CMIO Rant with … Dr. Andy

Now Why Didn’t I Think of That?
By Andy Spooner, MD

I am sure the AMA meant well in its statements demanding some changes to how the business of designing and implementing EHRs should go. I like the spirit in which the statements were offered. I see that these statements resonate with physicians. The problem is that I am not sure what action to take in response to them.

I have worked with several EHR companies, and all of them do all of these things that the AMA recommends— even companies that are small or struggling – at least the things that are within their control.

Some of the items on the list are not really within the control of the software at all. For example, the AMA recommends that "EHR systems … should … allow physicians to delegate tasks as appropriate.” Isn’t this more a matter of policy than software design? If it is acceptable from a regulatory standpoint to delegate some data-management task, I don’t really know how an EHR could prevent one from delegating it. The AMA could really help by lobbying against regulations that require overly detailed physician documentation, like the CMS E & M coding guidelines, which really set a floor of complexity below which we cannot sink.

The statements are also somewhat self-contradictory. For example, we are supposed to expect our EHRs to "reduce cognitive workload,” and at the same time "track referrals, consultations, orders, and labs so physicians easily can follow the patient’s progression throughout their care.” The latter entails a massive “cognitive workload.” To do all this tracking on paper would be intractable; therefore we did not do it, and had a lower “cognitive workload” as a result. The EHR at least gives us a way to track all this stuff, but one still must take a look at the data and react to the fact that Patient X never made it to see the cardiologist you referred them to. On paper, you might never have known this until they came back in for a future appointment (if you could even find the note where you mentioned the referral). In the EHR, you can track this stuff prospectively or post-hoc … either way, there’s “cognitive workload.” Is this workload the fault of the system that makes it possible for you to do what was impossible before?

The fundamental “problem” with EHRs is that they allow us to do more. For example, we can comply with documentation regulations at a level far exceeding what was ever possible on paper. We can examine information that was simply not available before. We can track things. We can review the lifetime clinical record. We can peer into the practice of multiple specialists. We can obtain records from providers located hundreds of miles away in seconds — even if they do not use the same brand of EHR we use. We can see which prescriptions got picked up, and which did not.

On paper, we got accustomed to lack of access to information. Now that we have more, we want to give our patients the very best service possible by reviewing all of it. We should review all of it. We need to realize that access to information is not a design flaw … it’s what we’ve wanted since the earliest visions of EHRs. It comes at a cost, but most people would agree that it is our job to synthesize what we know and can know about a patient.

The other big contradiction in the statements seemed to assume that user input is not being sought by those who design EHRs. If anything, EHR designers seek too much user input, trying to make the systems do all things for all people and making these systems, following the exact advice of the AMA, “customized for each practice environment.” Customization can be really good, but it does not tend to make software simpler. I have heard people ask why the EHR can’t work more like an iPod. Part of the reason it cannot is that the iPod user interface was not designed by trying to accommodate every conceivable use of the device. Steve Jobs openly eschewed focus groups for a reason. I am not suggesting the same approach for the EHR industry. But customization begets complexity. And we work in a complex profession.

I went for a checkup the other day. My internist and I went through my chart, reviewing meds, ED visits, consultant reports, family history, and so on. In the old days we might have just shot the breeze for a few minutes, and I might have brought up a few tidbits of stuff I remembered about my medical past. And that’s all he’d have to work with. He has more to work with now. I feel like he knows me, and can give me good advice. The visit probably took longer than it might have in a less information-rich time. Is that bad?

