Industry Watch

Automation

Riverside Methodist Hospital, part of OhioHealth, plans to implement McKesson’s CytoCare robot as part of an IV automation initiative, a move that will enable the 800-bed facility to meet the anticipated growth within its cancer services department without requiring additional staff.

With McKesson barcode-scanning technology for medications already in place in the pharmacy, Riverside will deploy CytoCare in an effort to introduce the same level of automation and barcoding to further improve the safety of oncology preparations. According to hospital leaders, the solution will enable pharmacy staff to more efficiently prepare IVs while reducing their exposure to hazardous drugs and the potential for manual compounding errors.

“Our pharmacy technicians prepare approximately 500 chemotherapy IVs each month for inpatients and our outpatient cancer facility, and a pharmacist checks each preparation,” says Charles McCluskey, PharmD, system vice president of pharmacy for the OhioHealth system. “With CytoCare, we can more efficiently prepare the IVs while reducing our technicians’ exposure to hazardous drugs and reducing the potential for manual compounding errors.”

Green

Document-shredding service provider Cintas Corporation recently announced that, by its own estimates, it has saved more than 1.6 million trees through October 2010 by recycling confidential documents. In addition to trees, Cintas says that it has saved more than 196,000 barrels of oil, 688 million gallons of water, 294,000 cubic yards of landfill space and 393 million kilowatts of energy.

What happens when you call the shredder company? First, the paper is collected by Cintas and destroyed through its secure SmartShred process. This process can take place on Cintas’ mobile shredding trucks or at any of its nationwide locations. The shredded paper is then delivered to a paper mill to be recycled. At the mill, the paper is sorted to remove contaminants such as paper clips, plastic and other materials that can’t be recycled. It is then turned into a pulp and manufactured into secondary paper products, such as paper cups, paper towels and tissue.

“Recycling paper saves water, reduces greenhouse gas emissions and uses approximately 25 percent less energy than manufacturing paper from trees,” says Pamela Coleman, director of supplier diversity and corporate sustainability, Cintas.

www.cintas.com/documentmanagement

Analytics

The TriZetto Group is enhancing its care management and value-based solutions for health plan members and their providers through a strategic partnership with clinical analytics developer MEDai. The goal of combining TriZetto solutions and MEDai analytics is to provide a comprehensive approach to maximizing the use and benefits of care management programs and value-based incentive and reimbursement programs by including enhanced features, such as clinical risk modeling, identification and stratification, patient compliance monitoring, provider cost and utilization analysis and comparison, cohort analysis, and other health data analytic capabilities. These capabilities are expected to be embedded in TriZetto’s Clinical CareAdvance and Value-Based Benefits Solution in 2011, in addition to future integration into TriZetto’s patient-centered medical home (PCMH) solution and core administration systems.

Health plans and medical practices alike will be able to use the integrated solution to model and compare their costs based on full practitioner and patient compliance with clinical best practices versus actual compliance or noncompliance. In this way, both payers and practitioners can manage the clinical and financial outcomes for their members, patients and practices.

Web site

The Center for Telehealth & e-Health Law (CTeL) recently launched a first-of-its-kind, comprehensive Web site to address detailed legal and regulatory telehealth issues. The site will provide continuously updated legal and regulatory telehealth resources and offer complex and specialized information for CTeL members.

In addition to numerous resources, including fact sheets, briefing memos, reports and white papers, the site will also include comprehensive reports detailing laws and regulations for each of the 50 states and the District of Columbia as they impact the delivery of telehealth. Through an interactive licensing map, physicians providing services via telehealth will be able to research how to meet out-of-state licensing and prescribing requirements – information vital to the practice of telemedicine.

According to CTeL, the site will utilize social media components, including Facebook, Twitter, YouTube, Flickr and LinkedIn, to keep users engaged and up to date on the most important issues, legislation, decisions and cases. The site also plans to host virtual “Tele-Town Halls” that will serve as live, interactive forums for discussing emerging telehealth issues.

www.ctel.org

Tools

Streamlining the search for computerized physician order entry (CPOE) information and insight just got easier. The new HIMSS CPOE wiki brings data, documents and valuable guidelines on meeting and exceeding meaningful use into one location. The HIMSS Enterprise CPOE Workgroup developed the wiki with the leadership of workgroup chair Paul Kleeberg, M.D., clinical director for Minnesota and North Dakota REC REACH.

What’s a wiki, you ask? It’s a Web site that allows any visitor to edit and/or update content. So all interested parties get a chance to chime in.

The HIMSS CPOE wiki connects users as they introduce new or participate in current conversations on CPOE. It’s been designed as an interactive discussion forum, so following threads is easy.

