A new focus: How to become empowered patients

Attention, kind readers. After years of doing this blog in fits and starts — particularly the two-year gap while I was essentially prohibited by a full-time employer from writing about health IT here or anywhere else but that company’s site — I have decided to refocus on healthcare consumers rather than industry insiders.

The “Meaningful HIT News” name itself has become dated, given that the Meaningful Use program from which this blog takes its name has evolved and kind of fallen out of favor. For those not up on the lingo, “meaningful use” is the standard healthcare providers must meet to qualify for Medicare and Medicaid bonus payments for use of health information technology and/or avoid penalties for not being “meaningful” users of electronic health records.

The program came about in 2009 with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, a bipartisan part of the very partisan American Recovery and Reinvestment Act (ARRA); ARRA was President Barack Obama’s $831 billion stimulus legislation. Despite what you may have read elsewhere, Meaningful Use was not part of the Patient Protection and Affordable Care Act, the 2010 bill that’s come to be known as Obamacare.

Meaningful Use was largely successful in getting hospitals and physician practices to adopt electronic health records, which was the goal of Stage 1 (2011-13, give or take). But it started to fall apart in Stage 2 (2014-16), which required participants to share data with other healthcare organizations. Now we have reached Stage 3, in which hospitals and doctors are supposed to prove that they are able to provide better, safer, less costly care with the help of their electronic records.

While all this was happening, Congress got impatient about the $35 billion in incentive money that has been distributed to date and passed legislation at the end of 2015 that changed how physicians are paid for treating Medicare patients. Long story short, Meaningful Use Stage 3, at least for doctors and other individual practitioners, is now part of a bigger calculation that pays for outcomes rather than for simply providing more services. The Meaningful Use program remains unchanged for hospitals.

I won’t bore you with any more details, but I think it’s time to look at the bigger picture, namely the rights and responsibilities patients have in making their own care better. Stay tuned for real patient stories and advice in the next few days. In the meantime, check out the post that represented a shift in my thinking, after my dad passed away nearly five years ago.

I want to help you become empowered patients. That, to me, is what is really meaningful.

I’ll categorize every relevant post as “The Patient Journey” so you can find these stories in the future.


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Half of Medication Errors Found In PA Study Involve HIT Issues

A new study by a Pennsylvania healthcare organization has found that computerized order entry systems and pharmacy systems were the most commonly reported factors contributing to medication errors in the state.

The Pennsylvania Patient Safety Authority, an independent agency tasked with finding and reducing the rate of medical errors in the state, recently released a report on medication errors reported to the agency during the first six months of last year. Under state law, Pennsylvania-based providers cutting across several categories, including hospitals, ambulatory surgical facilities and birthing centers, are required to disclose adverse events and “near misses” to the agency.

Between January 1 and June 30, 2016, the state’s healthcare facilities reported 889 medication-error events which cited health IT as a factor in the event(s). The errors most often reported were dose omission, wrong dose or overdosage and extra dosages, while CPOE and pharmacy systems-related problems were the most commonly reported health IT issues. (High-alert medications such as opioids, insulin and anticoagulants – which pose a higher risk of harm if misused – occupied three of the top five drug categories involved in most events.)

When they analyzed the data, agency analysts found that health IT-related errors took place during every step of the medication use process, and worse, most of those errors affected the patient directly, the data suggested.  And things may get worse before they improve. To hear agency officials tell it, HIT-related medication problems have become more common as health IT infrastructures have matured.

“As more healthcare organizations adopted EHRs and such systems became increasingly interoperable, the Authority observed an increase in reports of HIT-related events, particularly in relationship to medication errors,” said agency executive director Regina Hoffman in a prepared statement.

The Authority’s data doesn’t gibe completely with other research. For example, a report by the Leapfrog Group and Castlight Health notes that CPOE use has been very effective at reducing medication error rates. The report specifically refers to a CPOE study led by David Bates, MD, chief of general medicine at Brigham & Women’s Hospital, in which rates of serious medication errors fell by 88 percent during the period studied. Elsewhere, Leapfrog has cited studies in which CPOE use seems to have cut hospital lengths of stay, as well as major reductions in pharmacy, radiology and lab turnaround times.

On the other hand, the same report notes that CPOE systems still have a long way to go before they realize their potential. According to the 2015 Leapfrog Hospital Survey, hospitals’ CPOE systems failed to flag 39 percent of all potentially harmful drug orders, as well as 13 percent of potentially fatal orders. So it’s not a huge stretch to imagine that CPOE-using Pennsylvania hospitals are still having medication errors fall through the cracks.

