EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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NIH Clinics Receive Stage 7 HIMSS Award for EHR Adoption

NIH Clinics Receive Stage 7 HIMSS Award for EHR Adoption | EHR and Health IT Consulting |

The National Institutes of Health (NIH) Clinical Centers has become the first federal healthcare clinic to receive a HIMSS Stage 7 Award, according to a public announcement Friday. The NIH clinics join a select group of healthcare facilities who have received this award for excellence in EHR adoption. Healthcare facilities qualify as HIMSS Stage 7 by transitioning completely from paper health records to EHRs.

The HIMSS Stage 7 Award signifies that the NIH clinics have reached the highest level of the Electronic Medical Record Adoption Model (EMRAM), a decade-old system for monitoring the effectiveness of EHRs for all HIMSS hospitals. The EMRAM operates on a scale of 0-7, 7 being the highest level. This year, only 3.7 percent of hospitals attained this ranking, proving just how prestigious this award is for NIH.

In order to receive this award, NIH had to go through rigorous examination. “The validation process to confirm a hospital has reached Stage 7 includes a site visit by an executive from HIMSS Analytics and former or current chief information officers to ensure an unbiased evaluation of the State 7 environments,” the organization stated.

According to an NIH press release, the clinic has been using electronic health records since the 1970s, but are being awarded for their most recent accomplishments in electronic health record use. These accomplishments include eradicating the use of all paper healthcare records, using electronic records for research to improve quality of care, and improving interoperability amongst their electronic medical record systems and those at other authorized healthcare centers.

HIMSS evaluated the NIH’s Clinical Research Information System (CRIS), the clinic’s fundamental software used for electronic medical records. Used by over 2,750 clinic staff members, CRIS is used in a variety of settings.

“NIH experts rely on CRIS to manage patient protocol information, write medical orders, retrieve laboratory results, documents progress notes and other aspects of medical care,” NIH says.

HIMSS says it was a clear choice awarding NIH with Stage 7.

“The NIH Clinical Center is a remarkable place doing remarkable things with its EHR for the patients they serve,” said John H. Daniels, CNM, FACHE, FHIMSS, CPHIMS, Global Vice President, Healthcare Advisory Services Group, HIMSS Analytics. “From automatically capturing discrete data on anomalies found in digital imaging to providing pharmacogenomics clinical decisions support to physicians, they are clearly a Stage 7 organization.”

The NIH Clinical Center is the research hospital for the National Institutes for Health. Using clinical research, the NIH clinics aim to improve treatments, which in turn should improve the national health. A branch of the Department of Health & Human Services (HHS), NIH is the nation’s primary source for clinical research.

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EHR Interoperability Stressed in DeSalvo’s Keynote Address

EHR Interoperability Stressed in DeSalvo’s Keynote Address | EHR and Health IT Consulting |

To conclude the 2015 HIMSS Annual Conference and Exhibition in Chicago that brought in 35,000 healthcare IT professionals, providers, and other key stakeholders, Dr. Karen B. DeSalvo, National Coordinator for Health IT, delivered a keynote address. EHR interoperability was a major topic of DeSalvo’s speech.

“It has been a great week here at HIMSS,” DeSalvo starts. “I’m so optimistic about the bright future that we have ahead to leverage health information technology and enable better health for everyone in this country.”

“Last year, I stood before you as a brand new National Coordinator and shared what I saw as the need to move our focus beyond adoption and focus on interoperability,” she said. “Unlocking the data can [put it] to many important uses demanded by consumers, hospitals, doctors, and others who are part of our learning health system. We’ve had a very busy year. We took the time to listen, to understand, and to shift our strategic focus to see that we can built upon the strong foundation that we all have built.”

“I personally had the chance to participate in or host two dozen listening sessions across the country. In those sessions, I was able to hear from people on the front lines about what matters most to them,” DeSalvo stated. “I became more and more optimistic as I heard how people are committed to see that we would leverage health IT to the advancement of everyone’s health.”

“In Alabama, adoption can still be a debate in some circles. They have challenges like lack of broadband access in rural communities. In New Jersey, the close proximity to other states and differing state privacy laws when crossing state lines has become an increasing challenge,” DeSalvo continued.

