Saturday, May 21, 2011

Weekly Overseas Health IT Links - 21 May, 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.


Most Calif. docs using EHRs: report

By Joseph Conn

Posted: May 10, 2011 - 12:00 pm ET

A majority (55%) of California primary-care physicians now use electronic health-record systems, according to a new report (PDF) from the California HealthCare Foundation.

The 41-page report, "The State of Health Information Technology in California," also showed, as has been found in similar surveys, that when it comes to IT adoption, the size of a physician practice matters.

For example, just 20% of solo practitioners have adopted an EHR, compared with 39% of practices with two to five physicians, 64% of groups with between six and 50 doctors, and 80% of groups that have 51 or more physicians. For all medical specialties and practice sizes, 48% of physicians in California have implemented EHR systems, according to the foundation.


How European nations run national health services

Belgium, France, Germany and Sweden run publicly funded health services similar in scope to the UK's NHS – but in very different ways

Looking at different countries' healthcare systems is like looking at the NHS in a circus mirror: the main elements are all there, but it's a different image. There are differences between almost all countries' organisational structures, along with the way their 'insurance' system is administered, usually for historical reasons. And while European citizens can use other countries' public healthcare under the European health insurance card scheme, attempts to join systems up (such as patient records) are at an early stage.

An interesting aspect of this is how similar the administration of these countries is to the UK's pre-1974 NHS structure, which evolved because of county council involvement. English councils will soon be involved in public health, and could have more significant powers depending on how the NHS

What differs, however, is the way treatment is controlled at the point of care, and how the patient pays and is reimbursed. In some countries, this has profound implications for the unemployed or homeless, although most doctors will treat first and organise the paperwork afterwards.


Connecting Electronic Health Information For GTA Residents

Delivering Faster, Smarter and More Coordinated Patient Care

May 11, 2011 (Toronto, ON) - Work is underway to ensure health care providers will be able to share electronic health information for Greater Toronto Area (GTA) residents, who represent 47 per cent of the province’s population.

The ConnectingGTA project will allow 700 service providers to securely share patient health information across the five GTA Local Health Integration Networks (LHINs). Currently, electronic health information is shared in silos within the system. Soon, all 700 service providers will be connected under one "electronic roof" - allowing patient information to move from one service provider to another within the system.

Patients will receive better, faster and more coordinated health care from their providers - and providers will be able to share information more effectively. Patients and providers will also benefit from improved productivity and more timely treatment. It will also reduce duplicate tests on patients which will save time and money.


iPhone can diagnose stroke quickly, accurately

May 09, 2011 | Healthcare IT News Staff

CALGARY, AB – Doctors can make a stroke diagnosis using an iPhone application with the same accuracy as if they use a medical computer workstation, according to new research from the University of Calgary's Faculty of Medicine.

Researchers say this technology can be particularly useful in rural medical settings. This allows for real-time access to specialists such as neurologists, regardless of where the physicians and patients are located.

Neuro-radiologists in the study looked at 120 recent consecutive noncontrast computed tomography (NCCT) brain scans and 70 computed tomography angiogram (CTA) head scans that were obtained from the Calgary Stroke Program database. Scans were read by two neuro-radiologists, on a medical diagnostic workstation and on an iPhone. The research is published in the May 6th edition of Journal of Medical Internet Research. The study was designed by Dr. Mayank Goyal, and involved the iPhone software technology originally developed by Dr. Ross Mitchell, PhD, and his team at the Hotchkiss Brain Institute (HBI), then further enhanced and commercialized by Calgary Scientific Inc.


EHRs Deemed 'Essential' To Pediatric Healthcare

Electronic health records and other IT systems support "medical home" concepts of information sharing, care coordination, and evidence-based medicine, said American Academy of Pediatrics policy statement.

By Neil Versel, InformationWeek

May 05, 2011


The American Academy of Pediatrics (AAP) is calling electronic health records (EHRs) and other information technology "essential" to success of the medical home model of providing quality healthcare management for children. Likewise, IT systems must be able to support the goals of the medical home, according to the professional society.

"Medical home information-management systems must facilitate accurate, real-time collection, storage, retrieval, review, and communication of patient health information over time and across providers. For pediatrics, the core of such systems is a lifelong, electronic health record (EHR)," according to an AAP policy statement in the May issue of Pediatrics.


