Practicing ecologically sound and sustainable policies are garnering continued interest across the healthcare marketplace.  Have you been introduced to the Healthier Hospitals Initiative (HHI)?  This collaborative effort between hundreds of hospitals, the Center for Health Design, and Practice Greenhealth seeks to improve environmental health and sustainability in the health care sector in 6 key areas: engaged leadership, healthier food, leaner energy, less waste, safer chemicals, and smarter purchasing.

Going green is far from today’s flavor of the month – it’s propelling to “new normal” status faster than a Silicon Valley coding competition.

IT departments can lead the charge, too.  How do your efforts to reduce “e-waste” – or electronic equipment that is nearing, or at the end of its useful lifecycle - stack up?  According to a recent blog post in Earth911, “In 2009, about 2.37 million tons of discarded TVs, computers, peripherals (including printers, scanners, fax machines), keyboards, mice and cell phones ended up in the waste stream in the U.S, according to EPA facts and figures.”

How does your medical center or business recycle, re-use or upcycle electronics that are no longer in play?  Currently, there is no Federal mandate to recycle e-waste. There have been numerous attempts to develop a Federal law, but to date – no surprise – consensus hasn’t been reached.  There are however, guidelines to follow within each state that rival the stringency of any Federal mandate.

Electronic products are made from valuable resources and materials – metals, plastics, and glass – all of which require energy to mine and manufacture. Donating or recycling consumer electronics conserves natural resources and avoids air and water pollution and greenhouse gas emissions caused by manufacturing brand new materials.

The problem is, some electronics, such as color CRTs computer monitors, color CRT TV tubes, and smaller items such as cell phones and other “hand-helds” may test “hazardous” under Federal law.  If so, they are subject to special handling requirements under Federal law, subject to certain exemptions.  Still, the EPA does encourage the reuse and recycling of used electronics, including those that test “hazardous.”   For those regulatory requirements, visit EPA’s website.

Responsible Stewardship of e-waste is a Health Matter

It’s in our local and global interest to dispose of e-waste carefully to prevent the exploitation of those in impoverished countries where much of the e-waste from the U.S. has historically been disposed.  Media coverage of companies that transferred e-waste overseas where unsuspecting workers scavenged through potentially hazardous material to forage recyclable metals exposed the problem our e-waste caused.  This spurred many states to pass e-waste recycling laws that help to ensure responsible recycling and disposal of hazardous materials – check out your state’ s policy here.

Of course, a great deal of electronic components relegated to “e-waste” status isn’t waste at all, but rather could serve as readily marketable for reuse. It’s why companies such as Bitlist.com have emerged to turn one man’s e-waste into another man’s aftermarket treasure.   At iData, we recycle all of our electronics locally, and we’re always searching for new ideas and resources.  What’s your organization’s policy?  Check out EPA’s site for ideas on recycling electronics.  And share your resources with us; let’s all work together to make every day, Earth Day.

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The post Code Green: Reduce your “e-waste” quotient appeared first on iData Blog.

We could despair – and we all do at some level.  But in the days that follow, those of us who serve or work in the healthcare marketplace can use the moment to glean some new perspective.  To consider what we really do – visualize who we’re really helping.  It’s not just our hospitals and managers and clients, it’s doctors and nurses.  (Or the “Helpers,” as a popular Mr. Rogers’ Facebook meme reminded us.)

It gives us pause to consider that the programs, hardware, software and data we’re working so relentlessly to manage, repair, design, analyze, code and protect serves the needs of heroes dressed in faded blue scrubs, and the sick and injured for whom they often sacrifice.

Here at iData, we’ve stopped for a moment to think about those medical records that now include lost limbs and shattered bones.  With the physical and emotional trauma associated with what has historically celebrated as a joyous event marked by legendary Boston pride.  At the end of the day, the data we work so hard to capture and report belongs to people.

It’s why we, and so many across our industry, should take pride in what we do.  The infrastructure and processes we empower ensures that healthcare data is captured and delivered efficiently.   Which means clinicians can work more smoothly.  And that means something to the injured runner who will now count on his specialists to be able to access and share information seamlessly.

It’s the least we can do.