It’s also worth pointing out that doctors don’t necessarily see CPOE systems as their best friend either. A study published last year in the Mayo Clinic Proceedings found that physicians who use EMRs and CPOE had lower satisfaction with time spent on clerical tasks and higher rates of burnout. Of course, given that the study lumps CPOE use in with EMR use, the results are somewhat skewed, but it’s still a data point worth considering.

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Survey Data on the Healthcare IT Job Market

I’ve been working for a number of years with Pivot Point Consulting, a Vaco Company (previously known as Greythorn) on their Health IT Market Report that looks at the Healthcare IT career space. This year they decided to do a trends edition that took this year’s survey results and compared it with historical data from the past three years which added a new layer of insight to the report.

While at the HIMSS conference, I had a chance to sit down with Ben Weber, Managing Partner, Pivot Point Consulting, a Vaco Company, to talk about their Health IT Market Report and the insights that were gleaned from their survey.

You can find my full video interview with Ben Weber at the bottom of this post or click on any of the links below to skip to a specific topic we discussed:

Be sure to download the full 2017 Healthcare IT Market Report: Trends Edition to dive into the responses to all the questions on the survey. Let us know in the comments what survey results stand out to you.

If you’re searching for a healthcare IT job, be sure to check out the jobs that Pivot Point Consulting has posted on Healthcare IT Central.

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Who’s Over MACRA? CIO? COO?

In no surprising way, MACRA is a major topic in pretty much every hospital and health system in the US. There’s a lot of money to be had or lost with MACRA. This is especially true for health systems with a lot of providers. Plus, it sets the foundation for the future as well. I believe MACRA will be as impactful as meaningful use, but without as many incentive payments (chew on that idea for a minute).

As I’ve talked to hundreds of organizations about MACRA, I’ve seen a whole array of responses for how they’re addressing MACRA and who is in charge. Is this a CIO responsibility since MACRA certainly requires EHR and other technology? Is this a COO job because MACRA is more of an operations problem than it is a technical problem? Some might make the case for the CMO/CMIO to be in charge since MACRA requires so much involvement from your providers.

From my experience, the decision usually comes down to choosing between the CIO and the COO, but with input and buy-in from the CMO/CMIO. How the CIO positions themselves will determine if they are over MACRA or not. Some CIOs see themselves as tech people and so they shy away from touching MACRA. Other CIOs see themselves as integral part of their business success and so they want to have MACRA under their purview. Most progressive CIOs that I talk to want the later.

I’m an advocate for a CIO that’s involved in the business side of things. Those CIOs that don’t want this duty are going to miss out on strategic opportunities for their organization. I heard one CIO describe that they viewed their IT organization as Information As A Service provider. Their job as the IT department was just to provide the information from the IT systems to someone else who would deal with the information, the MACRA regulations, etc.

The Information as a Service provider concept has issues on multiple levels. The most important is that if you’re just an information provider, then you lose out on the opportunity to be a strategic part of your organization. However, from a more practical MACRA level, it’s really challenging to provide the right information for MACRA when you’re just an information provider and know little about the regulation. We all know how quickly communication can break down when the person needing the information is disconnected from the people who provide the information and they’re disconnected from the people entering the information.

No doubt a healthcare CIO has to be careful what projects they add to their plate. However, I don’t think MACRA is one of those projects that should be pushed off to someone else. Certainly there can be specific organization cultures where it makes sense for the COO to run things, but I think that should be pretty rare.

How are you approaching MACRA at your organization? Who’s over it? I look forward to hearing your experiences in the comments.

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AliveCor Interview – Raises $30 Million

When I look across the mobile health ecosystem, one of the big winners is AliveCor. They’ve done an incredible job with their company and bringing their ECG readings to a much wider audience. The news recently came out that they’d raised their Series D round of investment of $30 million. As part of that announcement, my colleague Neil Versel from Meaningful Health IT News did an interview with the COO from AliveCor, Doug Biehn. You can check out the full interview below:

I hadn’t caught up with AliveCor for a while, so it was interesting to hear how much progress the company has made. Neil does a good job covering how AliveCor has been trying to figure out the balance between a consumer solution and a provider (FDA cleared) solution.

One of my favorite comments from the video above is when Neil asks about their new AlieCor platform and Doug Biehn says, “We’ve been launching new apps in the consumer space every 6 weeks for the past year, but this is our first big entree into the medical professional market.” I love this sort of iterative development in healthcare. While AliveCor does ECG, I think they’re just getting started. I’ll be interested to see what else comes out of this company as it continues to iterate and mature.

