US News & World Report used data from HIMSS Analytics to create their list of the 118 “Most Connected Hospitals.” (See the list here: bit.ly John Hoyt talks about the criteria they used and how being connected can help improve patient care. Start setting your own course to become one of the most connected hospitals by getting your EMRAM score here: (bit.ly Contact Patti Harris at HIMSS Analytics to learn more: firstname.lastname@example.org.
Posts tagged Data
Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice. Measure Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). Exclusion An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically. For more information visit www.healthcois.com
IBM helped the Institut Catala de la Salut consolidate patient data across its entire hospital network, allowing doctors to access patient information whenever they need. By doing this and streamlining their financial processes, IBM helped Catalonia’s largest healthcare provider save €45 million and radically improve patient care. For more information: www.ibm.com
I don’t know of a single medical practice that does not perform some kind of data backup or save information on some medium. The correct choice often goes unnoticed, but the incorrect backup selection can lead to many issues. So what are some of the challenges you may face in a data storage environment?
• Traditional data backup is time consuming, intrusive and unreliable. Mission critical medical data and information can only be backed up into whatever time is available, usually during off hours or weekends.
• Data restore is especially critical and must be fast and reliable. The backup process is usually uneventful, but the quality of data retention will not be known until someone needs the data right now. Did you know that 50% of tape back ups fail to properly restore data, and tape failures were often caused by human error.
Now there is a more effective solution; a “managed offsite” backup solution which securely backs up all of your network data. Backup is accomplished directly to an offsite secure vault. With this system:
• there are no time-consuming manual programs;
• no tapes to manage or store;
• no expensive tape hardware to maintain;
• backup more often to minimize data loss between runs;
• and quick recovery lost data.
Further, an offsite data back up system is cost effective because you only pay for the total aggregate amount of data protected—no matter how many servers, personal computers and laptops you are protecting. Typically pricing is based on gigabytes of data backup on a per month basis; and usually the more you store the lower the price per gigabyte.
If a practice is heavily invested in a current backup system, one should consider a migration strategy that begins with the back up of practice management or EMR data to an offsite vault. As the current backup system becomes obsolete, one can move additional data offsite.
In the final analysis, as with everything, not all offsite backup solutions are created equal. When a practice is considering an offsite solution, the following key factors need serious examination:
• Fast, easy installation—is there just one software application to install or are you required to install multiple agents to accomplish your backup needs?
• Accountability—can you easily access real-time reports and/or is there email alerts to ensure that you will know your backups were successful?
• Fast and efficient data recovery— is there quick restore capability? And is there an option of having the most recent data backup being stored locally and in the vault?
• Data security—is there advanced security technology that is HIPPA compliant to ensure safety and confidentiality of your data at all times? The minimum is AES 128 bit encryption, but one should consider AES 256 bit encryption.
• Network optimization—is a solution capable of detecting data duplication and block-level incremental backup? Is the data compressed to reduce the amount of data transmitted to a vault?
• Restorability—is there an enabler that ensures that data stored in a vault is restorable? Without this feature, there is no way to confirm data can be restored.
As for implementing an offsite data backup solution, one must first perform an assessment of all medical practice data. The assessment begins with locating the data, then identifying duplicate data to ensure the back up of the right and appropriate data. Depending on the amount and size of data to initially back up, it may be downloaded to an external hard drive, enabling the delivery and uploading to a vault. All subsequent data backup would be completed automatically through a secure Internet connection. And scheduling of the
backup could be throughout the day, at the end of day or as dictated by policy.
In sum, there are many solid data storage solutions. However, the traditional backup method where tapes are used is expensive, time consuming, unreliable and could spell disaster. In fact, 40% of firms that shut down for three days due to a disaster, failed within 36 months as cited in Contingency Planning and Management magazine.
What you may not know about a data conversion is critical when you consider if and by whom you will do a conversion. Presented here are some items that could make a significant difference in the immediate and long-term outcome of that decision.
You probably have heard there are issues to deal with when transferring data from a legacy system electronically. There also things that can be done electronically which can never be accomplished manually. One example is the contamination of 1.2 million note records with.5 million invalid note records. Removal of those records electronically might require an hour programming time and some computer run time.