For a bit of inspiration, remember on those days when the project seems never ending, when you’ve pulled an all-nighter to repair a glitch, when you’re struggling to decipher a physician’s verbiage – that the hard work contributes to something meaningful.  People’s health.  What’s more important than that?

So on that fateful day, what started as triumph turned into tragedy.  But then, it turned to triumph again as stories trickled in showcasing doctors, nurses, first responders and many spectators who jumped in to help.   And as always in the face of trauma most of us can hardly fathom, medical center personal deftly, calmly and compassionately navigated the chaos and the carnage.

According to the Boston Globe, “More than 13 hospitals treated some 180 victims, many in critical condition; at least 10 of them were children. Speaking to the press, trauma surgeons and emergency room doctors from the largest hospitals — including Mass. General, Brigham and Women’s, Boston Medical Center, and Children’s updated the public regularly with detailed casualty reports, describing emergency amputations, shrapnel wounds, fractures, ruptured internal organs, and severe burns. In doing so, they supplied some of the first clues as to what could have caused the injuries they were treating.” 

These are the professionals we serve.  They are why we get up every day to do it all over again in the midst of setbacks and struggles. Their grace and grit and immeasurable contributions can inspire us to push through.  We’re helpers, too after all.

The post How Boston’s “Helpers” can inspire Healthcare IT Professionals appeared first on iData Blog.

Unless, that is you count, “The Donald,” who tweeted, “@Marissamayer is right to expect Yahoo employees to come to the workplace vs. working at home. She is doing a great job!”  Some felt her decision was bold and courageous; from others, the backlash was swift. Mayer’s mandate struck a cord among champions of telecommuting as a means to achieve a better balance between work and family.

Telecommuting is also an issue close to iData’s heart, since it’s not just our medical transcriptionists who work from home. Our entire office does. iData’s decision to build the entire company around a virtual office has only added to our ability to provide the leanest, most efficient service in the business. But as many who reacted to Mayer’s memo have written, telecommuting may not work for every company.

A story in The Atlantic Monthly quotes an ex-Yahoo! employee who describes a lot of abuse of the policy, and goes on to describe a particularly stubborn corporate culture that Mayer is trying to change after having tried several other techniques: “Any leader who has had to transform a company or an institution understands that culture change is essential. People have to think differently about their jobs and their employers before they will do their jobs differently. Moreover, when a ship is going down, it is not unreasonable to demand all hands on deck.”

Meanwhile, Emily Sams argues differently: “As a working mother in the IT field, I am confident of my abilities to juggle, multitask and, most important, organize and execute my work. Having multiple demands requires working mothers to focus on juggling and keeping balls in the air. My personal and professional network is made up of working mothers. Most would tend to agree that it’s easier if all balls are in the air. If one drops, they all do.”

Mayer did in fact enjoy both compliments and criticism, and her decision stirred up the age-old debate over whether telecommuting detracts from corporate synergy and productivity.

The decision also raised questions about the degree to which telecommuting policies impact the fierce competition for IT talent. It’s no secret Silicon Valley’s biggest players offer perks that replicate the comforts of home – the free food and volleyball courts are designed to entice employees, especially young professionals with little tolerance for a stodgy corporate culture. Those benefits also encourage older employees who value flexibility because it helps them better balance work and family.

IT employees especially seem to value flexibility. As Sams points out: “Working from home or telecommuting is part of life for IT professionals. We don’t work traditional hours, so traditional management approaches to sitting in an office from 9 to 5 are counterproductive. Ask any leader if they want to apply a database upgrade at 10 a.m. on Wednesday and see how they react.”

Today, it’s IT professionals who work tirelessly to create the virtual world that enables the rest of us to work wherever.  Seems they should get to enjoy the fruits of their labors – but in Mayer’s defense, the CEO gets to call the shots. And if calling people back back to a central office boosts Yahoo’s competitive edge, then perhaps she made the right choice for her company.

In the healthcare marketplace, it seems as though many hospitals are offering the option to telecommute for at least part of the work-week in an effort to help secure top talent. In Working Mother magazine’s annual report of the 100 best companies for working parents, several hospitals earned a spot in the prestigious list, including Children’s Memorial Hospital (Chicago, IL), CJW Medical Center (Richmond ,VA), Mercy Health System (Janesville, WI), Providence Alaska Medical Center (Anchorage AK),  TriHealth (Cincinnati, OH) and Inova Health System (Falls Church, VA).

