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Two southeast Missouri healthcare organizations – SoutheastHEALTH, in Cape Giradeau, and Missouri Delta Medical Center, in Sikeston – will each install a Cerner Millennium EHR system. The platform provides an integrated digital record of a patient's health history, including clinical and financial data. Also, by using the online patient portal, patients will be able to securely message their physicians, schedule appointments and access their health history. "SoutheastHEALTH prides itself on being a high-tech, high-touch hospital focused on making a positive impact, and the EHR will help fulfill that mission," said Ken Bateman, president and CEO of SoutheastHEALTH, in a statement. Besides transitioning to Millennium, Missouri Delta Medical Center will also deploy Cerner's CommunityWorks technology, a prescriptive and remote-hosted IT platform tailored to support community healthcare organizations that provide care to rural communities. [Also: Cerner taps John Glaser to lead EHR company's population health efforts] More than half of Cerner clients that are live with the CommunityWorks model have achieved Stage 6 of the HIMSS Electronic Medical Record Adoption Model. "As a rural community hospital, we have been recognized with top performing patient satisfaction scores and clinical process of care measures," said Jason Schrumpf, president and CEO of Missouri Delta Medical Center, in a statement. Both organizations expect to benefit from advanced interoperability capabilities, which will enable the transfer of patient data between the organizations and among health systems across the country. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

"With respect to some business practices: It's time to lead, follow or get out of the way," CMS Acting Administrator Andy Slavitt said at the 2016 Health Datapalooza in Washington, D.C. "If you want to lead the way with innovations that help consumers, great; if you want to follow by using established standards for data and measurement and technology, also great," he added. "If you have a business model which relies on silo-ing data, not using standards or not allowing data to follow the needs of patients – pick a new business model or pick a new business." On the heels of the April announcement of the proposed MACRA ruling, Slavitt spoke to healthcare innovators, industry leaders and developers early Tuesday evening. And while he had no further news to share with the specifics of the proposal, it was clear his intentions were firm. "What Vice President Biden said should stick with us: As taxpayers, we did not spend $35 billion so companies could build their own silos," Slavitt said. "At this stage, there's no room for business practices that don’t match the need of patients." On the forefront of Slavitt's thoughts were patients with the least access to care and an "obsession with a plight of the independent physician." However, "physicians are baffled by what feels like the 'physician data paradox.' They're overloaded on data entry and yet rampantly under-informed," Slavitt said. And the majority of providers are seeing a chasm between the time needed to invest in making the IT work and the actual positive results within their practices. "Technology isn’t doing the things we know it can," he added. "Help us make smarter decisions, reduce our wasted time, help us communicate or understand what to expect next." While these issues are troubling, according to Slavitt, the solution isn't the need for more IT inventions. But rather five crucial steps to initiate change in the healthcare industry: the massive release of data; changing incentives to reward providers for patient outcomes; creating "core" quality measures across all payers; advancing interoperability; and the proposed replacement of meaningful use. "These steps are designed to make it easier for you to innovate, to open up competition and to move the focus from designing around regulations, to allowing you to design around patients’ and physicians’ needs," Slavitt said. "The opportunity for you to transform healthcare into an information industry has never been more ripe or more urgent." Twitter: @JessieFDavis Email the writer: jessica.davis@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

