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Philip Moeller, On Friday August 27, 2010, 11:06 am EDT
It's rare that government gets accused of moving too fast. But in only five months, federal incentive payments will be available for healthcare providers that implement electronic health records (EHRs). There is a $20-billion-plus pot of money that can fund these projects, so the gold rush is on. But according to the American Medical Association, there are no EHR systems that currently meet the government's new standards. Of course, those standards were published all of a month ago. And while the incentive payments are the carrot, beginning in 2015, healthcare providers can be penalized for not providing acceptable EHRs.
So, it's a safe bet we are on the front edge of a massive information technology overhaul to digitize the U.S. healthcare system. Many participants, particularly doctors in smaller practices, will be kicking and screaming all the way. Consumers may not feel this technological pull for a while. But they will, especially in Medicare, Medicaid, and other programs used heavily by older Americans. These large-scale programs with heavy government controls will likely lead the digital charge.
Posted: September 2, 2010 - 11:15 am ET
The American Medical Informatics Association, a trade group representing healthcare-informatics professionals, has created an organization to serve as an international training ground, resource center and facilitator of informatics use in low-resource regions.
Posted: September 2, 2010 - 11:45 am ET
Policymakers charged with disseminating comparative effectiveness research will need to proceed carefully and strategically to overcome obstacles such as a lack of standardized methodology and public perceptions of CER.
Those were among the findings of a recently released issue brief from the New England Healthcare Institute, a not-for-profit health policy research organization based in Cambridge, Mass. The brief's authors recommended several strategies for effective CER dissemination, including the integration of CER into the current push for expanded use of health information technology.
By Daniel J. Marino
To see a return on their EMR investment, hospitals need to create new processes, partnerships and skills.
While hospitals nationwide are taking a leading role in helping physicians implement electronic medical records, many do not have a clear plan for recouping the cost of their investment.
The lack of a plan is unfortunate, as the total cost of rolling out an electronic medical record (EMR) outweighs any direct savings from improved information management. Many hospital leaders figure the cost is simply the price of keeping up with technology. The problem is that an ongoing EMR cost imbalance could threaten a hospital's ability to make future IT investments.
The only way to avoid chronic losses is to enhance the value of the physician EMR. The key is to create new processes, new connections and new management skills that amplify the clinical, financial and strategic utility of the core EMR system.
September 2, 2010 — 2:09pm ET | By Neil Versel
Surprise, surprise! Even as buyers have grown more savvy and able to find a cost-effective EMR, the true cost of ownership of an acute-care EMR often is far higher than expected, KLAS Enterprises reports. And vendor choice can play an important part in whether a hospital gets its money's worth.
For example, the Orem, Utah-based research firm says in a new report, it often takes huge investments in staffing, vendor and consultant services to move from "general clinical use" of an inpatient EMR to strong adoption of advanced functions like computerized physician order entry.
August 30, 2010 | Bernie Monegain, Editor
DETROIT – Detroit Medical Center executives say they have achieved improved patient safety and saved $5 million to boot, thanks to DMC's system-wide electronic medical system.
It is the second year in a row in which computer-based healthcare information processing created major improvements in quality of care and cost-savings for DMC's eight hospitals, officials said.
The windfall in savings - triggered by highly effective electronic monitoring of critical tasks such as treating pressure ulcers and preventing medication errors - resulted in a healthy return on investment, they said.
The $50 million system powered by Kansas City, Mo-based Cerner Corp, has gone online throughout the DMC in gradual stages over a 12-year period, starting in 1998.
Changes in reimbursement practices more important that government incentives in driving physician practices to adopt electronic health record software, reports Frost & Sullivan.
By Nicole Lewis, InformationWeek
Aug. 31, 2010
A study by Frost & Sullivan predicts that revenue for the U.S. ambulatory electronic health record (EHR) market will double from $1.3 billion in 2009 to an estimated $2.6 billion in 2012. Further, by 2013, the market will reach its peak, posting revenue of $3 billion. However, by 2016 market saturation will have occurred and revenue is expected to fall to $1.4 billion.
