This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Saturday, October 01, 2011
Weekly Overseas Health IT Links - 01 October, 2011.
Note: Each link is followed by a title and few paragraphs. 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.
Technology-induced medical errors—a problem that health IT stakeholders once were loathe to admit existed—now are part of mainstream discussions about the implications of health information technology.
BETHESDA, MD – The Agency for Healthcare Research and Quality (AHRQ) is testing a tool among physicians to identify and report patient safety risks and near misses that may arise from the interaction of health IT with other systems or as a result of software design.
The health IT hazard manager will ultimately be scalable for use as a national clearinghouse of health IT-related risks, near misses and safety incidents so they can be compared and analyzed and systems corrected.
The hazard manager enables providers to classify and communicate the unintended consequences of establishing electronic health records (EHRs) and other health IT system so the problems can be fixed or controlled before they reach the patient, said Dr. James Walker, CIO of the Geisinger Health System, which is one of seven providers testing the usefulness and usability of the software. Four health IT vendors also participate in the pilot.
How speech recognition software is changing so doctors don't have to.
By Erica Naone
Doctors don't like technology to get in their way, especially when they are dictating notes about patients. When the typewriter was invented, doctors found someone else to type their observations. When the tape recorder arrived, they mailed off tapes to transcription services.
With computers, speech recognition software has automated the work of turning a doctor's spoken words into text. The match has been good for doctors and also for Nuance Communications, based in Burlington, Mass., the market leader in medical dictation software, which last year generated about $450 million in sales of its Dragon speech software to the medical profession.
But now both Nuance and doctors are facing a threat to the way they do business: the spread of electronic medical records. Record-keeping software, heavily promoted by the government, is meant to improve patient care by getting doctors to record data in digital forms with computer-readable fields. The problem: doctors can't talk into the forms.
Medicare/Medicaid transactions processor ABILITY Network Inc., formerly VisionShare, has introduced software to locate fragmented patient medical records or partial medical records on a real-time basis.
In addition to handling claims submission, eligibility, claim status and other transactions, the vendor offers a master patient index assessment service to identify duplicate records. It also resells records cleanup and verification services from consulting firm Just Associates.
The global telehealth market is headed for explosive growth over the next decade, according to a new report from InMedica, a division of IMS Research. The main reasons are increasing disease prevalence, an aging population, and governmental pressure to hold down healthcare costs.
"Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital," said Diane Wilkinson, research manager at InMedica, in a press release. "This has led to a growing trend for healthcare to be managed outside the traditional hospital environment, and as a result, there is a growing trend for patients to be monitored in their home environment using telehealth technologies once their treatment is complete."
When Dr. David Blumenthal was appointed in 2009 by the Obama administration to coordinate national efforts to promote electronic health records, his wife thought it was “a huge failure of vetting,” he told an audience at a Schwartz Center for Compassionate Healthcare event last night. She manages their home computers. And he had not grown up as someone naturally interested in information technology.
Blumenthal, who left his federal role earlier this year and is a Harvard Medical School professor of health care policy, said that as he learned to use the electronic systems as a primary care physician at Massachusetts General Hospital in the early 2000s, he became a believer. Quite simply, he said, the electronic records made him a better doctor.
Accenture identified the technology standards, architecture, and strategy to ensure consistency with state and federal requirements. The strategy will support interoperable health information management and exchange among unaffiliated organizations. Accenture also developed an enterprise architecture blueprint (EAB) for state-level HIE services and a plan to manage the EAB lifecycle to help ensure compatibility as standards evolve.
WASHINGTON – The doctor doesn't think your sore throat is bad enough yet to order a strep test — unaware that a dozen people across town were diagnosed with strep throat just last week.
Doctors rarely know what bugs are brewing in the neighborhood until their own waiting rooms start to fill. Harvard University researchers reported Monday that getting them real-time information on nearby infections could improve patient care — for strep throat alone, potentially helping tens of thousands avoid either a delayed diagnosis or getting antibiotics they didn't need.
When did you have that appendectomy? What's the dosage of your blood pressure medication? What was your blood glucose level last Wednesday at noon?
Admit it: If the specifics of our own health history formed the basis of questions on "Who Wants to be a Millionaire?" most of us would be lucky to leave with the change in our pockets.
