Saturday, June 16, 2012

Weekly Overseas Health IT Links - 16th June, 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.

Shared EHRs improve coordination of after-hours care

June 5, 2012 | By Marla Durben Hirsch
A shared electronic health record system between primary care practices and the after-hours providers they use is "extremely helpful" in maintaining continuity of patient information, according to a new study by the Center for Studying Health System Change, published in the Journal of General Internal Medicine.
Improving after-hours access to care would improve outcomes and at a lower cost than use of a hospital's emergency department. However, access to such care in the United States is "poor," according to the study, which strove to identify the most effective models of after-hours care.
June 7, 2012

In Growing Health IT Job Market, Clinical Background Necessary

The growing demand for health informatics workers in the U.S. has been well documented through various studies over the past few months. Another recent study, from career market intelligence vendor Burning Glass (Boston, Mass.), confirms since 2007, the demand for health IT workers has risen steadily. Burning Glass, which used intelligence systems to analyze job postings for the study, found that healthcare informatics jobs increased by 36 percent from 2007 to 2011, compared to a nine percent growth in all healthcare postings.

Geo-Medicine New Frontier In Medical Informatics

Healthcare researchers want to know if marrying geographic data on large patient populations to clinical databases can reveal hidden disease patterns.
Health IT specialists will soon want to know more about a field called geo-medicine, which combines geographic information system (GIS) software with clinical databases to provide insights that might improve individual and population health. While most of the activity is still confined to academic research, GIS firms have begun to explore its commercial potential as well.
According to Esri, a Redlands, Calif.-based GIS vendor, "A geographic information system (GIS) integrates hardware, software, and data for capturing, managing, analyzing, and displaying all forms of geographically referenced information." A GIS application allows users to plug data into electronic maps to find out where particular things are, measure the quantity or density of those things in certain geographical areas, or find out what's inside a particular area or what's nearby. AdTech Ad

Association to study liability risks of EHRs

Posted: June 5, 2012 - 3:00 pm ET
The American Health Lawyers Association will sponsor a year-long research project to address patient-safety events and malpractice liability stemming from the implementation of electronic health-record systems, the association has announced.
The goal is to produce tools and a checklist of best practices “to help minimize the occurrence of EHR-related errors,” according to an association news release.

ONC launches clinical decision support wiki

June 8, 2012 | By Ken Terry
The Office of the National Coordinator of Health IT (ONC) has launched a new S&I Framework Initiative called Health eDecisions. A descendant of multiple prior efforts to standardize clinical decision support (CDS), this new wiki will enable public- and private-sector experts to tackle the problem together.
According to ONC's announcement, much progress has been made on models for organizing and sharing CDS. However, ONC said, "there is still a gap between the work to date and the practical goal of producing updatable, findable, distributable, maintainable CDS interventions that can be widely used and shared (or sold) by Electronic Health Records vendors, knowledge vendors, providers and quality program leaders.

Health-Monitoring Devices Market Outpaces Telehealth

Market for consumer devices to monitor conditions such as high blood pressure is growing faster than telehealth systems, says IMS Research study.
Medical devices purchased by consumers used to self-monitor health conditions will account for more than 80% of wireless devices in 2016, according to a study conducted by IMS Research.
Data from Wireless Opportunities in Health and Wellness Monitoring – 2012 Edition, reveals that the market for self-monitoring for conditions such as high blood pressure and blood glucose is growing faster than telehealth implementation. The proportion of wireless devices used in managed telehealth programs is predicted to increase from 5% in 2011 to 20% in 2016, according to the study.

Computers Can Help Treat Adolescent Depression

Cognitive behavioral therapy delivered to depressed adolescents by computer was at least as effective as usual treatment.
Fewer than 20% of adolescents with depression receive treatment, partly because of a shortage of qualified mental health providers. Could a computerized intervention fill this gap? To find out, investigators in New Zealand randomized 187 adolescents (60% female; mean age, 15.5 years) who sought help for clinically significant depression to receive usual treatment (face-to-face therapy provided by trained counselors or general practitioners) or a computerized cognitive behavioral therapy (CBT) intervention (SPARX).

