Cerner win at Defense a crossroads for interoperability (US)

Modern Healthcare’s analysis of the Cerner/Leidos/Accenture win of the Department of Defense (DoD) EHR contract focuses on its effect on interoperability. In their view, it’s positive in three points for active military, retirees and their dependents.

* EHR interoperability with the civilian sector is needed because 60-70 percent of the 9.6 million Military Health System beneficiaries—active duty military personnel, retirees and their families—is delivered by providers in the US private sector through Tricare, the military health insurance program.

* A major criticism by Congress and veterans’ groups of both DoD and VA is the lack of interoperability between these systems as well as civilian. Many military members change their status several times during service, and can cycle within a few years as active, Reserve, National Guard and inactive reserve. Records famously get lost, sometimes disastrously.

* It’s a boost to state health information exchanges (HIE) in states with large military bases and also for the CommonWell Health Alliance, an industry group which is establishing EHR interoperability standards.

Less optimistic are some industry observers who see the DoD contract as sidelining resources demanded by Cerner’s civilian hospital clients, and whether realistically they can develop a system to exchange data with every EHR, including dental, and e-prescribing system in the US (and probably foreign as well). Modern Healthcare

EHRs: now safety, info exchange concerns (US, AU, CA)

What’s this? EHRs reducing, not increasing, safety? Reports from both the US and Australia seem to indicate another spanner (US: wrench) in the EHR works, aside from the laggardness in achieving the HITECH Act’s goals [TTA 27 Mar].

  • The Joint Commission, which is the chief US accreditation and certification body for healthcare organizations and programs, and thus to be taken very VERY seriously, released a Sentinel Event (Patient Safety Event) Alert yesterday. It warned of EHR-related adverse events affecting patient health, resulting from incorrect or miscommunicated information entered into EHRs. Interfaces built into the technology can contribute and studies have documented mixed results in the systems’ ability to detect and prevent errors. It identifies eight key factors,led by human-computer interface, workflow and communication and clinical content, that can lead to a sentinel event and three major remedy actions. While the JC does take pains to confirm the positive effects of well-designed and appropriately used EHRs, with strong clinical processes in place, it is the first ‘red flag’ this Editor can recall (more…)