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    Congress has added new reporting requirements for the Defense Department’s massive Cerner EHR implementation within the newly brokered budget deal for 2017. Specifically, the Defense Appropriation Act mandates quarterly updates on the new system’s schedule, costs, timeline and progress in reaching interoperability with the Department of Veterans Affairs’ system. 

    DoD awarded the $4.3 billion contract to Cerner, Accenture and Leidos in July of 2019 and rolled out the first pilot, dubbed MHS Genesis, at Fairchild Air Force Base in February 2017. The VA, for its part, is gearing up to decide whether it will modernize its current VistA EHR or instead replace it with a commercial product. The departments have a long history of struggling to fully integrate their medical records, including the multi-billion dollar iEHR project they ultimately abandoned.

    [Also: Cerner picking up big business from small hospitals]

    “Concerns remain with the progress being made by the Departments of Defense and Veterans Affairs to fully develop, procure and deploy an interoperable electronic health record solution,” the legislation stated. “The two systems must be completely and meaningfully interoperable.”

    The act goes on to say that the reports should include changes to timelines, refinements of cost estimates, assurance that DoD’s acquisition strategy complies with rules and regulations, and status updates on the effort to achieve interoperability with the VA. 

    Congress further directed the program executive officer to continue to brief House and Senate Appropriations committees on a quarterly basis and provide written notification to these committees prior to signing any contract for electronic health record systems in excess of $5 million.

    Further, the program executive officer must provide to the federal chief information officer monthly updates on progress made by the two departments to reach interoperability and modernize their respective electronic health records.
     

    Twitter: @SiwickiHealthIT
    Email the writer: bill.siwicki@himssmedia.com


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    CHARLOTTE, NC – Carolinas HealthCare Systems Craig Richardville said the healthcare industry will achieve information interoperability faster than the financial services sector did.

    “You’ll see that happening in our industry, quicker than the decades it took them,” Richardville, who is Carolinas Chief Information and Analytics Officer, said during an interview at his offices here. “Ours will be in probably half a dozen years, you’ll start seeing that really mature.”

    As healthcare has been striving to make exchanging data more common interoperability is widely viewed as chief among the biggest technological, cultural and business challenges. 

    [Also: Hospital datacenters: Extinct in 5 years]

    Carolinas, for instance, built its own private health information exchange, called CareConnect, which gives physicians electronic access to their patients’ medical information. Carolinas HealthCare created the exchange, Richardville said, “to be able to communicate back and forth with more data and at more frequency.”

    And Richardville sees bigger and broader exchange possibilities in the wings with Carequality, an initiative of the Sequoia Project, which makes exchanging information among competing EHRs more viable than ever before.

    “You know, there is a whole thing about Cerner vs. Epic, right? That they can’t communicate,” Richardville said. “I don’t think people would expect Wells Fargo and Bank America to communicate directly,” he said of the two banking giants with headquarters in Charlotte, N.C. “So the highway that’s being built will allow them to participate in Carequality.”

    He pointed out that Cerner is part of the CommonWell Alliance, and CommonWell is now a member of Carequality.

    “It will allow us to be able to communicate on that roadmap, as opposed to try to take two things and make them talk and have all this point-to- point,” he said.

    Today, many other CIOs, EHR vendors, policymakers, providers and patients all have their eyes on the prize: A truly interoperable healthcare system that puts the right data in the right hands at the right time.

    Indeed, Richardville said that the interoperability imperative will take healthcare to a whole new level – one that is nimble and more responsive.

    Twitter: @Bernie_HITN
    Email the writer: bernie.monegain@himssmedia.com


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    The patient records of about 500,000 children are up for grabs on the dark web, a hacker named Skyscraper told DataBreaches.net on Wednesday.

    These records contain both child and parent names, Social Security numbers, phone numbers and addresses. DataBreaches didn’t name the breached organizations but also said that another 200,000 records were stolen from elementary schools.

    To make matters worse, the amount of breached records for pediatricians reported to the Department of Health and Human Services’ Office of Civil Rights is not equal to that number, meaning many of these providers are likely unaware their data has been exposed. 

    The hacker finds the records by simply searching for “patients,” and the search returns entire databases left exposed. DataBreaches said the hacker pointed to these organizations using outdated or free software. Further, many of the records were of former patients and therefore didn’t need to be online.

    Patient records of children are in high-demand on the dark web, according to ICIT Senior Fellow James Scott. 

    These complete medical records can be sold on the Dark Web for abut $500 to $1,200, which depends on how much information is included and the market type, a September ICIT report found. The criminal can build a fake identity from the child’s information, as many breach records take a long time to be discovered.
     

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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    Author: 
    Slideshow Image: 
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    Slideshow Description: 

    Healthcare proved itself a lucrative target for hackers in 2016, and so far 2017 is unfortunately following suit. From organizations with exposed, unused websites to unencrypted storage drives, health organizations appear to still have much to learn about security.

    This gallery highlights some of the biggest breaches across the industry – and points to some mistakes to avoid in the future.

    Updated May 5, 2017

    Slideshow Image: 
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    Slideshow Title: 
    Aesthetic Dentistry and OC Gastrocare
    Slideshow Description: 

    Dark Web hacker TheDarkOverlord has released 180,000 patient records from three hacks, DataBreaches.net revealed May 4. More than 3,400 patient records were released from New York City-based Aesthetic Dentistry, 34,100 from California’s OC Gastocare and 142,000 Tampa Bay Surgery Center. TDO used a Twitter account to post a link to a site that allows any user to download the patient databases from these organizations.

