Monthly Archives: September 2006

Leapfrog is irrelevant

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It’s official (because I am writing it here). The Leapfrog Group is no longer relevant. Perhaps they never were. We can stop talking about them now.

I just finished reading through their 2006 press releases. Almost all of those press releases are the Leapfrog Group commenting on other organization’s quality initiatives.

The only accomplishment that the Leapfrog Group claims is receiving more surveys than ever before. Like usual, there is no comment on the pace at which the submitters of those surveys are embracing the leaps. It seems like they could have counted up those surveys by now (they were due on June 30). I suspect they know the numbers, but there isn’t anything to brag about.

Where are the corporate sponsors? I thought they were big into accountability?

I believe the Leapfrog Group made a mistake in choosing CPOE as their first leap. There are so many other safety initiatives that produce excellent safety results and are significantly more achievable.

The fact is that the number of hospitals that have implemented CPOE is insignificant. Last year that number was less than 80 (out of nearly 1,000 surveys received). That is pretty dismal for the 4th year. I don’t expect a great increase this year. Ironically, one of my hospitals will be one of the few additions.

And, what has ever happened to the Leapfrog Group/FCG tool to test the clinical alerts in a CPOE system? This was announced in 2001? Is it out there and I just missed it? Or, is the Leapfrog Group 4 years behind schedule?

It really doesn’t matter. Because there are far more important patient safety initiatives (IHI’s 100K lives). And, because nobody is listening. CPOE mania is dying as executives realize that they have better patient safety opportunities that are more proven and don’t disrupt their admitters.

Since Leapfrog launched 5 years ago they have never steered a single patient to a hospital with CPOE (I could only hope). I would bet they never will.

Fin.

EHR vs. EMR

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I am always frustrated how some often used terms in Healthcare IT are used in very different ways by different people. A simple example is Electronic Health Record (EHR) and Electronic Medical Record (EMR).

For a period of time the term Computer-based Patient Record was hot, but that seems to have been a short-lived fad.

So, what is the difference between and EHR and an EMR? As we are in the midst of developing a new EHR strategy for our 400-physician group this is a debate that is near and dear to my heart.

I think CCHIT and HL7 EHR-S do a nice job of describing core EHR capabilities. Those would include medication management, allergy list, problem lists, immunization, etc.

However, we are looking for a phrase that captures what we are trying to do. For our purposes we are saying that the EHR promotes the practice of medicine. Whereas an EMR is simply an electronic version of the traditional medical record. That is, the information is in there and it is retrievable, but it is generally organized around the hospital departments.

We have great doctors at Affinity and Ministry. Our goal is to continue to provide better tools that allow physicians to focus on the practice medicine, not search for data. By giving them IT systems that present the most clinically relevant information to care for each patient we can make these doctors even more efficient and effective.

What is your definition of an EHR?

My Trip to MEDITECH

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I just got back from spending the better part of two days at MEDITECH. Even though I have been a MEDITECH CIO for 11 years I had only been to Boston 1 other time. I just don’t feel like I need to talk strategy very often. I also feel guilty tying up executive time for a little 15 hospital chain in Wisconsin.

The MEDITECH campuses are beautiful. I suppose that is in part because founder Neal Pappalardo’s daughter is an interior decorator. There is tasteful art everywhere. My understanding is that MEDITECH has unintentionally done very well with real estate appreciation.

Anyone that states that MEDITECH is a closed system that is difficult to interface to/from is stuck in the 90’s, presumably listening the Spice Girls and using CompuServe on their 486. I have always been able to get the MEDITECH interfaces I need. But, the interoperability efforts they have underway really made me say “wow.” They are clearly adopted emerging standards in a way that they never have before.

We were supposed to go to dinner with the MEDITECH folks last night, but we decided to cancel out in order spend some time working (rarely are our clinical IT leaders in the same place). I felt bad about canceling, but I assumed the MEDITECH execs would appreciate their unexpected free time. Today I asked Howard Messing (President and COO) how he spent his free night instead of schmoozing customers. He told us that he installed a new distribution of Linux on one of his computers. I love that dude.

I asked Howard if I should read a business strategy into that. He told me that they are already running some Linux applications internally and have been playing with it. I don’t suspect there is a Linux option forthcoming for MEDITECH’s HIS customers. But Howard, feel free to take Microsoft out of the equation. We can split the savings 50/50.