, have been promoted to “payers,” and patients’ position in the hierarchy has diminished from “principals” to “stakeholders” – a rank on par with 3rd parties such as insurers, HHS and other unaccountable parasites.

Wall of Shame

Ominously, HHS recently changed the contentious name “Wall of Shame” to a more innocuous“ breach reporting tool,” to describe the public list of data breaches involving the medical records of more than 500 patients. It turns out that the growing list of major data breaches is unexpectedly shaming far too many providers and payers – including Medicare/Medicaid. Imagine that!

In fact, since Americans’ growing disgust with privacy breaches threatens the very success of Obamacare, there is evidence that HHS has turned to betraying its lawful obligation to the nation by hiding breaches from those who are most vulnerable – Americans.

HIPAA Failure

The half-baked plan to shame providers who experience data breaches – perhaps through no fault of their own – is not working out like HHS had hoped. Due to HIPAA’s abysmal failure to halt data breaches, the Wall of Shame has become a national embarrassment and an obstacle to EHR adoption. I expect the public listing of major breaches to be quietly scrapped soon in favor of keeping patients in the dark concerning their risks of identity theft.

Dentistry

In dentistry, on the other hand, common sense as well as market resistance evidently caused HHS and other stakeholders to give up trying to prohibit use of the 8 syllable “electronic dental records” in favor of the 14 syllable “electronic health records for dental practices.”

Nevertheless, holdouts (including Dissent Doe) still occasionally feel it is important to correct this dentists when I use “EDR” instead of “EHR.” You got to love ‘em.

Assessment

Transparent silliness suggests that HHS is failing in its duties. Due to lack of accountability, we can expect EHRs and EDRs to become even more expensive and more dangerous, possibly bringing an end to Obamacare.

Conclusion

Link: http://feeds.feedburner.com/HealthcareFinancialsthePostForcxos

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

DICTIONARIES: http://www.springerpub.com/Search/marcinko
PHYSICIANS: www.MedicalBusinessAdvisors.com
PRACTICES: www.BusinessofMedicalPractice.com
HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
CLINICS: http://www.crcpress.com/product/isbn/9781439879900
BLOG: www.MedicalExecutivePost.com
FINANCE: Financial Planning for Physicians and Advisors
INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors

Filed under: Information Technology, Pruitt's Platform | Tagged: ACA, Darrell K. Pruitt DDS, dental records, Dissent Doe, eDRs, EHRs, electronic dental records, electronic medical records, HIPAA, ObamaCare, PP-ACA | 23 Comments »

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