Mike Miliard

Open-source technology will offer flexibility and cost-efficiencies, officials say.

Other new contributor members include lifeIMAGE, a medical image sharing network, and MediPortal, a developer of patient engagement tools.

A recent study funded by Agency for Healthcare Research and Quality suggests that patients with fully electronic health records experienced fewer adverse events such as hospital-acquired infections. In order to be considered a fully electronic EHR, "physician notes, nursing assessments, problem lists, medication lists, discharge summaries and provider orders are electronically generated," according to researchers. Using 2012 and 2013 Medicare Patient Safety Monitoring System data, AHRQ examined outcomes for cardiovascular, pneumonia and surgery patients – specifically with regard to occurrence rates of 21 adverse events in four clinical domains: hospital-acquired infections, adverse drug events, general events (falls or pressure ulcers, for instance) and post-procedural events. [Also: CMS awards $110M for patient safety] "To assess the role of EHRs in preventing adverse events, the researchers measured to what extent care received by patients in the 1,351 hospitals was captured by a fully electronic EHR," said Amy Helwig, MD, deputy director of AHRQ's Center for Quality Improvement and Patient Safety, and Edwin Lomotan, MD, medical officer and chief of clinical informatics at AHRQ's Center for Evidence and Practice Improvement, in a blog post. The findings of the study, published in the Journal of Patient Safety, show that, of more than 45,000 patients at risk for nearly 350,000 adverse events in the study sample, 13 percent were exposed to fully electronic health records. Among all patients examined in the study, the occurrence rate of adverse events was 2.3 percent, or 7,820 adverse events. Patients with EHRs, meanwhile, had 17 to 30 percent lower odds of any adverse event. Helwig and Lomotan said that health IT has shown patient safety gains, but research to prove it has often looked at just one healthcare provider at a time. "A question that remains unanswered is the impact of fully installed electronic health records systems used in multiple organizations," they wrote. "Another big question: can EHRs go beyond improving safety-related processes to actually preventing adverse events, such as potentially deadly hospital-acquired infections, from reaching patients?" The findings from "Electronic Health Record Adoption and Rates of In-hospital Adverse Events"  suggest hospitals with EHR can offer more coordinated care from admission to discharge to reduce the risk of patient harm. They note, however, that adverse event odds varied by medical condition and type of event. “For example, patients hospitalized for pneumonia and exposed to a fully electronic EHR had 35 percent lower odds of adverse drug events, 34 percent lower odds of hospital-acquired infections, and 25 percent lower odds of general events. Among patients hospitalized for cardiovascular surgery, a fully electronic EHR was associated with 31 percent lower odds of post-procedural events and 21 percent fewer general events," they wrote. [Like Healthcare IT News on Facebook] Helwig and Lomotan caution that the AHRQ study raises a few questions. “The findings showed a significant relationship between fully electronic EHRs and adverse drug event rates for patients hospitalized with pneumonia, but not for those with cardiovascular disease or needing surgery,” they wrote. “This may be due to the fact that certain high-alert medications, such as opioids, which are often associated with adverse drug events, were not included in the MPSMS measures." Still, the authors said as more hospitals mature in their use of EHRs, those systems can play a key role in preventing adverse events. Twitter: @MikeMiliardHITN

Cerner has launched its new Cerner Open Developer Experience -- known as "code_" -- in a bid to spur wider collaboration with third-party and client developers for SMART on FHIR applications. SMART on FHIR tools run on top of electronic health records, giving physicians access to the apps from within their workflow, enabling them to more easily interact with health data. Developers who visit code.cerner.com can begin coding immediately with the SMART on FHIR tools and browse current apps that are available or in development. Cerner officials say code_ is designed with open communications and robust API documentation in mind, meant to offer access to tools that enable innovative app development. See all of our HIMSS16 previews "Cerner is committed to taking a leadership role to support third-party developers and help further health information technology," said David McCallie, MD, senior vice president, medical informatics, at Cerner, in a statement. "Encouraging innovators to develop apps that work across existing health records can help the industry advance the way care is delivered through improved interoperability capabilities," he added. [Also: Cerner adds FHIR power] Fifteen new SMART on FHIR apps are in development or in production and will be showcased in Cerner (Booth 2032) at HIMSS16, which takes place Feb. 29 to March 4, at Sands Expo Center in Las Vegas. "Fostering new ideas from the developer community enables us to reach a broader market of potential users,” said Bob Robke, Cerner's vice president of interoperability, noting that the platform "has potential to unlock the next cutting-edge solution that could benefit not only our entire client base, but the industry as well." Twitter: @MikeMiliardHITN This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