    Read the full article

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%20500k.png
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    Children health records
    Slideshow Description: 

    The patient records of about 500,000 children are up for grabs on the dark web, a hacker named Skyscraper told DataBreaches.net on April 26. These records contain both child and parent names, Social Security numbers, phone numbers and addresses. DataBreaches didn’t name the breached organizations but also said that another 200,000 records were stolen from elementary schools. The amount of breached records for pediatricians reported to the Department of Health and Human Services’ Office of Civil Rights is not equal to that number, meaning many of these providers are likely unaware their data has been exposed.

    Read the full article

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2020k.png
    Slideshow Title: 
    Lifespan
    Slideshow Description: 

    Providence-based Lifespan, Rhode Island's largest health network, has notified about 20,000 of its patients that a laptop theft may have exposed their sensitive information. The health organization said an employee's MacBook was taken after a car break-in on Feb. 25. The employee immediately contacted both law enforcement and Lifespan officials, who were able to change the employee’s credentials used to access Lifespan system resources.

    Read the full article

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%20918k.png
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    HealthNow Networks
    Slideshow Description: 

    The personal health data of 918,000 seniors was posted online for months, after a software developer working for HealthNow Networks uploaded a backup database to the internet, an investigation by ZDNet and DataBreaches.net found. Boca Raton, Florida-based HealthNow Networks is a telemarketing company that used to provide medical supplies to mostly seniors who rely on diabetic equipment. However, it’s no longer a registered business as of 2015, when it failed to file an annual report with Florida authorities. The software developer was contracted to build a customer database for HealthNow Networks, but the developer told researchers it was "too much work."

    Read the full article

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2055k.png
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    ABCD Children's Pediatrics
    Slideshow Description: 

    A ransomware attack at San Antonio-based ABCD Children’s Pediatrics may have breached the data of 55,447 patients. Affected files may have included patient names, Social Security numbers, insurance billing information, dates of birth, medical records, laboratory results, procedure technology codes, demographic data, address and telephone numbers. Investigators determined it was the Dharma virus, a variant of the Crisis ransomware family. While this virus doesn’t typically exfiltrate data, the provider was unable to rule it out, officials said.

    Read the full article

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    Washington University School of Medicine
    Slideshow Description: 

    A Washington University School of Medicine employee fell victim to a phishing attack that may have compromised 80,270 patient records. The medical school learned of the incident on Jan. 24 -- seven weeks after the phishing attack occurred on Dec. 2, officials said in a statement. The employee responded to a phishing email designed to look like a legitimate request. As a result, an unauthorized party may have gained access to employee email accounts that contained patient data.

    Read the full article.

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2017k.png
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    Metropolitan Urology Group
    Slideshow Description: 

    This Milwaukee-based provider began notifying patients that a November ransomware attack may have exposed their personal data. There were 17,634 patients affected, according to the U.S. Department of Health and Human Services' Office for Civil Rights. Two of Metropolitan Urology’s servers were infected by the virus, which may have exposed data of patients between 2003 and 2010. Officials said the data contained names, patient account numbers, provider identification, medical procedure codes and data of the provided services. About 5 percent of these patients had their Social Security numbers exposed.

    Read the full article.

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%20years%20vuln.png
    Slideshow Title: 
    Denton Heart Group
    Slideshow Description: 

    An unencrypted hard drive that contained seven years of backup electronic health record data was stolen from the Denton Health Group, a member of the HealthTexas Provider Network. The backup files contained a hoard of patient data from 2009 until 2016: Names, Social Security numbers, dates of birth, addresses, phone numbers, driver's license numbers, medical record numbers, insurance provider and policy details, physician names, clinic account numbers, medical history, medications, lab results and other clinical data.

    Read the full article.

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2014k.png
    Slideshow Title: 
    Brand New Day
    Slideshow Description: 

    In March, the Medicare-approved health plan notified 14,005 patients of a potential breach of electronic protected health information after an unauthorized access through a third-party vendor system. On Dec. 28, Brand New Day discovered that an unauthorized user had accessed the ePHI provided to one of its HIPAA business associates on Dec. 22. The access occurred through a vendor system used by a contracted provider, officials said.

    Read the full article.

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2022k.png
    Slideshow Title: 
    Singh and Arora Oncology Hematology
    Slideshow Description: 

    In February, the Flint, Michigan, cancer center notified 22,000 patients of a breach discovered in August 2016. Hackers had access to the practice's server between February and July of 2016, local affiliate ABC12 reported. The files contained names, Social Security numbers, addresses, phone numbers, dates of birth, CPT codes and insurance information.

    Read the full article.

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2010k.png
    Slideshow Title: 
    Verity Medical Foundation-San Jose Medical Group
    Slideshow Description: 

    Verity Medical Foundation-San Jose Medical Group website, part of the Verity Health System in Redwood City, California, was hacked, exposing the data of 10,164 patients. Verity includes six California hospitals, the Verity Medical Foundation and Verity Physician Network. An unauthorized user hacked into the website from October 2015 until it was discovered by Verity Health on January 6. The website was no longer in use.

    Read the full article.

