Saturday, March 17, 2012

Weekly Overseas Health IT Links - 17th March, 2012.

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.
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Monday, March 05, 2012

A Closer Look at the Stage 2 Meaningful Use Proposed Rule

On Feb. 23, CMS released the much anticipated proposed rule on the Stage 2 requirements that health care providers must meet to achieve "meaningful use" of certified electronic health records under the Medicare and Medicaid EHR Incentive Programs. 
The proposed rule covers a broad array of issues, including:
  • Revisions to Stage 1 objectives and measures;
  • New measures for Stage 2;
  • Expanded clinical quality measures and reporting options;
  • Medicare payment adjustments for health care providers who fail to demonstrate meaningful use;
  • Details on meaningful use audit appeals;
  • Guidance for states on their Medicaid EHR Incentive Programs; and
  • Technical corrections. 
One Year Delay for Stage 2 for Providers Who Were Meaningful Users in 2011 Formalized
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12 integration capabilities EHRs will need to have

By Michelle McNickle, Web Content Producer
Created 03/06/2012
With Stage 2 waiting in the wings, the focus is now shifting onto the electronic capture of health information and fostering data exchange at points of care transitions, said Shahid Shah, software analyst and author of the blog, The Healthcare IT Guy. And unlike meaningful use Stage 1, Stage 2 is looking to "raise the bar" and require true interoperability. 
"Current generation EHRs already do some, if not most, of the requirements recommended for Stage 2," he said. "But the reason they won’t meet or exceed the requirements of modern interoperability is [because] next-generation EHRs need far more sophisticated integration capabilities, not just basic interoperability between systems as suggested by the MU Stage 2 NPRM." 
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Study: Physician mergers, private networks won't hurt HIEs

By mdhirsch
Created Mar 7 2012 - 1:18pm
Public community and state health information exchanges (HIEs) will still be useful even if physicians and other providers to merge into larger, more private networks.
That's the conclusion of a new study [1] of care transition data from 10 Massachusetts communities conducted by the Rand Corporation, the Massachusetts Institute of Technology and others, published this week in Health Affairs. The researchers speculated that the pressure to join accountable care organizations may cause physician groups to merge and support private data sharing networks, rather than public HIEs, which focus on the exchange of patient data among independent providers.
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Health IT at 'tipping point' says CDW survey

By Mike Miliard, Managing Editor
Created 03/07/2012
VERNON HILLS, IL – A new survey sponsored by CDW Healthcare shows 84 percent of providers reporting their care delivery has improved with help from health IT. Moreover, they say the IT systems themselves are also improving.
The "CDW Healthcare IT Tipping Point Report" polled 200 IT professionals and more than 200 caregivers at large hospitals, officials say. Its findings indicate an increasingly sanguine view of health information technology systems and their capabilities.
Doctors and nurses polled cite the availability of better information (85 percent), the accuracy of care delivered to patients (72 percent), and the ability to track follow-up care (68 percent) as the technology's top benefits.
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Thursday, March 08, 2012

Private-Sector Insurers Tap Health IT To Support Accountable Care

Health IT is a key enabler of new payment models that pay for health care value, rather than for each incidence of care.
Accountable care has been an important topic of conversation lately. But even before the federal government launched several accountable care organization programs, ACO-style payment arrangements already had been adopted by private insurers.
Health plans and large employers have tried for some time to direct patients to preferred providers as a way to control costs. This has become even more important as mounting evidence shows that high costs do not necessarily signal high quality. HMOs directed patients to particular providers by using closed networks in the mid-1990s, and some have said that ACOs are just the same old pig in a new dress.
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3 Solutions for Major Telemedicine Barriers

Written by Kathleen Roney | March 06, 2012
A recently published study in Telemedicine and e-Health found that despite numerous benefits there are three major barriers to telemedicine implementation and use that need to be addressed.
Telemedicine has and will continue to change care delivery and patient outcomes. Based on this study's survey responses alone, healthcare professionals see the following benefits of teletechnology: immediate patient access, reduced service gaps, improved quality, additional clinical support, better patient satisfaction and improved adherence to care standards.
Telemedicine itself is an established technology; it has existed for over 40 years. However, the advent of powerful computer technology making real-time audiovisual communication feasible — the ability of a physician to remotely consult with a patient via a robot and LCD screen — has transformed care facilitations.
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Patients getting short shrift in EHR privacy and access

