One CIO’s Journey In Selecting and Implementing an EMR

http://emr-journey.blogspot.com/

Follow the CIO of Children’s Hospital, Oakland, as he leads the selection and implementation of an EMR

SCRUM and AGILE Software Development Methodology

I’m hearing more and more about the use of SCRUM and Agile software development techniques in healthcare.

http://scrummethodology.com/scrum-user-stories/

Many of the NHIN components are being generated using these methodologies which depart from the past waterfall approach of long builds followed by testing and long deployment cycles.

In the SCRUM and AGILE Software Development Methodologies, small, quick builds are developed to the user for feedback and rapid iterative prototypes over time.

Software is build in SPRINTS with releases as quick as every couple of weeks.

Watch for future posts.

National Healthcare Information Technology Week

BRIEFING ANNOUNCEMENT

Health Care Information Technology Showcase and NHIN Presentation

When:
Thursday, September 24th, 10:00 am – 2:30 pm

Where:
Room 325 Russell Senate Office Building, Delaware and Constitution Ave., NE, Washington, DC 20510

RSVP:
Register now

Cost:
Complimentary for registered attendees

Please join us for our annual Capitol Hill “Steering Committee on Telehealth and Healthcare Informatics” Health Care Information Technology Showcase and NHIN Presentation on Capitol Hill, Thursday, September 24th, 10:00 am – 3:00 pm., Room 325 Russell Senate Office Building, Delaware and Constitution Ave., NE, Washington, DC .

On Monday the Senate unanimously renamed the beautiful and historic caucus room “The Kennedy Caucus Room”. The event is open to the public and will be widely attended.

There will be more than 30 interactive tabletop displays by government, industry and academia.

Lead Members of Congress including: Senators Kent Conrad (D-ND); Sheldon Whitehouse (D-RI); and Representatives Patrick Kennedy (D-RI); Allyson Y. Schwartz (D-PA); Tim Murphy (R-PA) and David Wu (D-OR) are anticipated to address an assembled audience at noon.

Jean-Philippe Linteau, Senior Trade Commissioner and Commercial Counselor of the Canadian Embassy will deliver remarks following the Members of Congress.

DHHS Deputy Assistant Secretary for Minority Health, Garth Graham, M.D. will be on hand to discuss the Health Information Technology for Underserved Populations (HIT-UP) initiative.

In addition, key federal agency officials including: Vish Sankaran, Program Director, Federal Health Architecture, Office of The National Coordinator for HIT; Jim Borland, Social Security Administration Special Advisor for Health IT; and Lieutenant Commander Steve Steffensen from TATRC; will lead a presentation of the National Health Information Network and CONNECT efforts.

Four projects being demonstrated are:

*Wounded Warrior: The Department of Defense, Department of Veterans Affairs, Indian Health Service and Social Security Administration will demonstrate the ability to share a soldier’s health record throughout the continuity of care as well as during the disability determination process.

*Biosurveillance: The CDC, state health organizations and other private entities will demonstrate ways mandated public health case reporting can be enhanced using NHIN-enabled health information exchange, yielding opportunities to blaze new trails regarding knowledge of infectious and chronic diseases as well as injuries, ultimately yielding an ability to reduce morbidity, mortality and healthcare costs.

*Long Term Disability Determination: The Social Security Administration and MedVirginia will demonstrate how access to electronic health records can dramatically speed the process of collecting the evidence required to make disability determinations.

*Cancer Research: The National Cancer Institute (NCI) will demonstrate how information can be exchanged using a caBIG(r) caGrid service and CONNECT to link research and care delivery – ultimately advancing research and supporting healthcare decisions.

Once again this year the HIT Technology Showcase will be integrated into the activities of “National HIT Week” September 21st – 25th.