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%20220k.png
    Slideshow Title: 
    CoPilot Provider Support Services
    Slideshow Description: 

    More than a year after discovering a potential breach to its websites, healthcare administrative services and IT provider, CoPilot Provider Support Services notified 220,000 patients and doctors who used its service. An unauthorized user breached one of CoPilot's databases, used by both healthcare providers and patients, in October 2015, according to officials. The hacker downloaded files that contained names, dates of birth, addresses, phone numbers, health insurers and some Social Security numbers of some users. No financial, medical treatment or other information was accessed.

    Read the full article.

    Slideshow Image: 
    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2043-ransom.png
    Slideshow Title: 
    Indiana-based Cancer Services
    Slideshow Description: 

    The server and back-up drive of Muncie, Indiana-based Cancer Services of East Central Indiana-Little Red Door were hacked and the data stripped, encrypted and taken for ransom by the cybercriminal organization, TheDarkOverlord, or TDO, the agency revealed Jan. 18. The hack took place on Jan. 11. TDO asked for 50 bitcoin, or about $43,000, in ransom, first in a text message to the personal cellphones of the company’s executive director, president and vice president. Officials said, TDO followed up in a form letter and several emails that contained extortion threats and promises to contact family members of the cancer patients, donors and community partners.

    Read the full article.

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%20Slide.png
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    Emory Healthcare
    Slideshow Description: 

    Atlanta-based Emory Healthcare was hacked by the Harak1r1 the 0.2 Bitcoin Ransomware, MacKeeper security researcher Chris Vickery discovered on Jan. 3. On Dec. 30, MacKeeper Security Research Center discovered a misconfigured MongoDB database that contained data from over 200,000 patients and other sensitive information. On Jan. 3, the firm confirmed this data was linked to Emory Brain Health Center. It appeared Harak1r1 wiped a database of the Brain Health Center and blocked access to these records, Vickery said.

    Read the full article.

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    http://www.healthcareitnews.com/sites/default/files/HITN%20Data%20Breach%2011GB.png
    Slideshow Title: 
    Potomac Healthcare
    Slideshow Description: 

    Subcontractor Potomac Healthcare exposed more than 11 gigabytes of sensitive data for health workers employed by the U.S. military's Special Operations Command, or SOCOM, according to security researcher Chris Vickery. Potomac Healthcare is a Department of Defense subcontractor, which provides health workers to the government through management consulting firm Booz Allen Hamilton. Vickery, a white hat hacker with MacKeeper, discovered the flaw in an unprotected remote synchronization service and brought the information to the attention of Potomac Health via both phone and email, he said, but after an hour the data remained online.

    Read the full article.

    Teaser: 

    Healthcare proved itself a lucrative target for hackers in 2016, and so far 2017 is unfortunately following suit. This gallery highlights some of the biggest breaches in healthcare -- and points to mistakes to avoid in the future.

    Thumbnail: 
    biggest healthcare breaches 2017
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    NYC Health + Hospitals will implement new revenue cycle technology from Epic Systems with the aim of improving efficiency and collecting the maximum amount of revenue for the services it delivers.

    In February, NYC Health + Hospitals pushed back the next phase of its $764 million, systemwide Epic electronic health record system rollout by several months. The delay came nearly a year after Charles Perry, MD, associate executive director and liaison to the Epic project at NYC H+H’s Queens and Elmhurst Hospital Centers, quit amid a controversy over patient safety. The health system said the delay was to take into account insights learned from the successful first phase of the implementation, though it declined to specify what those insights were.

    [Also: NYC H+H delays next stage of Epic EHR rollout]

    NYC H+H now projects the Epic revenue cycle system will help it capture an additional 5 percent of adjusted patient revenue, which would total $142 million based on 2016 patient volume. Additional expected benefits include improved clinical documentation to support billed services, reduced claims denials and accelerated reimbursements.

    The new technology is expected to standardize revenue collection and will integrate seamlessly with the Epic electronic health record system NYC Health + Hospitals began to adopt last year. The health system added that Epic’s revenue cycle technology will create a common platform for all providers, who will be able to complete tasks without having to jump from system to system.

    NYC Health + Hospitals, the city’s public health system, will invest $289 million over the next five years to fully implement the new system at its 11 hospitals, five long-term care facilities, and more than 70 community-based health centers, the provider organization said. The City of New York has allocated $150 million in capital funds, and NYC Health + Hospitals will invest $139 million out of its operating costs, pending approval by its board, it added.

    The rollout of the integrated platform is expected to begin in the fourth quarter of 2018. The integrated revenue cycle and electronic health record suite is expected to be fully completed in the last quarter of 2020.

    “This information technology system is an essential investment that will pay for itself in a couple of years and provide the IT foundation for more advanced population health efforts,” said NYC Health + Hospitals interim president and CEO Stan Brezenoff. “In addition to its impact on our revenue, it’s also a fundamental component of our health system’s transformation to more streamlined and efficient operations. The result will be a greatly improved user and patient experience.”

    Having revenue and clinical processes in a single system should make a big difference in productivity for the largest public health system in the country, said Judy Faulkner, Epic founder and CEO.

    Twitter: @SiwickiHealthIT
    Email the writer: bill.siwicki@himssmedia.com


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    http://pages.healthcareitnews.com/A-Framework-for-EHR-Affiliate-Strategy.html?topic=ehr%2C%20strategicplanning%2C%20workflow
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    Making electronic healthcare data accessible across a healthcare community continues to be a challenge for healthcare providers. To help address this challenge, many organizations are seeking partnership affiliations to realize the benefits of economies of scale, improved care, and reduced costs.


