Saturday, December 01, 2012

Weekly Overseas Health IT Links - 1st December, 2012.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Who are the doctors most trusted by doctors? Big data can tell you.

By Ki Mae Heussner | GigaOM.com, Published: November 20

ZocDocHealthgradesVitalsYelp and other sites can tell you what patients think of their doctors. But finding out in any aggregate way what doctors think of their peers has been much harder, if not near impossible, for patients — up until now.
By accessing information in government databases through FOIA (Freedom of Information Act) requests, healthcare innovators are now able to share connections between doctors that are based on millions of physician referrals — a valuable indicator of who doctors hold in esteem.
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EHRs pinpoint patients who need personalized health messages

November 17, 2012 | By Marla Durben Hirsch
Patients who received personalized messages about their risk of cardiovascular disease generated from EHR data were more likely to get medication to reduce their cholesterol, one of the risk factors for the disease, according to a study published in the Journal of General Internal Medicine.
The researchers, from Northwestern University, theorized that assessment of patient risk for cardiovascular disease often did not occur at the primary care level, and that using the EHRs to pinpoint patients who were at risk would increase preventive care. The study of 29 physicians and 435 eligible patients used the physicians' EHRs to automatically identify at-risk patients not being treated for high cholesterol, enabling the physicians to generate personalized messages delivered by mail suggesting that the patients come in to discuss this issue.
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38% of physicians 'highly satisfied' with their EHR systems

November 16, 2012 | By Marla Durben Hirsch
Physician opinions on electronic health records appears to be generally positive, according to the results of a new survey published by the American Academy of Family Physicians. Thirty-eight percent of the survey's 3,088 respondents reported that they're "highly satisfied" with their systems, while 37 percent said that they "liked" their EHR.
The survey focused on user satisfaction with the 31 EHR products most used by the respondents. It concentrated on 17 different aspects of EHRs, such as ease of learning the system, how well alerts worked, and how easy it was to attain Meaningful Use.
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Mostashari on Meaningful Use: It's a long road, but we have a roadmap

November 14, 2012 | By Dan Bowman
A delicate balance needs to be struck between the urgency to modernize the U.S. healthcare system and the pace of change that can be absorbed by both providers and IT vendors, National Coordinator for Health IT Farzad Mostashari said at a Congressional hearing in Washington, D.C., this morning focusing on if Meaningful Use is delivering meaningful results. Mostashari said that while he thought meeting Meaningful Use was meant to be challenging, substantial progress has been made to date with regard to interoperability.Mostashari said that while he thought meeting Meaningful Use was meant to be challenging, substantial progress has been made to date with regard to interoperability.
"This is a long road," Mostashari said. "But we have a roadmap, and we have, through Meaningful Use, a phased approach to being able to bring the floor up and create infrastructure in stage after stage after stage to help increase that journey toward interoperability."
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Long, winding road for IHE

By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Created 11/21/2012
At the Radiological Society of North America’s annual conference this year, a real-world use case of Integrating the Healthcare Enterprise (IHE) medical image and personal health record standards is slated for demonstration.
IHEs road leading up to RSNA 2012, however has been a long and involved one.
Back in 1998, HIMSS and the Radiological Society of North America created Integrating the Healthcare Enterprise (IHE), in an effort to coax some more efficiency into health IT systems and help them communicate — or, as the industry speaks now, become interoperable.
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Online access spurs greater use of healthcare services

November 21, 2012 | By Susan D. Hall
Patients with online access to their medical records and email communication with clinicians have more interaction with their clinicians, including office visits and phone calls, according to a study published this week in the Journal of the American Medical Association.
The results contradict previous research suggesting that if patients could look up test results, schedule appointments and request refills themselves, they would use traditional healthcare services less.
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Researchers develop architecture to support practice-based research networks

