Industry Watch

EHRs
The Office of the National Coordinator for Health Information Technology (ONC) issued a final rule on June 18, 2010 to establish a temporary certification program for electronic health record (EHR) technology. The temporary certification program establishes processes that organizations will need to follow in order to be authorized by the National Coordinator to test and certify EHR technology.

Meaningful use – a concept introduced only a year ago – appears to be spurring an increase in healthcare information-technology (IT) spending, along with a brightening economy, suggests results of the 21st annual Healthcare Information and Management Systems Society (HIMSS) leadership survey. The American Reinvestment and Recovery Act (ARRA) promises financial incentives to providers and hospitals for the "meaningful use" of certified healthcare IT products. Although criteria for meaningful use will not be established until later this year, 59 percent of the 398 respondents to this year’s survey said they plan to make additional investments to position themselves to qualify for the incentives.

Of the wide-ranging 100,000 iPhone apps, approximately 2,000 are healthcare related, according to an overview by the mHealth Initiative of the exploding field of clinical and consumer healthcare applications available on mobile devices (mDevices). Close to an additional 3,000 healthcare applications are available for other types of smart phones.

Some of these 5,000 healthcare applications have widespread adoption. Epocrates, for example, reports more than 100,000 users just on the iPhone and, when taking into account access through other devices, a worldwide subscriber base of 750,000.

Today, most hospital business offices rely on third-party vendors, such as collection agencies, extended business-office partners and eligibility firms, to augment their internal collection efforts. Every day, accounts and financial updates flow back and forth between a hospital and its vendors. "Despite everyone’s best intentions, the current operating routines and processes often result in inconsistencies between the inventory records of a hospital and its vendors," says Steven Levin, CEO of Connance, a provider of back-office, self-pay collection and scoring solutions.

The use of electronic medical records (EMRs) in small and midsize ambulatory practices can result in many of the same benefits as in large practices, including migration from paper charts, electronic ordering, charge capture, and improvements to patient safety and quality of care as a result of features such as clinical decision support. According to Judy Hanover, research manager with IDC, however, small practices do not see the economies of scale that accrue with process efficiencies upon EMR introduction in larger practices, making the ROI questionable for many small practices. "For small practices, selecting the right EMR and choosing functionality that meets the practice’s needs, without creating unnecessary complexity or support costs, are critical," she says.

Since January 2008, more than 110 healthcare organizations have reported the loss of sensitive PII, according to the Open Security Foundation, affecting in excess of 5.3 million individuals. More than 46 percent of these reported data-loss incidents were caused by theft (stolen laptops, computers or media/tapes). The remaining 24 percent were the result of loss or negligence by staff or third parties, 12 percent were caused by malicious insiders and 12 percent were caused by Web exposure.

Lean Six Sigma for the Medical Practice: Improving Profitability by Improving Processes, by Frank Cohen and Owen Dahl, translates the Lean Six Sigma principles and tools specifically for the real-world medical practice environment.