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August 17, 2010  10:06 AM

Patient data capture: Your key to reducing the learning curve on EHR use

Posted by: Jenny Laurello
Data management, EHR usability

Guest Post: Stephen Dart, Senior Architect, EHR Product Line, AdvancedMD Software, Inc

Among the many characteristics you should evaluate in an EHR is its use of pre-built encounter templates. The physician, new to clinical automation tools, needs a starting point, and typically wants to minimize the time it takes to get productive on a new system. To reduce the learning curve, the EHR should offer a range of pre-built visit type templates  and support a variety note capture methods, so the physician can select the input method  most natural to them, including keyboard, point and click, writing stylus, and voice-to-text.  Additionally, short-cut abbreviations should be offered as part of the encounter templates, to further facilitate data capture. 

Another feature you should look for in your EHR is its ability to capture and store discrete patient data – such as weight, diagnosis, medications, lab results, review of systems, plan of care, and health maintenance protocols. When captured as discrete data elements, as opposed to a textual document, your system is in a better position to produce detailed statistical output that can support reports and trend analysis research. This will be critical going forward to provide support for the proposed meaningful use standards for interoperability.  This will be difficult for textual-oriented systems to achieve.

Converting patient visit notes into correspondence is another area to evaluate. There may be patient data the physician wants to include in a referring physician letter, for example. That data may have been captured in a previous visit or is information that is outside the scope of the current encounter documentation. This is accomplished using query technology that can embed specific information pulled from anywhere within the system — demographics, charts, notes, medications, lab results, even financial information. Not all EHRs are designed with this range of flexibility. The benefit is that the physician can generate a more personalized letter that delivers a much broader view of the patient than information gathered during the most recent encounter.

 For more information, please visit AdvancedMD Software, Inc

August 6, 2010  9:00 AM

Upcoming webcast: Understanding Meaningful Use EHR Incentive Mandates

Posted by: Jenny Laurello

Press Release

Complimentary Webcast by Healthcare Infotech Expert Pabrai on Aug 12

NEWPORT BEACH, CALIFORNIA, USA – August 6: The Centers for Medicare & Medicare Services (CMS) introduced rules to implement provisions of ARRA to provide incentive payments for the meaningful use of certified Electronic Health Record (EHR) technology. Further, meaningfull use has an impact on HIPAA and HITECH mandates. There are two incentive programs introduced as a direct result of HITECH’s Meaningful Use program. All attendees receive complimentary Meaningful Use EHR Incentive Program Quick Reference Card.

Join ecfirst – home of the HIPAA Academy – for a compelling Webcast on August 12Understanding Meaningful Use Electronic Health Records (EHR) Incentive Mandates.  

Testimonial: “I am the HIPAA Security Officer here and have also been following the EHR requirements in order to become familiar with the Certification documents and Rules.  I appreciate these ecfirst Webinars as the information is extremely helpful.  The EHR presentation was very thorough and helpful and contained some points I had not heard previously.  I rely on ecfirst’s leadership in these matters.”- Iris Anderson, HIPAA Security Officer, Prime Healthcare Systems

Register exclusively at Webcast is presented by Healthcare Information Technology (HIT) expert, Ali Pabrai, MSEE, CISSP. Walk through both the Medicare and Medicaid incentive programs and understand critical parameters associated with the meaningful use requirement.

Is your organization/practice prepared to address meaningful use requirements for EHR? Attend this 29-minute fast-paced, fact-based, Webcast to learn about core requirements for adopting and implementing capabilities required for EHR.

The Medicare EHR incentive program provides incentive payments to Eligible Professionals (EPs), eligible hospitals, and Critical Access Hospitals (CAHs) – meaningful users of certified EHR technology. The Medicaid EHR incentive program provides incentive payments to EPs and hospitals to adopt, implement, or upgrade certified EHR technology or for meaningful use in the first year of their participation in the program and for demonstrating meaningful use during each of the subsequent 5 years. Understand both meaningful use programs in this Webcast on August 12 at 8:30 am pacific, 10:30 central.

These EHR meaningful use initiatives are coupled with strong mandates for privacy and security compliance that must be addressed. Step through what organizations must do to comply with critical meaningful use mandates for compliance.

Private Webcast: To discuss a private Webcast tailored for your organization, please contact John Schelewitz at +1.480.663.3225 or at

About ecfirst: ecfirst delivers world-class Healthcare Information Technology (HIT) solutions with expertise in HITECH, HIPAA mandates and global standards such as ISO 27000 and PCI DSS.

With over 1,500+ clients, ecfirst was recognized as an Inc. 500 business – America’s Top 500 Fastest Growing Privately Held Business in 2004 – our first year of eligibility. ecfirst assists organizations with their compliance initiatives for a secure information infrastructure that is compliant with regulations such as HITECH, HIPAA, ISO 27000, or federal and state legislations (such as California or Massachusetts).