Are Computers Getting Between You and Your Doctor?

By John Henning Schumann
The age of digitzed medicine is here. But for all its promises of simplifying doctors' visits, the technology also risks alienating the very people it's meant to help.
The use of computers in everyday medical practice has finally reached the tipping point.
The HITECH Act, part of the 2009 federal stimulus bill, has been the final kick in the pants that U.S. health care has long needed to make the conversion to digital. The act states that, by employing electronic health records (EHRs) in a fashion known as meaningful use, doctors are individually eligible for Medicare subsidies of $44,000, paid out over five years. Before now, only early adopters and deep-pocketed institutions like hospitals and large medical groups could afford the investment to convert to EHRs.
In general, EHRs are secure digital repositories of patient information--doctors' notes, lab and X-ray reports, and letters from specialist physicians. They are an electronic version of the paper chart. Newer, more advanced EHRs are integrated systems and allow doctors to order tests, generate bills, communicate with patients, and run analyses on aggregate patient data. In hospitals, nurses use EHRs to administer and record medication dosing and document other patient care activities.

Are You a Bystander to Bad Data?

JUN 7, 2012 10:14am ET
In his recent Harvard Business Review blog post “Break the Bad Data Habit,” Tom Redman cautioned against correcting data quality issues without providing feedback to where the data originated.
“At a minimum,” Redman explained, “others using the erred data may not spot the error. There is no telling where it might turn up or who might be victimized.” And correcting bad data without providing feedback to its source also denies the organization an opportunity to get to the bottom of the problem.

Debating the Privacy Issues to Come

JUN 7, 2012 9:35am ET
A discussion on regulation during the Health Privacy Summit in Washington considered emerging issues that will confront the industry, consumers and government regulators.
On the table, for instance, was the right of patients to have some degree of control over their de-identified data. The HIPAA rules are set up to not only permit use of such data, but to actually encourage its use, noted Marcy Wilder, a privacy and information management attorney at the law firm Hogan Lovells. However, if there is a way to recover the data, it cannot be considered de-identifiable.

EHRs: A legal 'game changer,' privacy experts say

By Diana Manos, Senior Editor
Created 06/06/2012
WASHINGTON – A panel of experts gathered at the 2nd International Summit on the Future of Health Privacy in Washington, DC on Wednesday all seemed to agree that the stakes are high when it comes to electronic medical records and privacy.
"Electronic technology is a game changer, legally, because the damage that can be done to someone is perpetual and the damages that can be awarded are incalculable," said James Pyles, co-founder and principal of the law firm of Powers, Pyles, Sutter, & Verville.

New York RHIOs and HIEs team up to create 'model for the rest of the nation'

By Mike Miliard, Managing Editor
Created 06/07/2012
NEW YORK – The New York eHealth Collaborative (NYeC) and the New York State Department of Health announced Wednesday that three regional health information organizations (RHIOs) and three health information exchange (HIE) vendors will participate in the Statewide Health Information Network of New York (SHIN-NY), which officials say will function much like a public utility.
The RHIOs – Brooklyn Health Information Exchange, e-Health Network of Long Island and THINC – and HIE vendors (HealthUnity, IBM and InterSystems) have signed on with NYeC to facilitate information exchange across New York's downstate region, which comprises New York City's five boroughs, Long Island and the Hudson Valley, with a combined population of 13 million.

What's to blame for health data breaches: Tech or culture?

