Saturday, December 04, 2010

Weekly Overseas Health IT Links - 03 December, 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.


Health Execs Laud EHRs For Boosting Care

Government Accountability Office report finds that e-health records support disease management by improving data sharing and communication.

By Nicole Lewis, InformationWeek

Nov. 23, 2010


Integrated healthcare delivery organizations say electronic health records (EHRs) support their patient care strategies by increasing the availability of individual patient and patient population data and by improving communication among providers.

These findings are from a U.S. Government Accountability Office (GAO) report, Health Care Delivery: Features of Integrated Systems Support Patient Care Strategies and Access to Care, but Systems Face Challenges.

The GAO examined 15 private and public integrated delivery systems (IDSs) that are clinically aligned across primary, specialty, and acute care. These healthcare organizations vary in their degree of integration, specific organizational features, and payer mix (such as the extent to which they serve Medicare and Medicaid beneficiaries and the uninsured).


NCVHS Advises on Sensitive Data

HDM Breaking News, November 23, 2010

An advisory body to the Department of Health and Human Services has made a series of recommendations on restricting the sharing of sensitive information in electronic health records.

In a report to HHS, the National Committee on Vital and Health Statistics offers initial definitions of categories of sensitive information. These include genetic, mental health, substance abuse, and sexuality or reproductive health information, as well as treatments paid for out-of-pocket and the rights of adolescent minors under some state laws to segregate certain information.


Text of the 14-page letter, "Recommendations Regarding Sensitive Health Information," is available at


InfoCom says e-health in Europe already a multi-billion market

E-health to grow significantly in the coming years — Available e-health solutions are tele-monitoring or services for disabled people — Mobile network operators offer most of available services.

PRLog (Press Release)Nov 24, 2010 – Stuttgart, Germany — According to a recent research carried out by InfoCom, in Western Europe, although the number of offers addressing different needs is growing steadily, most of available e-health solutions are services for tele-monitoring — for instance remotely monitoring vital signs of patients — or, alternatively, services addressing disabled people. Already a multi-billion market, e-health is expected to grow significantly in the coming years.

E-health in general consists of various telecommunication and IT solutions for the healthcare sector connecting medical informatics, health services and the delivery of information through the Internet and other related technologies. Most of e-health solutions are services supporting physicians and hospital staff, analysis services via mobile phones, emergency and locating services, healthcare hotlines and information services, multimedia solutions, offers for disabled people, reminder services and tele-monitoring.


Healthcare IT isn't living up to the hype

Computerization is slowly improving the healthcare system, but it's a long way from living up to expectations.

Mary K. Pratt

November 22, 2010 (Computerworld)

It's been 19 years since the prestigious Institute of Medicine urged greater adoption of computer systems in healthcare, and more than six years since then-President George W. Bush declared, "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs and improve care."

So, how are we doing so far?

There are positive signs at places like Methodist Dallas Medical Center, which has a nearly foolproof way to make sure the right drug gets to the right patient in the right dose at the right time: It uses bar-code technology to clear all medications through a computerized program.

Pamela McNutt, CIO at Dallas-based Methodist Health System, says the technology means the hospital can avoid drug errors, which are responsible for an estimated 100,000 deaths nationwide each year.

That success encouraged McNutt to push forward with other IT initiatives. "The reason we continue getting everything into an electronic format is so we can analyze our data, look at what's going on for efficiency reasons and monitor quality as it's happening," she says. "And the only way you can do that is through the use of structured data."


Parties mull options after Rx privacy law struck

By Joseph Conn

Posted: November 24, 2010 - 9:00 am ET

In a split decision, a federal appeals court in New York has overturned a Vermont law seeking to restrict the use of prescription drug data in the marketing of pharmaceuticals to physicians.

The ruling by a majority of the three-judge panel in the 2nd U.S. Circuit Court of Appeals came in favor of the appellants—IMS Health; Verispan; Source Healthcare Analytics, a subsidiary of Wolters Kluwer Health; and the Pharmaceutical Research and Manufacturers of America—and found that the 2007 Vermont law constituted "an impermissible restriction of commercial speech."



