Friday, September 03, 2010

Weekly Overseas Health IT Links - 03 September, 2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.


Authors issue reality check on health IT

By Joseph Conn / HITS staff writer

Posted: August 27, 2010 - 11:15 am ET

A pair of Boston-area researchers with a penchant for planting proverbial two-by-fours of reality between the eyes of federal healthcare information technology policymakers have landed another whack.

You have to look really hard to find the bright side in the most recent writings of Ashish Jha and Catherine DesRoches. Their article, published online in the policy journal Health Affairs, declares that roughly 2%—and that's rounding up—of U.S. hospitals in 2009 would have had a chance at passing muster under the new federal criteria for meaningful use of health IT.

The overriding message is that even after five years of federal health IT cheerleading, about 98% of hospitals would have failed to qualify for federal subsidy payments for the purchase of electronic health-record technology under the American Recovery and Reinvestment Act of 2009.

The researchers also conclude that there is a discernable IT adoption gap between the digital haves and have-nots in this country, that the divide is widening, and that the jury is still out as to whether the IT incentives portion of the federal stimulus law will remediate or exacerbate the problem of IT inequality.


Be wary about health information you get on the Internet

About 70 percent of households have Internet access and with the increasing use of smart phones, the Internet is becoming an even more popular source of medical information for parents. Parents and adolescents often use the Internet before contact with a physician. Sometimes information obtained online may be the only health care advice sought and used.

How accurate is this information? A study to be published in the Archives of Diseases of Children addresses this question. The authors of this study chose five health issues that reflect concerns often expressed to practicing clinicians and have clear answers supported by scientific evidence.


Evaluating and selecting EHRs

By Ron Piana | August 25, 2010

As adoption of electronic health records (EHRs) continues to grow, there still exists a gap in the ability of some providers and vendors to ensure successful implementation. The core factor in EHR delays and failures is a lack of readiness. This list of resources can arm you with the knowledge to take advantage of government incentives.

Healthcare Information and Management Systems Society (HIMSS): The HIMSS EHR Selector is an online database of EHR products and vendors.

Government Initiatives

Office of the National Coordinator for Health Information Technology (ONCHIT) The Office of the National Coordinator for Health Information Technology provides leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to improve the quality and efficiency of health care and the ability of consumers to manage their care and safety.


Words Matter When it Comes to Tech-Savvy Patients

Gienna Shaw, for HealthLeaders Media, August 24, 2010

Steel yourself for some alarming news: Cyberchondriacs are on the rise, up from 50 million in 1998 to 175 million today, according to market research firm Harris Interactive. And they’re also getting more active: "Fully 32% of all adults who are online say they look for health information 'often,' compared to 22% last year."

Sounds like bad news, doesn't it? But wait—what exactly is a cyberchondriac? According to Harris, they've used the term since 1998 to describe people (are you sitting down?) who look for healthcare information online.


Tighter Medical Privacy Rules Sought


WASHINGTON — The Obama administration is rewriting new rules on medical privacy after an outpouring of criticism from consumer groups and members of Congress who say the rules do not adequately protect the rights of patients.

Democratic lawmakers and a few Republicans have denounced the rules, saying they fall short of offering patients the fullest protections possible. Hospitals and insurance companies, seeking to maintain greater control over patient notification, generally support the rules. The White House finds itself caught in the middle.

The rules specify when doctors, hospitals and insurers must tell patients about the improper use or disclosure of information in their medical records. Such breaches appear to have become more frequent, with the growing use of health information technology, social media and the Internet.


Progress on advanced privacy controls

By Joseph Conn / HITS staff writer

Posted: August 24, 2010 - 12:00 pm ET

The ad hoc work group charged with advising the federal Health IT Policy Committee on matters of information privacy and security recommended last week that the government commit resources to privacy protection technology. The difficulty, the group noted in a 19-page report, is that this technology's development isn't even across vendors, and its lack of widespread use among providers is such that it won't be of much use in the near term to protect patient privacy.

The Privacy and Security Tiger Team based its findings in part on a June 29 hearing at which seven developers of privacy protection technology demonstrated their wares. One of them was Duane DeCouteau, a senior technologist working under contract to the Office of Health Information at the Veterans Affairs Department.

DeCouteau co-authored a computerized data communication profile for privacy and security authorizations, sometimes called "consent directives."


