BayScribe

So much talk, so little leadership

admin — Wed, 16 May 2012 21:18:15 +0000

The Feds have published the Meaningful Use Stage 2 information and there is mention of the Consolidated CDA, which is fantastic. But why can’t our leaders at ONC just go ahead and require the EHR vendors to accept all of the Consolidated CDA work types, giving physicians the freedom to dictate their clinical notes without sacrificing the structured data we need in for improved care?

Collaborative Care (Health Information Exchange (HIE)) and Accountable Care are going to struggle (read: Fail) without widespread physician adoption — and a key element of that adoption is trust! And physicians are less likely to trust a report from a cookie-cutter EHR than they are the actual physician narrative that tells the complete story — the Health Story.

Get with it ONC — make acceptance of Consolidated CDA a requirement for MU2 certification and let’s get collaborating!

CDA ubiquity

admin — Wed, 04 Jan 2012 20:47:30 +0000

Dr. Doug Fridsma of the ONC recently blogged that “reducing optionality improves interoperability and lowers the cost for vendors to implement, thus lowering the cost for healthcare providers as well”. Right on Dr. Fridsma.

“ONC is identifying the vocabularies, the message and the transport of ‘building blocks’ that will enable interoperability,” he continued. And that, “while vendors should be able to flexibly combine them to support interoperable health information exchange (HIE), these ‘building blocks’ need to be unambiguous and have very limited (or no) optionality.”

The key to this ‘interoperability’ is CDA (Clinical Document Architecture). In my opinion, the key to ubiquitous CDA is commoditization. If you (Dr. Provider Person) could receive a secure, interoperable document for the same price as a fax, why wouldn’t you? How much would it be worth to get your patient information into your EHR directly from the patients other providers, in near real-time, without any clerical effort (re-keying)…

Enough said.

New Year, same Feds?

admin — Mon, 02 Jan 2012 15:12:01 +0000

Catching up on my reading over the Holiday I was not-so-surprised to learn that PHI data breaches are on the rise. I guess if I started googling around I would probably find that everyone wants the Feds to ease up on MU stage 2 & 3 requirements, as well as physicians complaining about EHR usability. What’s new? I hope and pray that 2012 is a year of Federal leadership! Regardless of your political position, or mine, I hope that this year we see true leadership from our friends at the ONC, NIST, VA, DoD and others who influence the future of Health IT. It’s time to stop talking about what can be done and what should be done and start doing! I challenge those in and around the DC beltway to show the way — to LEAD!

Let’s get DOING!

The new role of the HIMe Director

admin — Wed, 09 Nov 2011 18:42:12 +0000

Last Friday I had the good fortune of speaking at the NCHIMA regional event in Charlotte at Piedmont College. My topic was about the role of HIM supporting the facility in its quest in meeting Meaningful Use. It wasn’t about detailed areas of responsibility that are, or are not, definitively ‘HIM’, but rather to encourage the HIM Directors of tomorrow to acknowledge that their role is evolving and the future is clear… HIM will become HIMe (Health Information Management & Exchange). HIE is the key to interoperability, patient safety and physician adoption. My evangelism met little (no) resistance. Buckle Up HIMe Directors; you are a major player in our industry’s evolution!

Thanks to the good folks who invited me and those who attended.

More of the same…

admin — Tue, 11 Oct 2011 14:01:02 +0000

I almost have to force myself to type this. In case you haven’t already seen it, there was a new report on Healthcare IT News last week. The topic? 10 things you hate about your EMR. Shocking, I know. Not so shocking is the consistent references to usability. Hopefully, the EMR vendors are going to come around soon. The FEDS are starting to pay more attention. If you didn’t already hear, in the new Federal Health Strategic Plan 2011-2015 posted a couple weeks ago Usability is a key topic for the first time. Hallelujah! Can I get an amen?!

Could it be that the FEDS are listening to the market? What will the EMR vendors reactions be if the FEDS mandate metrics for Usability? Wouldn’t that rock the EMR-applecart!

Simple Math

admin — Thu, 15 Sep 2011 19:44:46 +0000

The physician community has been complaining rather vocally about the poor usability of EMR systems, and been doing so for some time now. We recently announced an integration with a forward-thinking EMR vendor, SynaMed, that clearly demonstrates that physicians don’t have to type into the EMR to get data into the EMR for Meaningful Use. So, the question now is will they embrace what it is that they have asked for ? Will physicians do the Math?

If you utilize an EMR in the traditional sense, point & click in the templates, the odds are you will either see fewer patients each day, or work even longer hours. Or like some I have spoke with, just not complete the documentation… which is certainly NOT what the EMR initiative in our nation is about. It will be interesting to see how many physicians are good at math. Seriously. If you can see 20% more patients AND work fewer hours, but you have to spend some money to do so, isn’t that what business is all about. ROI? And how about quality of life? Does that mean anything to anyone? I am sure these physicians spouses would like to know what we are up to

What the heck is Semantic Interoperability?

admin — Mon, 22 Aug 2011 13:13:26 +0000

Don’t worry, you aren’t alone. For most healthcare folks, especially non-IT, this is a new term. If you visit Wikipedia, Semantic Interoperability is ”the ability of computer systems to communicate information and have that information properly interpreted by the receiving system in the same sense as intended by the transmitting system”. In healthcare, that means that successfully transmitting a patient record, like a Continuity of Care Record (CCR) from one healthcare provider to another. So, if you live in NY and you are on vacation in South Florida, and you get stung by a Sea Ray or get run over on your rental moped, that the local hospital can quickly and easily retrieve your medical history to be sure NOT to give you Penicillin if you are deathly allergic to it. You can see how that might be important! Semantic Interoperability — it is pretty important to the future of healthcare.

Standard CDA. What standard?

admin — Tue, 09 Aug 2011 12:54:40 +0000

CCD. HITSP C32/C83. IHE PCC. HealthStory. These are all based on the Clinical Document Architecture (CDA) ‘standard’. Now the Feds are talking about introducing UEL for MU Stage 2 (or 3). The Universal Exchange Language (UEL) may or may not ever come to pass, but one thing is for sure; until the Government steps in (or steps up as it were) and says “this is the interoperable document standard by which all EMR/EHR will adhere to” and eliminates the variants, the chances for sharing clinical data amongst providers easily and inexpensively are slim. HL7 messaging was ‘supposed’ to be a standard, and we all know how that turned out.

Will EHR vendors ever get it?

admin — Fri, 29 Jul 2011 14:21:18 +0000

Usability is not a concern of EHR vendors. Will it ever be? How many more years are we, as an industry, going to talk about the issues surrounding physician adoption? The fact the government has to subsidize use serves as an enabler for the EHR vendors. Why make EHRs more usable if the government is forcing adoption? As remarked by David Yanga, MD on March 22, 2011…

I find the government incentive structure in the EHR world fascinating from an economic perspective. Did the government have to pay me to use Google, Twitter, my laptop or my smart phone? Physicians rapidly adopt technology that works well, simplifies life, and provides a meaningful function. The fact the the government has to subsidize EHR’s tells you that the current technology does not work very well for most physicians…

Amen, Dr. Yanga!

The future is here, today…

admin — Tue, 19 Jul 2011 21:32:55 +0000

BayScribe is the future of Clinical Documentation. BayScribe makes clinician adoption of EHR less arduous by allowing them to continue to dictate and handwrite notes, because the structured data needed for Meaningful Use and other measures can be directly integrated into the EHR.

Does anyone really believe that EHR/EMR vendors care about Usability? Let us know what you think.