Electronic Health Records (EHR, EMR)

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.

The Senate Committee on Health, Education, Labor and Pensions on Tuesday passed the bipartisan Improving Health Information Technology Act with a vote of 22-0.  The bill addresses electronic health record usability and seeks to reduce burdens tied to documentation. It also calls for transparent ratings on EHR usability and security, calls out information blocking and gives the Department of Health of Human Services’ Office of the Inspector General the authority to establish deterrents. [Also: Senate panel to look into EHR usability] The legislation, which moves to the full Senate, also promises to convene existing data-sharing networks to develop a voluntary model framework and common agreement for the secure exchange of health information across existing networks. The bill also directs the Governmental Accountability Office to conduct a study of methods for securely matching patient records to the correct individual. “Our goal is to make our country's electronic health record system something that helps patients rather than something that doctors and hospitals dread so much that patients are not helped,” said Sen. Lamar Alexander, R-Tennessee, in a statement. Alexander and Sen. Patty Murray, D-Washington, led the effort. “Democrats and Republicans have been able to reach agreement on policies that will help empower patients and providers with more and better information to help drive treatment and improve health outcomes,” Murray added. Twitter: @HealthITNews

Health IT giant Cerner Corp. has scored a $50.7 million data hosting contract from U.S. Department of Defense as part of its Defense Healthcare Management Systems Modernization, according to official documents. The DoD last year awarded Cerner and partner Leidos the $4.3 billion contract to deploy the new electronic health record for the U.S. military worldwide. Cerner won the contract over the objections of Amazon.com, Computer Sciences Corp., General Dynamics and IBM Corp., which appealed the decision and lost their case, documents showed. The DoD said that Cerner had made it clear to the government that the comapany does not allow connections to its managed services by any other commercial entity. In fact, Cerner's restrictions made it impossible for the Defense Department EHR's data to be hosted even by the DoD itself. [Also: DoD awards Cerner, Leidos, Accenture EHR contract] Cerner's EHR system also includes historical data, anonymized information from healthcare provider organizations that use the company's EHR and from the vendor's analytical models based on years of research and development. Had the DoD opted for a different company to host data, it would not have been able to use the Cerner historical data in conjunction with military EHR data and would have had to deal with a separate data setting, adding costs to the project, Pentagon officials said. [Like Healthcare IT News on Facebook] The competing vendors' objections weren't all specified, but according to a report from FCW, one vendor had suggested the DoD could compel Cerner to share its data/modeling functions with a third-party hosting company. Another bidder suggested replacing Cerner's analytics modules with those from another vendor. But DoD said that would lead to cost redundancies. Some of these same vendors, such as IBM and CSC, competed for the initial DHMSM contract in 2015 and didn't protest the initial award to Leidos/Cerner. Cerner's suite of healthcare information systems will replace the DoD's legacy health IT system in its 55 hospitals and more than 350 clinics, as well as in ships, submarines and other military locations. In addition to Leidos, Cerner also aligned with Accenture, Henry Schein and a number of small business partners to serve the Military Health System and its 9.6 million beneficiaries. Intermountain Healthcare is also a strategic partner providing clinical governance of solutions and workflow. Jessica Davis contributed to this report. Twitter: @SiwickiHealthIT

The American Hospital Association has sent a list of demands the Centers for Medicare and Medicaid Services before the federal agency creates new rules surrounding electronic quality reporting measures. CMS earlier this month extended the public comment period for eCQM from Feb. 1 to Feb. 16, 2016. For starters, AHA, the largest hospital organization in the country, wants CMS to release the results of the previous eCQM demonstrations and pilots. [Also: CMS extends comment period on quality reporting] The organization also wants the agency to expand eCQM education and outreach. CMS and the Office of the National Coordinator first put out their request for public comment on Dec. 31, 2015, which called for feedback on several items related to the certification of health information technology. The request also asks for feedback on electronic health record products used for reporting to CMS incentive programs such as the Hospital Inpatient Quality Reporting Program and the Physician Quality Reporting System. AHA senior vice president of public policy Ashley Thompson wrote in comments to acting CMS administrator Andy Slavitt that the “AHA is encouraged that CMS is requesting feedback on several areas of concern to providers.” AHA leaders want CMS to outline transition plans from chart-based reporting to electronic reporting across CMS programs and clearly explain how eCQM will work other organizations’ reporting requirements, such as The Joint Commission. [Like Healthcare IT News on Facebook] Lastly, the AHA asked the agency to speed up efforts to identify and define data needed for reporting and to make sure that any modifications to definitions will align with existing requirements for eligible and critical access hospitals. “The AHA recommends that CMS also consider the input received to date from EHs, CAHs and eligible providers about their eCQM experiences, including the evidence from CMS eCQM pilots and demonstrations, to inform future rulemaking,” AHA wrote. Twitter: @HealthITNews

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.

By John Halamka’s standards, healthcare IT is pretty average. In fact, he’d only give the sector a B-minus.