The Thursday, September 24th program will also be webcast live courtesy of www.NextGenWeb.org and rebroadcast via www.Internet2.edu

The Technology Showcase schedule for September 24th is:

10:00 am – HIT Technology Showcase Opens to the Public 12:00 pm – Lunch remarks by Members of Congress & Federal Agency Leaders (Box Lunch Available) 12:30 pm – Demonstration of NHIN / Federal Health Architecture
1:00 pm – Tabletop Displays Resumes
3:00 pm – Showcase Closes

The session is part of a 2009 series of educational programs on behalf of the Capitol Hill “Steering Committee on Telehealth and Healthcare Informatics.”

The Steering Committee has convened more than 130 widely attended educational sessions and healthcare technology demonstrations since 1993 for Members of Congress, congressional staff, key federal agency officials, industry professionals and the general public.

In May of last year, the Healthcare Information Management Systems Society (HIMSS) Foundation launched the Washington-based “Institute for e-Health Policy” www.e-healthpolicy.org to provide educational and research opportunities for public and private sector stakeholders impacted by e-health policy decisions. The Institute is continuing operation and management of the Capitol Hill HIT briefing series.

*PLEASE NOTE: PER CONGRESSIONAL RULES, THIS EVENT IS CATEGORIZED AS A “WIDELY ATTENDED EVENT OPEN TO THE PUBLIC”. IF YOU’VE RECEIVED THIS ADVISORY FROM A COLLEAGUE RATHER THAN DIRECTLY FROM THE INSTITUTE FOR E-HEALTH POLICY, YOU CANNOT USE THE ONE-CLICK LINK ABOVE TO REGISTER FOR THIS BRIEFING. THAT LINK CAN BE USED ONLY BY THE PERSON WHO ORIGINALLY GOT THE ADVISORY FROM THE ALLIANCE.

If you have any problems or questions, please contact Wayne Humphries at (703) 562-8870 or e-mail us at info@ehealthpolicy.org.

Special Thanks to Our Early 2009 Sponsors

* Agency for Healthcare Research and Quality (AHRQ)
* Alaska Federal Healthcare Access Network (AFHAN)
* American Health Information Management Association (AHIMA)
* American Hospital Association (AHA)
* American Medical Informatics Association (AMIA)
* American Telemedicine Association (ATA)
* Army Telemedicine and Advanced Technology Research Center (TATRC)
* Association of Clinicians for the Underserved (ACU)
* AT&T, Inc.
* Blue Cross Blue Shield Association (BCBSA)
* Cisco Systems, Inc.
* College of Healthcare Information Management Executives (CHIME)
* Commonwealth Fund
* Continua Health Alliance
* eHealth Initiative (eHI)
* Harris Corporation
* Healthcare Information and Management Systems Society (HIMSS)
* Inland Northwest Health Services (INHS)
* INRange Systems, Inc.
* Institute of Electrical and Electronics Engineers (IEEE-USA)
* Internet Innovation Alliance (IIA)
* Internet2 Coalition
* National Library of Medicine (NLM)
* New York Presbyterian Hospitals
* Northrop Grumman
* Perot Systems
* RCHN Community Health Foundation
* RTI International
* Rural Health IT Corporation
* Science Applications International Corporation (SAIC)
* TriZetto
* Verizon Foundation

Honorary Steering Committee
Co-chairs are:

Senators
Kent Conrad (D-N.D.)
Mike Crapo (R-ID)
John Thune (R-S.D.)
Sheldon Whitehouse (D-RI)

Representatives
Eric Cantor (R-VA)
Rick Boucher (D-VA)
Bart Gordon (D-TN)
Allyson Y. Schwartz (D-PA)
David Wu (D-OR)

The Steering Committee coordinates many activities with the U.S. House of Representatives’ 21st Century Health Care Caucus, co-chaired by Reps. Tim Murphy (R-PA) and Patrick Kennedy (D-RI), and is supported by more than 20 major organizations in the healthcare and health information technology (HIT) communities, including trade associations, government agencies, universities and corporations.

Special thanks to NextGenWeb and Internet2 for recording and archiving webcasts of today’s program on their sites. An archived version of the webcast will also be available on the Institute’s web site .