Biden touts stimulus law's IT benefits

By Jennifer Lubell / HITS staff writer

Posted: August 24, 2010 - 12:15 pm ET

Recovery Act investments in health information technology are making headway in improving patient care and reducing medical errors, according to a new White House report (PDF).

The report, unveiled by Vice President Joe Biden in Washington Tuesday, details the effects of the American Recovery and Reinvestment Act of 2009, which funneled more than $100 billion to various programs, including $20 billion in healthcare information technology.


Health IT Contracts Offer Little Protection For Buyers

Key questions healthcare providers should ask before signing an electronic health record vendor agreement detailed by lawyer.

By Nicole Lewis, InformationWeek

Aug. 23, 2010


As healthcare providers purchase electronic health record software and other health IT to meet meaningful use requirements, they must insist that the legal contracts they sign with vendors will protect their interests.

Last week at the American Health Information Management Association's (AHIMA) 2010 Legal Electronic Health Record (EHR) Conference in Chicago, Steven Fox, a lawyer focusing on health IT issues with law firm Post & Schell, urged healthcare providers to ask themselves key questions when acquiring EHR technology to achieve meaningful use, including: What technology and services should be purchased? What is to be paid for and when? How to assure that requirements will be met? And what happens if the product fails?


Physician Investment in IT, Accountable Care, Needed for Reform

Janice Simmons, for HealthLeaders Media, August 24, 2010

While issues such as permanently fixing the sustainable growth rate (SGR) formula have disappointed physicians, it still would be in their best interest to support the many provisions of the Affordable Care Act as they work at the practice of medicine, several White House officials write in the latest issue of the Annals of Internal Medicine released Monday.

No one is "more disappointed" than President Obama "who has made it clear" in a statement that he is "committed to permanently reforming this Medicare formula in a way that balances fiscal responsibility with the responsibility we have to doctors and seniors," write the authors who include Nancy-Ann DeParle, director of the Office of Health Reform and counselor to the President, and Ezekiel Emanuel, MD, the special advisor on health policy with the Office of Management and Budget.


EMR courtship: Hospitals wooing doctors to stay afloat

Technically Speaking. By Pamela Lewis Dolan, amednews staff. Posted Aug. 23, 2010.

With hospitals racing to meet meaningful use requirements -- and struggling with declining patient loads -- experts say hospitals want to hook up, technologically speaking, with physicians as a means of ensuring their economic survival.

Despite the hospitals' struggles to meet meaningful use criteria, which would award them bonus money from Medicare or Medicaid, they also are struggling to stay afloat in a bad economy. A recent report by the American Hospital Assn. on the effects of the recession found that 72% of hospitals reported a decline in the number of elective procedures, and 70% reported a drop in patient volume from 2009.



Paul Ohm*

Computer scientists have recently undermined our faith in the privacyprotecting power of anonymization, the name for techniques that protect the privacy of individuals in large databases by deleting information like names and social security numbers. These scientists have demonstrated that they can often “reidentify” or “deanonymize” individuals hidden in anonymized data with astonishing ease. By understanding this research, we realize we have made a mistake, labored beneath a fundamental misunderstanding, which has assured us much less privacy than we have assumed. This mistake pervades nearly every information privacy law, regulation, and debate, yet regulators and legal scholars have paid it scant attention. We must respond to the surprising failure of anonymization, and this Article provides the tools to do so.


Wis. submits health info exchange plan

By Andis Robeznieks / HITS staff writer

Posted: August 27, 2010 - 11:30 am ET

The Wisconsin Relay for Electronic Data for Health, also known as WIRED for Health, submitted its plan (PDF) to HHS for a statewide electronic health information-exchange network, and it includes a suggested framework for the governance and financing of the network, the services it would provide and the technical architecture it would require.


Lockheed Martin Wins $9 Million HHS Contract

Supporting development of future Nationwide Health Information Network capabilities is focus of Department of Health and Human Services work.

By Nicole Lewis, InformationWeek

Aug. 26, 2010


Lockheed Martin has announced that it has won two contracts worth a total of $9 million to help the Nationwide Health Information Network (NHIN) advance digital health records and secure health information exchanges. The contracts were awarded by the Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC).

The Baltimore, Md.-based company said Wednesday that, under the first contract, Lockheed Martin will create new reference implementation software to support the development, testing, and adoption of future NHIN capabilities. The second contract calls for Lockheed Martin to develop real-world demonstrations and pilots for emergent capabilities.


