Cloud Computing Audit and Certification
If you are considering using cloud-based data storage – then you need this process to be audited, and confirmation that your process is certified according to industry standards. This is as much for your own protection as the protection of the sensitive data that you are handling.
So say the Uk based CRT Partnership, whose European Director, Andja Komso, is qualified and certified to audit your own processes and issue certificates of compliance. Andja was responsible for introducing Value Added Tax into the country of Slovenia some years ago, before joining Hermes SoftLab and spearheading their rise as the number one vendor of EHR solutions and integration in Central Europe.
Andja is now part of the CRT Team, who for the last four years have been liaising with US hospitals about the pros and cons of new technology roll out.
If you wish to discuss in detail how to be certified and audited, please email; richard@crtp.eu.
Cloud Computing in Healthcare – On Demand Conference
Florent Saint-Clair, General Manager of eMix, will lead an On-Demand Education Session of Virtual HIMSS12 titled “Cloud-Based Medical Data Exchange: What We’ve Learned So Far.” EMRconnect™ will also be one of the new elements featured in the eMix booth, along with a unique, new cloud-based EHR for radiologists, and enterprise imaging information technology from DR Systems.
In his session, Saint-Clair will discuss the various ways cloud-based medical data exchange services can be used. He will also illustrate how the services can improve patient care, especially when compared to the ways that medical data is typically shared – for example, via CDs or virtual private networks (VPNs). Finally, he will describe transitional issues in using such services involving workflow and protocols for handling images.
Saint-Clair’s session will be held Monday, February 20, 8 a.m. to 9 a.m. It will also be available after that time on an on-demand basis.
Health Story: Comprehensive electronic records that tell a patient’s complete health story.
Much of the information needed for patient care is locked in unstructured documents, such as transcribed notes. This can be unlocked with data standards that support information flow between narrative documents and EHR systems.
Approximately 1.2 billion clinical documents are produced in the United States each year. These documents comprise around 60% of all clinical data. This tremendous source of clinical information is underutilized in today’s computer- based record systems.
Health Story is an alliance of healthcare vendors, providers and associations that pooled resources over the previous four years in a rapid-development initiative to produce data standards for the flow of information between common types of healthcare documents and electronic medical record (EMR) systems.
Health Story has an Associate Charter Agreement with the HL7 data standards organization. Using HL7 Clinical Document Architecture (CDA®), the group developed the following technical guides, which are now available in a consolidated package along with the Continuity of Care Document (CCD) standard. The consolidation effort was supported within the ONC Standards & Interoperability Framework in partnership with IHE and HL7:
1. ConsultationNote 2. DiagnosticImagingReports 3. DischargeSummary 4. HistoryandPhysical 5. OperativeNote 6. ProcedureNote 7. ProgressNotes 8. UnstructuredDocuments
Adoption of these standards will unlock the valuable data from clinical notes and make possible an unrestricted flow of this narrative- source data into EMR systems and expedite the development of interoperable clinical document databases for use within healthcare enterprises and health information exchanges.
Health Story supports implementation of these standards and works to inform industry about the availability and benefits of the Health Story pathway.
The Health Story approach is appealing to providers looking for a glide path to interoperability that allows clinicians to move toward EMR adoption and to meet early ARRA targets for meaningful use of EMRs while retaining their preferred methods of care.
If this looks like it is for you… you can see Health Story in action at the HIMSS12 Interoperability Showcase, Feb. 21-23, in Las Vegas, as eleven vendor volunteers demonstrate how to apply Health Story to a transition of care use case developed by the American College of Physicians.
You can join the project, and support the Health Story approach by contacting the
Organization Affiliates and Promoter Members at: www.healthstory.com, or also visiting the HIMSS12 Interoperability Showcase Hall G, Booth #11000, Use Case 13:
But what about “Maintaining the Patient Story Across Transitions of Care”?
A significant percent—some estimates as high as 85%—of the information needed to care for a patient at some point crosses enterprise boundaries. For the first time, Health Story will demonstrate how to maximize the information available to the Electronic Health Record (EHR) while maintaining the patient story using all available channels, from unstructured, scanned documents to dictated notes enriched with abstractor, computer-assisted and Natural Language Processing (NLP) coding.
The American College of Physicians (ACP) recently developed a use case to
address gaps in the referral process—a critical area of care transition and coordination. The intent was to define a “care coordination agreement,” including the interactions and expectations for information exchange to improve the referral process. The ACP allowed Health Story to demonstrate its use case at the HIMSS12 Interoperability Showcase using the clinical document standards that Health Story helped create through the HL7 International data standards organization over the previous three years.
