The HIT Transition Weblog

More Uses for English Majors

I feel like I hit the lottery! NAHIT has published its list of healthcare IT jargon definitions. And I win!

We were more or less assuming the RHIO and HIE definitions three years ago. But it seemed like anybody who wanted a for-profit model wanted HIE, while the NPO [Ed. note: That's "Non-Profit Organization," for those of you stuck in the money-making paradigm.], crowd was unafraid of RHIO and its hoary socialist allusions: Regional and Organization. Now maybe everybody won't think they know what I'm talking about when I say RHIO (pinko commie big brother freebie hippie healthcare) versus HIE (fat cat capitalist libertarian survival of the fittest healthcare).

Instead, now HIE -- health information exchange -- is a process of exchanging records, while HIO -- health information organization -- is the thingy that exchanges them, and a RHIO is a "type" of HIO -- presumably a HIO for a R(egion), but NAHIT's still a little cagey on that point.

Glad we got that straight.

Quick! Everybody grab the new keyword!

HITTG Throws a HISsies Script

Last night's HISsies Awards at the HIMSS conference were presented in a wholly new way. As a cartoon. We produced the seven-minute animated awards ceremony for the folks at the HIStalk blog and had no difficulty casting our co-stars, Cerner's Neal Patterson and athenahealth's Jonathan Bush. Of course, the anonymous Mr. HIStalk and Inga anchored the highjinx as awards presenters a la Oscar. Jon Bush's uncanny resemblance to Michael J. Fox, alongside Patterson's notorious hate-mail to middle management, gave us more than enough material to frolic with.

In case you forgot about Patterson's notorious management style, here's just a taste of that missive:

The parking lot is sparsely used at 8AM; likewise at 5PM. As managers -- you either do not know what your EMPLOYEES are doing; or YOU do not CARE. You have created expectations on the work effort which allowed this to happen inside Cerner, creating a very unhealthy environment. In either case, you have a problem and you will fix it or I will replace you. [Sic. sic sic sic.]

Oh, you didn't know that Healthcare IT Transition Group makes animated HIT videos? Catch up...

Don't Touch That Dial
Over the holidays we invested a few bucks and a lot more time in our media production capacity. This is just the beginning, with even more to come. Last fall, we quietly set up our (pre-beta)... 

CIA to Take Over VA Medical Records

[Okay, this was originally a clever and slightly scary story about the involvement of the CIA in a certain Health IT company (true) that is developing certain identification technologies (again, true) that take advantage of a very sophisticated database technology (absolutely true).

Unfortunately, the author of the story has been unable to substantiate a direct connection between that HIT company and the company that develops the database technology, and it is that second company that is working with the VA.  So, the wry, but somewhat worrisome tone of the original text falls pretty much flat on its face.  The editor regrets the error, and the author is scrambling for some old notes.  I wish him the best.

We don't usually do conspiracy stories.  Maybe this is why.  Hope you like the cartoon, which is still valid, as it concerns only the proven connection between Company A and The Company, as it were. -Ed.]

Feds say "Ewww!" to Senior Sex

I'm just minding my own business, scrolling through Medicare's FAQs when I come upon this one: Are Erectile Dysfunction (ED) drugs covered under Part D?

Now, I know just mentioning this on my blog (plus using the dreaded S-word in the subject) will add to our negatives on the spam nazi sites.  But still....

The answer to the question, of course, is "No."  Or, more specifically, "Not anymore."  For Contract Year 2006, they were covered, but your friendly representatives explicitly withdrew funding via the QI, TMA, and Abstinence Programs Extension and Hurricane Katrina Unemployment Relief Act of 2005. (I swear I did not make that legislative title up).

This comes hard on (oops!  There I go again!) the heels of a survey that reported that a lot of seniors actually enjoy s--, um, you know.  And I'm thinking you wouldn't have to look too har--, er, far to find evidence that being, um, well, active was good for them -- improving their mental health, providing exercise, and perhaps, in certain instances, helping them pay their way through the Part D donut h--

Oh geez.  Forget about it. 

Just like Grandpa may have to....

