Electronic Medical Records (EMR) systems – I am curious to know what EMR systems others are using and to know the kind of experience others have had with implementation. My organization is using Cerner products and we have implemented portions of it such as Powerchart but still need to move into areas like Computerized Physician Order Entry. Part of the challenge from the medical staff has been a discussion around whether this product as a whole makes sense and if finding a different EMR system would be an option. Have any of you changed systems mid-stream and if yes, has it been a productive decision?

In the reading packet on page 335, one of the discussion questions says, "Discuss the potential impact of genetic testing on health information systems security."  I am not sure what is being asked to discuss here.  Any insight would be greatly appreciated.

I work at a large integrated system, where 450 MDs are alredy on EHR and now we are beginning to roll it out through 4 hospitals.  We will spend another $25M over a few years in this journey.  Is htere any reason to the madness regarding how such systems are priced, any industry metric etc?  Such as X dollars per hospital bed, per FTE, etc?

Why must one pay an annual license fee for every user of various software packages?  I do not understand this.

What are some ranges of consequences for violating HIPAA?  In my org, a few years ago it was one strike and you're out.  We lost a 25 yr employee who made an error in judgement and let another employee use her access code.  We have since evolved into a more case by case basis, where consequences are more in alignment with the crime - ranging from formal written disciplinary action, to a few day's suspension, to terminiation - the latter being more for purposeful unnecessary accessing medical records, malicious intent etc.  Others?

I believe integrations are very challenge. The technology on one hand is rapider developing; and updating the technology is annually, however each facility has to take the turns get the equipment updated, due to the financial budget. In addition, there are varieties of programs, software packages. To have seamlessly integration, on the other hand, the healthcare system itself is adjusting all the time; strategy is changing all the time. To convert newly development to the newly updated planning for the strategy, and obey the budget control, most importantly to keep the quality control and more. It is a hard task.

What are some of the advantages/disadvantages of implementing patient-driven information systems on an organization IS/IT department?

Some examples that I'm thinking of:  on-line scheduling, on-line bill paying, kiosk patient registration.

While there are great advantages to HCO in terms of reduced labor costs and accurate information gathering/retention, it would seem that costs would be added back with IS support for these technologies.

I'm hearing of a number of HCO's who are implementing the aforementioned technologies and more (i.e. I've heard some ED's are allowing pre-scheduled appointments for non-emergent care), and am wondering if any of you have any experiences to share and what types of barriers there are...if any?

On February 17, 2009, President Obama signed into law the ARRA.  Provisions of the ARRA provide funding to HHS, individual states,physicians and other entities to encourage the adoption and use of health information technology(HIT) systems and promote health information exchange. I manage a 60 bed rural hospital and will receive $3.7 million over four years.  To qualify to receive the Medicare and Medicaid HIT incentive payments, providers must already have in place a "certified EHR system", and be a meaningful user of such a system.  This will include using a certified EHR  system that can exchange health information and report on quality measures....intended to encourage EHR adoption and use, the program may actually work as as reward system that will partially offset the costs incurred by providers that have or will shortly adopt and use certified EHR systems.

I feel one of our biggest security problems I see is "passwords" to both networks or specific applications and how the employees use them, post them in the offices for quick use or give them to their co-workers.   Making the password requirements too complex seems to increase workload for the IT folks; less complex opens the door for potential hackers.    Comments??   Has anyone implemented a bio-system (thumb or retinal scan) for access to the network?   I don't know much about these bio system, but it seems this would address my problem.