Electronic Health Records (EHR, EMR)

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.

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

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Dubbed release candidate number 3, the latest incarnation of the emerging interoperability standard also brings advancements for workflow, eClaims, CCDA profiles and provider directories. 

In response to Cerner missing projected revenues, financial analysts said the market for other technologies is heating up and can increase deal sizes.

Centers for Medicare and Medicaid Services chief Andy Slavitt asks hospital executives for 'meaningful engagement' with the proposed new MACRA policy, and hints they should follow Washington rule-making closely in the near future.

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Michael Middleton, MD, credits online patient portals with helping him grow his Orlando, Florida-based pediatric practice more than three-fold in two-and-a-half years – while keeping staff cost increases at 20 percent.

A group of Republican senators who have been looking to "reboot" meaningful us since 2013 released new draft legislation this week they say aims to make the incentive program work better for providers and taxpayers. U.S. Senators John Thune, R-South Dakota, Lamar Alexander, R-Tennessee, Mike Enzi, R-Wyoming, Pat Roberts, R-Kansas, Richard Burr, R-North Carolina and Bill Cassidy, R-Louisiana – all of whom voted against the 2009 ARRA law that helped establish meaningful use through the HITECH Act – wrote this week to HHS Secretary Sylvia Burwell and CMS Acting Administrator Andy Slavitt, looking for feedback on the bill. [Also: Republican senators want to ‘reboot’ MU] The draft legislation would shorten the reporting period for eligible physicians and hospitals from 365 days to 90 days, which would give providers more time to implement EHR systems, relax the all-or-nothing nature of the current program requirement, and extend the ability for eligible providers and hospitals to apply for a hardship exemption from the meaningful use requirements. "These policies seek to provide CMS with the tools and guidance necessary to advance the use of EHRs as part of utilizing health IT to the benefit of patients in a manner that protects the significant taxpayer investment in our nation’s health care system," the legislators write. Thune, Alexander, Enzi, Roberts, and Burr are original members of the Senate’s health IT working group, known as Re-examining the Strategies Needed to Successfully Adopt Health IT, or REBOOT. Back in 2013, they published a white paper outlining their complaints about lack of momentum toward interoperability, patient privacy concerns, EHRs' potential to enable fraud and abuse and other concerns about federal health IT policy. [Also: EHRA critiques GOP's MU 'reboot' plan] "We received critical feedback in response to our 2013 report which has informed our work on these issues," the senators wrote to Burwell and Slavitt this week. "We also engaged with stakeholders including health IT developers, providers, and patient-focused organizations to assess their experiences with the meaningful use program, as well as their concerns with the state of health IT, specifically EHRs, over the years. "In response to this feedback we have identified a few key policy changes outlined in the enclosed draft legislation, and we respectfully request feedback as part of our continued constructive dialogue on these issues."