WellSpan Surgery and Rehabilitation Hospital is the latest health organization to earn a Stage 7 Award from HIMSS Analytics. The achievement represents the York, Pennsylvania-based hospital’s attainment of the highest level on the Electronic Medical Record Adoption Model, whose eight stages measure a facility's prowess in implementing and using information technology. Only 4.1 percent of the more than 5,400 hospitals in the U.S. have reached Stage 7, which requires a complete EMR environment with continuity of care transactions, and data continuity with the ED, ambulatory sites and more. [Also: Stage 7 success stories] WellSpan Health, which serves the communities of central Pennsylvania and northern Maryland, is an an integrated health system with more than 850 physicians and advanced practice clinicians, a home care organization, six hospitals and more than than 140 patient care locations. John H. Daniels, global vice president in the healthcare advisory services group, of HIMSS Analytics, said a couple things stood out during a validation site visit to WellSpan Health – notably, strong operational and governance support of its overall electronic health record strategy and a commitment to clinical leadership in its IT projects. "This approach was evident in the case studies they presented that showed significant benefits realization in improved outcomes and cost savings," Daniels said in a statement [Like Healthcare IT News on Facebook] R. Hal Baker, MD, senior vice president of clinical improvement and chief information officer at WellSpan, said the hospital "was built around leveraging the electronic medical record," and pointed to effective the integration of biomedical devices as one of its biggest achievements. WellSpan Surgery and Rehabilitation Hospital will be recognized at the 2016 HIMSS Conference & Exhibition, which takes place Feb. 29, through March 4, at the  Sands Expo Center in Las Vegas. Twitter: @MikeMiliardHITN This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

Analytics functionality has improved measurably in recent years, according to Chilmark Research, but  workflow integration remains a key hurdle.

Since his days as executive editor at WIRED magazine, which he led to a dozen National Magazine Awards in as many years, science journalist Thomas Goetz has been driven by a key question: "How are industries tipping in the face of information technology?"

The model will use risk stratification to help identify Medicare patients most at risk of a first heart attack or stroke in the next year.