E-Prescribing Increases 71 Percent

HDM Breaking News, May 12, 2011

Electronic prescriptions among U.S. office-based prescribers increased 71 percent to 326 million in 2010, compared with 190 million the previous year, according to an annual progress report from e-prescribing network vendor Surescripts.

Major drivers of the increase, according to report authors, include the electronic health records meaningful use incentives program and Medicare's e-prescribing incentive program, particularly among physicians without EHRs.


GAO calls out VA on IT security, efficiency

By Maureen McKinney

Posted: May 12, 2011 - 11:45 am ET

The U.S. Veterans Affairs Department has faltered in its efforts to effectively manage its information technology systems, spending billions of dollars on projects that often failed to reach their intended goals, according to a report (PDF) from the Government Accountability Office.

Specifically, according to the report, the VA spent $127 million over nine years to develop a more-effective outpatient-scheduling system. But that project was bogged down by weaknesses such as inappropriate software testing and inadequate risk-management strategies.


Experts: Devices Prone to Malicious Attacks

HDM Breaking News, May 11, 2011

Digitally networked medical devices are now part of the health care infrastructure at many hospitals and that’s putting data on the devices--and the hospital network--at risk, says Dale Nordenberg, M.D., founder of the Medical Device Innovation, Safety and Security Consortium, which focuses on the safety and security of devices and electronic health records.

“Medical devices are operating on networks to a degree that no one planned,” Nordenberg told attendees at the federally sponsored Safeguarding Health Information Conference in Washington. Consequently, threats to the integrity of data or programs, causing a lack of operational effectiveness, can directly harm patients. And tens of millions of patients each year have treatment that includes a variety of devices.


No CSC deal until NAO reports - PM

11 May 2011 Lyn Whitfield and Gozde Zorlu

The Prime Minister has said that no changes will be made to CSC's deal under the National Programme for IT in the NHS until the National Audit Office completes its latest investigation into the programme.

Responding to a question from MP Richard Bacon at today’s Prime Minister’s Questions, David Cameron said he was making no plans to sign any new contracts, or to terminate some or all of the existing contract with CSC, until the NAO reports.

However, this may not significantly hold up a new deal for the local service provider for the North, Midlands and East of England, since the NAO is due to make its report next Wednesday.


Thursday, May 12, 2011

Certification Regulations Complicate Meaningful Use Program

Of the three tenets of meaningful use -- adopt certified electronic health record technology, demonstrate core and menu set requirements, and report on clinical quality measures -- the piece about adopting certified EHRs is more complicated than most health care providers anticipated. For starters, the Office of the National Coordinator of Health IT clarified in December 2010 that health care providers must possess all of the meaningful use capabilities, not just those that they intend to report on.

This means that even though CMS has afforded health care providers the flexibility in reporting on any five of the 10 menu requirements in addition to all the core requirements, ONC requires those providers to possess all the core set and the 10 menu set capabilities. In essence, health care providers are being forced to possess capabilities that they do not intend to use and report on in Stage 1.


Mass. offers a REC success story

Written by Editorial Staff

May 11, 2011

WORCESTER, Mass.—There are 62 Regional Extension Centers (RECs) covering every state and several territories, providing educational outreach, vendor selection and support and implementation guidance for small practices, said Fadesola Adetosoye, MS, project officer of the REC program at the Office of the National Coordinator for Health IT (ONC). But only one REC—the Massachusetts e-Health Institute (MeHI)—has achieved its goal of enrolling 2,500 providers.

There are now 2,540 providers (and counting) enrolled in the state’s REC, out of 6,700 providers eligible for REC services, said Adetosoye, speaking at the “Heath IT: Improving Healthcare and the Economy” conference on May 10.

Forty-five percent of those providers work in the ONC’s priority setting of small practices (one to 10 providers); 10 percent work in public hospitals and 29 percent work in community health centers. And 114 providers are at go-live with e-prescribing and can generate electronic reports, aligned with state plans for meaningful use, she said.


