Elsevier, a provider of scientific, technical and medical information products and services, announced today the availability of SimChart, an educational simulated electronic health record system designed for nursing students.

SimChart covers the core areas of nursing including medical surgical, pediatrics, women’s health, and psychiatric, combining practical, real-world experience in electronic documentation with integrated educator support to incorporate EHR practice into a nursing education curriculum. Fully web-based and built using Elsevier’s world-class clinical content, SimChart comes equipped with several real-life cases that allow students and educators to incorporate electronic documentation into the classroom, simulation center, skills lab, and clinical setting. Users are able to practice in a safe, monitored environment before they practice on real patients, and can also customize their content by adding additional cases into the system. The dynamic interface prepares students to chart on any system they may encounter in a practice or clinical setting.

“Using SimChart in the lab makes simulation and lab experiences much more realistic and allows students to become familiar with the process of finding information and documenting care in an EHR, resulting in more effective use of time on the clinical unit,” said Deborah Bambini, PhD,WHNP-BC, CNE, Associate Professor, Kirkhof College of Nursing, Grand Valley State University. “It is also very helpful that students can log their clinical experiences and build a portfolio for future employers.”

Additionally, SimChart offers the following distinctive features:

• Comprehensive instructor support by Elsevier – including training,  an implementation manual, and educator-oriented webinars and videos;
• Educational tools which bolster the care planning and patient teaching skills of students;
• Evaluation features which allow instructors to assess and grade students’ documentation and generate reports;
• Clinical Decision Support via direct access to Elsevier resources such as Mosby’s Nursing Consult Student Edition, which includes content from 20 leading nursing and medical texts, and Elsevier CPM Resource Center’s CPMGuidelines™, which deliver concise evidence-based information to interprofessional clinicians so that they may perform their specific professional responsibilities as effectively as possible.

“Healthcare organizations have very few resources to train nurses on electronic documentation, because most lack time or money to invest in these solutions,” said Susan Sportsman, PhD, RN, ANEF, Director, Academic Consulting Group, Elsevier. “Nursing professionals also find it difficult to learn electronic documentation on the job, while caring for patients. With SimChart, nursing students will be able to learn and understand this skill prior to getting jobs in clinical settings.”

Merge Healthcare has announced that Southern Illinois Healthcare, will implement Merge’s entire cardiology solution suite across its system of six hospitals and healthcare clinics to create an integrated and enterprise-wide imaging platform.

“Southern Illinois Healthcare represents the type of organization we like to partner with,” said Jeff Surges, CEO, Merge Healthcare. “One of their main goals is to deliver a complete, patient-centric EHR, and they know that to do so, it must include images. In addition, they need to provide physicians with access to those images anywhere, any time. They turned to Merge because we were the only partner able to provide a solution that solved that challenge.”

“Our challenge was that we were not consistent across our products; we had a piece meal approach that made workflow difficult for our physicians,” said Dave Holland, Vice President and CIO of Southern Illinois Healthcare. ”It’s our job to provide our physicians with the tools required to provide care, and those tools must increase efficiency. Now, with the integrated Merge Cardio solution all of the information our physicians need about a patient is right at their fingertips. It’s this type of healthcare technology automation that is driving efficiency into our processes and helping us provide better care.”

Southern Illinois Healthcare will implement the full portfolio of Merge cardiology solutions, including Merge Cardio, an enterprise-level image and information system that manages digital images and clinical tools such as web-based physician reporting; Merge Hemo, a catheterization laboratory knowledge tool, ranked #1 by KLAS, that integrates complete functionality for data collection, analysis and reporting; and Merge iConnect VNA, a vendor-neutral archive that consolidates images from disparate PACS, specialties and sites for a consolidated patient view that allows physicians to access current and historical images at the point of care.

Please allow me to start out by stating the obvious:  EHR Products are sold by companies that hope to make a profit selling and supporting those products.    Now for something less obvious – with hundreds of companies selling and supporting EHR software products it’s inevitable that some will not be successful.

Some of the less successful products will be sold, with the responsibility of supporting the customers of those products moving to the acquiring company as well.  Heck – some products that do extremely well will be sold to larger companies that want to get into or enlarge their position in the EHR market.

If you’re using a product and are notified that it has been sold it’s a good idea to pay attention.  The change of ownership could have a significant impact on your practice.

