Saturday, August 13, 2011

Weekly Overseas Health IT Links - 13 August, 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.


HHS Plans to Issue Rule on EHR Metadata Standards

Joseph Goedert

HDM Breaking News, August 5, 2011

The Department of Health and Human Services expects soon to issue an "advance notice of proposed rulemaking," on adoption of metadata standards to support the electronic exchange of health information.

The notice is a first step toward implementing certain recommendations from the President's Council of Advisors on Science and Technology, particularly focused on including some degree of metadata in Stages 2 and 3 of electronic health records meaningful use criteria.


Don't Shortchange Nursing Informatics

The feds are offering $71.3 million to expand nursing education, but lack of targeted funding for nursing informatics is a missed opportunity, says a nurse leader.

By Nicole Lewis, InformationWeek

August 01, 2011


When Dr. Bonnie Westra learned that the Department of Health and Human Services (HHS) was issuing grants totaling $71.3 million to expand nursing education, she had mixed feelings. On the one hand, Westra was delighted that federal dollars will support entry-level preparation, advanced practice nurses, and faculty to teach the nation's future nursing workforce. On the other hand, she was disappointed that HHS' press release said nothing regarding specific funds directed toward nurse informatics training.

"This is a missed opportunity," said Westra, who sits on the board of directors at American Medical Informatics Association (AMIA) and is also co-chair of the Alliance of Nursing Informatics. She also said that as the healthcare sector shifts toward building a health information infrastructure that will support last year's health reform law, HHS should increasingly direct its dollars toward educating nurses in health IT skills.


London Cerner costs now put at £31m

3 August 2011 Shanna Crispin

The average cost of Cerner Millennium in London rose to £31m in the latest deal with BT as part of the National Programme for IT in the NHS.

The revelation comes in a note from the Department of Health to the Commons’ public accounts committee, which held a hearing on a National Audit Office investigation into the programme in May.

The NAO estimated that contract renegotiations with BT as the local service provider for the capital had “resulted in an increase in the average cost of Millennium per acute trust by at least 18%”.


Doctors Love the iPad. But What’s the Prescription for Tablet Security?

Jul. 30 2011 - 2:19 pm

I recently had the good fortune of having dinner with the chief security officers (CSOs) from five major healthcare providers. The CSOs weren’t shy about what was plaguing them.

The biggest headache? Managing consumer devices. Doctors love their iPads and want to use them for work. (It must be the form factor-a next-gen version of the metal-covered chart ubiquitous on medical drama TV shows.) The real life numbers tell the same story. According to Manhattan Research, a healthcare market research firm, just one year after the iPad hit the market, 30 percent of U.S. physicians had adopted the device and an additional 28 percent plan to purchase an iPad within the next six months.


5 Considerations on Health Information Exchanges: What Your Hospital or Health System Needs to Know

Written by Bob Herman | August 01, 2011

Hospitals and health systems are scrambling to become meaningful users of certified electronic health record technology within their own entities, but what's the next step to share health information after that step? The answer for many organizations will be health information exchanges.

HIEs mobilize patient healthcare information electronically across multiple member organizations, hospitals and other stakeholders. In many ways, it's like an EHR for an entire geographical region or, on a smaller scale, a health system that gives physicians and other healthcare professionals secure access to patient data when it might be needed in critical moments. The following five considerations can give hospitals and health systems more insight on what a HIE is and what the benefits and drawbacks of joining or creating one are.


Thursday, August 04, 2011

The Sky Is Falling: Reports Criticize Health IT Security Standards and Enforcement

Earlier this year, HHS' Office of Inspector General issued two reports -- the Nationwide Rollup Review of the Centers for Medicare & Medicaid Services Health Insurance Portability and Accountability Act of 1996 Oversight ("Nationwide Review of CMS' HIPAA Oversight") and the Audit of Information Technology Security Included in Health Information Technology Standards ("Audit of Health IT Security") -- that the office said "raise significant concerns about the security of electronic patient health information."