For more information, please contact or 1.877.899.9974 x16 and visit

July 29, 2010  11:41 AM

Best practices for streamlining data management with HSV

Posted by: Jenny Laurello
Data management, healthcare storage virtualization, HSV

Guest Post: Tony Cotterill, founder and CEO, BridgeHead Software

Healthcare Storage Virtualization, or HSV, is a flexible data and storage management platform that decouples software applications from the physical storage hardware on which the application data resides. By separating these applications from their respective storage devices, healthcare organizations have more choice, flexibility and control over the way data is accessed, protected and managed. The aim, ultimately, is to ensure optimal efficiency and cost effectiveness through better utilization of hardware resources and, more importantly, the easy, safe and reliable access, use and management of critical electronic patient data.

In fact, HSV’s hardware agnostic framework liberates healthcare organizations from the lock-in of a proprietary hardware solution. Users are free to take advantage of their existing infrastructure and mix and match systems components from multiple vendors. Over time, they can incrementally build their HSV foundation by gradually adding new hardware as their budget permits.

HSV offers full functionality to streamline and cost-effectively manage your storage throughout the data lifecycle, including HSV advanced services, compression, de-duplication, encryption, content tiering, content verification, content indexing, legal hold, retention management and immutable storage

With HSV, healthcare organizations consequently benefit from:

  • Improved storage utilization that enables healthcare IT professionals to make the most of their current infrastructures; the application of advanced services, such as compression and de-duplication, maximize available storage utilization.
  • Trouble-free data migration provides controlled movement of data across storage devices, as and where required. As the data is processed and managed by the virtualization layer, it can be transferred between storage devices, invisibly in the background.
  • Enhanced content access realized through the application of comprehensive content indexing (metadata and full-text indexing) to the data in the background as it flows through the virtualization layer and is written into storage. This enables the presentation of a single, virtual data repository available to applications, storage devices or users directly.
  • Better data protection and security achieved via the virtualization layer’s ability to transfer data onto geographically dispersed and highly protected systems outside of a hospital’s primary storage backup repository.

In short, HSV enables healthcare organizations to addresses both their immediate and long-term data management challenges. While it’s a destination to be achieved systematically over time, its benefits can be realized and demonstrated almost immediately.

Tony Cotterill is founder and CEO of Healthcare Storage Virtualization (HSV) company BridgeHead Software, which offers a scalable, future-proof platform to overcome rising data volumes and increasing storage costs while delivering peace of mind around the access, availability and protection of critical electronic patient data.

July 22, 2010  9:56 AM

Overcoming barriers to healthcare storage virtualization

Posted by: Jenny Laurello
healthcare storage virtualization, HSV, virtualization

Q&A with Tony Cotterill, founder and CEO, BridgeHead Software

Q. “What are the top five barriers in achieving health care storage virtualization and best practices for overcoming those constraints?”

1. Exploding volumes of health care data

Health care organizations worldwide are faced with growing volumes of digital data.  The adoption and expanded use of Electronic Health Records (EHR) is being spurred by forces such as the HITECH provision of the American Recovery and Reinvestment Act in the United States, Canada Health Infoway, and the European Institute for Health Records (EuroRec).  And while the amount of this digital data (and the storage needed to maintain it) is growing at an unprecedented rate, it pales in comparison to the new data created every day by PACS (Picture Archiving and Communication Systems).  Not only are traditional Radiology PACS creating larger digital files as imaging modalities improve, but as other clinical disciplines (such as Mammography, Cardiology, Pathology, Endoscopy, and Ophthalmology, to name but a few) adopt digital imaging technology, data growth is increasing exponentially.

As health care providers increasingly come to rely on computerized systems in the course of caring for patients, Healthcare IT is under increasing pressure to protect, retain, and make available 24/7 this vast amount of medical data.  In the event of a system outage, their response must be swift, enacted confidently and without hesitation so that the business of patient care can continue with minimal disruption.

2. Not all health care data is created equally

Not only do hospitals cope with exploding volumes of data, but they also must deal with three different types of data: structured data, unstructured data and semi-structured data. In order to successfully implement a Healthcare Storage Virtualization (HSV) architecture, hospitals must understand each data category and plan to adopt separate management policies for each type.