June 7, 2012 | By Dan Bowman
Panelists participating in a discussion on technology and its potential for patient harm at the Second Annual International Summit on the Future of Health Privacy in Washington, D.C. yesterday pondered whether complex--and often conflicting--privacy policies were to blame.
Technology can harm people because of how we define harm, said William Sage, M.D., a law professor at the University of Texas at Austin and Vice Provost for Health Affairs. Sage repeatedly called the American healthcare system "not very good" and blamed ever-increasing medical data breaches on a culture of training doctors to think they must know everything all the time. 
6.5.12 | Deanna Pogorelc

‘Google for docs’ brings a new kind of smart searching to medical research

The largest publisher of original medical reference content has created a new, comprehensive tool for medical research to make its content – and select third-party content – easily searchable.
ClinicalKey is the recently launched reference database from Elsevier that’s being deemed the Google for docs. It contains full-text content from more than 500 journals and 800 books published by Elsevier (including Neuroscience, Cell and The Lancet), plus Medline abstracts, select third-party journal articles (but it’s missing some important ones), a library of medical images and videos, and clinical trials information. Users can filter, save, export and share this content.
Thursday, June 07, 2012

DIY Remote Health Monitoring -- More Team Than Solo Sport

by Jane Sarasohn-Kahn
IMS Research forecasts that health providers and payers won't drive growth in wireless-enabled remote health monitoring by 2016; it's consumers who will demand and pay for 80% of devices four years from now. IMS says that, "The demand for self-monitoring one's health is growing much faster than that for telehealth implementation. Even without healthcare systems that are adapted for this, consumers want to be able to monitor and manage their own health at home."
I am an N of 1. In my personal life, I'm an early adopter of health self-monitoring, regularly using a Wi-Fi scale, a turbocharged pedometer and a sleep device. Using these devices has become habit-forming for me and has had a positive impact on my health and in lowering risk factors.

Online Technologies Doctors Love: Age Matters

Docs love tablets, but adoption of Internet technologies varies depending on gender, age, and work environment, study says.
In some respects, physicians are technological trend setters. For example, 62% of physicians are now using iPads or other tablet computers, while just 19% of U.S. adults have tablet computers. But within the physician community, there are sharp differences in technology adoption. A new study shows that in regard to Internet technologies, these differences are related to physician demographics rather than to professional variables such as specialty, practice setting, or the number of patients they see per week.

10 of the largest data breaches in 2012 ... so far

By Michelle McNickle, Web Content Producer
Created 06/05/2012
We're six months into 2012, and numerous headlines have showcased some large health data breaches. Whether it's outright theft, the actions of a disgruntled employee or overall carelessness, 2012 is already chock-full of noteworthy breaches. And according to recent research, the problem is only growing. 

Leapfrog Issues Hospital Safety Report Cards

Cheryl Clark, for HealthLeaders Media , June 6, 2012

Hospitals are getting report cards.
A new "Hospital Safety Score" issued by The Leapfrog Group, a non-profit employer-sponsored organization enables anyone with internet access to check out which hospitals are the least, and which ones the most, likely to cause avoidable patient harm.
Leapfrog reviewed 2,651 facilities across the country and generated a report card for each, with an A, B, C, D or F letter grade.

AARP, Microsoft partner on PHR aimed at seniors

By Mike Miliard, Managing Editor
Created 06/05/2012
WASHINGTON – AARP on Tuesday announced the launch of AARP Health Record. By connecting with Microsoft HealthVault, it enables people over 50 to store their personal health information in a secure, central location and share it selectively with caregivers and family members.
Officials say Health Record, which is offered free to AARP members, makes it easy to create and maintain security-enhanced, up-to-date electronic records that can be accessed from an Internet connection. By storing all of their health information in one location, members can partner more effectively with their doctors and other healthcare providers, be better prepared for emergencies and reduce wasteful and redundant paperwork.

EHR Research: A Study in Contradictions

JUN 1, 2012
Now that electronic health records and other clinical computing tools are becoming more commonplace, the pressure's on to prove (or disprove) their worth. Since the 2009 stimulus bill made federal investment in health information technology a political football (or maybe a golf ball, considering the relatively small, in Washington terms, amount of money involved), any hint that it might be wasted counts as news.
Case in point: The March 12 issue of the policy journal Health Affairs featured a paper questioning the financial value of electronic health records. At least, that's how the lay press positioned enough of the coverage to prompt an exchange of irritated commentary between the National Coordinator for Health Information Technology and the study's authors.