John Bowis and Health First Europe unveil 5 key e-Health principles for policymakers

Health First Europe | information technology (IT) |

BUDAPEST, HU - (HealthTech Wire / News) - Health First Europe (HFE) Honorary President John Bowis announced HFE´s key tenets for e-Health petitioning policymakers to adopt the policy recommendations in order to foster increased access to medical technologies for patients. Speaking at the Hungarian Presidency Ministerial e-Health conference in Budapest, Hungary, Mr. Bowis revealed the key principles which include e-Independence, e-Workforce, e-Value, e-Accessibility and e-Transparency and incorporate each health constituency perspective - patients, healthcare professionals and industry. The recommendations provide prescriptive, concrete measures for expanding the uptake and use of e-Health technologies for citiziens throughout the EU.


NHS patients record project faces cull

By Nicholas Timmins

Published: May 11 2011 19:56 | Last updated: May 11 2011 19:56

Ministers are considering cancelling all or part of the biggest single contract in the NHS’s £11bn project to create an electronic patients record, David Cameron has revealed.

The move would in effect put an end to the programme in its current form.

Of the original big four suppliers, only BT, which is responsible for London and a few hospitals in the south, would remain.

The prime minister’s disclosure that “all options” were on the table in CSC’s £3bn deal to install systems across the north, midlands and east of England came after the US-owned company missed more deadlines to get its Lorenzo patient record software working – and as a key NHS partner walked away.


Patient Advocates Want More Say In Health IT

Coalition platform calls consumers "most significant untapped resource in healthcare," demands a role in ensuring that health information exchange and other technologies consider their needs, expectations.

By Neil Versel, InformationWeek

May 10, 2011


Calling consumers "the most significant untapped resource" in healthcare, a coalition of consumer, labor, and patient advocacy groups has articulated a vision for a technology-enabled, communication-based healthcare system that considers patients both partners and leaders in their own care.

"We are not interested in using technology merely to tweak a dysfunctional system; we want to transform it," reads the Consumer Platform for Health IT from the Consumer Partnership for eHealth, which includes organizations such as AARP, the National Consumers League, the National Health Law Program, and the American Heart Association.


The End of Document Management?

HDM Breaking News, May 9, 2011

The federal meaningful use incentive program is predicated on “structured data,” namely discrete, searchable data that is easily mined and exchanged. Many industry providers, however, have long depended on document management systems, which scan paper forms and assemble them as electronically accessible—but not easily searchable—files. Scanning technology can reduce storage costs associated with maintaining bulging files, and well-indexed files can serve as a stepping stone to more fully blown EHR systems, experts say. But many industry observers say the meaningful use program will relegate document imaging systems to a secondary role.


Docs urge caution for AMA on IT mandates

By Andis Robeznieks

Posted: May 10, 2011 - 2:45 pm ET

Discussion of physicians' and hospitals' use of health information technology will be on the agenda when the American Medical Association's House of Delegates meets June 18-22 in Chicago, with resolutions calling for defining e-visit criteria, facilitating the certification of open-source software and slowing hospitals' transition to new IT applications slated for review.

Also on the docket is a trustees report (PDF) stemming from a 2009 resolution calling on the AMA to promote the adoption of a standardized electronic health-record system user interface and to advocate for a federal mandate for interoperability of EHR systems. That report concluded that such a mandate would be counterproductive at this time.


Guerra On Healthcare: Follow The HIE Leaders

CHIME, the National Association of State Chief Information Officers, and several private organizations are all influencing the development of health information exchanges.

By Anthony Guerra, InformationWeek

May 09, 2011


While most advice on executive conduct focuses on leadership, equally important is the ability to skillfully follow. Internally, you lead the IT department and increasingly--with the growing integration of technology into every aspect of clinical and administrative processes--the organization. Externally, you must follow and comply with federal, state, and local laws, regulations, and best practices. And you must do these things not just as pertains to meaningful use, but also those for accountable care organizations, ICD-10/HIPAA 5010, and health information exchanges (HIEs).

It is in pursuit of the latter that the skill of following may be raised to an art, for nowhere must you stay in closer step with all influential entities than with respect to HIEs. Further complicating matters, in no area is an issue's leadership so diffuse. Rather than wait for the HIT Policy Committee's Information Exchange Workgroup to have all the fun, the National Association of State Chief Information Officers (NASCIO) recently got into the act by releasing a report, "A Call to Action: Information Exchange Strategies for Effective State Government." With Medicaid meaningful use dollars radiating from the states, this is a document worth perusing.