My recommendations to the AMA would be:

1. Lobby to simplify E & M coding guidelines. Make reimbursement guidelines more about time than the number of bullets you can document.
2. Set a professional standard that text should not be copied forward, since reading the same paragraphs over and over (placed there for bogus "billing purposes”) is unnecessary.
3. Promote reimbursement incentives for those who use choose to use time-saving, existing tools to summarize the patient’s state, like the problem list.
4. If it is thought that there is a minimal number of clicks or certain kinds of displays that are acceptable to do something, write a specification and lobby to make it part of an incentive program. Personally, I am skeptical that such a specification is possible to create, but there is probably much to be learned in proving me wrong.
5. Work to align AMA policy with the literature on EHRs. If there are gaps in that literature (there are), encourage the filling of those gaps in AMA journals so that statements like “the quality of the clinical narrative in paper charts is more succinct and reflective of the pertinent clinical information” or “these products have performed poorly in real-world practice settings” have some objective basis.
6. Get to know people at EHR companies and align statements with what they are actually doing. Commission an article for JAMA that explains how this industry really works. Include interviews with the physicians who do the design — there are lots of them.

We have all experienced clinical software that seems like it could be more elegant or functional. The fact that EHR software creators (both the commercial providers and the home-grown shops) continue to publish upgrades is testament to that. All of those upgrades reflect a desire to achieve the goals the AMA articulates, while continuing somehow to maintain stable software and respond to a torrent of user feedback to allow the software to work better within the team-based workflows we all use. Organized medicine could really help things along by setting professional standards, promoting advancement of knowledge, and, most importantly, by lobbying for regulations that reduce complexity of the practice of medicine.

Andy Spooner, MD, MS, FAAP is CMIO at Cincinnati Children’s Hospital Medical Center. A general pediatrician, he practices hospital medicine when he’s not enjoying the work involved in keeping the integrated HER system useful for the pediatric specialists, primary care providers, and other child health professionals in Cincy.

News 9/18/14

Top News

Congresswoman Renee Ellmers (R-NC) introduces the Flexibility of Health IT Reporting Act of 2014, which if approved would allow providers to report HIT upgrades in 2015 through a 90-day reporting period as opposed to a full year. In addition, providers would have the option to choose any three-month quarter for the EHR reporting period in 2015 to qualify for Meaningful Use. Introduction of the act coincides with a letter to HHS Secretary Sylvia Burwell from 16 industry groups calling for similar adjustment.

HIStalk Practice Announcements and Requests

Thanks to all of the HIStalk sponsors that have requested to be a part of our annual MGMA “Must-See" Exhibitors Guide. Don’t worry, there’s still time to participate. Fill out this brief form by September 30 to ensure a spot in the digital guide. We’ll also include contact information for companies not exhibiting but looking to schedule one-on-one meetings.

Webinars

Today (Thursday) 1:00 p.m. ET.  DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project. Presented by HIStalk. Presenters: Dim-Sum, an anonymous expert in government healthcare IT, military veteran, and unwavering patriot; Mr. HIStalk. The Department of Defense’s selection of a commercially available EHR will drastically change the winning bidders, the health and welfare of service members all over the world, and possibly the entire healthcare IT industry. The presentation will include overview of the military health environment; the military’s history of using contractors to develop its systems vs. its new direction in buying an off-the-shelf system; its population health management challenges in caring for nearly 10 million patients all over the world, some of them on the battlefield; and a review of the big players that are bidding. This presentation will be geared toward a general audience and will be freely sprinkled with humor and wry cynicism developed in years of working in two often illogical industries that hate change.

September 25 (Thursday) 1:00 ET. Using BI Maturity Models to Tap the Power of Analytics. Presented by Siemens Healthcare. Presenters: James Gaston, senior director of maturity models, HIMSS Analytics; Christopher Bocchino, principal consultant, Siemens Healthcare. Business intelligence capabilities are becoming critical for healthcare organizations as ACOs and population health management initiatives evolve in the new healthcare marketplace. The presenters will explain how BI maturity models can help optimize clinical, financial, and operational decisions and how organizations can measure and mature their analytics capabilities.