Best Kept Secrets in HIT (Part I)

Vince Ciotti

Health Data Management Blogs, August 25, 2010

Most people in the HIT business know about Healthquest, McKesson’s aging mainframe product line, which has roots back to Medipac (COBOL/VSAM) in the halcyon ’70s. And many know about their aging Star and Series products, both born in the minicomputer revolution of the ’80s, and growing a little long in the tooth today. But how many people know that McKesson now has a fully modern replacement for all three of these aging products?


VA hospital to join Ind. health info exchange

By Joseph Conn / HITS staff writer

Posted: August 26, 2010 - 11:30 am ET

The Veterans Affairs Department hospital in Indianapolis will participate in a pilot project to exchange veterans' health information with private-sector healthcare organizations via the Indiana Health Information Exchange, the VA announced.

Joining the exchange is part of a broader government effort—also encompassing the Defense Department—that President Barack Obama announced last year to create a virtual lifetime electronic record for active-duty and retired armed-services members.


Ealing improves discharge with SRC

25 Aug 2010

Ealing Hospital NHS Trust in London is using a electronic discharge summary solution from SRC to deliver discharge summaries to GPs within 24 hours of patients leaving hospital.

SRC says the eDS system is in use in 15 wards and clinical areas and was rolled out in just two months. The company worked with Bluewire Technologies, hospital clinicians and pharmacists to tailor the system to the trust’s workflows and medicines management requirements.

The system is integrated with the hospital’s patient administration system, and updates patient records using HL7 messaging. The interface means that discharge summaries can be produced quickly, with all the required patient data available through a single application.


Thursday, August 26, 2010

RECs Face Uphill Battle in Meeting Tight Deadlines

With the country's 60 regional extension centers already four or six months into their first two-year budget period, it appears they have their work cut out for them to reach the federal government's ambitious goal of helping 100,000 primary care providers become meaningful users of electronic health records by 2012.

The HITECH Act authorized the creation of regional extension centers to:

  • Provide training and support services to help health care providers adopt EHRs;
  • Offer information and guidance on EHR implementation; and
  • Provide technical assistance.

The Office of the National Coordinator for Health IT announced 32 REC awards in February 2010 and 28 REC awards in April 2010. Under the REC program, there are two two-year budget periods. The RECs are slated to receive a total of $643 million in federal funding in the first two years and additional $42 million in the subsequent two years.


Advanced EMRs save time in ERs, hospitals

August 26, 2010 — 9:29am ET | By Ken Terry

In ambulatory care, it has long been known that introducing a basic EMR for electronic documentation while continuing to perform other tasks on paper can actually make a physician practice less efficient. Now the same trend is emerging in studies of the use of EMRs in emergency rooms and hospitals.

A new paper shows that patients who go to emergency departments (EDs) that have advanced EMRs spend 22 percent less time there, on average, than people who present at EDs that lack EMRs. In the study of 30,000 patient visits to 364 hospitals nationwide, Michael Furukawa of Arizona State University found that EDs with the best EMRs had 13 percent shorter treatment times, 24 percent shorter stays for patients who eventually were admitted to the hospital, and 21 percent shorter stays for those who were treated and then discharged from the ED.


50,000 extra employees needed to meet meaningful use criteria

August 26, 2010 — 9:39am ET | By Ken Terry

The Office of the National Coordinator of Health IT projects that healthcare providers will need 50,000 additional IT workers to meet the meaningful use criteria to get government incentives for EMRs. Despite government moves to help train these additional IT workers, a new report from CSC says, healthcare providers will have to adopt alternative strategies to get the job done because the workforce won't expand rapidly enough to meet their needs.

A 2010 College of Healthcare Information Management Executives (CHIME) survey found that only 10.7 percent of respondents listed staffing as their top concern, the CSC study notes. But about half of the respondents listed staff levels and capabilities among their top three concerns, and it was the most frequently mentioned second and third concern.


The New Momentum Behind Electronic Health Records

Aug 26, 2010

A funny thing happened on the way to a 21st century health care system.

Many different groups representing vastly different interests across health care recently came together around an issue that seemed like a roadblock to building a healthier America a short time ago.

At a press conference earlier this month sponsored by the medical journal Health Affairs and Brandeis University’s Health Industry Forum, major insurance companies, provider groups, doctors, hospitals, and patients announced that they will team up to support so-called “meaningful use” regulations – guidelines that doctors and hospitals will have to follow to earn incentives for moving from paper to electronic medical files.

