Saturday, October 29, 2011

Weekly Overseas Health IT Links - 29 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.

Vocera updates mobile comms badge

17 October 2011   Shanna Crispin
Futuristic mobile communications company Vocera is looking to introduce an updated version of its communication badge to hospitals in the United Kingdom.
The wireless Vocera systems are activated by voice through the communication badges worn around the neck.
Royal Liverpool and Broadgreen University Hospitals NHS Trust has been using the system since 2008.
Vocera has redesigned the Star Treck-style badge following customer consultation and feedback from users.
October 15, 2011

Those Scan Results Are Just an App Away

EVEN in the vast world of apps, Dr. Patrick J. Gagnon has one with an unusual distinction: it had to be cleared for use by the Food and Drug Administration.
Dr. Gagnon, a radiation oncologist, uses the app when he sees patients in his Fairhaven, Mass., office. He pulls his iPhone out of his pocket, and then he and a patient, side by side, can view images on it and discuss treatment.
“It’s a nice way to go through a scan with a patient,” he said.
The app he uses, called Mobile MIM, made by MIM Software, can turn an iPhone or an iPad into a diagnostic medical instrument. It allows physicians to examine scans and to make diagnoses based on magnetic resonance imaging, computed tomography and other technologies if they are away from their workstations.

Better NHS IT could avoid 16,000 deaths

18 October 2011   Jon Hoeksma
Better use of advanced clinical information technology in England's hospitals could help prevent 16,000 deaths a year, according to figures cited in a new report.
University Hospitals Birmingham NHS Trust includes the figure, based on its own experience, in a new report submitted to the team investigating above-average death rates from 2005 to 2008 at Stafford Hospital.
The trust says that use of its’ locally developed PICS clinical system, now offered commercially with CSE Healthcare, has led to a 17% fall in deaths among emergency patients over 12 months, which would equate to 16,000 deaths prevented across England.

Talk about a revolution

Professor Michael Thick, the former clinical director NHS Connecting for Health, now McKesson’s VP clinical strategy and governance, explains why the success of the NHS reforms will not be ensured by technology alone.
19 October 2011
When plans for the vision of the future of healthcare in the UK were recently announced, one of its central aims would be to bring NHS resources and decision-making ‘as close to the patient as possible’.
The phrase “No decision about me, without me” not only provided a neat sound-bite to encapsulate the message, but it also casually condensed a multitude of major challenges into just six words. Moreover, it threw down the gauntlet to stakeholders across the marketplace that those responsible for designing and implementing health informatics systems needed to raise their game.
And though IT itself cannot lead change, its suppliers can show leadership and influence others to drive cultural change. The most effective suppliers will add true value to the dialogue. They will have an intrinsic understanding of the NHS and how it operates at senior levels – and will be able to contribute meaningfully to discussions around service design because of it. There are savvy suppliers out there already working with the NHS – and patients – to enable healthcare to be provided in new and innovative ways.

NHS rejects fears over roll out of medical database

Published on Saturday 22 October 2011 22:00
THE NHS in North Yorkshire has begun transferring medical records on to an electronic database to help boost life-saving treatment for hundreds of thousands of patients.
But health chiefs have maintained strict procedures will be in place to protect patients’ confidential records, which can be accessed by doctors anywhere in the country.
Angela Wood, NHS North Yorkshire and York’s assistant director of informatics, said: “Anything that can be done to save vital minutes in the treatment of patients can only be a good thing.
“When the new database starts to save lives, hopefully the concerns about the new procedures will diminish.

Leeds releases portal open source code

20 October 2011  
Leeds Teaching Hospital has released the open source code related to its Opensource clinical portal after a successful development phase.
The Opensource portal, developed with integration service provider ReStart Consulting, provides a single view of patient events and data from key departmental systems. The successful Phase 1 of its development saw integration from five systems to the portal via the trust’s integration engine using HL7 messaging.
The five systems are iSoft’s PatientCentre PAS; the trust’s own Patient Pathway Manager, which is used in the trust’s oncology department, and information from applications provided by Bluespier, Ascribe and EMIS.
Dr Tony Shannon, clinical lead for informatics at Leeds Teaching Hospital, said: “We are pleased that the first pilot phase of the Open Portal project has been a useful success. The feedback from clinical teams here at the Trust is very positive and the pilot project has proven to be both clinically and technically useful.”

