Saturday, February 19, 2011

Weekly Overseas Health IT Links - 19 February, 2011.

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.

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Blumenthal Slams EHR Critics

The national coordinator for health IT said a recent study that showed little clinical benefits from electronic health records is flawed.

By Nicole Lewis, InformationWeek

Feb. 7, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229202272

Dr. David Blumenthal, national coordinator for health IT, took a swipe at a recent study published last month in the Archives of Internal Medicine that showed that the use of electronic health records (EHRs) did not significantly improve the quality of patient care, even when they were used with clinical decision support (CDS) systems that help health professionals make clinical decisions to better manage care for patients.

During a question and answer session with reporters at last week's Direct Project health information exchange launch, Blumenthal said that the database used and the timeframe in which the study was conducted were contributors to flawed results. He also said EHR technology has improved since the study was done.

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http://www.nytimes.com/2011/02/06/magazine/06FOB-Medium-t.html?_r=3

The Medium

A Prescription for Fear

By VIRGINIA HEFFERNAN
Published: February 4, 2011

If you’re looking for the name of a new pill to “ask your doctor about,” as the ads say, the Mayo Clinic Health Information site is not the place for you. If you’re shopping for a newly branded disorder that might account for your general feeling of unease, Mayo is not for you either. But if you want workaday, can-do health information in a nonprofit environment, plug your symptoms into Mayo’s Symptom Checker. What you’ll get is: No hysteria. No drug peddling. Good medicine. Good ideas.

This is very, very rare on the medical Web, which is dominated by an enormous and powerful site whose name — oh, what the hay, it’s WebMD — has become a panicky byword among laysurfers for “hypochondria time suck.” In more whistle-blowing quarters, WebMD is synonymous with Big Pharma Shilling. A February 2010 investigation into WebMD’s relationship with drug maker Eli Lilly by Senator Chuck Grassley of Iowa confirmed the suspicions of longtime WebMD users. With the site’s (admitted) connections to pharmaceutical and other companies, WebMD has become permeated with pseudomedicine and subtle misinformation.

Because of the way WebMD frames health information commercially, using the meretricious voice of a pharmaceutical rep, I now recommend that anyone except advertising executives whose job entails monitoring product placement actually block WebMD. It’s not only a waste of time, but it’s also a disorder in and of itself — one that preys on the fear and vulnerability of its users to sell them half-truths and, eventually, pills.

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http://www.healthleadersmedia.com/content/PHY-262449/Security-Challenges-of-EHR-Adoption

Security Challenges of EHR Adoption

Tony Ryzinski, for HealthLeaders Media , February 10, 2011

Providers and healthcare consumers both feel that the electronic health records will produce better healthcare outcomes. There’s still some disagreement, though, about how each party feels about the security of such tools.

The practice of medicine is changing with technology, which calls for an adjustment of its perceptions in the space. Our physician clients tell us daily that EHR tools assist them in providing better care. EHRs alone don’t mean doctors are better doctors, but they do help doctors provide better care. However, the patients of those physicians worry about security of EHRs. That fear is easily countered once they see the technology being used, though.

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http://healthcareitnews.com/news/cloud-computing-myths-vs-risks

Cloud computing myths vs. risks

February 08, 2011 | Molly Merrill, Associate Editor

NAPLES, FL – Cloud computing has become a hot topic among healthcare CIOs, who are divided about its benefits.

Andrew Sroka, president and CEO of Fischer International, says the debate over cloud computing is well-justified given the proliferation of soft data, new patient privacy standards and ever-changing regulation. Sroka shares with Healthcare IT News the most common myths and potential risks associated with deploying IT processes via cloud computing.

Three of the most common myths:

Myth #1: Identity management in the cloud is less secure. Quite the opposite, says Sroka. The cloud is often more secure and, in most cases, offers a more reliable and more scalable facility for healthcare organizations. Most information is encrypted in the cloud, whereas when solutions are deployed on-premise it is not uncommon for sensitive information to remain unencrypted, such as administrative credentials coded into scripts or configuration files, and personally-identifiable information.

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http://healthsystemcio.com/2011/02/09/are-you-ready-for-whole-genomes-in-the-ehr/

Are You Ready for Whole Genomes in the EHR?