In reviewing these two reports, perhaps what troubles us most is that one of the reports -- the Audit of Health IT Security -- relies on the findings of the other report -- the Nationwide Review of CMS' HIPAA Oversight -- that are dated and do not take into account key statutory requirements under the HITECH Act and the Office for Civil Rights' reported actions on those requirements.


Oncology journal puts EMRs, CPOE under the bright lights

August 4, 2011 — 2:52pm ET | By Wendy Johnson

The latest issue of the Journal of Oncology Practice offers a treasure-trove of electronic medical record goodies, with articles ranging from the relevance of Meaningful Use to CPOE implementation tips and traps.

Writing about the vital role that EMRs will play in healthcare delivery, Dr. Peter Paul Yu, of the Palo Alto (Calif.) Medical Foundation, points out the many problems plaguing our healthcare system--a fragmented provider base; poor communication among providers and patients; misaligned stakeholder incentives; disparate governance structures and insufficient financial resources.


Partners' mEHR app improves workflow, communication with patients

August 4, 2011 — 10:57am ET | By Sara Jackson

Boston-based Partners HealthCare kicked its mobile strategy into high gear this week, launching an app for its electronic health record, and setting its sights on mobile radiology next.

The healthcare system announced Tuesday that it had completed a light-speed pilot/rollout of only 90 days. Already more than 2,000 clinicians are using the new app, and it's having a "positive impact on workflow" for most, John Pappas, Partners' associate director of clinical systems integration, said in an announcement.

"Instead of finding a workstation, logging in, accessing the patient record and then going to see a patient, they can just pull the iPhone from a pocket and review results at the bedside while they're talking to the patient," he said. "And, they can check on the latest information-test results, for example-at any time from any location."


Patient records system failure looms over CSC acquisition

August 3, 2011 — 3:15pm ET | By Ken Terry

It will be interesting to see what kind of fruit Computer Sciences Corporation's (CSC) recent acquisition of international healthcare software supplier iSOFT will bear in the U.S., after reports that the latter's electronic patient record system in the U.K. has flopped.

Falls Church, Va.-based CSC's $189 million purchase of the Australian company, which provides clinical and business information systems to hospitals in more than 40 countries, was finalized this week, according to a CSC announcement. While iSOFT--which conducts most of its business outside of the U.S., particularly in Australia, India, Spain and the U.K.--is supposed to help CSC expand its global presence in the healthcare IT market, CSC is expected to help iSOFT make a move into the U.S. market.


PAC warns against CSC monopoly

3 August 2011 Jon Hoeksma

The Commons’ public accounts committee has warned the government not to let the Department of Health award a new contract to CSC that would give it “an effective monopoly” in the North Midlands and East of England.

The PAC’s report on the National Audit Office’s investigation of the delivery of detailed care records by the National Programme for IT in the NHS says that both BT and CSC have failed to meet commitments, and damns weak programme management by the DH.

Margaret Hodge MP, chair of the PAC, said: "[The Department] should now urgently review whether it is worth continuing with the remaining elements of the care records system.

“The £4.3 billion which the Department expects to spend might be better used to buy systems that are proven to work, that are good value for money and which deliver demonstrable benefits to the NHS.”


Direct Project gives doctors secure access to data exchange

Technically Speaking. By Pamela Lewis Dolan, amednews staff. Posted Aug. 1, 2011.

Many physicians, even those with electronic medical records, wonder what the advantage is to having their offices "connected" when their systems don't talk to their hospital's systems or the system of the specialist to whom they have referred patients.

When completed, the Nationwide Health Information Network will bring the connectivity physicians and patients are looking for by linking multiple health information exchanges from across the country in a way that will allow them to talk to one another.

But health information exchanges -- the presumed backbone of the network -- have been slow to grow into viable operations. Without them, doctors hoping to qualify for meaningful use incentives need some way to exchange information securely.


Making the Most of Patient Safety I.T.

Neil Versel

Health Data Management Magazine, 08/01/2011

Seemingly every health care organization is head-down and working toward meaningful use of electronic health records, reshaping themselves as accountable care organizations and preparing for the conversion to 5010 transaction standards and ICD-10 coding.

With deadlines fast approaching, some organizations are homing in on the specific capabilities necessary to get incentive checks. Others, however, are trying to think through the process and interject and upgrade technologies that, while not tied into incentives, can significantly improve patient safety.