To the cloud? Better check your security arrangements

June 6, 2012 | By Ken Terry
One might think that private cloud services would be more secure than public cloud services because the former are designed to serve a single enterprise, whereas the latter are open to the public. But in a column in Health Data Management, an intellectual property expert says that no valid comparisons have been made between the security of private and public clouds. Moreover, writes John Pavolotsky of the Greenberg Traurig law firm, such comparisons would be impossible because most public cloud vendors do not disclose their security arrangements.
This will not be good news to healthcare providers who are considering using cloud-based services. In a recent KLAS study, the research firm attributed the wariness of many hospitals about using the cloud to concerns about reliability and security.

iPad works well for emergency MRI and CT reads, study finds

iPads are just as effective as traditional workstations for radiologists reading MRI and CT scans in emergency situations, according to new research published in the Journal of Digital Imaging.
Researchers from Changi General Hospital in Singapore theorized that tablet computers such as the iPad could hold lots of potential for radiologists, because they could fill the need for a lightweight, portable wireless device that would allow radiologists to review images remotely.
The iPad could provide radiologists with advantages over laptops (bulky with low-battery life) and smartphones (small screen size), according to the researchers.

Reputable hospitals score poorly on patient safety

June 6, 2012 | By Alicia Caramenico
Hospitals are getting new safety report cards from the Leapfrog Group, which gave more than 2,600 facilities an A, B, C, D or F for how well they keep patients safe from infections, injuries and errors. But despite outstanding reputations for quality, some of the most renowned hospitals scored poorly for patient safety, according to a Leapfrog statement released today.
For example, Baldridge Award winner Henry Ford Hospital in Detroit and the Cleveland Clinic's main campus (and most of its hospitals) scored Cs, HealthLeaders Media reported.

Cloud Security: Public versus Private

JUN 4, 2012 5:18pm ET
The debate between public (cloud infrastructure provided to general public) and private (cloud infrastructure operated for particular customer) shows no signs of relenting. Conventional wisdom suggests that a private cloud may be more secure due to a higher level of control and visibility.
However, the problem is that an apples-to-apples comparison is virtually impossible. Public cloud providers will rarely disclose their specific security practices and architectures, which may be viewed as proprietary and thus a source of competitive advantage. They also typically won’t shed any light on how well their security measures are implemented. In contrast, during the course of negotiations, private providers may be more likely to not reveal their practices but also to negotiate in certain protective provisions (as discussed below). Put otherwise, the public cloud service may be as secure, if not more secure, than the equivalent private cloud service, but there isn’t an effective way to confirm one way or the other.

MRs swift to pinpoint prevention, follow-up care

By Bernie Monegain, Editor
Created 06/05/2012
TORONTO – Primary care practices with electronic medical records identified patients who need preventative or follow-up care approximately 30 times more quickly than paper-based clinics, according to a study commissioned by Canada Health Infoway, a not-for-profit organization funded by the Canadian government.
Researchers from St. Mary's Research Centre, MedbASE Research and McGill University challenged participating clinics to review their patients' records to identify those who would benefit from six different types of evidence-based interventions: immunization, follow-up care after a heart attack, cancer screening, diabetes management and two medication recalls.

Nurses often skeptical of bar coding for med administration

June 5, 2012 | By Dan Bowman
While bar-coding technology can improve medication administration safety by reducing errors, it's not always preferred by the nurses who use it. Worse, some nurses try to override or work around the technology. 
Researchers publishing online this week in the Journal of the American Medical Informatics Association concluded that before hospital administrators implement and require use of bar codes--or any other technology--by staff, perceived ease of use should be determined in order to limit such work around attempts.