Posted by Gerry Higgins on February 9th, 2011

Gerry Higgins, Director, Translational Informatics, Johns Hopkins Medicine

Clinical practitioners can now interactively produce and query a patient report for genetic tests spanning over 2000 inherited diseases from a single whole-genome sequence, using www.genetests.org (www.ncbi.nlm.nih.gov/sites/GeneTests/?db=GeneTests) as a valid guide. GenomeQuest (www.genomequest.com) , a company based near Boston, MA, which serves as the data management provider for most of the U.S. pharmaceutical industry, has a sequence database engine that is purpose-built for storing, managing, and analyzing next generation sequence data at whole- and multi-genome scale.

The company claims that it can span from sequencing and analysis of a patient’s entire genome to clinical diagnostic test results that can be stored in the Electronic Health Record. The entire genome, or whole exome arrays, can be stored and subsequently analyzed as new genome-disease associations are discovered over time.

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http://www.healthdatamanagement.com/news/Feds-to-Query-Docs-on-EHR-Use-Workflows-41907-1.html

Feds to Query Docs on EHR Use, Workflows

HDM Breaking News, February 11, 2011

As part of the annual National Ambulatory Medical Care Survey from the CDC’s National Center for Health Statistics, nearly 5,500 physicians will receive a supplement survey assessing electronic health records adoption and impacts.

The overall survey size also could expand by 1,500 physicians if Congress approves budget increases for the survey. “These increases will greatly improve the ability to track providers’ practice patterns, including their adoption and meaningful use of health information technology,” according to a CDC notice published Feb. 11 in the Federal Register.

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http://www.computerweekly.com/Articles/2011/02/11/245397/Department-of-Health-considers-scrapping-CSC-contract-for-NHS.htm

Department of Health considers scrapping CSC contract for NHS records

Kathleen Hall

Friday 11 February 2011 12:48

The Department of Health (DH) is considering scrapping its £3bn Lorenzo patient records software contract with CSC.

The iSoft Lorenzo Care Records Service was one of the main products within the £12bn National Programme for IT (NPfIT). The implementation was due to be rolled out this week at Pennine Care NHS Foundation Trust, but will now not happen until mid-2011- the latest in a series of missed milestones.

The DH has formally notified CSC that it has breached its contract by missing a key milestone and is considering whether to terminate the contract.

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http://www.ihealthbeat.org/perspectives/2011/transition-to-icd10-holds-host-of-challenges-for-providers.aspx

Friday, February 11, 2011

Transition to ICD-10 Holds Host of Challenges for Providers

Many health care IT executives are fully engaged in the task of implementing electronic health records and tracking the complex details of the meaningful use program so their organizations can qualify for incentive payments.

The implementation of EHRs represents a monumental task, and it's attracting a lot of attention from hospitals' senior executives and board members. Those projects appear to have overshadowed an equally daunting challenge that lies ahead -- transitioning to ICD-10 code sets to meet deadlines established by CMS.

Health care IT and information management organizations are warning that the transition process will be complex and lengthy. The switch to the new codes will affect a variety of departments within hospitals and will require a long lead time to accommodate training of personnel and testing of systems before the Oct. 1, 2013, deadline established by CMS.

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https://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/688

Infoway invests $380 million to help physicians and nurse practitioners implement electronic medical record (EMR) systems

February 9, 2011 (Toronto, ON) - With its newest investment program, Canada Health Infoway (Infoway) is funding Electronic Medical Record (EMR) systems in community-based practices and outpatient settings throughout Canada. Infoway President and CEO, Richard Alvarez, today provided details about the $380 million fund which is designed to focus investment at the points of care where the benefits of health information technology can deliver immediate value to patients and clinicians.

“Connecting health providers to the health information systems being developed across the country is fundamental to Infoway’s mandate,” says Alvarez. “This new wave of investment, in collaboration with the provinces and territories, will help us reach our target to enroll an additional 8,000 to 9,000 physicians and nurse practitioners in EMR programs by March 2012.”

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http://www.modernhealthcare.com/article/20110210/BLOGS02/302109999

Tagging privacy

The quest for a technology-enhanced, patient-centered healthcare system has continually bumped up against the issue of a patient's right to consent to the electronic sharing of his or her medical information.