Keeping our health records -- and keeping them current -- always has been a challenge for busy consumers. But, as it has for so many other aspects of 21st century life, the Internet offers help, in the form of personal health record services.
September 20, 2011 | Michelle McNickle, Web Content Producer
With new health IT products springing up left and right, you may find yourself swimming in a sea of apps, updates, frameworks and systems.
Shahid Shah, enterprise software analyst and owner of the blog The Healthcare IT Guy, breaks it down to the five technologies every hospital should be using.
1. Single Sign-On (SSO) and common identity management with CCOW integration. "Start to phase out all applications that cannot meet common identity or SSO requirements," said Shah. The benefits of SSO are many, and include end-to-end user audit sessions to improve security reporting and auditing as well as significant password help desk cost savings. Likewise, Clinical Context Object Workgroup (CCOW) was designed to allow information sharing between clinical and health IT applications, Shah wrote on his blog, adding that "if a hospital can get their labs, EMR, and CPOE vendors to become CCOW compliant, they can share patient context instead of the user having to log in and out of each application separately."
September 22, 2011 | Molly Merrill, Associate Editor
WHITE PLAINS, NY – A new computerized family history tool aimed at allowing providers to take a detailed family history during the first prenatal visit, helping screen for inherited conditions and preterm birth, is being piloted by the March of Dimes and its partner organizations.
The March of Dimes, along with the National Coalition for Health Professional Education in Genetics, the Genetic Alliance and Massachusetts General Hospital will begin piloting their new family history electronic tool in several clinical settings, including a federally funded health center, putting family medical history at doctors' fingertips.
The College of Healthcare Information Management Executives is counseling federal health information technology policy makers to go slowly and not tie the use of metadata tagging to future meaningful-use criteria for electronic health-record incentive payments.
Patients at Dr. Surinder Saini’s Newport Beach (Calif.) office are no longer given a clipboard upon arrival. Instead, they’re handed an iPad, where they tick off symptoms and allergies with the touch of a finger. A nurse uses her own iPad to plug in vital signs. In the exam room, Saini summons the data by tapping on his tablet and is aided by a list of likely diagnoses for, say, abdominal pain. “Most patients are amazed,” says the gastroenterologist. After the visit, Saini dictates his notes about the patient straight into the iPad, where they’re instantly transcribed and stored with other records.
Lured by new technologies and financial incentives from the U.S. government, doctors are throwing out stacks of paper and replacing them with handheld computers. The programs, made by heavyweights such as Allscripts (MDRX) and Cerner (CERN) as well as a raft of scrappy Silicon Valley startups, promise to save physicians time and help them make smarter decisions based on reliable data that are accessible online. An extra nudge comes from the 2009 economic stimulus, which set aside $27.4 billion to jump-start the switch to electronic records. The law offers doctors up to $63,750 over five years to help pay for the change if they can prove they’re making “meaningful use” of the systems by, say, submitting prescriptions electronically.
The Department of Health is to work with Intellect to stimulate the market for NHS IT, following this morning’s announcement that the national programme is to be “dismantled.”
A press release issued by the DH this morning says that a new partnership will “explore ways to stimulate a market place that will no longer exclude small and medium sized companies from participating in significant government healthcare IT projects.”
In response, Intellect issued a statement saying that it wanted the DH to focus on helping the market to deliver interoperable systems and to develop a "central focus on clinical information sharing in the NHS Information Strategy."
A majority of Americans believe that electronic health records don't keep their medical records confidential, according to a new survey released by security firm SailPoint.
The survey, released September 20, found that 80 percent of Americans were concerned about moving their personal medical information to EHRs because of the risks of identity theft, exposure of their information on the Internet and the viewing of their records by those not directly related to their care. There also was concern that patients' private health conditions could be revealed to current or potential employers.
With all of the hoopla regarding how electronic heath records enable providers to earn incentive payments, it's heartening to read Health Affairs' new study that indicates meeting the computerized physician order entry (CPOE) standards for meaningful use may reduce the number of inpatient deaths due to heart attack or failure.
It's even better, however, to learn about real examples of EHRs improving the quality of care for patients.