By Anna Gorman, Kaiser Health News Lacee Badgley, the mother of a seven-year-old, works full time as an insurance adjuster. Like most working parents, she finds making time for doctor’s appointments a challenge. “I don’t have the time or energy to drive around town and then wait,” she said. That’s why Badgley, 36, switched from her previous doctors to Zoom+, a medical provider and health insurer that aims to give patients more control and transparency. She can make same-day appointments through a mobile app, and she’s usually in and out within 30 minutes. “It’s one-stop shopping,” she said. “I am a big fan of getting everything quickly … I get my medication, my tests, everything in one visit.” Zoom, which serves patients in Portland, Seattle and Vancouver, Washington, is trying to buck the traditional health care system by offering what it bills as convenient, affordable care in a hip and user-friendly environment. The retail clinics, painted a vibrant turquoise, are stylish and simple. The prices are posted on the walls. Zoom was created by doctors Dave Sanders and Albert DiPiero to address problems that have plagued medical care for decades: rising costs, poor service and low quality, Sanders said. “We fundamentally wanted to change the system,” he said. The company targets millennials, who have been at the forefront of change in other industries. Zoom is designed for an imaginary patient named Sarah, who is in her early thirties and wants to get her health care the same way she gets other services in her life — quickly and efficiently. The waiting rooms clearly illustrate that dynamic: There are no magazines because patients don’t typically wait long enough to read. Zoom started as a single clinic in Portland 10 years ago and now has more than 30 locations. Last year, the company expanded in Portland and now offers dental care, mental health services and chronic disease management, as well as appointments with cardiologists, dermatologists and other specialists. It also opened a “performance studio” to help people reach their fitness goals and a clinic that treats emergencies such as broken bones and concussions. This year, Zoom began selling insurance through the Oregon health exchange. Sanders said that by having insurance members of its own, Zoom will be able to better assess its success at controlling expenses and improving care. Only about 2,500 have signed up for Zoom’s insurance, Sanders said. He hopes to expand the insurance arm over time and believes the overall model could be replicated in other cities. In some ways, Zoom is similar to Kaiser Permanente, which also provides medical care and insurance. But Kaiser is a closed system: It only accepts Kaiser members. Zoom is more of a hybrid, treating not only Zoom insurance members but people with other health plans and self-paying patients as well. As a result, the company is both a partner and a competitor to some other insurers. Of course, Kaiser is also a health care giant that operates in multiple states, while Zoom is much smaller and regionally contained. People covered by Zoom insurance can get care at Zoom medical facilities or with Zoom partners, including Oregon Health & Science University hospitals. In recent years, more health care providers have been offering insurance, but the vast majority of them are hospital systems, said Katherine Hempstead, director of coverage for the Robert Wood Johnson Foundation. It’s unique for a network of retail clinics to add an insurance arm, and Zoom’s model is distinct because it is selling a branded experience to a specific population, Hempstead said. One Zoom poster says the complete health system is “designed to make you happier, healthier, smarter, faster, sexier, creativer.” Hempstead said Zoom seems to be betting on the idea that young people are brand-loyal and view health much more broadly. As a result, they may be coming to Zoom not only to see a doctor but also to work with a fitness coach, get therapy or take cooking classes. “It’s a totally new-school approach,” she said. “A company like this is saying, ‘We will be the destination of everything you think of when you want to stay healthy.’ The question is: Will the economics work out?” That could be a challenge given how saturated the Portland insurance market is, said Sabrina Corlette, a research professor at Georgetown University’s Health Policy Institute. And some insurers on the exchange are much more established. In addition, millennials aren’t typically heavy users of the health care system, though many come for regular checkups, she said. Zoom’s success as an insurer depends in part on convincing young people that insurance “is a valuable thing for them to get and maintain,” Corlette said. Attracting young, healthy consumers also helps balance out any older, sicker members. Other health care companies are marketing to millennials also, including New York-based insurer Oscar, which attracts younger consumers with its user-friendly technology. Oscar started selling coverage through Covered California this year. Harken Health, a subsidiary of UnitedHealthcare, assigns members in Chicago and Atlanta to a personal health coach, and — like Zoom — it also offers classes in cooking and yoga. Darcy Hoyt, a veterinarian, said she signed up for Zoom insurance after regularly using the clinics for the past few years. The monthly premiums to cover her and her two children are lower than what her previous insurer charged, and she appreciates knowing in advance how much everything will cost. “So far, so good,” Hoyt said. “For the relatively young, healthy families with kids falling off bikes and getting common colds, it’s very streamlined.” The model appeals to people who want a different approach to medicine that doesn’t have the “vestigial appendices of a health care