• Large files make manual data entry impractical
• Leaving clinical data behind is generally not acceptable
• Inaccuracies in clinical data create an unacceptable level of risk
• Elapsed time for implementation is much shorter with an electronic data migration
• Options and changes are more readily available electronically
• Data conversions can be outsourced freeing staff time for more important clinic duties
Clinical data files are huge. Even when you put the image files in a category by themselves the remaining EMR data is many times larger than the data associated with an average billing system. Data integrity becomes exponentially more problematic when reentering large volumes of data manually. Not so electronically.
You can’t leave data behind. It has to be available for physicians to do their work. Reporting requirements of various agencies make it necessary to have the data available. Any form of data retention other than maintaining it in the current EMR system significantly increases the cost of using it.
What are the risks to a physician when medical outcomes depend upon questionably accurate data? The risk is unacceptable so the physician will likely resort to a back up paper chart or the legacy EMR system with their associated maintenance and retrieval costs.
Use a phased implementation to get live sooner and with less disruptive down time and almost no duplicate data entry. If your vendor can’t do this, ask why.
It is unlikely the data entry scheme will be tested with any significant number of records. Yet testing with volumes is unquestionably the most effective way to prove conversion methodology and evaluate decisions regarding what data will be and won’t be converted. Electronic migrations lend themselves to large volume testing and change orders. The latter will likely incur additional costs. They will be relative and therefore somewhat predictable. The key is having the option, which manual data entry does not offer.
Data migration work can and probably should be outsourced. While you might be tempted to outsource data entry work, doing so will increase the rate of inaccuracies. Temps you hire won’t know your office, procedures or patients. They’ll be more prone to small errors that are important but hard to detect.
A good data conversion is hard. A bad one is downright painful and unnecessary. This is not about technology. It is about business. Your business. Ask questions up front then make an informed business decision
The world is growing and fruiting with the help of technological conceptual advancements. These improvements in technology, has brought a change that all the sectors now use to serve with modern facilities and maintain the best coordination among these facilities. The introduction of medical software like EMR and EHR is the advancement in medical sector which coordinates with the areas of clinical decision making, drug prescribing etc. The clinical decision making, and drug and treatment prescribing are the first hand uses of EHR data. But there are some alternate uses of EHR data also. We better can say it to be the re-use of EHR data. Mostly in case of clinical and other drug related researches and studies the reuse of EHR/EMR data is incorporated. A clinical research is geared by the need to provide reliable data to support safety and efficacy. And the data from EHR lays the foundation for the reliability of the data from a clinical research which is to be used in furtherance. Data retrieved from medical software systems like EHR should be of such a quality that it improves the efficiency of patient care. This quality concern should not be there only from the point of first use of EHR data but also from the re-uses of data mostly by researchers to support healthcare. But the re-use of EHR data must be treated with caution, because the data protection issue is always pertained to reuse of data like the EHR data. So, we need a system that can help us in achieving a proper balance in between the protection of data in one hand and more optimized reuse of data on the other.
The use and re-use of EHR data in the healthcare information segment is always accompanied by various drawbacks. These drawbacks accompanying re-use of data vary from lack of legal and technical standards to uniformity of use. We need proper standards and protocols of data collection and the re-use. Only a properly collected piece of information whether primary or secondary can help in achieving research objectives. The re-use of data, generated by a medical software be it an EHR or any other record keeping system, should be cost-effective. Clinical experiments or trials done with re-use of EHR data is a cost effective way than collecting the data afresh. The uniformity in approach in re-use of data from medical software (EHR) is another point of concern in our discussion. The present situation in health care requires researches to carry out research studies in isolated fashion at different locations. The use of the EHR which is the common medical software in use varies widely across different nations worldwide and so challenges the re-use of EHR data in clinical researches and other uses. Other issues like the maintenance of patient confidentiality, requirement of time and cost effective resources are a few to requiring attention in the field of re-use of EHR data. A qualitative control on re-use of EHR data can lead to a sustainable, beneficial and commercial impact on treatment and drug development which ultimately will lead to better healthcare system in a viable economy.
With the increased focus on HIT (Health Information Technology), the situations in US and EU in re-use of EHR data is changing positively. Introduction of HITECH act in US is an initiative in the direction of Health Information Technology. The European Seventh Framework Program for research and technological development is the initiative by EU to focus on HIT. The use of proper EHR systems in place is growing fast in US. The vision of the EFPIA EHR task force is another forcing factor that will help in attaining the standards for re-use of EHR data.
And in future with such a huge amount of efforts we surely will have a proper system with proper medical software in place which will coordinate in re-use of EHR or any such data with satisfaction.