Most software products that change hands take one of four possible paths:

1.  The product is being sold to a larger, more successful company that loves the technology.  They will keep the existing support and development staff on board, and the company will spend significant resources continuing to improve the product.  This is the best possible scenario for the users.

2.  The product is being sold to a company that wants to add sales revenue by acquiring products with existing customer bases and recurring sales revenue.  In this situation many of the people you’ve been dealing with will stay with the new company – at least for a while and the product will continue to be supported, though it might not be improved much going forward.

3.  The product is being acquired by a company that wants to either eliminate a competitor or to buy a user base that they can transition to one of their existing products.    This is the worst possible scenario for the user.  One way or another they’re going to need to switch products and at this stage in the product life cycle that’s not an easy thing to do.

4.  The product is acquired by a company that loves the technology with the intent of doing great things with it, but then things change.  There may be a strategic change of direction or they may just realize they had made a mistake.  Rather than continuing to enhance or even continue on with the product they may try and sell it to another vendor, or they may simply discontinue the product and try and keep the users as happy as possible while doing so.

An example of a product being acquired and then discontinued is playing out right now with GE and their Web-based ambulatory GE Centricity Advance product.  According to an Information Week article GE has sent out letters to their “couple hundred” physician practices letting them know that the product is being discontinued and will no longer be supported after June 30th.

Centricity Advance was originally named MedPlexus and GE acquired it in March of 2010.   When the acquisition was announced by GE Healthcare the following language was used to describe the transaction:

The company will use the acquisition to strengthen its presence in the independent physician office market.

The addition of MedPlexus products will also give GE Healthcare customers the option of buying physician practice management solutions and EHR systems through a “software as a service” platform, which deploys software for use over the Internet.

Twenty-three months later they’ve released a written statement saying that “Our decision to terminate the Centricity Advance product line will enable GE Healthcare to focus our efforts on a single ambulatory EMR/PM platform, which means we can deliver new innovations– like mobility and clinical depth — to our customers more quickly.”

Whatever the reason, and I’m sure their reasons are sound, there are a number of users who will need to migrate data to new systems.  According to the Information Week article GE will help the customers with this migration to either Centricity Practice Solution or a competing EHR product.    It’s great that they’re offering to migrate the data but it will be painful for those practices that believed in the company and the product they licensed.

I’ve been in the software business most of my adult life and this is the nature of the business.  Products are developed, enhanced, sold and very often discontinued.  Keep this in mind when you’re negotiating the license for whatever product you decide upon.  The license agreement spells your rights in these situations.  If you don’t understand the licensing process get help from someone with specific experience in healthcare technology licensing.   As with all major purchasing decisions caveat emptor.

 Related articles

• GE Discontinues Centricity Advance EHR for Small Practices (ducknetweb.blogspot.com)
• GE To Fold Web-Based EHR (informationweek.com)

HIMSS Analytics announced that Moanalua Medical Center, a Kaiser Permanente hospital in Honolulu, Hawaii, has received its Stage 7 Award. The award represents attainment of the highest level on the Electronic Medical Records Adoption Model (EMRAM), which is used to track EMR progress at hospitals and health systems.

HIMSS Analytics developed the EMR Adoption Model in 2005 as a methodology for evaluating the progress and impact of electronic medical record systems for hospitals in the HIMSS Analytics™ Database. There are eight stages (0-7) that measure a hospital’s implementation and utilization of information technology applications. The final stage, Stage 7, represents an advanced patient record environment. 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 Stage 7 environments.

The hospital will be recognized at the 2012 Annual HIMSS Conference & Exhibition on Feb. 21-24, 2012, in Las Vegas. As of December 2011, Moanalua Medical Center is the first hospital in the state of Hawaii, and one of only 65 U.S. facilities, or 1.2 percent, of the more than 5,000 U.S. hospitals in the HIMSS Analytics Database, to be awarded the HIMSS Analytics Stage 7 Award.

“Being the first and only hospital in Hawaii to achieve the highest level of recognition by HIMSS Analytics for our electronic medical records model is a testament to our physicians and staff at our Moanalua Medical Center and their dedication to providing the highest quality and safest care to our patients,” said Brian Yoshii, Kaiser Permanente’s Vice President, Information Technology. “Kaiser Permanente has been investing in interactive online systems to enhance service and convenience for our members for more than a decade. With one of the most robust and sophisticated EMR systems available anywhere, our patients benefit from proactive prevention measures and the coordination of care between our physicians.”

