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March 22, 2011 | Bernie Monegain, Editor
INDIANAPOLIS – Electronic medical records improve the quality of care in developing countries, according to a new study conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University in Eldoret, Kenya.
The study is one of the first to explore and demonstrate the impact of electronic record systems on quality of medical care in a developing country.
In a paper published in the March 2011 issue of the Journal of the American Medical Informatics Association, Martin Chieng Were, MD, assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute investigator, and his colleagues report that computer-generated reminders about overdue tests yielded nearly a 50 percent increase in the appropriate ordering of CD4 blood tests. CD4 counts are critical to monitoring the health of patients with HIV. The tests help guide treatment decisions.
March 22, 2011 — 6:35pm ET | By Janice Simmons
A new comparative study in Sub‑Saharan Africa using computer‑generated clinical reminders--within electronic medical records (EMRs)--found significantly improved clinician adherence to blood testing guidelines used for monitoring patients with HIV.
The study, conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University in Kenya, is one of the first ever to examine and demonstrate the impact of EMRs on quality of medical care in a developing country. The comparative study used clinical summaries with computer‑generated reminders.
Telemedicine and collaborative tools are also high on health IT professionals' project lists, reports Avaya survey.
By Nicole Lewis, InformationWeek
March 21, 2011
During the next three years, 95% of healthcare IT professionals believe that communication and workflow integration into healthcare information systems will be a very important issue to address as healthcare delivery organizations prepare to meet meaningful use and accountable care requirements.
The findings come from a survey conducted by Avaya, which interviewed 130 healthcare IT professionals in February at the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, Fla.
The survey results, which were released March 14, also showed that 74% of respondents listed automated patient follow-up applications, and 64% rated voice, video, and text collaborative tools as important technologies that will impact their work during the next three years.
Published: Saturday, 19 Mar 2011 | 9:37 AM ET
PROVIDENCE, R.I. - Some Rhode Island lawmakers are looking to outlaw illegible writing by physicians.
Doctors and other medical professionals who continue to handwrite notes and records would face a fine under legislation sponsored by five state senators. Instead, physicians would have to type all their notes, records and files.
March 22, 2011 | Molly Merrill, Associate Editor
NEW YORK – More effective use of information technology after a major disaster could significantly improve patient outcomes, according to a study by researchers at Weill Cornell Medical College and the University of California, Davis.
A control tower-style telemedicine hub that can manage electronic traffic between first responders and remote medical experts could boost the likelihood that critically-injured victims will get timely care and survive, according to the research team's computer simulation model.
"Since its introduction in the 1970s, telemedicine – the electronic linkage of healthcare providers and recipients – has held promise for improved disaster response outcomes," said the study's senior author, Nathaniel Hupert, associate professor of public health and medicine at Weill Cornell Medical College and co-director of the Cornell Institute for Disease and Disaster Preparedness. "As information technology becomes pervasive, we want to ensure that systems are in place to fully realize its potential for helping patients – particularly for emergency response."
Posted: March 23, 2011 - 12:15 pm ET
The Institute of Medicine has issued eight recommended standards to develop trustworthy clinical practice guidelines and 21 recommended standards for systematic review of the comparative effectiveness of medical or surgical interventions. The IOM also said it encourages HHS' Agency for Healthcare Research and Quality to pilot-test the standards and assess their reliability and validity. “If guideline users had a mechanism to immediately identify high quality, trustworthy clinical practice guidelines, their health-related decisionmaking would be improved—potentially improving both healthcare quality and health outcomes,” the IOM wrote in a description of its report Clinical Practice Guidelines We Can Trust, which outlines eight standards that address issues including transparency, conflict of interest and external reviews.
Thursday, March 24, 2011
Last week, Sen. Sheldon Whitehouse (D-R.I.) introduced the Behavioral Health Information Technology Act of 2011 (S 539) to expand eligibility for meaningful use incentive payments to include behavioral health, mental health and substance misuse treatment professionals and facilities.
