This blog is totally independent, unpaid 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.
Thursday, April 05, 2012
Weekly Overseas Health IT Links - 5th 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 payment.
Photoacoustic tomography (PAT) may provide better, deeper imaging photographs and improve patient care--without the health hazards associated with X-rays.
That's the upshot of a study recently published in Science by researchers from Washington University in St. Louis. PAT enables users to take images deeper in the body than more conventional forms of imaging and to form images that are clearer and multicolored due to light absorption by colored molecules, such as hemoglobin. X-rays also can take deep images, but they're harder to read and pump radiation into the patient.
"The trick of photoacoustic tomography is to convert light absorbed at depth to sound waves, which scatter a thousand times less than light, for transmission back to the surface," an announcement for the study from the school says.
by Bonnie Darves, iHealthBeat Contributing Reporter
Electronic health records haven't exactly been touted as health care's Holy Grail. But there are high expectations for the technology's ability to fix some of health care's major comorbidities -- information unavailability, poor interprovider communication and inconsistent (or no) documentation -- and thereby improve patient safety across the board. Too high, some experts claim.
"If EHR systems didn't have value, no one would use them," Edward Fotsch -- CEO of PDR Network, a distributor of drug-labeling and safety systems -- said, adding, "There's no doubt that HIT -- and EHRs -- are keeping patients from being injured.
March 23, 2012 — Physicians recently notified that they will be penalized this year for not electronically prescribing for their Medicare patients have been given another chance to get off the hook, although it promises to be a slim chance.
The Centers for Medicare and Medicaid Services (CMS) has been giving bonuses to physicians and other clinicians for e-prescribing — defined as sending a script directly from their computer to a pharmacy's computer — under an incentive program created by Congress in 2008. However, the program also calls for CMS to reduce a physician’s Medicare reimbursement by 1% — a “payment adjustment” — in 2012 if he or she failed to meet the agency’s e-prescribing requirements in 2011.
The decision to postpone the Oct. 1, 2013 deadline for ICD-10 implementation gained greater currency this week with the release of a poll showing that nearly half of health providers don't know when they will complete their impact assessment, a key milestone that should have been met in 2011, according to the Workgroup for Electronic Data Interchange (WEDI), which conducted the survey.
The poll took place in February and interviewed nearly 2,600 respondents including 2,118 providers, 231 vendors, and 242 health plans. Results showed that although one third of providers expected to begin external testing in 2013, another half of respondents said they didn't know when testing would occur.
WASHINGTON – As the United States moves to paperless medicine, doctors are grappling with an awkward challenge: How do they tap the promise of computers, smartphones and iPads in the exam room without losing the human connection with their patients? Are the gadgets a boon or a distraction?
"That's the tension I feel every day," says Dr. Vincent WinklerPrins, a family medicine specialist at Georgetown University. The medical school is developing one of a growing number of programs to train new doctors in that balancing act, this one using actors as patients to point out the problems ahead of time.
FRAMINGHAM, Mass., March 28, 2012 –The universe of smart connected devices, including PCs, media tablets, and smartphones, saw shipments of more than 916 million units and revenues surpassing $489 billion dollars in 2011, according to the International Data Corporation (IDC). These numbers reflect the combined total from IDC's Worldwide Quarterly PC Tracker, Mobile Phone Tracker, and Media Tablet Tracker.
"Whether it's consumers looking for a phone that can tap into several robust 'app' ecosystems, businesses looking at deploying tablet devices into their environments, or educational institutions working to update their school's computer labs, smart, connected, compute-capable devices are playing an increasingly important role in nearly every individual's life," said Bob O'Donnell, vice president, Clients and Displays at IDC.
A strategic plan is crucial to the success of an organization's IT, but today's healthcare landscape is calling for a more patient-centered approach to planning for information technology. In fact, Sue Sutton, president and CEO of Tower Strategies, believes the future of IT planning should focus on an inclusive approach -- all while optimizing workflows, playing up social media, and keeping staff needs in mind.
Physicians who had access to a health information exchange (HIE) ordered fewer lab tests for patients with prior test results after the HIE was formed than they did previously, according to a new study published in the Archives of Internal Medicine.
This finding appears to contradict the results of a controversial paper recently published in Health Affairs in early March. In that study, researchers determined that physicians with access to the results of a patient's previous imaging and blood tests in an electronic health record (EHR) ordered more tests than those who did not have an EHR.