White House promotes patient access to data at invite-only meeting

June 5, 2012 | By Gienna Shaw
Officials from the Obama administration, the office of the national coordinator for health IT and other agencies met (somewhat quietly, some noted) with a number of health IT enthusiasts and advocates for patient access to data yesterday. The goals of the meeting, according to some of those who were on the invite-only list:
  • Identify and prioritize a list of standards and best practice activities needed to advance patient and consumer access to health data
  • Establish a process for addressing the priority standards activities
  • Galvanize participants to engage constructively in this process
6.4.12 | Stephanie Baum

Reducing unnecessary ER visits by providing nearby alternatives

Reducing the cost of unnecessary emergency room visits was the subject of the winning entry for the first Startup Weekend focusing on healthcare in which entrepreneurs assembled to brainstorm their approaches to reduce healthcare costs, improve access to information or tackle obesity.
QuickSeeMD’s web-based tool provides alternatives to the ER by giving users the locations of nearby clinics and physician practices based on where they live. The tool is designed to cut down on the perceived cost of unnecessary ER visits estimated at $4 billion .

Can patient photos help cut medical errors?

Amy Norton
1:31 PM EDT, June 4, 2012
NEW YORK (Reuters Health) - Putting children's photos in their electronic hospital charts could help reduce one type of medical error, a study published Monday suggests.
Policymakers have been pushing hospitals and doctors to replace old-fashioned paper records with electronic ones. The goal is to improve the quality of people's medical care -- which includes preventing errors.
But e-records have not eliminated human error. And in some cases, hospital patients may get a test or treatment intended for someone else because the doctor mistakenly put an order in the wrong electronic chart.
Summary and Comment

Telemedicine Monitoring of Older Adults with Chronic Diseases

Such monitoring had no effect on preventing hospitalizations or emergency department visits.
Older patients with multiple chronic diseases have high rates of hospital and emergency department use. In the search for novel approaches to monitoring these patients, telemonitoring of clinical status and metrics has been explored, with variable success.


June 5, 2012

The extinction of an e-health strategy

The message, if not the theme, quickly became apparent: Admit defeat and move on.
Over and again, delegates to e-Health 2012: Innovating Health e-Care, Canada’s annual gathering of e-health administrators, suppliers and users, were told that monolithic, centralized e-health databases are as outmoded as fax machines and other electronic devices which have long been supplanted by superior technologies and more efficient ways of doing things.
It’s a bold new mobile world out there that is poised to revolutionize health care, Dr. John Hamalka, chief information officer of the Harvard (University) Medical School and the Beth Israel Deaconess Medical Center in Boston, Massachusetts, said in his keynote address to the gathering in Vancouver, British Columbia.
Grand, top-down e-health strategies are being eclipsed by “Facebook for health” concepts, Hamalka said, while arguing that it is up to clinicians and patients to use mobile technologies to connect “the doctor’s brain to the patient’s pain.”

As patients' records go digital, theft and hacking problems grow

By Kaiser Health News
Created 06/04/2012
By David Schultz
This story was produced in collaboration with The Washington Post.
As more doctors and hospitals go digital with medical records, the size and frequency of data breaches are alarming privacy advocates and public health officials.
Keeping records secure is a challenge that doctors, public health officials and federal regulators are just beginning to grasp. And, as two recent incidents at Howard University Hospital show, inadequate data security can affect huge numbers of people.
On May 14, federal prosecutors charged one of the hospital's medical technicians with violating the Health Insurance Portability and Accountability Act, or HIPAA. Prosecutors say that over a 17-month period Laurie Napper used her position at the hospital to gain access to patients' names, addresses and Medicare numbers in order to sell their information. A plea hearing has been set for June 12; Napper's attorney declined comment.

From glow caps to cell scopes, mobile health future is near

By Mary Mosquera, Contributing Editor
Created 06/04/2012
CHICAGO – The future is getting closer for emerging mobile technologies to take a critical role in engaging consumers to make better health decisions, and in equipping providers with tools to obtain more data from their patients to improve outcomes.
Two early examples are contact lenses that can send and receive data, and vital signs sensors capable of continuously monitoring the wearer.
A “super” convergence of technology and market trends is opening up new ways to coordinate care and manage personal health, said Mike Wisz, a health IT consultant.