2 Imaging the medical business: DICOM
The efficiency in every sphere of life due to the technological and scientific advancements includes the health sector also. With the technological and scientific progress the people are becoming more aware of their health and nutrition. And due to this growing importance on health, the medical sector is also experiencing a huge growth. This growth in the medical sector is accompanied by the technological improvements as in the cases of other sectors. Almost all the hospitals and clinics are using technological advancements in their practices. Be it the medical software for billing or the EMR software system they are using. It is estimated that the use of an appropriate medical software product in place has the potential to increase the earnings by a considerable amount of more than or equal to 30%. So, simply you cannot neglect the importance that a right medical software product bears in medical industry.
And in this age of advancement any medical business unit without the imaging division is just incomplete. Imaging in medical business is of a great importance that nobody can ignore and even alter. The image reports like cardiographs, biomagnetic imaging, computer radiography, tomography, diaphanographs, microscopy, endoscopy, mammography, spectroscopy, radio fluoroscopy, thermographs, ultra sound, x-ray angiography are a few of the imaging services to name that comes into the scene when we talk about medical imaging reports. Today’s treatment of a patient is incomplete if no one of these images accompanies his records. And with these imaging services there is a common standard for the handling, storage, printing and transmission of imaged information in medical imaging. This common standard or the common format for the images is known as DICOM.
DICOM is the abbreviation for Digital Imaging and Communications in Medicine. The Picture Archiving and Communication System or simply PACS which is a system, uses this standard for the all the medical imaging. DICOM includes a file format definition and a network communication protocol. And this network communication protocol uses TCP/IP for communication in between the systems. DICOM enables the integration of scanners, printers, workstations, computer systems and other network hardware into PACS. DICOM supportive devices come with the capacity to support different DICOM classes separately. DICOM is developed by American College of Radiology (ACR) and National Electrical Manufacturers Association (NEMA). The present DICOM is the third version of this standard. The first version was released in the year 1985. It was ACR/NEMA 300. The second version came in the year 1988 by the name ACR/NEMA V2.0.
DICOM bears some very necessary information along with the images like the patient ID, which is inseparable from this information even by mistake. While handling DICOM data different medical software products are used. Software tools for the transfer, organizing of DICOM data, for image supports etc. are very widely used. Trial Wire is a very useful medical software used in DICOM data transfer, de-identify and handling. There are other software products like GDCM, OsiriX, ImageVis3D, VRRender, ImageJ, MicroDicom, Medstrat, kPacs, UniPACS etc. which are very commonly used in DICOM interpretation.
Trial Wire is a medical software product used to transfer DICOM image from one to another web enabled computer. It is a java based tool available free of cost. The use of a medical software product like Trial Wire reduces the cost associated with the couriers used to transfer DICOM data from one location to the other. Trial Wire also provides an audit trail for any changes made to the DICOM data in order to comply with the HIPAA regulations.
3 Medical Software in HIS sphere:
Automated health practice management systems, e-prescribing, CAT scanners, heart rate monitoring with software are a few of the names from the medical area in the 21st technology driven century. From the patient’s personal data to the cardiographs everything has got the driving force of technological advancement. Introduction of PACS or Picture Archiving and Communication System and DICOM or Digital Imaging and Communication in Medicine has changed the way of imaging in the medical practices. Similarly the introduction of EMR/EHR medical software has changed the way of medical record keeping. In most of the hospitals and clinics in EU, US or Canada you would notice the use of medical software like an EMR system in practice very well. Likewise the introduction of medical software for billing purpose is another important contribution of modern technology. Medical billing software used in billing has introduced the comfort of coordination among other medical services like lab report of patients and its coordination with proper insurance claims etc.
Medical Software is the modern technological term that has driven the medical sector to an unalterable stage of advancement. The introduction of various medical software products has changed the way of management and even the administration concerned with hospitals and clinics across EU and US. Medical software use even in health informatics like HIS is of great help. HIS or Hospital Information System is the platform covering all the medical related clinical as well as administrative sections. From the simple hospital discipline management to the management of health records, financial records, and other medical reports all are covered under this single umbrella named HIS.
