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Information technology is not medicine's enemy but an ally that can ultimately improve patient care and reduce costs.
By Jason Burke, InformationWeek
May 25, 2011
The latest digital issue of InformationWeek Healthcare featured an intriguing article by Paul Cerrato suggesting that some of my ideas regarding evidence-based medicine are a source of animosity between CIOs and their physician stakeholders--physicians whom he believes consider information technology "the enemy" of good medicine. His article touches on several key issues that should be top of mind for every physician leader and CIO today. But is IT really the enemy of good medicine?
Is Medicine An Art or A Science?
At the heart of the article is a very old debate: Is medicine an art or a science? I've never understood why it can't be both. But the more important question is the degree to which we pursue the art at the expense of science, Carl Sagan, my childhood idol, once wrote of the origins of modern medicine:
"Hippocrates introduced elements of the scientific method. He urged careful and meticulous observation: 'Leave nothing to chance. Overlook nothing. Combine contradictory observations. Allow yourself enough time.' … He stressed honesty. He was willing to admit the limitations of the physician's knowledge."
The man behind the oath every practicing physician takes was very much an advocate for science. And any physician advocating art over science is ignoring centuries of transformative medical progress made through science. Personally, I don't run into many physicians like that anymore--they are literally a dying breed.
May 26, 2011 | Healthcare IT News Staf
NEW YORK – Newer electronic health record systems can aid in the reduction of prescription errors, but making the upgrade to these systems can be very difficult for doctors, according to a new study.
A team of physician-scientists from Weill Cornell Medical College tracked the prescription errors of 19 physicians in an adult ambulatory clinic before the switch from an older EHR to a newer system, then again 12 weeks after the switch and once again a year later.
The new electronic system provided extra guidance for prescribing to improve safety, such as alerts notifying providers about use of inappropriate abbreviations that can result in patient harm, as well as checks for drug-allergy interactions, drug-drug interactions and duplicate drugs.
By: Kathleen Lau On: 26 May 2011 For: ComputerWorld Canada
While electronic health records means more lives will be saved with broad access to patients’ medical information, a panel of experts discuss the challenges brought on by going digital. Plus, Ontario Shores’ cloud journey
TORONTO—Currently, in Canada, 80 per cent of medical images exist in digital form as the health care industry continues to move toward widely implementing electronic medical records. But out of this, arises the challenge of managing this huge amount of digital data from all sources, said a Dell Inc. executive during a panel discussion on innovation in health care.
Jamie Coffin, vice-president and general manager of health care and life sciences with the Round Rock, Tx.-based vendor, pointed out that, by the year 2015, 35 per cent of all health care information in Canada will be digitized. Besides medical images, that will also include data such as lab results and measurements taken from smart medical devices.
May 26, 2011 | Healthcare IT News Staff
MENLO PARK, CA – A new personal health record platform set to launch this summer aims at giving parents anytime, anywhere access to a comprehensive view of their children's health records.
MotherKnows, a provider of online medical records for moms based in Menlo Park, Calif., launched their online platform May 24 at TechCrunch Disrupt, giving parents a way to instantly and securely access their children's health records any time – from life-threatening emergencies to routine school, daycare and camp registrations – from a smartphone or easy-to-use website.
While the service will open to the public this summer, the website is accepting signups from interested parents. Those that sign up now gain the opportunity for early access.
Data analytics tools, clinical applications, and other technologies technologies can help accountable care organizations deliver on the promise of curbing costs and improving care.
By Nicole Lewis, InformationWeek
May 26, 2011
As the drive to design a workable accountable care organization model gets under way, the Centers for Medicare and Medicaid Services announced several Affordable Care Act initiatives that require a robust health IT infrastructure to support doctors, hospitals, and other healthcare providers in improving care with Medicare through ACOs. The new ACO models could save Medicare up to $430 million, CMS said.