Kaiser Permanente’s web site – KP.org – embraces two fully integrated secure systems: My Health Manager for member access and HealthConnect™ for internal management of members’ records. The two features provide members with the convenience of e-mailing their personal physician, accessing lab results, prescription refills and appointment scheduling.

In addition, the general public is encouraged to access health care information, hundreds of recipes, podcasts, health-related videos, interactive health tools and more through this paperless system. Kaiser Permanente is the exclusive provider of HealthConnect™, improving prevention and the coordination of care for members and enhancing the way physicians work together.

Through HealthConnect™ every entry in a member’s record is securely integrated into a single EMR that is accessible to the entire network of more than 450 physicians and thousands of clinical support staff. Specialists no longer have to wait for the delivery of paper-based records and test results, and under appropriate patient confidentiality safeguards, secure EMR allow health care providers in different locations to collaborate and coordinate care for their patients based on current, comprehensive clinical information. Reduced paperwork not only speeds access to care, but improves patient safety by eliminating the need for caregivers and pharmacists to decipher handwritten information on charts and prescriptions.

“Moanalua Medical Center has a superb disaster recovery and business continuity plan, one very well thought out and explained (during our discussions). This is a very open group who demonstrated that they listen to the users’ needs and make adjustments accordingly to improve and enhance use of their health IT systems, “ said John P. Hoyt, FACHE, FHIMSS, Executive Vice President, HIMSS Analytics. “The hospital’s CPOE and bar-coded medication administration all show superb acceptance and use by clinicians, as noted in the usage percentages.”

 Ambir Technology, a provider of digital image capture solutions, has announced a hardware and software partnership with SOAPware, Inc., a market leader in electronic medical record software. The two are confident the union of their product lines brings comprehensive digital document management solutions to customers in the healthcare industry.

“Our customers are looking for an easy, secure way to scan into our EMR software through terminal services. Ambir’s innovative document management products provide a cost-effective solution for the healthcare industry,” said Daniel Cox, director of business development at SOAPware. “Ambir products are designed with a small footprint, which fits well on a front desk, and they boast time-tested reliability and unparalleled sales and support service.”

SOAPware recommends several Ambir scanners for use in conjunction with their EMR and practice management software, including the Ambir ImageScan 820i, a high-speed, automatic-feeding duplex scanner that accommodates full-sized documents and ID cards. They also recommend that customers utilizing SOAPware’s hosted solution implement ScanLink® PRO, a new Ambir software program that facilitates network scanning, connecting all office workstations to a secure centralized server.

“SOAPware healthcare IT solutions dramatically increase the efficiency of their customers’ practices by putting relevant medical information in doctors’ hands quickly,” said Mike O’Leary, CEO of Ambir Technology. “With our high-quality scanners and integration software, we’re excited to give them a secure, streamlined admittance process and an easy way to organize and access their records, as well.”

By the end of 2011, over 10,000 New York State healthcare providers had enrolled into a federally subsidized program that will help them transition from paper to electronic medical records, continuing the effort to improve the quality and coordination of care for all patients across the state. Federal and state data has long shown that health information technologies measurably improve healthcare and reduce its cost.

Called Regional Extension Centers (RECs), the program instructs doctors and nurses how to implement EMRs and teaches them how to achieve the federally defined “Meaningful Use” of them, which qualifies them for reimbursements. The program supports mainly primary care providers and small practices, who often struggle with the transition.

New York has two entities that administer REC programs throughout the state. The New York City Health Department, through its NYC REACH program, covers the five boroughs. The New York eHealth Collaborative (NYeC), a federally designated public private partnership, oversees the rest of the state including Long Island. Both entities created individualized programs while working closely together on shared goals. By the end of 2011, the REC programs combined had enrolled well over 10,000 providers, with each REC meeting its goal (NYeC goal: 5,107; NYC REACH goal: 4,543).

“10,000 is a big number and we’re proud to have worked closely with our partners at NYC REACH to achieve it.  Of course enrollment is just the first step and now we are focused on helping all of these providers reach the Meaningful Use of these technologies.  That’s what will really help providers and their patients,” said Paul Wilder, director of the NYeC REC.

“In New York City, we’ve seen how health IT can help doctors. EMRs let them see which patients are falling through gaps in our health system and help practices set priorities to improve population health,” said Jesse Singer, DO, Assistant Commissioner at the NYC Health Department. “We are excited to help more doctors understand how to use data to improve the lives of their patients.”