  • Structured Data — Applications that generated structured data are database driven.  The most common example is the HIS, which may store it data in databases such as MUMPS, Cache, MAGIC, Oracle, or SQL.  RIS (Radiology Information System), LIS (Laboratory Information System), EHR (Electronic Health Record) and accounting systems typically fall into this category as well.  The amount of data these systems generate typically falls in the hundreds of GB range, maybe approaching a few TB in larger facilities.
  • Unstructured Data — Applications that generate unstructured data produce discrete files that are not associated with a database.  Office productivity suites are a good example of this.  Word processing documents and spreadsheets are routinely created by hospital administrative staff, and these files are typically stored on files servers.  And often, different users may store individual copies of identical files.  Other file types such as presentations, audio and video files, and pictures are stored in this manner as well.  The file systems storing this data may be of modest size in a small facility but can grow quite large in a multi-facility organization.  Many TB of unstructured file data can be a challenge to backup and recover for any Health care IT organization.
  • Semi-structured Data – There is a third category of data common to hospitals that we shall call semi-structured.  The two best examples of semi-structured data are PACS (Picture Archiving and Communication Systems) and ECM (Enterprise Content Management System) systems.  Both maintain a database of information (structured data) that reference often large quantities of discrete files (unstructured data).  A PACS database may run on Oracle or SQL, and its size may be relatively small in relation to the many TB of DICOM images that database references.

3. Interoperability and sharing of data

One of the biggest and most frustrating challenges facing health care IT professionals today is the complexity of data sharing among IT systems, departments and hospitals. Today, clinicians cannot easily (if at all), view a patient’s records and medical images in one place. The negative impact of this can be as serious as depriving patients of the high quality of care upon which their life may depend.

Part of this problem is that many IT solutions operate in stand-alone silos, and therefore will not interoperate with other applications. In the picture archiving and communication system (PACS) world, for instance, systems may be implemented as end-to-end solutions, with an integrated application and storage layer working together. This often means that the medical images stored within the PACS such as those created via endoscopy, mammograms and digital radiography are either inaccessible by other applications, or are using proprietary technology that doesn’t communicate with other software.

In either case, the data in question is of no use outside of its primary function. As a result, a patient may have to undergo a repetition of the scans, leading to duplicated effort, increased costs and wasted time. In order to increase data interoperability and overcome content sharing issues, health care IT professionals are increasingly expected to devise ways and means to ensure data can be utilized for multiple applications, across departments and even across geographically dispersed hospitals.

4. Data migration headaches

In health care environments, data migrations mainly occur in the event of hardware or application failures, or of the hospital’s desire to implement new technologies. Given that the typical lifespan of a storage device is between three and five years, migrations are not uncommon, and they often create challenges to keeping the hospital up and running at optimal levels.

Because medical records are often stored for the duration of a patient’s lifetime and perhaps longer, data is often migrated several times throughout its existence from one storage facility to another, or across applications. Migrations require the time, resources and effort of health care IT professionals to ensure that hospital systems can continue to operate, providing the necessary service levels of care expected.

The increased digitization of health care-related information brings with it many opportunities to deliver better quality care while bringing hospital systems in line with the commercial world. The road is not necessarily an easy one, however, with many challenges afoot. Health care Storage Virtualization provides a strategic framework to assist health care IT organizations in addressing these challenges head-on, creating a highly functional data and storage management environment today while ensuring a future-proof solution for tomorrow.

5. Growing backup windows for health care storage

With acts of nature such as Hurricane Katrina (responsible for destroying a U.S. hospital and the majority of its patient data), as well as more common outages and disruptions always looming, health care organizations require a robust Disaster Recovery (DR) strategy. Ensuring continuity of service that minimizes potential downtime and speeds recovery time should disaster occur now lies firmly within the health care IT department. Managers and executives are clearly conscious of this as illustrated in a recent survey[1], in which the majority of professionals indicated that DR is high on their current agenda. Yet many hospitals don’t have a DR strategy in place. Likewise, many claim to have a workable DR system, but have never tested it.

Furthermore, hospitals often struggle to maintain a robust data back-up process. This is largely due to the sheer volume of information – many institutions can’t physically backup the vast amount of data within available time windows, even as an overnight process. We’ve already established that data volumes are continuously rising. Consequently, back-up processes (and their impact on DR) are only going to become more challenging in the future.



Tony Cotterill is founder and CEO of Healthcare Storage Virtualization (HSV) company BridgeHead Software, which offers a scalable, future-proof platform to overcome rising data volumes and increasing storage costs while delivering peace of mind around the access, availability and protection of critical electronic patient data.


[1] BridgeHead Software, Data Management Healthcheck Survey, 2010.

July 2, 2010  11:58 AM

The Changing Health IT Landscape Offers New Terrain for Consumerism

Posted by: Jenny Laurello
Consumerism, Web 2.0

Guest Post:

By: Marc Perlman, Global Vice President, Healthcare and Life Sciences, Oracle Corporation

Consumerism in healthcare, while not a new concept, has failed to gain significant traction in the United States…until now.  The unprecedented recent shift in public policy and technological innovation presents our best opportunity yet for broader consumer participation so that individuals have greater control over personal healthcare decisions.