“In the Silicon Valley, the entrepreneurial community is moving past the notion of an electronic health record and is thinking about the next phase – the person-centered health records and the Internet. In places like Chicago and Minnesota, a history of collaboration showed me that when we let go of our own interests, communities move further when they work together instead of against each other and we can put priorities like the public’s health at the top of the agenda.”

DeSalvo also acknowledged her team who have attended HIMSS and spent time listening and discussing the challenges of EHR interoperability as well as the solutions that can improve nationwide data exchange.

“We [need to] continue the great progress and get to a place where every American has access to their electronic health information,” DeSalvo continued. “They, like me, remain steady and unwavering in that vision. Indeed, that was the vision more than a decade ago when President Bush signed an executive order and asked David Brailer to stand in the Office for the National Coordinator for Health Information Technology. In 2009, Congress codified the role and we carry out those responsibilities every day on behalf of the people in this country.”

“The flurry of work in the five years since the HITECH Act, through a set of grant programs, certification programs, the EHR Incentive Programs, has brought us all to a tipping point. Today we know that adoption is strong.”

“We have much work to do to digitize the care experience across the entire care continuum. We also have to see that we achieve true interoperability – not only exchange,” DeSalvo said. “What became clear quickly is that we need to develop a strategic approach that would leverage health IT beyond electronic health records using levers beyond meaningful use to bring not only better healthcare but better health.”

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Beacon Partners’ Bruce Eckert on the Proposed Stage 3 Rule for Meaningful Use—and Beyond

Beacon Partners’ Bruce Eckert on the Proposed Stage 3 Rule for Meaningful Use—and Beyond | EHR and Health IT Consulting |

Bruce Eckert, the national practice director at Beacon Partners Healthcare Management Consultants, leads the strategy, business intelligence, and meaningful use teams at the Weymouth, Mass.-based consulting firm, which recently merged with the New York-based KPMG.

In a meeting at the McCormick Place Convention Center in Chicago with HCI Editor-in-Chief Mark Hagland on Monday, April 13 during the HIMSS Conference, Eckert responded to Hagland’s questions about meaningful use and other issues facing the industry.

Asked about the proposed change to Stage 2 meaningful use requirements that would change the previous requirement that eligible providers get 5 percent of their patients to view, download, and transmit their health information to requiring that only one patient do so—with the anticipation that 25 percent of patients must then view, download and transmit under Stage 3, he admitted that he was as puzzled as everyone else seemed to be, and expressed the hope that federal officials at the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) would clarify that point soon.

Below are additional excerpts from their Monday interview.

What do you think of the Stage 3 proposed rule overall?

I like the structure, in that they're very compressed things down to 8 measures, and the menu sets are embedded in the measures. And they're collecting higher level data than before. So it's a nice framework. And we just did a HIMSS focus group around patient engagement. We had 12 people. Not universally but many are having challenges getting patients to use portals. Not so many problems with secure messaging, because the patients find value in it. So what the patients find value in, works well.

One of the challenges, it seems, continues to be timelines. Your thoughts?

Clearly in my mind, CMS is still trying to recover from the 2014 vendor certification debacle, with a lack of time to catch up. And they're setting up possibly the same timeline compression on the vendor side again coming into Stage 3. But I do think we've learned something from the 2014 CEHRT debacle. And perhaps this flexibility will help, because it might provide some breathing room for organizations.

You’ve just finished moderating a focus group with a diverse group of healthcare IT leaders. What kinds of concerns did they talk about?

They talked about things like appointment reminders, and push messaging for diagnostic results. And they didn't seem to think the patient education element in meaningful use would be difficult.

Overall, how did they perceive the challenges of Stage 3?

Most said it would be challenging, but doable, as long as they get the 2015 CEHRT in, in time. There's nothing really revolutionary in Stage 3, to be honest. And though it's not specifically on there, I think we'll see widespread adoption of PHRs, because a lot of the requirements wrap around that.

Who will manage the personal health record has long been a practical issue in the industry. Has that question been resolved?

