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Friday, October 29, 2010
The patient-centered medical home concept has been around since 1967, when it was first introduced by the American Academy of Pediatrics. More than 40 years later, widespread implementation has yet to occur, but the health reform law and the "meaningful use" incentives have given the concept new legs.
The patient-centered medical home model aims to improve consumer access to primary care services and increase care coordination. Advocates say such a team-based care model can reduce costs, prevent unnecessary hospitalizations and improve population-based health.
According to Paul Keckley, executive director of the Deloitte Center for Health Solutions, the patient-centered medical home "is an advancement in the design, delivery and payment for health care services that leverages emergent characteristics of a transformed health system -- shared decision-making with patients, multidisciplinary teams where all participate actively in the continuum of care, incentives for adherence to evidence-based practices and cost efficiency, and health information technologies that equip members of the care team and consumers to make appropriate decisions and monitor results."
By Jeff Rowe, Editor
Providers and policymakers working hard to transition the healthcare sector to EHRs might not want to think about this, but at least one longtime observer of HIT is suggesting that EHRs have already had their day and it’s time to move on to something new.
After a brief overview of the development and introduction of electronic health records, he turns the corner and declares, “It’s time to forget and rethink the model.”
It’s not that he thinks EHRs don’t provide significant value; it’s that “new approaches” to healthcare delivery, such as patient-centered medical homes (PCMH) and accountable care organizations (ACOs), “require a different toolset than traditionally has been available to the healthcare market. EHRs, while evidence of technological progress in the industry, were designed to support a provider- and hospital-centric approach to care. As such, they are not fully equipped to catapult the industry towards the collaborative strategy preferred today. ACOs, PMHCs and other approaches will rely upon a platform that facilitates collaboration beyond the enterprise and across the community to achieve multidisciplinary care coordination.”
More than half of U.S. medical offices affiliated with large healthcare groups have implemented electronic health records, ahead of the U.S. average of 39%.
By Nicole Lewis, InformationWeek
Oct. 26, 2010
Medical offices owned by hospitals and health systems saw the biggest jump in electronic health record (EHR) adoption rates between January and October 2010, according to the latest results of an ongoing survey released Monday by SK&A, a provider of healthcare information solutions and research.
The latest findings from the biannual survey, "Physician Office Usage of Electronic Healthcare Records Software," show EHR adoption at hospital-owned offices grew from 44.1% to 54.9%, a 10.8% increase. Adoption at heath-system-owned offices grew from 50.2% to 61.2%, an 11% increase. Overall, U.S. medical office EHR adoption has grown from 36.1% to 38.7%, a 3% increase.
SK&A's report is an ongoing study that tracks EHR adoption data and summarizes market research from 213,500 medical offices representing 643,000 physicians.
Health 2.0 initiatives reduce medical expenses while improving the quality of care, finds Healthcare Performance Management Institute study.
By Nicole Lewis, InformationWeek
Oct. 27, 2010
Social media initiatives that help physicians, patients, and the medical research community share patient information will drive down healthcare-related costs while improving the quality of care, a report concludes.
The report, "Healthcare Performance Management in the Era of 'Twitter,'" was published this week by the Healthcare Performance Management Institute. Drawing on a number of case studies across the country, the report gives examples of how social media and other Health 2.0 initiatives are transforming the healthcare marketplace to promote a cost-efficient interactive healthcare system that provides better patient outcomes.
October 25, 2010 | Molly Merrill, Associate Editor
DENVER – An intensive population management program that matches heart disease patients to personal nurses and clinical pharmacy specialists is able to save lives, reduce hospital visits and drive down costs, according to a new study from Kaiser Permanente Colorado.
Researchers in the study examined healthcare expenditures in two populations of patients with heart disease: a group of 628 people enrolled in the Kaiser Permanente Collaborative Cardiac Care Service (CCS), a population disease management program, and 628 matched patients receiving standard care. The goal of the study was to determine if an intensive disease management program could provide more value than usual care.
28 Oct 2010
Analysts and professional bodies have expressed concern about the government’s ability to bring about an information revolution without additional funding or detail on how the change will be led in a period of NHS reform.
Experts contacted by E-Health Insider for their reaction to the government’s consultation on an NHS information strategy, also queried the lack of focus of the IT required to deliver the records that lie at the heart of many of its proposals.
Jonathan Edwards, Gartner’s research vice president for health, told EHI that without funds and a focus on the practical details of delivery many statements in the document were “little more than fantasy.”