As an example… let’s look at a Patient Visit to Primary Care Physician, Dr. Crow.
A patient visits Dr. Crow due to fatigue, rapid weight loss and increased thirst. Dr. Crow conducts an exam, dictates and authenticates a progress note, pulls historical patient information for review, and consults an Endocrinologist who agrees to see the patient the next day. Dr. Crow creates and sends a lab order, and asks the patient to go for testing. He then dictates a referral request, which is sent to the Endocrinologist along with all related historical documents. Dr. Crow uses an EHR system, dictation with NLP, and a Multifunction Peripheral (MFP) to scan documents.
1. M*Modal: Dr. Crow conducts an exam and dictates a Progress Note. See M*Modal create a level-3 HL7 CDA Progress Note using real-time speech recognition and real- time natural language understanding technologies, which can also leverage prior documentation and automated summarizations from prior data.
2. Verizon: Verizon uses a secure transport layer throughout the demonstration to exchange all CDA documents. Visitors can review transport history using Medical Data Exchange with audit logs.
3. Canon/Nuance: Dr. Crow’s office scans historical patient records (progress note and lab) using Canon imageRUNNER ADVANCE MFP embedded with Nuance eCopy ShareScan v5 to turn the documents into HL7 CDA Unstructured Documents.
4. MIE: MIE demonstrates the ability to collect and integrate HL7 CDA documents with its EHR system. Dr. Crow authenticates the Progress Note and sends the Referral Request to the Endocrinologist. (MIE received a level-2 CDA-based Referral Request from Lantana Consulting Group, which created it from dictation using its Trifolia Toolkit with HL7 greenCDA.
Visit the Lab (hand carry your lab (printed at the Canon station) to the next stop.
www.healthstory.com
Or let’s consider a Patient Visit to Endocrinologist, Dr. Nest:
The patient visits Dr. Nest and shares a hard copy of his lab results. Dr. Nest’s office staff scans the lab results, and she performs a full physical examination of the patient. Dr. Nest produces a History & Physical and Referral Response letter, which is made available to Dr. Crow and a Clinical Knowledge Exchange. Dr. Nest uses an MFP to scan documents, a documentation creation system, NLP coding system, and a Clinical Knowledge Exchange.
5. Inofile with Fujitsu and Ricoh: Dr. Nest’s office scans the hand-carried lab report, and locates the patient in the system. A Fujitsu scanner or Ricoh MFP running Inofile software is used to combine live patient data from a Virtual Health Record and turn the lab report into an HL7 CDA Unstructured Document, which is sent to Apixio via XDR.
6. ChartLogic: ChartLogic Stella automatically registers the patient in Dr. Crow’s workflow using the incoming CDA documents. Dr. Nest reviews the new lab and the notes provided by Dr. Crow. She examines the patient and uses Stella to build both a level-2 CDA-based History & Physical and a CDA-based Referral Response.
7. OptumInsight: Optum demonstrates how it extracts codes from the History & Physical using NLP.
8. Lantana Consulting Group: Lantana shows how it takes the level-2 CDA-based History & Physical from ChartLogic and merges it with NLP coded data from Optum to create a level-3 CDA using the Lantana Trifolia Toolkit.
9. Apixio: Dr. Nest uses Apixio to review the complete patient story of all CDA documents and information sent in both directions throughout the demonstration and to make recommendations. Information is completely searchable. All documents within the demonstration can also be displayed within the MIE EHR system, allowing Dr. Crow to review the full patient story as well in preparation for patient follow up.
Here you can now see the IHE Profiles & Domains Featured, and the HL7 Standards and Tools Featured:
HL7 Clinical Document Architecture (CDA) R2 Normative Edition 2005 HL7 Implementation Guide for CDA Release 2: IHE Health Story Consolidation HL7 Implementation Guide for CDA Release 2: History & Physical HL7 Implementation Guide for CDA Release 2: Progress Note HL7 Implementation Guide for CDA Release 2: Unstructured Documents HL7 Patient Demographics Query (PDQ) HL7 greenCDA Implementation Guide Trifolia Workbench: Consolidation Project Edition 1.0
“There are Health Story members who can produce electronic documents today based on HL7 CDA,” said Bob Dolin, MD, Vice Chair of HL7 International. “We need to raise awareness of this option,” he continued. “Many EMR system vendors do not know that companies in the clinical documentation industry can produce and offer structured, electronic documents in the HL7 CDA format. And, providers are not aware that they can ask for this approach to discrete data capture, which is minimally disruptive to clinician workflow.”
