Unconscious in a meaningful ER
What if payers, providers and private vendors offered something called "the electronic medical home" ? The patient needs to pick some hosting option they trust. Just as Stage 1 of meaningful use supports push transactions from provider to provider, the same transactions could be pushed to the electronic medical home designated by the patient.
If every producer of data (lab, pharmacy, hospital, eligible professional, etc.) pushed a copy of the data they generated to the electronic medical home chosen by the patient, then the patient could become steward of their lifetime medical record hosted by the trusted agent of their choice. Medical home data would be complete and constantly updated by data producers.
Patients could store their electronic medical home designation on a card in their wallet or on a medical alert bracelet. If patients visited the emergency room of a hospital they had registered at previously, the hospital would have a record of the patient's electronic medical home selection since the hospital would be one of the medical home data sources.
"From My Life as a Healthcare CIO by Dr. John Halamka, chief information officer, Harvard Medical School
Training is AHLTA linchpin
The upgrade to AHLTA, AHLTA 3.3, addresses many issues previously encountered with system stability, reliability and interoperability. However, the Military Health System recognizes that resolving system issues only addresses the technology and system capabilities. User knowledge and understanding is also critical, which is why MHS is implementing improved training programs.
In years past, AHLTA training provided a basic understanding of AHLTA followed by in-depth service-specific training. Unfortunately, this created an educational gap where AHLTA users didn't get to learn all of the needed system functions before they were provided specific service training.
Based upon our discussions with the users, we learned that those in the field do not have the foundation required to effectively use AHLTA. Service medical CIOs are working closely with the AHLTA development team to improve the training process. EHR trainers are refining our current training program, focusing on educating our users and emphasizing the importance of understanding the system and its capabilities. We hope this enhanced knowledge will help to "fill the gap" between the original AHLTA training and service specific programs.
Training is the linchpin of user acceptance.
"From MHS Blog by Mary Ann Rockey, deputy chief information officer (acquisition), Military Health System
Sea change in health info exchange
The use of the National Information Exchange Model (NIEM) to promote health information sharing represents a major shift of direction by policymakers working on expediting use of the Nationwide Health Information Network.
The NIEM (pronounced "NEEM" ) is a working model for standardizing information exchange that has been operating among federal, state and local government agencies in areas such as emergency management and law enforcement.
Up to now, its use has been driven by the need"especially in the post 9/11 world"to share information in a common format rapidly among agencies and across jurisdictions. It has been used successfully to enable information sharing among disparate federal, state and local law enforcement agencies.
The same NIEM processes that have driven interoperability and secure data sharing in homeland security scenarios can also be repurposed to promote information exchange in the critical area of health care"and not just among all levels of government. The NIEM process can help promote standardized data exchange between the public and private sectors.
In health care, the use of NIEM would provide a set of standardized information exchange packages that could be used by Nationwide Health Information Network participants in a wide variety of settings. The result would dramatically expand the number of clinicians and public health officials actively sharing electronic health information using the Nationwide Health Information Network.
Using the NIEM paradigm is an innovative advance in the evolution of the Nationwide Health Information Network.
"From Government Health IT guest column by Eric Pupo, senior advisor to the Office of the National Coordinator for the Federal Health Architecture program and health interoperability architect for Vangent Inc.
VistA modernization must use MUMPS
Once more, the debate about "whether" to migrate VistA from MUMPS has come up again in mainstream press. This always makes me sad because it shows just how fundamentally ignorant people are of what VistA is. So lets get something straight. If you are not using MUMPS, in some form or fashion, it is not VistA. It is a new software project. New software projects to develop comprehensive EHR solutions do not work. Ever. That is called "big bang development" and it is utterly doomed to fail.
"From the blog of Fred Trotter, "hacktivist, coding for social change"