“The workgroup launched the wiki to broaden use and understanding of CPOE, a health IT application with continued growth and relevance to electronic health-record system implementations,” says Dr. Kleeberg. “Physicians, nurses, implementation staff, pharmacists and anyone supporting the adoption and use of CPOE can find and contribute valuable information resources on the wiki.”

Users also can find/compare content, share best practices and templates and review lessons learned on CPOE implementation. The wiki is organized by various stages of implementation: initiating, planning, executing, monitoring/controlling, and transitioning to operations and optimization/maintenance. It is also organized by topics called “building blocks” that transcend stages of implementations.

https://himsscpoewiki.pbworks.com

EHR Beat

By Arthur Gasch

September and October saw three significant medical conferences: the new Digital Medical Office of the Future in Las Vegas, the 2010 AHIMA conference in Orlando and the Health Summit West in San Francisco.

HITECH definitely has the attention of integrated delivery networks, but individual physicians were underrepresented. Those with whom we spoke cited several factors keeping them on the EMR sidelines: a pending cut in CMS reimbursement; confusion about meaningful use and CCHIT certification; and concerns about HIPAA 5010, ICD-10 adoption and where they fit into accountable care organization structures and the Medical Home Initiative.

Many of the 100,000 practices that HITECH has targeted are waiting to see if any new changes will be coming. This has caused the EMR market to contract and new revenues to dry up for smaller vendors, but it has blessed about 10 vendors with new sales to pursue. By the end of the Health Summit West conference, 40 EHR products had been certified as ONC-compliant, but only about 18 of these companies have been selected by a regional extension center (REC), so their potential ROI is questionable. EMR developers are folding and merging rapidly, causing group practices to wonder if the vendor they pick today has the ability to survive tomorrow.

Ingenix, a company known for its position in medical coding, is buying into the market, recently acquiring A-Life, Picis, Axolotl, ENS and Executive Health Resources. Likewise, Allscripts has acquired Eclipsys, and GE has acquired MedPlexus (which now becomes Centricity Advance, extending Centricity down into the smaller group practice setting). More acquisitions will occur in the next six months.

Regrettably, the ONC has taken a shotgun approach, launching all aspects of many programs at once, rather than in a slower, more logical sequence. Nothing is actually ready to go yet. The announcement of the last two regional extension centers (RECs) was made in early October; some RECs are getting organized, while others are up and open for business. The ONC educational initiatives are in progress, but ideally market education should have preceded the REC initiative. RECs are taking diverse approaches to the task of creating the next 100,000 meaningful users. We get the feeling that all of these different approaches are going to vary in their success, and that the waters of EMR adoption are going to be deeper than some of the organizations expect. The grants only run for two years before falling off, and that doesn’t leave much time, which is a big part of the problem.

A persistent theme at all three of these conferences was the scope of technology change that smaller group practices and hospitals face in the widespread adoption of EMR technology. There were certainly encouraging success stories, but failure and dissatisfaction with EMR rates are also running high (at 30 and 60 percent, respectively), so EMR adoption is so far achieving a very mixed result. Some have expressed their concerns to the ONC, formerly or informally, and have found their concerns falling on deaf ears. We didn’t find that many were convinced the objective would be met on time, and many were concerned that if the government spends the money and fails, or continues to distort and disrupt the EMR market, that it could do more harm than good because it could drive 300-plus EMR vendors out of the market. When two companies merge, not all products remain on the market with active development; some are acquired for their market share only. The state of the EMR market right now is supercharged, turbulent and a Wild West scenario.

Gasch is author of “Successfully Choosing Your EMR” and founder of Medical Strategic Planning. Contact him at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 732-219-5090.

Security

Biometric systems that are designed to automatically recognize individuals based on biological and behavioral traits such as fingerprints, palm prints or voice or face recognition are “inherently fallible” and no single trait has been identified that is stable and distinctive across all groups, according to a report issued Sept. 24, 2010 by the National Research Council.. The council advises that additional research is needed at virtually all levels of design and operation to strengthen the science and improve the system effectiveness of biometrics.

The systems provide “probabilistic results,” meaning that confidence in results must be tempered by an understanding of the inherent uncertainty in any given system, the report says. The report identifies numerous sources of uncertainty in the systems that need to be considered in system design and ­operation.

“For nearly 50 years, the promise of biometrics has outpaced the application of the technology,” says Joseph N. Pato, chair of the committee that wrote the report and distinguished technologist at Hewlett-Packard’s HP Laboratories, Palo Alto, Calif. “While some biometric systems can be effective for specific tasks, they are not nearly as infallible as their depiction in popular culture might suggest.”

Copies of “Biometric Recognition: Challenges and Opportunities” are available at www.nap.edu.