November 21, 2012 | By Julie Bird
A joint U.S. and British research group has developed an information architecture to support electronic practice-based research networks (PBRNs), linking disparate electronic health record systems and providing a foundation for software development in support of network-based research, according to a report published in the current issue of the Annals of Family Medicine.
Electronic support of PBRNs facilitates participation in clinical trials and other clinical research opportunities, including collection of aggregated data and the exchange of information between investigators and "clusters of independent data sites," according to the article, "A Model for the Electronic Support of Practice-Based Research Networks."
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Online diabetes care management program shows gains

November 21, 2012 | By Susan D. Hall
A nurse-led, multidisciplinary health team working through an online disease management program helped Type 2 diabetes patients achieve better A1C results at six months, though the gains were not sustained at 12 months. Still, the researchers found the program a viable way to help patients manage their disease.
In the study, published at the Journal of American Medical Information Association clinicians at the Palo Alto Medical Foundation in California sought to engage and motivate patients through an online monitoring system that included features including wirelessly uploaded home glucometer readings, online messaging with the health team, advice from a nurse care manager and dietician and personalized text and video clips sent to patients.
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Epic contract under review

19 November 2012   Lis Evenstad
Cambridge University Hospitals and Papworth Hospital NHS foundation trusts’ joint electronic patient record contract with Epic is under review, while Monitor takes a close look at Cambridge’s finances and performance.
The EPR is a part of Cambridge and Papworth Hospitals’ eHospital programme.
In what was seen by many as one of the most important NHS IT procurements in recent years, the trusts announced in April that they were awarding the software component of the tender to US supplier Epic and the hardware and infrastructure contract to Hewlett Packard.
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NHS CB mandated to create EHR

13 November 2012   Rebecca Todd
The NHS Commissioning Board should have plans in place for all patients to have an integrated electronic record of their care that can follow them to any part of the NHS or social care system, by 2015.
The government mandate to the NHS CB, published today, says the board should promote the implementation of electronic records in all health and care settings and set national information standards to support integration.
By March 2015, “clear plans will be in place to enable secure linking of these electronic health and care records wherever they are held, so there is as complete a record as possible of the care someone receives.”
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Advocate Health Care's Technology Plans for the Long Run

Scott Mace, for HealthLeaders Media , November 20, 2012

How are healthcare CIOs preparing for the possibility of the federal government going over the fiscal cliff? I spoke last week with Bruce Smith, CIO of Advocate Health Care, the largest integrated healthcare system in Illinois, about the post-election landscape.
"We've got strong cost management processes in place," he says. "Actually, we put those in place regardless of the fiscal cliff. We're making the assumption going down the road—if you look at where Washington's at and what's coming out there—there are going to be reductions in healthcare spending, so we know there's a good possibility that we are going to be under more economic pressure."
Chicago-based Advocate is big, with more than 250 sites of care, 10 acute-care hospitals, and a children's hospital with two campuses. In the grand scheme of things, the recent election was barely a blip on a six-year-old mission to build electronic medical records and digitize as much clinical information as possible to make it available anywhere, anytime.
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Can public and private HIEs get along?

By Diana Manos, Healthcare IT News
Public health information exchanges (HIEs) have expressed concerns about compatibility and sustainability as the number of private HIEs continues to rise, according to eHealth Initiative's 12th Annual HIE Survey.
The survey of 161 HIEs nationwide indicates that if public and private HIEs are operating on different systems within a state or region, it will become increasingly difficult to exchange and leverage useful data to improve the quality and coordination of care in the United States, researchers said.
According to eHealth Initiative (eHI), there should be a level playing field between public and private HIEs.
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Pediatricians cite cost, uncertainty of benefits as barriers to EHR adoption

By Erin McCann, Associate Editor
Created 11/20/2012
Pediatricians in the U.S. continue to adopt electronic health record (EHR) systems at an underwhelming rate, citing costs and hesitancy over potential system benefits, according to a new report published Monday.
The study, published in Pediatrics and conducted by researchers at the Seattle Children’s Hospital, East Carolina University and the American Academy of Pediatrics, sought to shed light on the often opaque and limited data surrounding pediatricians and health IT adoption rates.
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UK GPs top for use of EMRs