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See you at the HIT Marketing Conference in Vegas

After several years of trying, John Lynn — host of the Healthcare Scene blog network, of which this blog is a part — has finally gotten me to speak on a panel at his Health IT Marketing and PR Conference, April 5-7 in Las Vegas. I’ve had schedule conflicts or disinterested bosses in the past, but now that I’m mostly unemployed, hey, let’s do it!

I will be on the panel entitled, “The Best Ways to Interact with the Health IT Press,” along with some familiar names: Author and freelance journalist Dan Munro; Scott Mace of H3.Group, publisher of HealthLeaders, DecisionHealth, HCPro, Patient Safety & Quality Healthcare and ACDIS; conference host John Lynn; and session moderator Shahid “The Healthcare IT Guy” Shah. The panel takes place April 6 at 1:30 p.m. PDT at the SLS Las Vegas, which I’m told is far nicer than the hotel it replaced on the south end of the Strip, the Sahara.

Some of you PR and marketing types might find this ironic because I’m notoriously prickly when it comes to dealing with some of you, particularly in the weeks leading up to HIMSS each year. I can’t speak for the other panelists, but I’m hoping that this discussion can help shed some light on how I think when dealing with a seemingly endless flow of pitches, how journalists and publicists can make best use of each other’s time and how we can forge better working relationships.

I haven’t decided exactly what I’m going to say yet because I’m still mostly flying by the seat of my pants, having lost my full-time job less than three weeks ago.

(Yes, I’m still looking for something full-time, but accepting freelance gigs for now, with a major caveat: I can’t take one-off gigs for vendors or anyone else I might cover because that creates conflicts of interest with other work I do. Here’s an idea of what I’m thinking. And while you’re at it, go read my posts at Forbes.com because I get paid by the click. So does Munro, another Forbes contributor.)

It will be a quick trip to Vegas, less than 24 hours on the ground, but it should be worthwhile. I hope to see you there.

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Bayshore Networks(R) Closes Oversubscribed Venture Funding

Final Investment from Benhamou Global Ventures Completes Series A for Leader in Industrial Cyber Protection

BETHESDA, MD–(Marketwired – March 20, 2017) – Bayshore Networks, the leading provider of cyber protection for industrial infrastructure, today announced the closing of its Series A venture capital investment. With a final investment from Benhamou Global Ventures (BGV), the round was oversubscribed at more than $11M, bringing total investment in the company to $15M. Bayshore will use the investment to aggressively grow go-to-market channels, and further develop its industry leading industrial cyber protection platform.

“The market for Bayshore’s industrial cyber protection solutions is expanding quickly,” said Mike Dager, CEO of Bayshore Networks. “Industrial cyber protection is now a key strategic initiative for large enterprises, utilities, and governments alike. We’re experiencing rapid growth because unlike passive visualization and reporting packages, Bayshore’s comprehensive industrial cyber protection platform stops industrial cyber threats before they start.”

“We are impressed with Bayshore’s experienced management team and differentiated technology,” said Anik Bose, General Partner at BGV, who has joined Bayshore’s Board of Directors following the investment. “There is a compelling global need for industrial cyber protection solutions, and we believe Bayshore is well positioned in this burgeoning market.”

“Bayshore’s innovation in the emerging Industrial IoT cyber protection market is well recognized. We led Bayshore’s Series A in support of their pioneering technology in a critical market that is largely untapped to date,” said Alberto Yépez, managing director of Trident Capital Cybersecurity. “We are happy to have BGV join us in supporting the company’s growth.”

About Bayshore Networks, Inc.

Bayshore Networks® is the leading provider of industrial cyber protection. The Company’s award-winning technology unlocks the power of the Industrial Internet of Things (IIoT), providing enterprises with unprecedented visibility into their Operational Technology infrastructure while safely and securely protecting ICS systems, industrial applications, networks, machines, and workers from cyber threats. Bayshore’s strategic partners include among others Arista, AT&T, BAE, Cisco, Dell, SAP, VMware, and Yokogawa. Bayshore is a privately held company headquartered in Washington, DC and backed by Trident Capital Cybersecurity, Yokogawa, Samsung Next, and BGV Capital. For more information, visit www.BayshoreNetworks.com

About Benhamou Global Ventures

BGV, is an early-stage venture capital firm with deep Silicon Valley roots, with an exclusive focus on enterprise information technology opportunities in global markets. BGV currently has 17 active companies in its portfolio. The BGV team has successfully built and implemented a cross-border venture investing model with companies from Israel, Europe and Asia. The fund was founded by Eric Benhamou, former chairman and CEO of 3Com, Palm and co-founder of Bridge Communications. Comprised of an experienced partnership team of global operating executives and investors, BGV is often the first and most active institutional investor in a company and has a powerful network of technical advisors, executives and functional experts who actively engage with its portfolio companies. The company has offices in Palo Alto, California and Tel Aviv, Israel.