UnitedHealth Races McKesson in $11 Billion Health-Tech Hunt

By Alex Nussbaum and Pat Wechsler - Aug 25, 2010

UnitedHealth Group Inc., the biggest U.S. insurer, and McKesson Corp., the largest drug distributor, are vying for billions of dollars in added sales by bulking up their information-technology units.

The companies are expanding beyond their core business to help insurers cope with the health overhaul, which threatens to swamp industry computer systems, said Joanne Galimi, a Boston- based analyst for technology researcher Gartner Inc.

Bracing for added taxes and regulations, insurers are upgrading long-neglected systems used to enroll members, track care and process claims, Galimi said. They also face a 2013 switch to a new government-mandated system for classifying diseases. As a result, insurer spending on data technology will jump 24 percent by 2013, to $11.3 billion, according to a March report by IDC Health Insights, of Framingham, Massachusetts.


N.Y. info exchange uses grant to fight diabetes

By Joseph Conn / HITS staff writer

Posted: August 25, 2010 - 11:15 am ET

Here's a pop quiz on healthcare information technology, geography, culinary traditions and public health.

Where in the world was David Blumenthal on Tuesday if the eight-county region he was visiting has had an operating clinical health information exchange since 2008 but is better known for its spicy chicken wings and lake-effect blizzards?

The answer is western New York—Buffalo, specifically, the home of not only Buffalo hot wings but also HealtheLink, a regional health information exchange, or RHIO, that in May received a nearly $16.1 million Beacon Community grant from the Office of the National Coordinator for Health Information Technology. The award, provided to help the region combat rising diabetes rates, was the largest of 17 Beacon Community grants distributed across the country.


US med info body joins Euro federation

23 Aug 2010

The American Health Information Management Association has been accepted as an institutional member of the European Federation for Medical Informatics.

The AHIMA is a health information management professional association that is dedicated to the effective management of health information.


St George’s suffers Cerner teething pain

26 Aug 2010

St George’s Healthcare NHS Trust is facing teething problems with its installation of a Cerner Millennium hospital information system.

The trust went live with the Millennium in March, under a new local delivery model from local service provider BT.

Five months later, the trust, which is one of the largest in London, has had to second additional senior management expertise into the project team and institute an additional programme of workflow changes and training.


Headed to ER? Some post waits by text, billboard


The Associated Press

Monday, August 23, 2010; 2:56 PM

WASHINGTON -- Need an X-ray or stitches? Online, via text message or flashing on a billboard, some emergency rooms are advertising how long the dreaded wait for care will be, with estimates updated every few minutes.

It's a marketing move aimed at less urgent patients, not the true emergencies that automatically go to the front of the line anyway - and shouldn't waste precious minutes checking the wait.

"If you're in a car accident, you're not going to flip open your iPhone and see what the wait times are," cautions Dr. Sandra Schneider, president-elect of the American College of Emergency Physicians.


Telehealth programs win rural healthcare grants

By Jessica Zigmond / HITS staff writer

Posted: August 24, 2010 - 10:15 am ET

HHS Secretary Kathleen Sebelius has announced $32 million in funding to help improve access to healthcare services for rural Americans. The funding will be allocated to seven programs that are administered by the Office of Rural Health Policy in HHS' Health Resources and Services Administration.

"The grants will strengthen partnerships among rural health providers," HRSA Administrator Mary Wakefield said in a news release about the funds. "Funds will be used to recruit and retain rural healthcare professionals and modernize the healthcare infrastructure in rural areas."


Iraq providers to test open-source VistA EHR

By Joseph Conn / HITS staff writer

Posted: August 24, 2010 - 11:45 am ET

A Defense Department media contractor is reporting that three Iraqi government healthcare organizations will test at a Baghdad military hospital an open-source version of the VistA electronic health-record system developed and used by the Veterans Affairs Department.

According to a story posted Monday on the website of the Defense Video & Imagery Distribution System, a U.S. military media outlet, the Iraqi ministries of Defense and Health and the Kurdistan Ministry of Health signed an agreement earlier this month to implement the open-source WorldVistA software system at the Al Muthana Hospital in Baghdad. The 50-bed Iraqi military hospital opened in 2009. The EHR should be in place by October, the story said.

London completes move to RiO 5.4

19 Aug 2010

All 36 of the community and mental health trusts in London that opted to take the RiO electronic patient record have been upgraded to the latest version by local service provider BT.