In December, the President's Council of Advisors on Science and Technology threw a few brickbats at Dr. David Blumenthal and his fellow federal IT policy wonks at the ONC. One of them dealt with privacy and consent.

The PCAST report envisioned a whole new architectural approach for an interoperable health information exchange system—one leveraging Web-based technologies and XML-like meta-data tagging of individual elements in a patient's record.

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http://www.healthcareitnews.com/news/blumenthal-credited-building-solid-base-health-it

Blumenthal credited with building solid base for health IT

February 07, 2011 | Bernie Monegain, Editor

WASHINGTON – Industry leaders say David Blumenthal, MD, the national coordinator for health IT, has built a strong foundation for the transformation of the country’s paper-based healthcare system into a digital one. They give him kudos for his leadership and for his policy and political expertise.

The Office of the National Coordinator confirmed Feb. 3 that Blumenthal would be leaving his post in the spring to return to Harvard. Prior to his role at the ONC, which began in March of 2009, he was a practicing primary care physician and Harvard Medical school professor. He taught medicine and healthcare policy and served as director of Massachusetts General Hospital's Institute for Health Policy.

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http://www.fierceemr.com/story/va-test-new-mobile-ehr-application/2011-02-10

VA to test new mobile EHR application

February 10, 2011 — 3:29pm ET | By Janice Simmons - Contributing Editor

Four new health IT projects, including an electronic medical record that works with mobile devices, have been awarded contracts by the Department of Veterans Affairs in its third and latest Innovation Initiative (VAi2) competition. They represent the first of nearly two-dozen more awards to be made in the coming months, according to an announcement by the VA.

One of the awards was made to Agilex Technologies of Chantilly, Va., to fund a pilot project at the Washington, D.C. VA Medical Center to explore how to extend elements of VA's EMRs to mobile electronic devices.

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http://www.fierceemr.com/story/plans-use-emrs-help-predict-drug-related-adverse-events/2011-02-10

Plans use EMRs to help predict drug-related adverse events

February 10, 2011 — 2:57pm ET | By Janice Simmons - Contributing Editor

A new collaborative effort involving several managed care plans will use electronic medical records to identify genetic markers to help foresee possible risks linked with three serious drug‑related adverse events.

The International Serious Adverse Events Consortium (iSAEC) will use centralized clinical data warehouses of nine members of the HMO Research Network to examine the genetics related to three serious drug-induced conditions: hepatoxicity; serious skin rashes; and extreme weight gain in users of atypical antipsychotic medications.

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http://healthit.hhs.gov/portal/server.pt?open=512&objID=1147&parentname=CommunityPage&parentid=32&mode=2&in_hi_userid=11113&cached=true

Advancing Privacy and Security in Health Information Exchange

The public comment period ran through Sept. 13, 2010, for proposed modifications to the HIPAA Privacy & Security Rules. These modifications will guide the implementation and enforcement of the provisions passed by Congress in the HITECH Act of 2009 that add new protections to the regulations from the original 1996 HIPAA authority. The new regulations will improve patient privacy and security protections by extending the Office for Civil Rights’ enforcement to business associates and covered entities, strengthening individuals' rights to request and receive their medical information in electronic form, and setting new limits on the use and sale of individuals’ information. The Office for Civil Rights enforces the HIPAA Privacy and Security Rules and regulates any modifications to these rules.

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http://www.healthimaging.com/index.php?option=com_articles&view=article&id=26186:kalorama-tomorrows-labs-need-powerful-it-today

Kalorama: Tomorrow's labs need powerful IT today

Written by Editorial Staff

February 7, 2011

Tomorrow's laboratories will utilize advanced diagnostic and information management technologies such as digital pathology and molecular studies, and will require sophisticated, interoperable laboratory information systems/laboratory information management systems (LIS/LIMS) to handle more complex and high-volume data, according to a report from Kalorama Information.

The study, “Laboratory Information Systems (LIS/LIMS) Markets,” estimated that the market for LIS in the clinical laboratory will grow in the 6 percent range annually in the next few years from $800 million in 2010.