Not entirely, but there will be third parties. And if you look at how HealthKit and HealthVault are architected, they really do give the patient the power. So I really do see third party vendors doing this. The issue would be whether they would be considered business associates under HIPAA. But if they add data in, the providers, then they would be covered. But I’ll predict that PHRs will be widely adopted under Stage 3. And I think we're approaching the end of the HIE [health information exchange] era. I attended the ONC's annual meeting in February. And they had a panel with all the former national coordinators together. And one of them said, the honest truth we have to face is that there's no business model for HIEs. That's evidence number one And look at the way meaningful is going. CMS is effectively supporting DIRECT protocols. I can see that whole infrastructure development—from regional HIEs to state HIEs to some anticipated nationwide infrastructure, simply not coming to fruition in the end. I think we're going to see the end of HIEs.

What should our audience be thinking about in the next few years?

Having more data, better data, and the ability to analyze data, will be key. Those organizations that manage and analyze data better will succeed, those that don't, won't. And we really moving in the direction of intensive data consumption, analytics, and management going forward, partly because of the impact of meaningful use.

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Lessons learned from an award-winning EHR system replacement | Healthcare IT News

Lessons learned from an award-winning EHR system replacement | Healthcare IT News | EHR and Health IT Consulting |
In 2012, ARcare undertook a fast-paced transition to a next-generation electronic health record system. Less than two years later, ARcare was nationally recognized, receiving HIMSS Analytics' Stage 7 Ambulatory Award, the highest HIMSS honor for EHR adoption.

[See also: Cleveland Clinic scores Stage 7 ambulatory award from HIMSS Analytics]

ARcare, a private, non-profit corporation providing primary care in rural Arkansas and Kentucky through a network of clinics, pharmacies and wellness centers, is the first Federally Qualified Health Center – and was one of only two ambulatory practices not connected with a hospital – to receive a Stage 7 ambulatory award.

On the way to a successful implementation, ARcare learned a great deal about the relationship between ongoing physician involvement and final clinical training – information that may help our peers who are moving forward with similarly ambitious systems replacements.
Managing change during the transition

ARcare’s system replacement involved moving from comparatively basic EHR use to a more comprehensive system with clinical event functionality that would enable us to better manage patient conditions across multiple care venues. A primary goal was to have the system drive orders and events rather than merely document clinical activity.

Migrating to next-generation technology across an enterprise requires significant IT resources, training, management support and workflow changes. Our strategy was to tie these elements together with a carefully constructed change-management plan, in which a highly experienced, multi-disciplinary team with C-level support facilitated all aspects of system adoption. The change-management team was tasked with creating a continuum of sustained change with a primary focus on improved patient care, stripping away governance of information silos. In this spirit of change management, each identified issue was relevant to the team – rather than individual roles – without regard to reporting structures.
The importance of keeping physicians in the change-management loop

Although ARcare achieved significant success in the arena of change management from an IT perspective, and within an aggressive timeframe, we also found in hindsight that keeping physicians in the loop throughout the transition can simplify clinical training during the final stages of implementation.

While ARcare actively sought input and buy-in from physicians on the front end of the transition, our sensitivity to the demands on physicians’ available time led us to remove most of them from the actual transition process, preserving involvement to a select few clinical staff members as physician representatives. While physicians remained involved to provide input to the new standardized workflows required by the new system, most of them had minimal exposure to the new system prior to clinical training.

[See also: Rip and Replace: Atlanta Thrasher Fans Feel Providers' Pain]

The scheduled training sessions involved the clinical staff who were part of the change-management team performing training duty: nurse practitioners training other nurse practitioners and physicians training other physicians. We had anticipated this to be one of the easier tasks of implementation, and hadn’t fully accounted for the learning needs of clinical staff.

Although our physician leadership group requested they be the trainers, it soon became apparent that many healthcare professionals are simply uncomfortable voicing the need for additional help, especially to their peers. We also learned that having select clinical staff involved in the overall process didn’t necessarily translate directly to building teaching skills; the ability to understand complex technology and to teach its use are quite different. We decided to revisit training with the assistance of our own KMS – knowledge management systems – education team.
Getting clinical training back on track

Together with the KMS education team and led by four top instructors, we created a new, three-day program that integrated training for physicians, nurses and physician assistants.

