Saturday, September 29, 2012

Weekly Overseas Health IT Links - 29th September, 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.

EHR vendors among Forbes' richest

By Bernie Monegain, Editor
Created 09/21/2012
NEW YORK – Epic Systems CEO Judy Faulkner and Cerner Chairman, CEO and President Neal Patterson are among the Forbes' 400 wealthiest people in America. Well-known billionaires Microsoft founder Bill Gates, Berkshire Hathaway Chairman Warren Buffett and Oracle CEO Larry Ellison take the top three positions.
Forbes describes both CEOs as “self-made.” Both started their companies in 1979.
Today, Cerner and Epic have the most market share of any EHR vendors, with Cerner ahead of Epic, according to a recent report from research firm KLAS.

EMR jobs going gangbusters

By Mike Miliard, Managing Editor
Created 09/21/2012
NEW YORK – In August, more than 15,000 jobs were advertised online for healthcare professionals that have experience with electronic medical records in the United States, and the market is growing 31 percent year-over-year, according to market researcher WANTED Analytics.
The HITECH Act provides funding for health providers to convert patient records into electronic files, causing more medical organizations to employ this technology and recruit professionals with knowledge of these systems. The number of job ads increased 31 percent compared to August of 2011 and 88 percent since August 2010, and is currently the most commonly required skill in healthcare job ads, say WANTED analysts.

10 EHR Vendors Pledge Patient Records Access Within Months

SEP 21, 2012 11:51am ET
The Office of the National Coordinator for Health Information Technology recently challenged electronic health records vendors to have their systems support patients viewing, downloading and transmitting their health information by the 2013 HIMSS Conference in March.
Tuesday, September 18, 2012

Adoption and Diffusion of Health Information Technology - The Case of Primary Care Clinics

From the abstract: "We empirically examine the determinants of adoption of information technology by primary healthcare clinics using a large sample of physician clinics from several States in the U.S. Ours is one of the first studies to intensively investigate primary care clinics. These clinics are important as they represent the frontlines in the delivery of services in this large and complex market. Our study generates several interesting results related to the adoption and diffusion of Health Information Technology (HIT), including: (1) the adoption probabilities vary considerably by the specific type of clinic; (2) in contrast to numerous studies in the broader technology adoption literature, we find little evidence to suggest a relationship between firm (clinic) size and the likelihood of adoption; (3) there appears to be no definitive relationship between the age of a clinic and the likelihood of adoption; (4) there is a strong effect of geographic location, as measured by specific types of urban and rural counties, on the likelihood of adoption; (5) market competitive forces appear to have a mixed influence on adoption; (6) there is a distinct State-specific effect suggesting that information privacy, medical malpractice laws and State initiatives may play an important role in adoption; and (7) HIT is diffusing at a faster rate over time. Our findings have the potential to provide a better understanding of the longer-run effectiveness and efficiency in the provision of healthcare, and crafting appropriate policy responses. We note some future extensions of our work." Read more
Wednesday, September 19, 2012

The Future of Health Care: Using the Internet to Deliver Health Interventions

From the blog:  "The best Internet interventions are sophisticated, structured, tailored, behavior treatment programs that you can log onto and get the same kind of personalized expert care very few people around the country are currently able to receive. These systems employ all the advantages of the Internet -- graphics, animations, audio, video -- and custom-tailor your intervention based on algorithms created and empirically validated in randomized clinical trials. Many are fully automated, requiring no human support, dramatically reducing costs. Some are supported with minimal clinician contact (maybe a personalized email or phone call). It's obviously not face-to-face care, but it's been shown to be almost, if not as good as, face-to-face treatment for many kinds of problems." Read more

More Passwords, More Problems

The more we depend on the Web, the more passwords we accumulate—and forget. Some startups think they have a solution.
Friday, September 21, 2012
It's easy to remember one username and password. Keeping five or 10 straight is much harder. Password overload has long afflicted techies, but as we all spend more time doing everything from shopping to banking to playing games on the Web, it's become a more widespread problem.
A number of companies are trying to combat the problem. Approaches range from password managers that secure your login details with one master password to methods that eliminate the need for multiple passwords in the first place.
A 2007 study by Microsoft Research explored the strength, frequency, and usage of passwords belonging to 500,000 computer users. The study found that each person had an average of 6.5 passwords that they used for 25 different online accounts—meaning each password was being recycled about four times.

