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Is Big Data the Solution to VA’s Health Care Woes?

By Mark Byers // October 17, 2014

everything possible/

Mark Byers is the president and CEO of DSS, Inc.

The pace of change in health care is fast and furious, but one thing is constant: a shift from reactive to proactive patient care.

And the key component fueling this shift is data, which is becoming more accessible and used to inform more decisions each day. 

Health care organizations -- including the Department of Veterans Affairs -- must ensure the proper technology and strategies are in place to transform a field from one that primarily reacts to changes in patient health to one that proactively keeps watch over and anticipates patient health needs.

The difficulty comes when providers don’t have the tools to leverage their data.

They must have systems that help them use existing data or create data to streamline workflow and improve clinical decision support.

To illustrate this, we’ll examine two examples of leveraging big data in different departments of a hospital or health system -- oncology and radiology.

Big Data Improves Efficiency

Support for oncologists is a perfect example of what’s possible when big data is successfully harnessed. Cancer treatment plans are complex, taking into account the type of cancer, the stage it's in, the patient...

Surprise: Every American Will Not Have an Electronic Health Record This Year

By Bob Brewin // October 9, 2014

Brian A Jackson/

In 2004, President George W. Bush kicked off a project designed to provide most Americans with an electronic health record in 2014. That was followed by a similar goal set by President Barack Obama in 2009.

 But as the end of 2014 comes nearer, these ambitious goals still have not been met.

“We have made great progress … [but] we have much more work to do,” said Jodi Daniel, director of the Office of Policy in the Office of the National Coordinator Health Information Technology in the Department of Health and Human Services.

So far, about 75 percent of the clinicians and 91 percent of the hospitals who treat patients under Medicare or Medicaid have adopted health information technology under an incentive program in the 2009 Health Information Technology for Economic and Clinical Health – or HITECH – Act, Daniel said.

Since 2011, the Centers for Medicare and Medicaid Service have paid out $23.7 billion to hospitals and medical professionals to adopt electronic health records. This covers 385,158 clinicians and 4,993 hospitals.

But Daniel said her office has no way to determine how many patients cared for by CMS providers actually have electronic health records. CMS provides care for about...

Epic Systems, Leading Defense EHR Bidder, Slammed for Lack of Interoperability

By Bob Brewin // October 3, 2014


Epic Systems, considered the front-runner for the Defense Department’s $11 billion electronic health record contract, has come under sustained criticism for lack of interoperability with other EHRs, including most recently a front-page story in The New York Times last Sunday.

The Times story reported the privately held Epic, which partnered with IBM for the defense EHR contract, “and its enigmatic founder, Judith R. Faulkner, are being denounced by those who say its empire has been built with towering walls, deliberately built not to share patient information with competing systems.”

Interoperability between Epic and other EHRs is possible, but only after hospitals pay high fees, the Times reported.

Modern Healthcare, in a recent article on Epic, said, “While interface fees are common across the EHR industry, some observers say Epic's leading role in the EHR market means it has a disproportionate negative effect on interoperability.”

This March, in a report on a variety of medical technologies, the Rand Corporation described the Epic EHR as a “closed platform,” which “can make it challenging and costly for hospitals to interface their EHR with the clinical or billing software of other companies.”

Large Hospital Systems Embrace Epic

Large hospital systems, such as...

Who Needs an EHR? Some Defense Hospital Emergency Rooms Still Use Paper

By Bob Brewin // October 2, 2014

Defense Secretary Chuck Hagel
Defense Secretary Chuck Hagel // Cliff Owen/AP

Despite investing billions of dollars in information technology over the past decade, three out of seven military hospitals surveyed in a review of the Military Health System reported their emergency rooms still use paper records.

Released yesterday, the report said the current MHS IT infrastructure “and rigid network requirements resonate across all MTFs [military treatment facilities] as problematic” -- including issues with electronic health records.

Defense Secretary Chuck Hagel ordered the review May 28.  MHS operates 56 hospitals and 361 clinics worldwide.

Two of the hospitals visited by the review team said technical challenges with the outpatient Armed Forces Health Longitudinal Technology Application, the underlying Composite Health Care System, which has laboratory, pharmacy and scheduling modules, and the Essentris inpatient EHR, “expressed concerns that this could affect patient care and safety (e.g., access to medical record).”

On Sept. 30, the Defense Health Agency awarded CliniComp International a sole-source, one-year $30 million contract to maintain and continue to support Essentris.

One military hospital experienced interface connectivity issues between laboratory analyzers and CHCS, lasting seven months, resulting in manual data entry, increasing risk for error, the report said. It added,“there are delays for new staff members to gain access to the...

VA’s Scheduling System Revamp Will Be Big Test of Agency’s Agile Approach

By Jack Moore // August 29, 2014

Matt York/AP

The last attempt by the Department of Veterans Affairs to update the system used by hundreds of VA facilities nationwide to schedule and manage veterans’ medical appointments was one of those failed IT projects that have come to hog the spotlight in the age.

In 2009, after eight years of development and costing $167 million, VA canceled that program after it failed to deliver the promised capability.

VA this week announced it would kick off the search for a full replacement system beginning next month.

And even amid the scandal over the agency’s handling of patient times -- stemming in no small part from the archaic system VA had been saddled with -- agency IT officials are bullish failure won’t be an option this time.

That’s because since the failure of that last attempt, VA has been taking a new approach to modernizing its legacy IT systems. Rather than building massive, monolithic systems with development lead times stretching into years, the agency is breaking big projects into smaller pieces and making sure they can deliver functionality in the short term.

It’s called agile, or modular, development. Five years ago, VA began pushing project managers to deliver...