Meaningful Use Stage 2: Can Librarians Help?

A colleague tweeted this article, “Are Physicians Truly Engaging with their Patients? by Nancy Finn” about physicians, EMRs and meaningful use.  According to the article, “as of March, 2013, 160,890 eligible professionals had received Medicare incentive payments and 83,765 professionals had received Medicaid incentive payments” for achieving stage 1 one meaningful use. While they were able to achieve stage 1, are they ready for stage 2? How are they changing their practice patterns to achieve stage 2?

The article states stage 2 requirements are:

  • Provide patients with their health information (via a web portal) on 50% of occasions and have at least 5% of these patients actually download, view or transmit that data to a third party.
  • Provide a summary of the care record for 50% of transitions of care during referral or transfer of patient care settings.
  • Provide patient-specific education resources identified by Certified EHR technology to more than 10% of patients with an office visit.
  • Engage in secure messaging to communicate with patients on relevant health information.
  • Make available all imaging results through certified EHR technology.
  • Provide clinical summaries to more than 50% of patients within one business day.

Finn wonders if “a majority of physicians remain steadfast in dominating the physician/patient relationship, convinced that engaging patients in their care is a burden? Or are many of them beginning to realize that engaging the patient in their health care decisions will make health care more efficient and cost effective, and improve patient outcomes?”

The librarian in me wonders if there are ways we can help physicians meet stage 2 requirements.  I know with EPIC a physician can send a request for a librarian to provide patient education information to the patient through their portal.  I know specifically of one librarian who got a message in Epic to do that.  She logged in, provide links and contact information to appropriate free patient ed resources to the patient.  The patient got the information through My Chart and was so happy that she emailed the librarian thanking her for the information.  Another nice thing about this patient ed transaction, EPIC noted that patient education information was sent to the patient and included that in her chart for the doctor to see. 

I’m not trying to say that doctors shouldn’t help provide patient education information, but I also know that in a hospital environment things can be hectic, confusing, scary, etc. for the patient.  They may have gotten information from the doctor but not understood it or wanted more detailed information.  Using the librarian to provide patient education material through EPIC (and EPIC notes that it was provided) has got to help both doctors and patients.

Are there other ways that librarians can help doctors and their institutions meet stage 2 requirements? Please comment with your ideas.

 

Business of Hospital Libraries on #medlibs Tomorrow

Join me tomorrow April 25th for a #medlibs Twitter chat at 6pm Pacific/9 Eastern on the topic of the business of hospital libraries, hosted by yours truly (@Krafty).

The Affordable Care Act has changed the way hospitals are reimbursed for medicare patients. In the past hospitals made more money off of patients who were readmitted for things they were orginally discharged with. Now, they are penalized for readmissions happening within 1 month of discharge for certain conditions. This means that a lot of hospitals are going to be seeing losses of millions of dollars.

Where does the library stand in the face of these losses when technology has changed the way we search for things and users often search Google before asking a librarian. The librarian needs to get lean and mean and start operating his/her library like a hospital department that is responsible for achieving the specific goals of the hospital. So if the hospital’s goal is to reduce readmissions by x% then the librarian needs to figure out specifically how the library can help the hospital do that. (If your answer is I can give them more literature searches, then think again because that won’t help you keep your job because administrators think they can do that already.)

This tweet chat will discuss the various ways librarians can specifically show their worth to their own administration instead of passivley pointing to some standard or study illustrating the need for a hospital library. We will be discussing ideas of what we can do to answer our administration’s always constant question “What have you done for me lately and why should I give you money instead of another department?” The game has changed and we need to change our strategy.

If you are new to Twitter or the idea of tweet chats then I highly recommend participating using the website http://www.tweetchat.com.  Login to the site using your Twitter username and password then type in the word medlibs into the box at the top of the page next to the go button.  You will be able to follow the discussion very easily and you won’t have to worry about adding #medlibs to every post because it already does that for you. For more information about tweet chats check out this quick guide.

Librarians Take a Consumer Health Information Survey & Win

Researchers from Louisiana State University Health Sciences Center in Shreveport, LA are conducting a 15-20 minute survey to identify consumer health information services. 

The researchers hope to receive responses from public libraries, academic institutions, hospitals and not-for-profit organizations involved in consumer health information services.  The goal is to identify what services are currently offered, who is offering them and how often. 

