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Meeting practical business and security challenges of healthcare apps in the cloud

There has been, understandably, a great deal of interest for moving all kinds of applications “into the cloud” (like software as a service or SaaS) because it can ease deployment and reduce costs. However, due to the nature of the healthcare data, security is a special concern. If you’re interested in moving to the cloud, check out an article I wrote last week for IBM entitled “Cloud computing by government agencies“; while it’s focused on public sector, it’s just as applicable to healthcare sector because the problems are identical.

Shahid N. Shah

McKinsey estimates that MU incentives may pay for less than 20% of hospital EHR roll out costs

One of my favorite publications, McKinsey Quarterly, published an article this month entitled “Reforming hospitals with IT investment” which speaks in plain business language about the costs and benefits of hospitals rolling out EHRs. The article requires registration but is otherwise free and is worth reading. Here are some of the highlights for a 200 bed hospital: They estimate the costs of EHRs to be around $80,000 to $100,000 per hospital bed They estimate the government incentives will bring in about $17,500 per hospital bed They say that if you use the high-end scenario of $100k per bed, the government incentives will amount to less than 20% of the cost They note that these costs do not scale linearly for larger hospitals.

Shahid N. Shah

Guest Article: What the low-tech checklist can teach techies about medical business processes and proper system design

I’ve often said that if you can’t repeat something, you can’t automate it — meaning trying to jump into creating software or systems before you have identified and fixed your human processes is always prone to failure. One of the best ways to understand if your process is repeatable is to create checklists and see if people follow them. I recently ran across Jacob Ukelson, Chief Technology Officer of ActionBase, who is somewhat of an expert on human process management and action tracking solutions that enable organizations to manage business-critical processes.

Shahid N. Shah

NIST says Meaningful Use Test Procedures have been approved by ONC

NIST updated Meaningful Use Test Approved Test Procedures page today: The Approved (Pending) Test Procedures were formally approved on August 2, 2010 for the Office of the National Coordinator for Health Information Technology (ONC) Temporary Certification Program. Notice of the approval appears in the August 9, 2010 Federal Register. The set of Test Procedures marked ‘Approved (Pending)’ will be reissued as ‘Approved’ by August 13, 2010. The approval process did not result in changes to the test procedures.

Shahid N. Shah

Guest Article: Lessons from the trenches – transitioning to EMR without risking data loss

The government’s promise of billions in EHR incentives has you interested in what you might be able to get so many of you are looking for advice and lessons learned from practices who have taken the leap to EMRs. I invited James Andrassy_, M.Ed,_ _PA-C__, who_ _has worked as a healthcare provider for the past 33 years to talk about some practical lessons. As the practice administrator and network engineer for Gastroenterology Associates of Cleveland and the Cleveland Center for Digestive Health and Endoscopy, he has seen many kinds of problems so_ _I asked him to talk about EMR data management, specifically data loss.

Shahid N. Shah

An overview of NHIN, NHIN CONNECT, and NHIN Direct

IBM developerWorks invited me to write an article that provides a technical overview of the National Health Information Network (NHIN) along with its related sub projects called NHIN CONNECT and NHIN Direct. The article was published today and covers how you can use CONNECT right now to create your own health information exchange (HIE) or connect to an existing HIE. In the article I also discuss NHIN Direct, a new project without immediately usable code yet, which you can use it to push or pull data from your medical systems to other healthcare systems directly (without necessarily going through an HIE).

Shahid N. Shah

My view on HIT (or other technical) certifications

On July 14th I conducted a seminar on How Meaningful Use Impacts Healthcare Data Management and IT Professionals. It was pretty popular and I got lots of questions at the event and many afterwards as well. One of the questions that kept coming up over and over again was about how to enter the healthcare IT field. One really good question was about certification and what i thought about it — here was the gist of the query:

Shahid N. Shah

NIST releases revised draft test procedures to adjust to the final Meaningful Use rules

As promised, NIST has released its revised draft test procedures to adjust to the final Meaningful Use rules that were unveiled last week. Here’s how they describe the latest updates: Approved (Pending) Test Procedures A Final Rule on an initial set of standards, implementation specifications, and certification criteria for adoption by the HHS Secretary was issued on July 13, 2010. NIST has completed its revisions of the draft test procedures to adjust to the Final Rule.

Shahid N. Shah

NIST planning to update draft test procedures tied to final MU rules on July 22

NIST just posted the following on their Health IT Testing and Standards draft test plans page: July 19, 2010 Note: A Final Rule on an initial set of standards, implementation specifications, and certification criteria for adoption by the HHS Secretary was issued on July 13, 2010. NIST is currently updating the Test Procedures to reflect the Final Rule and anticipates publication by July 22, 2010. NIST’s test plans are what will be used by the certification bodies and form the basis of what really will be required in EHRs so it’ll be important to keep any eye on these.

Shahid N. Shah

Final MU rules are out but don’t forget, you’ve still got all of 2011 and 2012 to get paid

As you’re probably already aware, the final meaningful use rules were released by the government about 48 hours ago. Overall, I’m impressed with the transparency, quality, and timeliness of the final regulations. I think the “little guy” won one because the MU rules have mostly been reduced from the original requirements and the two additions are relatively easy. While I don’t think we should be doing any top-down initiative like MU, given that it’s the law, HHS, CMS, and NIST is doing as good a job as they can in writing the rules and attempting to make them understandable.

Shahid N. Shah
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