SSM Health Care of Wisconsin, for example, has put together a closed-loop medication administration for all inpatient areas at its St. Mary's Hospital in Madison, St. Clair Hospital in Baraboo and one affiliate hospital. Two more affiliates will get the technology in October, as will a new SSM Wisconsin facility in Janesville when it opens in January 2012.

A physician places an order in the Epic Systems EHR, and the system then checks the dosage before sending the order to the pharmacy queue, where the pharmacist can apply another check. Then the bedside nurse applies bar-coded medication administration technology, going through the "five rights" before giving the medication. "That piece has huge patient-safety implications," says Annette Fox, R.N., director of clinical systems for the Wisconsin Integrated Information Technology and Telemedicine System, a joint venture of SSM Wisconsin and Madison-based Dean Clinic.


Unraveling Data Breaches

Joseph Goedert

Health Data Management Magazine, 08/01/2011

The federal health care breach notification rule requires HIPAA covered entities-comprising providers, insurers and vendors who must comply with HIPAA transaction sets-to report breaches of protected health information affecting 500 or more individuals to the Department of Health and Human Services' Office for Civil Rights.

OCR posts the breaches to a public Web site. And there have been a lot of postings: by mid-June, 288 listings had filled what is called the "Wall of Shame" in just an 18-month period.

Health Data Management contacted numerous organizations that had suffered a data breach, hoping to find one that would share its experiences about dealing with and recovering from a major breach. Only one responded, and that was to say it declined to comment. Susan McAndrew, deputy director for health information privacy at OCR, believes the reluctance is a missed opportunity.


Chronic Care, Chronic I.T. Problems

Gary Baldwin

Health Data Management Magazine, 08/01/2011

Deb Friesen, M.D., knows chronic disease up close and personal. The internist is also a devotee of electronic health records, and says that without one her job would be much more difficult than it already is. A member of the Kaiser Permanente's Colorado Medical Group, she says that three-fourths of the patients in her internal medicine practice suffer from at least one chronic condition. "Diabetes is really common," says Friesen, whose practice is located in Wheat Ridge, Col., a Denver suburb. "I also treat hypertension, obesity and back pain." Left unchecked, such conditions can be debilitating, and patient involvement in their own care is critical, Friesen says.

That's why Friesen was glad to see one of her older female diabetic patients come in for a recent appointment. Two years had passed since this patient's last exam, well beyond the recommended interval. When the patient's visit was finished, she remarked, on her way out the door, that "her period had returned," the internist recalls. Concerned about uterine bleeding, Friesen ordered an immediate outpatient biopsy, which revealed the patient had endometrial cancer. "She had a hysterectomy and is now cancer-free," Friesen says.


NHS pulls the plug on its £11bn IT system

After nine years and with billions already spent, doomed computer system is abandoned

By Oliver Wright, Whitehall Editor
Wednesday, 3 August 2011

A plan to create the world's largest single civilian computer system linking all parts of the National Health Service is to be abandoned by the Government after running up billions of pounds in bills. Ministers are expected to announce next month that they are scrapping a central part of the much-delayed and hugely controversial 10-year National Programme for IT.

Instead, local health trusts and hospitals will be allowed to develop or buy individual computer systems to suit their needs – with a much smaller central server capable of "interrogating" them to provide centralised information on patient care. News of the Government's plans comes as a damning report from a cross-party committee of MPs concludes that the £11.4bn programme had proved "beyond the capacity of the Department of Health to deliver".


NHS should consider abandoning £7bn IT project

The Department of Health should consider abandoning a disastrous £7billion project to computerise all patients’ medical records, according to a powerful group of MPs.

6:15AM BST 03 Aug 2011

The Public Accounts Committee says that although £2.7bn of taxpayers’ money has already gone on the scheme, it is unclear what the benefits have been and so ministers should think about whether the rest of the cash could be better spent elsewhere.

Although the intention was to create a single network that would allow NHS staff across England to access any patients’ details, the report says this will not happen now and the country has been left with a “patchwork” of costly and fragmented IT systems whose future is uncertain because of reforms to the health service.