Hospital Information System or simply HIS is the information system assisting all the administrative, financial and clinical aspects of a hospital or a clinic. HIS also known as CIS or Clinical Information System comprises of a comprehensive, integrated information system covering all the papered and non-papered software based clinical as well as administrative medical areas of concern. A simple HIS construction can be understood as the sphere covering the entire medical aspects from EMR systems to the software based billing services. A proper HIS is always aimed at achieving best possible support towards the health care of patients and an adequate management by deploying either medical software products or machineries along with responsible technicians/persons. Radiology information system, Laboratory Information System, PACS, etc. are the sub categories of Hospital Information System. EMR, EHR, software based billing services, insurance claims, patient care, profit drive, hospital management, administrative works all belong to the sphere of HIS.
The advantage from HIS includes well maintained decision support system in healthcare, exchange of information towards the betterment of the healthcare services, coordinating the standards of ancillary services with the primary one, enabling referring physicians and doctors to access all the studies and reports via a single user interface etc. In a nut shell a proper HIS with adequate medical software support is the demand of the time, conforming to which can rise your business in the medical sector to an incredible level.
Earnings Preview 4/30/10
Earnings season will be in full gear next week as 991 firms report, including 99 (1/5) of the firms in the S&P 500. The list of companies reporting includes such heavy-hitters as Kraft (KFT), Merck (MRK), Pfizer (PFE), Time Warner (TWX) and Duke Energy (DUK).
In addition to the ongoing earnings parade, there will also be a heavy calendar of economic data, with several numbers that could have a big impact on the market. We start the week with March data on Personal Income and Spending, along with data on auto sales. Along the way, we get both sets of ISM numbers as well as the productivity growth in the first quarter. This all leads up to the biggest number of all: the employment report on Friday.
* Personal Income is expected to have risen by 0.3% in March after having been unchanged in February. Personal income is a broad measure that not only includes wages and salaries, but government transfer payments, dividend checks and rental income. It ultimately is the chief source of fuel for consumer spending.
* Personal Spending is expected to rise by 0.6% in March up from 0.3% growth in February. If spending is rising faster than income, then it means that the savings rate is falling. In the short term, that is good news since a falling savings rate helps boost the economy. In the long term, it is very bad news since it starves the economy of the investment capital it needs for growth (or forces us to import the capital in the form of a higher trade deficit). Over the long term, the current U.S. savings rates, which are among the lowest in the world, are unsustainable. A core dilemma for the U.S. economy is the fact that it is impossible to move from an unsustainably low savings rate to a higher savings rates without the savings rate actually rising and thus slowing economic growth.
* The ISM Manufacturing survey (PMI) is expected to show growth accelerating in the manufacturing sector with a reading of 60.0, up from 59.6 in March. The index is constructed so that any reading over 50 indicates expansion, and a reading below the magic 50 level means contraction. It is a compilation of ten sub-indexes covering things like the level of production, new orders, and employment levels. An overall reading of 60.0 is a very healthy level, but there is more information to be gleaned in looking at the behavior of the sub-indexes, as well.
* Construction spending is expected to have contracted again in March, but at only 0.3% rather than the 1.3% decline in February. Don’t read the slower rate of decline as being all that much good news, however. The decline in February was probably exaggerated by the blizzards. Construction, both residential and commercial, continues to act as a major drag on the economic recovery.
* Auto and truck sales are expected to have fallen back slightly in April, with consensus expectations of a rate of 4.2 million for autos, down from 4.3 million in March and truck sales falling to 4.6 million from 4.8 million. Personally, I think there is enough momentum that sales will surprise to the upside. On the other hand, March sales were boosted by heavy incentive spending.
* Factory Orders are expected to have fallen by 0.2% in March, partly reversing a 0.6% gain in February. This report is mostly “old news,” as the most volatile part of factory orders are the orders for durable goods that were already released (they were strong, with the exception of the very lumpy civilian aircraft category).
* Pending Home Sales are expected to have risen by 5.0% on top of a 8.2% rise in February. With the end of the homebuyer tax credit approaching, I’ll take the “over” on this one as well, although there will be much more of that impact in the April report, which will be coming out a month from now. The bigger question is how much of a sales hangover we have in May and June from the party in April.
* The ADP “appetizer” for the big employment report main course on Friday is expected to show an increase of 30,000 private sector jobs. Last month the survey greatly undershot the “official BLS numbers” by reporting a loss of 23,000 jobs while the BLS noted a gain of over 100,000 private sector jobs. The ADP survey does not include government workers at any level. With the ongoing hiring for the Census, that is a very large difference at this time.