Few HIEs financially self-sustaining, survey finds

Posted: October 20, 2011 - 11:00 am ET
Financial sustainability remains an unsolved mystery for the vast majority of health information exchanges, according to a synopsis of a new survey report by the eHealth Initiative, a not-for-profit organization promoting health information technology.
A small but growing number of HIEs, however, have found the secrets to financial success, and they should be studied and emulated, the survey summary said.
There were 196 health information exchange “initiatives” responding to the 2011 version of survey, and just 24—that’s 12%—reported they were financially self-sustaining, according to a news release about the report, “Health Information Exchange: Sustainable HIE in a Changing Landscape,” which the eHealth Initiative is selling for $250.

eHealth Initiative Releases 2011 Report on Health Information Exchange Sustainability

Trends show advancement with a small number of programs, but action is needed to support health information exchange sustainability now more than ever

WASHINGTON, Oct 18, 2011 (BUSINESS WIRE) -- Today, eHealth Initiative (eHI) released its 2011 Report on Sustainability entitled, Health Information Exchange: Sustainable HIE in a Changing Landscape, taking stock of community-based efforts designed to improve health and healthcare through the mobilization of health information electronically.
This report builds on the 2011 HIE survey results which indicate that at least 255 communities across the U.S. are continuing to bring together multiple stakeholders to focus on the secure exchange of health data to improve health and outcomes for patients. Such efforts bring all stakeholders within the health system, including clinicians, community health centers, consumers, employers, health plans, hospitals, laboratories, pharmacies, public health agencies and government together to streamline data delivery between patients and providers.

ONC reorganizes, adds deputy slot

Posted: October 20, 2011 - 11:30 am ET
The Office of the National Coordinator for Health Information Technology now has a No. 2, at least on the organization chart.
As part of a reorganization “to more effectively meet the mission” outlined by the Health Information Technology for Economic and Clinical Health Act, a section of the American Recovery and Reinvestment Act of 2009, the office will add the position of principal deputy, according to a notice by HHS Secretary Kathleen Sebelius.
According to the notice, to be published in the Federal Register, the principal deputy “works with and reports directly to” the national coordinator “and will be responsible for day-to-day operations, decision making and staff management of ONC.”
By Joseph Conn

For now, trust no one on Internet privacy

Trust, once lost, is hard to restore.
Earlier this month, Federal Communications Commission Chairman Jon Liebowitz talked about roping trust like a runaway horse and leading it back into the barn of fair Internet commerce.
Liebowitz was speaking at a half-day conference in Washington about online privacy.
At the same conference, Stanford University graduate student Jonathan Mayer presented his research report, “Tracking the Trackers: Where Everybody Knows Your Username” The “leakage” of personally identifiable information from one web site operator to another is ubiquitous, Mayer said.

Majority of consumers skeptical about EHR use

October 20, 2011 — 8:01am ET | By Marla Durben Hirsch - Contributing Editor
An estimated 56 million people have viewed their medical data on an electronic health record maintained by their doctor, and another 41 million are interested in doing so, according to a new survey released by Manhattan Research. Despite such growth, however, a majority of adult patients are skeptical about accessing their health information via a doctor's EHR.
More than half of American adults--140 million people--were estimated to have not accessed their medical records via their physicians' EHRs, and had no desire to do so. According to the survey, those who weren't interested were older, less educated and "significantly" less likely to use the Internet or electronic devices. 

Many Patients Love EHRs, Fear Storing Data Themselves

Consumer interest in accessing electronic health records is growing, but still below majority level, survey reports.
By Ken Terry,  InformationWeek
October 17, 2011
Nearly half of consumers have viewed or would be interested in seeing their electronic health records (EHRs), according to a new survey by Manhattan Research. But so far, that interest has not translated into a leap in the use of personal health record (PHR) applications to store that data.
Based on the survey's sample of 8,745 adults, Manhattan Research estimated that 56 million people, or 24% of the adult population, have already accessed data in their physician's EHR. Moreover, the New York-based firm said, 41 million (17%) more consumers would like to have this access.
In contrast, 140 million consumers--a 59% majority--report that they have not used and would not be interested in accessing their medical records in their doctor's EHR.