28 Oct 2010
Experts have not been fired with enthusiasm by the government’s ideas for an information revolution. In fact, analysts and professional bodies are asking where the commitment, money and practical details have got to. Sarah Bruce reports.
In opposition, health secretary Andrew Lansley promised NHS staff and patients an “information revolution” to support quality, promote choice and deliver accountability.
July’s white paper, ‘Equity and excellence: Liberating the NHS’, said an information strategy would be published to help to bring the revolution about.
Last week, a 68 page consultation emerged from the Department of Health. Yet analysts and professional bodies are struggling to find anything terribly revolutionary about it.
There is also considerable skepticism about whether its proposals can be carried through. A major cause of concern is that there will be no funding for any of the initiatives proposed.
October 28, 2010 — 10:56am ET | By Neil Versel
The Department of Veterans Affairs won't be trying to replace VistA anymore, but instead will be looking for ways to improve the powerful EMR system via open-source collaboration with the private sector.
"Let's be clear, in my view, VA over the last 10 years has tried to replace VistA. I don't think that's possible. It would be like Microsoft trying to replace Windows with not an evolutionary product, but with something brand new, but it has to come out and it has to be better the day it's introduced," VA CIO Roger Baker says in a in-depth interview with FierceGovernmentIT. "That, basically, was the criteria for what VA was trying to do. That program was called HealtheVet. I have stepped VA away from HealtheVet, and what we're now looking at is how do we continue the evolution of VistA.
In medias res is a narrative device that begins a story by plunging a reader or viewer into the middle or near the story's chronological end.
Think of the opening scene in Sunset Boulevard and the disembodied voice of William Holden explaining why Joe Gillis is taking such a long soak in Norma Desmond's pool.
In medias res is what a policy committee of the federal government is doing just now, seeking public comment on how to govern a proposed network for health information exchange, development of which is already well under way.
A federal proposal to develop what was then called a National Health Information Network dates to 2004 and David Brailer, the first National Coordinator for Health Information Technology at HHS. And work began that year, funded by the Markle and Robert Wood Johnson foundations, on what would become Markle’s "Common Framework," a set of policy and technical guidelines for the NHIN.
At the end of September 2010, eHealth Insider hosted a roundtable on the future of IT in primary care, sponsored by ISOFT.
The debate took place just a few weeks after the launch of the white paper, ‘Equity and excellence: Liberating the NHS’, but before the publication of the information strategy that will support it. So there was much discussion of the many details of future policy that are still unknown.
Despite this, the participants agreed that information for both clinical decision making and commissioning will become ever more important - and that more information will need to be shared with other providers and with patients as well.
They also agreed that online services and telehealth will become more widely used and influential. And that future IT developments will need to be moulded around the needs of clinicians and the patients they serve.
EHRs can sometimes be the difference between life and death
October 27, 2010 (Computerworld)
The digital divide is alive and well when it comes to health care technology.
Although President Barack Obama has made it a priority to have medical facilities deploy electronic health records (EHR) over the next four years, the people most likely to benefit -- those in poor and minority communities -- are unlikely to see them anytime soon.
Physicians' practices and small clinics, where most doctors work, don't have the money to implement the technology, which can cost tens of thousands of dollars.
In an open letter to IT vendors, David Blumenthal, National Coordinator for Health IT, asked that they do what they can to improve health care for low-income and minority communities to prevent health disparities caused by a "digital divide."
EHRs, which can help ensure that medical best practices are followed and aid in tracking illnesses by geographic regions, can mean the difference between life and death.
October 25, 2010 — 12:13pm ET | By Neil Versel
With costs falling and video quality rapidly improving, more healthcare providers are taking a serious look at videoconferencing for telemedicine, helping to standardize the field while also extending the reach of healthcare professionals, according to a report from Frost & Sullivan. However, factors including staff training and lack of third-party reimbursement are holding back wider growth, the London-based research firm says.
"The costs of telemedicine videoconferencing systems and transmission service are not a major barrier to their deployments any more," Frost & Sullivan research analyst Iwona Petruczynik says in a press release. "In the last two years, there has been a significant reduction in prices of equipment and a substantial improvement in endpoint functionality, especially video quality."
ClearPractice's Nimble e-health record product running on the iPad has convinced some nervous doctors that digital charts aren't so bad after all.
By Marianne Kolbasuk McGee, InformationWeek
Oct. 26, 2010
The iPad in healthcare has a lot of potential to be a preferred device for clinical applications, including e-health records. Not only is the device mobile and affordable, its ease of use could be just the thing to hook physicians who are otherwise scared of trading in their paper charts for digital records.