It seems fitting that hospitals, in the business of promoting health and wellness, would identify “flex appeal” as an attractive recruiting tool.  After all, technology makes it easier to connect and collaborate with colleagues from all corners of the globe, enabling hospitals to tap into a broader pool of candidates. What’s been your experience with telecommuting – does it detract from productivity, or empower it?

Would your hospital’s flextime policy make IT professionals and other top talent yell, “Yahoo?”

The post The War on Telecommuting? Yahoo’s Mandate & the Battle for IT Talent appeared first on iData Blog.

It’s the date looming across the healthcare landscape as hospitals, HIMs and doctors sprint toward the Meaningful Use deadline in order to receive the incentives delivered via the HITECH Act. Many found, though, that while the EHR may have promised to help nix the cost of clinical documentation, the reality hasn’t quite matched the rhetoric.

EHR Backlash

In fact, backlash against the EHR has reached the level of earning its own hashtag on Twitter: #EHRbacklash, with several stories in recent weeks (see here and here) describing the pullback.

Clearly EHR implementation has proven a tough nut to crack, stacked with challenges that include decreased productivity, training, systems interoperability, typical scope creep, and clinician resistance, some of which is a loss of physician productivity. All this is stuff the EHR was meant to improve.

In his piece in Medical Economics from last year, Michael Mcbride wrote, “As a general rule, during the EHR implementation period … you can expect to see up to 50% fewer patients in the same period of time. Simultaneously, you may have to increase your staff, or approve significant overtime for your existing staff members, just to get everyone home for dinner. That’s not even considering the extra time you need to invest to learn the new systems.”

Dr. Marshall Steele, Medical Director at Stryker Performance Solutions, put it this way: “Engaging the patient fully, listening carefully and watching their body language is an essential aspect of diagnosis and creating trust that is essential to obtaining compliance and treatment. Physicians who interact too much with the EHR can create a significant obstacle to this important aspect of care…”

The EHR Meets Outsourced Medical Transcription

The challenges of EHR implementation means the need for clinical medical transcription hasn’t at all dissipated. Instead, the need for flexible, agile options created a demand for a hybrid approach, satisfying government meaningful use and reporting requirements, doctor satisfaction, and quality patient care.

Many practitioners and hospitals are choosing to integrate their EHR system with outsourced clinical documentation services, allowing doctors the freedom to integrate the varied choices in data transmission. HIM professionals may implement different processes to capture dictation based on physician preference, practice patterns, and document types that are integrated seamlessly into the EHR via Discrete Data Capture. Instead of replacing traditional transcription, some providers are instead viewing it as a partnership toward meaningful use.

Using this blended approach, physicians are invited to choose which data to enter into templates, integrating the option of dictation when they deem appropriate. For example, in one care setting, structured history and physical templates populated by a physician assistant might be applicable, while a dictated and transcribed narrative report may be the best documentation method to record inpatient discharge summaries, encounter notes, findings, and assessments. Physicians use templates where and when they make the most sense to them, and still retain the option to dictate the details of a patient visit. Everyone wins.

This blended approach streamlines clinical documentation processes without sacrificing the unique facts and narrative that impact quality patient care. It’s just one more step toward truly achieving Meaningful Use.

The post The Blended Approach: EHR & Medical Transcription appeared first on iData Blog.

But first, consider the sheer number of articles, posts, and all-out rants you’ve seen the past year about how EMRs have thus far failed to live up to their promise (In the unlikely case that none are coming to mind, see here, here, here, and here). One headline from a story published in KevinMD proclaimed, “Why EMR is a dirty word to many doctors.”

Needless to say, reaction to the unrelenting stage one, stage two, stage seven march of “meaningful use” guidelines and the frequent headaches of EMR implementation, which is sometimes followed closely by outright EMR failure, has been mixed.

Usually the least satisfied party in this unfolding is the physician, who is now asked to click, click their way through a patient note, fumbling to see how fast they can open the drop down list and get their mouse’s sticky scroll wheel to navigate down to the correct data point. These physicians know they haven’t gotten more productive, although their attention has been successfully diverted from the patient. Later that night, they go home and read the latest study on how EMRs haven’t improved patient outcomes, either.