New Award for Business Intelligence solutions
Health Care Dataworks, a Central Ohio company that launched three years ago to provide business intelligence solutions that enable healthcare organizations to improve their quality of care and reduce costs, was named Outstanding Start-up Business at the region’s technology and innovation awards gala.
TechColumbus announced last Thursday the winners of its annual innovation awards, recognizing Central Ohio companies for their outstanding achievements in technology, leadership and innovation. In a competitive field of more than 32 semi-finalists, Health Care DataWorks was chosen as the 2011 Outstanding Start-up Business. Winners were revealed in various categories at a gala at the Battelle Hall in the Greater Columbus Convention Center.
“We are thrilled to receive this honor,” said Health Care DataWorks CEO Herb Smaltz. “We are proud of what our team has accomplished in just three years. 2011 marked another successful year for HCD, as we continue to partner with healthcare systems across the country, providing them with the business solutions they need to improve their quality of care and cut their costs. Our Enterprise Data Warehouse solution is the BI solution that can do just that. It is exciting that TechColumbus has recognized us for both our technology and innovation.”
The TechColumbus Innovation awards are considered the premier event for the Central Ohio tech community, showcasing the best and brightest individuals, companies and technology teams for their contributions and achievements in innovation. Winners are selected by independent judges from the community and recognized in a number of different categories. Key criteria for Best Start-up Business include technical innovation that is groundbreaking, ahead of its time and/or superior to market alternatives. Health Care DataWorks offers health care systems a fully functioning enterprise data warehouse complete with all of the software and hardware needed to get fast results. This approach has resonated with healthcare systems that continue to turn to Health Care DataWorks over much larger competitors for their business intelligence needs.
Health Care DataWorks will be exhibiting at the 2012 Annual HIMSS Conference & Exhibition at the Venetian Sands Expo Center, Booth #7513. Health Care DataWorks is proud to be an exhibitor at this annual event that helps healthcare IT and management system professionals make the right decisions about their upcoming purchases. In addition, HCD CEO Herb Smaltz is moderating the education session “Implementing an Enterprise Data Warehouse” featuring two of our health system partners on Tuesday, February 21 at the Venetian Sands Expo Center, Lando 4303.
Some fun at HIMSS Las Vegas
Helen Phung at Practice Fusion, has written to ask us if we want to participate in their Challenge, at the upcoming HIMSS. We can hardly refuse – but we thought you would like to at least know about it…. here’s what she says:
“We’d like to hold a contest during the 2012 HIMSS conference in Las Vegas and hoping you could participate as well. The contest simply involves you wearing a FitBit or a Jawbone Up pedometer device – yours to keep at the end of the contest. Both conference attendees and those following the #HIMSS hashtag on Twitter could tweet their guess at how many steps you’ve taken during the day for a chance to win a device of their own. It’s that simple. We hope to give away one device each day so attendees can have a chance to follow the conversation on each day of the conference.”
Our view is; EHR needs some livening up. Full marks to Practice Fusion for doing that. They can be contacted on;helen@practicefusion.com.
New Awards in Clinical Decision Support
Logical Images’ “VisualDx®” was recognized as the Category Leader for Clinical Decision Support in the 2011Best in KLAS Awards: Software & Services report released on December 15, 2011. This recognition is awarded to vendors who have excelled in their respective market segments and signifies leadership in working with customers to resolve issues and match expectations to reality.
Logical Images VisualDx was recently included in the KLAS study Clinical Decision Support 2011: Understanding the Impact. Customers surveyed rated VisualDx a 92.7 overall score – highest of all the Clinical Decision Support (CDS) tools evaluated in the study. KLAS interviewed 404 providers about their CDS tools’ performance to understand the impact those tools are having on patient care.
KLAS performed the Clinical Decision Support 2011: Understanding the Impact study as providers embark on Stage 2 of meaningful use to measure how CDS technology is being leveraged to impact patient care. Pointing out that by itself electronic medical records (EMR) does not mean better care for patients. In 2010 KLAS performed a perception study to find out what CDS solutions providers were using. VisualDx, a diagnostic tool, was identified as one of the CDS tools being used by clinicians to assist them in navigating complex care situations in order to improve patient outcomes.
The study states that although diagnostic tools by design are used less frequently, they retain the highest customer satisfaction score among CDS tools. Those providers who are using diagnostic tools found them especially effective for patients with less common, obscure, or complex symptoms. As one provider commented “Not every misdiagnosis will translate into a lawsuit, but if we do the right things, we can avoid that risk and can really provide much better care.” It was noted that VisualDx seemed to have a wider adoption as evidenced by higher impact ratings in most measured areas including influence on decision making and impact on outcomes.