September 26 (Friday) 1:00 ET. Data Governance – Why You Can’t Put It Off. Presented by Encore, A Quintiles Company. Presenters: Steve Morgan, MD, SVP for IT and data analytics and CMIO, Carilion Clinic; Randy Thomas, associate partner, Encore, A Quintiles Company. In this second webinar in a series, “It’s All About the Data,” the presenters will review the pressing need for data governance and smart strategies for implementing it using strained resources.

Acquisitions, Funding, Business, and Stock

Doc Halo and American Messaging Services enter into a revenue-sharing agreement and partnership that will deliver a combined suite of mobile health, secure communication, and critical messaging technologies to healthcare providers. American Messaging will also acquire a 25-percent equity interest in Doc Halo.

The CEO Council on Health and Innovation, which includes leaders from Verizon, Walgreens, Coca-Cola, Aetna, and Bank of America, challenges business leaders to formally quantify and share ideas and data on company wellness practices and outcomes. Their advocacy ties into the release of a similarly themed report and initiative at the Bipartisan Policy Center.

Government and Politics

This article predicts that former U.S. CTO Todd Park will be subpoenaed by Washington, D.C. lawmakers in order to force him to testify about Healthcare.gov’s security flaws before a subcommittee of the House Science, Space, and Technology Committee. Park has refused to testify before the Science Committee on multiple occasions without a subpoena. I’m sure the use of one will make him that much more willing to “come clean” about the security failings of the federal insurance marketplace.

U.S. Digital Service Administrator Mikey Dickerson shares Healthcare.gov war stories with the O’Reilly Velocity New York Conference audience: “Amazingly, there was no sense of urgency, because this was just like any other government project. Government IT contracts fail all the time. There was almost no place where we could point to a decision and say we’d made the right one. We didn’t expect to fix this. We just gave it our best shot, because somebody had to. Most of this was labor-intensive, but not very hard.”

Announcements and Implementations

Madison Radiology Medical Group implements Meaningful Use-certified eRAD RIS with Speech Recognition. The group, which has been an eRAD PACS customer since 2001, plans to start attestation for Meaningful Use right away.

IDC Health Insights launches Healthcare IT Services Strategies, an advisory service that provides data and analysis to suppliers and purchasers of IT services to help them save time, reduce cost, and mitigate risk.

An investment group affiliated with Goldman Sachs invests $400 million to fund the expansion of Privia Health, a physician-led ACO and population health technology company. Investors have set up holding company Brighton Health Group to align with Privia and help prioritize its expansion into eastern U.S. markets.

Wide River partners with 4Medapproved to offer its customers 4Medapproved’s online education and certification resources. 4Medapproved’s customers will, in turn, be introduced to Wide River’s healthcare IT consulting services.

The Kentucky Health Information Exchange unveils the myhealthnow patient portal, developed in collaboration with NoMoreClipboard. The portal rollout is in pilot phase with an unspecified number of healthcare facilities across the state. It is expected to be available to the public for use later this year.

Surescripts adds four pharmacy benefit management companies and six EHRs to its electronic prior authorization service.

GlobalMed introduces the ClearSteth Digital Stethoscope, which is capable of sending sounds within the body to an off-site healthcare provider. The digital stethoscope can then save the audio file in a patient’s EHR.

Research and Innovation

A new study finds, not surprisingly, that consumers who use social networks – especially those with chronic diseases – are more likely than those who don’t to search for health information online. It also found that there is still a significant gap between the online health information gathering habits of older men with low incomes and minorities, and those of women and people with higher incomes. None of this is particularly revealing in and of itself. Study results should, however, temper the enthusiasm of those who think Apple’s entry into healthcare will be the game changer that patients truly need. There are too many consumers who are not sporting the latest smartphone or overly interested in quantifying themselves to provide Apple with the critical mass it needs to shake up healthcare outcomes.

New research estimates that the global  mobile health market will account for over $13 billion in 2015, and could represent up to $290 billion in annual healthcare cost savings worldwide by the end of next year. It also predicts that wearable devices will account for over 150 million unit global shipments by the end of 2020. That kind of prediction may not represent critical mass, but it does prove that Apple can make a significant impact if it plays its cards right.