Still, if there’s anything that is clear about EMRs, it’s that they are inevitable. EMR adoption is picking up, with more practices and hospitals achieving higher stages of meaningful use. After all, in 2015 the nice cash incentives that hospitals and physicians’ practices have been receiving for adopting EMRs will be joined by financial penalties for failing to adopt them. The hope is that by then the negatives of EMRs will be outweighed by the positives. The sad part is, it didn’t really have to be this way.

Discrete Reportable Transcription (DRT)

Yes, we know that “discrete reportable transcription” is a mouthful. How does “discrete data capture” sound instead? Not much better? Ok, here are just two words that should be well familiar to any CIO: structured data.

Whatever term you use, the idea is the same. Discrete Reportable Transcription allows a previously “flat” computer file that served as an addendum to the medical record to be mined, searched, and analyzed for useful data. It’s sort of like the difference between a scanned image of a page of text and a searchable PDF document, except the PDF document is connected to a flexible database of thousands more PDFs, providing the owner the ability to search it for meta information, catch errors, and predict trends. That’s what discrete reportable transcription, or the capability to blend traditional medical transcription with discrete data capture, gives its user.

When this searchable, relational database is merged with an EMR, it’s almost like having your EMR cake and eating it too. The EMR can deliver on its promise of portability, speed, and efficiency, while the physicians stay happy and productive because they can continue to use the dependable medical transcription systems they have relied on for years.

The post How To Have Your EMR Cake and Eat It Too: Discrete Data Capture appeared first on iData Blog.

The outbreak, which killed more than 40 people and infected hundreds more, also raised scary questions for patients who had received spine injections: Did I receive the tainted drug? Is this headache just a headache, or a precursor to something worse?

One question that was lost among the media coverage of the outbreak, however, was whether hospitals had practical access to the kind of information they needed to identify new cases or assess the risk that patients treated in their hospitals may have been exposed. As more and more cases were reported, tracking the path of the outbreak became almost a guessing game, and hospitals and orthopaedic practices alike scrambled to figure out whether they had treated patients with the steroid in question.

It may seem hard to believe, but at the height of the outbreak, many  hospitals could not access key information contained within the medical record, for example, which doctors used a particular drug, and which patients received it? Often when doctor’s dictate, the key pieces of information about the patient encounter are in a flat file that is not searchable even though the file is attached to the EMR record.

Though most hospitals have integrated an EMR with their transcribed reports, the key data elements that a hospital would want to search when a situation with drug contamination or new research on how to treat patients with heart disease are often not captured in a database.

That’s where discrete data capture comes in. Discrete data capture turns the medical transcription record from a flat file that serves as an addendum to the medical record, and turns it into a searchable, relational database from which key strategic information can be gleaned within minutes.

For example: did any physicians in my hospital use a particular steroid on back pain patients?

Ensuring that your hospital has discrete data capture integrated with your medical transcription solution should be non-negotiable, especially in light of last year’s outbreak. iData’s solutions will attach to your current medical transcription program or integrate with your EMR. iData has already interfaced with more than 400 different systems to make sure hospital administrators get the data they need.

So when the next health crisis hits, don’t be left in the dark.

The post Hospital CEOs: What If Your Docs Gave the Fungal Meningitis Steroid and There Was No Way For You to Know? appeared first on iData Blog.

What’s that saying – no rest for the weary. Sure, you’ve put on your cape and artfully created solutions to problems implicit in transitioning to the EHR – determining eligibility criteria, mapping new software or upgrades, configuring hardware, navigating dueling deadlines for multiple high-priority projects, wrangling money out of the budget, assigning staff and project managers, re-assigning workflows, coping with interface and interoperability snags, and managing staff resistance to change. Whew!

Better keep that cape on, though, because that was the easy part.

One recent report likened EHR implementation to a “psychological roller coaster.” The process includes “unrealistic expectations that reach a peak right before implementation, a plunge into a “trough of disillusionment” and then a recovery phase involving a lot of hard work, according to WIREC officials,” according to a recent story in FierceEMR.

So, as you sprint toward live implementation of your brand-spanking-new EHR, how will you integrate training for a new system to go live with a new one in time for the looming deadline?