Published this month, the U.S. Ambulatory EHR Market report said that, while the federal funds from the American Recovery and Reinvestment Act of 2009 and the Medicare and Medicaid EHR incentive programs are contributing to the acceleration of EHR adoption, there are other factors such as the need to improve safety and the drive to build greater efficiency into physician workflows that are important drivers in the adoption of EHRs.
Posted: September 1, 2010 - 11:00 am ET
The Veterans Affairs Department, which has been a pacesetter in healthcare information technology for more than 30 years, is proving to be a role model once more. This time it is giving patients easier access to their own health information.
The New York-based Markle Foundation's Connecting for Health program has released a policy paper co-signed by 46 organizations, including more than a dozen health IT companies, in support of the so-called “blue button” technology being developed by the VA in conjunction with the Medicare and Medicaid programs at the CMS.
The technology aims to make it easy for patients to go online and download copies of their medical records.
25 Aug 2010
The value of the European picture archiving and communications system market is predicted to double over the next six years, driven by demand for radiology information systems.
New analysis from Frost and Sullivan has found that the market was valued at €535m ($679m) in 2009 and estimates that this will reach €1,065m ($1,353m) in 2016.
While the uptake of PACS in European hospitals is 80%, the RIS systems that drive PACS have only reached a penetration level of about 41%.
Gienna Shaw, for HealthLeaders Media, August 31, 2010
Low-tech solutions such as checklists and calling a time-out before surgery can dramatically improve safety in the operating room, according to the American College of Obstetricians and Gynecologists (ACOG), which recently released guidelines to deter surgical errors. But there are plenty of technologies that can help make the OR a safer place—from systems that keep track of sponges and to robots that may someday be able to deliver anesthesia remotely to systems that help counteract alert fatigue.
The ACOG guidance supports the Joint Commission's "three-part universal protocol" as a useful tool for healthcare teams to prevent surgical errors. The first protocol calls for the healthcare team to ensure that each patient's relevant documents and all of the surgical equipment are available, correctly identified, and reviewed before surgery."Using standard checklists, systems, and routines may sound to some like cook-book medicine, but they have been proven to greatly reduce surgery errors," said Richard Waldman, MD, ACOG's president.
HDM Breaking News, August 31, 2010
Recent reports show electronic health records sales ramping up sharply in coming years, along with a reality check on why those sales are being made.
According to HIMSS Analytics, a Chicago-based research firm with a database that tracks hospital use of I.T., 86 percent of hospitals today are not in position to qualify for the first of three stages of EHR meaningful use criteria, which start in 2011. But 51 percent of hospitals are close to meeting the first criteria stage and receiving incentive payments, and another 17 percent are a year or two behind.
Kalorama Information, a New York-based research firm, estimates the total EHR market in 2008 for hospitals and ambulatory providers was $12 billion. The firm expects the market will more than double to $25.3 billion by 2013, with a 2009-2013 compound annual growth rate of 16.2 percent. These numbers cover only clinical information systems.
By Leslie Tamura
Washington Post Staff Writer
Tuesday, August 31, 2010; HE01
The night before his fourth birthday, Rohan Giare of Rockville rolled off his bed and gashed the bridge of his nose. Rohan's dad, not knowing whether he should focus on getting the bleeding to stop or go immediately to the emergency room, snapped pictures of the cut with his BlackBerry and sent them to his doctor friend, Neal Sikka.
"I just gave [Sikka] a ring," Vishal Giare said, "and got initial input on how serious it might be."
Sikka, an emergency physician at George Washington University, looked at the photos and recommended a trip to the hospital.
Posted: August 31, 2010 - 11:15 am ET
It's the first word that came out of Karen Bell's mouth when asked how she felt about Monday's big news.
HHS had tapped the Certification Commission for Health Information Technology, of which Bell serves as chairwoman, as one of the first two organizations qualified to test and certify electronic health-record systems as eligible for federal reimbursements under the American Recovery and Reinvestment Act of 2009.
"We've been ready to go for some time," Bell said. "We know the industry is ready to go. We've just been waiting for the day to get beyond all this."
