Care and Collaboration

Physicians prefer VistA. So should decision makers.

Posted on: July 24th, 2014 by Edmund Billings, MD 1 Comment
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Let’s start simply with the results. The questions will come later.

In their 2014 EHR Report—a survey of 18,575 physicians on their EHR preferences—Medscape concludes that doctors like using the VA’s Computerized Provider Record System (CPRS), the core electronic record in the broader VistA platform, more than any other solution. Read more …

The VA Waitlist Fiasco: VistA should not be thrown out with the bathwater

Posted on: July 1st, 2014 by Edmund Billings, MD 1 Comment
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Without a doubt, the death of American veterans as a result of the VA waitlist debacle is tragic and unacceptable. The Obama administration must move quickly and deliberately to fix the underlying problems and restore faith in the agency. Read more …

VistA and Epic: A Tale of Two Systems

Posted on: June 10th, 2014 by Edmund Billings, MD 1 Comment
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Two Platforms, Two Approaches

Over the last few weeks, access to VA health care for veterans has been all over the news.  At the same time, the DoD is moving to procure a replacement EHR system.  So it seems there is no time like the present to review a recent RAND case studies report entitled “Redirecting Innovation in U.S. Health Care: Options to Decrease Spending and Increase Value.”   Read more …

An unfunded EHR mandate for behavioral health: All stick, no carrot

Posted on: May 13th, 2014 by Edmund Billings, MD No Comments
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Why politics, parity and performance requirements mean behavioral health hospitals should adopt now

Imagine you go to work one day and your boss says all employees will be evaluated based on the performance of a new set of job skills that require additional training and, perhaps, new computer hardware and software. The boss also announces that some employees will be reimbursed for the cost of acquiring these skills and tools. You aren’t among this privileged group. Read more …

The ICD 10 Extension: For whatever reasons, Congress did the right thing!

Posted on: April 23rd, 2014 by Edmund Billings, MD 1 Comment
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Did you hear the one about the CMS administrator who was asked what it would take to delay the 2014 ICD-10 implementation deadline? An act of Congress, he smugly replied, according to unverified reports.

Good thing he didn’t say an act of God. Read more …

Does ICD-10 pilot forecast a perfect storm for healthcare?

Posted on: December 9th, 2013 by Edmund Billings, MD 5 Comments
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Let me concede from the outset that, in this blog post, I lean toward the negative—dire predictions, worst-case scenarios, a bit of doom and gloom, etc.

But I ask you, oh gentle, patient reader, how could I not? Read more …

Darwinian Health IT: Only well-designed EHRs will survive

Posted on: October 7th, 2013 by Edmund Billings, MD 1 Comment
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Remember the Ford Pinto and the AMC Pacer, aka the Pregnant Pinto? Both serve as reminders of an era in which the American auto industry lost its way and assumed drivers would buy whatever they put on the lot. Foreign competition, primarily from Japan, filled the void created by American apathy for quality and design, and the industry has never been the same. Read more …

Health IT Innovation? Not Without Open Platforms

Posted on: July 22nd, 2013 by Edmund Billings, MD No Comments
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The word ‘innovation’ gets bandied about with such frequency in healthcare analyses these days, you’d think it had some kind of magic transformational power. Read more …

Defense Probably Goes Commercial, Not Necessarily Proprietary

Posted on: June 5th, 2013 by Edmund Billings, MD 2 Comments
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Secretary of Defense Chuck Hagel’s long-awaited (in health IT circles, anyway) decision on the Department of Defense’s core health IT system has been made. The VA’s VistA system is out as the preferred DoD. Unless it’s not. Read more …

The HIT Tipping Point: Intended and Unintended Financial Consequences

Posted on: May 9th, 2013 by Edmund Billings, MD 1 Comment
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A question: What is the opposite of health IT return on investment?

The answer: Unintended financial consequences, or UFCs, for short. Read more …

For hospitals on the edge, HIT is the tipping point

Posted on: April 29th, 2013 by Edmund Billings, MD No Comments
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“No aspect of health IT entails as much uncertainty as the magnitude of its potential benefits.”

A few years into the Meaningful Use program, it seems this quote from a 2008 Congressional Budget Office report entitled “Evidence on the Costs and Benefits of Health Information Technology” may have been written with the assistance of a crystal ball.

