Conn. Hospital Selects eClincialWorks

eClinicalWorks, a market leader in ambulatory clinical systems, announced that Stamford Hospital, serving Connecticut’s lower Fairfield County and a major teaching affiliate of the Columbia University College of Physicians and Surgeons, has selected eClinicalWorks’s unified electronic medical records (EMR) and practice management (PM) solution for its employed and affiliated physicians. In addition to the EMR/PM system, Stamford will use eClinicalWorks’s Patient Portal, Electronic Health eXchange (eEHX), Enterprise Business Optimizer (eBO) and eClinicalMobile – all designed to extend the use of electronic health records beyond the practice’s walls to improve communication and access to real-time information.

Can Patients Access EMRs From Their Home Computer?

The answer is maybe, but I do not believe the physician is obligated to make the emr electronically available. I was reading an article in the Orlando Sentinel (don't ask why, considering I'm in New Jersey), and I came across an interesting question in the paper's "ask a lawyer section". It's pretty short, scroll to the bottom for the link:

Q. My doctor has an electronic medical-records system. Does the law allow me to access my medical records, and, if so, can I access them from my home computer?~T.E. ORLANDO

A. Generally, the Health Insurance Portability and Accountability Act, a federal law commonly referred to as HIPAA, governs your right to access your medical records. Under HIPAA, upon request, your doctor must let you inspect or give you a copy of your medical records. There are some limited exceptions to this general rule, such as when a request is made for psychotherapy records. Also, your doctor is not required to release records obtained from other doctors...However, your doctor is not required to provide you an electronic version of such records or let you access such records from your home computer.

For more information about your rights under HIPAA, go to hhs.gov/ocr/.

Now I'm not the attorney who answered the question. HOWEVER, it does stand to reason that the doctor does not have to give electronic access to the record due to security reasons. Why in the world would congress go through all the trouble of requiring security in the physician's office if a doctor was to freely make his patient's medical record available without assessing the security threat?

Source: Kristy Johnson, Can Medical Records Be Accessed on Computer?, Orlando Sentinel, The Law & You Section; Florida; Ask a lawyer, pg. B1 (July 27, 2009) (available here)

The Doc is Logged In

The LA times just had a nice article on IT in the practice.

Wow. I've just taken care of three patients in 12 minutes, and I didn't do it by "churning" them through my office as if it's some sort of factory assembly line. Rather, those patients (their parents, more specifically -- I'm a pediatrician), e-mailed me over a secure network with questions and descriptions of signs and symptoms.

One mother attached a digital photo of a rash on her 3-month-old daughter's face; it turned out be nothing more serious than baby acne (it'll go away in a month or so). Another mom had noticed that her son was missing one of his pre-kindergarten immunizations (she had pulled up his shot records online) and requested that I order it. And the father of a 5-month-old boy told me that his son has been constipated off and on for the last month. I e-mailed him a questionnaire so I could determine whether the family should try something at home or bring the child to the office.

The articles goes on to list some advantages and disadvantages of healthcare IT. Read the article here .

Source: Rahul Parikh, In Practice; The doctor is in and logged on; Let's not pass notes or play phone tag anymore: E-mail and e-records do it better., Los Angeles Times, Health Section, Features Desk, Part E, pg. 1 (July 20, 2009)

Meaningful Use definition begins to firm up

The Health IT Policy Committee gave its final recommendations on "meaningful use" to the Department of Health and Human Services' Office of the National Coordinator last Thursday. The meaningful use workgroup had tweaked its original recommendations because of the 700+ comments received.

Paul Tang of the Palo Alto Medical Foundation, chairman of the meaningful use workgroup, said the revised recommendations include a faster timeline for giving patients access to information. Access to electronic health information will be counted in 2011, he said, and real-time access within personal health records was moved to 2013 from 2015. The recommendations also went to an "adoption year" approach in which 2011 is considered the first year. An organization must meet the 2011 standards for its first year of use, the 2013 standards for its third year and so on, even if it first adopts EHRs in 2012, 2013 or 2014. However, to qualify for the full five years of incentive payments, the organization would have to adopt by 2012. Penalties begin in 2015, and Tony Trenkle of the Centers for Medicare & Medicaid Services worried that an organization adopting EHRs in 2014 would have to jump a huge bar in one year to avoid the penalties.

