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Epic launches patient-data-sharing platform that works without EHRs

Epic has launched a new global interoperability platform called Share Everywhere.

Healthcare Dive reports that it lets patients “grant access to their personal data to any provider with Internet access, regardless of whether they have EHRs. Providers can also send progress notes to the patient’s primary care organization, enhancing care coordination and continuity.

“The technology builds on Epic’s Care Everywhere technology, which allows organizations to exchange patient records between Epic and non-Epic systems. Some 2 million records move about on Care Everywhere on a daily basis, according to Epic.’’

Using their smartphones, patients can forward a view of their Epic chart to any clinician. The patient determines who has access and Epic records each exchange.

Such EHR vendors as Epic, Cerner and Allscripts are all starting to accept beginning  open platforms and thus a more connected digital experience for their clients. Healthcare Dive says “The move could open the door to more novel features and capabilities in areas like population health and data sharing.’’

To read more, please hit this link.



MD Anderson trying to stem losses


The famed and very expensive University of Texas MD Anderson Cancer Center, in Houston, may lay off staff and cut back research cutbacks after major operating losses, the Houston Chronicle reports.

MD Anderson had  an operating loss of $60.9 million for October, compared to an operating surplus of $11.5 million a year earlier.

IMD Anderson officials have blamed its recent financial woes on such factors as  a costly Epic EHR implementation as well as a decline in the number of potential patients because of restricted insurance coverage.

That could  include cutbacks to its celebrated “Moon Shots” cancer research program, Dan Fontaine, MD Anderson’s executive vice president of administration, told the  Chronicle.

Mr. Fontaine told the paper that the hospital executives are asking physicians “to make it easier for patients to get in the door” through  such efforts as more patient education on MD Anderson’s offerings and easing criteria that can  stop patients from enrolling in medical trials or receiving care at the hospital.

Mr. Fontaine noted an improved financial picture in November as a result of belt-tightening and promotion.

To read the Chronicle story, please hit this link.


Epic rebuts Jonathan Bush’s remarks on connectivity


Epic has fact-checked a   recent interview of  athenahealth co-founder and CEO Jonathan Bush in MedCity News and found some of his assertions wanting.

The interviewer asked Mr. Bush what he would ask of Epic if he were a hospital chief information officer.

“‘I would ask them to connect and that’s starting to happen,’ Mr. Bush said in the interview. adding that   athenahealth can now connect to “most of the Epic-user hospitals in the country,” but that they have only been able to do so in the past couple of months.

Epic said that statement is false. “Epic customers have been exchanging patient records with others since 2008. One hundred percent of Epic’s live customers are able to connect with other groups that use either Epic or non-Epic systems,” the company said.

Epic also said that  Epic and athenahealth sites started to connect back in May 2014.

Mr. Bush also said in the MedCity News interview that Epic was subpoenaed by the House Energy and Commerce Committee regarding information-blocking.

“Epic has never been subpoenaed by Congress,” Epic retorted.

To read the Becker’s article on this flap, please hit this link.

To read the MedCity News article, please hit this link.

Partners in frustration



Anger and frustration are rife in the still rocky introduction at Partners HealthCare’s hospitals, in Greater Boston, of Epic’s electronic health record system. Some say the technology is hurting patient care and reducing efficiency. This Boston Globe story tells the tale well.



Brigham reports big deficit; EHR part of the problem



In the Brigham and Women’s complex.

Boston-based Brigham and Women’s Hospital has  its first budget deficit in more than 15 years, reports STAT, the healthcare-news service connected to The Boston Globe.

The Partners HealthCare institution was $53 million short of its budget in the fiscal year that ended Sept. 30. Part of this was connected to unexpected costs of its EHR transition.

STAT reported that the EHR transition — part of an Epic implementation across 10 Boston-based Partners HealthCare hospitals — “cost Brigham $27 million more than its $47 million cost estimation,” reported Becker’s Hospital Review.

The hospital cited   improperly coded patient visits  that led to lower reimbursements from insurers, estimated at $13.5 million of the $27 million in excess costs. “The other half came from reduced patient volume this past summer in an attempt to avoid miscoding,” reported Becker’s


Increasing the number of physicians who know veterans’ issues



“Memorial Day, Boston,” by Henry Sandham.


For Kaiser Health News

Most former servicemen and women (and their families) get their healthcare at civilian facilities, where only rarely do health professionals ask patients if they or close relatives have a military background. But not only do veterans suffer from a disproportionate share of ailments such as post-traumatic stress disorder and brain injury, many who were in combat zones may also have been exposed to hazards such as the defoliant Agent Orange in Vietnam, or huge burn pits in Iraq and Afghanistan that produced toxic fumes.