15 November 2012   Rebecca Todd
More than two thirds of UK GPs use electronic medical records and can also order tests or prescriptions online, manage patients lists or generate patient information electronically, a new survey reveals.
The 2012 Commonwealth Fund International Health Policy Survey of 8,500 primary care doctors in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, the United Kingdom and the United States, places the UK at the top of the table in their use of electronic records.
The report, published today, shows that more than two thirds (68%) of GPs in the UK said they have ‘multi-functional HIT capacity.’
This means they use EMRs with at least two electronic functions such as; order prescriptions or diagnostic tests online; manage patient lists and generate patient information electronically; and routine clinical support.
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Health IT ROI hampered by staff shortages, limited data sources

November 20, 2012 | By Julie Bird
The potential return on investment for health IT is compromised by personnel shortages and limited sources for "clean, comprehensive data," according to a recently released survey by Deloitte Consulting and the American Medical Informatics Association.
"(E)ven when the budget is available, these organizations are unable to secure the right people and the right data to meet their needs," the authors concluded in the "2012 Deloitte-AMIA Health Informatics Industry Maturity Survey." They added that the gap "represents an opportunity for those with a desire to enter the field and for those with potential data sources to make them available."
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How one hospital uses EHR data to track core measures

November 20, 2012 | By Gienna Shaw
The following is an excerpt from an article published in the FierceEMR eBook "Making Data Meaningful." Download the eBook here to read more.
Now in its second stage, the Meaningful Use incentive program has no doubt increased the number of hospitals and physicians who are using electronic health record systems. Still, some say there is a danger that Meaningful Use program participants will simply "check the boxes" to get their incentive payments.
But there is so much more organizations can do with the data.
A more "holistic" approach to data mining includes clinical data from electronic health records combined with financial and administrative information to provide a more well-rounded view of the quality and efficiency of patient care--and then using that information to make strategic decisions, according to market research firm Frost & Sullivan.
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E-visits could lead to overprescribing

November 20, 2012 | By Dan Bowman
While patients who "see" their doctor via an e-visit aren't any more likely to need follow-up care than those who see their doctors in person, researchers have found that they are more likely to receive prescriptions for antibiotics without relevant testing, according to a study published online this week in the Archives of Internal Medicine. The study's authors, from the University of Pittsburgh School of Medicine and UPMC, say their findings could be indicative of overprescribing during e-visitors.
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Health IT collaborative releases patient engagement guide

Posted: November 19, 2012 - 2:00 pm ET
Healthcare providers wanting a recipe to follow to improve patient engagement within their organizations can start by looking over the Patient Engagement Framework released by the National eHealth Collaborative.
“We are at a critical moment when patient engagement is becoming increasingly important given the movement toward meaningful use and accountable care,” said the collaborative's CEO Kate Berry in a news release. “We as individuals should be more engaged in managing and improving our own health. This framework is intended as a guide organizations can aspire to as they move in this direction.”
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How is a medical informatician trained?

By Daniela Chueke, Managing Editor, EHealth Reporter Latin America
Created 11/15/2012
The Hospital Italiano offers a course specializing in health IT as part of its HIBA residency program through its University Institute.
The course trains recently graduated doctors in supporting the work of other doctors. It includes tools from Healthcare Administration and Management Sciences as well as studies in new technologies such as computer and information sciences. Also, as the discipline is relatively new, it includes a space dedicated to research into the impact of its application for which reason it also involves the study of epidemiological issues.
The training program is designed both for those who have just graduated and those who already have a specialty, the former studying for four years and the latter for two years.
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Decision time on insurance exchanges

By Mary Mosquera, Senior Editor
Created 11/19/2012
The continuing saga around the deadline delay for states to decide whether or not they'll establish their own health insurance exchanges doesn’t change the final upshot: All states are anticipated to have an online insurance marketplace, one way or another.
The delays may also make a federal/state partnership model for the exchange more palatable and a way out for unprepared states, at least in the initial years, according to an expert on state healthcare issues.
The continuing saga around the deadline delay for states to decide whether or not they'll establish their own health insurance exchanges doesn’t change the final upshot: All states are anticipated to have an online insurance marketplace, one way or another.
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The Fiscal Cliff and Meaningful Use: Be Very Afraid