75 Percent of Physicians Prefer Apple iPad, iPhone: Survey

By: Brian T. Horowitz


With the rapid growth of mobile devices in health care, 75 percent of doctors in the United States own some form of Apple device (iPhone, iPad, or iPod), according to a new study by Manhattan Research.

A new survey by Manhattan Research reveals that 75 percent of physicians in the United States have purchased an Apple mobile device such as an iPad, iPhone or iPod.

The firm has completed its "Taking the Pulse U.S. 11.0" survey, an annual report that examines how physicians are using technology. It studies physicians' use of the Web, mobile devices and other technology tools.


Moms turn to Facebook for health information

May 10, 2011 | Healthcare IT News Staff

NEW YORK – Facebook is one of the top choices for moms who are looking to spread or find news about health information, according to a recent survey.

The survey was conducted by Lucid Marketing and, an online community of mothers – both of which were founded by Kevin Burke who compiled the survey results in a new report.

The report finds that technology that connects friends is a top choice for moms seeking health-related information. As part of her caregiver role, mothers are using the expanding online community to talk, share and learn, said Burke.


Health IT market to soar in U.S.

May 10, 2011 | Government Health IT Staff

Noting that the U.S. healthcare IT industry has been “taking huge strides” for the past several years, an Indian research firm published a report projecting that to continue for the next three years, if not beyond.

“The healthcare IT market in the U.S. is anticipated to grow at a compound annual growth rate (CAGR) of over 24 percent during 2012-2014,” according to a new report from RNCOS, a market research and analysis company.


HP Brings Advanced Analytics Tools To Pediatrics Hospital

A $25 million commitment will help doctors gauge disease risks by analyzing clinical, genetic, and environmental data.

By Nicole Lewis, InformationWeek

May 06, 2011


HP will commit $25 million to Lucile Packard Children's Hospital (LPCH) at Stanford University School of Medicine over the next 10 years to expand the hospital's ongoing research on ways to improve the quality of pediatric care and save lives.

HP's planned commitment to provide funding will support efforts to find trends and patterns in clinical, genetic, and environmental data that solve clinical challenges. In the partnership, LPCH will contribute physician scientists with clinical expertise and HP Labs will offer researchers with data analytics skills.

Since 2007, both organizations have developed groundbreaking research using bioinformatics tools and the hospital's digitized patient records which has already produced significant progress in identifying signs of an oncoming cardiac arrest in children.


Potential hazards of PCAST

May 09, 2011 | Tom Sullivan, Editor

The PCAST vision “risks paralyzing current adoption of electronic health records ... and sacrificing progress to date on standards harmonization.”

That’s according to The National Committee on Vital and Health Statistics in a letter penned to Health and Human Services Secretary Kathleen Sebelius.

Noting that the PCAST (President’s Council of Advisors on Science and Technology) report is a “compelling and audacious vision,” the NCVHS definitively supports PCAST’s transformative goals for healthcare.


NHS Direct hopes to access SCR

9 May 2011 Fiona Barr

Health helpline NHS Direct has revealed that it hopes to get access to England’s Summary Care Record.

The health helpline has outlined plans to link to the SCR as part of a range of projects under its Delivering Today programme. Another project on NHS Direct’s list, which must be completed first, is to set up links with the Spine and Personal Demographics Service.

A spokesperson for NHS Direct told EHI Primary Care: “Assuming that full roll-out of the Summary Care Record is confirmed as an integral part of the NHS Information Strategy, it is our intention to set-up access to the Summary Care Record. The project is in its early stages at this point as we assess what integration would be needed to achieve this.”


E-discharge 'increases drug errors'

5 May 2011 Daloni Carlisle

Patients are nearly three times more likely to be given the wrong medicines as a result of an error in their hospital discharge letter if the information is compiled electronically, according to new research from the University of East Anglia and Basildon and Thurrock University Hospitals NHS Trust.

In a paper presented today at a conference at the University of East Anglia, clinical pharmacist Keshma Patel will outline early research on two wards indicating problems with electronic discharge letters.

Her study into error rates before and after the introduction of electronic letters showed that 24% of the 80 patients in her study had at least one drug error in their hand-written letter from the hospital.

