April 2009

Going with the Patient Flow Newsletter

Stimulus Act Keeps Attendance High at 2009 HIMSS Conference
Joseph Conn, Modern Healthcare

HIMSS President and Chair Stephen Lieber attributed the high turnout at the group's annual conference to the federal stimulus package. During the conference's final day, former Federal Reserve Board Chair Alan Greenspan delivered a keynote address and lawyers offered advice on preparing for stimulus package incentive payments.  Despite the worst economic downturn since the Great Depression, the HIMSS show, according to unaudited figures, drew about 27,500 attendees, down about 5% from the record 29,100 the show drew to sunny Orlando, Fla., last year, which was well before the nation's economic storm broke this fall. The numbers were well ahead of the 24,700 or so who attended the 2007 show in New Orleans.
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090409/REG/304099965

HIMSS Talk Dominated by Meaningful User
Jim Molpus, Health Leaders Media

It seemed there were as many different definitions of what a "meaningful user" of an EHR was at HIMSS as there were exhibitor booths. Lacking any concrete guidance from the federal government, speakers and vendor at HIMSS were left with some educated guesswork about what the government really intends to define as a "meaningful user" to qualify for ARRA funds. There doesn't seem to be much doubt that CCHIT will be named the certification body for lack of any other choice, but there is a much wider field of doubt about whether the government view of a meaningful user will be restrictive and more complex, or more inclusive and less complex.
http://blogs.healthleadersmedia.com/leadtime/2009/04/himss-talk-dominated-by-meaningful-user/

IT Investments for Naught Unless They Cut Healthcare Costs, Says Greenspan
Healthcare IT News

During a keynote address at the HIMSS conference on Wednesday, former Federal Reserve Board Chair Alan Greenspan said a massive investment in health IT will be meaningless if the technology does not curb the federal government's unsustainable health care spending. He said, "If you cannot solve the overall funding problem, the (global) competitive issue will be quite secondary." Greenspan said it is a mistake in any reform debate to discuss entitlement programs as a single entity because Medicare is not a defined-benefit program like Social Security. The latter can be fixed much more easily with extra money, while Medicare is much more of a moving target because it's impossible to predict how medicine will advance. Only a sharp boost in healthcare efficiency can keep these factors in check, he said.
http://www.healthcareitnews.com/news/it-investments-naught-unless-they-cut-healthcare-costs-says-greenspan

Optimizing Patient Flow to Protect Against the RAC
Janelle Randazza, HCPro

Waits, delays, and cancellations are so common in healthcare that patients and providers have come to expect waiting as part of the care process. But poor patient flow can have seriously adverse effects on patient outcomes and your facility's bottom line-and can even increase your susceptibility to RAC audits. According to
Kelly Cooke, MSN, RN, the director of clinical resource management, social work, and documentation improvement at the Hospital of the University of Pennsylvania, part of maintaining optimal patient flow is placing patients in appropriate level of care and creating a system that guard against readmissions.
http://blogs.hcpro.com/casemanagement/2009/04/optimizing-patient-flow-to-protect-against-the-rac/

Let the IT Spending Begin
Annual IT Survey Shows Support For Stimulus, Trend Toward Spending Uptick

Joseph Conn, Modern Healthcare

The federal government is poised to pour, by Congressional Budget Office estimates, as much as $38.3 billion into healthcare information technology support through 2015 under the American Recovery and Reinvestment Act of 2009. The following trends, based on data from the 19th annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues, reflect the impact the legislation might have on the industry. According to our survey results, an overwhelming majority of respondents aligned more with recent congressional intent and favored the government changing the game plan by providing direct financial support for a federal IT development program.
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090406/REG/904039990

E-Health Software on a Budget
Rachael King, Business Week

David Whiles faced sticker shock when he decided to install electronic health records at Midland Memorial Hospital in 2003. He had been toying with the idea of installing digital medical records at the 320-bed hospital in Midland, Texas, for more than 5 years. Vendors told Whiles it would cost about $18 to $20 million to install a system. "That's far beyond what we could afford," says Whiles, Midland Memorial's director of information systems. Many hospital IT executives are now grappling with the same problem, as the Obama Administration is pushing doctors and hospitals to provide electronic health records for every American by 2014. Today, less than 2% of acute care hospitals have a comprehensive electronic health record system in place. Today, Midland Memorial is one of the few hospitals in the private sector that is nearly paperless.
http://www.businessweek.com/technology/technology_at_work/archives/2009/04/e-health_softwa.html?chan=technology_technology+index+page_top+stories