At least that's the thinking of Joel Andersen, president of ClearPractice, a vendor that offers web-based, software-as-a-service e-medical record, e-prescribing and practice management applications for physician practices that have 10 or fewer clinicians.
Last month, the company introduced its newest offering, Nimble, an EMR for the iPad.
By LAURAN NEERGAARD
The Associated Press
Monday, October 25, 2010; 4:02 PM
WASHINGTON -- Think you entered the digital health age when your doctor switched from paper charts to computerized medical records? Think again: An e-chart stored in one doctor's computer too often can't be read by another's across town.
Now the country's largest network for paperless prescribing is poised to help tackle that hurdle. Surescripts is expanding so that doctors around the country can choose to share medical reports, X-rays and other health data over its network much as they send e-prescriptions to drugstores today, regardless of what competing brand of computerized health records they use.
"What doctors would like to do is share comprehensive information with each other - give me the whole file as opposed to writing me a note," says Surescripts executive vice president Cris Ross. "No other industry would stand for that level of clumsy communication."
With 200,000 doctors already using Surescripts for e-prescribing, the move is among the largest of a growing number of efforts to connect electronic medical records - including work to link Veterans Affairs hospitals with private physicians in certain cities, and half a dozen soon-to-start pilot projects in a government-industry partnership.
Last year the Joint Commission, which accredits hospitals, said its new Center for Transforming Healthcare would collaborate with hospitals and health-care systems to help them fix some of the most serious problems in patient care.
The center started with handwashing, the seemingly straightforward hygiene measure that health-care workers often fail to take. Today the Joint Commission gave an update on a project targeting the miscommunication that can happen when a patient is handed off from one caregiver to another. (Other ongoing projects tackle surgical-site infections and wrong-site surgery.)
The Joint Commission said that the ten hospitals and systems that volunteered to collaborate on the issue initially found that hand-offs were defective 37% of the time. That’s important, because those crossed signals are estimated to be associated with 80% of serious medical errors, the commission said.
October 22, 2010 | Bernie Monegain, Editor
VANCOUVER, BRITISH COLUMBIA – Fueled by efforts to reduce acute and long-term care costs, the U.S. patient monitoring market is expected to reach almost $4 billion by 2017, according to a new report by iDataResearch, a global research and consulting firm.
Multi-parameter vital-sign devices represented the majority of the patient monitoring market in 2010, with the home telehealth segment growing more than 17 percent in 2010 and the hospital wireless telemetry monitoring segment growing at high double-digit rates. The second largest segment of this market was pulse oximetry, which is expected to exceed $934 million by 2017.
Posted: October 26, 2010 - 10:45 am ET
The Obama administration is forming a work group focused on online privacy, but the group's work, which could affect the privacy of millions of Americans online, possibly including health information, will be conducted mostly in private.
The Subcommittee on Privacy & Internet Policy will include a representative from HHS as well as other Cabinet-level departments—Justice, Homeland Security, Commerce, Energy, Education, State, Transportation and Treasury. Its membership also will draw from national intelligence and national security agencies under the executive branch, including the National Security Staff Cybersecurity Directorate and the National Security Council, whose members include the defense secretary, the chairman of the Joint Chiefs of Staff, the director of national intelligence and the assistant to the president for national security affairs.
Funding available for swift implementation: Minister
October 26, 2010 (Winnipeg, MB) - More Manitoba physicians will be able to make use of electronic medical records (EMR) to better manage patient information with the support of a new funding program, Health Minister Theresa Oswald announced today.
“Patients will receive faster access to better quality care with more doctors implementing electronic medical records,” said Oswald. “Together with Canada Health Infoway, we are making it easier and more affordable for family doctors to modernize their practices with electronic medical records.”
The electronic medical record is a system used within primary and specialist-care clinics to improve the management of patient information and care. EMRs contain information that is specific to the care a patient receives from a clinician or group of clinicians usually within one clinic or facility, such as diagnostic images like X-rays, prescriptions and medications, patient recalls and reminders and appointment scheduling.
HDM Breaking News, October 25, 2010
A report from the Medical Group Management Association, based on a survey of 1,324 primary care and specialty practice members, finds significant financial benefits to using an electronic health records system.
Englewood, Colo.-based MGMA reports that independent practices had a median of $49,916 more revenue after operating costs per full-time physician in 2009 than paper-based practices. Hospital- or delivery system-owned multi-specialty practices with an EHR had a median operating margin in 2009 of $42,042 more than paper-based practices.