Other

Steven Waldren, MD, director of the American Academy of Family Physician’s Alliance for eHealth Innovation, breaks down the Meaningful Use final rule and the definition of certified EHR technology. He notes that “The AAFP has articulated to CMS and ONC that not changing the 2015 reporting requirements means this is still a large stretch for many physicians.”

Epic has been in the news this week thanks to its gigantic user group meeting in Verona. While the company mainly grabs hospital-centric headlines, I can’t help but comment on the contrast between the amount of money in the room above, and recent headlines that the state of Wisconsin needs $760 million more to pay for healthcare for the needy over the next two years. Epic may be partly to blame: Part of the added cost to taxpayers for the state’s needed Medicaid programs also comes from automatic decreases in federal aid that are being triggered because of Wisconsin’s improving economy.

Family physician Eugene Heslin, MD reacts to recent reports that physicians lose 48 minutes each day due to EHR use:

“Efficiency need not be measured solely in terms of minutes required to use the electronic record. It should also be evaluated in terms of the quality of care and savings derived from reducing the number of costly, redundant lab tests and X-rays and reducing the number of patients who need to be admitted or re-admitted to a hospital. This level of efficiency requires electronic health records, and importantly, requires the ability to interconnect these electronic systems.”

Ruth Ann Crystal, MD tweets a picture of either the latest physician fashion accessory, or a bold statement on the current state of reimbursement.

Sponsor Updates

• Flagler Hospital (FL) chooses Allscripts dbMotion to connect community EHRs.
• Billian’s HealthDATA makes its searchable Vitals hospital news and RFP feed available at no charge. 
• Allscripts offers a short list of dos and don’ts of clinical IT deployment based on a new Alberta Health Services case study.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

Last Minute Preparation Tips for the HIPAA Omnibus Deadline

“You may delay, but time will not.”
― Benjamin Franklin

This famous quote reminds us that another HIPAA Omnibus deadline is fast approaching. Covered entities (CEs) and Business Associates (BAs) that did not update their Business Associate Agreements (BAAs) in 2013 must do so by Monday, September 22, 2014. There’s no more wiggle room for delay. The final deadline is here.

What You’ll Need
Practices, clinics, and other CEs are responsible for auditing all their BAs and subcontractors, and for ensuring receipt of an updated BAA. The modified BAAs must state, in writing, that the BA has achieved the following:

• Full compliance with the HIPAA Security Rule.
• Execution of BAAs with any of their subcontractors that create, receive, maintain, or transmit protected health information on behalf of the BA.
• Reporting of all security incidents, including breaches of unsecured health information.
• Full compliance with the Privacy Rule requirements applicable to covered entities if and to the extent the BA is to carry out a CE’s obligations under the Privacy Rule.

A more detailed checklist for BAA compliance is here.

Know the Gotchas
While many BAs and subcontractors will confess to HIPAA compliance, they must put it in writing by September 22. This may include such business partners as cloud storage companies, EHR vendors, PM software firms, coding and billing services, and release of information processors. Even copy services and testing modalities must update their BAAs and their subcontractor BAAs — if they haven’t already done so.

CEs should verify that they’ve identified each BAA and subcontractor by conducting a thorough self-audit of their practices — logging every device that captures, stores or submits PHI. Even C-arms can store and submit data. Create an inventory of all systems and equipment to identify gaps in BAA documentation.

Four Basic Steps
Beyond updated BAAs, there are four basic ways practices and clinics can protect the privacy and security of their patients:

• Establish a solid privacy and security program for PHI.
• Document your program within strong HIPAA policies and procedures that are reviewed and updated at least annually.
• Ensure staff receives initial and ongoing education regarding HIPAA and your overall privacy and security program with documentation of their attendance and any disciplinary actions.
• Define steps to react quickly if a breach occurs — including investigation of the event, mitigation of potential harm, and notification of patients.

