Tuesday, November 26, 2013

SAS's ZipCityDistance() function

I knew SAS could do just about anything but I didn't realize there was a function for counting the miles between zipcodes.
Below an example taken from a listserv at work,
data _null_;
            distance=zipcitydistance('94103', '04401');
            put 'Distance from San Francisco, CA, to Bangor, ME: ' distance 4.' miles';

Monday, November 25, 2013

Healthcare IT News: Epic to open source code to OHSU

Via Healthcare IT News,

Epic Systems Corp. will build two laboratory installations of its EpicCare electronic health record at Oregon Health & Science University for medical informatics education and research purposes. On the research side, the school will have access to Epic's source code.

This is Epic's first partnership with an academic informatics program and possibly an important turning point for the company. While Epic does release its source code to commercial customers, it historically has conducted research and development almost exclusively on its sprawling campus in Verona, Wis., where all of its employees are based.
"It's a little bit of a change for Epic," said William Hersh, MD, chair of the Department of Medical Informatics and Clinical Epidemiology at OHSU in Portland, Ore. Hersh said it took several years of cajoling to get the vendor to commit to an academic partnership.

 Cajoing indeed....

Tuesday, October 15, 2013

Ben Domenech on Affordable Care Act's worst case scenario

Domenech lays it out here.
I'd add one further nasty step to the worst case.  People who have lost their insurance and unable to sign up timely on the exhanges, and then faced with a health catastrophe in January would face the cruelist of fates.  Sick, without insurance, and a penalty for not having it.  None of it any fault of their own.


Sunlight Group: Good enough for government work? The contractors building Obamacare

InforWorld writes,
The biggest problem with Healthcare.gov seems simple enough: It was built by people who are apparently far more familiar with government cronyism than they are with IT.

That's one of the insights that can be gleaned from the work done by the Sunlight Foundation Reporting Group, a Washington, D.C.-based nonprofit that focuses on government transparency. In a report filed this past week, the group examined why the system broke as horribly as it did: The contracts awarded to those who built it were, by and large, existing government contractors with "deep political pockets."
Download the Sunlight Group's report for a list of all the vendors.  Yes, the lobbying and contributions explain some, but the biggest failure I suspect will be lack of imagination.  They did it the same old way.


Affordable Care Act's Software Vendors

In case your wondering the trio's "CGI Federal for the website itself,  "Quality Software Systems Inc. (QSSI) for the information "hub" that determines eligibility for programs and provides the data on qualified insurance plans, and "Booz Allen for enrollment and eligibility technical support."
Below via Obamacare site hits reset button on passwords as contractors scramble,
The result of the headlong rush to October 1 was a system that had never been tested at anything like the load it experienced on its first day of operation (if it was tested with loads at all). Those looking for a reason for the site's horrible performance on its first day had plenty of things to choose from.
First of all, there's the front-end site itself. The first page of the registration process (once you get to it) has 2,099 lines of HTML code, but it also calls 56 JavaScript files and 11 CSS files. That's not exactly optimal for heavy-load pages.
Navigating the site once you get past registration is something of a cheese chase through the rat-maze. "It's like a bad, boring video game where you try to grunt and hack your way through to the next step," one site user told Ars.
Once you get through all that, it's not clear that it's going to do you any good. Underlying problems in the back-end code—including the data hub built by QSSI—have been causing errors in determining whether individuals are eligible for subsidized plans under the program. In DC, that means health care plan prices won't be available to people registering through DC's portal until November. It may also mean that others who have registered already at the federal and state exchanges may get sticker shock later.
A Federal IT Acquistion a heck-of-a-thing to hang one's Political Legacy upon.  Administration will end up seeking a delay and that's what'll be remembered about this shutdown.

Wednesday, June 05, 2013

SAS/JMP Seminar on Predictive Modeling

I took one of the half-day freebie Seminiars from SAS on using JMP for Predictive Modeling and strongly recommend.  It's free, they buy you lunch, but mostly  you learn enough to get you really excited about the product.
So I ended up buying some books too.

Becker's: 5 Reasons Hospital ORs Score Low on Key Quality Measures

Via Becker's
The VBP Program tracks several measures from the Surgical Care Improvement Project. The program also incorporates patient satisfaction scores from the HCAHPS survey. Starting in fiscal year 2015, VBP will weave in several surgical complication measures, which are tracked by the American College of Surgeons National Surgical Quality Improvement Program.div>
VBP allready favors Medical Centers that can cherry pick their patients and disfavors disporportinate share Providers.  Adding NSQIP really aggrevates the destruction this "no child left behind" styled approach to reform will wrought on health care.

So pay attention to the advice in this article on improving your Surgical programs although it's going to be futile for many I think.

Wednesday, May 22, 2013

Becker's Hospital Review: 6 Value-Based Credit Rating Metrics Hospital CFOs Need to Know

One through five on the list I would have guessed but #6 a new one to me,
6. Risk-based revenues. Hospitals provide data on traditional forms of payment such as diagnosis-related groups, per diems and capitation, but Moody's will also be looking at how much a hospital receives from risk-based revenues. These include bundled payments and pay-for-performance reimbursement, or any other reimbursement that is based on the hospital's ability to delivery care at a lower cost.
Maybe I've just been too removed from the nuts-and-bolts of reimbursement to have had #6 cross my mind.

Friday, January 18, 2013

Study: Electronic Medical Records Not Generating Expected Savings

Study: Electronic Medical Records Not Generating Expected Savings

Solutions create tomorrow's problems....

Shaun Alfreds, Chief Operating Officer of HealthInfo Net - a Maine company that manages a centralized health records database for the state - says part of the problem may be the rush to implement EMRs over the past few years.

"And in this particular case, the focus was getting the systems to be electronic, not necessarily about changing the workflow of how health care is delivered." Because ultimately, Alfreds says, that's what EMRs are about: workflow.

Another problem that RAND identified is the inability of EMR systems to communicate with each other. "It's the bigggest challenge I've had in my career," says Ralph Johnson, chief information officer at Franklin Memorial Hospital in Farmington, which has been named among the nation's most wired hospitals.