Greg Goth

As policy wonks and advocates battle over just how much meaningful use will likely change in 2016, the Physician Quality Reporting System might have snuck up on healthcare IT staffs tasked with implementing new technology platforms. "The focus for most of the health IT folks has obviously been meaningful use regulations, and there hasn’t been a lot of focus on the PQRS," said Deborah Gash, CIO of Kansas City, Missouri-based St. Luke's Health System. In fact, Gash said she actually had what she called an "aha!" moment when colleagues at St. Luke's began asking her about how best to address PQRS stipulations in concert with other reporting requirements. [Also: 21 awesome photos from past HIMSS conferences] Gash and Anantachai Panjamapirom, senior consultant at The Advisory Board Company, will present on St. Luke's experience in "PQRS and Alignment Opportunity — Concept to Operationalization," during HIMSS16 beginning in late February. "Bringing awareness to what this program is, how we were able to work through all the operational issues, and create a program to allow us to follow through and successfully meet the requirements was something we thought would be worthwhile to share," Gash said. Panjamapirom said numerous Advisory Board clients, such as St. Luke's, have already taken steps to align not only MU and PQRS, but also try to devise strategies to bring other programs, such as Hospital Inpatient Quality Reporting and the Value-Based Payment Modifier, into efficient alignment. Twitter: @HealthITNews "Most of what you have to do is workflow and culture changes," Gash said, "such as documenting the right elements and being consistent about it, plus developing workflows and decision support tools in your EHR to ensure you're getting the quality data captured. That's really where the lion's share of the work is for organizations." Gash also said larger organizations are not necessarily better prepared to operationalize alignment. "I think the complexity of the organization can increase your risk," she said. "I find smaller practices that are paying attention do quite well.  It's that lack of awareness and understanding of what you have to do in the requirements that puts you at risk." "PQRS and Alignment Opportunity - Concept to Operationalization" will be presented March 1 from 2:30 - 3:30 p.m. at Sands Expo Convention Center, Palazzo D. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

Dignity exec to talk at HIMSS16 about how its helped create the specialist suite Optum360.

Consolidation, increased regulation and shortages of critical medications are just a few issues that have health system pharmacy managers scrambling. "We are being faced more and more by challenges within the system," said DeVere Day, pharmacy automation and technology manager at Salt Lake City-based Intermountain Healthcare. "We're facing challenges from an expense standpoint. There are certainly compliance and regulatory concerns. Automation has become very expensive for many hospital systems. Sterile compounding is a concern with hazardous drug therapies and medication shortages in the industry have created a lot of heartache." See all of our HIMSS16 previews Day will be presenting "Transforming the Pharmacy Supply Chain," an exploration of Intermountain's implementation of a central pharmacy supply chain center for its entire enterprise, and the strategic decision making that has resulted in pharmacy savings to the tune of approximately $3.5 million companywide in 2015. "We distribute about 4.5 million doses a year within our system," Day said. "The majority of those go to our 22 hospitals but we have 185 clinics we have begun working for as well, so we are now supplying many of the clinics within our system." Day cited technological platforms including carousels, packaging machines and a third-party software tool that enables staff at the supply chain center to visualize inventory at other Intermountain facilities. Those other facilities, in turn, can use that software to place orders directly, with each hospital's central pharmacy responsible for internal distribution. The technology is just the enabler of astute strategic thinking, however. For example, Intermountain compounds only nine IV drugs, and the focus on those leads to approximate savings of $500,000 annually over buying those drugs from a wholesaler, Day said. He cited rapidly changing industry status, such as the recent merger between Pfizer and Hospira, and AmerisourceBergen's announced purchase of compounder PharMEDium, as elements the central supply chain center can help cope with. "We have put ourselves into a position where we can adapt to market changes, and the market is changing so fast it's hard to predict where your greatest impact is going to be," he said. And while Day explained that economies of scale at a larger system may yield benefits smaller organizations can't match, that's no reason not to evaluate just what can be done to improve efficiency. [Like Healthcare IT News on Facebook] "I guess the strategic planning side of it has value for anybody," he said. "Some of our shops are as small as 20 beds, some as large as 400, and we have found ways to provide value for all of those." Day will be presenting "Transforming the Pharmacy Supply Chain" from 4 - 5 p.m. March 1 at the Sands Expo Convention Center, Marcello 4401. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