Among the initiatives introduced is the Pioneer ACO Model, an ACO model that will be available to providers this summer and is designed for advanced organizations ready to participate in shared savings. The Center for Medicare and Medicaid Innovation will support this model, CMS said.
Their adoption of smartphones and tablet computers has resulted in demand for systems in which they can use them.
By Pamela Lewis Dolan, amednews staff. Posted May 23, 2011.
When physicians at Albany (N.Y.) Medical Center started adopting smartphones a few years ago, they almost immediately looked for ways to use them in their clinical lives.
Doctors liked being able to access their patients' records and clinical tools anytime, from any place, so they pressured the hospital to give them access.
With an estimated 81% of physicians using smartphones (up from 72% in 2010), according to a survey of 2,041 physicians released May 4 by Manhattan Research, Albany Medical Center was not alone in feeling pressure from physicians to allow them mobile access. Hospitals and health information technology vendors are realizing that the way to sell physicians on health information technology is to make it mobile. Instead of hospitals and vendors telling physicians to adapt to their preferred ways of using technology, physicians are gaining the power to sway hospitals and vendors to their preferred way of using it.
Posted: May 27, 2011 - 1:00 pm ET
HHS' Office for Civil Rights has posted proposed changes to rules regarding the disclosure of patients' health information that could give patients more insight into how their information is shared.
The 95-page proposed rule (PDF), to be published in the May 31 issue of the Federal Register, proposes changes to the privacy regulations under the 1996 Health Insurance Portability and Accountability Act.
The Civil Rights Office has enforcement authority for the HIPAA privacy rule and said the proposed rule reflects changes mandated by the Health Information Technology for Economic and Clinical Health Act, or HITECH, which are part of the American Recovery and Reinvestment Act of 2009. However, the Civil Rights Office noted that it also is looking to exercise the "more general authority" granted to it through HHS under HIPAA itself.
Posted: May 27, 2011 - 11:45 am ET
Data mining of electronic health records and an adverse-event database has led to the discovery of an unexpected and dangerous side effect that could result from a combination of two commonly used medications, a group of researchers reports.
According to a report on the study published online in the journal Clinical Pharmacology and Therapeutics, the researchers analyzed the U.S. Food and Drug Administration's adverse-event reporting database and electronic health-record data from Stanford University, Palo Alto, Calif.; Vanderbilt University, Nashville; and Harvard Medical School, Boston.
May 24, 2011 | Healthcare IT News Staf
INDIANAPOLIS – The lists of potential side effects that accompany prescription drugs have ballooned in size, but thanks to computer software designed to monitor side effects on drug labels, physicians may be able to better identify which medications would be best for their patients.
The average list of drug side effects on a label is 70 reactions per drug, a number that can overwhelm physicians trying to select suitable treatments for their patients, according to a new study of drug labels.
May 26, 2011 — 10:58am ET | By Janice Simmons
Patients with diabetes who receive treatment at HealthPartners clinics soon may be able to use a new personalized tool--called the Diabetes Wizard--which may be one of the first applications to use electronic health records to customize individual care.
The Wizard has been designed by researchers and physicians at the Minneapolis-based organization to help physicians--particularly in primary care settings--work with diabetic patients to tailor the best treatment plans for them. This will include evaluating appropriate lifestyle improvements and determining the medications that provide the best blood pressure, blood sugar, and cholesterol control.
May 26, 2011 — 10:46am ET | By Janice Simmons
Even a 10 percent increase in the hospital use of electronic medical records could save 16 babies for every 100,000 live births in the U.S. And, making a complete national transition to EHRs could save an estimated 6,400 infants each year nationwide, according to a new study published in the Journal of Political Economy.
The study looked at the death rates of infants at hospitals with and without EMRs in more than 2,500 counties nationwide over a 12-year period. The data set permitted the researchers--Amalia Miller of the University of Virginia and RAND, and Catherine Tucker of the Massachusetts Institute of Technology Sloan School of Management--to control for other factors that could impact infant mortality, such as an area's socioeconomic status.
