Even the most robust technology itself cannot improve healthcare outcomes, as Vanderbilt University Medical center discovered on its way to lowering ventilator-associated pneumonia rates – saving money. During the last decade, Vanderbilt University Medical Center built into its operations the attention to clinical quality that now figures prominently in health reform, using a level of digital documentation and decision support that anyone seeking meaningful use of health IT would love to have. The problem: All that effort was falling flat where it really counted. "We had all of the technology anybody's talking about," said William Stead, the Nashville-based medical center's chief strategy and information officer. "We could show that the percentage of the time we did what we wanted to do with decision support went from, say, 10-30% up to 40-60% – major improvement. But even so, our performance on summative quality measures such as observed to expected mortality were average or actually below average."
Creative thinking is essential for any IT team, but unless it's combined with lots of sweat equity, it doesn't get you far. Trinity HealthCare clearly knows how to combine the two. The hospital system, the fourth-largest Catholic healthcare system in the country, has put a great deal of creativity and man hours into a platform it calls Genesis. Genesis includes 28 computer applications from nine vendors, and touches virtually every major clinical and revenue process at the hospital. Getting Genesis up and running required the tightly choreographed integration of new systems with multiple legacy applications, including laboratory, picture archiving, communication, and enterprise resource planning systems. More than 60 real-time and batch interfaces were activated during conversion. All the work has paid off with measurable improvements in patient care.
Baltimore County police are looking for someone who stole thousands of X-rays from St. Joseph Medical Center in Towson in what they believe was a scheme to extract the silver from the images. The hospital said Friday that someone posed as a worker for a radiological film destruction company to get access to the X-rays. The theft was believed to have occurred Sept. 11 and discovered five days later. Hospital and police officials did not identify a suspect. The hospital says the X-rays were likely stolen for the silver and that it does not think that patient information was a target. X-rays are coated with silver to enhance images. The silver can be removed while destroying the X-rays and then sold. The theft comprised about 5,000 X-rays and radiological films taken during 2004, 2005 and part of 2007.
There's good news and bad news in the latest research from the Healthcare Information and Management Systems Society. The good news is that from February to September 2011 there has been a 16% increase (from 25% to 41%) in the number of eligible hospitals saying that they are likely to meet criteria for stage 1 of Meaningful Use. The bad news is that 53% of hospitals say they cannot meet 10 or more of the 14 core requirements set out in stage 1. The survey, Summary of Meaningful Use Readiness, reflects that hospitals increasingly recognize the need to adopt health IT, but also face many challenges as they attempt to transition from paper-based medical charts to digitized medical records.
The Office of the National Coordinator for Health IT will delay the launch of the permanent program for certification of electronic health records until mid-2012 to coincide with the anticipated final rule for stage 2 of meaningful use and standards and certification criteria. ONC also said it needed more time to assemble and approve testing labs and authorized certifying bodies, ONC said in a Nov. 2 announcement by Dr. Farzad Mostashari, the national health IT coordinator, in a preview area of the Federal Register. ONC will officially publish the notice Nov. 3. Previously, ONC intended to sunset its temporary program at the end of the year and open the permanent and more comprehensive program on or around Jan. 1.
The number of hospitals ready to meet Stage 1 of meaningful use jumped 16% from February to September, according to a HIMSS Analytics Report, “Summary of Meaningful Use Readiness.” In those seven months, U.S. hospitals went from 25% to 41% being well positioned. The report also indicated that more eligible hospitals are likely to succeed in meeting the criteria for this first stage. The Centers for Medicare & Medicaid Services also have shown continued growth in the number of eligible hospitals moving toward or meeting Stage 1. As of Sept. 30, the CMS reported 2,215 eligible hospitals have registered for Medicare and Medicaid EHR incentive programs; 564 hospitals (158/Medicare and 406/Medicaid) have received payment for meeting Stage 1 of meaningful use, as of this same date.