The committee also adopted the broad outlines of the recommendations made by the certification group, which were to focus certification on meaningful use, leverage certification to improve security, privacy and interoperability, improve objectivity and transparency of the certification process, expand certification to a range of software sources, including open source and self-developed and develop a short-term transition plan. Within those high- level recommendations, the workgroup had suggested details, which it will continue to work on. Among them were that HHS should define certification criteria, rather than certification organizations, and that multiple organizations should be authorized to certify. The workgroup recognized industry concerns about opening up the process, but determined that competition would be better and would also help alleviate any bottlenecks that might ensue, co-chairmen Marc Probst of Intermountain Healthcare and Paul Egerman told the committee. They said they intended to accept public comment.

There are many suggestions out there, as the definition solidifies over the next few weeks, I'll keep you posted.

Source: Leslie Cantu, Meaningful Use Definition for Health IT Begins to Firm Up, Washington Internet Daily, Today's News Section (July 17, 2009)

Massachusetts helping to shape US efforts to digitize records

I forgot to blog about a recent article I read in the Boston Globe that emphasized why Massachusetts is in the fortunate position of being the country's electronic medical records focal point. According to Paul Egerman, Massachusetts is like the Silicone Valley of healthcare information technology.

Egerman went on to start one company, IDX Systems Corp., that was bought by General Electric for $1.2 billion, and another, eScription Inc., that was acquired by Nuance Communications Inc. last year for $363 million. He is now a volunteer adviser to David Blumenthal, the national coordinator for health information technology - and a former Harvard professor and Mass. General physician.

Synopsis of why Massachusetts is so influential in healthcare IT and the Obama Administration's goals?

- More experience than any other state

- Massachusetts doctors and hospitals do more electronic prescribing - eliminating the need for handwritten scraps of paper - than their counterparts in any other state.

According to John Halamka, chief information officer at CareGroup Healthcare System, ``The average use of EMRs in the US is between 2 and 20 percent. In Massachusetts, we're somewhere between 30 and 50 percent, so we've had a fair degree of experience with what works and what doesn't work.''

- Massachusetts won influence because Harvard economist David Cutler was the primary architect of candidate Barack Obama's healthcare plan.

Girish Navani of eClinicalWorks was also quoted in that article.

EClinicalWorks software is already used by about 25,000 doctors, and the company brought in $100 million in revenue last year. The company is hiring about twice as quickly - roughly 200 people in 2009, mainly in areas like training and customer support - as it would be without the stimulus, according to Girish Navani, eClinicalWorks chief executive...``The big picture,'' says Navani, ``is truly transforming healthcare, rather than just spending a lot of money and not getting to our goal.''

I included the source of the article so that you can read it in depth. It's really a good article! (I say that about most of the articles I cite to because I only blog about the good ones!)

Source: Scott Kirsner, State helping to shape US efforts to digitize health records for all, The Boston Globe, Business Section, pg.1 (July 12, 2009 Sunday

Mayor Bloomberg's Campaign Accountability Report

Mayor Michael R. Bloomberg released his fourth Campaign Accountability Report, which shows major progress has been made in implementing the 2005 campaign promises since the last report was issued in 2007. Today, 97 percent of the 100 campaign promises the Mayor made during the 2005 campaign are either listed as done or are currently being implemented. Compared to the last report, there have been major gains on promises that are fully or substantially implemented, up to 67 percent today from 38 percent in 2007. The 2001 Campaign Accountability Report was also updated. The reports were released at the Goodhue Camp on Staten Island, and the Mayor highlighted a promise he made to expand the Out-of-School Time system and increase the number of young people served. Since the 2005-2006 school year, the Out-of-School Time budget has increased from $47 million to $110.7 million, with enrollments increasing from 59,000 to a projected 75,000 students in the 2009-2010 school year.

The Bloomberg Administration is working to complete several proposals that are already making a substantial difference in the lives of New Yorkers, such as its ambitious goal of providing electronic medical records to 3,000 doctors. So far, more than 1,100 primary care providers serving 1 million patients are already using the system – an achievement that has made New York City a national leader in the field.For the current 2005 update, no promise remains undone.

The Campaign Accountability Report can be viewed at www.nyc.gov/campaignpromises. If a New York City resident wants to receive a paper copy of the database, he or she can email campaignpromises@cityhall.nyc.gov or call 311.

Event: Briefing - The Children's Health Fund

Location: CVC-Congressional Meeting Room South, U.S. Capitol -- July 15, 2009 11:30 am

Subject: The Children's Health Fund (CHF) will hold a briefing to explore how electronic health records and health information technology are integral to enhancing the concept of a "medical home" for children and their families.

Participants: CHF Co-Founder and President Irwin Redlener; National Coordinator for Health Information Technology David Blumenthal; and CHF Chief Information Officer Jeb Weisman