* The ISM Non-Manufacturing, or Service, index is expected to show growth in the Service sector (far larger than the Manufacturing sector) accelerating with a reading of 56.1, up from 55.4. The Service index has lagged well behind the Manufacturing index for several months now, but has also been seeing steady increases. As with the Manufacturing index, it is based on a Magic 50 number and is comprised of 10 sub-indexes, each of which provides useful information in addition to the headline number.
* Weekly initial claims for unemployment insurance come out. They fell 11,000 in the last week to 448,000. After a huge downtrend from mid-April through the end of 2009, initial claims have become very erratic so far in 2010. Look for them to fall again next week, with the consensus looking for 440,000. Longer term, we have made good progress, but not good enough. We probably need for weekly claims (and the four-week moving average of them) to get down to closer to 400,000 to signal that the economy is on balance adding jobs. We are a lot closer now than we were last spring when they were running north of 640,000 on a consistent basis, but we still have a ways to go.
* Continuing claims have also been in a steep downtrend of late. However, that is in part due to people simply exhausting their regular state benefits, which run out after 26 weeks. If one factors in the extended claims paid by the Federal government as part of the Stimulus program, claims soared last week. Looking at just the regular continuing claims numbers is a serious mistake. They only include a little over half of the unemployed now given the unprecedentedly high duration of unemployment figures. Last week regular continuing claims were 4.645 million, down 18,000 from the previous week. Extended claims (paid from Federal ARRA funds) were 5.403 million, a decline of 91,000. That decline was probably as much the result of people falling off the rolls due to even the extended benefits running out, not because they all found new jobs. Make sure to look at both sets of numbers! Many of the press reports will not, but we will here at Zacks.
* The rate of Productivity growth is expected to have slowed to 2.4% from the breakneck pace of 6.9% it recorded in the fourth quarter. Over the very long term, productivity growth is one of the most important of all economic statistics, since it governs the growth of GDP per capita, which is really the measure of how rich the country is, more than total GDP. After all, even under Mao, China had a larger GDP than Sweden, even though no one would have thought that the Chinese were richer than the Swedes. In the short-term, though, it means that we are able to make the same amount of stuff with fewer workers, which is really not what we want when faced with persistently high unemployment. The expected rate of 2.4% is more consistent with the long-term trend. The 6.9% rate of the fourth quarter, and the even faster rate in the third quarter of 7.8%, are reflective of an economic rebound and are not sustainable over the long term. If the number comes in higher than the 2.4% rate, look for an upward revision to the 3.2% rate of GDP growth.
* The unemployment rate is expected to remain at 9.7% for the fourth month in a row. If this number surprises, it is likely to come in higher rather than lower, even if the economy starts to add jobs as in economic recoveries the civilian participation rate, or the percentage of the population that is either working or wants to work tends to rise. The participation rate has already started to increase, rising by 0.1% in each of the last three months, a trend that is likely to accelerate.
* The economy is expected to have added 187,000 more jobs in April, on top of the 162,000 it added in March. While that certainly is a massive improvement over the loss of a quarter million jobs a month that the economy was recording in late 2008 and early 2009, at that rate it will take a very long time to make up for the 8.4 million jobs that have been lost in the downturn. Of particular interest will be two types of temporary jobs. Regular temporary workers from places like Kelly Services (KELYA) are a good leading indicator of future employment trends. The other temporary jobs of note will be new Census jobs, which are a once a decade short-term boost to the employment numbers. While the jobs pay fairly well and are better than people being unemployed, growth that comes from that source will be considered low quality growth since the jobs will only last five or six months at the most.
* Other data to look for in the report are the unemployment duration numbers, which have been particularly awful in this downturn and hit new records in March. Check the under-employment rate (U-6), which includes the discouraged workers as well as those that are only working part time but want full-time jobs, the length of the average work week — which is expected to remain flat at 34.0 hours — and the employment-to-population ratio (also known as the employment rate, which measures the percentage of the population, including the very young and very old) — that are working. Also average hourly earnings, which are expected to rise by 0.1%, would reverse a 0.1% decline in March.
* Consumer Credit (not including real estate backed debt like mortgages) is expected to have declined by $3.9 billion in March on top of a $11.5 billion decline in February. This downturn has been unusual in the extent that consumer credit has declined as people try to restore their personal balance sheets.