Physicians take a stand on reuse of health data

October 19, 2011 | Bernie Monegain, Editor
WASHINGTON – The American College of Physicians, which represents 132,000 internal medicine specialists, is proposing a privacy rule that says researchers should maximize appropriate uses of information to achieve scientific advances without compromising ethical obligations to protect individual welfare and privacy.
The ACP discusses its members fears about re-uses of personal data as well as re-uses of research data and samples a new document, which is an update of a paper produced by ACP two years ago.
The release of “Health Information Technology & Privacy” comes near the close of the comment period Oct. 26 for the Advance Notice of Proposed Rulemaking (ANPRM) of “Human Subjects Research Protections: Enhancing Protections for Research Subjects and Reducing Burden, Delay, and Ambiguity for Investigators." The proposed changes, which will be highlighted in ACP’s ANPRM comments, are designed to strengthen protections for human research subjects.

Health IT M&A activity down in 2011, value up

October 20, 2011 | Diana Manos, Senior Editor
NEW YORK – The first three quarters of 2011 mergers and acquisitions volume is down 6 percent compared with transactions in 2010, according to a report investment bank Berkery Noyes released Oct. 17.  The study also found transaction value increased by 245 percent in 2011 over 2010.
Berkery Noyes, specializing in information content and technology industries research, attributed the sharp increase in transaction value to the Blackstone Group’s announced third quarter acquisition of Emdeon for $3.03 billion, the largest transaction thus far in 2011.

Are Scribes the Missing Link Between Physicians and EHRs?

Written by Sabrina Rodak | October 17, 2011
Hospitals across the country are implementing electronic health records as they work towards meeting meaningful use requirements and receiving incentive payments. Physicians and other healthcare providers may need to alter their workflow as they transition from paper to electronic records. Physicians in the emergency department, however, may have more difficulty fitting EHRs in their workday due to the fast-paced environment.

"There are huge benefits [of EHRs] in terms of sharing information and data mining, for epidemiological reasons and billing reasons; but there's just that missing link," says Jason Ruben, MD, director of CEP America's Scribe Program. To integrate EHRs into the ED without disrupting physicians' time with patients, Dr. Ruben helps hospitals develop scribe programs, in which people, typically pre-med students, follow ED physicians and enter their data into the EHR for them. Dr. Ruben explains the benefits of scribes and why they might be used hospital-wide in the future.
Thursday, October 20, 2011

An IT-Driven Colonoscopy: What Hospitals Can Learn From Other Industries

When I went in for my first-ever screening colonoscopy, I was worried about complications or the doctor finding cancer. The procedure was routine, my results were good and I was back at work the next morning; however, the process was uncoordinated, inefficient and lacked a customer focus. The experience could have been improved with IT solutions common in other industries.
The GI Referral and Initial Office Visit
My first colonoscopy began with a routine visit to my primary care practitioner. When I mentioned that I had not had my recommended colonoscopy after turning 50, she referred me to a gastroenterologist. My PCP uses an electronic health record, but the gastroenterologist to whom she referred me does not. So when I visited the gastrointestinal (GI) practice for my pre-procedure exam, I had to complete all the same paperwork, including a detailed medical history, and I had the same physical exam I had just gone through with my PCP. I also received printed instructions about what I needed to do and what to expect the week of my colonoscopy.

Consent system puts patients in charge of their health data

A pilot program will show how records are used and shared and how choices are stored electronically.

By Pamela Lewis Dolan, amednews staff. Posted Oct. 19, 2011.
A few physician practices are scheduled to test a federally authorized system that would make it easier for patients to decide how, when and with whom to share their health data -- and easier for doctors to know their patients' choices.
The Health and Human Services Office of the National Coordinator for Health Information Technology has given a $1.2 million contract to a private company to develop and pilot a system for patients to learn their options for consenting to the use of their data and recording their choices electronically.
The system will be piloted at four physician offices that are part of western New York's health information exchange, HEALTHeLINK. It's not yet known how the system will be presented to patients or how physicians will be involved.