In fact, folks at CCHIT, a Chicago-based not-for-profit organization, have been in prolonged limbo, waiting more than a year for final word as to whether their practice of testing and certifying EHR systems according to federal standards would continue to have HHS' blessing.
EHR testing at CCHIT pursuant to government specifications began in 2006 after the commission received a $7.5 million contract with the federal Office of the National Coordinator for Health Information Technology. CCHIT's work was put on hold last year while ONC head David Blumenthal decided whether he would exercise the authority given to him under the stimulus law and keep CCHIT as the only government-anointed body to certify health IT systems. The stimulus law authorized Blumenthal to "keep or recognize a program or programs for the voluntary certification of health information technology."
The Certification Commission for Health IT (CCHIT), created by the HIMSS trade group to seek a monopoly on certifying gear to meet government standards under the Bush Administration, finally got approval to certify, along with the Drummond Group of Austin, Texas.
The news comes just one month before the start of the 2011 fiscal year, under which meaningful use will qualify for that sweet, sweet stimulus cash. And the government press release announcing the decision pointedly noted other applications are under review.
26 Aug 2010
The Summary Care Record is not the only shared record in town. Sarah Bruce reports from a Graphnet event at which NHS Hampshire and Birmingham Teaching Primary Care Trust shared their experiences of creating shared detailed care records using the company’s technology.
As debate continues about the merits or otherwise of the national Summary Care Record, Graphnet has been holding a series of intimate meetings to show trusts what others have been doing to create a locally held detailed care record.
At one recent event at Bletchley Park, two primary care trusts from different strategic health authority areas gave their perspective on what detailed health records can do for the local health economy.
Medical Bracelets Go High-Tech. Style Aside, More People Find They Should Wear Them.
· By LAURA LANDRO
It's a simple step, but one many doctors forget to remind patients to take: Wear a medical-alert bracelet.
A growing number of American adults and children face complex medical conditions like heart disease and diabetes. They may have drug or food allergies, suffer from disorders like autism, or take medications like the blood thinner coumadin that medical staff should know about in an emergency.
New bracelets and other medical-identification systems can fill in first responders on practically a patient's complete health history. They're a far cry from the simple identification bracelets of the past, which with a few engraved words informed medics that a person was, perhaps, allergic to penicillin. They can steer first responders to a secure website or toll-free phone number, or initiate a text message, to get the medical and prescription history of a patient who may be unconscious or unable to talk about their condition.
Posted: August 30, 2010 - 11:30 am ET
As the Veterans Affairs Department put another toe in the water of electronic health information exchange with the private sector, one of the oldest and most prominent of the nation's regional health information exchanges will adapt to the VA's legal and cultural approach to privacy protection.
Last week, the VA announced it will run a pilot project with the Indianapolis-based Indiana Health Information Exchange as part of the government's virtual lifetime electronic record project, an ongoing federal effort announced last year by President Barack Obama to provide veterans and active-duty armed-services personnel with a longitudinal electronic health record.
The 153-hospital, 768-clinic Veterans Health Administration also has clinical information-sharing tests under way in San Diego with the Defense Department and the integrated delivery network Kaiser Permanente and in the Hampton/Tidewater area of Virginia with the MedVirginia RHIO.
August 27, 2010 | Bernie Monegain, Editor
RESTON, VA – Spending on state and local health IT systems will increase by 19 percent over the next five years, forecasts a new report from market research firm INPUT.
"States, localities, and regional extension centers are going to move quickly to capitalize on EHR funding," said Kristina Mulholland, senior analyst, at INPUT. "It is essential that they fulfill Stage 1 requirements – especially when it comes to meeting computerized physician order entry, and they will need to seek technical assistance from contractors that specialize in system integration and hardware, software, and professional services along the way."
August 27, 2010 | Bernie Monegain, Editor
WASHINGTON – The convergence of personal health records and mobile communication devices may offer the right tool to engage consumers to use technology for self-care, taking cost out of the healthcare system, according to a new Deloitte Issue Brief from the Deloitte Center for Health Solutions.