The HIPAA Omnibus rule changed your BAA requirements. Under the rule, all BAs and subcontractors are now also liable for breach penalties and fines. You’re no longer alone – but you’re also responsible.

Alisha R. Smith, RHIA is the Health Information Management Compliance Educator for HealthPort Corp. of Alpharetta, Georgia. 

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.

DOCtalk with Dr. Gregg 9/16/14

When Meaningful Isn’t

There are just so many times in a physician’s life when Meaningful Use just doesn’t mean anything.

Picture this:

A beautifully pregnant mother is preparing for the birth of her very first child. The pregnancy is uncomplicated, except for the fact that the child is now breech. Despite the best efforts of a wonderful obstetrician, the infant remains in breech position and the decision is made to deliver the baby via Caesarian section.

The surgical suite is fully prepped and the procedure proceeds with no untoward signs. The fetus’ vital signs are being monitored closely and show no indications of any distress. The section proceeds uneventfully until …

… until the moment of delivery, the moment when everyone expects a beautiful, normal, well-developed fetus to be delivered as a beautiful, healthy, well-developed new baby. Only …

… only it isn’t.

It isn’t beautiful. It isn’t normal. It isn’t well-developed.

The wonderful expectation is a flaccid, blue, non-responsive handful of tissue that appears, for all intents and purposes, as if it was intended for something, anything, other than the beautiful life for which it was anticipated. It looks bloated. It looks lifeless. It looks almost other-worldly in its exposure to life outside of the womb.

The neonatal team, fully ready, is nonetheless aghast. This is not the delightful new entry into the world that was expected. This is trauma. This is drama. This is a potentially horrific outcome to a marvelous prospect.

The lifeless form is handed over from the obstetric surgical team to the awaiting neonatal resuscitation crew. Drying. Bagging. Intubating. Chest percussions and every life-inducing mechanism are begun. The lifeless form remains lifeless.

One minute. Two minutes. Five. And more.

The form looks abnormal, but the abnormalities are indescript. There is normalcy amidst gross abnormality. There is life despite blatant lifelessness. There is something that calls the team to heroic measures despite protocols that call for cessation of all heroism.

The team persists.

And, thank God, the team prevails.

Spontaneous breaths are induced. Heart sounds begin where no heart sounds had been. Movement and facial expressions show that life has emerged where no life had once been. Stabilization ensues.

The nearest tertiary care neonatal center mobile team arrives via life flight and begins its superb “assess, address, and de-stress” routine. They load the non-diagnosed, non-normal , non-categorizable newborn into a now-safe haven of neonatal nurturing in their life flight-enabled neonatal incubator. They roll out, fly off, and proceed to care for this newborn child that only moments ago was a mass of nondescript protoplasm incapable of independent life.

Fast forward eight years. Standing in a coffee shop queue. A beautiful woman approaches, an amazing smile upon her lips. She greets you with the warmth of a thousand suns as she proclaims, out loud and to no one in particular, that you are the one who saved her child’s life. Her child. The now-diagnosed “gifted” wunderkind of third grade. The remarkably abnormal, normal girl who astonishes her teachers on a daily basis.

Think back. Did you document every moment? Did you record for an auditor who may never come the minute details of the indescribable moments of non-life before life? Did you capture the essential details that would allow for appropriate upcoding and enhanced reimbursement? Did you ensure transition of care documentation? Did you check off all the bullet points that insurance company column-and-row counters seek? Did you show Meaningful Use via “meaningful” digital documentation detail?

Seriously … does any of that matter when this mother stands before you with her look of indescribable gratitude?

From the trenches…

“Do not let your grand ambitions stand in the way of small but meaningful accomplishments.” – Bryant H. McGill

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).