Under the 2009 federal economic stimulus package, hospitals and eligible professionals who demonstrate meaningful use of electronic health records can qualify for Medicare and Medicaid incentive payments. Under the current law, most mental health providers and facilities are excluded from the health IT incentive payments.
Healthcare providers have an almost singular focus on putting electronic records in place this year and are highly optimistic about getting it done.
By Marianne Kolbasuk McGee, InformationWeek
March 19, 2011
Healthcare providers are doing whatever it takes to deploy electronic health record systems and all the related technology they'll need to qualify for a share of the $27 billion in U.S. federal stimulus funds set aside to encourage investment in health IT. Their top priorities this year all relate in some way to the government's financial incentive program, including meeting regulatory requirements, managing digital patient data, improving care, reducing costs, and increasing efficiencies.
It's not surprising that providers are focused on grabbing those subsidies. But it is surprising how confident they are that they'll be able to handle the task ahead.
Nearly six in 10 healthcare organizations still need to buy an EHR system or upgrade an existing one to qualify for the federal funds, according the InformationWeek Analytics' Healthcare IT Priorities Survey of 357 business tech- nology professionals at healthcare providers. And 62% of respondents who have EHRs or are planning them say they'll spend more than 20% of their annual IT budget on EHR projects this year. In other words, there's still a lot of heavy lifting for U.S. hospitals and doctors' practices to deploy systems that comply with federal guidelines.
HDM Breaking News, March 24, 2011
Drug store chain Walgreens has signed a definitive agreement to acquire drugstore.com Inc. for $409 million, gaining access to more than 3 million online customers and adding about 60,000 new products along with new vendor partners to Walgreens' online product portfolio.
March 24, 2011 — 9:26am ET | By Janice Simmons
Montana is known for many things--its Big Sky beauty, its national parks, and its rough and tumble history. But this month it is standing out over what has become a battleground over the funding of electronic health records (EHRs).
On March 14, the GOP-led state legislature passed House Bill 2, which denied the state's Department of Public Health and Human Services the authority to accept $35 million in federal meaningful use incentive payments for hospitals to adopt EHRs.
While many state governors and legislators are faced with considering belt-tightening strategies in a weakened economy, this has become a polarizing issue between the Montana legislative and executive branches. And, it has become a challenging issue for healthcare providers and patients as well who are being inserted into the middle of this debate.
March 24, 2011 — 4:10pm ET
With the advent of EMRs and the government's stimulus benefits, doctors are slowly but surely incorporating them into their practices. The government has increased the benefit this year to encourage more physicians to jump on the bandwagon. Currently only 30 percent of primary-care physicians and 20 percent of hospitals have installed some form of electronic medical records.
By Jeff Rowe, Editor
Policymakers are currently discussing how much of last year’s report from the President’s Council of Advisors on Science and Technology (PCAST) can be incorporated into Stage 2 MU requirements.
But while the consensus seems to be that the PCAST report has several recommendations worth heeding, policymakers are pointing to the overall MU schedule as the reason why most of the recommendations will have to wait.
According to this report, ONC “could include in the requirements for the next stage of meaningful use some functions that would build toward the comprehensive information exchange system that (PCAST) recommended last year.
March 25th, 2011
by Mark Frisse
Editor’s Note” As David Blumenthal prepares to step down as the National Coordinator for Health Information Technology, where does the United States stand in the continuing effort to promote widespread adoption of electronic health records? What are the challenges that the next health IT coordinator will face? Health Affairs Blog asked two leading experts to address these questions: Mark Frisse does so below, and Carol Diamond provides her analysis in another post.
You can find more on the adoption and impact of electronic health records in the current issue of Health Affairs, which contains articles by Melinda Buntin, Brian Bruen, and Neil Fleming (and colleagues in each case). These articles were discussed at the release event for the issue, which you can listen to on the Health Affairs website.