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    Sponsor: 
    Leidos
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    http://pages.healthcareitnews.com/Best-Practices-for-an-EHR-Go-Live.html?topic=ehr%2C%20strategicplanning%2C%20workflow
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    The launch of an Electronic Health Record (EHR) may mark the end of a large technology initiative to modernize a hospital’s IT system , but it can also mark the launch of a disruptive period for staff, clinicians and patients. After significant investment of time, money and effort, it is time to drive user adoption of the EHR. Read about go-live strategies to help ensure go-live success.


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    Body: 

    Launching a new system like an Electronic Healthcare Record (EHR) is a tense time for a hospital or a clinic. Costs can quickly escalate, adoption can suffer, and clinician satisfaction can wane if this new technology isn’t supported well enough. Which is why adding a clinical service desk can offer more than just support.


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    Healthcare organizations are getting smarter about the ways they deploy their technology, and doing better at putting it to work for clinicians, a new report shows.

    Forty-three percent of respondents to a survey from the Experience Innovation Network say they involve front-line staff and physicians in the selection and configuration of new IT systems.

    That may sound like a no-brainer, but it's become a common complaint that clinicians are frustrated by poorly configured EHRs that don't fit with their workflow and were implemented with little input from them.

    [Also: Doctors demand extreme EHR makeover ... right now]

    The report from the Experience Innovation Network, a project of Vocera Communications, polled more than 200 healthcare experience experts. It found encouraging news with regard to the ways technology is being deployed for the benefit of clinical end-users.

    Specifically, the study, "Experience Beyond Boundaries: The Next Generation CXO," focused on hospital chief experience officers and similar roles, examining the ways they're working to improve the day-to-day processes of their physicians and care teams.

    Seventy percent of respondents say they ask for IT improvement ideas from doctors and other front-line staffers. Forty-eight percent say front-liners are "involved in the codesign and dissemination of key experience parameters," and 43 percent say those employees actually help select and configure new technology implementations. Forty percent say they have a formal process in place to vet, select and implement ideas from front-line staff.

    Only 9 percent of survey-takers, on the other hand, said they do not engage front-line staff with experience improvement in any way.

    Nonetheless, with IT having become so intrinsic to care delivery, most CXOs polled agree that physicians and other frontline staff should play an expanded role in driving technology selection.

    Toward the goal of improved clinician experience, more and more hospitals are deploying new technologies and strategies to improve workflow and efficiency, the study shows. These include tools for direct communication among physicians and nurses such as texting and Skype; scribes or other EHR interfaces to help minimize data entry during patient visits; and telehealth platforms that include video, structured email and remote monitoring capabilities.

    Still, there's a way to go before the clinical experience is as optimal as it might be. While more attention is been paid to front-line frustrations and awareness of physician and nurse burnout is on the rise, only 18 percent of respondents said their organizations are explicitly tracking metrics that tie to physician, nurse and staff well-being, such as the Maslach Burnout Inventory, according to the report.

    Twitter: @MikeMiliardHITN
    Email the writer: mike.miliard@himssmedia.com


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    Analytics, health IT, data, documentation and standards are the hottest skills right now, according to an analysis of job postings on Indeed.com.

    The American Health Information Management Association found that hospitals are shifting their hiring practices to attract employees with more technical chops than ever before.

    AHIMA compiled the research in February 2017 by looking at 456 unique active job postings on Indeed.com.

    [Also: AHIMA pushes Congress to fund ONC, continue investing in EHR interoperability]

    “Collectively, the 100 most frequent terms revealed that many job postings appeared to focus on documentation, standards, data, health information technology, and analytics,” according to an article the May issue of the Journal of AHIMA.

    AHIMA broke down the job postings by percentage looking for specific skills and the most sought is medical records administration skills at 75.29 percent. All the others dipped down into single digits with revenue cycle management coding and billing the second most frequent terms at 8.87 percent. Information technology and infrastructure followed at 6.24 percent and informatics/data analysis at 6 percent.

    Education/communication and compliance/risk management rounded out the list at 2.40 percent and 1.20 percent, respectively.

    AHIMA also found a notable increase in the job postings that were looking for healthcare privacy and security skills.

    “It is important to not only meet current requirements, but also stay apprised of the future needs of the field,” AHIMA CEO Lynne Thomas Gordon said. “Emerging careers such as information governance, informatics, and data analytics … is where we anticipate seeing the most growth for our profession.”

    Twitter: SullyHIT
    Email the writer: tom.sullivan@himssmedia.com


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    As intrigue surrounds the U.S. Department of Veterans Affairs' plans for its VistA electronic health record, one VA hospital is making its own move for improved care coordination by partnering with a statewide HIE.

    Providence VA Medical Center and Rhode Island Quality Institute have announced a new partnership through which providers at the VA and those across Rhode Island can now more easily share medical information to improve care and treatment for veterans.

    The initiative, Health Care Coordination for Rhode Island Veterans, allows for more seamless information exchange thanks to the integration of VA clinical information with RIQI's CurrentCare statewide HIE.

    [Also: Rhode Island providers leverage statewide HIE for real-time transition notifications]

    Prior to the partnership, caregivers at Providence VAMC were often left in the dark about what care patients were getting from other providers in the community. Often, veterans had to gather their own paper records and carry them to their medical appointments.