Thursday, May 26, 2011
by Bruce Merlin Fried and Rebecca Fayed
Cloud computing offers users significant efficiencies by outsourcing IT systems, along with the management and administration of those systems. This might include, for example, having data stored, processed and managed by the cloud computing provider. Although privacy and security issues affect any cloud user, the highly regulated health care industry should remain cautiously optimistic when weighing the financial benefits of the cloud against the potential compliance risks.
So the question remains: Can HIPAA-covered entities (e.g. health care providers and health plans) store protected health information (PHI) in the cloud and still comply with HIPAA privacy and security regulations? The answer is: It depends. It depends on the cloud computing service provider and how that provider sees itself and its obligations to protect the privacy and security of the data. The better answer to the question then is that covered entities can store PHI in the cloud and still comply with HIPAA, assuming they choose the right cloud computing provider. But who is the right cloud computing provider?
Sales of anesthesia information management systems are driving much of the growth, according to an iData Research report.
By Nicole Lewis, InformationWeek
May 24, 2011
The anesthesia, respiratory, and sleep management device market will reach approximately $4 billion by 2017, and much of that growth will be driven by sales of anesthesia information management systems, or AIMS, a report from iData Research shows.
The report, "U.S. Market for Anesthesia, Respiratory, and Sleep Management Devices," shows that in 2010 the market was valued at more than $2.5 billion, a 3.7% increase over the previous year. The overall market is estimated to grow at a midlevel single-digit rate over the forecast period.
iPads and other mobile consumer devices have made their way into the exam room, bringing with them concerns about security, tech support, and infection control.
By David F. Carr, InformationWeek
May 21, 2011
Since gadget-happy doctors got their hands on the iPad last year, many have turned it from a toy into a professional tool.
Dr. Jeffrey Westcott, cardiology board chair at Swedish Medical Center, a four-hospital complex in Seattle, even sees it as a lifesaver. It can "help me avoid mistakes by knowing more about the patient when I'm asked to make a decision."
Just the other day, he got a phone call from a pain doctor who wanted to attach electrodes into the epidural area around the spine of a mutual patient and wanted to take her off her anticoagulant in preparation for the surgery. Westcott was at home when he got the call, but he had his iPad and logged into his hospital's Epic electronic medical records system's iPad client and was able to see that the woman had an artificial aortic valve and must remain on the drug for that reason.
Posted: May 25, 2011 - 12:00 pm ET
HHS' Office of the National Coordinator for Health Information Technology kicked off a new process today to receive public input on a project meant to improve secure communications protocols for health information exchange.
The Provider Directories and Certificate Interoperability Initiatives aim to give ONC advice on creating ways to access a proposed set of provider directories and digital certificates that parties to an exchange of patient records can use to ensure those records are going to and coming from the intended, appropriate authorized parties.
24 May 2011 Jon Hoeksma
Negotiations on the terms of a potential new deal with local service provider CSC have been completed, NHS chief information officer Christine Connelly has told eHealth Insider.
Any new deal though remains contingent on a review of the National Programme for IT in the NHS by the Cabinet Office’s major projects review group, which is expected to last a week.
Approval of a new deal will also require joint Cabinet Office and Treasury approval.
Assuming any new deal survives these steps unscathed it would then have to be approved by the Secretary of State for Health.
Connelly spoke to EHI the day after she was grilled by the Commons’ public accounts committee on the National Audit Office’s third report on the National Programme for IT in the NHS.
By Sally Gainsbury and Nicholas Timmins
Published: May 24 2011 23:12 | Last updated: May 24 2011 23:12
The biggest contractor to the troubled NHS IT programme was accused on Tuesday of seeking a one-third reduction in the cost of its contract in return for doing two-thirds less work.
