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Live from HIMSS: Conversing with the Oracle

April 8, 2009
by Mark Hagland
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Every industry has its thought-leaders, and some are more thoughtful than others. For my money, there’s no one in healthcare IT who can match Erica Drazen, ScD. Drazen, who is managing partner in the Emerging Practices division at the Falls Church, Va.-based CSC has been something like a personal Oracle of Delphi for me since I began writing intensively in this space a decade and a half ago. Erica has also seen the crest and fall of pretty much every fad and thought-bubble in the past two decades or more.

So it wasn’t surprising that Erica has strong opinions regarding the Zeitgeist of this year’s HIMSS. Having attended or participated in numerous sessions in the past couple of days that have been dedicated to discussion of the federal stimulus, she says simply and commonsensically, “People want to know all the answers to the questions around the stimulus, but clearly, the answers aren’t there yet. We don’t have an HHS secretary yet, and we’ve just had the new ONC head named. I’m concerned that people are so focused on getting the stimulus money and what they need to do to get it, whereas we all know what we need to do generally. We know that we need EMR and CPOE and meds administration/eMAR with barcoding. So we’re kind of losing focus on what we should be doing. We’re working on a stimulus-based set of requirements, rather than focusing on the bigger picture.”

I couldn’t agree more. Rather than focusing maniacally on the phrase “meaningful use,” as so many seem to be at this HIMSS Conference, Erica says, let’s do what is obvious—implement the above systems, and do what’s right. Because it’s absolutely clear that by doing so, they will end up in the correct zone once “meaningful use” is finally fully parsed. “We know that ‘meaningful use' needs to include an integrated clinical information system with CPOE, with the whole closed-loop medication safety, and nursing and physician documentation,” she told me. And of course, it’s obviously the case that hospital leaders who sit around waiting to learn the ultimate “meaning of meaningful use” are wasting their and their organizations’ time. Not that people shouldn’t have good discussions about these topics; the HIMSS Conference is the natural venue for such conversations. Let’s just get commonsensical about this and move forward with alacrity. That’s also what HIMSS is about—building a consensus for industry-wide forward movement. So let’s all move forward, and in the process, help lead healthcare to where it needs to be. Some things are clear, after all.

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Most interesting vendor-related tidbit: The folks at Sunquest, a laboratory IS vendor, stopped by the Healthcare Informatics booth for a chat on Monday. And one of the interesting things they talked about, which is also the subject of an article in a recent corporate newsletter, is the concept that they and others are promoting of the “Five Rights of Laboratory Testing.” Now, we all know about the “five rights” of medication administration. But I found this new list of “five rights” intriguing. After all, diagnostic lab-related mistakes, while not as pervasive as medication-related errors, are common enough, and can be devastating to patients and to the provider organizations that care for them. So emulating the “five rights” formula could be a way to promote greater awareness of patient safety gaps and needs. What are the “five rights” when it comes to lab testing? Performing the right test on the right patient at the right time, using the right indicators, and resulting in the right diagnosis.

I would add an important “right” to all this, and that is, the right documentation. In other words, let’s build and continually improve on systems that reach for 100 percent reliability in the diagnostic lab area, for the sake of our patients, and in the process, benefit our organizations as well.

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Comments

Joe,

That's all terrific. I wish I'd been able to make it to the AHRQ booth, but I wasn't able to.

What's great is that I know that very thoughtful people like you and Erica will be around for a long time, to help guide the industry forward as we navigate some very complex waters going forward. We need the smart, clued-in people to speak up more than ever!

Mark,
Thanks for this post. Erica Drazen was very supportive and instrumental in my career as well, although I haven't touched base with her for years.

While at HIMSS, I picked up a free copy of Health Affairs (March/April 2009.) I read it, cover-to-cover on the 90 minute flight home. There's a great article that makes your point about the big picture from HCI Blog commenter Dr Jim Walker.

It starts out describing the difference between how breast cancer screening follow-up can be handled, illustrating how bad our task-oriented approach to HCIT can be.

There's also an international comparative study of CPOE (Koppel), and probably 20 other great articles. A nice series on PHRs and PHR thinking as well.

That visit to the AHRQ booth was a highlight for me with HIMSS in other ways as well. Great people.

Mark Hagland

Editor-In-Chief

Mark Hagland

@hci_markhagland

www.healthcare-informatics.com/blog/mark-hagland

Mark Hagland became Editor-in-Chief of Healthcare Informatics in January 2010. Prior to that, he...