Showing posts with label Electronic Health Records. Show all posts
Showing posts with label Electronic Health Records. Show all posts
Wednesday, March 9, 2011
Passing Out
It's not official until some paperwork gets filled out, but my company's Electronic Health Record (EHR) software passed its certification exam today. I'm tired, but very happy. And my awesome boss is buying me a new iPad 2!
Sunday, March 6, 2011
Spraining My Brain
I don't feel totally ready for my company's all-day certification test on Wednesday, but after reviewing output files and the test script all weekend, I can no longer think straight. When I got home from the office this afternoon, I forced myself to walk on the treadmill for a half hour because my butt was numb from sitting in front of a computer all day. I can put my body on autopilot while I walk so long as I've got something distracting to watch or listen to, but I was so brain-dead that I could hardly follow a TiVo'ed episode of "Law & Order: SVU" that I've probably seen three times already. So I watched "America's Next Top Model" instead. That's pretty freakin' brain-dead.
I'm probably going to dream in XML tonight. Yuck.
I'm probably going to dream in XML tonight. Yuck.
Saturday, March 5, 2011
Naming Names
The certification test for my company's Electronic Health Record (EHR) software is next week, so this week (and weekend) are busy for me. One of the many tasks on my list is entering a bunch of sample patient data into the program in advance. I wish we could just create two patient accounts, one for "John Doe" and one for "Jane Roe," but the government wants a little more than that to work with.
I'm paranoid about even giving the appearance of accidentally releasing a real patient's information, so when I'm testing software in-house, I use names that are (to me, at least) obviously fake. Characters from cartoons and sitcoms of my childhood are good; my test databases almost always include "George Jetson," "Wilma Flintstone," and "Greg Brady." I went through a "retro" period once, but that kinda backfired for my boss when he demonstrated our software for a potential client. The poor lady had never heard of "Betty Boop" and thought that Mark was teasing her when he tried to get her to type that name.
For a serious test like the one next week, I need serious amounts of data. Names, lots and lots of names. Downloading names from the U.S. Census Bureau works pretty well (they have lists of the most popular first and last names from past censuses), but when I'm switching back and forth between patient accounts, common names all tend to blur together in my mind. It's hard to remember whether I wanted the chart for Ms. Anderson or Mr. Baker or Mrs. Clark. I find it easier to work with names that are more memorable, so I've been creating alphabetical lists of items like animals, flowers, and colors. The hardest part is coming up with things whose names start with letters like "u" and "x," but thanks to Google and Wikipedia, I can usually find something. I don't insist it be recognizable or pronounceable so long as it's unlikely to be mistaken for a real patient's name. (For the record, a "uakkri" is a kind of South American monkey.) And if you come across what looks like a medical chart for "Amy Amaryllis" or "Zebediah Zebra," just send it my way, OK?
I'm paranoid about even giving the appearance of accidentally releasing a real patient's information, so when I'm testing software in-house, I use names that are (to me, at least) obviously fake. Characters from cartoons and sitcoms of my childhood are good; my test databases almost always include "George Jetson," "Wilma Flintstone," and "Greg Brady." I went through a "retro" period once, but that kinda backfired for my boss when he demonstrated our software for a potential client. The poor lady had never heard of "Betty Boop" and thought that Mark was teasing her when he tried to get her to type that name.
For a serious test like the one next week, I need serious amounts of data. Names, lots and lots of names. Downloading names from the U.S. Census Bureau works pretty well (they have lists of the most popular first and last names from past censuses), but when I'm switching back and forth between patient accounts, common names all tend to blur together in my mind. It's hard to remember whether I wanted the chart for Ms. Anderson or Mr. Baker or Mrs. Clark. I find it easier to work with names that are more memorable, so I've been creating alphabetical lists of items like animals, flowers, and colors. The hardest part is coming up with things whose names start with letters like "u" and "x," but thanks to Google and Wikipedia, I can usually find something. I don't insist it be recognizable or pronounceable so long as it's unlikely to be mistaken for a real patient's name. (For the record, a "uakkri" is a kind of South American monkey.) And if you come across what looks like a medical chart for "Amy Amaryllis" or "Zebediah Zebra," just send it my way, OK?
Monday, February 28, 2011
Testing to Destruction
The company I work for develops Electronic Health Record (EHR) software, which lets doctors' offices store patient information in computerized format rather than in paper-based charts that can be hard to read and easy to misplace. The federal government has recently gotten into the business of certifying EHR software, and in a couple of weeks, a company that represents the government will put us through a day-long, 35-step test during which we'll show how† our software does things like:
It's the doctors and their employees who'll really have the hard part. Once we've updated their software to the certified version and trained them on the new features, they're the ones who actually have to use the software in a "meaningful" way. In fact, the phrase "Meaningful Use" is the unifying theme of this whole government initiative. It's not enough for the doctors to own and install the software,††† they also have to use it in ways that the government believes actually contribute to improved healthcare. The government is dangling incentive money in their faces, ostensibly to offset the costs of having to install new systems (for those who don't already use EHRs) or to upgrade their existing systems to certified versions, but the doctors are going to have to jump through a lot of hoops to get their checks.