    Now, VA physicians can see patient data, relayed by CurrentCare, directly through the EHR, without needing to log on to another system, officials said. They can also use the CurrentCare Viewer to access additional patient information.

    "Many Veterans receive care both in the VA system and from non-VA community providers,” said Paul Pirraglia, MD, chief of primary care at the Providence VAMC. "The recent integration of VA clinical information and CurrentCare really enhances our ability to coordinate complex care across multiple systems."

    "This project has filled an important gap in the care and treatment of Veterans receiving care at both the VA and in community-based healthcare settings throughout Rhode Island," added Laura Adams, president and CEO of Rhode Island Quality Institute.

    Clinicians at Providence VAMC – and care teams at more than 475 community-based care organizations across Rhode Island – can now more easily share information about medications, lab test results, hospital and emergency encounters and other data. They now have electronic access to imaging reports, discharge summaries, specialist consults and more.

    The information comes from a national database, meaning any veteran in the U.S. who receives care in Rhode Island can have their patient information accessible to non-VA providers. In order for VA data to display in CurrentCare, Veterans must enroll in both CurrentCare and in the VA's Virtual Lifetime Electronic Record HIE program.

    U.S. Sen. Sheldon Whitehouse, D-Rhode Island, founded RIQI while serving as the state's attorney general.

    Twitter: @MikeMiliardHITN
    Email the writer: mike.miliard@himssmedia.com


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    Healthcare executives are still focused on buying electronic health records, a new report shows, but when it comes to choosing between the top vendors, Epic is slightly edging out the rest. 

    EHR purchasing decisions are one aspect of the new report from Reaction’s Research Cloud, which gives hospitals an idea of what technologies their peers and competitors are moving forward with. 

    According to a new Reaction Research Cloud study of senior healthcare executives at hospitals, health systems and physician group practices, of those planning to buy inpatient EHRs in 2017, 40 percent will choose Epic, 39 percent want Cerner and 31 percent are looking at Meditech. The story is the same for outpatient EHRs: Epic at 45 percent, Cerner at 32 percent and MediTech at 31 percent.

    [Also: Doctors demand extreme EHR makeover ... right now]

    The buying trend report found provider organizations are focusing their IT purchasing on telemedicine and EHRs for the most part, but tools aimed at MACRA implementation are also gaining in interest.

    Reaction found 33 percent of respondents named telemedicine a buying priority, 32 percent picked inpatient EHRs, 20 percent said MACRA tools and another 20 percent are focused on patient engagement tech. Only 8 percent said they plan to buy nothing.

    [Also: Partners expands second-opinion service with Health Advocate partnership]

    The remainder mentioned machine learning, clinical trials management, revenue cycle, human resources systems, cybersecurity and PACS.

    Vendors most likely to win new business in telemedicine include Evisit, Secure Telehealth, Advanced Telehealth Solutions and InTouch Health, all at 17 percent, the study said. 

    [Also: Doc Halo raises $11 million to add patient engagement to platform]

    The vendors with the most mindshare in MACRA implementation include Premier at 22 percent, Advisory Board (Crimson) at 19 percent and Optum at 16 percent, the study found. For patient engagement it’s Epic at 37 percent, Press Ganey at 29 percent and Cerner at 24 percent. And for cybersecurity it’s Cisco at 61 percent, VMware at 34 percent and McAfee at 32 percent.

    The vendors most likely to win new business for data analytics include Epic at 33 percent, IBM at 25 percent, Cerner at 21 percent and MediTech at 21 percent, the study said. And for population health management technology it’s Cerner at 35 percent, Epic at 31 percent and Allscripts at 21 percent.

    In the Reaction Data study, entitled “Big Mega HIT Purchasing,” 47 percent of respondents were from standalone hospitals, 38 percent health systems, 10 percent hospital-owned physician group practices and 5 percent independent physician group practices.

    Twitter: @SiwickiHealthIT
    Email the writer: bill.siwicki@himssmedia.com


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    The U.S. Coast Guard finally scrapped a troubled rollout of Epic’s EHR and indicated that it is now seeking a new product.

    Unlike the Department of Veteran’s Affairs, the Coast Guard is not tied to a homemade EHR, which means it’s likely to be another off-the-shelf product that the agency chooses.

    [Also: How the Coast Guard’s ugly, Epic EHR break-up played out]

    So which EHR should the Coast Guard pick?

    Twitter: SullyHIT
    Email the writer: tom.sullivan@himssmedia.com


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    Customer service, account management and long-term value for the investment are among the key points in developing a good vendor relationship.

    You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues and upgrades. So, what should you expect from your vendor in this ongoing relationship?

    I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

    My post “Keys to successful vendor management” covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

    It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

    Whether it is a large, proven vendor or a small start-up, here’s what you should expect:

    1. Excellent customer service: this means being highly responsive, providing quick resolution to issues without escalation, and well-trained, expert support staff. All in the context of a service culture.
    2. Effective account management: every client needs a primary point person who is the face of the vendor, who effectively and expeditiously navigates the vendor’s organization regardless of its complexity on behalf of the client, tracks and reports on all open issues and ensures overall excellent customer service.
    3. Executive level relationship: vendor executives who regularly meet with client executives to ensure an effective, ongoing win-win partnership and who understand and support the client’s strategic plans.
    4. Long term value for the investment: vendors should work with their clients to help them fully leverage and utilize current products they have already licensed, have deep knowledge and transparency around the product roadmap, and sell new add-on products only when there is a clear client need.
    5. Support mergers and acquisitions: provide pricing, licensing and maintenance models that enable and support continued mergers and acquisitions; not create burdens and roadblocks that hinder growing integrated delivery systems.