They were prescribed on average eight drugs each. When it came to incorporating information from the hand-written letter into the GP record, the error rate rose to 42% of patients having at least one error.

She expected the introduction of an electronic system to reduce the error rate. But in fact, she found they nearly trebled.


Dell: Health IT can drive higher care efficiency

May 2, 2011 — 4:39pm ET | By Ken Terry

Michael Dell, chairman and CEO of Dell Inc., recently laid out his vision of how health IT can help drive higher efficiency and quality in healthcare while supporting innovations in prevention, wellness, and personalized medicine. At the same time, he displayed his company's growing ambitions in the healthcare field.


Mostashari: 'Usability,' better decision-making, key EHR success

May 9, 2011 — 8:16am ET | By Ken Terry

The Office of the National Coordinator of Health IT (ONC) must balance the competing concerns of a wide range of stakeholder groups, including patients, providers, health plans, vendors and government agencies. Because of the pervasive effects of health IT and Meaningful Use on these stakeholders, some of them regard government regulations as heavy-handed and excessive. Newly appointed National Coordinator of Health IT Farzad Mostashari, MD, however, is committed to keeping the government's role in check.

In a recent interview with FierceHealthIT, I asked Mostashari how ONC will work with the National Institute of Standards and Technology (NIST) to develop usability standards for electronic health records, and whether that might lead to certification of EHRs for usability.

"The goal is clear...there should be a greater emphasis on usability, a better science around how to measure usability, and an improved ability of providers to use usability in their purchasing decisions," Mostashari said. "So transparency is the goal here, not regulation, per se."

When pressed further, Mostashari deferred to the Health IT Policy Committee, a government advisory body that makes recommendations to ONC about meaningful use and the certification of EHRs.


E-Prescribing Not Meeting Expectations

Physicians say systems are often too difficult to use and don't provide useful data, diminishing potential safety and cost-savings benefits.

By Neil Versel, InformationWeek

May 06, 2011


While office-based medical practices are increasingly turning to electronic prescribing, two important shortcomings with e-prescribing technology are holding back wider adoption and preventing physicians from achieving many of the touted safety and cost-saving benefits, a new survey suggests.

In many cases, it's difficult to import prescription data, including medication history and insurance information, into patient records, and the data available aren't always useful enough for physicians to take time to review during typical office visits, according to the Center for Studying Health System Change (HSC), a Washington-based healthcare research organization.

In a research brief released Thursday, HSC said that just one-sixth of practices interviewed regularly reviewed patient medication history from a third party--usually insurance or pharmacy records--when writing electronic prescriptions.


Intel, GE Launch Care Innovations Telehealth Platform for Portable Devices

By: Brian T. Horowitz


Care Innovations, an Intel/GE joint venture, has rolled out a telehealth platform to boost remote communications between patients and doctors on multiple consumer devices.

Care Innovations, a joint venture between Intel and GE Health Care, has launched a commercial version of the Intel-GE Care Innovations Guide, a telehealth platform that provides patients with portability while receiving remote care from physicians on multiple commercial off-the-shelf products, including desktops, laptops, netbooks, tablets and all-in-one devices.

"What we've done with the COTS [commercial off-the-shelf] offering is create literally thousands of platforms that the software can run on," Greg Hooper, Care Innovations' marketing manager for disease management, told eWEEK.


3M Unveils Advanced Mobile Healthcare App

The software helps physicians keep track of patients' whereabouts, manages dictation, and captures charges.

By Nicole Lewis, InformationWeek

May 06, 2011


3M has unveiled a health application that it says will enable physicians to better coordinate and manage their daily schedules, review patient information, dictate progress notes, and log accurate charges on their mobile devices.

Announced Tuesday, company officials say the 3M Mobile Physician Solution was designed with features and functionality that address many aspects of a physician's daily tasks, and will work with many devices including the iPad, iPhone, Android, Blackberry, and Windows Mobile devices.


ASQ: IT can ameliorate health worker shortage

Health IT, especially EMRs, can help organizations and patients deal with the expected shortage of U.S. healthcare workers, according to a survey from the American Society for Quality (ASQ).