Dr. David Blumenthal’s tenure at the Office for the National Coordinator for Health Information Technology (ONC) is without precedent. Never in American history has the public experienced such an aggressive and deliberate effort to introduce health information technology (HIT) into clinical settings with such a deliberate goal of producing a safer, more efficient, more reliable, and more effective health care delivery system. Following the script of the HITECH Act of 2009, Blumenthal’s ONC implemented: consensus-building processes to develop financial incentives for EHR adoption (Meaningful Use); more flexible EHR certification methods; regional extension centers to support EHR adoption; HIT workforce training and education programs; state-level health information exchange programs; simpler and more widely accepted communication standards; new health information technology research grants; and many other initiatives fostering widespread HIT adoption. Through ONC, HITECH has evolved from a stage of words and ideas to a time of action. Appropriated funds have been spent. A massive machine has been set in motion. And all has taken place over only two years.
The EHR and the dare; What should be done when patients can access their raw test results electronically before their doctor has seen them?
MARCH 24, 2011
The issue of patient anxiety about what they find when they access their personal medical information has come up in a number of interviews I’ve conducted over the past few years. In all instances, the answers from experts have been fuzzy, but the general view is clear enough: “Don’t worry, we’ll find the right way to control access to electronic health records (EHRs), and we won’t be facing an anxiety-ridden population stressing over incomprehensible medical data.”
The reason? It will first be filtered. It will be well-explained. The medical community will stand in front of the results as benevolent explicators, and individuals will not suffer the distress of being exposed to raw, unfiltered data.
It’s as if the tortoise is convinced it can simply tell the hare to slow down.
By Mary Mosquera
Monday, March 21, 2011
The Health & Human Services Department has released the National Strategy for Quality Improvement in Health Care to promote quality health care focused on the needs of patients. At the same time, it wants to make the health care system work better for physicians and other healthcare providers, through such things as reducing their administrative burdens and helping them collaborate more to improve care.
The HHS strategy includes calls for the increased adoption of electronic health records (EHR), which are a foundation for many of the projects that will realize HHS goals.
The national quality strategy was required under the health reform law, the Affordable Care Act, and is the first effort to create national aims and priorities to guide local, state, and national efforts to improve healthcare quality.
24 March 2011 Sarah Bruce
Patients at the University Hospitals Birmingham NHS Foundation Trust are being given access to their own online medical records.
Twelve liver patients at the Queen Elizabeth Hospital Birmingham will begin trialling the myhealth@qebh system next week.
It will enable them to view documents about their care, such as details of past and future appointments, medications, diagnosis and test results online.
James Ferguson, consultant hepatalogist at the trust who pioneered the idea, told eHealth Insider: “A lot of patients come a long distance and have a number of clinicians looking after them.
Health Data Management Blogs, March 18, 2011
Often, while talking to industry experts for a certain topic, I uncover an entirely new story. And lately, that emerging story is one of fatigue. For recent articles, I’ve reported on 5010, ICD-10 and meaningful use. Conversations that drill down into these topics increasingly begin with the phrase, “We have a lot on our plate.”
Simply put, providers are starting to reel under the weight of these multiple—and concurrent—federal mandates and programs. There are more than these three—there’s also the looming specter of health reform, with its accountable care organizations, adoption of more uniform HIPAA transactions and potential expansion of the insured Medicaid pool. There are looming payment audits under Medicare, whose RAC program is an after-the-fact effort to reclaim inappropriately paid claims, and commercial carriers likely will launch similar audits. As federal officials ramp up privacy and security enforcement, providers will have to enhance their protection of health information. To top it all off, there are some serious labor shortages among the key personnel needed to cope with these programs.
Posted: March 22, 2011 - 12:00 pm ET
The rate of medication errors dropped 87.7% in an 88-bed psychiatric unit at Johns Hopkins Hospital in Baltimore after computerized provider order-entry and error-reporting systems were implemented, according to a report in the March issue of the Journal of Psychiatric Practice.