    No vendor or product is perfect. As clients, we must make tradeoffs. But we invest big dollars in long term relationships with our vendors. There is a reason that the Gartner magic quadrant has two dimensions – “ability to execute” and “completeness of vision.” We need robust products that work reliably today and that will evolve in the future to meet changing needs.

    How does your vendor stack up against these expectations? Yes, “awesome” is a very high bar. But if you gave them a low grade, it may be time for some face to face discussions.

    This was first published on Health IT Connect .

     

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    Hospitals invest so much money in EHR implementations that it changes the very nature of their organization. And that means they need to think about operating more like a software company than just a hospital.  

    If $100 million sounds like an exorbitant or even unrealistic ticket for an electronic health records platform, in fact, consider that Kaiser Permanente, Mayo Clinic and Partners HealthCare have publicly acknowledged spending an order of magnitude more than that — while other hospitals such as Scripps Health, Lehigh Valley Health Network, Lahey Hospital Medical Center and Lifespan revealed budgets bigger than $100 million. And that’s just to rattle off a fistful.

    “The day you made that investment you became a software vendor,” said David Chou, CIO of Children’s Mercy Hospital Kansas City. “We all need to think like software companies because we are both hospital and software shop.” 

    EHR vendors and the patient experience

    Thinking like a software vendor — if not technically becoming one of sorts as some hospitals are, in fact, doing today — starts with considering clinicians, administrators, executives and, really, all employees to be actual customers and then serving them as such.

    When Microsoft is working on a new operating system, for instance, it gives early versions to customers willing to test the software and offer feedback that Microsoft then incorporates into subsequent incarnations and it keeps that circle spinning through the product’s development lifecycle.

    The secret sauce: iterative development.

    That’s software-speak but it also happens in medicine with new devices, new drugs, new standards of care, according to Adrian Zai, MD, the clinical director of population informatics at Massachusetts General Hospital’s Laboratory of Computer Science.

    “Iterative technology development,” Zai said. “It’s the exact same model as medicine.”

    Indeed, Leora Horwitz, MD brings a medical perspective to innovation at NYU Langone Medical Center, where she directs its Center for Healthcare Innovation and Delivery Science.

    Horwitz recommended that technologists pick the user-centered interventions that can have the biggest impact and incorporate front-line input, then offer evidence to clinicians and other users to prove that the software is working.

    “Be sure you actually know what the problem is before you rush off and try to solve it,” Horwitz explained.

    She recounted a project to create a dashboard showing how many patients were discharged by noon every day as a shiny new object, just one entirely missing the point that better and more useful data to display would be the urgently-needed information about emergency department wait times and exactly which beds are open right now.

    “Expect things to go wrong,” Horwitz cautioned. “Things go wrong all the time.”


    Read more Innovation Pulse columns from Healthcare IT News.


    That’s a fair point. Not every hospital is exactly equipped to mimic a software company, according to HIMSS Analytics global vice president John Daniels. 

    “But hospitals do have to provide some level of support for those EHR users and that takes a new thought process and resources,” Daniels said. “I have even seen some create their own capabilities, build in-house software born out of a specific need they have but couldn’t find on the market or didn’t want to pay for and then turn around and monetize it through a business strategy.”

    Example: Zai has been building software products since 2000, including working on a system that his previous employer Partners HealthCare ultimately brought to market and Mass General licensed in 2012.

    Amazon, Uber changing behavior

    Adopting a software vendor’s mindset is actually not about technology for technology’s sake and, instead, hospitals should focus more on what users need than simply creating slick new systems.

    “High value technology interventions,” NYU Langone’s Horwitz said, “will become sticky and last for years.”

    That’s the hard part. IT, however, is well-suited to spearhead the metamorphosis because tech shops are in the middle of the entire hospital ecosystem enough to understand how the data flows and can work better than any other department with not just the information management but also security and senior leadership that are going to be critical in establishing a software vendor mindset.

    Chou recommended taking into account how people actually tap non-health technologies, such as launching Lyft and Uber on a smartphone at the same time to find the best ride for the lowest price available at a precise point in time.

    “IT has to provide a great experience for doctors and all other users. Think about how Amazon makes you change your behavior, think about how Uber changes your behavior,” Chou said. “From a healthcare perspective: How do you create that experience so that people come to you instead of a competitor?” 

    Twitter: SullyHIT
    Email the writer: tom.sullivan@himssmedia.com


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    When the U.S. Food and Drug Administration announced in April that it would let 23andMe market its Personal Genome Service Genetic Health Risk tests directly to consumers, it was seen as a victory for consumers to be more proactive in their healthcare and lifestyles.

    Indeed the tests would assess the patient’s likelihood of inheriting 10 different diseases, like Parkinson’s and Alzheimer’s.

    But there’s one major problem.

    “The healthcare industry is in no way prepared to deal with the consumer piece of precision medicine,” said Allscripts 2bPrecise Chief Medical Officer Joel Diamond.

    Consumer-driven tests are a boon of the healthcare industry, Diamond said. Patients are being handed in-depth, genetic workups, but they don’t know what to do with the information.