By Greg Goth
Created Mar 8 2012 - 11:15am
Healthcare providers and health information exchanges must do a better job of protecting patients' privacy, allowing them to access their own healthcare data, and developing consistent "rules of the road" to safeguard information, according to studies published by the New York Civil Liberties Union [1] and Consumers Union [2].
The Consumers Union study, conducted by University of California-San Francisco professor Robert H. Miller, examined the performance of five California-based provider organizations in meeting nine principles--intended to simultaneously increase provider access to data and protect patients' privacy--adopted by state patient and consumer groups in 2010.
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NHS strikes new deal with CSC for Lorenzo rollouts to continue

Department of Health and CSC sign agreement that will pave the way for deployments of electronic patient records systems at additional trusts
CSC and the Department of Health (DH) look to have concluded negotiations around the future of its Lorenzo system in the NHS.
A revised deal announced by CSC will see the US-based firm deliver additional implementations of the Lorenzo electronic patient records system beyond the 10 have already been rolled out, with "options for more where demand materialises".
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DH secures £1 billion savings from CSC

5 March 2012   Exclusive by Jon Hoeksma
CSC has announced a revised deal with the Department of Health that will secure savings of £1 billion from its disputed £3.1 billion deal for the North, Midlands and East of England.
EHealth Insider understands that the new deal draws a line under DH contractual liabilities as well as securing the savings.
The savings are twice those announced in 2011 when the government first announced that it would be 'scrapping' the National Programme for IT in the NHS.
The deal will also ensure that CSC is paid for past work done and for maintaining existing systems. But the extent to which it commits the NHS to further implementations from CSC is unclear.  
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End in sight for Lorenzo at Bury

8 March 2012   Chris Thorne
Pennine Care NHS Foundation Trust has given the strongest indication yet that it will switch off Lorenzo at Bury's community services.
In April last year, Pennine incorporated the community services arm of NHS Bury, which was the first ‘early adopter’ of Lorenzo; the IT system that CSC has been trying to install across the North, Midlands and East.
Pennine Care was itself supposed to be the fourth early adopter of the system. But it threw the National Programme for IT in the NHS into turmoil when it pulled out of the project last April, despite spending £3.2m preparing for the project.
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Experts: Meaningful Use Stage 2 could put an end to patient data-hoarding

By mdhirsch
Created Mar 8 2012 - 8:48am
Stage 2 of Meaningful Use may do more than spur the adoption of EHRs and the growth of health information exchange (HIE). It could change the way that providers regard their patient records, a panel of experts said during a roundtable discussion hosted by the National e-health Collaborative, a public-private partnership established by a grant from the Office of the National Coordinator (ONC) to foster national HIE.
The proposed rule for Stage 2 of Meaningful Use requires, among other things, that 10 percent of transitions of care and referrals be conducted electronically across vendor and provider boundaries. That means that providers must sending patient data to unrelated entities that may use a different EHR system, said Claudia Williams, director of ONC's state HIE program. Stage 2 also increases providers' obligations to provide patients with on line access to their health information.
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EHRs should include patient-reported data

By mdhirsch
Created Mar 8 2012 - 8:17am
Electronic health records would be more useful if they contained self-reported data from patients, according to a new analysis [1] published in the March issue of Health Affairs
EHRs should include patient-reported information about such topics as their health habits, psychosocial functioning and patient preferences in decision making. The authors, from the National Cancer Institute, Harvard University and the University of North Carolina at Chapel Hill, expressed concern that capturing data from only providers and payers but not patients themselves was insufficient for optimizing patients' health.
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Promoting Your Hospital's HIT Capabilities, Creatively

Marianne Aiello, for HealthLeaders Media , March 7, 2012

Promoting your facility's health information technology capabilities to the general public can be daunting. Without a deft touch, HIT marketing can come off as complicated, stuffy, and confusing. For these reasons, a lot of healthcare marketers don't want to touch it.
But don't be intimidated. There are some real benefits to promoting HIT, specifically electronic health records.  EHR can be a real market differentiator and a way to solidify your organization as a cutting-edge hospital in the minds of consumers. 
Kaiser Permanente's "Thrive" campaign may be one of the reasons healthcare marketers are so intimidated of advertising HIT. Anyone who has seen the sleek "Connected" ad with its high production quality and special effects will agree: Who can compete with that?
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ONC expects 'really rapid progress' on HIE

By Mary Mosquera
Created 2012-03-08 15:32
The Office of the National Coordinator for Health IT hopes to see “really rapid progress” this year on the building blocks that will promote health information exchange, such as provider directories, certificates to assure identification and rules of the road for the nationwide health information (NwHIN) Exchange.
Health information exchange (HIE) will need a variety of models to be able to scale up sharing among physicians, hospitals, and patients and across care settings as called for in the meaningful use stage 2 proposed rule. Over the years, ONC has considered a national architecture of regional health information organizations (RHIOs) and most recently a large role by single statewide HIEs.
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11 stages of the iPad's history in healthcare