Contra Costa County health doctors air complaints about county's new $45 million computer system

By Matthias Gafni Contra Costa Times
Posted:   09/18/2012 05:43:26 PM PDT
Updated:   09/19/2012 07:27:47 AM PDT
MARTINEZ -- One of every 10 emergency room patients at the county's public hospitals in September left without ever being seen by a doctor or nurse because of long waits -- a number rising since implementation of Contra Costa's $45 million computer system July 1.
One patient waited 40 hours to get a bed.
Dr. Brenda Reilly delivered the troubling news Tuesday afternoon to county supervisors. She was one of three dozen doctors in the supervisors' chamber complaining about EPIC, new computer software aimed at integrating all of the county's health departments to create a federally mandated electronic medical record for patients.
To allow for the major computer program installation and conversion, administrators cut doctors' patient loads in half, in turn cutting the number of available appointments in half.

Too much EHR variation holding the industry back

September 19, 2012 | By Marla Durben Hirsch
This week's opinion article in the Wall Street Journal certainly has sparked some debate. There already are more than 100 comments on the article, which run the gamut, some in favor of electronic health records, and some against. Readers complain about privacy concerns and the foolhardy rush to what amounted to experimental technology. They place blame on the government (both sides), greedy vendors, and associations such as HIMSS.
It's really no surprise that the article's authors referenced studies that reveal that EHRs don't save providers money or improve care. EHRs are only as good as the information they contain and how they are used. Different research studies testing different hospitals, methods and training will garner different results.

Patient demands should drive PHRs

20 September 2012   Rebecca Todd
Patients value online transactional services above the ability to view their electronic medical record; and patient access portals must be highly usable to succeed, a new report says.
2020health launched its report, 'Personal health records: putting patients in control?' with a round table at Church House in Westminster on Tuesday.
The government has pledged that all NHS patients will have online access to their GP record by 2015.

Therapeutic video games empower patients

September 20, 2012 | By Dan Bowman
Video games can have a therapeutic and empowering impact on patients with conditions, such as asthma, cancer, depression, diabetes and Parkinson's disease, according to a perspective published this week in the journal Science Translational Medicine. What's more, the researchers from the University of Utah say interactive games also can help providers in disease management and prevention.
The researchers, who talk about their own patient empowerment exercise game and several others, call the tools "nonpharmacological interventions" that can "enhance … resilience toward various chronic disorders." Carol Bruggers, the paper's lead author and a physician at Salt Lake City-based Primary Children's Medical Center, said that such games "show promise" for behavioral changes in self-management habits.

Southampton launches My Health Record

20 September 2012   Lyn Whitfield
University Hospital Southampton NHS Foundation Trust has become the first acute trust to launch a personal health record built on Microsoft’s HealthVault platform.
The trust booked a local cinema to launch My Health Record, which it has developed with Microsoft and US developers Get Real Consulting.
Dr Nick Marsden, one of the trust’s non-executive directors, presented it as a first step towards giving patients the kind of online and smartphone interaction with the NHS that they already have with retailers.

Report offers tech advice for exchanges from 'early innovators'

September 20, 2012 | By Susan D. Hall
Calling technology challenges one of the biggest issues facing states with regard to setting up health insurance exchanges, a new report from the University of Massachusetts Medical School and the National Academy of Social Insurance examines lessons learned from "early innovators" and others well along in the process.
The biggest takeaway: Don't try to do it alone. The report's authors say collaboration for states falling behind is crucial both with states that are farther along and with the federal government on the required infrastructure.