    For example, certain markers appear in genetic tests, but a patient may have no family history or symptoms. These patients want to understand why it’s significant -- but many general providers don’t know what to do with the information.

    “It’s an interesting intersection,” said Diamond. “Physicians are never happy on the culture side with consumer-driven healthcare initiatives -- despite that it may help awareness of certain conditions. They’re happy with patients having more knowledge, but are often dismayed when patients want a particular treatment or workup.”

    Doctors are uncomfortable with the consumer-driven piece in the first place, and direct-to-consumer genetic testing is now adding to the problem. Diamond said that it’s not necessarily that the providers don’t want change, rather they’re “struggling to keep up with very rapid advancements in the genomic industry over the last few years.”

    Another issue lies in analyzing the risk factors for a disease, in comparison to receiving a positive test for an illness. Diamond said that although a person may have a specific variant that increases the likelihood to develop a certain condition over time -- it doesn’t guarantee a person will get it.

    Further, some patients are being tested for diseases without any available early treatments, like Parkinson’s and Alzheimer’s. These risk factors may reveal susceptibility to developing certain conditions, but for now, this information can only reveal what a patient may or may not be at risk for in the future.

    Better EHR platforms are needed

    “Technology is moving at a breakneck speed on two fronts: Computer technology and the ability to interpret genetic testing results,” said Diamond. “It’s a big deal to move to next-gen sequencing, but interpretation of the tests requires great computing capacity.”

    The industry is moving in the right direction to be able to handle tests on whole genomes, especially as the price of tests comes down. But Diamond said that, like other technology, when the cost hits a certain point consumers will flock to these tests.

    “But medicine isn’t really prepared to do anything with the results,” said Diamond.

    Moving genomic data into EHRs will help, Diamond said. These tests, for now, are bound to paper and are without real standards. But that presents another issue. Physicians at the point of care are going to have to know the basics to be able to interpret the data -- at the very minimum.

    “Genetic information will need to be presented in a simple way in the EHR, just like any clinical data,” said Diamond. “Standards are being developed, but don’t translate into how to push this data in a meaningful way.”

    “It used to be that the costs of the test were the biggest barrier,” he said. “But from a technology standpoint, healthcare is still reeling from EHRs and meaningful use that took the oxygen out of the room… Asking people to invest in this technology is a tough one right now, as people are letting the dust settle on the other issues.”

    However, Diamond said the task is not insurmountable. And doctors should get used to the idea.

    “This is what our world is going to become.”

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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    Virtustream, a Dell Technologies business, introduced a new healthcare cloud platform on Wednesday at the Dell EMC World conference in Las Vegas.

    The Virtustream Healthcare Cloud, built on Virtustream Enterprise Cloud, provides hosting for critical healthcare platforms and applications in an HIPAA/HITECH-compliant environment, the company said.

    It is designed for the highly secure, highly compliant, complex IT applications that are prevalent in healthcare, company executives said. They also call attention to Virtustream’s consumption-based pricing model that ensures clients pay only for what they use.

    [Also: Buyers Guide to cloud computing]

    The Virtustream Healthcare Cloud is the most recent among many cloud offerings on the market. A recent HIMSS Analytics Cloud Survey, found that 83 percent of IT healthcare organizations are already using some form of cloud services.

    There are offerings from Amazon, Google, IBM, Microsoft and Verizon, to name just a few competing in healthcare as well as in other sectors.

    “Today’s healthcare sector faces many pressure points,” Michael Hoch, vice president at Virtustream, said in a statement. “Providers must modernize their IT infrastructure to support their evolving clinical care and patient management systems, while aging infrastructure and limited staff mean they’re often completely consumed with managing legacy day-to-day operations.”

    This new offering, he said, would give healthcare organizations optimal cloud infrastructure and managed services needed to manage all of the categories of critical applications including EHRs, ERP systems, workforce management systems, precision medicine platforms, and picture archive and communication systems – PACS.

    Twitter: @Bernie_HITN
    Email the writer: bernie.monegain@himssmedia.com


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    The third-party server that hosts the electronic health records of New Jersey Diamond Institute for Fertility and Menopause was hacked by an unauthorized individual, exposing protected health information of 14,633 patients.

    The database and EHR system was encrypted, which prevented the hackers from gaining access, officials said. However, many supporting documents stored on the hacked server were left unencrypted and could have been accessed.

    The data included names, addresses, birth dates, Social Security numbers, lab tests and sonograms. For the 14,633 patients, the data contained protected health data.

    Diamond Institute is uncertain when the database was initially accessed, but the organization learned of the breach on February 27.

    After an initial investigation, the organization did a full password reset and updated its firewall in an attempt to prevent future attacks. Officials said virtual network credentials were also changed and all unused open ports are now closed.

    Patients are being offered a full year of free credit monitoring and notifications were sent beginning April 28.

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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    As a whole, the healthcare industry has long-since aired its frustrations about clunky electronic health records that take the joy out of medicine. Some providers have gone as far as to say EHRs turn doctors into data entry specialists.

    However, when talking with users of the Veterans Affairs’ VistA -- the agency’s EHR and IT system -- the response is the exact opposite. In fact, while Congress has long since dubbed VistA as outdated, VistA users seem completely satisfied with the functionality, speed and security of the system -- among many other positive features.

    For starters, annual Medscape EHR Reports consistently rank VistA as the number one EHR over commercial, off-the-shelf vendors.

