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, April 28, 2012
Weekly Overseas Health IT Links - 28th April, 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
Hospitals with electronic
health records (EHRs) barely earn a passing grade when it comes to following
best practices in treating heart failure and pneumonia, according to an audit
by a clinical decision support content provider.
Only 62% of
hospitals' EHRs included clinical processes that have been proven to reduce
congestive heart failure patients' mortality, hospital readmissions, and
overall costs; 67% included clinical processes for treating pneumonia. That is
good for an overall grade of D or D-minus from Los Angeles-based Zynx Health, a unit of Hearst
Publishing. Company officials believe the study to be the first of its kind.
In an updated draft
of its national action plan for fighting healthcare-associated infections
(HAI), the Department of Health and Human Services (HHS) highlights the role of
and measuring HAIs is a critical component of the overall strategy to prevent
and reduce HAIs," the plan says." Advances in information
technology (IT), harmonization of disparate data standards, incentive programs
designed to promote the meaningful use of electronic health records (EHRs), and
capabilities to connect with and integrate multiple data types and sources all
provide opportunities to enhance national capacity to monitor, measure, and
prevent the occurrence of HAIs."
to use big data in healthcare and make it more widely accessible could play a
significant role in lowering overall costs, the authors of a new
this week argue.
out by the Kansas City, Mo.-based Ewing Marion Kauffman Foundation, which
promotes entrepreneurship--makes a number of specific recommendations,
including points regarding data use in both patient care and medical research.
Recently, big data
has been garnering attention as a potential
problem-solver for today's industry woes. But, before jumping into the new
"data-driven paradigm" of leveraging big data, a recent report by CSC suggests organizations take a look
at their basic, data-centered strategy.
organizations have more data to work with than they realize, but they need to
recognize the challenges and plan to overcome them," the report reads.
"For example, the data landscape is constantly changing. The size, scope,
and types of data available are rapidly evolving, and so are the tools needed
to make sense of it all. To identify competitive advantages and achieve better
command and control over their data, entrepreneurial healthcare executives need
to recognize this evolution."
In the largest
collaborative study of the brain to date, scientists using imaging technology
at more than 100 centers worldwide have for the first time zeroed in on genes
that they agree play a role in intelligence and memory.
to understand the biology of brain function — and especially those using brain
imaging, a blunt tool — have been badly stalled. But the new work, involving
more than 200 scientists, lays out a strategy for breaking the logjam. The
findings appear in a series of papers published online Sunday in the journal Nature Genetics.
Personal and health
information for about 315,000 patients is missing, Emory Healthcare announced
Wednesday. The hospital system has been unable to find 10 computer discs
containing the data.
The missing discs
held information on all patients who had surgery at Emory University Hospital,
Emory University Hospital Midtown and The Emory Clinic Ambulatory Surgery
Center between September 1990 and April 2007. The discs contained protected
health information, including patient names, along with the diagnosis, the name
of the surgical procedure and the surgeon. Approximately 228,000 of the patient
records also included Social Security numbers.
access means safer, higher quality care for patients
April 20, 2012
- Authorized health care providers can now use mobile devices to instantly and
securely access their patients’ health information, accelerating the
decision-making process and enhancing patient care, announced Murray
Glendining, Executive VP, Hamilton Health Sciences Corporation and CIO of the
Hamilton Niagara Haldimand Brant (HNHB) Local Health Integration Network
combination of a highly mobile device like the iPad, and comprehensive patient
data spanning many hospitals through ClinicalConnect, brings effective, fast,
secure and safe decision-making ability right to the bedside at any time, day
or night," said Dr. Rafi Setrak, emergency physician, Niagara Health
EHRs can wreak
havoc on a practitioner's clinical documentation of patient care, exposing the
provider to malpractice claims, warns HIT author Ron Sterling, in an article posted on hitechanswers.net.
the legitimacy of care and treatment, the inappropriate use of EHRs and/or EHR
design vulnerabilities are exposing physicians to questions on the quality of
care and physician due diligence," he writes.
Another is a series
of studies on what drives EHR implementation and use has found Meaningful Use
incentives are driving adoption among primary care physicians.
A whopping 95
percent of respondents reported that they're adopting EHRs to achieve
Meaningful Use. Meanwhile, 53 percent said they were doing it to improve
patient quality of care, according to a survey conducted by modermedicine.com.