Working in small groups, clinical staff participated in the training program, which was rolled out across facilities in series. Feedback gathered at the end of each training session helped to improve each subsequent session. Satisfaction increased quickly and steadily, and ARcare has continued to provide training updates on a regular basis to ensure continued optimal performance.
Well worth the effort

Five months after going live with our new system, ARcare became the first ambulatory practice that was not part of a hospital to achieve Stage 6 on the HIMSS Analytics EMR Adoption Model. One year later, we became the first FQHC to achieve the highest level of EHR usage, Stage 7.

The overall experience helped the organization recognize and develop an appreciation for the fact that change can and should be a positive experience. ARcare has developed a level of confidence across the organization where employees are less reluctant or fearful of change, and where learning from failure produced valuable outcome – not just in successful training, but in the successful adoption of a new Greenway Health EHR that brought with it substantial benefits, including:

Improved patient management with better information access for providers and clinical event management that drives events and orders, computerized provider order entry and closed-loop medication administration, and other advanced functions that improve patient care
The ability to exchange data directly with the state health department
Streamlined access to patient records across the network of primary care clinics, dental clinics, pharmacies and wellness centers

During the transition to the new system, ARcare successfully converted more than 17.2 million records, including clinical notes, images and test results. Now, when ARcare identifies and secures a new clinic site, the new site can be completely operational from an IT perspective in 30 days or less thanks to advanced system capabilities for scalability and extremely fast implementations. As of today, the system provides paperless charting and order entry for 37 ARcare clinics.

In all, it’s been a very satisfying transition in which the gains were well worth the pain – pain that can be avoided by following the lessons learned in ARcare’s approach and re-working of clinical training. In short: It’s all about identifying an effective training team.
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Do Meaningful Use Requirements Need the 5% Objective Back?

Do Meaningful Use Requirements Need the 5% Objective Back? | EHR and Health IT Consulting |

Ever since the proposed modifications to Stage 2 Meaningful Use requirements were announced, a wide variety of opinions and objections surfaced throughout the healthcare industry. For instance, patient engagement advocates are calling for a Data Independence Day. Other medical societies are sending forward their comments about both the proposed Stage 3 Meaningful Use requirements as well as the potential modifications to Stage 2.

HIMSS is one organization that supports some aspects that the Centers for Medicare & Medicaid Services (CMS) is pushing forward in the latest proposals for Stage 3 Meaningful Use requirements. For instance, reducing redundant reporting is very beneficial for the healthcare industry, according to a letter HIMSS representatives sent forward to CMS.

For example, HIMSS is supportive of the new 2015 Stage 2 Meaningful Use change to a 90-day reporting period. However, HIMSS is also looking to encourage CMS to develop a phased-in approach to meeting the Patient Electronic Access objectives under meaningful use requirements.

“HIMSS recommends a balanced approach for meeting this objective that recognizes the challenges that some providers are encountering as they try to get their patient population more engaged on viewing, downloading, or transmitting their information to a third party,” the letter stated. “As a part of this approach, given the tight timeline between the publication of this Final Rule and the end of calendar year 2015, CMS could leave the proposed measures in place for 2015, and then phase-in increased threshold requirements for 2016 and 2017, increasing each 1%, 2% to 3% per year to propel the field forward... Overall, HIMSS believes a phased-in approach for the patient electronic access objective to be an appropriate and balanced step forward.”

The Consumer Partnership for eHealth (CPeH), the Consumer-Purchaser Alliance (C-P Alliance), and other organizations sent a letter to CMS expressing their concern over a specific modification on patient engagement objectives under Stage 2 Meaningful Use requirements. Now that CMS intends to only have one patient view, download, and transmit their information under Stage 2 Meaningful Use, many organizations are pushing for bringing back the prior 5 percent requirement.

“CPeH, C-P Alliance, and the undersigned organizations and individuals are dismayed that CMS intends no longer to require that five percent of patients1 view, download or transmit their health information or send a secure message to their providers,” The letter from the Consumer Partnership for eHealth states. “Instead, CMS proposes that doctors and hospitals merely show that just one patient used online access to their health information, and that secure messaging was merely turned on, not whether any patient has actually used it. We are deeply disappointed in CMS’s reversal of these essential commitments to patient and family engagement.”

