Tuesday, March 2, 2010

HIMSS 2010 – Tuesday

I started out the day attending a keynote by Dr. John D. Halamka (Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network (NEHEN), Chair of the US Healthcare Information Technology Standards Panel (HITSP)/Co-Chair of the HIT Standards Committee, and a practicing Emergency Physician).

Okay, now that that’s out of the way…

It was an outstanding talk, far more interesting than the title (“Using Harmonized Standards in the Era of Meaningful Use”) would suggest. Basically, Dr. Halamka talked about some suggestions that HITSP made to improve the Meaningful Use requirements.

Instead of trying to summarize Dr. Halamka’s talk, I’ll just direct you to his blog, particularly his HIMSS Top 10 list.

Monday, March 1, 2010

HIMSS 2010 – Monday

We may be in the middle of a major recession, but they forgot to tell the organizers and attendees of the 2010 HIMSS Conference in Atlanta. The Georgia World Conference Center is bursting at the seams, and teeming with activity. If you didn’t know any better, you’d think the government was about to pump a few billion dollars into the healthcare industry.

So far, most of the energy seems to be around Meaningful Use (and, by extension, EHRs and interoperability in general), ICD-10, and 5010, in that order.

Meaningful Use is, of course, a very broad topic, since it covers requirements ranging from clinician workflow to interoperability to patient communication, and beyond.

Patient Portals

I attended a very interesting presentation by Dr. Eric Liederman and Jan Oldenburg of Kaiser Permanente this morning, explaining why and how they built a “transactional patient portal” and deployed it to all of their members (the last hospital to implement the system will go live this week).

Kaiser Permanente has the largest civilian EHR deployment in the world.

Some no-brainer points of interest:

  • According to a 2009 Deloitte survey of healthcare consumers, 57% of patients want a secure website to “access their medical records, schedule office visits, refill prescriptions and pay medical bills.”
  • Among Kaiser Permanente members, the retention rate is 2.6-4.6 percentage points higher among patient portal users than the rest of the population.

Some surprises (at least to me):

  • The most popular feature on KP’s patient portal is lab results.
  • Initially, only “normal” results were available to patients via the portal. Eventually, though, most KP regions started posting all results (that can be provided legally) on the portal, because they got more from people wondering why some of their results were missing than they would from people worried about abnormal results.

Patient portals (or something very close) will be required in 2013, so it’s inevitable that most doctors will need to find and implement a solution pretty soon.

5010/ICD-10

I also attended a great round table session on 5010 and ICD-10 migration. As we’ve known for a while, there is a lot of anxiety out there around these requirements and—surprise!—healthcare providers expect software and clearinghouse vendors to solve their problems for them.

In fact, there is a lot that technology can do (and providers will absolutely have to leverage technology to address the issues), but clinicians, coders, billers, office managers, front desk staff, etc., will all be heavily impacted by 5010 and ICD-10, regardless of what their software and clearinghouses do for them.

Much of the angst right now is centered around providing training and education to staff. Providers are looking to HIMSS, AHIMA, WEDI, and CMS for guidance.

Incidentally, a Product Manager from RealMed was sitting at my table and said that around 40% of their customers are still sending claims as print image files (PIFs) of HCFA 1500 forms and NSF files, and RealMed is translating them to 4010s. He anticipates that he’ll have to continue to convert those archaic file formats to 5010. Yikes!

Monday, January 25, 2010

Ten Years with MCSD

A few months ago, I downloaded my Microsoft Certified Professional Transcript. The significant portion is shown here:

image

Ten years ago today, I passed the SQL Server 7.0 exam—the final requirement for MCSD certification.

Remember SQL 7? That was back when none of us really knew whether Microsoft would be a serious player in the RDBMS space. I think we know the answer now.

We started building AdvancedMD using SQL 7, but migrated to SQL 2000 by the time we released. Today, we’re enjoying the T-SQL and data type benefits (think XML) of SQL 2005, and our DCO team is in the process of migrating our primary client database servers to SQL 2008. Combined with Windows Server 2008, it’s giving us some significant performance perks.

Back when I passed Exam 176, we were still basking in the glow of Windows NT 4.0, and the “Option Pack” (including MSMQ and MTS) that came out in 1998. (I started building on MSMQ when it was in beta testing in 1997.)

So…ten years since I passed any sort of Microsoft certification exam, and now I’m waxing nostalgic over a queueing system. I must be getting old…maybe it’s a good thing I’m not writing code any more!