The chief executive of the NHS, Sir David Nicholson, also comes in for criticism for failing to oversee the project properly while civil servants provided “late, inconsistent and contradictory” information to the MPs’ inquiry.


Mature HIEs build trust to share data, IT

August 03, 2011 | Mary Mosquera

Oklahoma health information exchange SMRTNET has managed to build a network of seven networks and has attracted a broad range of 3,000 providers in 2011 that share data between hospitals, Native American tribes, community health centers, labs, universities and private physicians.

The individual networks exchange data statewide using a shared set of common resources and privacy policies.

The Secure Medical Records Transfer Network (SMRTNET), a statewide non-profit organization, is one of the examples that the National eHealth Collaborative (NeHC) highlighted in its report of case studies of 12 sustainable and mature health information exchange (HIE) organizations across a variety of geographic regions.

The HIEs follow a number of business and marketing models, according to NeHC, which is a public/private partnership that promotes secure health information exchange, in “Secrets of HIE Success Revealed: Lessons from the Leaders,” released Aug. 2.


Health Information Exchanges Struggle With Sustainability

The number of HIEs in the U.S. is growing, but many struggle to maintain a healthy business according to a report from eHealth Initiative.

By Marianne Kolbasuk McGee, InformationWeek

August 01, 2011


Business sustainability continues to be among the biggest challenges for most health information exchanges, even as new HIEs are starting up and existing ones are figuring out ways to overcome technical and other various hurdles, according to a new report from eHealth Initiative.

The number of HIEs in the U.S. grew 9% in 2011 to 255 from 234 in 2010, according to a recently released annual report by eHealth Initiative, an independent non-profit membership organization that advocates for the use of health IT and studies HIE trends. The number of HIEs tallied by eHI reflects 10 initiatives shutting down or consolidating over the last year, and 46 new initiatives participating in the eHI survey.


Voice Badge Vendor Vocera to Go Public

Joseph Goedert

HDM Breaking News, August 2, 2011

Vocera Communications Inc., vendor of wireless, one-touch voice communication and documentation software that works via wearable badges and serving more than 750 hospitals, has filed to conduct an $80 million initial public offering of stock.

Founded in 2000, Vocera between October 2010 and January 2011 made its first acquisitions to expand its portfolio, buying four companies in that time span. They included Clinical Health Communications and Integrated Voice Solutions, which have software using landline or mobile phones to manage patient hand-off communications via voice or text; ExperiaHealth, a consultancy specializing in workflow issues; and Wallace Wireless, which sells delivery of pages, text messages and alerts to AT&T and Blackberry smart phones. For now, sales of the core voice communication product account for substantially all of Vocera's revenue, according to the registration statement.


By Joseph Conn

An exit interview with Dr. John Halamka

The day after Dr. John Halamka announced on his popular blog, "Life as a Healthcare CIO" that he would be stepping down as chief information officer at Harvard Medical School to focus on his CIO duties at Beth Israel Deaconess Medical Center, he was on a plane to Japan. He was there to lecture and meet with industry, academic and government leaders. He e-mailed with me after his plane landed. Here is part of my interview with him:

Conn: You are perhaps THE most active human being I've ever met. You mentioned in your blog announcing your decision that you often engage in self-reflection, and also that you're approaching 50. Is it possible that John Halamka wants to slow to a less-than-superhuman pace?

Halamka: Thanks so much for the kind words. I'll be 50 (in May). I've looked ahead at the work required for healthcare reform, and it requires depth of focus rather than breadth of activity. My teams and I will need to create the clinical registries, health information exchange, and business intelligence required to support the accountable care organization growing around BIDMC. This will require new staff in the clinical-systems, community-hospital, and community-practice portions of my organization. At the same time, we'll do 5010, ICD-10 and prepare for meaningful use Stage 2. Thus, it's not about the pace of work, it's about the nature of the work.


Rapid, cheap HIV test finds success as first of its kind tested in the field

By Christian Torres, Published: August 1

The first field trial for a “lab on a chip” accurately detected both HIV and syphilis among a Rwandan population, researchers reported Sunday.