Recognizing the potential for missing important health issues, a small group of medical professionals banded together to ensure that in the future doctors will at least be aware of the possible medical problems of former military members, who now number about 14 million. Going forward, the exam every medical student and new physician must take to get a license will include questions about military medicine. That, in turn will force medical schools to teach it.

Brian Baird, a former Democratic member of Congress from Washington and a licensed clinical psychologist, has helped spearhead the change, which is being publicized as the country prepares for Veterans Day this Wednesday. He said he was inspired by some of his own patients who returned from duty in need of help.

“We don’t even ask, ‘Have you or a loved one been deployed overseas,’” he said in an interview. “And I thought, what a terrible oversight.”

Baird set out to talk to every medical organization he could find. Several responded, or were working on a similar project at the same time, including the White House’s “Joining Forces” initiative.

Baird found an eager partner in Steven Haist, a physician and vice president at the National Board of Medical Examiners, which develops and runs the U.S. Medical Licensing Exam.

Haist has spent nearly four years organizing the effort and bringing in specialists from the Department of Veterans Affairs and every branch of the military to develop and write the questions. Military medicine will be included in all three of the exam’s “steps,” which students take at different points in medical school and after they complete the early phases of post-graduate training.

“In some respects, I think it could have been done a lot sooner,” said Haist, given many of the well-recognized issues affecting returning troops from Vietnam and the first Gulf War. But he said he hopes that ensuring that physicians know about potential problems “will improve the health care that is received by returning deployed servicemen and women and their families.”

Karen Sanders, M.D., who helps oversee academic training for the VA, and who got the project funded, says she’s confident the change will make things happen. “If you change the exams, schools and curricula will follow,” she said. “We hope this will drive schools to offer courses” in medical conditions experienced by members of the military. A surveyconducted by the Association of American Medical Colleges found that as of 2012, only about half the schools had such courses.

Other medical organizations have also acted to better integrate the health problems stemming from military duty into non-military health care. Both the American Medical Association and American Academy of Nursing are actively encouraging providers to ask patients about their or a family member’s military service.

But encouraging is not enough, say Howard and Jean Somers. Their son, Daniel, committed suicide in 2013 after being unable to receive treatment for mental-health issues upon returning from Iraq. They have been working to improve the care at the VA and bring more attention to returning troops’ health problems ever since.

“How do you make it a requirement without making it part of the licensing or re-licensing,” said Howard Somers, a retired urologist.

They called putting questions on the licensing exam “fantastic,” but stressed that something similar needs to be done to educate doctors who have completed their training and initial licensing.

In order to maintain his medical license, said Howard Somers, “I had to take an online course in pain management. That would be another way to address this, to get medical societies to make this a requirement.”

Former Congressman Baird agrees. “I’ve asked a lot of physicians about it, and many of them said, ‘You know I’ve had courses in things I will never see in my practice. But there’s a pretty darn good chance I’m going to see somebody who’s been deployed.’”

But getting military service training to be a required part of continuing education for doctors is a daunting task. “You’d have to deal (separately) with every state medical board,” says the VA’s Sanders.

There is also a parallel effort to put questions about military service not just on intake forms that patients fill out but also in the electronic medical records that are filled in by health care providers.

Epic, a spokeswoman for Epic, the dominant software developer in the market, said that the company’s standard record does include questions about military service, but they don’t show up unless the customer  — a hospital or doctor’s office – requests that.  “Pediatrics, for example, will not turn it on,” she said.

But Baird insists that the question should be included on every single electronic medical record, including those for children: “The classic case would be a child struggling in school, who can’t sleep.” A doctor might prescribe medication, he said, “but never stops to ask if anybody in the (child’s) family has been deployed.”

Baird recognizes that while the adoption of the test questions marks a milestone, there is still a long way to go. “My goal is nothing less than making this a permanent  aspect of our medical education and our health care system,” he said. “It’s rather shocking that it hasn’t been done actually.”

Epic does mighty well without marketing


Epic, the healthcare-software giant, is a famously secretive company that mostly doesn’t market its wares and yet remains the dominant force in its sector.

Only about 1 percent of Epic’s employees  are  in sales and marketing. The company doesn’t issue press releases and he hasn’t a “media” department on its Web  site.

“When I started the company, I had no idea how to do marketing, so we just didn’t do it,” founder, in 1979, and still CEO Judith Faulkner told Becker’s Hospital Review. “What I did know, because I was a technical person, is to be able to write good software. So we focused on writing good software, and we focused on doing good support. And then fortunately, word of mouth did the rest.”

Pressed by Feds, EHR vendors to waive sharing fees



EPIC and other electronic health record vendors have agreed to waive record-sharing fees after the Feds warn them about “data blocking.”

The fees have long irritated hospital executives. Now it appears that all EHR vendors will agree to absorb providers’ usage costs in sharing patient records.

It’s another advance for the much desired  and long overdue full interoperability  of EHR systems


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