Reaching the remote: Telemedicine gains ground

Services that provide specialists to patients in underserved areas are likely to expand as demands on the health care system increase.

By Carolyne Krupa, amednews staff. Posted Nov. 22, 2010.

Every Wednesday afternoon, Thomas Magnuson, MD, goes to a designated room at the University of Nebraska Medical Center to meet with patients in nursing homes around the state via an interactive video screen.

Many of his patients have Alzheimer's disease or other forms of dementia. Using teleconferencing technology, he is able to see and talk with patients, nursing home staff and family members.

The technology allows him to treat people who are hundreds of miles away and don't have easy access to a specialist. Through telemedicine, it's as though they are in his office.

"I live in a state that has not a lot of people, but a lot of area," said Dr. Magnuson, a psychiatrist specializing in geriatrics and an assistant professor at the medical center. "We have a lot of isolated places. We just had a big patient population out there that wasn't being seen."

Nationwide, telemedicine increasingly is being used to bridge gaps in access to care in rural and other medically underserved communities that have a hard time recruiting physicians. The technology provides primary care physicians and patients a vital link to specialists at large urban medical centers.


Private doctors key to e-health uptake in Hong Kong

To realise its vision for a complete, territory-wide electronic patient records repository within five years, the Hong Kong Hospital Authority needs buy-in from the 70 per cent of private doctors who are yet to embrace ePR.

All patient records should be available electronically to every doctor in Hong Kong through a dedicated e-health portal within three years, and to all patients by 2015, noted Dr C. P. Wong, Co-Chairman, Clinical Informatics Programme Steering Committee, Hong Kong Hospital Authority.

But although 100 per cent of doctors in the territory’s 44 public hospitals are using the ePR system, only 30 per cent of Hong Kong’s 4000 private doctors are doing so too, he pointed out.


Last Updated: November 23. 2010 1:00AM

Smartphone apps point toward closest ER

Melissa Burden / The Detroit News

A growing number of hospitals are looking to lend patients a helping hand — by smartphone — when health emergencies arise.

Henry Ford Health System and the Detroit Medical Center have introduced free smartphone applications to help guide patients to the nearest emergency room or urgent care.

Several Metro Detroit hospitals have mobile apps in the works, part of a nationwide trend among hospitals and insurance companies.

Health systems are tapping the growing popularity of apps not only to better serve patients, but also doctors and emergency workers. One local hospital is developing an app that will inform ambulance crews if an emergency room is closed.


Connect software gateway loses top two managers

By Mary Mosquera
Friday, November 19, 2010

The top two managers of the Connect exchange gateway are leaving the pioneering federal health information exchange (HIE) program as it sets new directions to advance the adoption of health information exchange for meaningful use.

Dave Riley, an independent consultant who is the Connect program’s lead technical manager, and Vanessa Manchester, an independent consultant who is Connect’s program manager, will be leaving by the beginning of December, according to a federal agency advisor. Both have helped shepherd the Connect exchange development community since 2007.


Where To Focus: Health Exchanges Or The Individual Market?

Rajiv Sabharwal
Health Data Management Blogs, November 19, 2010

Isn’t that the million-dollar question? Not a single day goes by that I don’t hear or read opinions about the strategies to implement state-based health benefit exchanges, various architectures that will be required and, for that matter, the probability that HBEs will come into existence at all. And don’t get me started on the volumes of patients expected to use HBEs. I’ve heard numbers ranging from 20 million to 150 million by 2016, and all those widely disparate estimates were supported by sound research and logic.

These are early days for health care reform in general and HBEs in particular. A lot of very good ideas are floating around, some of which will succeed and some that will fall by the wayside. There’s too much political uncertainty even for truly great ideas to have a 100 percent probability of success. So what is an organization to do? Can a commercial plan start strategizing their business around state-driven exchanges? Can a vendor start planning for a common platform that could be used by most, if not all, states to deliver the exchange services? Can a small employer expect to ally with similar-sized employers to enhance its leverage with large plans?