It's time to publicly compare EHR usability, IOM group says

September 20, 2012 | By Julie Bird
The world of electronic health records needs to open itself up to critical comparisons and earnest user evaluation if it wants to avoid formal regulation by the Food and Drug Administration, according to a discussion paper released this month by the Institute of Medicine.
Not only is there nowhere for health IT users to share publicly their experiences with different products, but vendors often prohibit users from sharing screenshots or otherwise publicly discussing EHR problems, notes the paper, "Comparative User Experiences of Health IT Products: How User Experiences Would Be Reported and Used."

Docs blast EHR system as 'clunky' and 'time-consuming'

September 20, 2012 | By Dan Bowman
Add doctors to the list of healthcare providers with California's Contra Costa Health Services complaining about its recently installed electronic health record system.
Roughly three dozen doctors met with county officials earlier this week to blast the installation of its Epic system, which was completed in July. According to the doctors, long waits for patients have been only one of the side effects of the installation, as many called the system "clunky" and "time-consuming." One out of every 10 emergency room patients at the county's public hospitals so far this month left without being seen because of the waits--which ballooned from one hour to four, according to the Contra Costa Times. One patient waited 40 hours for a bed.

Health Information Exchanges Struggle To Prove ROI

To survive, HIEs need to implement performance metrics to show they can improve quality of care and reduce costs.
To convince investors that health information exchanges (HIEs) are a worthwhile investment, organizers need to develop performance metrics that show HIEs can improve quality of care and generate a return on investment (ROI). A study published in the latest issue of Perspectives in Health Information Management, however, reveals that only 50% of surveyed HIE executives say they use or plan to use metrics to measure the impact of their exchange.
Amid doubts about the sustainability of HIEs, the results of the survey are disconcerting, lead author, Anjum Khurshid, director of the health systems division at the Louisiana Public Health Institute, and his colleagues conclude, because without incorporating quality of care and ROI metrics into their business model, many HIEs may not survive. AdTech Ad

Test highlights how to do EHR data sharing right

By Mary Mosquera, Contributing Editor
Created 09/19/2012
WASHINGTON – The Department Veterans Affairs  and the Substance Abuse and Mental Health Services Administration have demonstrated how to securely share sensitive health information via electronic health records  (EHRs).
The test also showed how substance abuse and other sensitive data can be tagged so that when it is sent in a summary of care record to another provider with the patient’s permission, the receiving provider will know  they need to obtain the patient’s authorization to further disclose the sensitive information with others, according to a Sept. 17 announcement by the Department of Health and Human Services. SAMHSA is an agency in HHS.

Electronic Staff Record up for re-tender

11 September 2012   Lyn Whitfield
The contract for one of the first, big national IT projects to be rolled out across the NHS will be re-tendered this autumn.
The Department of Health has issued a pre-tender for a framework contract to provide the Electronic Staff Record, which was built to replace a plethora of HR, payroll and associated systems with a single, national workforce solution.

Research finds racial disparities in physician use of health IT

September 19, 2012 | By Julie Bird
A recent study found significant differences in how white and non-white physicians use health IT, suggesting varying degrees of acceptance of health IT among different physician populations, the researchers said.

Mostashari says EHR incentives estimated to reach $20 billion by 2015

By Diana Manos, Healthcare IT News
There are no set appropriations for how much the federal government can spend on rewarding providers who adopt and use electronic health records under the Medicare and Medicaid meaningful use EHR incentive program, according to National Coordinator for Health IT Farzad Mostashari, MD.
"Whoever qualifies, gets paid; there's no hard cap," said Mostashari, who gave a keynote at the Annual Policy Summit for the Health Information Management and Systems Society (HIMSS) on Wednesday.