The allegation, to the Financial Times, by Margaret Hodge, chairman of the public accounts committee, followed a proposal from the Computer Sciences Corporation, that its contract should be reduced by £264m in return for slashing the number of NHS trusts that would receive new systems from 220 to 80.
CSC’s suggestion was revealed in a leaked memo prepared for Francis Maude, Cabinet Office minister and seen by the Financial Times. The company is struggling to meet the original demands of its £3bn contract. However if the proposal were to be implemented it would lead to two-thirds of NHS trusts in the north, Midlands and east of England being left without planned electronic patient record systems.
May 23, 2011 | Tom Sullivan, Editor
Among the top agencies listed in Federal Chief Technology Officer Vivek Kundra’s cloud-first policy are the Departmment of Defense, Health and Human Services and the Veterans Administration. All three will turning to clouds, be those of the public, private, or hybrid variety, under Kundra’s plan.
Government Health IT Editor Tom Sullivan spoke with Aileen Black, vice president of public sector for VMware, about what the potential spread of cloud computing into government means to the federal health IT realm, the advice she has for government health IT organizations tasked with creating a cloud, and why taxpayers want the model.
Posted: May 24, 2011 - 12:00 pm ET
Two longtime programmers at the VistA Community Meeting Monday at George Mason University in Fairfax, Va., offered a history of the U.S. Veterans Affairs Department's VistA electronic health-record system and a way forward for VA and military brass planning an estimated $28 billion retooling of VistA and a counterpart EHR within the Military Health System.
The meeting is being held by WorldVistA, a not-for-profit organization that promotes the use of an open-source version of the VA's health IT system in the U.S. and abroad.
Programmer Tom Munnecke, who started working at the VA in 1978, noted that the VistA precursor, the Decentralized Hospital Computer Program, was developed in spite of opposition from a centralized IT bureaucracy at the VA in Washington. He likened the development of VistA to the development of the Internet, which relied on three basic open-source components—URLs, http and html. DHCP, in comparison, was based on acceptance of a common database and programming environment.
Posted: May 26, 2011 - 12:00 pm ET
Roger Baker, assistant secretary for information technology at the U.S. Veterans Affairs Department, said the VA is committed completely to pursuing an open-source model for modernization of its VistA electronic health-record system.
"There is no half-hearted in this from the VA standpoint," Baker told his audience at a community meeting of World VistA, a not-for-profit organization formed to promote the use of an open-source version of VistA outside the VA. "We either succeed with open source or spend $16 billion" on switching to a commercial EHR system, he said.
A decade ago, according to Baker, the VA had the best EHR system in the world, but since then VistA's rate of improvement has diminished while the pace of progress among private-sector products has accelerated. VistA has "been ignored for a while," he said.
Gienna Shaw, for HealthLeaders Media , May 24, 2011
Wouldn't it be nice if someone gave you $206,817.63—simply because you asked for it? Well, that's more or less what happened at the Houston-based Richmond Bone & Joint Clinic.
"We were missing a big opportunity at our check-in desk to address balances in advance of the patient's visit," says CEO Juliet Breeze, MD. "So we would check the patient in and because the check-in people were so busy, they would sometimes forget to talk to the patient about the balance that we already knew was due."
The practice installed check-in kiosks that are integrated with its payment management system. The kiosks alert patients to current and past balances—they can pay with the swipe of a credit or debit card. Patients who don't pay can't complete the check-in process without speaking to a financial counselor.
The Fitch Ratings analysis suggests that better informatics and adherence to quality standards really do drive the bottom line.
By Nicole Lewis, InformationWeek
May 23, 2011
Hospitals with advanced health information technology systems and a high quality of care achieve greater revenue growth, attend to more patients, enjoy a superior reputation for excellence, and are better able to contain costs, a report from Fitch Ratings has revealed.
As hospitals accelerate the adoption of electronic health records, computerized physician order entry systems, electronic prescription technology, and other health IT, the findings give greater currency to the Obama administration's claim that its health IT incentive programs are worthwhile and will have a positive impact on improving the quality of care while containing healthcare costs.