Posted: October 25, 2010 - 12:01 am ET
The American Medical Association has a solution for physicians put off by the quickly evolving and high-stakes marketplace for health information technology.
Specifically, the association has a doorway to other people's solutions and is going to sell tickets for entry.
Over the past several months, the organization has announced partnerships with a handful of technology companies that have signed on as participants in this new online platform, including NextGen Healthcare Information Systems and CareTracker, which offer integrated electronic health-record and practice management applications.
The AMA and other national physician groups generally have steered clear of endorsing any particular product or vendor, choosing instead to be counselors and resource libraries to members attempting to understand a complex and quickly evolving marketplace before investing tens of thousands of dollars and untold hours into a product.
- OCTOBER 25, 2010
Are online services the best way to manage medical records? A look at three of the most popular sites.
One Saturday night, Michael Adamik, a retired engineer, was recording his weight and blood pressure when he discovered a startling gain of nine pounds from the day before. Sudden weight gain for someone who has congestive heart failure, as Mr. Adamik does, could indicate the condition is worsening.
So the Cleveland Clinic, where Mr. Adamik is a patient, asked him to sign up for Microsoft HealthVault, an online personal health record, or PHR. Now the 66-year-old from Brecksville, Ohio, enters his daily numbers directly into the online tool, which the clinic monitors in real time. If Mr. Adamik is in any danger, the clinic contacts him immediately.
"The biggest benefit" of the service, he says, "is that it takes the decision away from a non-medical person."
With people over 50 increasingly focused on ways to monitor and measure their health, PHRs are drawing more attention. In addition to Microsoft Corp.'s product, other well-known PHRs include Google Inc.'s Google Health and WebMD Health Manager from WebMD Health Corp. These tools can store your entire health history, saving you from chasing medical details spread over countless slips of paper from pharmacies, doctors and laboratories.
- Sun Oct 24 2010
A regional version of e-Health is taking shape and giving doctors access to most of a patient’s record from almost any hospital in the Local Health Integration Network (LHIN).
Although out-of-hospital records such as private lab test results and prescriptions are unavailable, Hamilton Health Sciences (HHS) wants people to know an electronic patient information system is closer than most would think.
It is still in a rollout phase, but “we have 3,000 physicians and clinicians (out of 15,000) enrolled and we continue to add hospitals onto the system,” said Mark Farrow, HHS assistant vice-president of information and technologies. The Hamilton Niagara Haldimand Brant LHIN e-health version, spearheaded by HHS, will also tap into the Wellington Waterloo LHIN’s hospitals.
Provincially, Ontario’s e-Health Program will standardize and connect all such versions for province-wide access.
25 Oct 2010
Wrightington, Wigan and Leigh NHS Foundation Trust has completed the sign-off of its contract with Cambio Healthcare Systems for a new hospital information system.
As first reported by E-Health Insider last month, the trust has awarded the Swedish company the ‘multi-year’ contract for a patient administration system, A&E functionality and e-prescribing.
The award followed a comprehensive tendering process that began in January. Speaking to E-Health Insider after finalising the contact, Stephen Dobson, head of IM&T at the trust, said it selected Cambio out of 25 competitors for “numerous reasons.”
By Joseph Conn
Posted: October 22, 2010 - 11:30 am ET
When it comes to privacy, the Obama administration is like a distracted student with a lot on his plate.
Obama's grades, while not terrible, have fallen off somewhat for 2010 as compared with 2009, according to a report card (PDF) released by the Electronic Privacy Information Center, a 16-year-old public interest research organization based in Washington.
EPIC, as the organization is more commonly known (it is not related to Epic Systems Corp., the Verona, Wis.-based health information technology developer), has filed numerous Freedom of Information Act requests to obtain information about the federal government's warrantless wiretapping and Total Information Awareness fiber-optic-network computer surveillance programs.
By Mary Mosquera
Tuesday, October 19, 2010
Federally funded “beacon” communities are tackling the problem of hospital readmissions and other tough health care challenges by testing the effectiveness of multiple treatment strategies simultaneously instead of taking the traditional approach of testing one treatment at a time, according to the program’s director.
The model communities, which have already embraced electronic health records and information exchange, are working to determine which specific treatments best improve patient outcomes for their region’s healthcare goals. They would then share for those results that they can share with other communities.
“No one specific intervention in each community is designed to be the thing that will lead to improved health goals,” said Aaron McKethan, director of ONC’s Beacon program in the Office of the National Coordinator.