The trusts have been upgraded to V5.4, which delivers improvements to clinical documentation and reporting, plus centralised demographics to provide the first steps to a more integrated care record.


EMIS buys Rx Systems for £10m

19 Aug 2010

GP system supplier EMIS has acquired a majority share in Rx Systems Ltd, a pharmacy software and services company, for almost £10m.

Rx Systems provides a range of integrated pharmacy and retail systems and services for the community pharmacy, including its core product, ProScript, a Windows-based dispensary management system.

The company also provides information required under the National Programme for IT in the NHS for pharmacist audit and remuneration purposes.


NPR: Technology Can Help Seniors Stay In Homes

NPR continued its series on seniors aging at home.

Part two examined a company called Adaptive Home, "one of a growing number of startups that use monitoring technology to revolutionize elder care. These companies are also betting on a big market as the baby boomers enter old age. Chris Bridgers says a basic package includes about a dozen motion sensors placed strategically around a house. They can provide adult children with a stunningly detailed rundown of a parent's day" (Ludden, 8/23).


Expert: Providers must make IT investments on their own, have new implementation strategies

August 19, 2010 | Molly Merrill, Associate Editor

CHICAGO – With government incentives only offsetting EHR costs by about 15 to 20 percent, providers should not only be prepared to make a significant investment in IT, but should also consider a "radical new approach to IT," say the authors of a new study.

The study was published by management consulting firm McKinsey & Company in its business journal McKinsey Quarterly, and was authored by Francois Laflamme and Nilesh Rajadhyax, associate principals in McKinsey's Chicago office, and Wayne Pietraszek, a principal.

The authors point out that not only do providers have to meet the government's accelerated timetable for achieving meaningful use of these systems before facing fines, but also have to meet new data coding standards with revisions to HIPAA and ICD-10. They estimate that providers should expect to spend around $120 billion, at an average cost of $80,000 to $100,000 per bed, for the required project planning, software, hardware, implementation and training required for this.


Kundra: Time to fine-tune federal IT projects

By Jennifer Lubell / HITS staff writer

Posted: August 23, 2010 - 12:00 pm ET

Several health information technology projects may be facing changes or budget cuts as part of a wide-ranging intervention on the federal government's behalf to increase the projects' efficiency.

At a teleconference Monday, White House Federal Chief Information Officer Vivek Kundra released a list of 26 so-called high-priority IT projects across the federal government that could benefit from some fine-tuning. The list appeared on the IT Dashboard, a website that lets federal agencies, industry members, the general public and other stakeholders view details of federal IT investments.

Assessing the Need for More I.T. Workers

HDM Breaking News, August 23, 2010

A new report from consultancy and software firm Computer Sciences Corp. examines the health information technology workforce shortage.

The Office of the National Coordinator for Health Information Technology estimates 50,000 additional I.T. workers are needed during the next five years, which is about 50 percent more than the current workforce of 108,000. The biggest demand now for staff obviously is to prepare for implementation of EHRs and health information exchange applications, Falls Church, Va.-based CSC notes.


The report lays out various challenges to beefing the I.T. workforce and examples of successful strategies. To access the report, click here.


Monday, August 23, 2010

'Meaningful Use': What Does Strategic Management Have To Say About It?

The "meaningful use" program is a governmental initiative aimed at influencing electronic health record adoption among hospitals and other providers. The million dollar question (actually, $27 billion) is not whether the meaningful use program will influence EHR adoption, but instead by how much?

Strategic management is about aligning an organization with its changing environment. Environmental changes include shifts in competition, regulation, customer preferences, political will, technology availability and/or economic conditions. For any given organization, environmental changes may serve as either threats or opportunities and can occur at the market level, industry level or societal level. From the perspective of an individual hospital or provider, the meaningful use program is an example of "change" that is occurring at the industry level. Implicitly, anything an organization does in response to the changing environment is a "strategy" being pursed presumably to align the organization with its environment.


DoD seeks ideas to modernize its e-health record

August 23, 2010

By Jason Miller

Executive Editor

Federal News Radio

The Defense Department is looking to modernize its electronic health record system.

The Tricare Management Activity issued a request for information Aug. 12 asking vendors to provide ideas for a comprehensive military health system capability for warfighters, beneficiaries and providers.

The RFI is part of Tricare's broader effort to improve its electronic health record. Tricare established an office in February to look at the future of the EHR, said Mary Ann Rockey, acting chief information officer for the Military Health System.




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