Sounds like the world will finally get a look at Google's much-discussed-but-as-yet-unseen plans to get into the health records business. Finally, the company will pull the curtain back on the online service. Patients will be able to enter basic medical data into an online repository, and invite their doctors to electronically submit information as well.
Riverview Hospital faced a difficult decision. Its legacy hospital information system was being retired by its vendor, and the county facility wanted to forge ahead on the IT path. Based in Noblesville, IN, Riverview is a county-owned hospital that competes with several other well-established hospital systems in the area. The 170-bed hospital set out to deploy a package of up-to-date information systems that would automate its major functions, including imaging, revenue cycle, and clinical documentation. Rather than turning to one main vendor, Riverview adopted what its chief information officer Randy Cox describes as a "best of suite" approach.
The approach is a compromise between a single vendor solution, in which a hospital turns to a single primary vendor for its functions, and best of breed, which calls for multiple niche applications. With the best of suite philosophy, the hospital leans on one vendor to supply multiple modules for a core group of functions. For example, its revenue cycle management supplier, Keane, provides integrated software that handles registration, billing, and accounts receivables. Its clinical system, from Quadramed, handles results, orders, and electronic signatures for physicians.
During his presentation at HIMSS, Cox described how he turned the management of the complex project over to various department leaders. Before vendor selection began, department leaders created their own "success criteria" for what they wanted to achieve with the new technology. The effort included mapping common patient scenarios and the data exchanges needed to facilitate them. The effort laid the groundwork for the entire project, Cox said.
Now that the systems are in place, Riverview is seeing enhanced efficiency and wider use of the technology by physicians, Cox said. Half of its physicians use remote access technology to retrieve clinical information.
Cox's next step will be upgrading Riverview's 20 owned medical group practices--which encompass about 50 physicians--to a hybrid practice management and clinical documentation system from Misys. The vendor's open source software will facilitate broader data exchange across the community, Cox said.
The South Carolina Hospital Association has launched myschospital.org, which contains information on roughly 65 hospitals throughout the state. Representatives from the Hospital Association said they hope the Web site will help steer consumers to the best hospital to treat their needs.
Cerner Corp. is partnering with manufacturer Hillenbrand Industries to feed data collected by "intelligent bed systems" into Cerner's medical records system. Initially, data including a patient's weight, bed-rail position and head elevation will be collected by beds manufactured by Hillenbrand subsidiary Hill-Rom and fed into Cerner's software applications. Later, other data will be collected and included, for instance allowing the bed to communicate with Cerner software when a patient calls for a nurse. The partnership will increase interoperability among medical devices and software used to monitor a patient's progress, and as result improve care, said Hill-Rom representatives.
I am down in Orlando this week, covering the massive HIMSS exhibition. Next week I will have a compilation of some of the top presentations I heard. Meanwhile, I wanted to share some of the correspondence I have received lately. The reactions to my piece, "Are IT Vendors Losing Their Marbles," are especially appropriate during HIMSS week, seeing as how the event showcases the wares of hundreds of companies trying to squeeze into this complex, crowded space.
First is a letter from Michael Davis, a member of HIMSS Analytics, which sponsored the survey I referenced.
Skeptical CIOs I enjoyed your article--"Are IT Vendors Losing Their Marbles." In most cases the healthcare IT professionals are looking for peer-to-peer interactions without vendor influence or facilitation. This is difficult for vendors to achieve. I do believe the vendors today are performing better in delivering competitive products and providing enhanced customer service, but healthcare IT professionals have been burned too many times with incomplete or overhyped vendor solutions. Thus, they will continue to be skeptical.
I enjoy reading your take on the market. Keep them coming.
Michael W. Davis Executive Vice President HIMSS Analytics Chicago, IL
'Crazy Like a Fox' I think this article ("Are IT Vendors Losing Their Marbles?") hits the nail on the head. CIOs waste so much of their (and their staff's) time cutting through the hype and trying to get straight answers that it places an enormous unnecessary cost on the process of selecting and implementing meaningful solutions. That being said, there's another side that's even worse--the great marketer HIT vendor that can't deliver. A select few HIT vendors have learned, even mastered, the art of creating the need at the board, executive, and/or physician level, and bypassing the CIO--who knows better.
These vendors paint a wonderful picture of a future state that only they can get the organization to. The people they court have no idea of how to evaluate much less challenge their claims. They make it look so easy too! The CIO is left to stand in front of this rushing train or risk trying to implement tremendously complex systems to unreasonable expectations set by the vendor. If (or more likely when) the project fails, the vendor conveniently lays the blame at the feet of the CIO, since it "has been successfully implemented at many other sites." The light at the end of the tunnel is that over time, a realization sets in that there was insufficient scrutiny of vendor claims and lack of due diligence by organizational leadership.
The bad part is that the CIO is usually left to sort it out and move things forward regardless. That's why it is vital that CIOs educate their executives early and often on the state of our industry and the HIT solutions available so they can set realistic expectations as an organization.
I guess the answer to your article title is 'yes' but that some vendors are 'crazy like a fox!'
Vincent S. Vitali, FHIMSS Interim CIO Navin, Haffty & Associates BroMenn Healthcare Normal, IL
Providers Not Paid to Cure You have hit on an interesting fact in healthcare that is generally underappreciated. ("Which Came First, the MRI or the Inflation?") Technology tends to raise the cost of care, not lower it (as it would in any other industry). Is healthcare fundamentally odd?
No. If providers got paid to cure something, then technology would lower the cost of care for any given outcome. But providers don't get paid to cure anything. They get paid to do something. If that something requires a piece of technology, and the technology item (a procedure, for example) has a bill code, then they do MORE of the item since they get paid for it.
In 1975 there were almost no gastroenterologists. Then we developed a number of increasingly complicated fiber optic scopes, and procedures related to them, each of which has a bill code for it. Each successive device is more expensive, and the associated bill code is higher. Now gastroenterology is one of the largest subspecialties, and the cost of GI treatment has skyrocketed, although outcomes have indeed improved.
Over the same time period, Lasik surgery has decreased in cost as outcomes rose. Lasik is not covered by insurance, hence docs get paid to deliver an outcome (to a consumer), not to perform a procedure (lasik results are often "guaranteed" to consumers).
Tim Breaux Principal InterCase Portland, OR
Live From HIMSS 2008
Senior Editor Gary Baldwin is reporting daily dispatches live from the annual HIMSS conference. Here are some of the stories he has published so far:
Vanderbilt University Medical Center Department of Anesthesiology was among the organizations recognized in a contest sponsored by Microsoft. Vanderbilt claimed top honors in the inpatient record category. Its vendor partner is Acuitec, which helped the Nashville-based organization build a consolidated view of patient data.
The Microsoft Healthcare Users Group (MS-HUG) announced the winners of the 11th annual MS-HUG Healthcare Innovation Awards 2008 at HIMSS. The contest recognizes organizations working with various vendors on the Microsoft platform.
Other winners included:
Primrose OB-GYN, with digiChart Inc., for its physician practice record
Sunnybrook Health Sciences Centre, with Neoteric Technology Ltd., for system upholding the safety of breast milk
St. Joseph Family Medicine Residency (Medical College of Wisconsin), with NextGen, for innovative use of an electronic medical record
Office of the Air Force Surgeon General, Data Modeling and Analysis Office, with IMS Government Solutions, for outcomes reporting technology
Note: HealthLeaders Media Technology Editor Gary Baldwin helped judge the contest.