The data may be able to assist other organizations in implementing new consumer health information services.  Organizations that participate will be entered for a drawing to win one of two $300 checks. After the survey period, 53 randomly chosen hospital librarians that complete the follow-up survey will receive $10 for their time and effort. 

This research is possible through financial support from the Hospital Libraries Section of the Medical Library Association. The survey will be open from April 15, 2013 to April 30, 2013 at 11:45 pm Pacific time. If you are willing to participate, please go to https://www.surveymonkey.com/s/2012_CHISS.

 

 

The Business of Hospital Libraries

Earlier last week people on medlib-l discussed (The  perfect library storm) closures of hospital libraries.  They are seeing a contradiction between Evidenced Based Medicine imperatives vs budget and resource demands on hospital libraries.  Some are seeing how the increase in pricing and bundling practices have caused the hospitals to “throw it back to the physicians and staff” causing libraries to close.  I interpret this statement to be that the hospitals are no longer willing to provide monies for institutional support of resources (the library) and require doctors and staff to buy their own resources.

This email conversation is very timely.  It turns out this week I will be in Tulsa, OK teaching the class, “The Evolving Librarian: Responding to changes in the workplace and in healthcare.”  Technology changes, social changes and healthcare changes have forced hospital librarians to step back and really change the way we do things.

Personally, we hospital librarians need to start treating our library like a hospital department and not a library.  I mentioned this in my medlib-l post. I know this statment sounds odd because you might think we do that already.  I think we could do better.  I think librarians not only need to align their goals to the hospitals, but they need to make the hospital’s goals their goals.

With the Affordable Care Act, hospitals stand to lose 1% of their Medicare payments in penalties if patients with specific conditions are readmitted within 1 month of discharge.  By 2015 it will be 3%.  That is billions of dollars.  To put it in perspective, Barnes-Jewish Hospital in St. Louis will lose $2 million dollars according to Kaiser Health News. Dr. John Lynch the chief medical officer of Barnes-Jewish says they could absorb the loss this year but not over time if penalties continue to accumulate.

You better believe all of the other hospital departments in your hospital are working toward the hospital goals.  Aligning the library to demonstrate specifically (hard numbers) how it can help the hospital achieve their goals is essential.

I thought long and hard about my post to medlib-l before I sent it.  The reason was I didn’t want to lay blame for hospital libraries closing on the librarians.  I didn’t want to imply that they weren’t doing their jobs or that if they “could’a, would’a, should’a” they would still have their jobs.  That wasn’t my intent.  Although, one person responded on the list saying they found it “disheartening that sometimes when a library staff is downsized or actually closed, that a too common belief is that if  only ‘that library’ had been doing more, building a stronger case, demonstrating their worth in concrete ways, etc., etc., this would not have happened.”

Who knows what the situations were at those hospital library closures or downsizings?  However, I firmly believe if you don’t start looking at your library as a business arm of the hospital and align your goals to support the hospital achieve its goals, then you are going to have a very rough time.  Because if an institution as established and good as Barnes-Jewish is dealing with these things, then it can, and is happening everywhere.  Where do you think the library stands when the institution has to deal with a $2 million dollar loss one year? Repeatedly?  Where do you think it stands if you do not illustrate exactly with hard numbers how your department has helped prevent that loss.

I think everyone (administrators, doctors, nurses, etc.) can agree that the idea of a library is good.  But when faced with money demands, that idea  needs concrete specific support.  That support must be generated from within.  Administration doesn’t care about the library in terms of JCAHO standards. Administration doesn’t care about the Rochester study or newer updated similar published research.  Administration cares about what your library is doing now.  Those studies, standards, etc. aren’t going to change your administration’s mind, you are.  They don’t care if you give them every flipping article under God’s green earth saying that a library will save them money and help them cure every disease known to man.  Administration only cares about you, your library, what you are doing, and how it benefits them.

I am not alone in thinking that hospital librarians need to change they way they think and do “library business.”  The Mid Atlantic Region will be running a CE webinar series starting May 31, 2013, entitled “Running Your Hospital Like a Business.”  Some of the things the series will address are: writing a business plan, art of negotiation, and proving your worth/adding to your value.  All of these things are those business skills that I ran away from in college but now am kicking myself as I realize I really need them today and could’a, should’a taken a business class back then.

Oh well, time to beef up now.

 

Friday Fun: The Unofficial MLA Drinking SIG

Many who go to MLA often find themselves in the evening after the meeting going out to dinner and the bars to discuss library and non-library stuff.  I remember somebody mentioning that we met for drinks so often that we could have our buisness meetings at the bar.  After a good laugh and a few more drinks later the unofficial Drinking SIG was born. 