Fast forward to 2013. Read more …

Republicans, Democrats Agree on IT Procurement; Apocalypse Expected Wednesday

Posted on: April 8th, 2013 by Edmund Billings, MD No Comments
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In these politically polarized times, Americans expect Republicans and Democrats to disagree on every detail right down to what day of the week it is. This is especially true in the posturing hurly-burly of the House, where members can appeal to the few select priorities of a gerrymandered district to win re-election. Read more …

Medsphere Voices Support for Sweeping Changes to Government IT Purchasing

Posted on: April 3rd, 2013 by Medsphere No Comments
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Technology Reform Act could be most significant reform of federal tech acquisition in more than 20 years

Carlsbad, Calif. —Medsphere Systems Corporation, the leading provider of affordable and interoperable healthcare IT platform solutions, today issued a public statement of support for the Federal Information Technology Acquisition Act (FITAR). The House legislation (H.R. 1232), jointly sponsored by California Republican Darrell Issa and Virginia Democrat Gerry Connolly, recently moved with unanimous bipartisan support from the House Oversight and Government Reform Committee to the floor for a full vote. Read more …

Beyond HIT Interoperability: Open Platforms are the Key

Posted on: March 12th, 2013 by Edmund Billings, MD No Comments
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I want to begin by sharing well-known information for the sake of comparison. Both the Apple and Google Android platforms welcome the introduction of new and (sometimes) highly valuable functionality through plug-n-play applications built by completely different companies.

You know that already. Read more …

IntraCare Behavioral Health Selects OpenVista® Healthcare IT Solution

Posted on: March 6th, 2013 by Medsphere No Comments
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Houston, TX, and Carlsbad, CA – March 6, 2013—Medsphere Systems Corporation, the leading provider of affordable and interoperable healthcare IT platform solutions, today announced that Houston’s IntraCare Behavioral Health will implement the company’s OpenVista® electronic health record (EHR).

Click here to read the release in its entirety.

Is HIT interoperability in the nature of healthcare?

Posted on: February 12th, 2013 by Edmund Billings, MD 6 Comments
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Anyone who understands the importance of continuity of care knows that health information exchange is essential. How are we supposed to cut waste and duplication from the healthcare system and truly focus on patient welfare if doctor B has no idea what tests doctor A conducted, or what the results were? Read more …

It’s the System, Stupid: Reversing the Law of Unintended Consequences

Posted on: February 4th, 2013 by Edmund Billings, MD 1 Comment
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We should have seen it coming, really. It was entirely predictable, and the most recent RAND report proves it.

We incentivized comprehensive IT adoption, making it easier to bill for every procedure, examination, aspirin, tongue depressor, kind word and gentle (or not) touch without first flipping the American healthcare paradigm on its head, if such a thing is even possible. Read more …

The RAND Report: Are healthcare and health IT in a dysfunctional relationship?

Posted on: January 22nd, 2013 by Edmund Billings, MD 3 Comments
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What a week! First the disgraced cyclist confession and later the baffling college-football-player-and-his nonexistent-(dead)-girlfriend story, with the RAND report sandwiched somewhere in between. It’s positively a scandal-palooza. Read more …

A Tale of Two Studies: What are the actual costs of an EHR?

Posted on: January 10th, 2013 by Edmund Billings, MD 3 Comments
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Does anyone in their right mind believe that these are the best of times in healthcare or health IT?

Scratch that.

Does anyone besides Judy Faulkner and Neal Patterson believe these are the best of times? Read more …

Considering an Epic Journey in 2013? Think Twice

Posted on: December 6th, 2012 by Edmund Billings, MD 1 Comment
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Faced with healthcare reform and any number of other enduring challenges, hospitals shouldn’t expect next year to be any easier than the one that’s currently winding down. Yes, that’s my grand prognostication for 2013—things will still be difficult. Read more …

An Election on Health Care and Costs

Posted on: November 9th, 2012 by Edmund Billings, MD No Comments
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The recently concluded election was seen by many as a referendum on the 2010 Affordable Care Act, now widely known and even embraced by the president as Obamacare. President Obama’s re-election ensures that the implementation of reform will continue, but how a divided Congress deals with it while trying to control federal spending will remain an open question for some time. Read more …

And the survey says … physicians prefer VistA

Posted on: October 31st, 2012 by Edmund Billings, MD 4 Comments
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Two recent surveys clearly show that, when it comes to enterprise EHRs, physicians prefer VistA.

In a 2012 survey by Medscape, 21,000 physicians in 25 specialties were asked to evaluate enterprise EHRs in hospital-based health delivery networks based on the following characteristics: Read more …

CPOE: Meaningful Use’s primary obstacle is VistA’s greatest strength

Posted on: October 9th, 2012 by Edmund Billings, MD No Comments
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A study recently published in the Journal of the American Medical Informatics Association (JAMIA) identifies the implementation and adoption of Computerized Provider Order Entry (CPOE) functionality as the number one barrier for hospitals working toward Meaningful Use Stage 1. Read more …

Buy vs. Build, or the Best of Both

Posted on: September 20th, 2012 by Edmund Billings, MD 1 Comment
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When it comes to IT system decisions, healthcare organizations often ask a key question: Should we buy it or should we build it ourselves? Open source offers a new option to this traditionally binary decision. This option becomes more compelling when the open source solution is the most broadly deployed EHR in the world—the VistA system from the U.S. Department of Veterans Affairs (VA). Instead of Buy vs. Build, it’s the Best of Both.

Read more …