Electronic Health Records (EHR, EMR)

This case study looks at the electronic prescription support technology now guiding roughly 80 percent of the health system's prescription decisions.

Post-surgical readmissions were halved at the health system, HIMSS says, driven by EHR optimization and decision support tools – it's also helped combat potential opioid dependency.

When developing, funding, scaling and evolving innovation projects, it's key to gain insights from around the world – and to keep consumer top of mind, HIMSS innovation expert Ian Hoffberg says.

And there’s already one in the JASON Report from 2014 that was eclipsed by the industry’s excitement about open APIs.

Beginning Sept. 21, VA will start accepting proposals for contractors to handle the technical and administrative services of its legacy EHR.

With a rare near-unanimous vote, the United States Senate passed The Opioid Crisis Response Act of 2018 on Monday evening. It's a massive bill comprising a wide array of proposals drawn from five Senate committees, and has many implications for the use and funding of health IT. Senate Majority Leader Mitch McConnell, R-Kentucky, called the bill – drawn up using input from more than 70 senators and passed by 99-1 vote – a "landmark" piece of legislation meant to combat the nationwide opioid epidemic from all angles. The legislation comes amid an ongoing opioid crisis in the U.S. as policymakers and technology vendors are working to address the issue, while hospitals are piloting apps to find blindspots in prescription drug monitoring programs and using mobile technologies to write fewer prescriptions. It contains funding for stopping the flow of illegal opioids from other countries, and for supporting local programs for prevention, treatment and recovery. The bill also seeks to spur research and development of new non-addictive painkillers and stem "doctor shopping" by boosting prescription drug monitoring programs. It also has funds to give behavioral and mental health providers the tools they need to offer treatment and recovery – including potential electronic health record incentives – and for hospitals to better care for infants with neonatal abstinence syndrome. The legislation's sponsor, Senate HELP Committee Chairman Lamar Alexander, R-Tennessee, said he is working to combine the Senate bill and a similar House version passed in June "into an even stronger law to fight the nation’s worst public health crisis, and there is a bipartisan sense of urgency to send the bill to the President quickly." The Senate bill contains many new proposals specifically related to information technology. Among them, it would: Call for the U.S. Department of Health and Human Services to "develop best practices for prominently displaying substance use treatment information in electronic health records, when requested by the patient." Enable the Centers for Medicare and Medicaid Services to test various models that "provide incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology to improve the quality and coordination of care through the electronic documentation and exchange of health information." Require physicians to prescribe Part D-covered controlled substances electronically and direct CMS specify a list of exceptions and outline the penalty for failure to comply when the e-prescribing requirements. Require that prior authorizations related to Part D e-prescriptions use a standard format to improve the way the authorizations are processed. Provide support for states and localities to improve their Prescription Drug Monitoring Programs and "implement other evidence-based prevention strategies, encourages data sharing between states, and supports other prevention and research activities related to controlled substances." Reauthorize HHS's NASPER grant program, allowing states to "develop, maintain, or improve PDMPs and improve the interoperability of PDMPs with other states and with other health information technology." Authorize new program through the Substance Abuse and Mental Health Services Administration for the establishment of comprehensive opioid recovery centers. "These entities may utilize the ECHO model, which supports care coordination and services delivery through technology." Give support for states to collaborate on strategies to improve care substance-exposed infants, including the development and upgrades of new technology and monitoring systems to more effectively implement plans of safe care. Require CMS to set up an online portal to enhance communication between the agency, Medicare Advantage plans with prescription drug plans, stand-alone drug plans and Medicare Drug Integrity Contractors.   .jumbotron{ background-image: url("http://www.himss.org/sites/himssorg/files/u351641/opioid-collection-hero-712.png"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Opioid Crisis: Tech fights epidemic Learn how tech is being used to battle abuse. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

The ongoing saga of athenahealth and Elliott Management continues. Shares of the cloud-based health IT company fell sharply Tuesday morning on news that the hedge fund – which has recently been seen as the most likely candidate to acquire the company after a long and contentious courtship – has reportedly recoiled from the $160 share price. While activist investor Paul Singer may finally be throwing in the towel after many months of pressure on the Watertown, Massachusetts company, he may also simply be angling for a lower price. Reports earlier this month, in fact, indicated that EHR rival Cerner and insurer UnitedHealthcare are not interested in athenahealth. Now, athenahealth seems willing to be patient and weigh its options, having extended the due date for a final bid by 10 days, according to the New York Post. Elliott Management had indicated its willingness to pay the $160 share price, a total of some $6.9 billion, for the company in May. But by June – when athenahealth founder and CEO Jonathan Bush was forced to step down after allegations of past domestic violence – at least one Wall Street observer wondered whether the sale process might eventually drag on so long that Elliott would rescind its offer, likely knocking the share price back down to the $135-$140 range. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

When its EHR vendor wasn’t going to be ready until 2020, the IT team took matters into its own hands in a low-budget open source project that is already paying off.

The first House VA Subcommittee on Technology Modernization hearing revealed that officials and congressional members are not on the same page when it comes to governance.

Glen Tullman has served as the CEO of a major EHR vendor and the founder of a startup app maker focused initially on diabetes. That background gives him a unique insight into the possibilities and constraints of each. For our Focus on Innovation, I spoke with Tullman about the foundation EHRs have created for the future of digital health, what to expect next from Livongo, and where he expects next-gen innovations to come from. Q: You formerly ran Allscripts and now lead Livongo. Given that perspective, what’s your take on the innovation happening in so many corners of healthcare right now? A: EHRs are fundamentally data repositories, so what do you need to do? You need to make them much easier for physicians to use on the front-end. On the back-end a lot of companies like IBM Watson and smaller startups are saying ‘we’ll take the data from the EHR and analyze it to give you real feedback on how to provide better care.’ But EHR vendors aren’t doing any of that innovation. Q: We are seeing EHR vendors take steps to open their platforms to third-party developers and enable them to drive some of that innovation but is that the answer? A: EHRs were an important step to get things digitized but they have not realized the promise of making it easier for physicians to deliver care and they haven’t been connected to each other. Why not? Technology-wise, they could be connected. Q: Well, there’s a lot of innovation happening in healthcare and much of has little to with EHRs. Where is it all going? A: The future of healthcare is not about big software systems in hospitals. That’s important but healthcare today is about how we empower people with chronic conditions, how we empower those people with software and technology to make it easier to be happier and healthier. Everything people can rip out of a hospital they’re ripping out of a hospital. Surgery centers, urgent care. Q: In which case, what’s next for Livongo? A: We’re going to release a cellular-enabled blood pressure monitor so we have hypertension data and give people real-time feedback outside the doctor’s office because 24 percent of people on meds actually have white coat hypertension instead of high blood pressure. Imagine if we could get them to check their blood pressure at home versus in the doctor’s office? It’s available now but the official release will happen at Health 2.0.   Q: And what about the broader industry, not just Livongo? A: We’re going to see a lot of innovation.  The world we’re talking about, tons of activity in digital health, making people smarter, helping them navigate the complex world of healthcare, making payments easier — that’s where the innovation is going to come from. .jumbotron{ background-image: url("http://mobihealthnews.com/sites/default/files/u751/Innovation-month-jumbotron-1.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Focus on Innovation In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation. Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com