Cost savings are
always key drivers of new initiatives. And in today's healthcare industry, as
priorities continue to shift and pressure is added to increase revenues and
improve outcomes, one element could be a key player in making it all happen:
think it's going to separate winners from losers in many markets over the next
five years," said Russ Richmond, MD, CEO of healthcare solutions and
consulting company Objective Health. "The institutions that are capable of
first understanding where the market is going … are going to have tremendous
advantages over the ones who can't or won't do this. We believe that over time,
it's going to become a core competency for hospitals, and it won't be something
seen as extra or nice to have – it's going to become a core part of how they
operate going forward."
This is the
expanded version of a piece that appears in the May 7, 2012 issue of Forbes
More than 6,500
guests gathered in an overflowing auditorium at the Intergalactic Headquarters
of Epic Systems this past September. The campus, nestled on 800 acres of
farmland in tiny Verona Wis., was the site of an annual event for customers.
The theme: “Once Upon A Time.” To loud applause, a dark-haired woman dressed in
leather chaps with a bandana tied around her head strode on stage, where a Harley-Davidson a.k.a. gooseneck
awaited. The modern-day Mother Goose in this fairy tale was Judith
Faulkner–simply known as Judy in the health care galaxy, living up to her
motto: “Do good, have fun, make money.”
She has made a
fistful. From her remote midwestern outpost, Faulkner, 68, has quietly built
Epic, which sells electronic health records into a $1.2 billion (2011 revenues)
business—double four years ago. She has done it without outside capital, and no
marketing. She remains the company’s single largest shareholder, rebuffing an
attempt by her biggest client health care giant Kaiser Permanente to get a
piece of equity, when Epic was much smaller. The company won’t disclose
earnings, but says it’s profitable, and proudly proclaims to have zero debt. By
next year, 127 million patients or nearly 40% of the U.S. population will have
its medical information stored in an Epic digital record. Helping enrich
Faulkner is also a piece of government legislation that subsidizes the adoption
of electronic medical records, by paying millions to qualifying hospitals. (See
Matthew Herper‘s story on Cerner here).
The role of privacy
officer has changed since it was mandated in 2003 by HIPAA. New regulations,
technology and data-sharing initiatives have reshaped the landscape, according
to Chris Dimick, staff writer for Journal
of AHIMA, who outlined the new role of the privacy officer in the
health information has become much more complex since 2003, when nearly all
healthcare organizations used time-tested systems to protect paper records,”
Dimick wrote. “In turn privacy officers now require an expanding set of
knowledge and skills, and as regulatory pressures and technological initiatives
have advanced, their roles have grown in strategic importance within their
A recent report
from Global Data pegged the global mHealth market as having a $500 million
value in 2010 that will top $8 billion by 2018. The research firm argues that
the rise of mobile health has been partially encouraged by the global financial
crisis, which led to a focus on finding cost efficiencies in the system in
addition to improved outcomes and quality of care.
“Despite years of
discussion and promises,” KLAS
reports that fewer than 10 providers in the
country are doing EMR integration with their smart pump vendors, even though
over half consider it key to future pump selection.
Report author Coray
Tate commented, “Providers are looking at EMR integration as the next big step
to make infusions safer. Drug libraries catch most errors, but mistakes can
still be made.”
healthcare information by patients and clinicians will help drive the business need for health information
exchanges, according to Dr. Farzad Mostashari, national health IT coordinator.
Clinicians and patients should ask for or seek relevant patient information whenever and
wherever healthcare decisions are made. Mostashari's timely comments put a
spotlight on the role of patient advocacy in care coordination and how that
advocacy intersects and enriches health information exchange.
Used in a
meaningful way by healthcare providers, health IT should help lower the cost of
care, while improving the quality of care, patient satisfaction and the
patient-provider relationship. Health IT in the form of personal health records
or data-capturing devices for patients ideally should help them be
knowledgeable of and manage their conditions. It should also empower them to be
their own advocates in this complex healthcare environment. This is an ideal
world and goals that the industry is trying to achieve.
BALTIMORE – The
number of physicians using electronic health records has doubled over the past
two years, Doug Fridsma, MD, told an audience at AHIMA's ICD-10 Summit Monday.
“We are making real
progress on EHR adoption and we
are developing a workforce that is beginning to be trained to support this
progress,” said Fridsma, director of the Office of Standards and
Interoperability, part of the Office of the National Coordinator for Health
Information Technology (ONC).
AUSTIN, TX –
Venture capital funding in the healthcare information technology sector for Q1
2012 totaled $184 million in 27 deals, the highest number ever recorded,
according to Austin, Texas-based consulting firm Mercom Captal Group.
An onslaught of
mobile health technology has forced an arranged marriage between smartphone app
makers and the Food and Drug Administration — because someone had to regulate
There’s just one
problem: Many of the tech wizards aren’t used to FDA supervision. And now, both
sides are struggling to figure out how to live with each other.