HIT Quote of the Day

I generally don't have time to read blogs, which makes it ironic that I spend an inordinate amount of time writing them.  But now I've become addicted to Mr. HISTalk, a much more "bloggy" blog than our own (which I internally characterize as a "wonky blog" in order to maintain a little personal dignity).  Mr. H's rambling posts cover a lot of ground, including some rumor/insider stuff on vendors that I love to read but have decided never to write.  His (HIS?) investment tip on athenahealth, for example, is something I would act on if I had any money and didn't have lingering fears about subsidizing family dynasties.

Here's a gem from today's post that I just needed to share:

This physician’s practice was at a loss when its PM/EMR system went offline because of a server problem, “.. going back to the dark ages. Paper receipts. Paper-only records. Vestiges of a bygone era.” That would be a great, feel-good EMR testimonial showing that not all docs are paper-bound. Except that he’s a veterinarian.

Arf.

RHIO Business Model Woefully Misunderstood by Health IT Media

More health IT humor at the HIT Bottom Archive.

Bottom Up, Top Down, Centralized Distributed HIT

Okay, I try not to wade into all this industry noise, but there are a number of things that all came over the transom in the last 60 minutes that make it impossible not to comment.

Freedom's Just Another Word
First, the Joint Commission (aka JCAHO), which basically is the gestapo of patient quality and arbitrary auditing (all welcomed, if feared, by the provider community, which wants a bi-annual report card to show its funders), has started a wiki with a pretty broad scope: they call it "wikiHealthCare," which sounds pretty all-encompassing and grandiose, until you go and visit it.  The first two topic areas are pretty constrained: Smoking Cessation and Smoking Policies on hospital campuses.  Also, they want you to register before you use it.  And they want to limit comments to "healthcare professionals."  And the URL is http://wikihealthcare.jointcommission.org/twiki/bin/view/Home/WebHome . 

Remember how East Germany used to call itself the German Democratic Republic? 

The Absolution of Truth
Google, the ultimate "whatever floats your collective boats" info-arbiter seemed to have been moving in the other direction, but now may have stumbled with the loss of their Google Health "architect," Adam Bosworth.  Bosworth's approach seems sort of anti-Google, which may have been the problem:

It is Google’s vision that these two core capabilities, reliable unambiguous computable medical data and safe systems for trust and authentication and controlled access will dovetail with the consumer needs for discovery about everything in their health arena.

Forget about Googling Adam Bosworth -- Danny Sullivan at Searchengineland has put together all the definitive links.  I'd drill down into the details to try to figure out what Bosworth was imagining when he referred to "reliable unambiguous computable medical data," but I lost interest when he seemed to be slipping into consumer-driven healthcare, which subject I give about the same credence as passenger-driven airline travel.

Maybe now that Bosworth has gone on permanent vacation, do you think this means that Google is going back to letting users decide whom to trust? 

Speaking of trust, the wrong Gates is mucking around in the healthcare space again....

Violet and Woodstock Win Dissemination Roulette

With all the flurry this week about the release of the NPI data, and the release of our own RHIO Finance Survey report, I haven't had time to announce that we have a winner in our NPI Dissemination Roulette contest.

In fact, we have two winners, and each gave a similar reason:

"Violet" estimated the release would happen on August 31, 2007, giving the reason: "None of the ones I could think of were printable!! How about a nice politically correct one instead? 'Many deliverables appear to occur just before a public holiday, when there is a low volume of users.' "

"Woodstock" said, "the system will go on-line August 31st.......just in time for us all to go on vacation for the labor day holiday. My theory is based on when they usually put out NPRMs they always seem to come right before a major holiday. (My family is always asking "What in the heck are you READING???" ("!!!!!")"

I guess the folks at CMS had mercy on us and granted us a three-day weekend before we would all glue ourselves to the screen, looking for Dr. Other.

Each contestant won a Major Award.

Our thanks go out to Peppermint Patty, Schroeder, Linus, Pig Pen and all the other contestants for their participation!

Medicare: Be Sure Those Patients are Eligible Before You Ask if They are Eligible!

This just in: Medicare is concerned about patient privacy, so before you send them a request to see if your patient is eligible, well...I can't say it any better than the MLM:

...examples of unauthorized purposes for requesting beneficiary Medicare eligibility information include:

• To determine eligibility for Medicare without screening the patient to determine if they are Medicare eligible