In my book, the answer is “not at this time” to all those questions. With so much uncertainty and so many variables to factor in, the smallest mistake could lead to disastrous consequences. But does that mean one should risk being left behind if everything that is being touted (errr, planned) comes to fruition? My response is “definitely not.”


VA bares all

By Joseph Conn

Posted: November 22, 2010 - 11:15 am ET

The Veterans Affairs Department launched a program of clinical performance transparency, exposing its own internal clinical quality dashboard to public view.

The public exposure of the two Web-based dashboards, the Linking Knowledge & Systems, or LinKS, which has been in internal use at the VA for about two years, and the recently developed Aspire system, are part of a pledge made by VA Secretary Eric Shinseki when he took office in 2009 to make the VA “as transparent as possible,” said Robert Petzel, the VA's undersecretary for health.


ACO Management Depends on IT

Tom Enders, Jordan Battani and Walt Zywiak, for HealthLeaders Media , November 19, 2010

There will be wide variability in the types of accountable care organizations that are established in the near future. Some will be tightly organized around existing integrated delivery networks. Others will be based on independent physician associations without an integrated hospital. Still, others will be formed as a collaborative multi-stakeholder initiative, perhaps building from a sustainable health information exchange. There will be distinct payer relationships.

Some ACOs will be Medicare-specific, others focused on Medicaid managed care and others multi-payer. As the health benefit exchanges become established there will be an additional stimulus to the development of ACOs—some with integrated insurance functions, others operating in partnership with managed care plans.

No matter what the particular ACO form, six key success factors will be critical for successfully delivering on the potential of accountable care. As the ACO becomes more mature, the breadth of information technology necessary also will increase so as to provide the connectivity and the decision support needed to manage the continuum of care.


Consumer e-health portal rolls out

Last Updated: Monday, November 22, 2010 | 8:06 PM ET

CBC News

Canadians will be able to create, store and manage their health information on a new, secure portal for consumers, a technology company says.

Telus health space will provide patients and their families with access to their health information in an encrypted online environment, the company and a Toronto hospital said Monday.

The idea is to use Telus health space and its e-health record system, called My Chart, to securely move health information from home, the clinic, hospital or elsewhere to the consumer's fingertips.


IT Speeds Bone Marrow Transplants To Save Lives

Business process management and analytics tools are expected to double number of transplants and halve wait time.

By Marianne Kolbasuk McGee, InformationWeek

Nov. 18, 2010


When people talk about health IT, it’s often in the context of how technology can improve patient care by preventing mistakes -- like alerting a doctor to a patient’s allergies or a drug interaction before a prescription gets ordered. But a project that’s underway by the National Marrow Donor Program reminds us that IT can do more than stop medical blunders. It can also facilitate life-saving cures.

The NMDP, which operates the national “Be The Match Registry,” organizes about 5,000 U.S. transplants a year, matching donors with patients who need transplants of bone marrow or umbilical cord blood to treat leukemia, genetic disorders and other life-threatening diseases.


VA reports on social media, software development

Updates presented on major areas

The Veterans Affairs Department has released its Fiscal 2010 Performance and Accountability Report that outlines progress on programs that include social media outreach, modernizing digital medical records and adopting an agile development model for new software.

The document was published on the VA’s website Nov. 15. It includes management objectives, performance goals and benchmarks and financial statement sections as well as background information on the department.


Don't go further than HIPAA: FAH exec

By Joseph Conn

Posted: November 22, 2010 - 11:30 am ET

There was pushback on privacy and patient consent at Friday's Health IT Policy Committee meeting—specifically on the work still under way by the committee's privacy and security work group, or tiger team.

"The federation has concerns with some of the discussions that are taking place in the tiger team that may be outside of the scope of HIPAA," Samantha Burch, director healthcare policy and research for the Federation of American Hospitals, said during the public-comment portion of the meeting.


Is HIPAA enough?

The federally chartered Health IT Policy Committee met Friday, and a recording of the entire meeting is posted on HHS' website, so even if you missed the meeting, just click and you'll have it.