The special healthcare report, Enhanced Accountability and Financial Performance noted that as health reforms accelerate the adoption of quality reporting and health IT investments, it's important to analyze the impact of these two drivers on hospital operations.
May 22, 2011 — 4:44pm ET | By Ken Terry
A new Harvard study published in the Annals of Internal Medicine questions whether regional health information organizations (RHIOs) will ever be able to function on their own. What's interesting about the survey is that its data is substantially the same as that in the latest survey of the eHealth Initiative, an organization that promotes RHIOs (better known today as regional health information exchanges). Yet the eHealth Initiative sees promise where the Harvard researchers see failure.
The Harvard researchers found that only 75 of the 197 known regional HIE initiatives were up and running, with only 25 not dependent on government grants. Similarly, the eHealth Initiative notes that last year, there were 73 operational initiatives, up from 57 in 2009, and 18 of the operational HIEs were financially independent.
Margaret Dick Tocknell, for HealthLeaders Media , May 23, 2011
The Office of the National Coordinator for Health Information Technology has released its first set of exams designed to help healthcare providers and other employers assess the health IT competencies of their existing staff and potential employees.
The health information technology professionals examinations will measure skill levels in the competencies identified as essential for key health IT professional workforce roles, including clinician/practitioner consulting, implementation management and support, practice workflow and information management redesign, technical/software support, and training.
HDM Breaking News, May 19, 2011
Childs Medical Clinic in Samson, Ala., successfully attested for meaningful use of electronic health records on April 19 and a month later was one of the first practices in the nation to receive an incentive payment from Medicare. Practice administrator Jule Childs has several tips for peer organizations, most importantly, "It's worthwhile."
The one physician, one nurse practitioner clinic spent three months working on collecting the data to attest. Several EHR vendors offer a dashboard application that tracks progress toward meeting meaningful use objectives and Childs found the dashboard with her EHR from Greenway Medical Technologies Inc. to be invaluable. The dashboard, for instance, pinpointed patients seen each day but not added to the numerator for applicable meaningful use measures.
By Joseph Conn
How much does a breach of patient records really cost?
It's what I asked Nick Economidis, an underwriter with Beazley, a specialty insurance group with headquarters in London and U.S. offices in Farmington, Conn., and Beth Diamond, Beazley's claims focus group leader for technology media and business service.
The company provides security and privacy liability insurance for health plans and hospital groups.
There have been rules of thumb tossed around—$250 to $300 per breached record—but don't buy into that, the two insurers say. It could be a lot less, but if it is, that doesn't mean you're lucky.
Posted: May 23, 2011 - 11:45 am ET
The Office of the National Coordinator for Health Information Technology has released a set of competency exams created to more easily identify expert-level IT professionals.
"The exams allow individuals to demonstrate their level of skill in competencies identified as essential for key health IT professional workforce roles," according to an e-mailed notice from the ONC. The exams also will let providers assess current staff members' health IT competency, according to the notice.
Posted: May 23, 2011 - 2:30 pm ET
Without "seamless interoperability," health information technology's potential will go unmet, a report on the healthcare digital infrastructure from the Institute of Medicine found.
That was the conclusion of health IT experts during a series of “expert meetings” organized by the Institute of Medicine in the summer and fall of 2010 at the request of the federal Office of the National Coordinator for Health Information Technology. Those experts—among them, researchers, computer scientists, privacy experts, clinicians, healthcare administrators, HIT professionals and representatives of patient advocacy groups—agreed that a digital health infrastructure cannot be effective unless it is integrated seamlessly within the healthcare processes "from which it draws and is meant to support care delivery, research, quality improvement and population health monitoring."
