Health IT for Health Centers: 2013-01-07

Here are my latest recommended links and comments on news items from the Health IT, community health center (CHC), nonprofit, and general IT sectors. I’d be delighted to hear your comments here, or chat me up on Twitter (@jmproffitt) and Google+.

Security

Today in free-reports-you-might-like we have a new one from a group of major security and IT players at major multinational corporations. And though that may sound dull, the report itself: Information Security Shakeup: Disruptive Innovations to Test Security’s Mettle in 2013 (PDF) is well put together and clear enough even for your CEO (sorry CEOs!). The big trends that will affect security planning this year: cloud computing, social media, so-called “big data,” and — of course — mobile devices. Mitigation techniques are proposed for the growing risks, of course. A nice report, really.

When you’re done with the pretty report, here’s some conceptual thinking for you: Compliance strategies can be the enemy of security strategies. Why? “The downside of compliance initiatives is that achieving a minimum may not result in any real change in the security posture…” Of course, compliance with HIPAA security and privacy provisions does help with security, but there are problems with a HIPAA-compliance-only approach. Namely, advancements in the regulations can’t possibly keep up with security (or risk) developments, and if all you do is comply, you won’t be positioning yourself for real-world security. Sounds like a head-scratcher at first, but it’s definitely not. Aim for security, not compliance.

Management

Healthcare Informatics has a nice profile of La Clinica de la Raza’s new CIO, Tina Buop. She started last May and since arriving she’s been dealing with classic Community Health Center (CHC) issues: data collection and reporting, an EHR deployment, and handling IT services across a sprawling 30-site, 1,200-employee organization.

Meanwhile, I gotta give a virtual high five to Dr. Lyle Berkowitz. He’s effectively addressed the “crisis” of too-few primary care providers with an intelligent crystal-ball look at what healthcare may look like in 2025:

Dashboards provide real-time analysis of the status of his panel of 5,000 patients. Patients in the Green Zone will be managed mainly by computerized systems which check on patients virtually to provide positive feedback and ensure they stay on track. Meanwhile, patients in the Yellow Zone will be visited by the physician’s care team at home or work, or perhaps have a virtual conference with the physician to answer their questions. Finally, those patients in the Red Zone will be seen in the office or home for longer sessions with the physician and his or her care team to help determine what is going on and how to get it under control.

And the title of his piece? “We Don’t Have a Shortage of PCPs, We Have a Shortage of Using Them Efficiently”. Yep. Nailed it.

Collaboration

Email is like Democracy: it’s the worst… except for every other system out there. But that may be changing, as companies discover and deploy new collaboration platforms. SharePoint got things started, but other platforms — especially simpler and more social platforms — are gaining traction, like Socialcast, Confluence, Yammer, Podio, SocialText, Chatter, and more. But here’s an idea: delete your email lists and force employees to use the new platform. Find out what one company learned when they went nuclear on email lists in a company of 17,000.

Mobile

Clinicians and pharmacists in your health center might appreciate this list of 6 mobile apps and resources for information on drugs, diseases and more. Keep in mind you can always deploy iPod touch devices if you don’t want to deploy smartphones.

EHR Technology

Tell us how you really feel, competing software vendor! “I don’t believe healthcare can afford Epic and Cerner, and I doubt you do either.” Those of us in the Community Health Center (CHC) world will never buy Epic or Cerner, for the price tag alone, not to mention they’re really built for hospitals. Still, this guy, hawking an open source solution has a point. Though he only cites one example in detail, it’s a good one: $9 million to deploy OpenVista versus $92 million to deploy Epic in facilities of similar size. Go with the open source solution and then take everyone to Hawaii to celebrate!

Now think back to 2009 and the federal cash that burst onto the scene to help pay for increased digitization of health. Mmmmm… cash! Now imagine where we’d be today without that money and the pushes of the HITECH program and ARRA. This piece over at Healthcare IT News argues we’re a lot further along today than we’d otherwise be with EHRs and other tech. I tend to agree. Healthcare organizations are nothing if not slow to change.

Finally, get ready to move mental health records right into your EHR, or at least link them and make them available to your EHR users. The stigma of mental health care is fading, and the advantages of primary care and hospital care physicians having access to both the “medical” record and the “mental” record at once are substantial. With more and more CHCs covering mental health services alongside medical, we may very well be on the cutting edge here. Who knew?

Telemedicine / Telehealth

Everyone’s getting the telehealth bug, so be prepared to support it in your health center. Even the feds are willing to start spending on remote doctor visits, or at least new legislation was introduced in Congress just after the fiscal cliff mess was (sort of) cleaned up. And of course private payers are covering more of this kind of care, too. Aren’t sure how telemedicine licensing works in your state? Check out where the states stand as of December 2012.