Healthcare providers should be able to meet the 5 percent requirement and better engage patients with their medical information, according to the letter. Additionally, prior analysis shows that this should be achievable, which is why the new CMS modification is causing such an uproar in the medical community. Research shows that more than half of patients want to be able to email their healthcare provider, which is why the secure messaging aspect of a patient portal should increase patient engagement if properly leveraged. CMS would be wise to take these comments under advisement as they continue to develop meaningful use requirements.

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Baystate Health's CIO on the Key to Solving Healthcare's Challenges

Baystate Health's CIO on the Key to Solving Healthcare's Challenges | EHR and Health IT Consulting |

At the Healthcare Information and Management Systems Society (HIMSS) conference this year, the buzz throughout the halls of McCormick Place Convention Center in Chicago has been largely around population health, analytics, health information exchange (HIE), and patient engagement. But according to Joel Vengco, vice president and CIO at the Springfield, Mass.-based Baystate Health, many healthcare leaders are forgetting a core piece to the puzzle—access to data.

Vengco has provided the vision, plan, and execution behind the December 2014 launch of the Springfield-based TechSpring Innovation Center, a collaborative initiative that will match private enterprises with partners from Baystate to take on some of healthcare’s most difficult challenges. Vengco says that TechSpring offers partners flexible space to work and the ability to collaborate directly with care providers from Baystate Health on their projects, assessing providers' needs and creating solutions to address those needs. On April 13 at HIMSS15, Vengco sat down with HCI Associate Editor Rajiv Leventhal to talk about this project, as well as what's further needed for the healthcare industry to meet its growing challenges. Below are excerpts of that interview.
HCI: Tell me more about the idea behind and goals of TechSpring. 
Vengco: We want to crowdsource innovation. There are so many problems in healthcare as a result of this new focus on value-based care. Don't get me wrong, these are good problems, but with them comes lots of challenges, and you need a lot solutions to address those issues. The vendor market today does not have all the answers, so TechSpring is an invitation for the globe to partner with health systems like Baystate Health to utilize assets including data, experts, the environment and clinical organizations, and bring solutions that we absolutely need in healthcare today. In today's environment, failing fast is a good thing. Inventing quickly and winning big is a capability that our systems have provided to us. So TechSpring is focused on bringing those solutions to market. 
What kind of solutions? 
Solutions beyond the electronic health record (EHR)—features and functions that are needed for caregivers that can take their  work and engagement to another level. Take a look at other industries that focus on consumer services, and think about how we can deliver solutions to our patients to enable us to engage with them. Consumer-based products such as Uber and OpenTable are examples of what we can address and achieve today in healthcare.  
The other part of this is around patient engagement and mobile apps. It's about turning hospitals and care delivery into the experience of the future; no longer are the four walls of buildings the way you should deliver care. How do we invite other industries to help us develop capabilities that consumers use to engage with us frequently? And of course, analytics is a big deal too. I don't believe that we have solved the big data issues, so let's bring in vendors and start-ups from this industry and others to utilize the data for these kinds of models. People from other industries can say, "Hey I've done this in the financial sector and it's worked." 
Can this kind of idea be the gateway to an open healthcare ecosystem?
Absolutely. It's a way to liberate the data, and a platform for innovators to develop solutions to create an ecosystem of capabilities and solutions for providers and patients to access. One of the things that's the focus is to fail fast and win big. Part of what we want for innovators to understand is when you come in to TechSpring, it's up to you to solve some of these challenges, in the way we believe we can solve them. It's okay to fail. Healthcare software in the past has been plagued with the idea that everything is part of a larger system, and that's an issue when you want to make everything so perfect. The life cycle becomes a multi-year journey. You can get to solutions in sprints as well. 
There's a huge issue to getting access to data from sourced systems, such as legacy EHR systems. Having access to data is paramount to getting to population health, analytics, and new care delivery models. We often forget about that core piece of the puzzle. TechSpring is pushing different ways to get there, via FHIR (fast healthcare interoperability resources) standards, and asking our vendors to move with application program interfaces (APIs). All of these pieces are critical for us. 
The feds have certainly put great pressure on vendors, though. Is that why they try to be so "perfect?"
You're right. Innovation has been stifled because of mandates that have have forced people to put resources into addressing problems such as EHR certifications and meaningful use, and not other challenges in healthcare. Even more relevant is to have the ability to crowdsource innovation. These larger vendors should feel compelled to grow inorganically to partner with these other innovators that are coming up with solutions.
Vendors are reluctant to open up their databases, as they want to be the solution provider for everything, though that's not possible. So many commercial vendors and start-ups are out there that can deliver solutions. There was a study a few years ago on the impact that holding onto data has on healthcare. They found that if data was open for innovators to get access to, it would be a $40 billion industry. There is lots of innovation still to be done. 
You presented yesterday during HIMSS' HIE Symposium. How is this lack of data liberation affecting data exchange?
We started a regional HIE, Pioneer Valley Information Exchange (PVIX), in western Massachusetts, and the single biggest issue right now by far is the cost of creating the connection from the EHR to the HIE. EHR vendor costs are inhibiting members to joining—smaller practices are finding the costs outrageous. The problem isn't the technology, it's that the up-front costs and transaction fees from EHR vendors makes interoperability expensive. I would say interoperability should be free.
Legislation won't change it. The feds won't develop legislation to force vendors to open their data, nor should they. But they can do different things to put pressure on vendors such as pushing open APIs, and pushing ways to access this data, perhaps through certification measures and through meaningful use. 
So you would say the biggest challenge in healthcare is...?
Access to that data is the single biggest challenge. There are cultural challenges as well, as sharing data with competitive organizations is still something that providers don't like. It comes back to the idea that we shouldn't be competing with the data, but instead what we should do with the data. Vendors should start to create larger alliances, and by that I don't mean just CommonWell with 60 percent of the patient population. It should be CommonWell plus Epic plus everyone else, so you have 100 percent of the population. But Epic may not ever agree to that, they may believe that their 40 percent share will continue to grow and be interoperable. But having data available will create more opportunities for patients and providers. 
So the "buzz" at HIMSS will focus a lot on patient engagement, and vehicles to engage patients like mobility. There will also be analytics buzz. Those two pieces bring you to population health management. However, what I'm really focused on is how these vendors and how these innovators are going to help us get access to the data. I'll be speaking with many of our vendors and partners to move the needle on data liberation. That is most important thing in healthcare today. We aren't there yet with the data, and that's the biggest issue for us.