I want to stress it is all in good fun and completely unofficial from MLA.  There are no dues but you will probably have a bar bill.  Last year was the first year the unofficial Drinking SIG came off of the barstool and started selling t-shirts and other fun items promoting the group.  This year for 2013 a new design and new set of items is available http://www.cafepress.com/drinkingsig for you to purchase. 

Even though the SIG is not official, it wouldn’t exist without the people of who attend MLA.  So all of the profits from the SIG’s cafepress site sold will go to the MLA scholarship fund. 

Next Friday Fun post will be a guest post from Heather Holmes about the unofficial Drinking SIG.

Moderate a #Medlibs Discussion

The last month we have had some really good #medlibs discussions on Twitter.  Many have been moderated by guest #medlibs who host the discussion on a specific topic. 

Previous Topics:

I hosted the Apps and Tablets discussion (as well as several previous ones) it is not only fun but pretty darn easy to do.  You welcome everybody to the group discussion and then you get the ball rolling with a question, thought or talking point that you post.  From there the discussion almost takes on a life of its own.  If there are specific points or topics you want to make sure you hit, then you monitor the discussion and throw them in either when the discussion moves that way or after a certain amount of time. 

One important thing you need to know is you don’t have to be an expert in the topic to moderate.  You just have to have an inquisitive mind and the ability to ask questions.  The rest of the group will take the discussion and move with it.  Often there are several people with many different perspectives that can help educate you and the rest of the group.

So if there is a topic you are dying to discuss, please become a #medlibs moderator.  (Remember I said it is very easy.) Go to the #medlibs Calendar and click on a date that works for you.  Then enter your topic and information in the details link.  Once you have done that, you are on the schedule and we will look forward to tweeting with you.

Askey Not Out of the EMP Legal Woods

I posted yesterday that EMP released a statement they were dropping the lawsuit against McMaster and Askey.  As I mentioned the CBC article indicates that they dropped 1 of the 2 lawsuits. I asked yesterday if anybody knew about EMP dropping the second lawsuit against Askey.  I have gotten a few replies indicating that EMP has not dropped the lawsuit against Askey, just the one against McMaster and Askey. 

So it appears that Askey is not free of the EMP lawsuit yet. 

According to an updated article from The Chronicle , “Mr. Askey declined to comment on the case that’s being dropped, but he did say that the separate lawsuit filed against him by Mr. Richardson appeared to be continuing for now.”

The Canadian Association of University Teachers announced that McMaster had decided to pay Askey’s legal expenses (Askey was covering them previously.).  However, it is unclear to me from this article whether Askey’s legal bills would be covered with the suit that included McMaster or whether they also were covering the legal bills for the suit that is just against Askey (which has yet to be dropped). 

If you have any updates to this post please comment below.

Mellen Drops Lawsuit against McMaster and Askey

According to this article from CBC News Edwin Mellen Press says it is dropping at least one of its lawsuits against Dale Askey.  The article does mention that EMP filed two lawsuits against Askey and McMaster for a total of $4.5 million in damages. 

EMP told the CBC that it “discontinued the court case against McMaster University and Dale Askey,” citing in a statement “financial pressure of the social media campaign and press on authors is severe. EMP is a small company. Therefore [it] mus choose to focus its resources on its business and serving its authors.”

So it appears according to this article that at lest 1 of the 2 lawsuits was dropped.  I couldn’t find any information on whether they planned to also drop the second.

If anybody knows please leave a comment with a link to the information.

Emerging Technology and Hospital Libraries

Thursday #medlibs will discuss the 2013 Horizon Report- Higher Education edition, “a decade-long research project designed to identify and describe   emerging technologies likely to have an impact on learning, teaching, and creative inquiry in higher education.”

When we are talking higher education it is barely just a hop, skip, and a jump to think of how all of it will impact libraries in higher education.  While academic libraries will see the impact quicker, hospital libraries aren’t immune to the changes.  Because what is considered trending technology by medical students will be common place when they enter their residency programs in the hospitals and will be outdated when they are staff physicians.

So what kind of technology does the Horizon Report list and what will be talking about on #medlibs?