The app also warns of possible harmful drug interactions
By Lucas Mearian
May 19, 2011 12:09 PM ET
Computerworld - Verizon Wireless and Medco Health Solutions today released a mobile application that guides BlackBerry and Android smartphone users to locations where they can purchase the lowest-cost prescription drugs.
Verizon said the new Medco Pharmacy mobile app can also identify potentially harmful drug interactions based on Medco members' medication histories.
May 20, 2011 | Healthcare IT News Staff
SAN DIEGO – Healthcare information technology tops the list of top 10 ‘hot careers’ for college graduates in 2011, according to a new study from the University of San Diego Extension.
Due to government initiatives in recent years, the study states, the healthcare industry adopted an advanced technology system for managing and utilizing health information, medical establishments have the goal of transferring all healthcare information to an advanced technology-driven database within the next decade.
“This fueling a demand for health information technicians who can support medical record reform,” say the authors of the study.
New Mexico study shows promise in extending specialty care to rural areas, but new payment models are needed.
By Neil Versel, InformationWeek
May 20, 2011
Telemedicine has great potential for extending the reach of a strained healthcare workforce and improving care coordination, but it needs to be accepted as just another means of providing care if the technology is to be sustainable, according to a newly published study.
"To make a substantial impact on how healthcare is delivered across the United States, the model needs to be incorporated into the healthcare system so that reimbursement mechanisms are created to pay for the various services it provides," researchers from the University of New Mexico School of Medicine, Albuquerque, wrote this week in the policy journal Health Affairs.
May 19, 2011 | Healthcare IT News Staff
TUSCON, AZ – Only 28 percent of pharmacies' clinical decision support software systems correctly identified potentially dangerous drug-drug interactions, according to a study conducted at the University of Arizona College of Pharmacy.
The study was conducted at 64 pharmacies across Arizona. Members of the research team tested the pharmacy software using a set of prescription orders for a standardized fictitious patient. The prescriptions consisted of 18 different medications that posed 13 clinically significant drug-drug interactions. Of the 64 pharmacies, only 18 correctly identified all of the eligible drug-drug interactions and non-interactions.
HDM Breaking News, May 20, 2011
Juan Salazar, M.D., a solo internal medicine practitioner in McAllen, Texas, recently received one of the first Medicare electronic health records meaningful incentive checks (for $18,000). He's been practicing for three decades and only adopted an EHR about 18 months ago.
Salazar understands the fears of peers to switch to electronic records, believing them to be cumbersome and adding little value to their practice. "When I started with EHRs I had the same fears," he notes. "I was changing cultures."
But he'll never return to paper because the ambulatory EHR from Cerner Corp. has made him and the office far more efficient while improving care. Patients, for instance, can see their health status trends on the laptop "and it gives a sense of wellbeing that they're getting better."
Monday, May 23, 2011
by Helen Pfister, Susan Ingargiola and Rachel Sam, Manatt Health Solutions
The first quarter of 2011 brought a couple of notable milestones in the federal government's implementation of the American Recovery and Reinvestment Act of 2009 -- the arrival of a new national coordinator for health IT and an invitation to the public to help define the country's health IT strategy. This update summarizes key first-quarter ARRA developments -- including those involving the Health Information Technology for Economic and Clinical Health Act.
David Blumenthal, former national coordinator for health IT, announced in February his intention to leave the Office of the National Coordinator for Health IT to return to Harvard University, where he was a practicing physician, tenured professor and researcher before President Obama named him to head ONC in March 2009. In April, he was replaced by Farzad Mostashari, ONC's former deputy national coordinator.
- By Alice Lipowicz
- May 20, 2011
The first milestone for the upcoming joint Veterans Affairs and Defense Department electronic health record platform is a common graphical user interface to be in place by July, according to W. Scott Gould, deputy secretary for the VA.
A prototype interface already has been developed, Gould told the Senate Committee on Veterans Affairs on May 18.
The user interface provides the front end and a point-of-entry for physicians to interact with the digital medical record system, he said.