The Office of the National Coordinator for HIT has made available at no cost an updated version of teaching materials used in the HITECH-funded community college health I.T. training programs.
The materials are available for all institutions of higher education and the general public. The materials were designed to support training for six I.T. roles: practice workflow and information management redesign specialist, clinician/practitioner consultant, implementation support specialist, implementation manager, technical/software support staff and trainer.
Healthcare data security spending is growing rapidly, and is expected to reach $40 billion in 2012—a 22-percent increase from 2011. The higher cost of maintaining data centers has led healthcare organizations to consider lower cost cities in which to locate these operations, according to a recently released report by The Boyd Company, Inc., Princeton, N.J. The study estimates that data security spending will top $70 billion by 2015, much of it stemming from investments in electronic healthcare systems, mobile health applications,, and efforts to comply with new government standards.
Speaking at the Healthcare Experience Design on Monday, Josh Clark, founder of Brooklyn, N.Y.-based Global Moxie, debunked a list of myths that mHealth developers would be wise to avoid.
Clark, whose firm bills itself as specializing in "design strategy and user experience for a mobile, multiscreen world," sought to help designers and developers steer clear of some of the "pitfalls of the last few years" as the market for smartphones, tablets and apps has exploded.
Different platforms and screen sizes and network capabilities mean that "mobile's pretty exciting, but it's also a huge pain," Clark joked.
WASHINGTON – Healthcare stands to reap big rewards from the government's $200 million "big data" project, launched March 29 by the Obama Administration.
Aiming to make the most of the fast-growing volume of digital data, the Obama Administration announced a “Big Data Research and Development Initiative,” pledging to “extract knowledge and insights from large and complex collections of digital data,” to help address the nation’s most pressing challenges.
“In the same way that past federal investments in information-technology R&D led to dramatic advances in supercomputing and the creation of the Internet, the initiative we are launching today promises to transform our ability to use big data for scientific discovery, environmental and biomedical research, education and national security,” said John P. Holdren, assistant to the president and director of the White House Office of Science and Technology Policy.
Andreas D. Arditya, The Jakarta Post, Jakarta | Fri, 03/30/2012 11:57 AM
With only a little over a month left before the deadline for the completion of the electronic identity (e-ID) data collection, the Home Ministry has asked the Jakarta administration to step up its work.
The card will contain information of marital status, blood type, parent names, employment, physical or mental disabilities, birth certificate, divorce certificate, place and date of birth, biometric fingerprints and a photo.
The government has recently announced its intention to add a health feature to the electronic identification (e-ID) card program, which will store each card holder’s personal health records.
The Assessment and Application of Technology Agency (BPPT) plan to implement an e-health program, which will also coincide with the launch of the second generation of e-ID cards, will use microchips to hold owners’ personal data, including their health records.
The UK has launched a new online research service that will give life sciences companies unprecedented access to large sets of anonymised NHS patient data.
The government wants to provide “a world-class health research service” with the new Clinical Practice Research Datalink, which it says will also provide “novel and powerful ways” to undertake clinical trials.
Minister for universities and science David Willetts said: “The UK is a world leader in life sciences, but both the research base and industry tell us that we could make better use of data in order to drive medical breakthroughs.
A randomized, controlled trial shows this treatment's superiority to online supportive therapy.
Cognitive-behavioral therapy (CBT) is effective for obsessive-compulsive disorder (OCD), but few patients have access to this treatment. Internet-based CBT is effective for other psychiatric conditions, such as panic disorder and social anxiety disorder. Now, researchers in Sweden have conducted a randomized, controlled, 10-week trial of Internet-based CBT, with therapist support, among 101 adults with a primary diagnosis of OCD (mean age, 34; mean duration of illness, 18 years).
Cloud-based electronic health record systems have become increasingly popular. But they raise security issues that providers need to address, according to attorney Howard Burde, speaking at the 20th National HIPAA Summit in Washington, D.C. this week.
"The healthcare information is stored, used, and analyzed remotely from the users, and accessed through the Internet," Burde said. "It's going somewhere you don't know."
University Hospitals of Leicester NHS Trust is looking at a shortlist of six suppliers for a hugely ambitious strategic and commercial partnership worth £600m over 15 years.
The trust issued a tender notice last November saying that it was looking for a partner to “support the delivery of world class information management and technology services”, implement a new electronic patient record, and “form a commercial arrangement to deliver services to other organisations.”