About Trident Capital Cybersecurity

Trident Capital Cybersecurity (TCC) is a $300 million fund that invests primarily in early stage and select growth equity companies. The firm is well positioned as the venture capital firm with the best connections in cybersecurity. Its 47-person Cybersecurity Industry Advisory Council, including industry CEOs, customers and former top-level government leaders is commended for its insights, connections and go-to-market support for TCC’s portfolio companies. TCC’s current portfolio companies include 4iQ, Appthority, Bayshore Networks, ID Experts and IronNet Cybersecurity. Managing Directors Alberto Yépez, Sean Cunningham and Don Dixon jointly lead the investment team and together have made 30 cybersecurity investments during a nearly 20 year period of investing at Trident and Intel Capital. For more information, visit www.tridentcybersecurity.com.

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Emergency Department Information Systems Market Fueled By Growing Patient Flow

A new research report has concluded that the size of the emergency department information systems market is expanding, driven by increasing patient flows. This dovetails with a report focused on 2016 data which also sees EDIS upgrades underway, though it points out that some hospital buyers don’t have the management support or a large enough budget to support the upgrade.

The more recent report, by Transparency Market Research, notes that ED traffic is being boosted by increases in the geriatric population, an increasing rate of accidents and overall population growth. In part to cope with this increase in patient flow, emergency departments are beginning to choose specialized, best-of-breed EDISs rather than less-differentiated electronic medical records systems, Transparency concludes.

Its analysis is supported by Black Book Research, whose 2016 report found that 69% of hospitals upgrading their existing EDIS are moving from enterprise EMR emergency models to freestanding platforms. Meanwhile, growing spending on healthcare and healthcare infrastructure is making the funds available to purchase EDIS platforms.

These factors are helping to fuel the emergence of robust EDIS market growth, according to Black Book. Its 2016 research, predicted that 35% of hospitals over 150 beds would replace their EDIS that year. Spurred by this spending, the US EDIS market should hit $420M, Black Book projects.

The most-popular EDIS features identified by Black Book include ease of use, reporting improvements, interoperability, physician productivity improvements, diagnosis enhancements and patient satisfaction, its research concluded.

All that being said, not all hospital leaders are well-informed about EDIS implementation and usability, which is holding growth back in some sectors. Also, high costs pose a barrier to adoption of these systems, according to Transparency.

Not only that, some hospital leaders don’t feel that it’s necessary to invest in an EDIS in addition to their enterprise EMR,. Black Book found. Thirty-nine percent of respondents to the 2016 study said that they were moderately or highly dissatisfied with their current EDIS, but 90% of the dissatisfied said they were being forced to rely on generic hospital-wide EMRs.

While all of this is interesting, it’s worth noting that EDIS investment is far from the biggest concern for hospital IT departments. According to a HIMSS survey on 2017 hospitals’ IT plans, top investment priorities include pharmacy technologies and EMR components.

Still, it appears that considering EDIS enhancements may be worth the trouble. For example, seventy-six percent of Black Book respondents implementing a replacement EDIS in Q2 2014 to Q1 2015 saw improved customer service outcomes attributed to the platform.

Also, 44% of hospitals over 200 beds implementing a replacement EDIS over the same period said that it reduced visit costs between 4% and 12%, the research firm found.

Posted in Cloud EHR, Hospital EHR, Hospital EHR Company, Hospital EHR Vendor, Hospital Electronic Health Record, Hospital Electronic Medical Record, Hospital EMR, Hospital EMR Vendor, Hospital Healthcare IT, Hospital IT Systems, Hospital Patient Flow | Tagged , , , , , , | Comments Off on Emergency Department Information Systems Market Fueled By Growing Patient Flow

Against Medical Advice – ZDoggMD’s New Show

For those of you reading this that don’t know ZDoggMD, what’s wrong with you? Seriously though, check out some ZDoggMD’s parody videos to see what I mean. Along with making “dope parody videos”, he has just started live streaming a new show he called Against Medical Advice which he streams live each week on the ZDoggMD Facebook page.

Check out the trailer for Against Medical Advice:

I love the goals that ZDoggMD has for the show and he’s such a unique talent so check it out. Against Medical Advice episode 1 and episode 2 are out if you want to see something you’ve never seen in healthcare.

If you’re not a fan of his new show, you’ll probably enjoy this heartfelt parody of 7 Years (A Life in Medicine). It’s a good reminder of the importance of the work we’re doing in healthcare.

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