As if healthcare executives don't have enough worries about implementing electronic health records, yet another issue is starting to ramp up. "What's been happening more frequently in the last few years is that certain plaintiffs' lawyers – a kind of group of them who communicate with each other – have started to see the medical record as an opportunity for litigation," said Mary Re Knack, a Seattle-based attorney for the firm Ogden Murphy Wallace. Knack will be presenting an exploration of these emerging litigation troubles in the session "Just Press Print: Challenges in Producing EHRs in Litigation" with colleague Elana R. Zana at HIMSS16, beginning in late February. Twitter: @HealthITNews Electronic health record design is paramount among those issues, Knack said, because EHR vendors quite naturally did not build the software with litigation in mind. "The data is all stored behind these templates, and depending on what you are trying to look at, whether it's a summary or lab reports or such, the data then populates the template on a screen. But when you print it, it doesn't print out as cleanly or as nicely,” Knack said. One of these obvious challenges in trying to review somebody's care is how do you see it? How do you even read what the care was? Who did what? And when? "You may have a case that's very straightforward medical malpractice, but because of the way the medical records get printed out, the same piece of data may appear in five places. Somebody who looks at it, whose goal is to show how it's confusing, can then start to challenge the care that was given based on the fact the medical record is confusing,” Knack explained. “They can take another step, and that is questioning whether the data in the medical record is accurate or if it has been changed." As a result, Knack said, a healthcare provider can find itself in litigation that is ostensibly about the care provided, when in actuality that organization has to " defend how the medical record works." [Like Healthcare IT News on Facebook] Practically speaking, she said, the potentially expensive situation needs to be addressed by enhanced communication between provider organizations, particularly C-suite staff, and their vendors, and also internally within provider systems. "In the healthcare community, the medical negligence work, because of the way it's insured, tends to kind of be off on the side,” she added. “This isn't true in every healthcare setting, of course, but it's off to the side many times so the people who are the decision makers with respect to bigger issues aren't necessarily aware of how these particulars are being used in litigation, because litigation is handled 'over there.'" Knack and Zana will be presenting "Just Press Print: Challenges in Producing EHRs in Litigation" from 2:30 - 3:30 p.m. March 1 at the Sands Expo Convention Center, Palazzo L. Twitter: @HealthITNews

While the development of accurate predictive analytics has the potential to head off debilitating and costly conditions among patients, one veteran of the burgeoning field says it’s important not to rush in without the proper planning. "The first thing to understand is you need to have the right technical infrastructure components in place and it has to address what you are looking to do with it," said David M. Seo, MD, associate vice president of IT for clinical applications and chief medical informatics officer for the University of Miami Health System. "But there is a lot people don't think about – like data curation and quality," he said. "Is the data you have good enough to even do predictive analytics? Because if it isn't, that prediction may actually harm you more than it helps. You may go off on a wrong tangent." Seo and Chitra Raghu, senior program manager and innovations officer for Lockheed Martin Health and Life Sciences, presented will be presenting the U of M system's experience in preparing its predictive analytics platform in "Predictive Analytics Drives Population Health Management" at HIMSS16 on Tuesday. Beyond the quality of the data itself, Seo said other factors, including the presence or absence of skilled data scientists; a thorough understanding of how to localize predictive models from other health systems; and how to best integrate existing investments in electronic health records with analytics technology, must be carefully considered before pulling the trigger on new platforms. "There are so many technologies," said Raghu. "You have to find what is the right one that will help hospitals achieve what they are trying to achieve, at the lowest cost." Seo added even health networks with a dozen or more hospitals are not likely to already have the necessary skill sets in-house. And even a platform that offers great analytics capabilities, for instance, may not be popular with either clinicians or financial executives if the caregivers need to toggle back and forth between an EHR and an analytics platform. "If I'm looking at a patient in front of me right now, I don't have time to go somewhere else, and when I've gone somewhere else I've already lost the advantage of this massive investment in my EHR,” Seo said. “So it has to be part of your system's ecosystem." The session "Predictive Analytics Drives Population Health Management" is slated for March 1 from 2:30-3:30 p.m. in, Palazzo I at the Sands Expo Convention Center.

The path of destruction in the Gulf Coast states wrought more than a decade ago by Hurricane Katrina also resulted in unforeseen benefits for healthcare providers in the region.

Orlando-based Florida Hospital installed surgical real-time location systems to quickly assess patient and facility status in 2013 and has since seen immediate improvements.

To help clinicians understand when palliative care orders might be most appropriate, Ascension Health is participating in an National Institutes of Health-funded study run by University of Pennsylvania researchers to evaluate electronic health record-prompted automation of palliative care consult orders in the acute care setting.