Use of IT can reduce disparities, study says

Posted: October 19, 2011 - 11:00 am ET
Effective use of health information technology can reduce racial and ethnic healthcare disparities, according to a newly published study in the Joint Commission Journal on Quality and Patient Safety.
The authors recommended a series of steps, including using health data to find and fix gaps in care, and developing clinical decision support tools that specifically address areas where disparities are common. Those strategies can help providers identify causes of healthcare inequities, such as language barriers and difficulty navigating a complex healthcare system, they said.
Written by Jeff Byers
October 18, 2011

Report: EHR market to hit $6.5B in 2012

The U.S. market earned revenues of $973.2 million in 2009 and total market revenues are expected to peak at $6.5 billion in 2012, primarily due to new licensing and upgrades as hospitals scramble to get certified EHR systems in place, according to a report from market researcher Frost & Sullivan.
“Revenues are expected to retrench some after 2013 due to increased market saturation and growing price competition,” the report, titled “U.S. Hospital EHR, 2009-2016: Charting the Course for Dramatic Change,” continued.
Since 2009, hospitals’ interest in EHRs has skyrocketed, primarily due to financial subsidies provided by the U.S. government’s HITECH Act, where the rate of hospital EHR adoption is expected to expand significantly over the next several years, particularly for advanced EHRs designed to meet meaningful use criteria, according to Frost & Sullivan.

Could ICD-10 have as big a financial impact as the mortgage crisis? Yes. Here's why.

October 17, 2011 | Michael F. Arrigo, Managing partner, healthcare practice, No World Borders
U.S. National Healthcare Expenditures (NHE) are $2.7 trillion in 20111 and are forecasted to grow 34% in five years. This multi-trillion dollar economy will shift its reimbursement paradigm to ICD-102 in under 24 months. ICD-10 will introduce opportunities and risks to hospitals and health plans that may be equivalent to the $148.2 billion to $500 billion in losses3 to the U.S. economy in the mortgage crisis. This is because ICD-10 introduces favorable and unfavorable reimbursement results.
Yet, ICD-10 was obscure outside the health care industry until just months ago. Only recently did mainstream business media start covering ICD-104, described by The Wall Street Journal as health care’s ‘Y2K5 problem’. It is ironic that Y2K, the mortgage crisis, and ICD-10 have similarities. Cynics criticized Y2K as an expensive non-event. As I’ll point out later, even if this were true, Y2K produced other important benefits. The mortgage crisis was about ethical failures in leadership, transparency, and poorly documented quality that led to higher than expected risk.

Mostashari: 'Our healthcare system is in trouble'

October 17, 2011 | Diana Manos, Healthcare IT News
Healthcare IT stakeholders gathered Oct. 14 in Washington for a work meeting, discussing ways IT could help improve transitions in care.
The invitation-only meeting was hosted by the Office of the National Coordinator for Health Information Technology (ONC), the John A. Hartford Foundation, the Gordon and Betty Moore Foundation, and Kaiser Permanente.
Attendees included federal officials, electronic health record vendors, entrepreneurs, grantees, leaders from ONC’s Beacon Communities and foundation funding organizations.
 “We basically have all the tribes together today,” said Aaron McKethan, director of ONC’s Beacon Program, as he kicked off the meeting.

Spotty IT adoption limits quality aims: report

Posted: October 18, 2011 - 11:30 am ET
A new report from the Commonwealth Fund says the nation's uneven adoption of health information technology has hindered quality improvement efforts. But the authors also said that recent changes, including those in the health reform law, could boost IT use.
“The Affordable Care Act and investments in information systems offer the potential for rapid programs in areas like adoption and use of health information technology, safer care and premature deaths from preventable complications,” said Dr. David Blumenthal, chair of the Commonwealth Fund's Commission on a High Performance Health System, which produced the report, and professor of medicine and healthcare policy at Massachusetts General Hospital, Boston, and Harvard Medical School.
Blumenthal is also the former head of HHS' Office of the National Coordinator for Health IT.

Interim care-transition standard near: ONC

Posted: October 17, 2011 - 11:00 am ET
A federal advisory group is expected to finalize a short-term implementation standard for transitions of care by year-end, according to officials from the Office of the National Coordinator for Health Information Technology.
The group of industry representatives, working as part of the S&I Framework in ONCHIT's Transitions of Care Initiative, aims for health IT vendors to begin using the interim implementation standard by the end of 2011, according to Dr. Douglas Fridsma, director of Standards and Interoperability for ONCHIT. The Transitions of Care Initiative aims to improve the electronic exchange of core clinical information among providers, patients and others as part of the federal EHR incentive program.