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The HIMSS Analytics Stage 7 Ambulatory Award honors ambulatory facilities operating in a paperless environment and representing best practices in implementing EHR

The HIMSS Analytics Stage 7 Ambulatory Award honors ambulatory facilities operating in a paperless environment and representing best practices in implementing EHR | EHR and Health IT Consulting |

HIMSS Analytics awarded Springhill Medical Center (SMC), in Mobile Ala., with its Stage 7 Ambulatory Award. The award represents Springhill Medical Center’s attainment of the highest level on the Electronic Medical Record Adoption Model™ (EMRAM) for both its hospital and physician practices.

Developed in 2011, the EMR Ambulatory Adoption Model provides a methodology for evaluating the progress and impact of electronic medical record systems for ambulatory facilities owned by hospitals in the HIMSS Analytics™ Database. Stage 7 represents the highest level of EMR adoption and indicates a health system’s advanced electronic patient record environment.
During the fourth quarter of 2014, only 6.21 percent of the more than 30,000  U.S. ambulatory clinics in the HIMSS Analytics® Database received the Stage 7 Ambulatory Award.
“To be designated a Stage 7 provider is validation of our continued successes in improving patient outcomes, participation, physician integration and financial performance. In doing so, I am reminded of a statement by our founder, the late Dr. Gerald L. Wallace, made while speaking of his vision to be uncommon. ‘As a hospital founder, to accept challenge, anticipate, and then answer the needs. We at Springhill Memorial Hospital will rewrite the traditional and make the most advanced a common occurrence. To build a medical center second to none.’ SMC has pursued this mission since its founding.  Achieving Stage 7 designation is testament to our fulfilling Dr. Wallace’s dream.