system that has been around for 50 years,” said John McConnell, director of Oregon Health & Science University’s Center for Health Systems Effectiveness. “It’s like the iPhone,” McConnell said. “Zoom changed the paradigm … The whole way of delivering care is very different.” Zoom is selective about its patient population. While it sees privately insured patients and uninsured ones with the ability to pay, it doesn’t accept people who are on Medicaid or Medicare. By limiting whom they serve, McConnell said, the company’s providers may be cherry-picking the least costly patients and leaving other medical groups and hospitals to deal with medically needier people. Sanders countered that one company can’t be all things to all people and Zoom has decided to invest its resources in serving a population that was ignored by the health system before the Affordable Care Act came along. Zoom keeps costs low by providing care in neighborhood clinics and avoiding unnecessary tests and procedures. It relies heavily on nurse practitioners and physician assistants, and maintains small staffs. It also has its own electronic health record system. “The whole process has been stripped,” Sanders said. “We took out a lot of the people, we took out all the paper, we took out the whole Taj Mahal.” To advance its mission, Zoom has taken on regulators and state policymakers. It successfully lobbied for laws in Oregon allowing nurse practitioners to dispense medication and insurers to reimburse for more telemedicine. The emergency clinic is one place where doctors said they are able to avoid overhead and pass savings along to patients. For patients paying out of pocket, a visit costs under $300. Badgley, who has private insurance, came in to the clinic recently because she had been in bed for days with what she thought was the flu but still felt horrible after returning to work. She only had to explain once why she was there. In the exam room, Dr. Aviva Zigman pulled out a pen and wrote Badgley’s symptoms on an oversized white board, along with the tests she might need and how long the appointment would take. Soon afterward, Zigman quickly determined that Badgley had an ear infection and gave her some antibiotics. Zigman said that as a provider, the Zoom model is much more efficient than a typical emergency room for routine ailments and her patients can get what they need quickly. Another Zoom patient, Amy Cannon, 45, goes to the company’s new primary care clinic for management of her high cholesterol, prediabetes and high blood pressure. The clinic, which has a kitchen in the lobby, offers cooking and yoga classes on site. Cannon said it feels more like a private club than a doctor’s office, and the assistant greets her with a hug. “It’s ‘Cheers’ for health care,” Cannon said. “Everybody knows your name.” This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.    

When Leapfrog released its Spring 2016 patient safety grades recently, 15 hospitals got slapped with a very public 'F' grade casting a spotlight on them that no institution wants. But with more patients weighing public hospital grades, experts, as well as a few hospitals that have faced down bad grades, say denial is the last thing a poorly marked hospital should do. Despite varied methodology among ratings programs, consumers are using these rankings to judge the institutions charged with healing them when they are at their most vulnerable, said Rita Numerof, president of healthcare strategy consulting firm Numerof & Associates. Consumers are also paying far closer attention to these types of rankings because they are shouldering increasingly larger portions of their healthcare costs, and are far more scrutinizing about where they spend those dollars, she said. "As organizations have moved to high deductible health plans and payers have incentivized consumers to go to organizations or have a benefits package that shifts choice to higher value organizations, consumers follow the money, she added. "They've never had this kind of information readily available to them before, and the bottom line is when the consumer is forced to spend more of his or her own money this choice matters." That's great news for those who scored well, but those who didn't make the grade must confront the fallout while fixing the issues that ail them. [See also: Leapfrog out with troubling hospital safety numbers.] Damage control Stony Brook University Hospital, located in Stony Brook, N.Y., was one of 15 hospitals to receive a failing grade from Leapfrog, capping what has been a years-long slide in the rankings. From the fall of 2013 through spring 2015 Stony Brook earned four B's in a row. This past fall it slipped to a C, and then bottomed out in the most recent rankings. The hospital profile on Medicare.gov shows  data to support Stony Brook has issues with patient safety. It has been penalized for the past two years by Medicare for patient safety incidents, and ranked "worse than the national average" on Medicare's Hospital Compare for serious surgical complications, healthcare