Leicester is completing the final ‘invitation to tender’ phase of the procurement process and anticipates having a partner in place by the end of August.
Specifically, investments in electronic health records and mobile technology to meet government compliance standards are cited as key to the expected spending splurge. Because of the inevitable increase in medical records sharing, new and improved efforts will be mandatory to keeping health data safe.
VANCOUVER, BC – The U.S. patient monitoring market, valued at more than $3.1 billion in 2011 is expected to grow to nearly $4.2 billion by 2018, according to to a new report by iData Research.
Researchers say the growth will be driven by the rapid adoption of wireless ambulatory telemetry monitors, and low-acuity vital signs monitors as well as telehealth for both remote monitoring of chronic conditions and for patients with cardiac implantable devices. Traditional monitoring products including multi-parameter vital signs monitoring, telemetry, fetal and neonatal monitoring will continue to grow to replace outdated systems.
Syntactic interoperability. Not exactly a popular topic of conversation at most dinner parties. But it's an important concept to grasp if you're in medical informatics.
It helps if you understand the concept of syntax in the English language itself. The best way to explain syntax is by listening to someone who ignores it. Jedi Master Yoda, for instance, was famous for lines like "Truly wonderful, the mind of a child is" and "Much to learn, you still have."
XML, HTML, and other formatting languages likewise have their own structures, or syntax. XML is used to identify different pieces of information and structure that information so that it forms a meaningful document. One advantage of XML over HTML is that it serves as a set of guidelines rather than a rigid set of tags, which means you can define your own tags depending on what you need to accomplish. So if you're putting a cake receipt on the Internet, you can create separate tags for food, calories, and so on.
While technology-based market leadership was the dominant strategy a decade ago, the transition from volume-based to value-driven care requires a fundamental rethinking of technology's future role in care delivery. New investment decisions come at a time when payment models are shifting to reward low-cost, high-value care. Simultaneously, technology is being expanded for critical service lines and complex chronic disease management is taking center stage. Continued success will be determined less by what technologies you have and more by how well you use these technologies across the care continuum.
Effectively adopting and deploying clinical technology across the organization will require a value-driven technology planning approach that formally evaluates each technology's impact on both growth and performance. Aligning technology adoption with organizational strategy and operations is part of the systematic process at the foundation of value creation. Finding the intersection of these areas (technology adoption, organizational strategy and operations) is essential to leveraging internal strengths and responding to emerging opportunities.
The demands placed on CIOs have grown within the past decade, but since the HITECH Act, these demands have exploded, making the role that much more crucial to the success not only of IT, but also the organization as a whole.
In a recent whitepaper, Pamela Dixon, managing partner at HIT recruitment company SSi-Search, helped outline the top 10 qualities today's CIOs need to have.
Internet-based telemedicine systems appear to lead to more appropriate and effective pharmacotherapy, better blood pressure control and an overall reduction in cardiovascular risk compared to conventional, periodic office visits, according to research presented today at the American College of Cardiology's 61st Annual Scientific Session. The Scientific Session, the premier cardiovascular medical meeting, brings cardiovascular professionals together to further advances in the field.
Patients who reported blood pressure readings more frequently via a web-based portal received more timely treatment decisions and medication adjustments from their health care team compared to a control group of hypertensive patients who had routine office visits. These findings have important implications for clinical practice given that – aside from lifestyle changes – antihypertensive medications are the most effective way to help patients lower their blood pressure. As many as 65 million American adults have high blood pressure, and roughly 74 percent take medication for it, according to the Centers for Disease Control and Prevention.
IU Health offers telemedicine in many specialties and services including pediatric, neurology, pre- and post-transplant, dermatology, sleep analysis and stroke care. The stroke telemedicine program is quite robust with seven sites currently live and 14 sites set to go live over the next two years. With the IU Health telemedicine network, patients who live in the farthest reaches of Indiana have access to comprehensive care.
Doug Lawrence, MSM, PMP, is the manager of telemedicine at IU Health. He has witnessed mistakes and successes while setting up IU Health's statewide telemedicine network. Here he discusses four best practices that made IU Health's experience in telemedicine implementation successful.
To explain why, the Federal Trade Commission, in its recent report on privacy, harkened back to 1890 and a seminal article in the Harvard Law Review.
"The Right to Privacy" was jointly written by Samuel Warren, who finished second in his class at Harvard law, and his law firm partner and classmate, Louis Brandeis, who finished first, and went on to become a Supreme Court justice.