    [Also: Congress presses VA secretary on VistA interoperability, costs]

    VistA developers who wrote its code worked directly with physicians to hear their thoughts and opinions about what an ideal system would look like. And even today, IT encourages VistA users to speak up about complaints, suggestions and needs, according to DSS Senior Health Informatics Consultant Deanne Clark.

    “When people really look at the history of VA, it has over 20 to 25 years of creating health informatics. It’s elevated the functionality requirements over time,” said Clark. “VA has been working with end users to really understand the software and users.”

    [Also: VA hospitals outperform mainstream facilities on readmissions, mortality rates]

    “In the VA it was encouraged that if software was seen as a barrier, IT got eyes on the problem very quickly. The culture is ‘let’s fix it and make it better,’” she said.

    This supportive culture of identifying user issues and visibility is another reason VistA is so popular. Clark said that the VA’s method doesn’t take away from the usefulness of the system because problems are fixed along the way. The VA identifies what it can do better and uses the software to solve it.

    “It stands up over time,” Clark said. “VistA is longitudinal with a focus on best practices, and it’s not tied to reimbursement. The emphasis is care and outcomes.”

    Firsthand experience with VistA

    To get a better understanding of the user’s point of view, Healthcare IT News spoke with a user who has worked with VistA since its early stages. The long-time user, who wished to remain anonymous, pointed to more than two dozen reasons for VistA’s success.

    His biggest point?

    “VistA was built by the VA for the people who use it,” he said.

    [Also: Not so fast, vendors, fixing VistA is not off the table]

    The platform is easily changed to meet needs of patients, specifically veterans with individual needs, down to their area of combat. He said this adaptability makes it easier to support veterans through every step of their care.

    VistA is can support up to 2,500 users at a time. There is also 99.5 percent uptime. In fact, there’s a shadow system for VistA used during periods of downtime that allows for seamless care transactions.

    And to top it off, one package talks to another. VistA is not just an EHR. The entire IT system runs on VistA, from billing to clinical care. This allows the doctor to see all relevant patient information at once.

    A recent Reddit thread shared similar accounts of VistA users with comments that ranged from “it looks like it was coded in 1980, but CPRS sucks way, way less than a lot of commercial products,” to “not the most advanced in the user interface, but at least it was built more for the clinician than the biller.”

    While many of these users found the system to be slower than they would like, the consensus was that a commercial vendor would not handle tasks any better.

    It’s these factors that have many users concerned: Could a commercial EHR support VA in this same way? And could a private sector vendor fully understand the needs of the veteran? Lastly, can a commercial off-the-shelf EHR handle the VA’s massive size?

    “The VA treats a population with greater health issues: more needs and functions than other private sectors patients,” said Clark. There’s trauma, active duty soldiers, mental health, prosthetics and other needs that a general EHR vendor without a military background may not be able to understand.
     

    Twitter: @JessieFDavis
    Email the writer: jessica.davis@himssmedia.com


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    Researchers at Vanderbilt University Medical Center and the University of Arizona College of Pharmacy have found that EHRs can aid the understanding, treatment – and ultimately – prevention of disease, said senior author Joshua Denny, MD, professor of biomedical informatics and medicine at Vanderbilt.

    The researchers created what they label as the first comprehensive catalog of diseases associated with variations in human leukocyte antigen, or HLA – genes that regulate the body's immune system.

    The catalog could help identify individuals who are at-risk for certain autoimmune diseases or who may generate antibodies that attack their own tissues in response to an infection.

    [Also: Indiana University launches $300 million precision health initiative]

    The findings, published in the journal Science Translational Medicine, notes the power of electronic health records to advance understanding, treatment and prevention of disease.

    "In one fell swoop we essentially replicated decades of research on autoimmune associations with the HLA," said Jason Karnes, co-author of the paper with Lisa Bastarache, lead data scientist in the Vanderbilt Center for Precision Medicine. Karnes is an assistant professor in the University of Arizona College of Pharmacy in Tucson. "To my knowledge no other investigations have made this level of data available" to the wider research community, Karnes said.

    HLAs are proteins expressed on the surfaces of cells. Like nametags, they enable the immune system to distinguish "self" tissues of the body from "non-self," such as invading pathogens.
    Individual variations in HLA genes also have been linked to adverse drug reactions, rejection of transplanted organs and autoimmune diseases including type 1 diabetes and rheumatoid arthritis, in which the immune system mistakes normal tissue for a foreign invader and attacks it.

    This research scanned patients' entire "phenome" of all health characteristics as noted in the EHR.

    To date, more than 230,000 samples from different individuals have been stored in BioVU, Vanderbilt's DNA database. Genetic samples are linked to the corresponding EHRs in which identifying information has been deleted to protect patient privacy.

    From the genetic code, the researchers inferred which HLAs would be expected to be expressed in nearly 29,000 individuals whose DNA samples were stored in BioVU and another 8,400 samples provided by Scott Hebbring and colleagues from the Marshfield Clinic.

    The EHRs from these individuals were screened for the presence of nearly 1,400 different phenotypes that could be linked to the HLA genes.

    Type 1 diabetes was the strongest previously described HLA association confirmed by the study, but the researchers also found evidence for several new potential associations with multiple sclerosis and cervical cancer.

    Twitter: @Bernie_HITN
    Email the writer: bernie.monegain@himssmedia.com


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