The Congressional Luncheon Seminar Series is a project managed by the Institute for e-Health Policy, a subsidiary of the HIMSS Foundation, a not-for-profit corporation organized and operated exclusively for charitable, scientific or educational purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code of 1986. The goal of the Institute is to promote education and research within the Washington, D.C. metropolitan area for key decision-makers and other stakeholders.

Capitol Hill Steering Committee on Telehealth and Healthcare Informatics Institute for e-Health Policy | Neal Neuberger, CISSP, Executive Director 4300 Wilson Boulevard, Suite 250, Arlington, VA 22203 703-562-8870 | www.e-healthpolicy.org

Healthcare IT Effectivness

Dr. Bumenthal’s latest thoughts on the need for more research on the effectivness of healthcare IT. Unfortunately, its a catch 22. Many CEOs/CIOS won’t invest in healthcare IT until more solid ROI numbers are available; but until we place healthcare IT into production, its difficult to measure its impact on outcomes. Some effectiveness can be tested in the lab, and through Congressional Special Interest Projects and SBIRS overseen by U.S. Årmy TATRC and others.

http://www.fiercehealthit.com/story/blumenthal-more-research-needed-health-it-effectiveness/2009-09-21

EHR, EMR, PHR, PHMT, CPR, HIE, RHIO Confusion Reigns

Consumers and healthcare professionals remained confused about the meanings of healthcare information technology terms, despite HHS/ONC for Healthcare IT funding “official definitions” from the National Association for Healthcare IT.   It is important that all come to consensus on what is meant by the many healthcare information technology terms.

Standard definitions by the National Alliance for Health Information Technology (which recently ceased operations shortly after delivering its healthcare IT terminology report):

Electronic medical record: Information on a patient that can be created, gathered, managed and consulted by authorized clinicians and staff in one health care organization.

Electronic health record: Information on a patient that conforms to nationally recognized interoperability standards. It can be created, managed and consulted by authorized clinicians and staff across more than one group.

Personal health record: Information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources. It is controlled by the patient.

Health information exchange: Electronic movement of health information among organizations according to nationally recognized standards.

Health information organization: A body that oversees and governs the exchange of health information among organizations according to nationally recognized standards.

Regional health information organization: A body that brings together health care stakeholders within a defined geographic area and governs health information exchange among them to improve health and care.

See also http://healthit.hhs.gov/portal/server.pt?open=512&objID=1256&parentname=CommunityPage&parentid=8&mode=2&in_hi_userid=10741&cached=true

Back in 2005, Gartner defined the term EHR as the larger government led effort to consolidate all health information into a longitudinal health record.

Note that the Gartner Term, “Computerized Patient Record” (CPR) was not addressed by the HHS group.  Gartner defined CPRs as large hospital-based systems that integrate clinicals and financials.  Examples are Epic, Cerner, GE Centricity, Eclypsis, Meditech.  Gartner defined functionalites necessary for various generational levels of the CPR.

Other glossaries:

Personal Health Record (PHR) Confusion

Great article on confusion over the PHR Term. With the advent of the NHIN, HIE, Microsoft HealthVault, Google Health, and RelayHealth, along with traditional medical journals maintained by the patient. the PHR can mean many things to many people.

http://chilmarkresearch.com/2009/09/09/time-to-kill-the-phr-term-part-1/

http://chilmarkresearch.com/2009/09/10/time-to-kill-the-phr-term-part-2/

Nuance Dragon Naturally Speaking, Medical Demonstration with AHLTA, DOD Electronic Health Record

Demonstration of how clinicians can dictate into AHLTA, DOD’s Electronic Health Record, using Nuance Dragon Naturally Speaking, Medical, at the point of care to turn voice into text.

http://www.nuance.com/mhs/videos.asp

Nuance Dragon Naturally Speaking, Medical, can be used for front end speech recognition with just about any EHR, EMR, CPR, resulting in increased clinician satisfaction and increases in patient through-put in some cases.

Compare this with the early vision of the Electronic Health Record in this 1961 video:

http://www.youtube.com/watch?v=t-aiKlIc6uk

We are moving in the right direction, but it is taking a long time.

Its almost 2010, and many hospitals don’t even have the equivalent of the 1961 system!