HIMSSWA, WSHIMA & CHITA Present: 5010 / ICD-10

Today the Washington state chapters of HIMSS, AHIMA, and CHITA streamed the content from our conference on 5010 & ICD-10. Many thanks to the incredible Television Services team at Bellevue College for making this possible.

Below are the ICD-10 talks:

10:00 am to Noon
Talks from:

Richard Saulsgiver – COMSYS
Joe Nichols – Health Data Consulting

12:45 pm to 3:15
Talks from:

Katheleen Peterson – Sr. Lecturer UW
Cheron Vail – VP/CIO Regence Blue Shield
Kellie Henderson – 3M HIS
Speaker Q & A

October 29, 2010 at 9:45 am Leave a comment

REC Using YouTube to Reach Healthcare Providers

How would any new startup business secure a minimum of 1,000 customers in less than 2 years?  Chances are they would need a robust and diverse marketing strategy.

Each of the sixty Regional Extension Centers (REC) has the ambitious goal of assisting at least 1,000 healthcare providers with their transition to EHRs (electronic health records) and achieving Meaningful Use during the next two years.  While businesses in the healthcare industry have primarily focused on more traditional marketing media, at least one REC, Tri-State Regional Extension Center in Ohio is promoting their services using a well crafted and informative video on You Tube.

In 5 ½ minutes, this video explains  the services that Tri-State REC provides, as well as the challenges and benefits healthcare providers encounter when transitioning to an EHR.  Are healthcare providers dialed into You Tube?  Will they seek out professional resources using You Tube?  Only time will tell.  However, kudos to Tri-State REC for thinking outside the traditional marketing box.

July 6, 2010 at 9:45 am Leave a comment

Our Thoughts on the Draft Meaningful Use Certification Testing Criteria

The Health IT branch of the National Institute for Standards & Technology (NIST) has been hard at work publishing draft certification procedures for hospitals, doctors, and vendors looking to achieve each of the Meaningful Use requirements.  You can see what they’ve published so far here: http://healthcare.nist.gov/use_testing.

We recently found these wonderful documents, and after reading through the ones that pertain to Nimbus eRelease, we realized a couple of them require the use of explicit data formats where none are warranted.  Namely, they require health information that must be presented to patients in an electronic, human-readable format, be done so via a CCD or CCR.

We wrote up our thoughts and posted them to hit-tst-fdbk@nist.gov today.  For anyone interested, our comments are below.  We’ll let you know what they say.

To whom it may concern:

We have a question regarding the test procedures for the “Electronic copy of health information” criteria.  According to the Meaningful Use Interm Final Rule, the objective of these criteria is to “Provide patients with an electronic copy of their health information.”  While the IFR mentions the use of CDs, USB drives, and providing online access to the information, it neither mentions nor requires the use of a particular health record format when storing, transmitting, or displaying the information to patients.

Knowing that, we were surprised by what appears to be, an explicit requirement in the test procedures (§170.304 (f) & §170.306 (d)) to structure the underlying health information in the HL7 CCD or ASTM CCR formats.

Question: Assuming all of the required information (e.g. diagnostic test results, problem list, medication lists, allergies, discharge summary, and procedures) is shared with the patient electronically in a human readable format, does it matter what the underlying format of the data is?

Note: the testing procedure for “Electronic copy of discharge information” (§170.306 (e)) has the same electronic delivery and human readable requirements, but appropriately, in our opinion, does not explicitly require the use of a particular standard for the underlying data.

Why We’re Asking

We have a module that enables sharing health information with patients from any EHR, even if the EHR doesn’t know how to produce CCD or CCR-formatted data.  We’re able to do this by offering an online service that redirects printed output from EHRs to our secure portal, where is it turned into a PDF that is accessible by the patient.  With this service, providers can securely share health information with patients electronically online, and in the same human-readable format as if it was printed directly from the EHR.

Due to the “plug-and-play” nature of the service, and to ensure it works for all EHRs (even ones that will see little investment going forward), we cannot customize the service to build a CCD or CCR out of the data, en-route to creating a PDF.  Not only would it be prohibitively expensive, it would ultimately be of little value since the final objectives are only that the health information be complete, electronic, and human readable.  Clearly, all of these objectives can be met without requiring a specific format for the underlying data.

Please let us know if we’re misinterpreting the draft procedures or if there’s an opportunity to adjust them before they are finalized.

Thank you for your time, and for the great work you’re doing preparing providers and vendors for certification.

June 17, 2010 at 3:37 pm 2 comments

Announcing Nimbus eRelease

Over the past 6 months we’ve talked with dozens of healthcare providers, members of Regional Extension Centers, service providers, and EHR vendors to get there take on a new service we were thinking about building.  We are now proud to share the details of that service with everyone with the announcement of  Nimbus eRelelase.