News 9/16/14

Top News

IT, consulting, and outsourcing services firm Cognizant agrees to acquire TriZetto, a developer and licensor of IT services for healthcare providers and payers, for $2.7 billion in cash. The deal will create a combined company with over $3 billion in revenue from its healthcare operations. Cognizant posted a total revenue of $8.8 billion in 2013.

HIStalk Practice Announcements and Requests

HIStalk sponsors, don’t miss out on the chance to be a part of our annual MGMA “Must-See Exhibitors Guide.” Fill out this brief form by September 30 to ensure a spot in the digital guide. I’ll also include contact information for companies not exhibiting but looking to schedule one-on-one meetings. I’ll be reporting from the exhibit hall, plus as many great after-show networking events as I can squeeze in. Hopefully, I’ll also find time to sneak away to marvel at the most decadent chocolate fountain on the Strip.

Webinars

September 18 (Thursday) 1:00 p.m. ET.  DHMSM 101: The Hopes, Politics, and Players of the DoD’s $11 Billion EHR Project. Presented by HIStalk. Presenters: Dim-Sum, an anonymous expert in government healthcare IT, military veteran, and unwavering patriot; Mr. HIStalk. The Department of Defense’s selection of a commercially available EHR will drastically change the winning bidders, the health and welfare of service members all over the world, and possibly the entire healthcare IT industry. The presentation will include an overview of the military health environment; the military’s history of using contractors to develop its systems vs. its new direction in buying an off-the-shelf system; its population health management challenges in caring for nearly 10 million patients all over the world, some of them on the battlefield; and a review of the big players that are bidding. This presentation will be geared toward a general audience and will be freely sprinkled with humor and wry cynicism developed in years of working in two often illogical industries that hate change.

September 25 (Thursday) 1:00 ET. Using BI Maturity Models to Tap the Power of Analytics. Presented by Siemens Healthcare. Presenters: James Gaston, senior director of maturity models, HIMSS Analytics; Christopher Bocchino, principal consultant, Siemens Healthcare. Business intelligence capabilities are becoming critical for healthcare organizations as ACOs and population health management initiatives evolve in the new healthcare marketplace. The presenters will explain how BI maturity models can help optimize clinical, financial, and operational decisions, and how organizations can measure and mature their analytics capabilities.

September 26 (Friday) 1:00 ET. Data Governance – Why You Can’t Put It Off. Presented by Encore, A Quintiles Company. Presenters: Steve Morgan, MD, SVP for IT and data analytics and CMIO, Carilion Clinic; Randy Thomas, associate partner, Encore, A Quintiles Company. In this second webinar in the “It’s All About the Data” series, the presenters will review the pressing need for data governance and smart strategies for implementing it using strained resources.

Announcements and Implementations

Pacific Medical Data Solutions launches a comprehensive revenue cycle management service to help physicians streamline front and back office billing practices, and medical coding.

New Jersey Physicians ACO selects the eClinicalWorks Care Coordination Medical Record for population health management. Founding ACO member Vinod Sancheti, MD noted that the eCW solution was chosen in part for its strong track record with primary care-focused ACOs.

Amazing Charts parent company Pri-Med releases the InLight EHR, featuring a Watson-like technology that enables the EHR to learn from its users, and then organize and offer information in a manner that best suits physician workflow.

NextServices and Quantta partner to offer new mobile and Web enterprise solutions for multispecialty groups, ambulatory surgery centers, and hospitals; data-oriented apps for remote healthcare delivery; and integration of Quantta’s analytics services into NextServices’ enki EHR.

Government and Politics

The App Association and a consortium of startups including CareSync, AngelMD, and AirStrip send a letter to Representative Tom Marino (R-PA) expressing frustration with HHS over the lack of developer-friendly online resources related to HIPAA privacy rules. Some developers are apparently relying on government information last updated in 2006, well before the release of the iPhone and other mobile devices. The group also asked that HHS provide better guidance on how health data can be stored in the cloud.