The brief explores the potential benefits of mobile communication devices, such as cell phones, smart phones and other mobile tablet personal computers, to collect environmental and patient-entered information and transmit it via the Internet to a personal health record. Combined with actionable decision support, the combination of mobile device and PHR, which Deloitte calls "mPHR," can analyze aggregate data to activate patient-specific output such as medication reminders, healthy habit tips and medical bill reminders.
HDM Breaking News, August 27, 2010
Vinson Hudson, president of the Jewson Enterprises consultancy in Austin, Texas, and proprietor of the POMIS database of the products, functions and capabilities of ambulatory care information systems, is offering free vendor selection consulting services to physician practices.
Of course, there is a catch, as Hudson expects to make money off the consulting, but it won't be the docs who pay. Rather, practice management and electronic health records vendors will be offered, for a fee, a customized report of "must have" and "nice to have" requirements, and other information that must be in their presentation to a physician practice that has three to five vendors on its finalist list.
HDM Breaking News, August 26, 2010
A new report from vendor research firm KLAS Enterprises shows many hospitals don't believe they are getting their money's worth from their acute care electronic health records systems.
The Orem, Utah-based company surveys thousands of provider organizations annually and produces a range of reports looking at customer satisfaction with various information technology products and services.
By Mary Mosquera
Friday, August 27, 2010
For health information exchanges to gain a footing, states will have to make sure physicians can access provider directories. Without these electronic listings of providers and patients across a state or region, vital health records and messages might not get to its proper destination.
To help pave the way, the Health IT Policy Committee this week created a task force to pursue the use of directories across state HIEs to support provider and patient look-up as well as to enhance public health reporting.
The task force, to operate under the Committee’s HIE workgroup, intend to make recommendations in October on best approaches to the issue, said Micky Tripathi, chairman of the HIE workgroup.
August 24, 2010 — 7:50pm ET | By Debra Beaulieu
It's not just patients who turn to Google or other search engines to research medical information. According to Google, 86 percent of doctors say they now regularly use the Internet on the job. Of that group, the majority start at Google, which they use as a springboard to look for general information about diseases and drugs, writes pediatrician Dr. Rahul K. Parikh in a special piece for the Los Angeles Times.
"Having the Internet at my fingertips makes me a better doctor," he writes, "though I'll admit that sometimes it feels a bit like cheating on an exam." He provides the example of looking up "retinitis pigmentosa" on the fly while gathering a patient's medical history to quickly determine that annual vision checks would suffice for the patient.
August 30, 2010 — 12:03pm ET | By Neil Versel
This may be the best characterization we've heard of the current HHS strategy for providers to achieve meaningful use of health IT and thus qualify for federal EMR subsidy payments: "It's a bit like, 'Fire, ready, aim,'" explains Brian Baker, senior VP of Regents Health Resources, a Brentwood, Tenn.-based consulting firm, according to AuntMinnie.com.
Baker, speaking at this month's American Healthcare Radiology Administrators (AHRA) annual conference in Washington, D.C., said that hospitals and physicians need to keep moving forward with EMR implementation plans, even as HHS develops much-needed guidance for meeting the standards for meaningful use. "These meaningful use guidelines are a mixed bag," Baker is quoted as saying. "Their implementation is great news and bad news, all at the same time."
August 30, 2010 — 12:31pm ET | By Neil Versel
As they prepare to meet federal requirements for "meaningful use" of EMRs, hospitals seem to be struggling most with getting CPOE right and with helping physicians embrace EMR technology, according to consulting firm Computer Sciences Corp. For "eligible professionals"--physicians, dentists, podiatrists, optometrists, chiropractors and, for Medicaid purposes, nurse midwives and some physician assistants--the top challenge is capturing data for clinical decision support and outcomes reporting. That's followed by establishing proper workflows to simplify data entry.
In two new papers, CSC, which has been busy churning out reports on health IT and meaningful use, identifies the top 10 challenges in achieving meaningful use for both hospitals and eligible health professionals. CPOE also makes the list for eligible professionals, while data capture is among the top 10 for hospitals.