Print 18 comment(s) - last by KLO.. on Oct 2 at 9:16 PM

Electronic Health Records system is called Practice Fusion

Electronic Health Records (EHR) are one of the vital components to overhauling the nation's health care network. The U.S. government feels that EHR will help reduce the cost of medical care by allowing doctors, labs, and hospitals to share data faster and easier than they can currently.

Part of the economic stimulus plan has funds that are set aside to reimburse medical care facilities and doctors for money spent moving to an EHR platform. EHR provider Practice Fusion has announced that its EHR system will be made available free of charge to physicians in a partnership with BioReference Laboratories.

BioReference will feed its lab data into the Practice Fusion EHR system and recommend the product to its network of 15,000 doctors. BioReference is the nation's third largest full-service medical testing lab behind Qwest and LabCorp. The two larger labs also integrate their data into the Practice Fusion system.

"With this deal, we've gained another 15,000 physicians," says the EHR vendor's CEO Ryan Howard. That statement is a bit inflated considering that the 15,000 physicians have to choose to use the Practice Fusion system. The Practice Fusion system is a cloud-based offering that is trying to attract doctors that currently use paper billing.

The labs are keen on EHR because it saves them time and money. With EHR platforms, they only need to update one record rather than individual doctors' offices. BioReference marketing VP Amar Kamath said, "we only have to integrate the data once, not for every doctor's office."

Dell also recently announced a new EHR offering that it was offering to physicians that is a complete turnkey package physicians and facilities must purchase and share data with a provider or a local hospital. The government is enticing physicians to move to EHR systems by promising bonus payments for those who migrate.

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Technical oversight?
By farsawoos on 9/23/2009 2:02:23 PM , Rating: 5
What kills me the most is how little of a choice organizations have. From where I'm standing, based on my terrible experiences with my employer's current solution, it looks like we get to choose between HUGE, steaming piles of poo, and smaller, less steamy piles of poo. To quote a games magazine article I read one time, we are essentially "picking the plumpest turd from the poo pond."

There's no standardization of data export/import requirements, there're no standards on software and hardware compatibility, and every single one of them has their own idea of HIPAA compliance. I don't know how many time I've argued w/ vendors and their techs over the phone about how their garage-band application that saves patient data in an unprotected ACCESS database ON THE ROOT OF C: (!!!!!!!) is probably NOT compliant with any sensible security policies, only to be told that "OH,, we know HIPAA, ok? We're totally compliant! Look at this letter that RANDOMCOMPANY001 wrote saying we are! They can't be wrong!"

*massive facepalm*

RE: Technical oversight?
By lightfoot on 9/23/2009 4:19:19 PM , Rating: 2
So now the records will be placed on the internet, in the cloud somewhere. Hopefully not in an unprotected Access database. They should at least be using an unprotected MySQL database.

RE: Technical oversight?
By Iaiken on 9/23/2009 4:37:21 PM , Rating: 2
You might want to brush up on your knowledge of how cloud computing works...

A proper cloud has all of its hardware and data compartmentalized so that it is inaccessible except through the thin client interface. This allows the clients to access the service without the need for sophisticated infrastructure on their end.

So the outside world basically interfaces with an interactive display that is relayed to/from the cloud service. This allows the security implementations to be independent of the architecture at each step from db -> service -> client and back again. For example, Encrypted DB -> Firewall -> DMZ -> Firewall -> service -> Package Encryption -> Firewall -> Client -> Package Decryption -> Data Decryption. Like Lego blocks, you just snap together an architecture that suits your needs.

Read, then talk...

RE: Technical oversight?
By lightfoot on 9/23/2009 7:30:57 PM , Rating: 2
You don't know me so I'll forgive your lack of understanding.

My entire post was sarcastic. There are huge benefits to cloud computing, and I would never condone the use of an unencrypted database from any vendor being used to store patient health records.

My only point is that a bad design will still be a bad design even if it uses "cloud computing." You must still engineer the solution to be accessible and secure (two traits that generally conflict with each other, but can be done.)

RE: Technical oversight?
By KLO on 10/2/2009 8:57:18 PM , Rating: 2
Okay, yes I get it also but heres the problem...when you don't own your own security on your own intranet then regardless of the number of times you encrypt someone else owns the key. We all have suffered enough at the hand of others but due to that we cannot go and make the same mistake again. I cannot stress how important it is not to put your eggs all in one basket especially for something as sensitive as HIPPA. We no longer have privacy anymore and this country has so many big brothers that we are now beginning to get selectively destroyed through electronics. Our health is our business and no one elses. Do not share it at all. Intranetworks can be interconnected and you do not need a cloud or a vulnerability. Accessibility may be the only good thing in the end but really its like a microwave. Is making the food any faster really that important? Would you go out and buy a microwave that went faster even if yours was fast enough even though you ran the risk of burning all your food? Come-on! This sounds like a disaster and this comes from an IT and Medical person.

By PAPutzback on 9/23/2009 11:25:50 AM , Rating: 3
I work in healthcare and it is unbelievable how many disparate software solutions are used to process a patient from beginning to end.

You start with the DR office. You got your record, billing and scheduling systems. Then the billing kicks out a proprietary formatted claim to transfer to a Clearinghouse to be assembled with a bunch of other offices. A lot of the time each office has their own format. Then the clearinghouse creates an EDI file to be sent to a payer.

Bah. I could explain the whole process and it would take a day to explain all the holes in the process. Needless to say Healthcare needs to go to the cloud.

