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Blue Cross Blue Shield of North Dakota partially blames its poor 2013 performance on newly implemented EHRs of providers that delayed their insurance claims submissions, which it says caused it to underestimate the value of those claims. I didn’t realize until reading the CEO’s discussion that Noridian Healthcare Solutions is a subsidiary of BCBS of North Dakota. Noridian built the failed Maryland health insurance exchange and was fired from its $193 million contract in February. Maryland has hinted that it may sue Noridian in hopes of getting back some of the $55 million it has already paid toward Noridian’s five-year contract. North Dakota’s insurance commissioner says the agency is watching BCBSND to make sure it doesn’t try to increase insurance premiums in the state to cover Noridian’s projected $17.8 million loss. Every time I hear that name I think of Veridan Dynamics from “Better Off Ted.”
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From Guillermo del Grande: “Re: CIOs. Here’s a list of “A Few Things CIOs Should Know (Or Think About).”
- If you want the FDA to regulate EMRs but have a service level agreement of two days for major fixes, you may want to learn about software development models. If you have to ask what a software development model is, how did you get to be a CIO?
- FDA requires waterfall development. This is not Niagara Falls.
- How many of the good EMRs use waterfall any more? Here’s a hint: not many. Most are agile. EMRs are more complicated than a medical device. How many different medical devices connect to your EMR? Do you even know? Do you feel like testing every scenario per medical device that connects to your EMR? Do you think your vendor does that?
- Are you afraid to let developers and your IT people watch healthcare and the software in action? You’re not agile. You’re going over the waterfall in a barrel.
- If your SLA is two days, but you require a change control meeting that only happens every two days, and then a software testing process that takes two days, and then another change control meeting, and then only migrate changes once a week, you may have a problem.
- How long does it take your vendor to fix a minor issue? You should be asking this question before you buy.
- What makes you think your IT staff can fix a problem in a SLA period when you don’t know if it’s something your IT folks can do or it’s something the vendor has to do?
- Do not try to manipulate an IT staff or a vendor into repairing your highest priority by only reporting that item. IT staff have lots of end users. Vendors have lots of customers and sometimes will fix issues only if lots of different …read more