Health informatics among fastest-growing fields

June 4, 2012 | By Susan D. Hall - Contributing Writer
Health informatics is a hot field with rising skill levels in demand, a new study confirms. The good news is that professionals can gain the necessary credentials mid-career.
The report was prepared by Burning Glass, a labor market analytics firm, for Credentials that Work, an initiative that helps colleges match their offerings to job demand.
It found that between 2007 to 2011,  job postings for positions in healthcare informatics grew by 36 percent, compared with a 9 percent growth in all healthcare postings, and 6 percent increase in all U.S. jobs. And informatics positions now constitute the eighth-largest share of healthcare occupation postings.

Harvard medicine professor: Tech won't revolutionize care

June 4, 2012 | By Dan Bowman
While hailed as a "tour de force" by some in the healthcare community, Eric Topol's book, "The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care," is not universally accepted by all medical professionals as an outline for the future of patient care. One of those detractors, Harvard Medical School professor emeritus of medicine and social medicine Arnold Relman, expressed doubt that patients would be as motivated to participate in their own care as the book portends in a panel discussion hosted on National Public Radio last week.
"I think however dazzling and impressive this new technology is, I don't think it's going to revolutionize the practice of medicine the way Eric suggests," Relman, a former editor-in-chief of the New England Journal of Medicine, told NPR. "I think that medicine is not going to go away, and I think that we will still need the person-to-person contact between well-informed, compassionate doctors and their patients."

HIEs remain in nascent stage despite rapid growth

June 4, 2012 | By Ken Terry
Two facts pop out of the new Black Book Rankings survey about health information exchanges (HIEs). First, 80 percent of hospitals and 97 percent of responding physicians said they're not currently participating in HIEs, according to Healthcare IT News. Second, 85 percent of hospital executives said their HIE plans were driven mainly by the industry-wide move toward accountable care organizations and new methods of reimbursement.
One reason for the very low participation of physicians in HIEs is that most doctors don't yet have electronic health records capable of exchanging data with other healthcare providers. While surveys show that more than half of physicians have some kind of EHR, a recent government report indicated that only about a third of doctors had systems that could be classified as "basic" EHRs--and that definition doesn't include the ability to exchange clinical information. Catherine DesRoches, senior scientist for Mathematica Policy Research, told iHealthBeat that she thinks only 12 percent to 15 percent of doctors have fully functional EHRs today.

A new AHRQ-funded study confirms the patient safety benefits of EHR implementation

Earlier this month, the federal Agency for Healthcare Research and Quality (AHRQ) publicized the results of a study that AHRQ had funded. This new study adds yet one more element of documentation to something we already knew: electronic health records (EHRs) improve nursing care quality, patient safety, and effectiveness.
As the article on the AHRQ website noted, “University of Pennsylvania researchers surveyed 16, 362 nurses working in 316 hospitals in four states (California, Florida, New Jersey, and Pennsylvania). Nurses were asked about their workload and patient outcomes, as well as their hospital’s patient safety culture using items from the AHRQ Hospital Survey on Patient Safety Culture. Of the 316 hospitals, only seven percent had a basic EHR system functioning on all patient care units,” AHRQ noted.
Monday, June 04, 2012

ONC Floats Possible Rules of the Road To Govern NwHIN

by Helen Pfister, Susan Ingargiola and Rachel Sam, Manatt Health Solutions
On May 15, the Office of the National Coordinator for Health IT published a request for information calling for public comment on proposed "rules of the road" to govern the Nationwide Health Information Network. The centerpiece of the proposal is a voluntary program under which entities that enable electronic health information exchange could be validated (i.e., formally recognized) for meeting ONC-established "conditions for trusted exchange," or "CTEs."
The question of how best to govern a nationwide system of HIE has long been an open one, percolating in the background while health care stakeholders have begun exchanging information within state boundaries. The RFI represents ONC's current thinking about the policies and standards necessary to enable HIE on a nationwide scale.


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