Researchers randomly selected 42 medical charts from 2003 and 40 each from 2005 and 2007, and collected data on the number and types of medication errors reported. Medication administration records were also examined to detect nonreported errors.
Webcam doctor visits called convenient and save time and money
- Lucas Mearian (Computerworld (US))
- 22 March, 2011 08:19
Results of a five-year study on telemedicine showed that patients can be treated virtually by physicians as effectively as if the patients made physical visits to the doctor's office. In another finding, the remote treatment also improved doctor-patient communications.
The study highlighted the efforts of Hospital Clinic of Barcelona to treat 200 HIV-infected patients remotely through its "Hospital VIHrtual" telemedicine program. The program used virtual consultations through videoconferencing and delivery of medications to a patient's home. The telemedicine program does not replace the traditional face-to-face visits between doctor and patient but complements and enhances them, the hospital said. The study results were published in the peer-reviewed journal PLos One.
Gienna Shaw, for HealthLeaders Media , March 16, 2011
If you have a patient portal, chances are you aren’t using it to its full potential. And if you don’t have one, you’re missing out on benefits from increased efficiency to improved patient satisfaction to an edge in the marketplace. And, experts predict, the capabilities of patient portals are only going to increase over the next few years. What remains to be seen is whether all this innovation will have an impact on market share and quality of care and whether significant numbers of consumers and providers will embrace them.
A January HealthLeaders Media Intelligence Report found that only 25% of physician practices with an EHR have patient portals and only 21% of hospital-based systems have them. And those that do have them aren’t exactly thrilled. Only 12% and 9% of physician practice- and hospital-based respondents, respectively, said they’re strongly satisfied with their patient portal’s capabilities.
Gienna Shaw, for HealthLeaders Media , March 22, 2011
The patient portal of today has some neat features that are convenient for patients and save time and money for providers—online appointment scheduling and lab results for example. But what will the portal of the future look like?
Well, it might have a social media vibe, according to providers and experts I interviewed for a story on patient portals in this month's issue of HealthLeaders Magazine.
"The future of the patient portal is unlimited at this point," said Barbara Fahl-Watkins, administrator of the Heart & Vascular Center of Arizona. "I feel like we are just scratching the surface in finding new ways to communicate more thoroughly and efficiently with patients."
March 17, 2011 — 4:42pm ET | By Ken Terry
The Heritage Provider Network, a managed care company that contracts with several medical groups in southern California, is launching a contest to develop the best algorithm for predicting which patients are most likely to be hospitalized within a year. The two-year competition begins in April, with a prize of $3 million. Contestants will be provided with a batch of de-identified claims to play with.
March 15, 2011 — 4:45pm ET | By Ken Terry
Zynx Health, the largest source of prebuilt order sets for computerized physician order entry systems, has agreed to incorporate the reference content of Thomson Reuter's Micromedix subsidiary in its ZynxOrder solution. Micromedix offers evidence-based reference materials for medication management, disease and condition management, toxicology, and patient education.
The integration of the two product lines pushes Micromedex's information to the point of care, giving physicians access to comprehensive drug information and disease protocols from their ZynxOrder evidence-based order set.
March 19, 2011 — 11:17am ET | By Ken Terry
In the past week, two organizations in different parts of the country announced efforts to harness information technology to improve predictive modeling. The Heritage Provider Network in southern California is offering $3 million to whoever comes up with the best algorithm for predicting which patients will be hospitalized. And a healthcare system in the Dallas-Fort Worth area is testing a new IT tool that forecasts which patients with congestive heart failure (CHF) are most likely to be readmitted within 30 days of hospital discharge.
In each case, there's an economic motive behind the search for a reliable method of forecasting illness. Heritage is a managed care company that takes financial risk for care, so it wants to be able to manage that risk better. And hospitals are facing new Medicare regulations that will penalize them financially for excessive readmissions, starting in October.