associated infections, including catheter associated UTI's, and intestinal infections, and several readmission categories as well. According to its website, the New York State Department of Health lists the hospital as high quality performers when it comes to hospital mortality for common conditions and average performers for its rates of hospital-acquired bloodstream and surgical site infections, and timely and effective care. The state lists its patient satisfaction rating as 68.44 percent. However, it was rated as poorly perforning when it came to common patient safety problems, emergency department timeliness, and 30-day hospital-wide unplanned readmissions. Why did Stony Brook perform poorly? Officials responded it was due to errors and misinterpretations on the voluntary portion of the Leapfrog survey, which the hospital took for the first time this year. "Due to a misunderstanding of the Leapfrog survey questions and electronic query processes, several operational and systems measures were given ratings that do not accurately reflect our current practices. This had a significant negative impact on our overall grade," Stony Brook officials said in a statement. "The areas where there was confusion included questions about operational, processes and reporting, not in the clinical outcomes. When the errors in interpretation were discovered and brought to the attention of Leapfrog, they advised that the review period had closed and the data could not be corrected and grade could not be changed," They did not address other questions with regard to some of the publicly available data that support's Leapfrog's grade, or whether they thought the alleged survey errors were the only reason for the poor grade. They also did not specify any measures currently underway to improve patient safety. Leapfrog said that while they had been in contact with Stony Brook over the survey issues, there may have been other issues at play. According to Missy Danforth, vice president of hospital ratings for Leapfrog, Stony Brook reviewed its survey results and the CEO explained there were practices the hospital is compliant with that his staff didn't know about and did not report on. Leapfrog said they encouraged them to take a different approach to completing the survey "as it is really a gap if there are policies and practices the CEO knows about that the front-line staff and senior managers are not aware of, particularly if they are related to patient safety." Leapfrog said Stony Brook informed them they are committed to improving this process for next year and that they are "working hard on many fronts related to patient safety." [See also: Leapfrog: Hospitals still falling short on maternity care.] However, Leapfrog also asserted that the errors could have been avoided if their review process had been followed appropriately. They explained that Leapfrog gives hospitals technical support through a help desk and hospitals have opportunities to review their submitted responses and make corrections while the survey is open. The survey is open from April 1 - January 31 of each year.  After the survey closes, no changes can be made. "We publicize our deadlines and make clear how our measures are scored. We also have a CEO attestation of accuracy that every CEO must sign off on, or designate a delegate to sign off on, for each submitted section of the Leapfrog survey. This hospital submitted their 2015 survey on December 22nd, and their results were publicly reported on our website on January 5th. We encourage all hospitals to review their publicly reported results to check for data inaccuracies. If the hospital had noticed discrepancies in reviewing their publicly reported results, they could have updated their survey at any point throughout the month of January prior to the survey closing." Whether the survey errors were the major culprit or not, the fact that they offered no other explanation coupled with existing public data, which doesn't paint an entirely flattering picture of the institution, casts doubt on the true significance of the survey issue and moreover plants a seed of doubt in the public's eyes, said Numeroff. "The worst approach is blame, denial or rationalizing away the numbers. Even if you don't like the measures, and there's lots of complexity behind the measures and they're far from perfect, knowing that you still have to perform against them. Taking this as a wake-up call and a lesson and recognizing that there is work to be done would be really helpful. You have to get your own house in order and to do that acknowledging mistakes is a starting point," Numerof said. Other hospitals who received F's didn't delve into enormous detail, but were willing to admit there were things they needed to do better. For Clarion Hospital, a small facility in Pennsylvania, this is the fourth failing grade they've gotten from Leapfrog, and they haven't scored better than a D since fall of 2013. They said there were not surprised that this spring brought their 4th 'F', but stress that they have been making improvements and are committed to patient safety. "Patient Safety is very important to us here at Clarion Hospital.  