Blood samples injected into the clear plastic, credit card-shaped device produced results within 20 minutes. This kind of test could offer a faster, cheaper and easier way to detect infectious diseases that afflict developing countries, according to the report published online by Nature Medicine.

“This is a big step,” said Doris Rouse, a vice president at RTI International in North Carolina, who specializes in global health technologies and was not involved with the study. “What’s especially exciting about this device is that it’s rugged, easy to use and doesn’t require a lot of infrastructure or training,” she added.


CSC completes iSoft acquisition

By Melanie Evans

Posted: August 1, 2011 - 11:45 am ET

Computer Sciences Corp. has completed its acquisition of iSoft Group, an Australian health information technology company.

Falls Church, Va.-based IT vendor CSC announced the roughly $189 million deal in April.


CSC and iSoft form unique company

1 August 2011 Jon Hoeksma

The chief operating officer of CSC Health says that the acquisition of iSoft by CSC creates an international powerhouse, combining a leading health software company and leading systems integration firm.

Andrea Fiumicelli, until Friday the chief executive of iSoft, told eHealth Insider that the acquisition removed the financial uncertainties that had hobbled the company.

“The company is a great business and profitable but the financing wasn’t right. After the IBA era we just had too much debt.”


Patient privacy concerns lead VA to test cloud application

July 27, 2011 — 2:30pm ET | By Ken Terry

The Department of Veterans Affairs (VA) is testing an unnamed commercial "cloud" application that will allow VA employees to share data in the cloud without compromising the personal health information of patients, according to a report in FierceGovernmentIT. VA Chief Information Office Roger Baker said a few months ago that this option would be available by the end of the summer.

The department's monthly reports to Congress have mentioned infractions of security rules involving unauthorized use of web-based solutions outside of the VA information system. Employees reportedly stored personally identifiable health data in commercial cloud collaboration applications such as GoogleDocs and Yahoo Calendar.


More federal funding needed for public health IT infrastructure

July 30, 2011 — 4:06pm ET | By Ken Terry

Back in 2004, when President George W. Bush launched the federal health IT initiative that has now morphed into Meaningful Use, it was clear that the terrorist attacks of Sept. 11, 2001, served as a major driver of the program. The National Health Information Network (NHIN) was conceived partly as a way to improve access to healthcare information across the country in the event of a bio-terrorist attack. And the "strategic framework" of David Brailer, the first National Coordinator for Health IT, included a major role for population health management, including the unification of "public health surveillance architectures."

But the public health agencies of the country, which would be the focal points in a national emergency, have received short shrift in terms of health IT funding. The HITECH Act provides up to $27 billion to incentivize hospitals and eligible professionals to show Meaningful Use of electronic health records. The legislation also allocates substantial sums to HIT regional extension centers, health information exchanges, community college training programs, Beacon Communities and Strategic Health IT Advanced Research Projects (SHARP). The parties that get the short end of the stick are public health agencies.


Monday, August 01, 2011

Health Care Stakeholders Share Best Practices for Meaningful Use Program

DENVER -- At the Institute for Health Technology Transformation's Health IT Summit in Denver last week, health care stakeholders shared experiences, advice and concerns about the meaningful use incentive program. The intimate 175-person summit allowed attendees to learn directly from their peers.

While the conference drew a diverse group of health care professionals from a variety of industries throughout the country, they overwhelmingly agreed on two things:

  1. Incentive payments alone should not be the driving force behind health IT adoption; and
  2. Meeting meaningful use requirements is not going to be easy.

Greg Veltri, CIO of Denver Health, said that "health care won't be able to exist without IT in 10 years." Still, he warned, "If all you're doing is implementing applications to get the money, you're going to end up harming patients."


Philippines to deliver rural e-health services

The Philippine Department of Health (DOH) is seeking to create an electronic database of patient’s medical records to share with rural health units and some government hospitals in central part of the country.

Together with the telecom firm, Smart communications, DOH will implement the programme called Secured Health Information Network and Exchange (Shine) to boosts the efficiency of healthcare delivery by cutting down the time spent in repetitive documentation of patient data in Iloilo city.




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