“As a physician in a small practice I can say I greatly appreciate what the NYeC REC has done for us,” noted Eugene Heslin, MD, owner of Bridge Street Family Medicine in Saugerties, NY. Dr. Heslin is also on the NYeC board of directors. “I’m excited to say that all five physicians in our practice have just attested to Meaningful Use.”

“Our practice made the decision to become a member of the REC in 2010.  Although we had successfully integrated EMR in 2006, as a busy OB-GYN practice, we realized that any resource we could tap to expedite achieving Meaningful Use would be a wonderful time management tool and stress reducer,” said Louise West, Practice Administrator at Myrtle Street Obstetrics & Gynecology, PC in Saratoga Springs, NY.  ”In March of 2011 our practice was among the first in New York State to achieve Meaningful Use.  I would recommend membership to any practice wishing to achieve Meaningful Use, regardless of their current EMR status.”

“I am proud to be working closely with the extension center,” said Sumir Sahgal, MD, of Essen Medical Associates in the South Bronx. The practice has been working with the NYC Health Department during every step of EMR adoption, and now delivers state-of-the-art care to patients in one of the most underserved areas in the state.  ”With more and more organizations adopting EMRs, I am looking forward to even more connectivity and having a full picture of my patients’ health at my fingertips.”

The New York eHealth Collaborative (NYeC) receives funding from state and federal grants to serve as the focal point for health IT in the state of New York. NYeC works to develop policies and standards, to assist healthcare providers in making the shift to electronic health records, and to coordinate the creation of a network to connect healthcare providers statewide. The goal of NYeC is that no patient, wherever they may need treatment within the state of New York, is ever without fast, secure, accurate, and accessible information. To learn more, visit www.nyehealth.org.

NYC REACH is the federally designated Health IT Regional Extension Center for New York City, charged with assisting physicians as they adopt and use health IT. A collaboration between the NYC Health Department’s Primary Care Information Project and the Fund for Public Health in New York, NYC REACH supports physicians to practice medicine that emphasizes chronic disease prevention and management using information from EMRs. NYC REACH works closely with physicians to help them navigate the complicated world of healthcare technology.

SOURCE  New York eHealth Collaborative

It’s one thing to read the news stories about obesity in the United States.  But, if reading the statistics is starling, then seeing the increase in obesity rates in video format is even more alarming.

Technology holds great promise as a tool in our battle to hold down the increasing cost of healthcare in this country, but there is no amount of technology savings that can overcome the increased costs we’ll face if more than 30% of Americans remain obese.

According to the Health Information Exchange Study: Assessing the Interest and Value in HIE Participation, conducted by healthcare management consulting firm Beacon Partners, many healthcare executive respondents recognize the benefits of participating in an HIE, but lack an HIE budget. Nearly 70% of respondents are currently planning for an HIE, despite their perceptions of high start-up costs and other governance issues.

More than 200 healthcare C-suite executives responded to this study, with more than half of the respondents being CIOs. Also, most respondents (58%) were from community hospitals, the largest segment of the hospital industry, according to the American Hospital Association.

“HIEs are top of mind for many healthcare organizations, and this study demonstrates their concerns and overall opinions,” says Kevin Burchill, director at Beacon Partners. “We’ve seen and heard first hand that healthcare executives know the importance and benefits of an HIE, but this study confirms their concerns over the lack of a budget — mostly due to high start-up costs and insufficient capital.”

In fact, 41% of respondents consider high start-up costs and insufficient capital to support HIEs as their top concerns.

Other significant findings include:

• 64% of respondents named the CIO as the person responsible for HIE development, while governance considerations for HIEs and potential connecting “partners” are the responsibility of others in the C-suite leadership group.
• Approximately half of respondents have not yet created a department, oversight group or executive role to handle the HIE initiative.
• 38% of respondents have annual budgets for HIE development of less than $1 million, while 21% have NO budget.
• 66% of respondents see HIEs as a positive move for their organization and 42% also believe HIEs will improve patient outcomes (and not one respondent felt it would have a negative effect on patient outcomes).
• Other HIE components that respondents felt would have a positive impact on their organization: Primary care connectivity (88%), Continuum-of-care (84%), Clinical quality reporting (74%), Patient accessibility (67%), Interoperable IT systems (66%) and Medical staff alignment efforts (59%).