Next time you are on vacation think about what would happen if you got in a medical emergency and there was no way to tell the doctor you were allergic to some drug and your records are sitting on a shelf 1000 miles away.

By kattanna on 9/23/2009 12:03:52 PM , Rating: 2
my wife does the coding for various clinics and man.. she tells me of all the various systems they have to jump through..combined with actually having to call back to clinics to confirm things to code the bills properly, its amazing.

all mountains of actual paperwork.

as for all the separate systems, i actually blame the insurance industry and their tactics of dropping people with pre-existing conditions and dropping them when they have issues. that forces people to go to various doctors "off the record" and be completely against an integrated system.

hopefully this forced tax increase being called health care reform might take care of that issue at least.

By SigmundEXactos on 9/23/2009 2:12:21 PM , Rating: 2
My mother-in-law's practice uses, and it's pretty damn good--it does EHR and billing and scheduling and all of that. It submits the claims for you, and get this--if you don't get your claim, they have an office in India who's job is to call up insurance companies asking about missing claims! :)

By KLO on 10/2/2009 9:04:16 PM , Rating: 2
Great! Another company that sends our jobs overseas! Just what we need in this recession! As great as it sounds for stream-lining, its a disaster for HIPPA, get off your lazy asses and start communicating. Its been working fine for now, "why fix something that ain't broke", people are just lazy and its not worth the security risk to the individuals. Thanks for letting me know Aetna does this, now I know why some companies are dropping them even though the new Insurance company makes exactly the same offer. They are no longer HIPPA compliant!

Oh Big Brother where art thou?
By R3T4rd on 9/23/2009 11:03:57 AM , Rating: 2
Seems like a good system....and.....

Until you start rationalizing, and put Stimulus, free, and Government together......

All I have to say is "Wut choo talkin bout Willus?!!?!"

RE: Oh Big Brother where art thou?
By R3T4rd on 9/23/09, Rating: 0
RE: Oh Big Brother where art thou?
By Ammohunt on 9/23/2009 2:27:30 PM , Rating: 2
That was my first thought Governent Government bureaucracy involved with patients records? Where to I opt out. EHR is a good idea but it needs to be kept private sector.

With the current Government it’s all about control of people’s lives not efficiency

By jhapp on 9/24/2009 1:55:19 AM , Rating: 2
Why would anyone give something free to a doctor? Are the starving or homeless? Can't they work for a living like everyone else? I just don't get it.

RE: Free?
By KLO on 10/2/2009 9:09:43 PM , Rating: 2
Another good point and that in itself should be a red flag. Its free because of the risk and they want to own them somehow.

Solves nothing......
By brshoemak on 9/24/2009 8:33:52 AM , Rating: 2
Pushing the location of EHR software into the cloud does not solving the underlying issue that is at the core of the problem. There are no set standards for data format/interface/structure. Each EHR company comes to the table with the mindset that all others should format and store data as they do, because of course their own way is the right way. Because of this, the providers will not sit down and work together on this issue. This impasse won't ever be overcome in the private sector - it's been 20 years and counting thus far.

The government needs to (and has been trying) to create a set of standards that all EHR software can follow. This doesn't mean government control or oversight of patient information. It just means that someone with authority needs to step in, spend time researching and come up with data formats/interface/structure that all software can abide by.

If you think the need for federal standards is unwarranted consider this, I've seen a firm spend $50K and 3-4 months on an interface that allowed two systems IN THE SAME PRACTICE to be able to share data. Multiply that cost and time by the number of different systems in a practice, multiplied by the number of practices (big and small) throughout the country and you get a better understanding of the obstacle EHR implementation faces on a nationwide scale. They can subsidize the cost of the EHR software, but are they going to subsidize the cost of the interfaces of every system that would need to be created to share information within and between practices?

Putting it "in the cloud" is simply a location where the software/data resides. Every single EHR software provider could run their system from a cloud, but that still doesn't mean they will all talk to one another. Without standardization of data, mandated by a group that has the authority to get it done, there is really no point in moving forward with EHR IMHO. I would love it, don't get me wrong, but it will just be the same clusterfluck it has been since it's inception.

RE: Solves nothing......
By KLO on 10/2/2009 9:07:38 PM , Rating: 2
yes, exactly the point I was trying to make but you made it way more succintly. Streamling is just about the design of software that is capable of communicating with other software and Security is getting compromised.

Healthcare IT as an ecosystem
By mikecuesta on 9/24/2009 11:21:05 AM , Rating: 2
Moving to the cloud is definitely the way to go. Also, I agree with many of the sentiments regarding the fragmented state of Healthcare - we need a solution that connects all of the disparate workflows.

For more information, check out

RE: Healthcare IT as an ecosystem
By KLO on 10/2/2009 9:16:57 PM , Rating: 2
Learn Java, Visual Basic, C++, coding, programming, design, and development, then create a software for your own company to use on the intranet that is capable of communicating with other software compatibly. But do not put your private info in someone else's hands. I was a process manager and I always think about the outcome of the process not just the benefit. By the way if you can build the above, you can patent it, package it and sell it to other hospitals..., sharing from one to another is not recommended for fear of leakage. People need to simply get way more responsible about their health. They need to have a long-term healt provider and only that provider can share information with others at your discretion. Once the software is in place sharing information and streamlining should not be a problem. It is similar to having Word on every computer so you can receive and write documents. But keep the information private. No Cloud.

"What would I do? I'd shut it down and give the money back to the shareholders." -- Michael Dell, after being asked what to do with Apple Computer in 1997
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