Taking time from the every day business for training is a daunting task under any circumstances, much less transitioning to a system as consuming as EHR implementation.  Moving to the EHR represents a cultural shift, too, so it’s necessary that leadership successfully communicates the benefits to skeptical staff members – and provides the time necessary to train folks effectively. Planning for enough time to train effectively mitigates the anxiety associated with change and gets everyone pumped up. Get their buy-in. In the end, most people in health care want to provide all the benefits of the EHR to their patients: security, privacy, accuracy and accessibility.

What are some best practices in implementing training?  HealthIT.gov recommends following a logical plan that includes training, mock “go-live” and pilot testing. This step should be 4th in a series that includes assessing readiness, planning the approach, choosing the EHR vendor, training & implementation, meaningful use and continued quality improvement. Each step poses its own challenges, but training always seems like the first thing to get nixed when time starts closing in.

In tandem with system training for the end user, you’ll want to check out the comprehensive set of tools and directions to guide you through the ancillary processes.   You’ll find downloadable guidelines including a chart migration and scanning checklist to assist with moving charts to the EHR; an EHR implementation go-live planning checklist to forecast issues that need to be addressed before rolling out the EHR; and, a system test plan that describes the types of tests typically performed on EHR systems and other health information technology (HIT) before going live. Plus, the National Learning Consortium Resources offers updates on what’s going on out there in the real world.

Don’t worry.  By this time next year, the EHR system will be up and running and you’ll move on to other Super-HIM duties.  And if you’re looking for hybrid solutions for clinical documentation, give us a call at iData.  We’ve got our own capes around here!

The post Happy 2013! Now – Is Your EHR Implementation on Course For 2014? appeared first on iData Blog.

During disasters – natural or otherwise – hospitals and medical facilities are exposed, and clinical documentation systems are tested. Power outages, flooding, fires, earthquakes. All have the potential to rob a hospital of its access to clinical documentation programs just as they need them most to care for victims. Even for those hospitals backed up by generators, it as clear in the aftermath of Hurricane Sandy that generator failure can be a disaster on its own.

In situations like this, patient life is, of course, most important. But a loss of electronic health records can also be devastating. Patients (especially those with chronic illnesses or Alzheimer’s disease, etc) rely on consistent and accurate care; if their medications, doses, procedures, and other notes are lost, then mistakes can occur.

In this instance, many may be quick to say that electronic health records are the key, but that is not wholly true. Experience over the years has shown that, while electronic health records are key, it is also helpful to have paper backups.

In Joplin, Missouri, for example, where devastating tornados knocked out power, killed 158 people, and injured over a thousand more in 2011, medical practices that did not have good clinical documentation systems had to close their doors. Conversely, during Sandy, hospitals that lost power and therefore could not access electronic health records were able to use the paper records as backup to continue patient care.

But having electronic health records stored onsite is not enough. They must be stored in multiple locations—like having your computer backed up on multiple hard drives. This way, if the on site paper and electronic health records are destroyed in a flood or a fire, there is another site that has them safe and sound. And the rationale of multiple sites is that if an entire region of the country is hit with a disaster, then there will be a site far away, like California, that is untouched. iData, for example, houses its clients’ data in Tier 4 data centers located in separate places around the country, each of which is redundant.

This aside, redundancy can often be unwelcomed in healthcare. And the idea of having both paper and electronic health records may seem to go against the effort to eliminate redundancy in healthcare, or, in other words, the effort to be as efficient as possible. Why continue to keep paper health records if one can use an electronic clinical documentation system? It’s a fair question. This approach may feel unnecessary most of the time—until disaster strikes.

The post A Year of Natural Disasters: Lessons for Clinical Documentation Systems appeared first on iData Blog.

Ok, so maybe you are actually going through an EHR implementation and have ceased to find obscure EHR usability puns amusing.

Either way, just in time for the holidays, the ONC (Office of the National Coordinator for Health Information Technology) has released the final test method for the 2014 edition of the electronic health records meaningful use certification program.

So if your CIO has made the nice list this holiday season, we can’t think of a better gift!

It’s also one that keeps giving when working toward earning some serious rewards promised in the HiTech Act. Those who adopt Certified EHR Technology and attest to its “meaningful use” are eligible to receive incentive payments through Centers for Medicare and Medicaid Services EHR Incentive Programs. And the 2014 deadline is looming.