As mentioned in the video, we have two goals with Nimbus eRelease:

  1. Tackle Meaningful Use
  2. Help providers tap into the Release of Information (ROI) revenue stream

While the ground beneath the healthcare industry is still moving quite a bit, we’ve tried to embrace the principles of Customer Development, as evangelized by terrific Steve Blank, as much as possible.  So far, we’re hearing a lot of positive responses to eRelease’s value prop, let’s hope they keep coming as Meaningful Use solidifies.

June 1, 2010 at 11:20 pm Leave a comment

Sharing Files with your Teammates Online

A friend of mine recently asked how she could easily share files with her teammates while they worked on a project.  Here are some great tools to securely do just that.

Google Docs
A free service for people to store documents online and share them with other people.  Simple, easy to use, and you can set it up yourself without any help.

Note, Google docs is not just for sharing files, it also has online editors for them (e.g. you can edit Excel, Word, files, etc. via their website), although it doesn’t have all of same functionality as Microsoft Office.

OffiSync
Awesome Microsoft Office plug-in that lets you share documents with anyone you like, work on them simultaneously, and merge them all within your favorite office app (e.g. Excel, Word, PowerPoint).  Uses Google Docs as your back end and it’s free!

Google Apps
The same functionality as Google Docs, but also enables you to provide email, calendar & other services for your teammates.  Feels a bit more official since people would log in with their business email addresses, but if you don’t want/need that, stick with Google Docs to start.

Free but you need to own a domain (e.g. http://www.NimbusHealth.com).

Syncplicity
This isn’t so much a web site, as it is an application that sits on your computer and automatically keeps copies of your business files backed up and synchronized with your associates.

You install it, tell it which directories you want it to watch, and not only will it back up those folders for you online, you can share those folders with other people and whenever you make a change to a file within it, it will automatically be updated on your teammates’ computer.  You can still access the files on their website, but you don’t have to re-upload them every time you make a change – it does it automatically.  Very cool.

Free for up to 2 gb of storage per-person.  I recommend only having it backup the directories with the files you want to share at first, you can extra directories later (because it takes a while to back up all of your My Documents, for example).

Basecamp
An online project management and file sharing/collaboration tool.  Very simple to use and includes the ability to schedule and track time as well as share files.

Office Live
I haven’t used this, but I think it’s a light weight version of Sharepoint.  Probably enough to a small team going.

Hosted Sharepoint

If you need the full functionality of a Sharepoint site, I suggest searching for hosted Sharepoint services online.   It shouldn’t take too long to setup and should be fairly inexpensive.

I know that’s quite a few options, but each one has their advantages for any given situation.  For reference, we use Google Apps for business purposes, Google Docs for personal, and Syncplicity for both.

[Update - 6/2/2010]
The gracious members of the HIMSS Small & Independent Consultants Special Interest Group (SIC SIG) offered some great suggestions as well:

Dropbox
Similar to Syncplicity mentioned above but focuses on a single directory. Keeps things simple.
- Terry Montgomery (Texas Health)

Lombardi Blueprint
Very cool tool for collaborating on workflow & process maps. Terrific for EHR implementations!
- Paul Snell (Re-Think Radiology)

Joomla or DotNetNuke
Content management systems you and also use as a company web site. If you use either system as your company web site, then creating workspaces for clients or colleagues is straightforward and you have easy access to all the functionality required to run your business.
- Jerome Carter (NTM Informatics)

Central Desktop
Feels like what Sharepoint would be if you built it in 2010. Highly integrated and collaborative file sharing, editing, project management and calendar functionality.
- Bob Brown (Mosaica Partners)

June 1, 2010 at 9:53 pm Leave a comment

Nimbus Health on Cloud Security & Scale

The folks at Amazon Web Services invited me to speak at an event last week focused on helping enterprise customers understand how they could leverage cloud services.

Considering we store sensitive information like electronic medical records in the cloud, they asked me to speak on how AWS can be HIPAA compliant, as well as how we scale our services.  Here’s the presentation I put together:

It covers:

  • Who is Nimbus Health & what we’re building
  • Why we chose AWS over traditional hosting
  • Why we prefer virtual servers over physical servers
  • Why we think cloud hosting is more secure from a HIPAA perspective than traditional hosting
  • How we use EC2, S3, Elastic Load Balancing, Auto-Scaling and Cloud Watch to automatically resize our infrastructure based on load

Some of the above won’t come through without my commentary, but perhaps when I get a moment I’ll record some.

Questions, comments, concerns?  Let’s hear ‘um.

May 18, 2010 at 10:17 am 6 comments

WSHIMA Conference: Professional Networking Online

I had the privlege of speaking at AHIMA’s Washington State’s annual chapter meeting, on the topic of Professional Social Networking last week.  I had a really great time.  The group was eager to learn, had some great energy, and as a bonus, I got to know quite a few of the attendees over the rest of the conference.

I decided to record the talk after the fact for anyone who wasn’t able to make it.  Questions and comments are welcome as always,  and I want to send  one more huge thanks again to the WSHIMA conference organizers and attendees; I had a blast.

Fullscreen version.

April 20, 2010 at 7:09 pm Leave a comment

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