New Zealand announces it will invest US$2.5 million in a nationwide initiative to encourage patient portal adoption amongst physician practices. The portals, currently used by 35,000 New Zealanders, are part of that country’s eHealth vision that aims to introduce e-prescribing, care plans, and a clinical data repository of patient information in 2014. For perspective, New Zealand is home to 4 million residents, while the U.S. is home to over 317 million.

National Health IT Week enters its second day of festivities. The ONC Consumer Health IT Summit kicked things off in Washington, D.C., yesterday, highlighting such themes as the Blue Button initiative, and policies and programs fostering patient and consumer engagement. You can view the official agenda for the rest of the week here.

People

Alan Santos is promoted to CEO of Pyramid Healthcare Solutions, and Manoj Malhotra (Salient Business Solutions) is appointed chairman of the company’s board.

James Prowant (Lehigh Valley Physician Group) joins the Mount Nittany Physician Group (PA) as COO.

Andrew Ferrier is appointed chairman of Orion Health.

Media outlets report that Lana Moriarty (HRSA) joins ONC as acting director for consumer e-health. Apparently one of her first duties as a digital consumer healthcare advocate was to create a Twitter account, just in time for National Health IT Week festivities. ONC continues to look for a permanent director. Check out this job listing to see if you qualify.

Research and Innovation

Tute Genomics launches MyGene, a cloud-based  patient results portal that enables healthcare organizations to share validated clinical genetics findings directly with patients. The technology may help primary care physicians overcome their hesitancy to incorporate genetics services into their care routines, among other barriers to adoption noted in new research. They include insufficient knowledge and competence related to genetic medicine, lack of knowledge about genetic risk assessment, concern for patient anxiety, a lack of access to genetics, and a lack of time. I have to assume that physicians already having trouble coming to grips with EHRs may not jump on the genomics portal bandwagon.

Global Kinetics Corp. receives FDA clearance for its wearable that helps detect Parkinson’s disease symptoms. The wrist-worn Personal KinetiGraph also offers medication reminders, and creates automated reports that neurologists and other caregivers can use to identify signs of neurological disorders.

The 2014 Survey of America’s Physicians finds that 85 percent of physicians surveyed have adopted EHRs, up from 69 percent in 2012. However, 46 percent indicate the technology has detracted from their efficiency, and just 24 percent say it has improved their efficiency. The survey findings tie into the American Medical Association’s call for an overhaul of the EHR, particularly as it relates to usability and higher-quality patient care. I’d love to hear how these results correlate with the experience of HIStalk Practice readers who are working “in the trenches,” as Dr. Gregg likes to say. Let me know if you’re interested in sharing your take with our audience.

Other 

Azalea Health donates its EHR software, services, and training to a dozen rural school clinics in Coffee County, Georgia. The donation is part of its commitment to the Rural School-Based Telehealth Center Initiative.

Pediatrician Charles McCormick, MD makes an interesting comparison between EHRs and the No Child Left Behind program:

“The use of templates is what makes an EMR so much like the public school use of No Child Left Behind, where children were taught to memorize information that would later appear on a test rather than teaching children how to think independently. As a physician, I do not want my thinking to be limited in any possible way by a template that I need to fill out in order to create a note. Every patient is different, and not a single one of us fits into the same box. We are, unfortunately, dumbing down medical care providers just like we dumbed down our teachers.”

Central Utah Clinic notifies 31,677 patients that one of its servers was “compromised” by unauthorized intruders in June. The server held some patient information, and a subset of written imaging and radiology reports dating back to 2010 and earlier. There has so far been no indication that patient information was stolen.

Doximity partners with U.S. News & World Report to offer the online Residency Navigator tool to help fourth-year medical students objectively assess residency programs. The tool ranks top programs based on physician survey results, and sub-specialization and board-pass rates, among other data points.

Sponsor Updates

• PerfectServe will discuss methods for improving healthcare at four leading industry events this fall.

Contacts

Mr. H, Lorre, Jennifer, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.