The healthcare worker shortage will result in more fragmented, uncoordinated care, longer waits and an increased possibility of medical errors, according to a poll of 475 ASQ-member U.S. healthcare quality professionals. Quality will be most affected by shortages of primary care physicians (cited by 44 percent of respondents), and shortages of nurses and nursing assistants (cited by 27 percent of respondents), stated ASQ, based in Milwaukee.

The U.S. Department of Health and Human Services predicts that healthcare staffing shortages will increase significantly after 2014, when approximately 32 million more people will be insured under the healthcare reform law, and as more baby boomers reach Medicare age.


Cell Phones Help Keep Blood Pressure, Diabetes in Check

Megan Brooks

May 6, 2011 (Tampa, Florida) — In a year-long study, a mobile-phone-based remote patient monitoring system helped patients with type 2 diabetes and uncontrolled hypertension get their blood pressure (BP) under control.

Study patients who merely checked their BP at home, without reporting it to their physician through the remote system, had no marked change in BP during the study.

"The act of just giving a patient a [BP] home monitor had no effect," said Joseph Cafazzo, PhD, PEng, senior director of eHealth Innovation at the University Health Network, in Toronto, Ontario, Canada. "It had to have the telemonitoring component."

"We believe that patients become far more self-aware and more accountable to their care provider knowing that the data are going back to their care provider and that the care provider will be acting on it," he explained.


Groups Unveil Vision of Patient-Centered Care

HDM Breaking News, May 8, 2011

A coalition of 27 health, aging, labor and consumer organizations has released a report, the "Consumer Platform for Health IT," which they call a vision for a patient-centered health care system.

Members of the Consumer Partnership for eHealth represent 127 million individuals. The platform represents five years of work by the organizations, according to the partnership. Consumers are the most significant untapped resources in health care and can contribute ideas and solutions that other stakeholders may never consider, according to the platform. "Full engagement of consumers in leadership and decision-making roles at the policy and governance levels is essential, not just for gaining their trust and buy-in, but also for maximizing the likelihood of meeting patient and consumer needs," the platform states.


VA unveils MVP -- Million Veteran Program

May 06, 2011 | Government Health IT Staff

The Department of Veterans Affairs went national May 5 with a genomics research program that officials call a “game-changer." The initiative, which relies heavily on databases, is underpinned by the use of healthcare information technology.

“It is my honor to join with so many fellow veterans in keeping VA at the leading edge of genomics research,” said Secretary of Veterans Affairs Eric K. Shinseki. “This innovative research program will support VA’s mission to provide veterans and their families with the care they have earned.”

“The Veterans Affairs Research and Development Program has launched the Million Veteran Program, or MVP – an important partnership between VA and veterans to learn more about how genes affect health, and thus, transform healthcare for veterans and for all Americans,” said Robert A. Petzel, MD, VA’s under secretary for health.


Allina fires 32 workers for snooping

By Paul Barr

Posted: May 6, 2011 - 5:45 pm ET

Allina Hospitals & Clinics, Minneapolis, terminated 28 employees at 221-bed Unity Hospital, Fridley, Minn., and four employees at 286-bed Mercy Hospital, Coon Rapids, Minn., for accessing patient records without a legitimate reason, system spokesman David Kanihan said.

The viewings of the records were related to patients that were part of a well-publicized mass drug overdose of teenagers and young adults in Blaine, Minn., which is near the two hospitals, Kanihan said.


Monday, May 09, 2011

Balance of Better Care, Privacy in Federal ACO Proposal

CMS, estimating that one-and-a-half to four million Medicare beneficiaries will receive care from health care providers participating in accountable care organizations within the program's first three years, is proposing to provide ACOs with Medicare claims and other data under the Medicare Shared Savings Program, authorized under the Affordable Care Act.

The agency's proposal to share Medicare data with ACOs reflects the important role of health information in health care delivery reform, and has important implications for patient privacy.

The MSSP is designed to restructure the way Medicare beneficiaries' health care is organized and incentivized, resulting in the three-part aim of better care for individuals, better health for populations and lower growth in expenditures. Under the program, health care providers would join together to create ACOs that would take responsibility for improving the quality of care and lowering the costs of a group of at least 5,000 beneficiaries. To succeed, ACOs will have to coordinate their beneficiaries' care, an activity that will require investment in health IT infrastructure and redesigned care processes.




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