We are aware that our score is below average and have developed internal processes to make the necessary improvements.  It is our mission to improve our Leapfrog grade within the next quarter," said CEO Byron Quinton. They said their rates of hospital-acquired infections, patient harm incidents and avoidable deaths are all in line with state averages, and cited outdated data as a potential contributor to their poor grade. "We are small community hospital and have lower numbers in comparison to many hospitals. The timeframe for the data, in some cases is greater than 3 years old and has not been updated, which reflects poorly on us even as improvements have been made," Clarion said in a statement. Saint Michael's Medical Center in Newark, New Jersey also doesn't have a history of high scores to refute their current 'F'. Four straight D's in a row starting in fall of 2013 were followed by a peak C in Fall of 2015. Then came the bottom this spring. They did not participate in the actual survey portion and said based on public data their performance is on par with state averages, so the failing grade was a surprise. According to Medicare.gov, St. Michael's is rated as a two-star hospital and is on par with national benchmark's when it comes to complications, and most readmissions/deaths categories except for unplanned readmissions for heart failure patients, where it was scored worse than the national average. While St. Michael's Chief Medical Officer Claudia Komer also pointed in part to outdated data as having influenced their grade, it was not a flat-out denial, and stressed that the issues they do have are being addressed. "The publicly reported data for two key areas used in the Leapfrog report, central line-associated bloodstream infection and catheter-associated urinary tract infections does show higher than average rates for the reporting period from April 2014 to March 2015.  The hospital, however, having already identified the issue, developed a corrective plan of action to reduce both types of infections. We are happy to report that in the first quarter of 2016, we had zero CLABSI and CAUTI infections." She said they have also addressed another shortcoming, the lack of a computerized physician order entry system. They said they received a zero in this category, but have since implemented such a new system. Finally, Komer said the hospital is under new ownership, having been acquired by Prime Healthcare in early May. She said the new parent company will open doors to better patient care for their hospital, and in the future they will definitely participate in the Leapfrog survey. "Prime brings extensive resources to Saint Michael's that the hospital just didn't have before, including the sharing of best practices with other Prime hospitals nationally. Prime also has a stringent internal quality reporting process and each hospital is held accountable to those standards. Saint Michael's will have the resources to achieve an entirely new level of intense focus on patient quality and safety. It's what our patients deserve." [Also: Leapfrog: 798 hospitals earn A scores for patient safety; See the list] Turnaround stories For Van Wert County Hospital in Van Wert, Ohio, the fall of 2014 and the spring of 2015 were bad months. The 70 bed nonprofit in northwestern Ohio received two failing grades in a row from the Leapfrog Group for patient safety, and staff there felt like they had been blindsided, having been under the impression that they provided safe and quality care. It was a bad assumption, Interim president and CEO Mike Holliday said, that had bred a culture of disconnect. "We really didn't have that top-down focus because everyone assumed that we didn't have those kinds of issues. Once the information came out from Leapfrog, that hit us in the face and made us stand up and take notice," Holliday said. His plan: fess up. There was no blaming their grades on survey errors or old data, Holliday said. They simply owned up to their problems. "We took it at face value that it is what it is. It's not a very pleasant situation to find ourselves in. We had some work to do and we were going to roll up our sleeves and address those issues," he said. Holliday said they got senior leadership involved from the start, and over time, invested in several programs that would help them discover where the issues were. They also instituted measures that brought staff closer together and opened the lines of communication wider than they had ever been. He said they sought education opportunities on how to improve their culture of patient safety, and put time and financial resources into the National Database on Nursing Quality Indicators program. The program's survey was provided to staff on a quarterly basis and the results helped steer their course in making needed improvements. Holliday said they fostered teamwork and communication through the implementation of daily patient safety