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August 24, 2009 News 2 Comments

Open-source software for physician offices may be gaining popularity, but this AMA article provides insight to some of the potential pitfalls. Risk of failure is higher than with mainstream alternatives; however, risk can be reduced by selecting software that has been around awhile, has a significant number of developers, has a history of providing regular releases, and is installed in a good number of practices. I’ve yet to see any PM/EMR solutions for the ambulatory world that I’d consider a safe bet, though I believe that Practice Fusion has been fairly successful. Most practices would be safer to go with a mainstream solution unless they have a super-techy doctor involved who wants to spend time tinkering with the computer system.


Speaking of the AMA, President J. James Rohack, MD launches a new blog entitled, “On the Road with Dr. Rohack.” Rohack travels 200 days a year, thus the on-the-road reference. He plans to write about AMA’s efforts to make an impact on issues important to patients and physicians. The first post is a little bland, but maybe Rohack will let some personality come through after he’s been writing awhile.

The HIT Standards Committee recommends using either ICD-9 or SNOMED to meet 2011 EMR standards, but wants to incent providers to move to SNOMED by 2015.

An Epocrates survey of medical students has some interesting findings from tomorrow’s doctors. They like mobile devices, with 45% of them using an iPhone or Touch and 60% of the non-users saying they’ll buy one of those Apple products within a year. They give medical schools an A- (up from a B) exposing them to technology, with 84% saying they’ve had EMR exposure and 90% saying use of an EMR will influence their practice choice. Over 70% of them give the US healthcare system a C grade or lower, and 90% say that information from drug salespeople are not credible (Mr. H paraphrased this finding to say the students believed the drug reps were “scumbag liars”; however, I don’t believe that many people would consider former enthusiastic cheerleaders and hunky football players liars.)

A couple of large medical supply companies say their second quarter sales were up, leading some experts to claim better economic times are ahead for office-based physicians. On the other hand, the uptick may simply be the result of higher sales of infection control supplies and antiviral medications for the upcoming flu season.

Also on the rise: the cost of health insurance. Between 2000 and 2009, the cost of a family premium provided by an employer increased 95.2%. And, plans today have higher deductibles and co-pays. Unfortunately, our incomes have only grown an average of 17.5% over the same period.


The Canadian Medical Association has a new president who is pushing for all physicians to go paperless by the end of 2011. During Dr. Ann Doig’s inauguration speech, she stressed that EMR is one of the keys to fixing Canada’s healthcare system. (That line has a familiar ring to it.)

Much to the pleasure of many clearinghouses, CIGNA Healthcare announces it will drop its five-year exclusive claims clearinghouse contract with Emdeon Business Services as of January 1, 2010. CIGNA names Ingenix as one clearinghouse from which it will accept claims and says other connections will be announced next year.

Depressed? Try sending an instant message to your therapist. Researchers conclude that “online cognitive behavioral therapy” (which sounds like a fancy way of saying you are IM’ing with your therapist) is an effective means of treating depression.


A camouflage-adorned robot helps stateside physicians check on patients as far away as Baghdad, Iraq. Dr. Kevin Chung, who heads the Army’s only burn intensive care unit, uses the “Chungbot” to monitor remote burn victims and to train nurses.

Community Health Centers and FQHCs continue to take advantage of ARRA stimulus funds to upgrade and expand their centers. Last week we noted that NextGen signed on a number of facilities and now eClinicalWorks announces the  addition of 37 new sites. The stimulus package included $851 million in grants so centers could purchase new equipment or HIT systems. HHS anticipates almost 400 clinics will add or expand EHRs.

The state of California awards $1.5 million loan repayment grants to 16 physicians providing care in underserved areas. Isn’t California on the verge of bankruptcy?


Modern Healthcare releases its annual list of the 100 Most Powerful People in Healthcare. Mr. H is noticeably absent (despite my lobbying efforts). President Obama tops the list. Other notables: David Blumenthal at number six; KP’s George Halverson at number 12; CCHIT’s Mark Leavitt at number 58; and the AMA’s James Rohack at number 95.

A man hunting through a dumpster for aluminum cans finds a paper goldmine instead. A Greensboro, NC man comes upon 623 medical charts in an area dumpster, complete with Social Security numbers and copies of drivers’ licenses. The records originated from a practice that had hired a third party to move the charts to a warehouse. No word yet how the charts ended up in the dumpster.

Meanwhile, HHS officials and members of an HIT panel provide assurance that the privacy and security of electronic health records are a priority. In fact, last week the HHS rules that providers and insurers must notify patients if their EHR records are breached, and, alert the media if it affects more than 500 people. I’m guessing the ruling does not apply to paper charts found in dumpsters.

The Ohio Senate considers legislation requiring nurses, doctors, and other healthcare professions to take cultural competency training. Other states apparently have similar laws on the book. Why target just health professionals? Aren’t there also bigots in government, education, and the local grocery store?


E-mail Inga.

Comments 2
  • It’s funny – to run an open source EHR, one needs a super-techy doc on staff. However, go with one of the non-free “mainstream” EHRs and you have to hire third party consultants or new full time staff people.

    Maybe it’s just that in OSS practices, it’s a doc who is most interested. FWIW, I’ve seen OSS work in practices where the SPOUSE of one of the docs is the nerd.

    [I’m frustrated by working with yet another practice (40 docs, primary care, 5 locations) who had to hire *3 full time employees* to manage their 2yo EHR installation, as the “mainstream vendor” is nowhere to be found. As a sponsor of your site, they’ll go nameless for now.]

  • Inga, how culturally insensitive of you to imply that my local grocery store (i.e., Kwik-E-Mart) is operated by anyone insensitive to racial or cultural differences. For that matter, my government here in the great state of Ohio is so leading edge when it comes to gender-race-religion-sexual orientation and even political inclination, that we the people of the great state of THE Ohio State University…oops, I mean of Ohio…are in a near Utopian society. So much so, that two prior attempts to pass similar legislation here have failed because, obviously, we Ohioans (medicos included) are just so darned enlightened.

    So, say what you want about my friend, Apu, down at our corner Kwik-E-Mart; we in Ohio know that cultural compassion and empathy abound here in the Heartland!

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