Archive for May, 2009

Maryland Passes EHR Adoption Incentive Law

Thursday, May 28th, 2009

Ocean City, Maryland
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The first state to do so, Maryland has passed a law requiring health insurers to to provide incentives to healthcare providers for their adoption of EHR systems.

As yet undecided, the incentives may take the form of increased reimbursements, lump-sum payments, in-kind services, or some combination of these.

You can view the entire text of Maryland’s HB 706 here.

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Software Maintenance Costs – Pop the Bubble

Wednesday, May 27th, 2009

Pop the Maintenance BubbleThe Situation – Because of the recession, companies have become more vigilant about their operating expenses. IT budgets in particular are under the microscope, and software maintenance and support expenses are in center view.

It’s unfortunate that it took a global recession to get companies to take a closer look at the expense of their software deployments. Better now than later (or never), but the thought of so much money wasted (under-utilized) is disturbing. No complaints from the software vendors, of course, but after actually analyzing their software expenses, many software buyers are feeling embarassed and even angry.

Image representing Oracle Corporation as depic...
Image via CrunchBase
The concept of software maintenance and support fees will go down in history as one of the greatest commercial ploys of all time. Along with cheap printers whose replacement ink is almost as expensive by weight as gold, and the old “rinse and repeat” instruction on shampoo bottles, the concept of software maintenance and support is sheer genius. That much I will grant software vendors.

There comes a point, however, at which tolerance of an industry norm is no longer acceptable. In the case of the software industry, I think we have reached that point, and it has taken the form of abusive, if not unconscionable, pricing for maintenance and support.

Image representing SAP as depicted in CrunchBase
Image via CrunchBase
In a recent article she wrote for the Wall Street Journal, Jessica Hodgson claims that Oracle enjoys a hefty 85% profit margin on its maintenance and support fees. In my experience, Oracle is the worst offender in the category of outsized maintenance expense, and SAP runs in second place year after year. But most other software vendors are nearly as bad (abusive).

What You Can Do – Good news, bad news. The good news is that there are many things you can do–many approaches you can take–to reduce your ongoing software maintenance and support expenses. The bad news is that I can’t list them all here in this single post, at least not with sufficient detail to help you in a meaningful way. So, look for follow-up posts in which I will go through various techniques, one by one, with some real-world experience and examples thrown in. I can help you pop the maintenance and support bubble and start saving some real cash.

Take me to Part Two: Reducing Maintenance Costs – Quick and Dirty Approach

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General

Tuesday, May 26th, 2009

General content.

ONCHIT Releases Operating Plan for ARRA EHR Incentives

Tuesday, May 26th, 2009

Saving For a Rainy DayThe Office of the National Coordinator for Health IT (ONCHIT) has released its operating plan for implementing the health IT provisions included in the federal stimulus package. But don’t get your hopes up. The plan is disappointingly brief and lacking in detail . . . more along the lines of “here’s what we’re going to do once we get started.” C’mon people! The clock is ticking!! Get with it.

Sadly, it’s looking more and more like the HIT provisions of ARRA will not have their intended effect: stimulating the economy. By the time ONCHIT releases its rules and guidelines, the absence of which has frozen EHR implementations, the U.S. economy will be well on its way to recovery. Sadder still, legislation that was designed to create spending has actually slowed spending.

Once again, the best laid plans of governement have gotten sidetracked in bureaucracy. Maybe we should save these EHR incentive dollars until a more considered plan can be developed.

You can view ONCHIT’s Operating Plan here.

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Remarkable PAPR for Hospitals, Clinics and Laboratories

Thursday, May 14th, 2009

Logo for the United States Occupational Safety...
Image via Wikipedia
Bio-Medical Devices International (BMDI) manufactures the NIOSH-approved MaxAir, a Powered Air Purifying Respirator (PAPR) that was specifically designed for hospitals, clinics and laboratories. The other PAPRs on the market were born in an industrial setting, and their bulky construction materials, hoses and filter cartridges make them less suitable for use outside of an industrial setting.

Occupational health and infection control professionals in hospitals, clinics and laboratories around the country have embraced the MaxAir as their PAPR of choice for disaster and emergency preparedness, as well as daily use. Because it is a PAPR, the MaxAir does not require the annual fit testing that is mandated by OSHA for non-PAPR respiratory protection devices (e.g., the N95). Annual fit testing expenses can be substantial for an organization, and there are always indivduals for whom an acceptable fit is not possible. MaxAir to the rescue.

You can learn more about BMDI and its MaxAir by visiting its corporate website.

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President Obama Speaks on Healthcare Reform

Monday, May 11th, 2009

Barack Obama 11.jpg
Image by christhedunn via Flickr
Read the latest on President Obama’s healthcare reform effort. You can view the transcript from his live telecast at 11:30 EST on May 11, 2009 here.

Not a lot of detail, but some broad-brush objectives stated very clearly.

Go here for more information on the meeting with healthcare industry constituents that preceded President Obama’s speech.

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Federal EHR Incentives – Carrot or Brick Wall?

Wednesday, May 6th, 2009

carrotBusiness is slow for EMR/EHR software providers at a time when business should be booming. With over $20 billion of funding available in the form of reimbursements, we would expect healthcare providers to be waiting in line for their EMR/EHR implementations. Ironically, the very legislation that created this generous funding also included provisions that have given doc’s and hospitals pause. Actually, it’s more than just pause. It’s outright paralysis.

The eligibility for federal dollars is tied to “meaningful use” of “qualified” EHR sytems, which sounds simple enough. But now–nearly four months after passage of the American Recovery and Reinvestment Act (ARRA)–no one knows what meaningful use is, and no one knows what a qualified EHR system is. We have some clues, but we have no official declaration.

brick-wallIf the Obabma adminstration is serious about HIT and EHRs, and it wants to see the economy benefit from this category of HIT spending (a secondary, but nonetheless important, objective of the funding), then the federal government needs to act quickly and decisively to define the eligibility criteria. If this cannot be accomplished quickly, then we’ll lose the economic stimulus feature of the plan–the economy is already starting to improve because of other measures taken and not taken. And if we miss the economic stimulus train, we might as well wait until a more considered approach can be taken with respect to HIT, including EHRs, in the broader scheme of healthcare reform.

What do you think? Is the lack of certainty with respect to EHR system eligibility criteria the main reason the rate of EHR adoption has not increased after passage of ARRA? What can the feds do to expedite development and promulgation of the eligibility criteria?

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