Doctors Use EHRs To Do 'Chart Biopsies'

Adoption of EHRs helps physicians to get up to speed on incoming patients before handoffs from the emergency department.
As the number of hospitals with electronic health record systems grows, a new study finds that inpatient physicians who receive patients from the emergency department have begun to do "chart biopsies" of electronic records to prepare for the handoffs.
Although the study in the Journal of the American Medical Informatics Association (JAMIA) doesn't reach any conclusions about whether chart biopsies are an improvement over traditional handoff methods, it points outs that "chart biopsies appear to impact important clinical and organizational processes. Among these are the nature and quality of handoff interactions and the quality of care." AdTech Ad

The case for improving health data liquidity

By Kristine Martin Anderson, Senior vice president, Booz Allen Hamilton's healthcare market
While some disagree on the right approach to transform our healthcare system, most will agree that patients must remain at the core. In order to deliver on the promise of more affordable, convenient care, healthcare decision makers should look at every decision with the patient at the center. How patients experience health reform over the next few years will be the measuring stick of health reform success.
To date, progress has been made in a few areas but we still stand removed from a truly patient-centric healthcare system. To meet this objective, more should be done with patient data – from how it moves within the healthcare system, to how it is analyzed and presented.

ONC unveils draft tests for 2014 EHRs

By Mary Mosquera
The Office of the National Coordinator for Health IT has unveiled its second set of draft test procedures to assure that electronic health records can perform functions required in 2014.
ONC also requested public comments and suggestions for the 2014 proposed certification test methods, according to a Sept. 14 ONC announcement. ONC released the first wave of test methods one week earlier.

Two-Way Data Archive Aims to Control Costs

Scott Mace, for HealthLeaders Media , September 18, 2012

My daughter wonders why it would be preferable for everyone to listen to the same music in her art class. Surely it would be better if everyone could listen to their own music on their own iPods or other music players.
The art teacher points out that the point of listening to the same music is to have a shared moment, not merely to inspire a painting. But in a society populated now with people listening to their own private music or media, it's like swimming against a current.
When you think about it, those shared moments can be few and far between these days. Whether we're watching TV, or surfing the Web, or listening to music, it's all too easy to slip into solitary, passive receptivity.

eClinicalWorks invests $10M in interoperability project

By Mike Miliard, Managing Editor
Created 09/17/2012
WESTBOROUGH, MA – In a bid to spur collaboration among providers, ambulatory electronic health record developer eClinicalWorks has launched Join The Network, a peer-to-peer communications platform that officials say will enable physicians to connect with each other, irrespective of the EHR they use.
With some 10,000 physicians already part of the network, eClinicalWorks officials say the firm is investing an additional $10 million over the next year to further expand the platform and connect physician practices, whether they're using EHRs or are still paper-based.

Social Image-sharing Apps Exposing Patient Information

By David Fuhriman, MBA, CPA | September 17, 2012
Patients, employees, and radiologists are sharing more than ever of their lives online. With the proliferation of smartphones, cameras, high-speed Internet connections and photo-sharing services, life’s moments can be broadcast in real time to friends, strangers, and the entire world.
Social photo sharing is already a part of radiology, whether you are aware about it or not. Instagram, a mobile photo sharing app, allows users to take pictures on their smartphones and post to the entire world. Facebook recently bought the company, which does not generate any revenue, for  billion. This image sharing will surely begin to cause security and privacy concerns and damage reputations. A few simple searches on Instagram yielded some fascinating discoveries.

HHS, VA Demonstrate Secure Sharing of Sensitive PHI

September 17, 2012
The Department of Health and Human Services (HHS) and the Department of Veterans Affairs (VA) today announced a demonstration of the standards to allow sensitive health information to be shared responsibly and to comply with confidentiality laws and regulations among providers using electronic health records (EHRs).  The demonstration also showed how sensitive information can be tagged so that when it is sent to another provider with the patient’s permission, the receiving provider will know that they need to obtain the patient’s authorization to further disclose the information with others.
“This project helps demonstrate that with proper standards in place existing privacy laws and policies can be implemented appropriately in an electronic environment,” said Office of the National Coordinator for Health Information Technology (ONC) Chief Privacy Officer Joy Pritts, in a statement.