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http://www.reuters.com/article/2011/02/08/cerner-idUSSGE7170EB20110208

UPDATE 1-Cerner Q4 profit beats market on strong bookings

Tue Feb 8, 2011 4:22pm EST

* Q4 adj EPS $0.87 vs est $0.84.

* Q4 rev rises 7 pct to $500.2 mln

* Sees Q1 adj EPS $0.73-$0.77 vs est $0.76

Feb 8 (Reuters) - Health information technology company Cerner Corp (CERN.O) posted a better-than-expected quarterly profit, helped by strong bookings.

For the fourth quarter, the company reported a net income of $70.6 million, or 82 cents a share, compared with $60.5 million, or 71 cents a share, a year ago.

Excluding items, it earned 87 cents a share. Revenue rose 7 percent to $500.2 million.

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http://www.healthleadersmedia.com/print/TEC-262301/RFID-100-Accurate-in-Surgical-Sponge-Tracking-Test

RFID 100% Accurate in Surgical Sponge Tracking Test

Cheryl Clark, for HealthLeaders Media , February 8, 2011

Surgical sponges embedded with a radiofrequency chip were identified 100% of the time, an accuracy rate far better than traditional counting or use of radiographs during surgery, according to a study at the Veteran's Affairs Medical Center in Iowa City.

The blinded clinical trial, funded by the VA, entailed the placement of 840 sponges, 619 of which had the RF chip and 221 of which did not, in opaque bags. The bags were attached to 210 participants' at the back of the torso and in each of four abdominal quadrants. Of the 210 participants, 101 were morbidly obese, a risk factor that has much higher rates of retained surgical sponges and other forgotten devices.

After the sponges were attached to the participants' torsos, the participants were asked to lie in a supine position on an exam table while operators blinded to the bags' contents waved a special RF wand, attached to a detection console made by RF Surgical Systems, over the participants.

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http://www.healthleadersmedia.com/print/TEC-262318/What-ONC-Needs-Now-Another-Doc-Who-Listens

What ONC Needs Now: Another Doc Who Listens

Gienna Shaw, for HealthLeaders Media , February 8, 2011

Shortly after David Blumenthal, MD, announced he would resign his post as national coordinator for health IT (a move that was planned when he was appointed two years ago) healthcare leaders began talking about what made him such an effective champion of electronic health systems and health information exchanges.

Two clear themes emerged. First, although has helped to set tough standards for healthcare organizations to achieve meaningful use of electronic health systems, he has also spent a lot of time listening to healthcare leaders, weaving their suggestions into those policies. And that MD after his name? That’s part of what makes him effective, too.

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http://www.modernhealthcare.com/article/20110208/NEWS/110209972/

ONC seeks one to accredit the certifiers

By Joseph Conn

Posted: February 8, 2011 - 12:30 pm ET

Applications are now being accepted for businesses and organizations seeking to become the sole authorized accreditor of health IT certification bodies.

The 30-day application window for organizations to submit written requests to be the Office of the National Coordinator for Health Information Technology's authorized accreditor starts Tuesday with publication of an official notice in the Federal Register.

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http://www.fiercehealthit.com/story/blumenthals-departure-will-not-derail-federal-health-it/2011-02-07

Blumenthal's departure will not derail federal health IT

February 7, 2011 — 11:10am ET | By Ken Terry - Contributing Editor

Dr. David Blumenthal, who announced late last week that he's leaving his post as National Coordinator for Health IT in the spring, is proud of his accomplishments--as evidenced by his departing memo to staff members--and continues to be the chief defender of the health information technology faith.

Both of those facets were on display at the recent press conference announcing the Direct Project, a secure messaging protocol designed to help healthcare providers exchange clinical data. At the end of Blumenthal's remarks, he unexpectedly rattled off a series of milestones that the Office of the National Coordinator of Health IT (ONC) has achieved: 14,000 providers registered for meaningful use incentives in the first month of eligibility; 40,000 physicians enrolled in the regional extension centers that are helping small practices choose and implement EHRs; thousands of new health IT technicians graduating from federally sponsored community college programs; and the dispensing of grants to state health information exchanges and "Beacon Communities" in the vanguard of health IT.