Potential Positive Surprises
Historically, the best indicators of firms likely to report positive surprises are a recent history of positive surprises and rising estimates going into the report. The Zacks Rank is also a good indicator of potential surprises. While normally firms that report better-than-expected earnings rise in reaction, that has not been the case so far this quarter. While pickings are getting slim, some of the companies that have these characteristics include:
Drew Industries (DW) is expected to report EPS of $0.31, up from a loss of $0.34 per share a year ago. Last time out, DW posted a positive surprise of 5.3%, and over the last month the mean estimate for its first quarter earnings is up 33.33%. DW has a Zacks #1 Rank.
Perkin Elmer (PKI) is expected to post EPS of $0.28, up from $0.26 a year ago. Last time, PKI beat expectations by 4.9%, and over the last month analysts have raised their estimates for the about-to-be-reported quarter by 0.44%. PKI is a Zacks #2 Ranked stock.
Sysco Systems (SYS) is expected to post EPS of $0.41, up from $0.38 a year ago. Last time out, the company beat expectations by 7.1%. Over the last month, estimates for the quarter are up 1.61%. SYS is a Zacks #2 Ranked stock.
Potential Negative Surprises
Centerpoint Energy (CNP) is expected to post EPS of $0.29 a share, versus EPS of $0.19 a year ago. Last time, they reported 10.0% below expectations. For this Zacks #5 Ranked stock, analysts have cut the estimates for this quarter over the last month by 2.05%.
Pepco (POM) is expected to earn $0.20 a share this quarter, up from of $0.17 a year ago. They were in line with expectations last time out. Analysts have cut the estimate for this quarter by 15.0% over the last month. The stock holds a Zacks #5 Rank.
Vulcan Materials (VMC) is expected to lose $0.37, versus a loss of $0.29 a year ago. Last time out, this Zacks #5 Ranked stock disappointed, but the amount could not be calculated since the expectations were for break-even and over the last month analysts have shaved their expectations for the quarter by 28.07%.
Dirk van Dijk – About the Author:
Dirk van Dijk, CFA is the Chief Equity Strategist for Zacks.com. With more than 25 years investment experience he has become a popular commentator appearing in the Wall Street Journal and on CNBC. Dirk is also the Editor in charge of the market-beating Zacks Strategic Investor service. For more information, visit http://www.zacks.com.
The healthcare industry is generally behind other organizations in terms of IT usage, but there is a ton of pressure now from health plans, consumers, and the government; increasingly strict reporting and compliance requirements; and an overall healthcare industry realization that IT can improve patient care and safety. So while IT usage in hospitals, physician practices and healthcare provider organizations lags behind other industries, its adoption and growth rates are among the highest in the United States.
Many hospitals continue to spend IT budgets on mission-critical administrative and financial applications, much of the increase in IT spend is now focused on clinical information systems and other applications that form the core of an electronic medical record, or EMR. Building an accurate and useful EMR typically requires the need to gather data from numerous applications and sometimes from multiple vendors. Effective integration of this data is critical for success.
In addition to the growing number of applications currently in use among healthcare providers, there also is the problem of the number of unique patient data interfaces currently in play. Hospitals use systems and applications acquired from multiple software vendors, and many physicians’ offices operate separately from their affiliate hospitals, the integration of patient data across the many applications in use, therefore, becomes paramount for true end-to-end process integration. And those hospitals that make the large investment in single-vendor solutions often spend years trying to tie all the disparate applications from internal sources or their secondary vendors.
Data integration platforms that were once only affordable for the larger healthcare providers are now being deployed at smaller hospitals. Faced with the challenge of data integration, a customized point-to-point interface is simply not a viable solution. So how does a healthcare provider go about selecting a data integration platform?
There are several factors that need to be considered when selecting a vendor, the obvious being a strong track record of success with deployments of similar size and scope as yours. But there are other considerations as well, including technology, performance, support, financial viability. The technology itself – or proposed solution – also needs to be evaluated thoroughly for security protocols, operational efficiency, documentation, and total cost of ownership (TCO).
Healthcare providers are heading in the right direction by deploying an integration platform. Health data integration will help create process efficiency across departments and among vendors and staff. It will reduce clinical errors and improve the safety and health of patients. And these improvements will ultimately save money for both hospitals and their constituents.
While reading a post on EMRandHIPAA today, I was reminded about an issues that I had thoroughly thought about two years ago when I was looking for a more capable EMR vendor to partner with for our medical practice clients.
A practice’s data (their patient charts) is not only what their business runs on, it’s proper maintenance is required by law and by a basic trust with their patients. Many EMR vendors seem to take advantage of this by holding their client’s EMR data hostage when they want to move to another product or even interface an ancillary service into their EMR.