By Michelle McNickle, Web Content Producer
Created 03/08/2012
The release of the "new iPad," aka the iPad 3, on March 16th, has health IT folks drooling over the tool's increased screen resolution, its iSight camera – complete with full HD 1080p video recording capabilities – and its voice dictation features. 
"I think it’s no secret that the healthcare industry right now is, to some degree, in love with this tablet," said Jennifer Dennard, social marketing director at Billan's HealthDATA/Porter Research/HITR.com. "Sure, there are the naysayers, but at least half the conversations I had at HIMSS with EMR vendors and HIT folks included at least one mention of 'Apple' or 'iPad.'" 
The past year has been eventful for the tech giant, which lost Chairman Steve Jobs to cancer in October 2011, just days before the public release of its iCloud solution for cloud computing. In anticipation of the release of the third-generation iPad, we look back through the device's history in healthcare and the ways physicians, patients, and IT professionals have used it. 
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Study: Incentive payments, not patient care, driving EHR adoption

By mdhirsch
Created Mar 9 2012 - 8:38am
Most hospitals that don't qualify for the electronic health record Meaningful Use incentive program haven't bothered to implement EHRs, suggesting that the incentive payments, not factors such as improved patient care, are the real drivers behind EHR adoption.
In a new study of long term acute, rehabilitation and psychiatric hospitals published in the March issue of Health Affairs, researchers found that these "ineligible" hospitals have "dismally low" rates of EHR adoption; while 12 percent of short term acute care hospitals had at least a basic EHR system, only 6 percent of long term acute care, 4 percent of rehabilitation and 2 percent of psychiatric hospitals did so.
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Just Enough Technology Should Be Your Goal

Scott Mace, for HealthLeaders Media , March 6, 2012

You can never be too rich or too thin, but you can have too much technology.
Walking around the show floor of the HIMSS conference a couple of weeks ago, just as I started with HealthLeaders Media, I was reminded of that again and again. The technology on display at HIMSS was an impressive summary of all that's been done in the past 20 or so years to use IT to solve some of healthcare's problems.
But at booth after booth, I saw software that boggled my mind in its complexity. One theme I've heard repeatedly as I've come up to speed on the challenges of the meaningful use of healthcare IT is how software can't do it all. How antiquated workflow routines in the clinic and at the bedside get in the way of quality care. How people and politics are the stumbling blocks to breaking apart those antiquated workflows and reassembling them with cost efficiency and patient satisfaction in mind.
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Experts: National HIE strategy evolving

By mdhirsch
Created Mar 6 2012 - 9:32am
There's consensus that the architecture of a nationwide health information network (NwHIN) is shifting. But there's less agreement as to whether this change is a favorable development.
That's the upshot of a panel of experts, addressing the issue in a roundtable discussion held this week by the National e-health Collaborative, a public-private partnership established by a grant from the Office of the National Coordinator for Health IT (ONC) to foster national health information exchange (HIE).
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Home telemonitoring needs health reform, more research to become widespread

By kterry
Created Mar 5 2012 - 9:40am
Several recent reports have predicted a rapid rise [1] in the use of remote patient monitoring. So far, however, it appears that only a small minority [2] of consumers are using these applications and that even fewer people have heard about them from their physicians. Moreover, the use of wellness and fitness apps on mobile devices--which does not require professional involvement--is taking precedence over monitoring of people with chronic diseases.
One reason is that most physicians are not yet organized or incentivized to participate in home or mobile telemonitoring. While healthcare systems and large physician groups employ an increasing number of doctors, the vast majority of physicians still work in small private practices. These practices are not set up for non-visit care management, nor can they afford the staff to keep tabs on telemonitoring data.
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Measures: Surprising HIT opportunities in Obama's federal budget

By Andrea Falciani, Research Analyst, Suss Consulting
Created 2012-03-05 08:18
The recent release of the President’s 2013 federal budget indicates a robust market for industry in the health IT marketplace.
The 2013 budget request is estimated at $11.8B, for instance, a slight increase from the 2012 levels of $11.6B. This boost in funding demonstrates the important role health IT provides in advancing our nation’s healthcare system.
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PwC study spotlights key role for clinical informatics