Continua Alliance to help Denmark with telemedicine standards

By Eric Wicklund, Contributing Editor
Created 08/17/2012
BEAVERTON, OR – The homeland of Hans Christian Andersen, Tivoli Gardens and Hamlet is considered one of Europe's leaders in telemedicine. Now Denmark is relying upon the Continua Health Alliance to make sure that effort follows a uniform set of standards.
Officials at Continua, the Beaverton, Ore.-based non-profit organization focused on end-to-end, plug-and-play connectivity for personal health devices and services, say Denmark will be using Continua's design guidelines to develop an "Action Plan for Telemedicine." That plan will establish reference architectures and national standards for health IT "in areas including the secure collection, transmission and storage of personal health data from patients’ homes, sharing medical documents and images, and the management of health records, medical appointments and other related information."

How Mobile Technologies Fuel TeleHealth Advances

Scott Mace, for HealthLeaders Media , September 17, 2012

This article appears in the September 2012 issue of HealthLeaders magazine.
Ever since the first experiments with telemedicine, providers have been taking steps to move healthcare closer to where patients live and work. Now, mobile technology—epitomized by the millions of such apps already downloaded to smartphones, but also appearing in nearly unlimited form factors—is accelerating those steps.
At Boston's Partners HealthCare, a system with 2,700 licensed beds, 45 employees scrutinize these developments at the Center for Connected Health. One early effort to equip cardiac patients with remote monitoring technology resulted in a 50% drop in readmissions, says Joseph Kvedar, MD, founder and director of the center.
"We're all committed to a healthcare delivery model that moves care out of the hospital, out of the office, and directly and continuously into the lives of patients," Kvedar says. "We find that the best technologies to facilitate that vision are monitoring and communications technologies properly applied."

5 health IT insiders offer their takes on EHR usability

By Bernie Monegain, Editor
Created 09/17/2012
EHR usability is suddenly front and center, now that usability testing is part of the EHR certification criteria for meaningful use Stage 2. We talked with diverse industry insiders for their take on what is critical to user-centric design and what the usability factors might mean to healthcare and to the healthcare IT market. Here is a sampling of some of the topics on their minds.

Most hospitals still seeking HIE solutions, study finds

By Erin McCann, Associate Editor
Created 09/14/2012
BURLINGTON, VT – Some 71 percent of U.S. hospitals plan to purchase new health information exchange (HIE) solutions, according to findings from the new "2012 U.S. Health Information Exchange Study" released Friday. 
The study, commissioned by the healthcare technology research firm CapSite, includes insight from more than 370 hospitals on the market adoption, marketshare, market opportunity and vendor perspectives across the U.S. hospital industry.
The numbers this year are down slightly from last year’s report, which found 74 percent of U.S. hospitals planning to purchase a new HIE solution. 

4 Points for a Strong Leadership Agenda During Health IT Implementation

Written by Kathleen Roney | September 17, 2012
Social Sharing
Leadership is an important element in successfully steering a hospital through any health information technology implementation effort. Strong leadership will help hospital staff adjust to barriers that may accompany health IT implementations and slow down success. In a webinar hosted by the Health Resources and Services Administration, Terry Hill, MPA, executive director of the National Rural Health Resource Center in Duluth, Minn., and Joe Wivoda, CIO of NRHRC, discussed the importance of leaderships role during health IT implementations.
"Over the years we have learned [success with health IT] is about leadership. There is no exact formula to follow when implementing an EHR system. The places where we've seen really good implementation had really good leadership. Leadership that was prepared, aligned and supportive," said Mr. Hill.
In order for executives to exhibit strong leadership, they need to have an agenda, which should cover the following four points.
1. Adoption path. In order for hospital executives to lead successfully, they need to outline a clear adoption path. According to Mr. Wivoda, the adoption path should include the following steps:
• Assessment — Assess the preparedness of the hospital to fully adopt an EHR.
• Planning — Develop and prepare the request for proposals from vendors and IT companies.
• Selection — Evaluate vendors and negotiate contracts.
• Evaluation — Review system performance and effectiveness.
• Improvement — Conduct additional training to improve workflows.