For instance, the Peter Christensen Health Center, a small family practice located on the Lac du Flambeau reservation in Northern Wisconsin, found that implementing an EHR system enabled the clinic to track patient health data and provide more preventive care to its medically underserved community. It also improved patient care to such an extent that the life expectancy of its patients increased overall by 3.5 years, according to Tony Ryzinski, senior vice president of product management and marketing for Sage Healthcare, whose EHR system the clinic uses.
Sept. 20 (Bloomberg) -- Major health insurers are pooling more than $1 trillion in claims data and creating an institute to cull the statistics and identify the drivers of higher health spending.
More than 5 billion medical claims from Aetna Inc., Humana Inc., Kaiser Permanente and UnitedHealth Group Inc. will be collected and combined with government health claims data by the newly formed Health Care Cost Institute. The nonprofit group, which will likely be housed in Washington, will begin publishing semi-annual scorecards beginning next year on spending and consumption of health-care services and products.
Medical imaging vendors in Europe are developing cardiology information systems (CIS) with advanced functionality and integration capabilities. New analysis from Frost & Sullivan suggests that this trend will spur revenue growth in the image management systems market.
The report, titled Clinical Information Systems in Europe – Cardiology, finds that in 2010 the market earned $54.5 million – a number that's estimated to reach $104.8 million by 2017.
A small but notably bipartisan group of lawmakers has introduced antifraud legislation that would create smartcards for Medicare enrollees and providers, a move that sponsors say could save $30 billion a year.
The proposed Medicare Common Access Card Act of 2011, introduced in the Senate (S. 1551) Sept. 13 by Sens. Mark Kirk (R-Ill.), Ron Wyden (D-Ore.), and Marco Rubio (R-Fla.), and in the House (H.R. 2925) Sept. 14 by Reps. Jim Gerlach (R-Pa.), Earl Blumenauer (D-Ore.), and John Shimkus (R-Ill.), would create a series of pilot programs to embed secure chips on Medicare identification cards. If the pilots were to prove successful after a year, the legislation would authorize distribution of smartcards to all beneficiaries of Medicare, currently about 48 million people and counting.
September 19, 2011 | Molly Merrill, Associate Editor
WASHINGTON – The U.S. Department of Health and Human Services announced new recommendations and initiatives on Monday to support health text messaging and mobile health (mHealth) programs.
In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives, which would deliver health information and resources to individuals via their mobile phones.
As medicine grows more complex, doctors are about to get an ambitious new assistant: the IBM computing system that defeated humans on Jeopardy!.
By Brian Bergstein
On the TV show House, Dr. Gregory House spends most of each hourlong episode wrestling with how to diagnose a patient who presents a bewildering set of symptoms.
IBM research engineer Steve Daniels jokes that he and his colleagues could turn House into a "five-second show." The doctors would simply ask, "Hey, Watson, what does this guy have?"
Watson is the supercomputing engine that beat the top two human competitors on the quiz show Jeopardy! this year, and Daniels is on the IBM team developing the software's first commercial application as what could be a stunningly useful diagnostic assistant for doctors. If it works as envisioned, Watson could help doctors identify what is afflicting any patient and suggest a course of treatment.
Health-care venture capitalists are often drawn to the bold promise of recent medical advances, but those hunting for their next fund should emphasize solutions within close reach when pitching David Brailer, America’s first digital-health czar and the chairman of investment firm Health Evolution Partners.
A physician and entrepreneur, Brailer is all for innovation. Before launching Health Evolution in 2007, he practiced medicine, formed a company, CareScience Inc., and in 2004 under President Bush began helping craft a 10-year plan for widespread deployment of health IT.
With Health Evolution he backs funds and companies. In either case, he favors those pursuing technologies or services that solve medical-industry problems in the near term.
The joint electronic health record (EHR) that the Department of Defense and VA are creating is not the first open source project a federal health agency has undertaken -- but it is the largest and arguably most important.
Consider the scope. According to VA CIO Roger Baker, "The key phrase is single common electronic health system. It's two large systems, and... the intention is to get to a point where there is a single repository for all the data related to an individual' s medical record whether generated in DoD or VA, and I might add through the nationwide health information network."
That admirably ambitious initiative will be composed of proprietary and open source code, many APIs and ATIs, myriad modules, perhaps hundreds of GUIs, beginning with the Tripler GUI currently being piloted in Hawaii, with North Chicago up next.