How HIT Can Make Care Transitions Safer

Gienna Shaw, for HealthLeaders Media , October 17, 2011

So much can go wrong during so-called transitions of care. Lack of communication and coordination with primary care physicians when a patient is discharged from the hospital, for example, can compromise patient safety, lead to ED visits and readmissions, and cause a host of other problems.
So how can health information technology make care transitions safer and more seamless?
That was the question posed at a working meeting of developers, healthcare providers, patient organizations, technology companies, health IT experts, and officials from government agencies in Washington, DC, on Friday. Kaiser Permanente sponsored the event along with the John A. Hartford Foundation and the Gordon and Betty Moore Foundation. Participants worked to identify immediate and short-term technology solutions to improve care transitions and brainstormed new ideas.

BT completes N3 internet speed boost

17 October 2011   Shanna Crispin
BT has completed a two-stage upgrade of the N3 network intended to speed up internet access across the NHS.
The service provider has announced it has more than doubled the capacity of the network’s internet gateway – the part of the broadband network which carries traffic to and from the internet.
During the spring BT increased capacity from 1.82Gbps to 3Gbps. It has now completed the second stage of the upgrade by expanding the capacity limit to 5Gbps.

Commentary: Why RECs and HIEs need each other

October 14, 2011 | Laura Kolkman
Regional Extension Centers (RECs) and health information exchange (HIE) initiatives share a common purpose: enabling the exchange of patient information to improve health outcomes and care quality. Their individual goals and objectives are also complementary. RECs support physicians in the selection, implementation and use of electronic health records (EHRs), while HIEs provide the infrastructure across which the information collected by those EHRs can be exchanged.
Yet in our work with RECs and HIEs nationwide, we have not seen consistent levels of meaningful coordination of efforts between the two. In fact, we’ve encountered areas where the REC and the HIE seem to be competing — a situation that is both confusing and counterproductive.

VA, DoD moving toward SOA as iEHR takes shape

October 13, 2011 | Mary Mosquera
ALEXANDRIA, VA – The Defense and Veterans Affairs Departments are much more alike in the healthcare services they deliver than they are different. That is critical as they build the components of their integrated electronic health record (iEHR), which will be based on common services applications instead of a large proprietary technology system, said Mark Goodge, chief technology officer of the Military Health System.
“We’ve done the mapping of what the VA and DOD do, and we’re so much alike, about 98 percent alike. There are some things that are different, like theater [battle operations] for us and long-term beneficiary care that VA does,” he said at an Oct. 12 conference sponsored by Defense Strategies Institute.

2-D bar codes help docs manage vaccines via EHRs

October 13, 2011 — 7:44pm ET | By Ken Terry
Cook Children's Health Care System in Fort Worth, Texas and athenahealth, a Watertown, Mass., electronic health records vendor, have demonstrated that a new 2-D bar coding system for vaccines can be used to help physician practices and the parents of pediatric patients manage vaccination data.
Besides athenahealth, Microsoft and drug manufacturers Sanofi Pasteur and Merck also collaborated on the pilot with Cook Children's, which includes a hospital and a group of 300 physicians. Clinicians administering shots to children use the bar codes to scan information about the vaccines into the cloud-based athenahealth EHR. Parents can use mobile devices to read the bar codes and upload them to personal health records on Microsoft HealthVault.

ACOs: A sustainable business model for HIEs?

October 14, 2011 — 4:47pm ET | By Ken Terry
Few regional and state health information exchanges have found a sustainable business model. John Tempesco, chief marketing officer at ICA, a Nashville-based HIE vendor, recently told attendees at a Massachusetts conference that accountable care organizations (ACO) might provide the solution.
Speaking at a meeting of the Massachusetts Health Data Consortium, Tempesco said that the key to HIE success will be "patient centered HIE technology" that enables true communication at critical hand offs, collaboration across the continuum of care and analytics to determine best practices to reduce costs while improving quality. These also are the goals that ACOs will have to achieve.
Monday, October 17, 2011

California Readies Medicaid EHR Incentive Program

California has taken one large step forward in its goal to make electronic health records a ubiquitous part of health care provider practices in the state.
Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs can qualify for inventive payments under Medicare and Medicaid.
The California Department of Health Care Services announced the application process for the Medicaid EHR incentive program is open for business. The state now is ready to distribute as much as $1.4 billion in federal incentive funding to hospitals and physician groups who treat beneficiaries of Medi-Cal, California's Medicaid program.
The application process will be staggered over three months: hospital registration opened on Oct. 3; physician groups are next in line, able to apply on Nov. 15; and individual physicians can file for the federal money beginning Dec. 15.


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