huddles, where every morning staff got together to review safety protocols and identify opportunities for improvement. These huddles happened at the management and executive levels as well, with senior leadership meeting daily to review the past 24 hours of activity for needed improvements and look ahead to what might come up in the next 24 hours. "We can't fix issues if we don't know about them. So it gives staff an opportunity to raise those issues, raise those concerns and red flags and then give management the opportunity to address them in a positive educational learning process. It also helps make staff more comfortable with reporting those issues and then we can show that there's no negative culture about it." Finally, to fix safety issues related to medications, pharmacists became part of rounding. They went with physicians, nurses and other staff as they met with patients to allow the pharmacist to communicate with the patient about their medication and also follow up with nurses and physicians on any issues. Holliday said the turnaround happened faster than expected, and the 'A' they earned this spring was a much appreciated validation of all their effort. But it wouldn't have been possible if they had instead chosen to close ranks, deny they had issues, and opt for tight-lipped damage control to the public and the media. "The benefit was to show the community we serve that we're transparent, that we're very serious about these issues, and that we know that they're depending on us as they're giving themselves up to us to help them through their medical conditions. It gave us the opportunity to re-earn their trust. Had we approached it differently we would have been subject to a lot of skepticism within the community and the potential of more negative press." Wayne Memorial Hospital in rural Jesup, Georgia, also earned an F in fall 2014 rankings from Leapfrog, and it hit staff hard. "We were devastated and our first focus was to find out where we could do better," said Kathy Buchannan, chief nursing officer. The small 84-bed nonprofit facility had just lost two long-time trusted surgeons, and had been going through a difficult transition as replacements who Buchannan said lacked a focus on patient safety came and went. "We felt like that was our weak link at the time," she said. She also explained staff communication was a problem. But since they had close relationships with the members of their small rural community, denial wasn't an option for them either. "It was in the newspaper. I remember when we got the F. We get a lot of the same patients because it is a small community. Some people didn't believe the F. But we told people we are better than that. We are working on it. So community members were aware of of it but were understanding," Buchannan said. Buchannan and Lisa Boatright, Wayne's director of quality management, both said that many problems were solved once the revolving door of surgeons stopped turning and they were able to finally put in place a team that was the right fit and had the right focus, patient safety. They also took communication and accountability to a much higher level. Boatright said physicians started bridging the gap between them and nurses by having educational conversations about procedures with them. Boatright said this improved the rapport between the two groups and made everyone more comfortable, especially new nurses who Buchannan said can often be timid about reaching out to doctors when they need help. They also instituted an open door, anonymous reporting system whereby staff could contact supervisors or hospital leadership through a variety of channels to report concerns or problems. "If people saw something they thought was unsafe they could report it anonymously. They could come into my office, call or just write it down. Names wouldn't be mentioned so they felt comfortable voicing concerns," Boatright said. Finally, they brought patients into the process by interviewing everyone that came in for treatment about their experience. Boatright and Buchannan said they would generally wait until the second or third day of their stay, but everyone was given the opportunity to provide feedback and voice issues they had with their care before they left the hospital. Even though these may not seem like huge steps to take, for a small rural hospital they made all the difference. In fact, earning an 'A' from Leapfrog this Spring wasn't even the biggest pay-off. In 2015, Wayne Memorial Hospital won the Small Hospital of the Year award from the Georgia Hospital Association. No small feat for a small facility that just a year prior was in turmoil. Buchannan said collaboration and commitment to change from all levels was key. "It just let us know what kind of ownership our staff had of our facility. It made us happy to know that and also that so many people wanted to help make it better." Twitter: @BethJSanborn    