Last year, the FDA
suggested some ground rules: If you make an app that claims to diagnose or
treat a medical condition, then you need to show that it’s safe and effective
before you sell it, just as other medical-device makers do.
A £5m telehealth
project in Gloucestershire has deployed less than a quarter of its 2,000
devices in its first ten months.
In June last year,
Tunstall Healthcare and NHS Gloucestershire launched a project to provide
telehealth to 2,000 patients with chronic obstructive pulmonary disease,
chronic heart failure, chronic heart disease and diabetes.
The stated aim was
to roll out the telehealth devices over 12 months, starting in the summer.
As social media
continues to grow as a communications medium, so too does its impact in
healthcare. According to a report published today by consulting firm PwC,
patients increasingly are turning to social media sites such as Facebook and
Twitter both to find and share medical information. What's more, of 1,060
surveyed consumers, 45 percent said that information obtained via social media
could impact their decision to get a second opinion.
at Purdue University and Princeton University have developed a proof-of-concept
device, called MedMon, that blocks hackers from hijacking or interfering with
wireless medical devices, like pacemakers, insulin pumps, or brain implants.
The researchers were motivated to work on the problem after discovering how
easy it was for hackers to break into current wireless medical systems.
believe that hundreds of thousands of people using wireless insulin pumps or
wireless-enabled pacemakers are currently vulnerable. Other devices, not yet in
the market, like brain implants that manage epilepsy and “smart prosthetics”
could also be hacked. Despite the potential for hacking, the researchers admit
the chances that any given would be hacked is low.
Doctors and other
ER staff are constantly waiting too — waiting to see if the X-Ray report is
available, waiting to see whether lab results are back and waiting to see
whether medication that was ordered was given to the patient.
And the only way to know
whether any of this information is available is to go into each patient’s
medical record individually and do a check. Repeat the same process for every
patient that’s in the ER.
But Dr. Vernon Smith at the Mayo Clinic has come up with a
real-time dashboard that is meant to take away all this repeated checking. It
incorporates easy-to-understand icons — X for an X-ray, a drop of blood to
represent lab results and mortar and pestle for medications – that are
displayed on large computer screens throughout the emergency department.
aims to help patients stay on their meds with a product that predicts who will
stop taking prescriptions before the person actually does it.
benefits manager is launching ScreenRx, a program that uses a computer to sift
through hundreds of factors that affect patients and forecast who is most
likely to forget a refill or simply stop taking their drugs. The company then
plans to contact those patients to help them stick with their doctor’s orders.
executives say their new program is focused on a big target.
Indiana University and the Indianapolis-based Regenstrief Institute have
developed an automated system aimed at helping enable pediatricians focus on
the specific health needs of each patient in the short time allotted for
preventive care. The systems comes on the heels of a new study, “Automated
Primary Care Screening in Pediatric Waiting Rooms,” in the May 2012 issue of
Pediatrics which found personalizing and automating the patient screening
process and then alerting the physician to positive results of risk factors
enables them to direct attention to the particular needs of the individual
child and the child’s family.
The automated system
created by the Indiana University and Regenstrief researchers, called the Child
Health Improvement through Computer Automation System (CHICA), aims to do
Cheryl Clark, for
, April 17, 2012
When something goes
wrong after robotic surgery with the da Vinci surgical system, it's most likely
due to co-morbidities in certain patients that make the procedure riskier, not
flaws in the robot's technology itself, according to a study of 884 surgeries published this week in the Archives of Surgery.
reviewing all these cases, we can say for sure that there is no specific
morbidity connected with the robot by itself, and that its mechanical failure
is very, very rare," says lead author Pier C. Giulianotti, MD, of the
Division of General and Minimally Invasive Surgery at the University of
Illinois at Chicago. "We can now say that the morbidity and mortality that
occurred in these patients was connected to the risk factors in the
The authors wrote
that by understanding which patients are at greater risk for robotic surgery
complications, surgeons eventually can develop a scoring system to measure
quality of care among providers and hospitals.
OREM, UT –
Thousands of urgent care centers are looking for an EMR to adapt to
increasing patient volume, and providers are finding success with three
different types of EMRs, according to a new report from research firm KLAS.
Of the more than
9,000 estimated urgent care centers, many report plans to increase in size or
location in the next 12 months. Many need an EMR.
Options for urgent
care centers include ambulatory EMRs, ED solutions, and best-of-breed urgent
care EMRs, KLAS reports.
care is the mantra of the movement to reform the nation's healthcare delivery
system. According to this credo, patients must be able to obtain copies of
their medical records and visit summaries; they should have personal health
records that they can share with their providers; they should have
"patient-centered medical homes"; they should share in medical
decision making; and, of course, the security and privacy of their personal
health information must be rigorously protected.