As the Zika virus spreads from South America to the United States, epidemiologist and public health expert Christine Hockett says disease surveillance technology is key to protecting against it. Keeping open lines of electronic communication between hospitals and their state and local health agencies is critical as those departments "collect and analyze disease counts and monitor how disease spreads throughout a community or geographic location," said Hockett, who works for Xerox-owned Consilience. [Also: Experts warn of Zika epidemic as hospitals, health departments prepare] Zika, spread to people through mosquito bites, is currently most prevalent in South America. In response, the U.S. Centers for Disease Control and Prevention issued a travel alert for U.S. citizens traveling to regions where virus transmission is ongoing. But Hockett says she expects the virus to increasingly move into the United States. She points to a recent article in The Lancet, which argued that, "with an estimated 440,000 – 1.3 million cases currently in Brazil alone, Zika virus could be following in the footsteps of dengue and chikungunya, which are also transmitted by the Aedes aegypti mosquito. "Given that an outbreak anywhere is potentially a threat everywhere," the authors argued, "now is the time to step up all efforts to prevent, detect, and respond to Zika virus." "I don't think 'scared' is the right word," said Hockett. "But we need to be aware of what's happening. And definitely, I think there are certain areas of the U.S. that are more vulnerable than others." Robust electronic surveillance – data collection and reporting – is essential to keeping that spread as limited as possible. Syndromic surveillance has been a key part of meaningful use since the very beginning, of course, with the government requiring providers to prove their ability to use "timely pre-diagnostic data and statistical tools to detect and characterize unusual activity for further public health investigation." The Maven Outbreak Management Software offers Web-based case management tools that can help local and state health systems do disease surveillance, enabling them to analyze the health data from specific diseases. Rather than a siloed database, the Maven tool is accessible across jurisdictions to local and state public health departments, and can integrate electronic reporting. Outbreaks can be assessed and triaged as confirmed cases emerge or patients at risk present themselves, with updates shared electronically or via its secure Web portal, according to the company. It can also be updated as new disease threats emerge. That happened in 2014 during the Ebola crisis, and it did again earlier this month as Zika started to spread. "With the configurability of Maven, you're able to adapt to these new emerging diseases," she said. "The CDC on Jan. 15 said, 'You need to be able to do this in your disease surveillance systems.' A couple weeks later, all of our deployments have this Zika-enabled data module." Here’s how it would work from hospital's perspective. "Say I recently just traveled to Brazil," she said. "And I come back to the U.S. I go and see my primary care provider and say, 'Please test me for the Zika virus, just to make sure I don't have it.'" (Zika symptoms are very mild, and could be easy to miss.) "So I get tested, that then gets entered into the EHR system. That lab report, once the lab processes that, not only does the doctor report it to the state health department, but the lab does too. That reporting is done through the connections into Maven, which is hosted within the local and state health departments – a case is created, the epidemiologist can see that I am a potential case of Zika. They would call me and do the necessary follow up and data collection needed, specific to the virus. Once that case is confirmed, the system is able to report it to CDC." If technology is critical in the fight against Zika, however, people and process are even more so. [Also: Questions raised about EHR workflow in Ebola case] As seen in the 2014 Ebola outbreak – when a patient at Dallas-based Texas Health Resources first appeared with Ebola symptoms, but the fact that he had recently traveled from Africa, while logged in his EHR, was still missed by subsequent members of his care team – the balance between IT and clinical workflow can be a challenge. "It's definitely a collaborative effort," said Hockett. She pointed to the One Health concept, which holds that the health of humans is inextricably connected to the health of animals and the environment. [Like Healthcare IT News on Facebook] That holistic approach means there's a deep need for collaboration, she said. "Use of effective surveillance systems is essential: knowing the symptoms of the diseases that are going on, talking with your provider community and epidemiologists and local and state health departments. The communications between hospitals and local and state health departments are critical." Twitter: @MikeMiliardHITN