As if healthcare executives don't have enough worries about implementing electronic health records, yet another issue is starting to ramp up. "What's been happening more frequently in the last few years is that certain plaintiffs' lawyers – a kind of group of them who communicate with each other – have started to see the medical record as an opportunity for litigation," said Mary Re Knack, a Seattle-based attorney for the firm Ogden Murphy Wallace. Knack will be presenting an exploration of these emerging litigation troubles in the session "Just Press Print: Challenges in Producing EHRs in Litigation" with colleague Elana R. Zana at HIMSS16, beginning in late February. Twitter: @HealthITNews Electronic health record design is paramount among those issues, Knack said, because EHR vendors quite naturally did not build the software with litigation in mind. "The data is all stored behind these templates, and depending on what you are trying to look at, whether it's a summary or lab reports or such, the data then populates the template on a screen. But when you print it, it doesn't print out as cleanly or as nicely,” Knack said. One of these obvious challenges in trying to review somebody's care is how do you see it? How do you even read what the care was? Who did what? And when? "You may have a case that's very straightforward medical malpractice, but because of the way the medical records get printed out, the same piece of data may appear in five places. Somebody who looks at it, whose goal is to show how it's confusing, can then start to challenge the care that was given based on the fact the medical record is confusing,” Knack explained. “They can take another step, and that is questioning whether the data in the medical record is accurate or if it has been changed." As a result, Knack said, a healthcare provider can find itself in litigation that is ostensibly about the care provided, when in actuality that organization has to " defend how the medical record works." [Like Healthcare IT News on Facebook] Practically speaking, she said, the potentially expensive situation needs to be addressed by enhanced communication between provider organizations, particularly C-suite staff, and their vendors, and also internally within provider systems. "In the healthcare community, the medical negligence work, because of the way it's insured, tends to kind of be off on the side,” she added. “This isn't true in every healthcare setting, of course, but it's off to the side many times so the people who are the decision makers with respect to bigger issues aren't necessarily aware of how these particulars are being used in litigation, because litigation is handled 'over there.'" Knack and Zana will be presenting "Just Press Print: Challenges in Producing EHRs in Litigation" from 2:30 - 3:30 p.m. March 1 at the Sands Expo Convention Center, Palazzo L. Twitter: @HealthITNews

Cincinnati, Ohio-based Mercy Health has saved more than $42 million on drugs since 2010 by building a formulary within its electronic health record platform. The move, according Wayne Bohenek, vice president of care transformation at Mercy Health, makes it easier for the system’s network of providers to order medications that are on its list and compliant with Mercy’s pharmaceutical contracts. The 23-hospital system went live with its Epic EHR in 2010. It took Mercy Health’s pharmacy and therapeutics committee three years to create the formulary -- a comprehensive list of medicines that Mercy Health would prescribe, said Bohenek. The committee, composed of prescribers from all specialties, evaluated the cost-effectiveness, side effects, comparable efficacy, indications and available literature for medications in 100 classes. [Also: Managed care pharmacies reap benefits of EHRs] Mercy places drugs in one of four categories: on the formulary and available from order sets; on the formulary but not available from order sets; restricted to a specific disease state or provider type; and neither on the formulary nor in order sets. These categories correspond to Mercy’s “bullseye” -- a visual representation of each medication class that committee members use to review their decisions.  For drugs that are neither on the formulary nor in order sets, Mercy built more than 800 therapeutic interchanges. When providers order a non-formulary medication, the system suggests formulary alternatives. If providers don’t choose an alternative, they document a reason. Mercy reports on the data to identify providers who routinely order non-formulary medications. “We generate reports on non-formulary drugs -- how many times they were ordered, and what the cost savings would be if we were to use a formulary drug instead,” Bohenek said. “We can provide that report by region and provider and have discussions with providers who are using non-formulary drugs. The reports show providers how much non-formulary drugs are costing the region.” “We’re pretty prescriptive about it,” said Susan Mashni, chief pharmacy officer at Mercy Health. “An extensive drug monograph is completed for each class of medications.” So far, Bohenek and Mashni said providers have been receptive tot eh workflow. “I think most prescribers see the reality of how much drugs cost and what the impact of prescribing them is,” Mashni said. “As long as it’s just an educational discussion, they’re very responsive to the concept that you’re going to improve patient compliance if you don’t give them the most expensive drug out there.” Mercy Health now has an average formulary compliance of more than 98 percent. [Like Healthcare IT News on Facebook] The formulary management is most effective with a single EHR across the health system because it enables the health system to make modifications as their contracts change and to monitor compliance.   The move to Epic – and the health system board’s insistence that 85 percent of content be standardized – provided the impetus Mercy needed to adopt a formulary. Prior to rolling out Epic, Mercy employed a mix of technology, primarily from McKesson and Meditech  – and paper. Twitter: @HealthITNews

Nebraska Medicine, comprising the University of Nebraska Medical Center, Bellevue Medical Center and UNMC Physicians, will be recognized at the 2016 HIMSS Annual Conference & Exhibition in Las Vegas for achieving Stage 7.