Springhill Medical Center is a 252-bed acute care hospital accredited by  the Joint Commission. Since 1975, Springhill has grown and expanded its services in the southwest Alabama market. The medical center provides full surgical capabilities including open-heart and robotic surgery, as well as complete diagnostic capabilities. Today, SMC includes the hospital, a unique and comprehensive heart center, senior residence, sleep medicine center, cancer center, athletic club, orthopedic surgery center, wound care and hyperbaric center, and an emergency department.
“Springhill Medical Center is an extremely paperless environment; there are no charts on the nursing units. The only residual paper is monitoring strips for cardiology and obstetrics. This is an excellent example of an enterprise deployment that is deeply embedded into their culture resulting in uniform usage,” said John P. Hoyt, FACHE, FHIMSS, executive vice president, HIMSS Analytics. “Report writing and systems background monitoring of processes are well supported by scripting tools that judiciously warn physicians without “pop-up overload.”
Springhill Medical Center will be recognized at the 2015 Annual HIMSS Conference & Exhibition on April 12-16, 2015, in Chicago, Ill.

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Employee sacked after snooping patient EMR records | Healthcare IT News

Employee sacked after snooping patient EMR records | Healthcare IT News | EHR and Health IT Consulting |

Your organization can have the most well-crafted privacy and security policies in the world. But if those policies are accompanied by lukewarm emphasis and no accountability, or your staff just downright ignores them, you have a big security problem – just like the folks at one Ohio-based health system did last week. 

Cleveland-based University Hospitals on Friday notified nearly 700 patients of a HIPAA privacy breach after one of its employees was caught snooping on confidential medical records. What's more is the employee was able to inappropriately access patient medical and financial records for nearly three and a half years without UH knowing. 

UH had received a complaint over the employee's inappropriate access to the health system's electronic medical record system, and only after the allegation did UH audit the user's EMR access, according to a UH spokesperson. On Oct. 2, health system officials discovered the staff member had been snooping into the EMRs of 692 patients from January 2011 through June 2014. 

The staff member, whose employment has since been terminated, was able to gain unfettered access to patient names, medical diagnoses, health insurance numbers, dates of birth, home addresses and additional treatment data. Other patients had their Social Security numbers, financial data, credit card numbers and driver's license numbers viewed. 

"UH takes the protection of patient health information very seriously," wrote UH officials in a Nov. 28 press release. "UH continually evaluates and modifies its practices to enhance the security and privacy of its patients' information, including the ongoing training, education and counseling of its workforce regarding patient privacy matters."

The biggest way to avoid the employee snooping problem? Audit your users and the data, said Suzanne Widup, senior analyst on the Verizon RISK team, who spoke to Healthcare IT News this spring regarding Verizon's annual breach report. "You need to know who has the data, who has access to the data, and you need to monitor it," said Widup. "When you see organizations implement some sort of auditing scheme, suddenly they start finding a lot of stuff they couldn't see before."

It's cases like what transpired at UH, where the action comes down to an individual employee, that have many healthcare security officials on edge.

"The biggest risk, as much as we talk about the hackers and people trying to get in and steal healthcare data, I think the biggest risk is still the individual employee who maybe forgot what the policy was and does something they shouldn't do," said Texas Health Resources Chief Information Officer Ed Marx, in an interview with Healthcare IT News this summer. 

Indeed, Marx is in good company. According to a HIMSS security survey released earlier this year, a whopping 80 percent of healthcare IT security professionals identified snooping on personal patient information by employees to be the top threat motivator for breaches. 

More than 41.4 million people have had their protected health information compromised in a reportable HIPAA privacy or security breach, according to data from the Department of Health and Human Services.

Laurie Bolick Wolf's curator insight, June 17, 2015 2:24 PM

This article addresses the issue of breech of confidential information within a patient record using electronic medical records.  Accessing patient's records is much easier with EMR.  Previously, with a paper chart there was only access to information from that visit contained within the record.  With EMR, all information is accessible.  This includes financial and private data.  The potential for a patient to have his or her personal information obtained is huge.  I believe it is the responsibility of the health care provider to monitor the use of this information by their employees to ensure proper use.