HDM Breaking News, March 21, 2011
Two leaders of the federally-funded CONNECT initiative to develop open source, downloadable health information exchange software now head a new foundation created to take the lead in promoting and expanding use of the technology.
Three companies working under a federal contract developed CONNECT in 2008 and early 2009, and it was released in April 2009 to the open source community.
While there has been some acceptance of CONNECT in the health care industry--by such organizations as HealthBridge, Regenstrief Institute, Thayer County Health Services in Nebraska, and Redwood MedNet in California--federal agencies have adopted the software more readily than the private sector. Some software vendors also have developed commercial products based on CONNECT technology.
“If banks can exchange funds electronically through the ATM system, why can’t my doctor and hospital exchange information electronically?”
Keith Boone’s concise article “A Doctor is Not a Bank” explains why this conclusion about healthcare interoperability is overly-simplistic.
The Canadian Press
Date: Friday Mar. 18, 2011 7:50 AM ET
TORONTO — Doctors at a Toronto hospital are banking on video game technology to save time and prevent contamination in the operating room.
A team at Sunnybrook Hospital has started using the Xbox Kinect, a hands-free gaming console equipped with a motion sensor, to virtually manipulate key medical images during surgery. The doctors use hand gestures to zoom in and out of the images or freeze a particular shot without leaving the operating table.
Surgeons typically have to leave the sterile field around the patient to pull up images such as MRI or CT scans on a nearby computer.
Published: March. 17, 2011 at 9:07 PM
SEATTLE, March 17 (UPI) -- Follow-up online messaging by trained nurses resulted in less depression among patients being treated for depression, U.S. researchers say.
Dr. Gregory E. Simon, a Group Health psychiatrist and Group Health Research Institute senior investigator, says the study involved a randomized controlled trial of 208 Group Health patients. Half had three online care contacts with a trained psychiatric nurse, and were significantly more likely to feel less depressed, take their antidepressant medication as prescribed and be more satisfied with their treatment for depression.
By Mary Mosquera
Friday, March 18, 2011
The Office of the National Coordinator for Health IT could include in the requirements for the next stage of meaningful use some functions that would build toward the comprehensive information exchange system that a presidential commission recommended last year.
These functions could include a patient’s ability to download information to a personal health record (PHR), simple search by providers and sharing immunization data, according to an advisory panel that is examining the report of the President’s Council of Advisors on Science and Technology (PCAST).
Meaningful use in 2013 could promote the use of patient portals, which give individuals access to their electronic health records. Patients could then send or “push” their information or specific data elements to their PHR, which they control, said William Stead, co-chair of the Health IT Policy Committee’s PCAST work group.
Written by Editorial Staff
March 20, 2011
No company has emerged as frontrunner in the EMR market, but there is a lead pack, according to a report from Kalorama Information, which valued the EMR market at $15.7 billion in 2010.
The report, “EMR 2011: The Market for Electronic Medical Record Systems,” said that revenue comes from a wide variety of vendors including hospital IT vendors and small web-based companies' offerings, the New York City-based healthcare market research firm stated.
March 17, 2011 | Molly Merrill, Associate Editor
NEW YORK – There is still no one company that dominates the market for electronic medical records, according to market research firm Kalorama Information.
Kalorama's most recent report valued the market for EMR at $15.7 billion in 2010.
"You still have no one company that is the leader in EMR, but there is a clear pack of competitors now," said Bruce Carlson, publisher of Kalorama Information. "There are still opportunities for new entrants, but this may not be the case for long as the competitive picture is more defined than it was."
March 15, 2011 | Mike Miliard, Managing Editor
IRVINE, CA – A new study from the Ponemon Institute, sponsored by Experian, finds that almost 1.5 million Americans are victims of medical identity theft – an increase from last year. While consumers grasp the importance of protecting their medical and personal information, it reports, few take the precautions to avoid medical ID theft.
The study also found that the average cost to resolve a case of medical identity theft stands at $20,663 – up from $20,160 in 2010.