Getting pharmacists involved in patient-centric activities, including being part of clinical care teams, is a little easier thanks to telepharmacy technology. When Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, needed to optimize its pharmacy workflow with the goal of improving patient care, it turned to PowergridRx, a cloud-based HIPAA–compliant telepharmacy platform from San Francisco-based PipelineRx. Starting in February, Dartmouth-Hitchcock began deploying PowerGridRx in its hospitals across New England. PowerGridRx is a software as a service platform that aggregates, manages and optimizes virtual pharmacy management for health systems. In addition, it differentiates Dartmouth-Hitchcock's telepharmacy network and manages the order verification process for current and future facilities. The interoperable technology platform is designed to improve medication administration visibility between facilities and addresses logistical and budgetary challenges that arise from managing and staffing multiple care settings. [Also: Dartmouth-Hitchcock, Harvard Pilgrim join forces on population health] Sarah Pletcher, MD, medical director and founder, Center for Telehealth at Dartmouth-Hitchcock Medical Center, said the health system uses PowerGrid Rx as a tool in the delivery of telepharmacy services across wider landscape. "Our customers are the ultimate end user in that regard," Pletcher said. After going live in six hospitals Dartmouth-Hitchcock has processed thousands of patient orders: "We have data that suggests the benefit to the hospitals in that we are allowing them to load-level staffing and optimize their in hospital team sometimes deploying them to more patient care or clinical activities," she said. Pletcher pointed out that for many smaller rural and critical access hospitals, the volumes that they see on weekends for example, aren't enough to rationalize them having an in-house pharmacist. "But we are also finding hospitals recognizing the value of having telepharmacy support for scenarios where they want to allow their pharmacists to be out on the floors helping with patient care," she said. In a cancer infusion suite for instance, Pletcher explained that oftentimes pharmacists are part of clinical team working on projects where they might be involved in an electronic medical record implementation, or working on quality or formulary projects for the hospital. "Any time we can help extend their team to allow them to optimize their in-hospital team, we're happy to be there for them," she said. From a technology perspective, Pletcher noted that there are obstacles associated with integration and with host IT systems and EMRs. She said that with anything involving multiple hospital IT departments and multiple hospital EMRs, there's always a challenge – not just the technology integration, but cultural barriers where hospitals have different levels of comfort for how much bi-directional integration they want with outside software platforms. "Because we offer so many other telemedicine services this is something we are familiar with managing – the telepharmacy is the latest service – we have six or seven other 24/7 telemedicine services to hospitals where we've had to contend with IT or EMR integration. We kind of know to expect and support those conversations." Pletcher said Dartmouth-Hitchcock is expanding its telepharmacy program to more sites and more regions. "We're excited about the opportunity to further integrate our telepharmacy solutions with other clinical services." Industry insiders contend that the demand for PowerGrid Rx-type technology is on the rise for multi-site multi-facility organizations that are growing and want to tie their pharmacy network closer and closer together. "We want to create a platform that enables them to share pharmacy labor and pharmacy resources across their whole organization, opposed to having to staff individually each hospital within their network, this enables them to tie them to together," said Brian Roberts, CEO of PipelineRx. Roberts noted that among the challenges is to work with different and multiple types of IT systems. "Some of our customers have eight to ten different types of IT systems that they work with - we integrate back with their host IT systems and bring it into one platform." The other side, according to Roberts, is that they want a system that can capture policies and procedures for each one of their individual hospitals. So for example, if they were creating a central telepharmacy center they would want that telepharmacist to have information at their fingertips. "Our tool helps consolidate and bring policies and procedures into one software offering," said Roberts who added that because PowerGrid Rx is a cloud-based piece of software – there is no hardware on each individual site. "So we use the power of the Internet to build a private cloud that can manage all that information – manage the information and store the information for the hospitals." Roberts said CIOs like that because it’s a cloud-based piece of software that doesn't require them to have to go and do updates and update hardware; that's all taken care of from the PipelineRx side.