Eight Tips for Managing Healthcare Information Systems Securely and Cost-Effectively
TerryAnn Fitzgerald, TMCnet.com

For the past few years, healthcare organizations have struggled to make healthcare more affordable and efficient by making information more accessible to nurses, doctors and patients; enabling real-time, remote diagnoses; and improving billing systems. Traditionally, that has meant quickly constructing islands of ad-hoc wired and wireless voice, video and data networks on-site and at remote locations. As a first step to solving this problem, CIOs and their teams have consolidated infrastructure and staffing into data centers, serving up applications, storage and expertise to remote and branch sites from centralized resource pools. While these are excellent first steps, healthcare organizations must also consider the benefits of leveraging centralized management to automate deployment, providing configuration and oversight of the data center and remote operations. Here are eight tips organizations can use as they begin to deploy centralized network management projects.
http://healthcare.tmcnet.com/topics/healthcare/articles/53824-eight-tips-managing-healthcare-information-systems-securely-cost.htm

Reminding us why the system must be improved

There's a human in that bed -- Will $20 billion Solve This Problem?
Frank Poggio, The Kelzon Group, on HIStalk
There was a poignant opinion editorial in the Chicago Tribune this Sunday that got my attention, written by Candy Schulman, entitled "There is a human in that bed". It caught my eye and got my empathy because I lived that same experience about a year ago. There were however, two major differences. First it happened in a different hospital in a different state. Second, since I have worked in the hospital world as an administrator, systems supplier, and consultant for thirty-five years, I had a better understanding of the issues and therefore was able to force a faster resolution. As I read Candy Shulman's article I kept asking myself, as I did a year ago, what is really wrong with this 'system' and what can be done about it?
http://histalk2.com/2009/04/01/readers-write-4109/

Candy Schulman, Chicago Tribune
http://www.chicagotribune.com/news/chi-oped0329humanmar29,0,552996.story

For an April Friday - from the totally absurd

30 Insane Inventions to Win Patents
Businessweek
You know how it goes: It's a beautiful day, and you've got a pet gerbil too cute to keep under wraps. What you need is a gerbil shirt. Its transparent tunnels allow you to show off your furry friend -- hands-free! -- while enjoying a stroll in the park. Or maybe you need the "half wit" -- a demi-helmet to wear when only part of your head is worth protecting. Hospital gown to cover your privates (don't hospital gowns have ties), and a watch which counts down to your death.
http://images.businessweek.com/ss/09/04/0408_ridiculous_patents/index.htm

From the C-side

Health CIOs Push for Increased Role in Delivering Quality Care
Health Data Management
A panel of chief medical information officers and health CIOs who attended this year's HIMSS conference said they want to shift their efforts from deploying IT solutions to enhancing the delivery and quality of care. These leaders need to collaborate and support each other to achieve such a goal, said Patricia Skarulis, CIO and vice president at Memorial Sloan-Kettering Cancer Center. Dr. David Artz, the New York-based facility's CMIO, works with the IT unit to ensure that the organization is "going in the right direction."
http://www.healthdatamanagement.com/news/HIMSS_Conference-28030-1.html

Executives Discuss Stage 7 EMR Deployment
Healthcare IT News
Officials from health care organizations talked about the process and advantages of a stage 7 deployment for electronic medical records at this year's HIMSS conference. Only .01% of U.S. hospitals have attained such a level of implementation, which involves a paperless system and interoperable functions for clinical data and decision support. Kaiser Permanente executives said funding and planning for the initiative should last five to 10 years.
http://www.healthcareitnews.com/news/few-us-hospitals-have-achieved-stage-7-ehr-implementation

3 Ways to Lead Like Leno
John Baldoni, Harvard Business Publishing Leadership Blog
Good leaders, like good comedians, "look at life from a different perspective," writes John Baldoni. He thinks leaders in difficult times should follow the example Jay Leno set during a visit to hard-hit Detroit: Point out absurdity, lampoon hypocrisy and cut the high and mighty down a notch.
http://blogs.harvardbusiness.org/baldoni/2009/04/what_you_can_learn_about_leade.html