Samantha Burch, director of healthcare policy and research at the Federation of American Hospitals, spoke during the public comment period at the tail end of the meeting about the work of the committee's privacy and security tiger team. The tiger team is hustling to get its recommendations to the full Health IT Policy Committee, which is to advise the Office of the National Coordinator for Health Information Technology.


Policy Committee Balks at NHIN Proposal

Posted by Anthony Guerra on November 19th, 2010

Proposal Sent Back for Further Review

Despite eagerness to have formal recommendations in place, the full HIT Policy Committee this week balked at a proposal for the National Health Information Network’s governance structure and instead asked workgroup chair John Lumpkin, M.D, to flesh out some thorny details before it could formally vote on the issue.

Those thorny details revolved around a portion of the program which called for the creation of a non-government organization (NGO) that would disseminate best practices and resolve problems faster than a formal government body could.


Online physician diagnoses come under scrutiny

November 22, 2010 — 11:38am ET | By Neil Versel

MDLiveCare, RingADoc and other companies that offer diagnostic and treatment services online or over the phone are drawing scrutiny from state regulators about the definition of a doctor/patient relationship, USA Today reports. Critics of such services wonder if conducting medical assessments of patients seen by webcam--or not at all--might miss signs of more serious conditions than the patient claims to have. The newspaper says a Colorado physician prescribed an antidepressant to a 19-year-old California student through an online pharmacy.


Canadian hospital tests Flash-based web PACS viewer

November 22, 2010 — 12:26pm ET | By Neil Versel

The cost of viewing PACS images is about to come down--way down.

Canadian software firm Client Outlook is testing its eUnity Flash-based viewing program at Sunnybrook Health Sciences Centre in Toronto, allowing clinicians to view diagnostic images in a web browser anywhere inside or outside the hospital rather than forcing them to go to a $20,000 PACS workstation.

"Not only is it something we don't have to install software [for] anywhere, but it's delivering those high-resolution images at an almost real-time speed--and that's not an easy thing, technically, to do," Sunnybrook PACS Administrator Andrew Volkening told the Canadian Press, reports Canadian Healthcare Technology.


AHRQ survey: Practices continue to struggle with HIE

November 22, 2010 — 2:29pm ET | By Neil Versel

If the early results of an Agency for Healthcare Research and Quality survey are a reliable indicator, physician practices are continuing to struggle with health information exchange.

In the just-released preliminary results of the 2010 AHRQ Medical Office Survey on Patient Safety Culture, practices reported problems with the accuracy, completeness or timeliness of patient data at least half the times they've exchanged electronically with other healthcare entities in the past year. Specifically, the 470 medical offices surveyed said they had HIE problems 55 percent of the time with outside laboratories or imaging centers, 50 percent of the time in transactions with other medical offices, 52 percent of the time with pharmacies and in 58 percent of exchanges with hospitals, CMIO reports.


Monday, November 22, 2010

'Meaningful Use' Now More Difficult: Five Ways To Stay on Track

by Protima Advani

CMS and the Office of the National Coordinator of Health IT recently provided a critical clarification on "meaningful use" for hospitals and eligible professionals (EPs) that will make demonstrating the criteria more difficult. Their guidance states that hospitals and EPs must implement all the meaningful use functionalities of the certified electronic health record. While hospitals and EPs are afforded flexibility in determining which of the five out of 10 menu set requirements they will report on for the purposes of demonstrating meaningful use, they are not afforded this same flexibility as it relates to implementation of the certified EHR.


Microsoft drops US HealthVault profit plans

By Andrew Jack in London

Published: November 21 2010 16:57 | Last updated: November 21 2010 16:57

Microsoft has abandoned efforts to make profits in the US out of its “HealthVault” cloud computing system designed to store personal medical data, because of the complexity of the country’s health system.

Peter Neupert, corporate vice-president for health, told the Financial Times the benefits to Microsoft in the US of HealthVault was simply to “increase the brand relationship” by raising its image with customers as “important, critical and trusted”.




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