For the sixth straight year, Epic has secured the top spot for Overall Software Suite in the Best in KLAS: Software & Services report, which is compiled based on feedback from healthcare providers. Epic was also named the best Overall Physician Practice Vendor and received Best in KLAS awards in seven segments. The Verona, Wisconsin-based behemoth also won for best acute care EMR, ambulatory EMR, and patient portal. Epic also notched a win in the health information exchange category, for its Care Everywhere technology. Impact Advisors, meanwhile, was tops in the Overall IT Services Firm category for the fourth year running, also winning Best in KLAS for IT Advisory Services. Also, with a 20 percent score increase from last year, Medicity won recognition as the overall most improved vendor for its population health technology. Among vendors who received multiple Best in KLAS awards, Merge earned three for cardiology, radiology and VNA/image archive; athenahealth, CareTech Solutions, CureMD and Galen Healthcare each earned two awards. "As healthcare continues to evolve, it is imperative that we seek innovation and constantly address the needs of a shifting market," said Adam Gale, CEO and president of KLAS in a statement.  "KLAS is honored to work with talented healthcare providers who willingly share their experiences with us and make the Best in KLAS report possible," he said. "We also commend all the vendors who strive to improve their products and services in order to provide the best possible healthcare." Here is the full list of winners: Award Category Recipient Award Category Recipient SEGMENT LEADERS: SOFTWARE Acute Care EMR Epic EpicCare Inpatient EMR (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Ambulatory EMR (1-10 Physicians) CureMD EMR (1-10 Physicians) SEGMENT LEADERS: SOFTWARE Ambulatory EMR (11-75 Physicians) athenahealth athenaClinicals SEGMENT LEADERS: SOFTWARE Ambulatory EMR (Over 75 Physicians) Epic EpicCare Ambulatory EMR (Over 75 Physicians) SEGMENT LEADERS: SOFTWARE Business Intelligence/ Analytics Dimensional Insight The Diver Solution SEGMENT LEADERS: SOFTWARE Cardiology Merge Cardio SEGMENT LEADERS: SOFTWARE Claims and Clearinghouse ZirMed Clearinghouse SEGMENT LEADERS: SOFTWARE Community HIS MEDITECH C/S Community HIS (v.6) (Small - 1-200 Beds) SEGMENT LEADERS: SOFTWARE Document Management and Imaging Hyland OnBase SEGMENT LEADERS: SOFTWARE Emergency Department Wellsoft EDIS SEGMENT LEADERS: SOFTWARE ERP Oracle PeopleSoft Enterprise SEGMENT LEADERS: SOFTWARE Global (Non-US) Acute EMR InterSystems TrakCare EPR SEGMENT LEADERS: SOFTWARE Global (Non-US) PACS Sectra PACS (Non-US) SEGMENT LEADERS: SOFTWARE Global (Non-US) Patient Administration Systems Cerner Millennium Patient Administration System (Non-US) SEGMENT LEADERS: SOFTWARE Health Information Exchange (HIE) Epic Care Everywhere SEGMENT LEADERS: SOFTWARE Homecare Thornberry NDoc SEGMENT LEADERS: SOFTWARE Laboratory McKesson Lab SEGMENT LEADERS: SOFTWARE Long-Term Care PointClickCare SEGMENT LEADERS: SOFTWARE PACS Sectra PACS (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Patient Access Experian Health eCare NEXT (Passport) SEGMENT LEADERS: SOFTWARE Patient Accounting and Patient Management Epic Resolute Hospital Billing (Large - Over 200 Beds) SEGMENT LEADERS: SOFTWARE Patient Portals Epic MyChart SEGMENT LEADERS: SOFTWARE Population Health IBM Population Health Management Suite (Phytel) SEGMENT LEADERS: SOFTWARE Practice Management (1-10 Physicians) CureMD PMS SEGMENT LEADERS: SOFTWARE Practice Management (11-75 Physicians) athenahealth athenaCollector (11-75 Physicians) SEGMENT LEADERS: SOFTWARE Practice Management (Over 75 Physicians) Epic Resolute/Prelude/Cadence Ambulatory (Over 75 Physicians) SEGMENT LEADERS: SOFTWARE Radiology Merge Unity RIS (DR Systems) SEGMENT LEADERS: SOFTWARE Speech Recognition - Front End Dolbey Fusion SpeechEMR (EMR) SEGMENT LEADERS: SOFTWARE Surgery Management Epic OpTime SEGMENT LEADERS: SOFTWARE VNA/Image Archive Merge iConnect Enterprise Archive SEGMENT LEADERS: PROFESSIONAL SERVICES Application Hosting (CIS ERP HIS) Cerner Application Hosting (CIS/ERP/HIS) SEGMENT LEADERS: PROFESSIONAL SERVICES Extended Business Office Navigant Cymetrix SEGMENT LEADERS: PROFESSIONAL SERVICES Extensive IT Outsourcing CareTech Solutions SEGMENT LEADERS: PROFESSIONAL SERVICES HIT Enterprise Implementation Leadership Navin, Hafty & Associates (NHA) SEGMENT LEADERS: PROFESSIONAL SERVICES HIT Implementation Support & Staffing Galen