New findings from hospital watchdog the Leapfrog Group shows many hospitals across the country are failing to meet national performance targets for  quality of maternity care. The study comes on the heels of Leapfrog's twice-yearly Hospital Safety Score, which assigns letter grades to hospitals based on their adherence to various safety standards. According to the report, 798 hospitals earned an 'A,' 639 earned a 'B,' 957 earned a 'C,' 1162 earned a 'D' and only 15 earned an 'F,' [See also: Leapfrog out with troubling hospital safety numbers.] When it comes to maternity care, facilities were deficient in a number of different areas, such as the rate of episiotomies. A once-routine incision made in the birth canal during childbirth, it's now recommended only in a very narrow set of cases; Leapfrog's target for all hospitals is to perform the incision in 5 percent or less of all cases. Yet the rates were too high among 68 percent of hospitals. Too many C-sections were also being performed, the data showed. At 60 percent of reporting hospitals, the rates surpassed Leapfrog's target rate of 23.9 percent for all hospitals, and the variation was dramatic -- ranging from as low as 10 percent to as high as 54 percent in one unidentified east coast city. Not all of the findings were dour. Four out of five hospitals meet Leapfrog's target of 5 percent for early elective deliveries, which are medically unnecessary inductions or C-sections performed at 39 weeks. That, the report said, means the facility is taking steps to minimize risks to the mother and child be delivering too soon. [See also: Leapfrog Group: Rate of serious, even fatal, hospital infections still too high.] Additionally, the early elective delivery rate has shrunk dramatically, with the national average at 2.8 percent, compared to the 17 percent reported in 2010. But the study also shows many hospitals don't have adequate experience with high-risk deliveries. Low-weight infants born with complications are more likely to survive if the hospital has an experienced neonatal intensive care unit on-site, yet 78 percent of hospitals performing high-risk deliveries don't meet the Leapfrog standard. "This report underscores the importance of understanding the risks associated with specific delivery choices and of improving the quality of care during birth for the wellbeing of both mothers and their babies," said Kristin Torres Mowat, senior vice president of plan development and data operations at Castlight Health, in a statement.

For Vice President Joe Biden, his National Cancer Moonshot Initiative is more than just a government program – it's personal.

In another big surge for healthcare hiring, the industry added 44,000 jobs in April -- representing more than a quarter of the 160,000 jobs created that month, according to data released Friday by the U.S. Department of Labor's Bureau of Labor Statistics.

In a deal with Bausch + Lomb, IBM announced a cloud-based app that helps cataract specialists plan and conduct surgeries.

While accurate data on deaths associated with medical errors is lacking, it is estimated that between 210,000 and 400,000 people in the U.S. die every year because of medical errors, making medical errors the third biggest cause of death in the country after heart disease and cancer, a new study found. While human error can never be completely eliminated, better measurement of medical errors can mitigate the frequency, visibility and consequences of such errors, the study said. To remedy the problem of human error, hospitals should properly investigate patient deaths for potential contribution of error, and should include additional information on death certificates, according to “Medical error—The third leading cause of death in the U.S.,” a report from research firm The BMJ. Martin Makary and Michael Daniel at Johns Hopkins University School of Medicine in Baltimore noted that U.S. death certificates have no place for acknowledging medical error, and the academics call for better reporting to help understand the scale of the medical errors problem and how to tackle it, the BMJ report said. Currently, death certification depends on assigning an International Classification of Disease (ICD) code to the cause of death; thus, causes of death not associated with an ICD code, such as human and system factors, are not captured. As a result, accurate data on deaths associated with medical errors is lacking. Using studies from 1999 onward, and extrapolating to the total number of U.S. hospital admissions in 2013, Makary and Daniel calculated a mean rate of death from medical errors of 251,454 a year, the study said. They acknowledge that human error is inevitable, but say “although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility and consequences,” according to the study. The Johns Hopkins experts believe strategies to reduce death from medical care should include three steps: Making errors more visible when they occur so their effects can be intercepted; having remedies at hand to rescue patients; and making errors less frequent by following principles that take human limitations into account, the study reported. For instance, instead of simply requiring cause of death, they suggest that death certificates could contain an extra field asking whether a preventable complication stemming from the patient’s medical care contributed to the death. Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com