The Veterans Affairs and Defense Departments have provided details on how they will rely on a graphical user interface to knit together current aging and proprietary systems into their planned integrated electronic health record (iEHR), providing a common look and feel.
The shared interface will unify what the providers, employees and patients see even as functions and systems change on the backend throughout the iEHR’s phases of development.
Less choice of system and mandated interoperability are likely to be the future of general practice IT, according to the Department of Health’s programme director for GP IT.
Kemi Adenubi told last week’s EMIS National User Group conference that no decisions had been made about future funding for GP IT when GP Systems of Choice ends in 2013.
“Nobody knows what’s going to happen in the new world and whether GPs are going to hold the money for GP systems and where choice is going to sit and that’s actually very empowering," she told conference goers.
HIMSS has asked Congress to support the development of a "nationwide patient identity solution" to promote interoperability and reduce errors related to mismatches between health data and patients. The association of health IT professionals also requested that Congress continue to support the adoption of health IT and not cut off funding for the government's electronic health record incentive program.
While there has been no overt effort to repeal the HITECH Act, which authorized up to $27 billion in incentives for Meaningful Use of EHRs, anything is considered possible as Congress moves to reduce the size of the federal budget deficit. So HIMSS' appeal is more than just pro forma.
The Office of the National Coordinator for Health Information Technology has announced the "soft launch" of an initiative to use metadata tagging to create patient consent-management controls over the movement of sensitive elements of patients' electronic records. The controls, the ONC noted in an e-mailed statement, are in keeping with recommendations of a December 2010 report by the President's Council of Advisors on Science and Technology.
The ONC's Office of the Chief Privacy Officer and the Office of Standards and Interoperability are leading the initiative, which aims to "address standards for the ability to exchange parts of a medical record (often called data segmentation)," according to the statement. The initiative is part of the ONC's Standards & Interoperability Framework. Johnathan Coleman was named as initiative coordinator and Jamie Parker as program manager.
He added: “It started with speech and language therapy and now lots of other specialists are asking for it and clinicians are using it for pre-operative assessment and also for follow-up appointments.”
HIMSS members rally on Capitol Hill, 'one voice, one vision' for HIT
September 16, 2011 | Diana Manos, Healthcare IT News
Against the backdrop of National Health IT Week, HIMSS members stormed Capitol Hill Sept. 15 with the intent to raise federal lawmakers' awareness of the importance of healthcare IT.
HIMSS representatives from all over the country rallied at the tenth annual HIMSS Policy Summit in preparation for meeting with their senators and representatives. The meeting was held at the Hyatt Regency Capitol Hill as part of National Health IT Week.
HIMSS’ mantra is “one voice, one vision.”
“With adequate knowledge and the right resources, we can work together to verbalize one voice with one vision, bettering our healthcare system through the use of health information technology,” said HIMSS leaders.
WASHINGTON -- The Robert Wood Johnson Foundation, the Office of the National Coordinator for Health IT and the Agency for Healthcare Research and Quality have teamed up on a new initiative aimed at boosting patient engagement in an effort to improve the quality of health care in the U.S. Health care experts argue that patient empowerment is key to driving health care improvements.
Risa Lavizzo-Mourey, president and CEO of RWJF, said in a news release, "Patients need to understand that the quality of health care varies widely across the nation -- even within communities -- and there are things they can do to ensure they and their loved ones get the best care possible." She added that "it is critical that we all do our part as patients to take responsibility for our own health and care, like learning more about our illness, taking care of ourselves and following recommendations from our doctors and nurses."
At an event on Thursday marking the midpoint of the monthlong project, called Care About Your Care, health care leaders discussed how patients can play an important role in helping to address health care cost and quality issues.
The health battles of millions, recorded digitally, open a world of virtual research.
By Neil Savage
The antidepressant Paxil was approved for sale in 1992, the cholesterol-lowering drug Pravachol in 1996. Company studies proved that each drug, on its own, works and is safe. But what about when they are taken together?
By mining tens of thousands of electronic patient records, researchers at Stanford University quickly discovered an unexpected answer: people who take both drugs have higher blood glucose levels. The effect was even greater in diabetics, for whom excess blood sugar is a health danger.