BEI HIT Blog
NV Daily, 3/16/14
BEI Commentary: Even with EHRs, the doctor-patient relationship remains very important, as noted by this local physician
With the recent push toward electronic medical records, a local doctor has conducted a study to find out how the patients themselves feel about the updated technology. He found that it all goes back to the relationship.
Dr. Bill Kerns of Front Royal Family Practice led a research team of physicians, looking into how patients want to engage with their electronic records.
Kerns found that the technology can be useful — so long as it enhances the relationship between physician and patient. Read More
Advance Health Network, 3/15/15
BEI Commentary: Just how bad is HIT security? 7 million. That is how many patient records were breached in 2013, an increase of 137% over 2012. As BEI says, and is also emphasized in the article: encrypt your data.
More than seven million health records in the United States were affected by data breaches in 2013, an increase of 137% over the previous year, according to the annual breach report by Redspin, an information security company based in Carpinteria, California.
Since 2009, there has been a rapid rise in the adoption of electronic health records in the US. There have also been 804 breaches of health information affecting nearly 30 million patient health records reported to the Secretary of Health and Human Services, as required by law. Read More
BEI Commentary: EHRs are very good at looking at patient data and providing recommendations for algorithms determined by evidence based medicine. Here is a success story in that regard from UC Davis. How can you use your EHR in a similar manner?
UC Davis researchers have found that routine information — blood pressure, respiratory rate, temperature and white blood cell count — from the electronic health records (EHRs) of hospitalized patients can be used to predict the early stages of sepsis, a leading cause of death and hospitalization in the U.S.
They also determined that just three measures — lactate level, blood pressure and respiratory rate — can pinpoint the likelihood that a patient will die from the disease.
UC Davis researchers have shown that electronic health records can bring precision to the early identification of sepsis. Read More
BEI Commentary: There is legislation proposed that would end the Meaningful Use program. While the program would go away, HIT incentives would not. Use of HIT would be baked directly into how physicians are paid.
Dr. Farzad Mostashari, the former head of the Office of the National Coordinator for Health Information Technology, is gung ho on a major change to the federal health IT incentive payment program incorporated in the proposed Medicare payment system for physicians to replace the sustainable growth-rate formula.
The legislation, unveiled Feb. 6 with bipartisan support, would eliminate penalties for noncompliance with Medicare meaningful-use criteria by 2017. The Medicare portion of the EHR incentive payment program, created under the American Recovery and Reinvestment Act, has already paid out about $4.1 billion to more than 218,000 physicians and other eligible professionals to adopt and meaningfully use EHRs. Read more
Heathcare IT News, February 7, 2014
BEI Commentary: CMS is extending the Meaningful Use attestation deadline by one month. Not sure why, but no one is complaining!
The Centers for Medicare & Medicaid Services is extending the deadline for eligible professionals to attest to meaningful use for the Medicare EHR Incentive Program 2013, the agency announced today.
“We are seeing extraordinary interest from healthcare providers participating in the Electronic Heath Records Incentive Programs, and to help ensure all eligible healthcare providers are able to receive their incentive payments, we are extending the attestation deadline for the Medicare EHR Incentive Program by one month for professionals,” CMS officials said in a statement. “Additionally, hospitals that may have missed their reporting deadline have an opportunity to submit their attestation retroactively.” Read More
Voice of the Doctor, January 27, 2014
BEI Commentary: We will keep saying it over and over until it is common practice – encrypt your hard drives (especially your laptops). Read about this practice in Canada that had an unencrypted laptop stolen that contained PHI for 627,000 patients.
In this latest release Medicentres Family Health Care Clinics, a 27-clinic medical group in Western Canada had an unencrypted clinic laptop stolen from one of the clinic’s IT consultants.
The laptop contained 620,000 patient names, dates of birth, health card numbers, medical diagnoses and billing codes, officials said. Read More
NY Times, January 12, 2014
BEI Commentary: Scribes have entered the scene in clinics and operating rooms, liberating physicians from the constant note-taking that modern electronic health records systems demand.
Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician in Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.
Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand. Read More
EMR & EHR, January 6, 2014
BEI Commentary: One of the purposes of an EHR is to provide better data at the point of care so that providers can make more informed clinical decisions. Clearly that is the case here where a hospital has materially reduced its mortality rate due to sepsis.
Two years ago, New York City’s Mount Sinai Hospital was struggling to catch cases of sepsis early enough to save lives. Since then, the hospital has almost halved the number of sepsis deaths taking place there thanks to use of its EMR, according to a piece in the Canadian Medical Association Journal.
Attacking sepsis deaths is critical for hospitals worldwide, which have been fighting what has been described as a losing battle against the condition. According to the CMAJ, hospitalizations for sepsis have more than doubled over the last 10 years, and an estimated 1/3 to 1/2 of those patients die as a result of the condition. Read More
Health IT Security, December 11, 2013
BEI Commentary: With much confusion over the Core Measure requirement to perform a Security Risk Analysis, CMS has issued some guidelines and other helpful information. Here is a helpful article that includes links to the relevant documents on the CMS website.
With the requirement that Medicare and Medicaid EHR Incentive Programs eligible professionals conduct a security risk analysis in both Stage 1 and Stage 2 Meaningful Use in mind, the Centers for Medicare and Medicaid Services (CMS) recently released a Security Risk Analysis Tipsheet.
Incentive program requirements align with federal privacy and security standards and CMS released these tips to aid HIPAA covered entities that are unsure of their responsibilities. Under HIPAA, 45 CFR 164.308(a)(1), these organizations must conduct risk analyses as well as take any additional “reasonable and appropriate” steps to reduce identified risks to reasonable and appropriate levels. CMS provided these considerations as organizations perform risk analyses:
- Review the existing security infrastructure in your medical practice against legal requirements and industry best practices
- Identify potential threats to patient privacy and security and assesses the impact on the confidentiality, integrity and availability of your e-PHI
- Prioritize risks based on the severity of their impact on your patients and practice
Modern Healthcare, December 10, 2013
BEI Commentary: Cutting and pasting in patient records can be dangerous. This article summarizes the issues and discusses how the federal government is cracking down on the practice and associated fraud.
Federal officials say the cut-and-paste features common to electronic health records invite fraudulent use of duplicated clinical notes and that there is a need to clamp down on the emerging threat. That concern is enhanced by the fact that it’s too easy to turn off features of EHR systems that allow tracking of sloppy or fraudulent records.
In an audit report released Tuesday morning (PDF), HHS agencies confirmed that they are developing comprehensive plans to deter fraud and abuse involving EHRs, including guidelines for cut-and-paste features. The issue arises at a time when critics say federally subsidized digital patient record systems are sometimes being used inappropriately by providers to drive up reimbursement.
“Certain EHR documentation features, if poorly designed or used inappropriately, can result in poor data quality or fraud,” according a report from HHS’ Office of the Inspector General. Read More