By Mike Miliard, Managing Editor
Created 03/02/2012
NEW YORK – A new report from PwC US Health Research Institute (HRI) shows how clinical informatics could be a crucial tool to fostering better population health and reducing healthcare costs.
Key to those benefits is for providers to use informatics to engage patients in managing their own health, the study found.
The report also suggests that health organizations view clinical informatics – the integration of information technology into healthcare – as paramount to their financial success and ability to effectively and affordably manage patient care and wellness.
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Report Assesses the Cost of PHI Breaches

MAR 5, 2012 12:12pm ET
A new report examines the financial impact of breaches of protected health information and ways to develop a business case for enhanced protection of the information.
The free report is a collaborative effort of the American National Standards Institute, consultancy The Santa Fe Group, and the Internet Security Alliance, with input from more than 100 members of 70 organizations.
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Report spotlights data-breach costs, concerns

Posted: March 5, 2012 - 12:30 pm ET
A new report by a task force of data privacy and security experts warns that although federal health information technology incentive payment programs have promoted the use of electronic health-record systems, efforts to promote digital security and maintain data integrity have not kept pace.
The 67-page report, "The Financial Impact of Breached Protected Health Information: A Business Case for Enhanced PHI Security," was released Monday morning. It is a product of the PHI Project—a coalition led by the American National Standards Institute and its Identity Theft Prevention and Identity Management Standards Panel, consultant Santa Fe Group and the Internet Security Alliance, an industry trade association. -----

Health IT lawyer decries 'epidemic' of privacy breaches

Posted: March 5, 2012 - 5:15 pm ET
The U.S. healthcare system faces an "untenable situation" as less than half of the country's providers and practitioners use electronic health information systems but there exists an "epidemic" of electronic privacy breaches, according to a member of the team that produced The Financial Impact of Breached Protected Health Information, a report from the American National Standards Institute.
The U.S. healthcare system faces an "untenable situation" as less than half of the country's providers and practitioners use electronic health information systems but there exists an "epidemic" of electronic privacy breaches, according to a member of the team that produced The Financial Impact of Breached Protected Health Information, a report from the American National Standards Institute.
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Electronic health records enabled better management of obesity among children

Electronic health records and embedded tools improved the identification, diagnosis and counseling for overweight or obese children, according to study findings recently published online.
To evaluate the effect of computer-assisted decision tools intended to standardize pediatric weight management in an integrated health care system, researchers conducted a large-scale implementation study documenting the effect of the Kaiser Permanente Southern California Pediatric Weight Management Initiative.
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AHRQ: 'Disappointing results' often seen in health IT deployment

Posted: March 9, 2012 - 12:15 pm ET
Citing "disappointing results" observed often in implementing health information technology, HHS' Agency for Healthcare Research and Quality is looking to evaluate the work-flow toolkit it created for clinical practices to solve problems related to health IT deployment.
AHRQ funded development of the Workflow Assessment for Health IT Toolkit in 2008. The kit is designed to promote a better understanding of how health IT issues affect workflow in ambulatory care at several stages of health IT adoption: determining system requirements, selecting a vendor, preparing for implementation, and using the newly implemented technology. The goal of AHRQ's newly proposed project is to find out how useful clinical practices find the toolkit.
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Mobile Technology Ready to Aid Health Care Worldwide: Report

Pilot projects show success for mobile technology in health care, according to a new report The Boston Consulting Group and Telenor presented at the Mobile World Congress in Barcelona, Spain.

As users are expected to have 7.4 billion mobile subscriptions by 2015, mobile technology is proving it can bring tangible improvement in health care, according to a new report by The Boston Consulting Group (BCG) and Telenor Group, a mobile operator based in Norway.
The companies presented the results of the survey on Feb. 28 at the Mobile World Congress in Barcelona, Spain.
For the study, "Socio-Economic Impact of mHealth," researchers examined the potential of mobile health projects in 12 countries, including Thailand, India and Norway.
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Social media an “ethical duty” for docs

29 February 2012   Jon Hoeksma
Doctors have an “ethical duty” to use the communication channels used by their patients to provide them with good medical advice beyond the occasional ten minute consultation.
This was the impassioned rallying call given by inspirational American paediatrician, mum and blogger Dr Wendy Swanson at HIMSS12 last week in Las Vegas.
Dr Swanson told her audience that people have moved en-masse online, with many now effectively living their lives within social networks, but healthcare professionals have yet to follow.
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France awards grants to 14 e-health R&D projects

Monday 5 March 2012 | 10:49 CET
 The French government has selected 14 R&D projects out of 45 candidates in the first round of its e-health call for projects. The winners will receive a total of EUR 9 million of state funding, with individual projects receiving between EUR 170,000 and EUR 1.7 million. Three-quarters of the support will go to SMEs.
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Docs with e-access to results order more tests: study