The executive summary can be downloaded at this  link.

The Centers for Medicare and Medicaid Services (CMS) have announced that the number of physicians and hospitals to have registered for the Medicare or Medicaid electronic health record incentive program has increased to over 176,000 through the end of 2012.  Total incentive payments issued during the year exceeded $2.5 billion.

According to a report available on the CMS website there were 124,089 medical professionals and hospitals that signed up for the Medicare program and 49,126 that signed up for the Medicaid program.  2,834 hospitals were eligible for both programs which brings the total registrants to 176,049.  That number increased by over 50% during the 4th quarter of 2011.

Total incentive funds paid out through year end now exceed $2.5 billion with $700 million of that having been paid out in the month of December.   The breakdown of the $2.5 billion paid out so far is as follows:

• Payments under the Medicare Program $1.38 billion
• Payments under the Medicaid Program $1.15 million

The CMS reports these numbers a few days after the close of each month.

Quest Diagnostics Incorporated has announced that, beginning January 23rd and throughout 2012, it is offering to eligible physician practices discounts of 85% off the retail price of its popular Care360® Electronic Health Record solution.

Through the Quest Diagnostics Grant program, physicians can receive a full, certified EHR solution, including EHR and Practice Management System licenses, training, hosting, maintenance and 24/7 support and training for less than $100 per month. New York and Missouri physicians are not eligible for the program and eligibility in New Jersey is limited in accordance with state law requirements.

Specifically, the Quest Diagnostics Grant offer includes:

Care360 EHR and PMS (Practice Management System) licensing, hosting, maintenance and support – The Grant program will donate 85 percent of the retail price of the EHR and PMS subscription price for eligible recipients during the Grant period.

Training and implementation – The Grant program will cover 85 percent of the retail price of standard training and implementation.

“Physicians are feeling economic pressure like never before,” said Richard Mahoney, vice president of Healthcare Information Solutions for Quest Diagnostics and president of its healthcare IT subsidiary MedPlus. “Quest Diagnostics wants to remain their trusted partner for all activities within their offices, and EHRs are one of the most top-of-mind challenges for physicians today.”

“As a longtime partner to independent physicians, we continue to look for opportunities to help them tackle EHR adoption challenges and achieve meaningful use of patient information,” Mahoney continued. “When thousands of physicians responded to our 2011 Grant program, we knew we’d found a way to encourage physicians to adopt an easy-to-implement, easy-to-use EHR–which can benefit their practices and their patients.”

Based on positive physician experiences with Care360 EHR resulting from the 2011 regional Grant program, Quest Diagnostics is now expanding the Grant program to be available to eligible physician practices in most states nationally.

“Our national Grant program means that for only 15 percent of the retail cost, eligible physicians can have a certified EHR that is up and running in approximately 45 days,” Mahoney said. “Not only can they save thousands of dollars, but they can earn tens of thousands more in Centers for Medicare and Medicaid Services (CMS) incentives.”

This offer represents a potential value of up to $9,400. Eligible grantees include any non-hospital-owned physician practice and any independent nurse practitioner practice that has not had an EHR in place. Other restrictions may apply.

Adoption of the Care360 EHR web-based solution continues to grow among primary care physicians operating in small to medium-sized physician practices across the nation. Approximately one third of U.S. physicians and many of the country’s leading hospitals, health plans and regional health exchanges currently rely on healthcare information solutions offered by Quest Diagnostics and MedPlus to document and monitor diagnostic, prescription and clinical data to provide better patient care.

Care360 EHR allows physicians to adopt an EHR quickly–on average, within 45 days after contract completion. Care360 EHR is a certified complete EHR solution*, meaning it can be used to help qualify each physician for up to $44,000 in Medicare incentives or $63,750 in Medicaid incentives through an EHR adoption program offered by CMS. As a web-based solution, Care360 gives physicians complete, secure EHR capabilities via the Internet and mobile devices such as iPad®, iPhone®, BlackBerry® and most other smartphones. As the first certified EHR to leverage the Direct Project specifications, physicians are able to easily and securely share information with other physicians, patients and hospitals – both those on the Care360 platform and with other technology solutions.

*This Complete EHR is 2011/2012 compliant and has been certified by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. Quality measures certified are all 44 Eligible Provider measures.

Date certified: December 15, 2010. Product version: 2011.2. Certification number: CC-1112-936980-1.