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http://www.fiercehealthit.com/story/orion-health-language-inc-partner-new-hie-approach/2011-02-07

Orion, Health Language Inc. partner in new HIE approach

February 7, 2011 — 10:08am ET | By Ken Terry - Contributing Editor

Orion Health, a developer of health information exchanges, and Health Language Inc., which specializes in mapping the myriad medical terms for the same concepts to a single terminology, have joined forces after working together on Maine's statewide HIE. This is an approach we might see more of.

Health information exchanges have so far used a central repository model, a federated, peer-to-peer approach, or some combination of the two to locate data. That's fine for viewing information, but when it comes to pushing data from one information system to another, we're still largely stuck with care summaries--such as the CCD, or HL7 messages--that don't completely convey the content of data.

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http://news.cnet.com/8301-10805_3-20030415-75.html

February 2, 2011 11:38 AM PST

Microsoft's HealthVault gets encrypted e-mailing

by Josh Lowensohn

Microsoft is trying to tighten up security on medical information that is sent by e-mail, while at the same time making it easier to share.

At a U.S. Department of Heath and Human Services event earlier today in Washington, D.C., the company unveiled an updated version of its HealthVault medical records system that can send encrypted copies of a patient's medical records via e-mail.

Microsoft says the new feature should make it easier for health care records and other information updates to be sent to its system, while at the same time meeting security protocols mandated by the Office of the National Coordinator's Direct Project. The first health care technology companies to use it will be MedPlus and VisionShare.

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http://voices.washingtonpost.com/checkup/2011/02/fda_oks_iphones_ipads_for_radi.html

FDA approves iPhone, iPad app for docs

By Rob Stein

The Food and Drug Administration announced Friday it had approved the first app that doctors can use to view medical images and make diagnoses using an iPhone or iPad.

The app enables doctors to view images produced by diagnostic tests such as CT (computed tomography) scans, MRIs (magnetic resonance imaging) and PET (positron emission tomography) scans.

The app "is not intended to replace full workstations and is indicated for use only when there is no access to a workstation," the FDA said.

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http://www.modernhealthcare.com/article/20110207/NEWS/302079987

ONC to track nationwide EHR, info-exchange use

By Joseph Conn

Posted: February 7, 2011 - 12:00 pm ET

The Office of the National Coordinator for Health Information Technology at HHS has awarded two contracts totaling more than $3.9 million to monitor the nationwide use of health information exchanges and adoption of electronic health-record systems.

Surescripts, an Arlington, Va.-based vendor of electronic prescribing services and, more recently, an information exchange portal and an ONC-authorized health IT testing and certification body, was awarded a contract valued at more than $1.4 million.

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http://www.modernhealthcare.com/article/20110207/BLOGS02/302079999

Indirect descriptions

Joseph Conn’s Blog

Federal officials were searching for metaphors to describe what the Direct Project is and does.

There were mentions of on-ramps and off-ramps. But Dr. David Blumenthal, head of the Office of the National Coordinator for Health Information Technology at HHS—at least for a little while longer—spoke at a news conference last week about the relationship of the Direct Project to a broader federal program to create a nationwide, interoperable, private and secure health information system.

"If that system is a bridge over a river, then what we are announcing today is a huge pillar for that bridge," Blumenthal said during the conference. "It's going to be one of the elementary methods of achieving interoperability and letting information travel."

I had a chance after the event to catch up by phone with Dr. Albert Puerini to get a few more details about the pilot project he had worked on using Direct Project technology. Puerini talked about it at the news conference.

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http://www.ihealthbeat.org/features/2011/could-health-it-progress-stall-given-recent-events.aspx

Monday, February 07, 2011

Could Health IT Progress Stall Given Recent Events?

It's been a busy time in the health IT sphere. On Thursday, National Coordinator for Health IT David Blumenthal announced that he plans to step down from his post as the country's health IT chief in April.

The news of Blumenthal's departure came just 10 days after Rep. Jim Jordan (R-Ohio) introduced a bill (HR 408) aimed at cutting $2.5 trillion in federal spending over 10 years partly by eliminating funding for the meaningful use incentive program. Under the meaningful use incentive program, included in the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of electronic health records can qualify for Medicare and Medicaid incentive payments. While Jordan's bill appears to have little chance of passing, it has raised concerns among health care providers who were preparing to move forward with their health IT adoption plans.

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Enjoy!

David.

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