Posted: March 5, 2012 - 5:15 pm ET
Physicians who have computerized access to patients' test results are actually more likely to order additional lab and imaging tests, according to a study published in Health Affairs.
The study's findings, which point to a 40% to 70% increase in testing among doctors with computerized access to test results, could shed doubt on long-held beliefs about health information technology’s potential to reduce healthcare spending and inefficiency, the authors said.
"Our findings should at a minimum raise questions about the whole idea that computerization decreases test ordering and therefore costs in the real world of outpatient practice," lead author Dr. Danny McCormick, assistant professor of medicine at Harvard Medical School, Boston, said in an e-mailed news release. "As with many other things, if you make things easier to do, people will do them more often."
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Study: E-Health Records Don’t Deter Testing, Spending

By Jenny Gold
March 5th, 2012, 4:00 PM
Electronic health records have long been touted by Democrats and Republicans alike as a sure-fire way to lower health spending. When doctors have easy electronic access to a patient’s records, advocates argue, they are less likely to order the duplicative and unnecessary tests that drive up the cost of health care in America.
But that assertion is not necessarily proving to be true. Doctors who use EHRs may actually order more diagnostic testing, and therefore make health care even more expensive, according to a study published in the the journal Health Affairs.
Researchers found that office-based physicians were actually 40 to 70 percent more likely to order an imaging test if they had access to computerized imaging results. The study is based on data from the 2008 National Ambulatory Medical Care Survey of 28,741 patient visits to 1,187 physicians.
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Electronic Health Records: A Study and Perspective

By STEVE LOHR
| March 6, 2012, 4:00 pm
I wrote an article in Tuesday’s New York Times, which was based on a study published Monday in the journal Health Affairs that casts doubt on the widespread claim that computerized patient records will cut health care spending.
The study found that doctors who were able to electronically track a patient’s recent imaging tests, like X-rays and MRIs, were more likely to order new imaging tests than doctors with paper records. That is sobering news for advocates of electronic health records, whose adoption is getting a big push from federal incentive payments to physicians.
But the study is another piece of evidence, among many, in the debate surrounding electronic health records. And it’s worth keeping in mind that the debate is really about the best way to adopt the technology, and at what pace — not whether moving from paper records to the computer age makes sense.
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Mostashari: Study on e-access and medical imaging doesn't get all the facts

By danb
Created Mar 7 2012 - 11:44am
National Coordinator for Health IT Farzad Mostashari, M.D., wrote a scathing post [1] Tuesday on the Health IT Buzz blog in response to the study published this week in Health Affairs [2] that concluded that electronic access to medical imaging and lab results led doctors to order more imaging and blood tests.
In addition to pointing out that the study failed to take into account the medical necessity of the tests ordered, Mostashari also said that the authors did not consider clinical decision support or the ability to exchange information electronically--both of which, he added, have been shown to reduce duplicate tests.
"While such interpretations may make for attention-getting headlines, it's important to get the facts," Mostashari wrote. "There are several reasons why [lead author Danny] McCormick's study ultimately tells us little about the ability of electronic health records to reduce costs, and why it tells us nothing about the impact of EHRs on improving care."
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Negative report on electronic medical records disputed by West Michigan health leaders

Published: Thursday, March 08, 2012, 7:15 AM
By Maria Amante | mamante@mlive.com
GRAND RAPIDS -- West Michigan leaders dispute the findings of a nationwide study that showed digital medical records don’t necessarily result in savings.
Research published in the journal Health Affairs said that digital medical records are unlikely to cut costs.
Lody Zwarensteyn, president of the Alliance for Health, said saving and cost cutting from electronic medical records all depend on how long they have been in use.
“Everything depends on the period in which you … pay off your cost,” Zwarensteyn said. “If you say, ‘Look, is it going to give us back our investment in the first year?’ the answer is no.”
Electronic medical records were promised to generate massive savings, as much as $80 billion a year, according to the New York Times report. 
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Mostashari Disputes Study Questioning Savings from Meaningful Use

Farzad Mostashari, national coordinator for health information technology, is taking issue with a new study in the March issue of Health Affairs that concludes having electronic access to medical imaging and lab test results increases the ordering of additional tests.
Authors noted that policy-based incentives for providers to adopt health information technologies, including the HITECH Act’s electronic health records meaningful use program, “are predicated on the assumption that, among other things, electronic access to patient test results and medical records will reduce diagnostic testing and save money.”
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Enjoy!
David.

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