To Warren and Brandeis, the right to privacy, the "right to be let alone," the right of "an inviolate personality," flowed not merely from contract or property rights, since "it was clear that only a part of the pain, pleasure and profit of life lay in physical things."
More universally, they reasoned, the right to privacy, evolved from "the intense intellectual and emotional life, and the heightening of sensations which came with the advance of civilization. Thoughts, emotions, and sensations demanded legal recognition, and the beautiful capacity for growth which characterizes the common law enabled the judges to afford the requisite protection.”
Dealing with the aftermath of the National Programme for IT in the NHS has been identified as one of the risks to the government’s latest reforms of the NHS, in a leaked draft of the risk register for the changes.
A pair of recently published reports assess the expected financial value of the patient monitoring market both on a national and a global scale. In the U.S., an iDataResearch report predicts, the patient monitoring market will be worth nearly $4.2 billion by 2018. Meanwhile, its worldwide counterpart is expected to grow to $8 billion by 2017, according to GBI Research report.
Specifically, the former report's authors point to increased awareness of the benefits of remote monitoring, as well as big spending by the Department of Veterans Affairs, for domestic growth thus far. Smartphone compatible monitoring products also are seen as a potential goldmine, particularly with regard to pulse oximetry and blood pressure monitoring products.
The usability of electronic health records has become a major concern, partly because of safety problems that may, in some cases, be attributed to poor EHR design. In addition, observers have pointed out that physicians are more likely to use EHRs that are well designed and easy to use.
These are among the reasons why the National Institute of Standards and Technology (NIST) devised a technical guidance document to help vendors and other parties evaluate the usability of EHR systems. NIST offers some valuable ideas on a technical level, but it does not address the main reasons why many physicians still find EHRs unusable or less usable than they should be.
One major issue is documentation--in other words, data entry by clinicians. Many physicians, for example, find it difficult to input data using point-and-click templates; most users find it challenging to get data into the system when an EHR is new and few patient visits have been documented on it; and some EHRs require physicians to switch to different portions of the record when they have to document their treatment of multiple problems.
The National Institute of Standards and Technology (NIST) has recently released formal protocol procedures for evaluating the usability of EHR systems. The goal, the agency says, is to encourage a user-centered approach to the development of EHR systems. NIST says the usability protocol will attempt to provide methods to measure and address critical errors in user performance before those systems are deployed in a medical setting.
John Commins, for HealthLeaders Media , March 27, 2012
An insurance industry study, touted as the largest of its kind, shows that medical costs can be reduced by more than $1,800 a year for each diabetic patient who receives periodontal care.
The study examined medical records from more than 1.6 million people who were covered by both United Concordia Dental and Highmark Inc. and identified about 90,000 Type 2 diabetics. About 25% of those diabetics elected to receive periodontal treatment in 2007 and the study compared their medical costs over the next three years with the 75% of diabetics in the group who declined the oral care.
"The data is striking. In 2007 you had fewer than half the inpatient admissions if the patients had periodontal surgery when compared with the patients who did not," says Marjorie Jeffcoat, DMD, with the University of Pennsylvania, the lead author of the study.
Scott Mace, for HealthLeaders Media , March 27, 2012
Last week's column on the shortcomings of some EMRs hit a nerve, and introduced what will be a continuing theme for me going forward: pointing out technology that makes other industries look good, but has yet to really impact healthcare.
The example I gave last week of such a technology was "big data," which marketing mavens are tapping to delve into the psyches of their customers to help them figure out what customers want even before the customers know.
This week's example comes from the travel and leisure industry, where a cornucopia of online choice and scheduling make vacation planning a breeze—a far cry from the days when travel agents (however skilled) made vacation planning tedious at best, and woefully misinformed excursions at worst.
BOSTON – Dr. Henry Feldman is a mobile technology evangelist. He struts boldly around Beth Israel Deaconess Medical Center, where he works as a hospitalist and programmer, armed with an iPhone and iPad. His nickname is the iDoctor.
Mobile technology, he argues, has made him a better, faster physician. "It lets me do everything I could do if I was sitting at my desktop at the patient's bedside, and actually some things I couldn't easily do," he explains enthusiastically. That includes showing patients impressive new animated apps, diagrams, medical records and even photos from their own surgeries as they recover.
Beth Israel, a teaching hospital for Harvard Medical School, is one of the most technically advanced hospitals in the country, especially when it comes to mobile technology.