Happening in one year or less according Horizon:
(I say it is happening now)

  • Massively Open Online Courses (MOOCs)
  • Tablet Computing

Happening 2-3 years:

  • Big Data and Learning Analytics
  • Game Based Learning

Happening 4-5 years:

  • 3D Printing
  • Wearable Technology

As a hospital librarian I have to say that tablet’s have exploded and it is in our world now.  Big Data is the next “big money” thing that hospital librarians need to be aware of.  There are already academic librarian positions for data management dealing with research.  Hospital librarians might think that they don’t need to worry about data management because their institution doesn’t really do research. WRONG?!?!

If your hospital has an EMR, it has tons of data that it needs to manage and most likely that data is either just sitting there in the EMR or communicating poorly with a few of the hodge podge of other computer systems within your hospital.

Hospitals eligible for Medicare EHR Incentive Programs must demonstrate meaningful use of the EHR technology. “Eligible hospitals and CAHs that do not successfully demonstrate meaningful use of certified EHR technology will be subject to Medicare payment adjustments beginning in FY 2015.” Read that as penalized.

Personally I see data management as a natural extension for libraries that have already been involved with IT and the EMR.

Here are two examples of many where hospitals are mining the data within the EMR to improve care.

  1. The Value of Data: It’s How You Use It.
  2. Health Fidelity Receives Grant from National Science Foundation to Support Use of EHR Data to Improve Quality of Care.

Perhaps I am old and my memory is failing but weren’t librarians talking about data mining in 2000? IT was mining for data withing bibliographic databases, but aren’t the principles the same?  Data mining and the EHR are one avenue that hospital librarians who are interested in the future of librarianship need to consider.

The Horizon Report lists other technologies, how do you see them impacting hospital librarians and when?  Feel free to comment below or better yet, join us Thursday at 9pm est. for the #medlibs discussion on Twitter.  (The easiest way to follow a discussion on Twitter is go to TweetChat, login using your Twitter login, then follow the #medlibs hastag.)

 

Libraries are Horrible at Marketing

The Results Are In and They Aren’t Good: Library Marketing” caught my eye a few weeks ago and it has been bouncing around in my head ever since.  The article reports on a marketing survey about how public libraries market themselves, effectiveness of marketing initiatives, and engagement within their communities. 

The results aren’t pretty.

The results clearly indicate there’s a disconnect; a canyon between what should be happening and what is happening within the marketing schemas of public libraries. In an era when the value of libraries are under scrutiny and library budgets are under siege it is essential that libraries communicate their value to users as well as non-users. A failed marketing practice is failed communication.”

While this article is specifically about public libraries, I can’t help but read it with medical librarian eyes.  I found myself nodding and talking back to the computer screen like a crazy librarian hopped up on caffeine.  I just kept thinking that medical libraries are probably just as bad or worse. 

How many institutions make it difficult to send out targeted emails to user groups?  How many institutions have decent front pages or information pages on their Intranet or Internet sites that employees actually read to stay informed?  How many of these same institutions only fill that information up with the institution’s marketing information and don’t allow departments (such as the library) post information? 

How many medical libraries rely on the website to post news?  The article clearly states that libraries don’t feel this is the most effective way to reach people.

Not only do we do a crummy job of marketing to our own users, we surely aren’t reaching non users.  I found an interesting article the other day, “Exploring factors in non-use of hospital library resources by healthcare personnel.” (Library Management. Vol 34. No. 1/2, 2013. pp.105-127.)  The study found out that the hospital libraries did a poor job of getting their message out.  Many people didn’t know there was a library, thought it was only for doctors or didn’t think it had information to help them. Those that knew about the library were misinformed at what exactly was in the library. 

After reading those articles my mind kept thinking, we have a serious uphill trek to make and we are wearing roller skates for it. 

I don’t have the answers but I know there are others who have ideas that have worked (and didn’t work) and might be willing to share them in the comments section.  Perhaps somebody can share how they can email large groups of people without falling afoul of the institution’s rules on mass emails.  Additionally, somebody might be able to share ways of getting their message out to people who may not think the library is for them like secretaries, nutritionists, social workers, etc.  How do you get your online message read? Where besides the library website do you post them?  Finally, one small plea… if you are using Facebook or Twitter to reach users please have engagement numbers beyond “Likes” in addition to your strategies.  I am tired of hearing about librarians who say they have a million “likes” on their Facebook page but nobody besides librarians are posting on their wall.  One way communication isn’t communication and isn’t engaging users.  That is no different than posting a flyer about library classes in the library staff break room.