All of this makes
sense, both for the individual and for the healthcare system. Since about 90
percent of healthcare is self care, consumers must be involved--and must, in
some cases, change their health behavior--to become healthier and reduce the
overall cost of care. "Patient engagement" is also a key component
of accountable care organizations, because ACOs' success depends on
keeping patients healthy and out of expensive care settings. Only by educating
patients and enlisting their cooperation can ACOs generate savings and remain
within their budgets.
Our GP columnist would
like a Star Cops-style personal assistant. Or failing that, some agreed
definitions of data and a decent dashboard to display them on.
3 April 2012
Did you ever watch
Star Cops in the late 80s? I don’t really remember any of the plots; just that
it involved a policeman solving crimes on the moon accompanied by his amazing
He would simply
talk to this marvellous device and it would wirelessly access loads of other
computers and databases and find out things for him, drawing conclusions and
unearthing clues based on very little input.
I’m pretty certain
that this led me to buy a Psion and numerous other PDAs since, most of which
haven’t lived up to the dream. It wasn’t until a few months ago, when Apple
demoed Siri, that the fantasy almost became reality.
BEAVERTON, OR –
Hoping to drive more "plug-and-play" connectivity of personal health
technologies, Continua Health Alliance has made available its most recent
design guidelines as a free download for device vendors.
guidelines, called Adrenaline, aim to help technology developers build
end-to-end systems more efficiently and cost-effectively by facilitating
connectivity between personal connected health products such as smartphones,
gateways and remote monitoring devices. They were previously available only to
Continua members during interoperability testing.
Under pressure to
do more with less, insurers, pharmacy benefit managers and health-care
providers are all pushing data analysis to new heights.
Insurers have been
crunching numbers for years to figure out which patients are most likely to
generate high costs. Now other groups are gauging probabilities of relapses,
and the likelihood of a patient's not taking his or her medicine. Using models
that draw on massive troves of medical and other data, some are also focusing
on seemingly healthy individuals, trying to prevent problems before they occur.
including UnitedHealth Group Inc. and WellPoint Inc., are seeking
to pinpoint who will develop conditions such as diabetes. Pharmacy-benefit
managers such as Express Scripts Inc. and CVS Caremark Corp. are working
on programs to predict medication compliance. Care providers, meanwhile, are
trying to identify who is most likely to be admitted—or readmitted—to a
hospital, and are adjusting their care to prevent such return visits.
(Reuters) - Baby
boomers wired to their iPads and smart phones are giving U.S. health experts
some new ideas about ways to cut the soaring costs of medical care in graying
Some of the ideas
might sound like "Robo-Granny". An astronautical engineer at the
Massachusetts Institute of Technology has made a skin-tight undersuit equipped
with sensors that can constantly monitor the vital signs of its elderly wearer
and feed the data into a computer that fires off health alerts. It was first
designed for a landing on Mars.
There's also Paro,
the robotic seal which has fur, big eyes and responds to voice commands, a
low-cost companion that the AgeLab at MIT is testing to help calm elderly people
with dementia. Then there is the magic carpet with a built-in sensor that
monitors gait to check for risk of falling.
Other ideas are
simpler and already are being tested by governments and private health
insurers. Marilyn Yeats, 79, is suffering from congestive heart failure and
uses a personal healthcare computer, Connect, provided by the health insurer
Humana Corp. She calls it My Little Nurse for helping her keep track of her
blood pressure, weight, temperature and whether she is taking her medicines on
How powerful is the
electronic medical record? Practice
Fusion will stretch the EMR’s muscles over the
next year as it tries to incorporate patient-friendly tools and make the
product more social. Think one part Yelp and another part Facebook with a dash
On Sunday night the
company will launch a physician review portal built on feedback in surveys from
the patients of doctors using Practice Fusion’s Web-based electronic medical
records system. Then later this week the company will release ChartShare, which will allow
doctors in and out of Practice Fusion’s network to chat with one another
similar to using Facebook chat (except it’s HIPAA
The Department of
Health recently announced Dame Fiona Caldicott’s independent review into the
protection of patient data. This announcement comes in response to the NHS
Future Forum’s recommendation that the balance of patient protection and
sharing of patient data needs to be addressed.
The last major
review of the security of patient information occurred in 1997. Since then,
there have been significant changes in the use and deployment of EHRs.
NHS is also
undergoing a transformation in which electronic healthcare will become
fundamental to every aspect of patient care. The radical reorganization of the
NHS in England is giving local healthcare providers even more responsibility
for their own EHRs, and for ensuring
they are secure.