And in the end, will any of this make a difference to the people who really matter...the patients? I'm not even going to venture a guess. All I know is that any EHR company that wants to stay in business has to get its software certified so its physician clients can at least try to earn the incentive money, so that's what we're doing. Wish us luck.
† Actually, at least at this stage of the game, the government isn't concerning itself with how the software does all this stuff, only that it can do it. The government-approved test script makes it clear that even if there's more than one way to fulfill a particular requirement, we should demonstrate only one method. They're not looking for razzle-dazzle, just results. It's very businesslike, and it also means that usability isn't a priority. An EHR system that can pass all 35 steps in the test script, but only by requiring users to fill out complicated screens or wander here and there throughout the system to complete a straightforward task, would pass the test, just as an elegantly-designed and intuitive system would. It's like that old joke: What do you call the person who graduates last in their class at medical school? "Doctor."
†† Not all pharmacies are hooked up to an "ePrescribing" system yet (although most are, and those that aren't are probably working on it), and not all prescriptions can be sent electronically. Although federal law has been updated to allow prescriptions for "controlled" substances like narcotic pain medications to be transmitted electronically, software for both doctors and pharmacies will need to be upgraded to handle the extra security measures that will be required.
††† Actually, for doctors with a sufficiently high percentage of Medicaid patients, just owning the software is enough to qualify for incentives in their first year of the program, but doctors who are attempting to earn incentive money from Medicare rather than Medicaid have to show 90 days' worth of "meaningful use" of the software to get the money. What's the difference between Medicare and Medicaid? In the U.S., Medicare is the federal program that helps the elderly and the disabled pay for medical care; Medicaid pays for medical care for low-income individuals and is managed by the states. (I believe that countries other than the U.S. also have programs called "Medicare," but I don't know how they compare to the American version.)
- Storing basic information like the patient's height, weight, blood pressure, and smoking status.
- Comparing new prescriptions against the patient's known allergies and existing medications (to prevent possible bad reactions) and transmitting prescriptions to pharmacies electronically whenever possible.††
- Allowing patients to access their basic health information (such as a list of the medications they currently take and results of some lab tests) in "real time" (which usually means through a web site called a "patient portal").
- Providing patients with summarized versions of their healthcare information as a printout, or as a specially-formatted computer file that could be imported into a Personal Health Record (PHR) like Google Health or Microsoft HealthVault.
It's the doctors and their employees who'll really have the hard part. Once we've updated their software to the certified version and trained them on the new features, they're the ones who actually have to use the software in a "meaningful" way. In fact, the phrase "Meaningful Use" is the unifying theme of this whole government initiative. It's not enough for the doctors to own and install the software,††† they also have to use it in ways that the government believes actually contribute to improved healthcare. The government is dangling incentive money in their faces, ostensibly to offset the costs of having to install new systems (for those who don't already use EHRs) or to upgrade their existing systems to certified versions, but the doctors are going to have to jump through a lot of hoops to get their checks.
And in the end, will any of this make a difference to the people who really matter...the patients? I'm not even going to venture a guess. All I know is that any EHR company that wants to stay in business has to get its software certified so its physician clients can at least try to earn the incentive money, so that's what we're doing. Wish us luck.
† Actually, at least at this stage of the game, the government isn't concerning itself with how the software does all this stuff, only that it can do it. The government-approved test script makes it clear that even if there's more than one way to fulfill a particular requirement, we should demonstrate only one method. They're not looking for razzle-dazzle, just results. It's very businesslike, and it also means that usability isn't a priority. An EHR system that can pass all 35 steps in the test script, but only by requiring users to fill out complicated screens or wander here and there throughout the system to complete a straightforward task, would pass the test, just as an elegantly-designed and intuitive system would. It's like that old joke: What do you call the person who graduates last in their class at medical school? "Doctor."
†† Not all pharmacies are hooked up to an "ePrescribing" system yet (although most are, and those that aren't are probably working on it), and not all prescriptions can be sent electronically. Although federal law has been updated to allow prescriptions for "controlled" substances like narcotic pain medications to be transmitted electronically, software for both doctors and pharmacies will need to be upgraded to handle the extra security measures that will be required.
††† Actually, for doctors with a sufficiently high percentage of Medicaid patients, just owning the software is enough to qualify for incentives in their first year of the program, but doctors who are attempting to earn incentive money from Medicare rather than Medicaid have to show 90 days' worth of "meaningful use" of the software to get the money. What's the difference between Medicare and Medicaid? In the U.S., Medicare is the federal program that helps the elderly and the disabled pay for medical care; Medicaid pays for medical care for low-income individuals and is managed by the states. (I believe that countries other than the U.S. also have programs called "Medicare," but I don't know how they compare to the American version.)
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