Proponents of greater consumer empowerment in healthcare have faced numerous barriers over the years, including early resistance from physician provider communities.  More challenging, however, has been a lack of transparency and full disclosure – about pricing, treatments, outcomes, services and other aspects of care delivery – which consumers need in order to make informed decisions about care.  This obstacle is now crumbling which will allow the United States to reach a new paradigm of consumerism in healthcare.

Much of the momentum can be attributed to the national focus on comparative effectiveness and outcomes-based medicine, stimulating Americans’ growing appetite for information delivered to their fingertips at the click of a mouse.  Facilitating this access is the rapid adoption of health information technology that enables integration of clinical, treatment and outcomes data from disparate sources to support expanded business intelligence and information delivered via Web 2.0 applications.  Combined, these applications provide an opportunity to open the door for a new era of transparency that can benefit consumers, providers and payers alike in the quest for higher quality and more affordable care.  To bend the cost-curve in healthcare we have to find a way to be successful in this quest.

All the pieces are coming together.  Now, the work of assembling them must begin, starting with IT investment as the foundation.  Public funds in the form of grants and programs for health information technology are an important catalyst.  Providers and payers must also be willing participants by making comparative cost and payment data readily available to consumers via the Web in an easy-to-understand format.  With the increase in better information, they must actively empower consumers to understand their roles and responsibilities in transforming healthcare in the United States.  And Consumers must commit to using the new tools at their disposal to make more informed choices that benefit all.  Together, we can use information to lower the cost of healthcare while ensuring that outcomes and quality are improved.

July 2, 2010  11:54 AM

Health IT Exchange to feature expertise from HIPAA Academy

Posted by: Jenny Laurello
Data privacy, Data security, HIPAA and the Health IT Exchange have announced a collaborative partnership with the HIPAA Academy, a service and accreditation organization geared towards ensuring privacy, security and compliance within the health care industry.

As a regulatory compliance and security expert in the field, and one of the industry’s foremost thought-leaders on the subject, HIPAA Academy co-founder and Chief Executive Officer Ali Pabrai will lend his expertise as a professional contributor on’s community portal, Health IT Exchange. To that end, Pabrai is hosting a webcast on July 8 entitled “Are Your Policies Audit Ready?” Visit for details and to register.

“I look forward to lending my knowledge and market experience to’s community and aim to address the mission-critical steps that HIT stakeholders must take to ensure compliance and the security of data in the era of increasing electronic data exchange.” Pabrai said in a statement.

The HIPAA Academy is run by ecfirst, which provides services to health care entities, business associates and personal health record vendors. These services cover topics that range from risk analysis and vulnerability assessment to managed compliance and security audits. The company was founded in 1999 and now has more than 1,500 clients.

July 1, 2010  2:09 PM


Posted by: Jenny Laurello

If this is your first stroll through our neck of the woods, I’d like to welcome you to the Health IT Exchange community! My name is Jenny Laurello, community manager and tour guide extraordinaire for IT publisher TechTarget’s health care IT (HIT) specific social community. Let me tell you the story behind our networking portal and the great benefits of which you can take advantage.

Designed for health care IT pros and launched in conjunction with TechTarget’s corresponding editorial site, the Health IT Exchange provides immediate access to a wealth of user-generated content and interactive discussions by your peers, for your peers. Here you have the ability to collaborate and exchange best practice solutions, real world advice and expert perspectives with your industry colleagues. Find those “in the know” who can help answer your most pressing questions around technology assessments, vendor selection, HIT reform, HITECH Act and HIPAA compliance and more.

An added member benefit comes in the form of earning Knowledge Points for every question or answer you contribute on our Q&A forum. The more you participate, the more points you’ll earn, brining you closer and closer to earning great prizes such as a Kindle, a Flip Cam, an iPhone  and more. Stay tuned to the community blogs for details on our first upcoming contest in the next few weeks.

If you haven’t yet, I encourage you to take a few minutes to look around the site, visit our Q&A forum, member and editorial blogs and begin adding your perspective to the conversations today. Remember, participation as an active member in the community means you can do the following:

  • Collaborate with your peers and share your insight
  • Get answers to questions by submitting your own
  • Search for answers easily findable by topic in our IT Answers section
  • Share your knowledge by creating your own member blog
  • Create a Watchlist to keep an eye on any changes to questions or answers of interest
  • Get notified when new questions are asked in topics which you are following
  • Discuss topics, questions and answers with your peers
  • View member profiles of other Health IT Exchange members and create one for yourself

Please don’t hesitate to contact me directly should you have any questions, thoughts, suggestions or ideas as you take a gander at the various features of the site. Interested in becoming a member or guest blogger on the site? HIT me with your best shot — i.e., shoot me an email.

Happy networking!

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