Healthcare SEGMENT LEADERS: PROFESSIONAL SERVICES IT Advisory Services Impact Advisors SEGMENT LEADERS: PROFESSIONAL SERVICES Partial IT Outsourcing CareTech Solutions SEGMENT LEADERS: PROFESSIONAL SERVICES Revenue Cycle Transformation Deloitte Consulting SEGMENT LEADERS: PROFESSIONAL SERVICES Technical Services Galen Healthcare SEGMENT LEADERS: PROFESSIONAL SERVICES Value-Based Care Advisory Services Premier SEGMENT LEADERS: PROFESSIONAL SERVICES Value-Based Care Managed Services Lumeris CATEGORY LEADERS: SOFTWARE 340B Management Systems Macro Helix 340B Architect CATEGORY LEADERS: SOFTWARE Acute Care EMR (Community) Cerner Millenium PowerChart/CommunityWorks Clinicals CATEGORY LEADERS: SOFTWARE Alarm Management Connexall CATEGORY LEADERS: SOFTWARE Anatomic Pathology Cerner CoPathPlus CATEGORY LEADERS: SOFTWARE Anesthesia Epic Anesthesia Information Management System CATEGORY LEADERS: SOFTWARE Cardiology Hemodynamics Merge Hemo CATEGORY LEADERS: SOFTWARE CDI Software Chartwise CDI CATEGORY LEADERS: SOFTWARE Chargemaster Management Craneware Chargemaster Toolkit CATEGORY LEADERS: SOFTWARE Claims Management MedAssets Claims Management CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Care Plans Zynx Health ZynxCare CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Order Sets Zynx Health ZynxOrder CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Point of Care Clinical Reference VisualDx (Logical Images) CATEGORY LEADERS: SOFTWARE Clinical Decision Support - Surveillance Wolters Kluwer Pharmacy OneSource Sentri7 CATEGORY LEADERS: SOFTWARE Computer-Assisted Coding Optum Optum360 Enterprise CAC CATEGORY LEADERS: SOFTWARE Decision Support - Business Strata Decision StrataJazz Decision Support CATEGORY LEADERS: SOFTWARE ECG Data Management Epiphany Healthcare cardio Server CATEGORY LEADERS: SOFTWARE Enterprise Advanced Visualization Philips IntellisSpace Portal CATEGORY LEADERS: SOFTWARE Enterprise Scheduling Streamline Health Looking Glass Enterprise Scheduling and Resource Management CATEGORY LEADERS: SOFTWARE Image Exchange DICOM Grid DG Suite CATEGORY LEADERS: SOFTWARE Infection Control and Monitoring BD MedMined (CareFusion) CATEGORY LEADERS: SOFTWARE Integration Engines Corepoint Health Integration Engine CATEGORY LEADERS: SOFTWARE Interactive Patient Systems TVRC pCare CATEGORY LEADERS: SOFTWARE Labor and Delivery Clinical Computer Systems OBIX Perinatal Data System CATEGORY LEADERS: SOFTWARE Laboratory (Small/Ambulatory) Orchard Harvest LIS CATEGORY LEADERS: SOFTWARE Medical Device Integration Systems Capsule DataCaptor CATEGORY LEADERS: SOFTWARE Medical Records Coding 3M Codefinder CATEGORY LEADERS: SOFTWARE Mobile Data Systems Ingenious Med impower & MedAptus Pro Charge Capture CATEGORY LEADERS: SOFTWARE Oncology Varian ARIA CATEGORY LEADERS: SOFTWARE PACS (Ambulatory) INFINITT PACS CATEGORY LEADERS: SOFTWARE PACS (Community) INFINITT PACS CATEGORY LEADERS: SOFTWARE Patient Accounting and Patient Management (Community) MEDITECH C/S Patient Accounting CATEGORY LEADERS: SOFTWARE Patient Flow TeleTracking Capacity Management Suite CATEGORY LEADERS: SOFTWARE Patient Privacy Monitoring Iatric Systems Security Audit Manager CATEGORY LEADERS: SOFTWARE Pharmacy - Outpatient (Retail) QS/1 NRx CATEGORY LEADERS: SOFTWARE Point of Use Inventory Management PAR Excellence Systems CATEGORY LEADERS: SOFTWARE Quality Management Nuance Clintegrity 360 Quality Management Solutions CATEGORY LEADERS: SOFTWARE Secure Messaging Imprivata Cortext CATEGORY LEADERS: SOFTWARE Single Sign-On Imprivata OneSign Single Sign-On CATEGORY LEADERS: SOFTWARE Speech Recognition - Back End Dolbey Fusion Speech CATEGORY LEADERS: SOFTWARE Staff/Nurse Scheduling GE Healthcare API Healthcare ShiftSelect CATEGORY LEADERS: SOFTWARE Talent Management Halogen Software TalentSpace for Healthcare CATEGORY LEADERS: SOFTWARE Time and Attendance Kronos Workforce Timekeeper CATEGORY LEADERS: SOFTWARE Treatment Planning Varian Eclipse CATEGORY LEADERS: SOFTWARE Urgent Care Practice Velocity VelociDoc Tablet Urgent Care CATEGORY LEADERS: SERVICES Business Solutions Implementation Services Xerox CATEGORY LEADERS: SERVICES CDI Services PwC CATEGORY LEADERS: SERVICES Go-Live Support Apex Systems CATEGORY LEADERS: SERVICES Outsourced Coding Oxford Healthcare IT (On Assignment) CATEGORY LEADERS: SERVICES Release of Information MRO Corp CATEGORY LEADERS: SERVICES Revenue Cycle Outsourcing MedAssets CATEGORY LEADERS: SERVICES Transcription Services FutureNet Twitter: @MikeMiliardHITN