We know – the final test method is endless, sometimes thankless, costly, time-consuming and stressful. But it CAN be done! Is your EMR implementation ready to be put to the test, literally?

This “gift” has been a work in progress. Beginning in the fall of 2012, ONC began posting its draft test methods in increments across their website, inviting public review.  The feedback received was carefully evaluated, but comments and deliberations were not shared publicly.

Once the review cycle was completed, the ONC updated the test materials for use by testing laboratories and certification bodies. These will be used to evaluate conformance and EHR functionality and modules against adopted standards, implementation specifications, and certification criteria. The approved edition includes a list of all meaningful use criteria EHRs must support, including links to each test procedure.

Ah, now that’s a meaningful holiday gift – interoperable capture, reporting, extraction and security of critical patient data. Happy holidays! So how does your system measure up?  Then again – maybe you’ll want to wait until after the holidays to find out …

Shameless plug:  At iData, many of our customers are transitioning to the EHR.  So in tandem with traditional medical transcription services, we’re offering new technologies help clinicians capture, record, and report critical patient data. Read more about voice recognition technology and discrete data elements, which drop critical data right into the EHR.

We hope you enjoy a fantastic holiday season that’s merry and bright!

The post A Last Minute Holiday Gift for the CIO – EHR Certification Testing! appeared first on iData Blog.

Americans have been trending toward a new level of comfort with technology—perhaps the crowning symbol of this brave new future is something like Google Goggles. Yes, that would be eyeglasses that work as computers and cell phones (so if you kiss someone, and your Google Goggles accidentally bump their Google Goggles, does that mean you will accidentally exchange playlists and your recent Instagram photos, as well?)

Given the increasing comfort with technology, it’s no surprise that medical institutions would eventually digitize everything from records (electronic medical records) to interactions (telehealth medicine). But in the never-ending quest for clinical documentation improvement, the trend toward seamless information exchange can sometimes obscure the need to protect patient privacy as well.

Tim Zoph, CIO for Northwestern Memorial Hospital in Chicago, highlighted this very problem in a speech to the HIMSS Media Privacy & Security Forum last week. Even drawing an example from the TV series Homeland, where a character kills his political nemesis by hacking into his pacemaker, Zoph noted many medical devices now-a-days are designed with connectivity, but not security, in mind.

Many doctors and nurses now carry tablets when they speak with patients, and it’s forecast that there will be a spike tablet-wielding doctors in the future. How can we make sure all this technology doesn’t lead to loss of patient privacy, as has happened in several high-profile data breaches this year?

Consider what’s at stake for the privacy of patients whose medical records are moved to a cloud or whose physicians rely on digital technology: address, surname, maiden name, insurance information, medical conditions, family history. The Health Insurance Portability and Accountability Act (HIPAA), passed by Congress in 1996, established the foundation for patient protection. Since then, a number of discussions and legal updates surrounding the topic have occurred.

What steps can medical professionals take to protect patients? Here are the top five best practices:

1.) Find somewhere to start by conducting an inventory of your own medical office’s privacy safety operations. Look for areas where information could be inadvertently shared. Create passcodes on tablets and other shared portable electronic devices.

2.) Limit the number of people who have access to the “master” data, meaning the entire lot of electronic data at a hospital or medical care provider.

3.) Create backup plans. First, have some kind of contingency plan, should electronic data become compromised, deleted, or in some other way damaged. Exact replicas of in-house data should be completed regularly. To that end, if electronic data is compromised, deleted or damaged, medical care providers should implement a strategy to restore immediately.

4.) Create a system of regular in-house audits to catch any deficiencies in your plan.

5.) Create a solid Incident Response Plan. No one ever wants to use this plan, but it still has to be in place. Think of the fire drills or the emergency run down on a flight. It’s information everyone needs in the event that a situation, unfortunately, turns awry. The IRP serves to satisfy HIPAA and HITECH requirements, while also providing a framework for the person in charge during a breach of patient privacy, and the team that works to mitigate damage and prevent another similar incident.

The post Clinical Documentation Improvement Must Include Protecting Patient Privacy appeared first on iData Blog.