What should be a simple database connection from a automated patient reminder service can turn into months of waiting and thousands of dollars of interface development fees from the EMR vendor. A much worse scenario is a vendor going out of business and your practice being unable to migrate to another EMR because there is no direct database access or published database schema.
With that being said, who’s data is it anyway? Most EMR Vendor’s contracts read that the data belongs to the practice. But what does that mean if you can’t move it, or interface with it without the aid and permission of the vendor?
Let me give you two examples of what we’ve run into over the years. The first was not a clinical setting, but the scenario still applies.
A law office client of mine had been running a legal PM application for a number of years when suddenly on December 1 1999 the system popped up a message that said your license expires in 31 days. Each day the countdown continued. They called me and I called the number on file for the vendor, a recording answered in a sexy female voice “Are you ready to have a good time?” The vendor was gone completely, they scrambled and bought a new system and manually transferred their information before the end of the month. Imagine that happening to your practice! There is no way to properly move to a new system in a clinical environment in 30 days!
Another example is what is currently happening with one of our medical practice clients.
They purchased a system a long time ago, and that system’s vendor has been sold a number of times over the years. The current vendor is one of the big guys and had changed their policy so that even systems purchased outright in the past require a maintenance contract to allow the system to function. So even though the own the software, as soon as they stop paying for support, the system stops working. So who’s data is it?
We partnered with Glostream in 2009 because they use a Microsoft SQL database and we can control access to the database. If our clients want to interface of move the data they can without paying the vendor anything. If they stop paying the annual maintenance, they stop getting support and new releases, but the application does not time bomb because the practice actually owns the software and data!
Whether its Glostream or another EMR vendor you choose, make sure that you own the data!
Some of the most highly-publicized information breaches in the United States occur due to vendor negligence, according to Dark Reading, a leading IT security journal.
The study examined vendor relationships among medical practices in 2010, underscoring the importance of choosing a medical records vendor capable of not only fulfilling your EMR back scanning projects, but properly securing confidential patient information protected under HIPAA and HITECH regulations.
Aside from loss and/or theft of information storage devices on behalf of the staff at a number of the healthcare provider companies, the largest breaches occurred when more trust was placed in the vendors hired than was warranted, according to the study. In all cases, the breaches illustrated were easily avoidable.
Forgetting to ask the right questions before selecting a medical record scanning company can mean major fines and feasible closure of your medical practice. But regrettably, this happens far too often. Since the Department of Health and Human Services has broadened the definition of a “covered entity” to include fundamentally anyone who has access to your patient files, HIPAA and HITECH violations are definite to follow even the most cautious medical practice.
Even the Largest Health Providers Fall Victim
Despite what some healthcare consumers may think, a number of the largest medical insurance companies in the world still suffer seemingly catastrophic information breaches that would otherwise get left under the radar and by default, the growing scope of the United States Department of Health and Human Services’ HIPAA enforcement function.
Now that mandatory HIPAA information breach reporting requirements are in effect that requires a “covered entity” to disclose all information breaches occurring within their organization that involves 500 or more individual patient records, the publicity surrounding healthcare information breaches is becoming far more common. But as the story points out, the companies are still lax in their revision of security procedures as we pertain to patient information.
How to Protect Your Patients (and Your Practice)
There’s a common assessment that many doctors and healthcare companies follow when selecting a long-term vendor to assume electronic medical record processing and storage. But a healthy dose of common sense prevails when it comes to managing your back scanning operation. First, you ought to look at the back-scanning method as a separate but equally important function of your medical practice. That is to say, give as much attention to your scanning procedures as you would your patient care protocols.
Query the So-Called “Specialists”
With the Federal Government providing financial incentives to medical practices that adopt electronic medical records before 2014, money making opportunities in the back scanning business are plentiful. That means lots of vendors specializing in document duplication and scanning are entering the EMR back scanning marketplace. When evaluating a seller to handle your EMR transition, be cautious of fly-by-night vendors.
The method of scanning a document is easy. But managing the information contained within a patient file is not. That is because scanning an ordinary document lets you save and store it in a variety of ways. But HIPAA-protected documentation requires strict encryption and highly-specialized information expertise functions usually outsourced by most medical providers.
The move to electronic files is not as simple as scanning and saving. The IT function, and how you manage those who manage it, becomes the front line in protecting patient data during the electronic medical record scanning and storage process.