Consumers want health tech to connect but say docs don't deliver

September 17, 2012 | By Jeff Byers - Contributing Writer
Patients want online access to medical records, prescriptions and test results, and want to talk to their doctor using modern forms of communication, according to a recent survey from market research firm Harris Interactive. But physicians aren't meeting their tech-savvy patients' expectations.
For example, 85 percent of respondents said they wanted to communicate with their physician by phone or email and more than 50 percent wanted to schedule appointments  and pay bills online. Just more than 10 percent report their physicians offer these services.
And although 65 percent of the 2,311 surveyed adults said access to personal health information is "very important" or "important", only 17 percent said their physicians actually offer it.

eHealth Initiative CEO Bordenick: Patients could drive provider data sharing

September 17, 2012 | By Julie Bird
Thanks to health IT, healthcare providers and other stakeholders are sitting on mountains of information--but it has yet to be mined to yield its full riches, says Jennifer Covich Bordenick (pictured), CEO of the Washington, D.C.-based eHealth Initiative, an independent, nonprofit organization geared toward improving healthcare quality and safety through the use of technology.
"We spent time figuring out how to collect data and the neat things we can do with it," Bordenick tells FierceHealthIT in an exclusive interview. "To do that, we need good analytic tools. CIOs recognize that, but a miniscule amount have the tools to do it."
The results of a recent survey from eHI and the College of Healthcare Informatics Management Executives "tell us a lot about what little we know," Bordenick says. That survey showed, for example, that while hospital CIOs considered the most important use of data to be analyzing clinician utilization and patient outcomes, the most common use of data was financial management.

HHS touts Twitter app for public health

By Erin McCann, Contributing Editor
Twitter, the much beloved social networking site, is set to take on disease outbreaks, after HHS officials announced the release of a new Web-based application tool available to public health officials.
Officials at HHS’ Office of the Assistant Secretary for Preparedness and Response (ASPR) announced Friday the arrival of MappyHealth, the winning submission in a developers’ challenge, “Now Trending: #Health in My Community,” sponsored by ASPR.
Health officials say they can use data gained through the app to complement other health surveillance systems in identifying emerging health issues and as an early warning of possible public health emergencies in a community. 
Monday, September 17, 2012

Patients' Use of Social Media Spurs More Clinical Research

by Lisa Zamosky, iHealthBeat Contributing Reporter
At 38 years old and in generally good health, Katherine Leon was an unlikely candidate for a heart attack.
Yet, on April 30, 2003, just six weeks after giving birth to her second child, she experienced classic heart attack symptoms and was rushed to the hospital by ambulance. After a number of tests, doctors told her there was nothing wrong with her and sent her home.
"I cried to my husband when leaving the [emergency department]. I knew it was my heart. You just know when it's not right," Leon said.
Experiencing similar physical symptoms, Leon returned to the hospital just three days later. But this time, doctors conducted an angiogram that revealed a serious block that required immediate double bypass surgery.

CSC to withdraw iSoft products from primary care

17th September 2012
CSC has denied speculation that it is pulling its iSoft products from the NHS primary care market.

The statement from the company, which acquired iSoft in April 2011, follows reports by the online journal eHealth Insider.
It claims it has received information from “reliable sources”, that CSC is withdrawing support for its GP systems in the UK.
However, a CSC spokesman said the company “remains fully committed to the primary care market” and that any suggestion otherwise is “speculation.”

Dalton McGuinty admits eHealth troubles continued with diabetes registry

Published on Monday September 17, 2012
Rob Ferguson
Queen’s Park Bureau
Premier Dalton McGuinty acknowledged that continued troubles at eHealth Ontario led to a push to scrap its registry to help diabetic patients — once a cornerstone of the province’s push for electronic health records.
“It’s a complicated field,” the premier said Monday following the Star’s weekend revelation that the board of eHealth is recommending Health Minister Deb Matthews axe the $46.2-million registry because it has been eclipsed by new technology.
“Obviously there were some particular challenges associated with this technology and the amount of time that it was taking,” McGuinty added near Pearson International Airport where he was touring construction for the airport rail line to downtown.


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