Participants of the study and KLAS subscribers can view the full study at www.KLASresearch.com.
Cloud solutions continue to grow
The eMix™ business venture incubated by DR Systems, has announced that 350 customers are now subscribing to its cloud-based service for sharing medical imaging studies and reports.
The 350th customer is Mercy Health Partners, a member of Trinity Health organization of hospitals, physicians, and other health care providers that serve the western Michigan region.
The announcement comes less then four months after eMix announced its 250th customer in August 2011. The service debuted in early 2010, when members of Image Movement of Montana (IMOM), a grassroots organization composed of Montana healthcare facilities, became the first institutions to go live with the service.
Since then, eMix has been adopted by facilities as diverse as large urban urgent-care medical centers, rural hospitals, teaching hospitals, community hospitals, radiology practices, and imaging centers.
“The addition of Mercy Health Partners to the large and growing body of eMix users demonstrates once again the applicability of eMix technology to medical facilities of all types and sizes,” said Florent Saint-Clair, eMix general manager. “Our multi-layered security approach satisfies the requirements of the largest, most sophisticated institutions. In addition, eMix’s ease of use and quick implementation is appreciated just as much by a hospital like Mercy as it is by independent imaging centers and radiology practices.”
eMix, which stands for Electronic Medical Information Exchange, enables secure sharing of images and reports among disparate institutions and physicians via the Internet. As a vendor-neutral, cloud-based technology, eMix makes possible the near-instantaneous transfer of imaging and other medical data, even between information technology systems that don’t normally “talk to each other.”
eMix provides eight layers of security to protect healthcare institutions’ patient data. The eMix security architecture enables institutions to comply with requirements of the Health Insurance Portability and Accountability Act (HIPAA), as well as enforce strict security policies of their own.
Using eMix is as simple as using email. The technology eliminates the need for provider facilities to burn CDs, print films, or fax reports. Because eMix is a hosted service, hospitals and other healthcare providers do not need to purchase or maintain any additional hardware or software, or to maintain virtual private networks.
eMix utilizes infrastructure solutions from EMC and data center virtualization technology from VMware.
Cloud computing is a virtual IT infrastructure that combines the controls and security of today’s data center with the agility required for eMix’s innovative approach to exam-sharing, while substantially reducing costs.
New features recently added to eMix include:
*Zero-Footprint eMix Viewer, which enables the receiver of an eMix package to clinically review the images on a web-connected computer or mobile device utilizing only an industry-standard browser.
*eMix EMRconnect™,which enables a reading facility to set up its referring physicians to receive reports automatically into their EMR inbox.
*Auto-Upload and Auto-Address, which enables users to upload an exam and address it to the recipient with one click.
eMix is a business venture incubated by DR Systems, one of the most respected names in healthcare information systems. Electronic Medical Information Exchange (eMix) is cloud-based technology developed for sharing medical imaging studies and reports between disparate healthcare facilities and physicians with the speed and simplicity of email. eMix will also facilitate the inclusion of patient images into electronic medical records (EMRs) and patients’ personal healthcare records (PHRs).
The business-to-business capability of eMix will be followed with the launch of a patient portal for business-to-consumer data exchanges, as well as a long-term storage feature with highly flexible user-driven storage rules and options.
Europe ehealth gets US boost
Qualcomm Inc. is the latest member to join COCIR in 2011. Qualcomm’s membership will strengthen COCIR’s position of excellence and leadership in eHealth. As one of the key leaders in 3G and next-generation mobile technologies in healthcare and other sectors, Qualcomm brings to the COCIR family considerable expertise in the integration of wireless connectivity and medical devices through its Qualcomm Life subsidiary.
On announcing the company’s decision to join COCIR, Isabella de Michelis, Vice President for Public Policy Europe, Middle East and North Africa said “Qualcomm is proud to join COCIR. We strongly believe in the potential of mobile technologies to address social and economic challenges and enhance people’s lives.”
“Mobile networks are the largest global existing platform and mobility solutions are unique in empowering the billions of 3G mobile users to take control of their health regime by providing secure personalised connected platforms. Technology innovation connects patients with their doctors, their care givers and their family members and enables real-time monitoring and response. We look forward to working with COCIR to promote mHealth, by taking advantage of mobile networks and affordable devices that will allow for new partnerships to flourish between the ICT and the health ecosystems,” she added.
COCIR Secretary General Nicole Denjoy said “We are delighted to welcome Qualcomm to COCIR so they can contribute to our combined efforts with other highly innovative and recognised COCIR companies, known for their leadership in healthcare delivery in Europe. As we continue into 2012 with many challenges and opportunities, this combination of efforts and competences will be crucial to contribute to better quality, increased access and cost- efficient solutions.”
Another award for DR Systems. Second time in a month.
KLAS® has recognized DR Systems and its Unity™ RIS-CVIS-PACS platform as the #1 ranked overall PACS vendor and product in its “2011 Top 20: Best in KLAS Awards – Software & Services Report.”
This is the second year in a row that DR Systems and the Unity Platform have received the honor. DR Systems was rated ahead of all other PACS providers including GE Medical Systems, Carestream Health, McKesson, Siemens, Phillips, and Merge.
The award marks the fifth time since 2001 that DR Systems has been ranked the #1 overall PACS vendor by KLAS. The company received the #1 overall PACS vendor ranking in 2001, 2006, 2007, 2010, and now 2011. In addition, in 2007, DR Systems was ranked the #1 overall healthcare information technology vendor by KLAS.
Earlier this year, KLAS recognized DR Systems as the leading PACS vendor for large hospitals in its November 2011 KLAS Specialty Report: PACS 2011- A Victim of Its Own Success. As with the overall top ranking for PACS, this was the second year in a row that DR Systems was voted the leading PACS vendor for large hospitals.
KLAS is a prominent research and consulting firm that specializes in monitoring and reporting the performance of healthcare information technology vendors, including picture archiving and communication systems (PACS) companies. The annual KLAS award “signifies leadership in working with customers to resolve issues and match expectations to reality.” For more information about KLAS, visit www.KLASresearch.com.
Healthcare executives, managers, and clinicians representing several thousand hospitals and clinics contributed feedback for the KLAS report.
“The 2011 KLAS report continues to reiterate that DR Systems works extremely hard at not only delivering cutting edge technology, but also at keeping our customers involved in what we do and how we do it. Being named the #1 Overall PACS provider 5 times in the last 11 years can be attributed to the relationships we work very hard at establishing with every customer,” said Richard Porritt, DR Systems’ President and CEO.
“We are especially pleased by this honor because KLAS compiles the views of thousands of PACS users and healthcare provider executives across the country – in other words, the people whose job it is to evaluate the best PACS in every category from functionality to reliability to cost.”
“How can we regularly outperform major multinational corporations like GE, McKesson, Philips and Carestream? Our entire company is 100% focused on enterprise diagnostic imaging related solutions, rather than just having an imaging division in a diverse business. The KLAS award confirms that we are closer to our customers and therefore better able to respond to their input and meet their needs.”
DR Systems’ latest offerings include: Unity™ v|Series RIS. Both desktop and server virtualization-capable, the new RIS can be accessed from pre-existing PACS or RIS workstations as well as mobile/non-mobile computing devices. It employs industry-standard methods for single sign-on and exam synchronization. A multi-site practice can employ a single unified Unity v|Series RIS worklist to launch and drive one or more PACS, or can launch the DR Systems Unity v|Series RIS/Reporting system from a third-party PACS.
The DR Systems Meaningful Use EHR will help qualify radiologists for the maximum federal incentive payments available for meaningful use (MU) compliance. Certification of DR Systems’ e|HR Meaningful Use EHR is anticipated for 1st quarter 2012 and General Availability in 2nd quarter 2012.
New PACS recognition awards from Klas
DR Systems has once again been recognized by KLAS as the leading PACS vendor for large hospitals. This is the second year in a row that the company has received the top ranking.
The ranking is published in the KLAS Specialty Report: PACS 2011. The company was rated ahead of all other PACS companies including McKesson, Fuji, GE Medical Systems, Siemens, Philips, and Merge.
The DR Systems Unity™ RIS/PACS received the top ranking in the category of large hospitals – defined as hospitals with 200 or more beds. Research for the report encompassed interviews with 423 healthcare provider organizations.
KLAS cited DR Systems for its continued “strong run of high performance in the large-hospital PACS market” and noted that “clients evangelize DR Systems more than they evangelize any other PACS vendor.”
The company also received the highest percentage of positive commentary among all PACS vendors, including 100% positive commentary in functionality/upgrades.
“Most [DR Systems] customers reported feeling they have a true partnership and a voice in the ongoing development and progress of the Unity PACS platform,” KLAS reported.
DR Systems has also been recognized by KLAS as the #1 overall PACS vendor in four of the last ten years (2001, 2006, 2007 and 2010). The 2011 winner will be announced later this year.
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