NOV 16, 2012 8:11pm ET
During the congressional tax/budget debate coming very soon, someone in the Republican Party is going to demand another $20 billion or so cut from an entitlement program or another government program that is near and dear to the Democratic Party. Someone in the Republican Party will mention that boondoggle health information technology initiative in the hated stimulus bill, and someone in the Democratic Party will decide that’s where another $20 billion in savings can come from. Whatever federal funds are left to support electronic health records meaningful use, health I.T. workforce training, health information exchanges, best practices dissemination, regional extension centers and anything else in the HITECH Act will be gone.
Don’t believe all the talk of how health I.T. has bi-partisan support. Nothing but the most sacred cows will be considered sacred in the upcoming budget battle. Since health I.T. doesn’t pass the sacred test, the spigot is in danger of running dry unless the nation’s physicians and hospitals rise up en masse and scare the hell out of their congressional representatives and senators.
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5 steps to engage patients in their healthcare data

November 19, 2012 | By Dan Bowman
The patient engagement requirement included in Stage 2 of the Meaningful Use incentive program has many providers worried about whether or not they'll be able to convince their patients to use interactive online tools to access their health data. The National eHealth Collaborative, a Washington, D.C.-based public-private partnership geared toward enabling nationwide health information exchange, thinks it might be able to help.
NeHC today released a model framework provider organizations can use to help spur patient engagement efforts. The model--dubbed the Patient Engagement Framework--is divided into five phases, each of which incorporates advice from organizations that have successfully launched and sustained patient engagement efforts.
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Reimbursement remains a major barrier to telehealth

November 19, 2012 | By Susan D. Hall
Though the landscape for telehealth continues to evolve, uncertainty over provider payment and unever reimbursement remains a barrier.
Telehealth is making advances in other countries, but there's still much to work out in the United States, according to a blog post from law firm EpsteinBeckerGreen.
Medicare regulations remain restrictive, covering fewer than 20 telehealth services and about 30 codes. It defines telehealth as real-time communication through audio or video link. And the patient must live in or use a facility deemed part of a rural Health Professional Shortage Area. Writer Rene Quashie says it will take an act of Congress to expand Medicare payments for telehealth, something he considers unlikely since federal regulators aren't convinced of the benefits of telehealth for many conditions and they fear expanding the program would raise costs.
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Evidence builds for SMS smoking cessation

By: Jonah Comstock | Nov 16, 2012
This week, the Cochrane Library published a review of mobile messaging-based smoking cessation interventions. The report found that, based on five studies, with a total of more than 9,000 participants, smokers who used mobile messaging interventions were twice as likely to make it six months without smoking than those who didn’t.
“We can’t say from the result that this means all text messaging cessation programs work, but we can say these studies have shown that they can work,” said Robyn Whittaker, the lead author of the review from the University of Auckland in New Zealand. She told MobiHealthNews that of the five studies looked at, three were pure text messaging interventions, one incorporated text messaging and use of a website, and one used both text and video messaging. In the mixed studies, the Cochrane review looked at the texting intervention specifically. Although not all of the five studies were conclusive, the meta-analysis of the five showed significant results, according to Whittaker.
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Monday, November 19, 2012

Patient Consent for Information Exchange Comes Into Focus

by Ken Terry, iHealthBeat Contributing Reporter
Federal and state laws require that patients give permission or be allowed to withhold consent for health information exchanges to use their individually identifiable health information (IIHI) for purposes other than direct patient care. Consequently, as health care providers start to adopt new care delivery models that necessitate clinical data exchange, patient consent is becoming a hot issue.
Despite the existing regulations -- or because of them, in some cases -- patient consent involves legal, technical and practical issues that are far from being resolved. Which circumstances require patient consent, which parties can be allowed to access particular information and whether patients must opt in to health information exchange or should be allowed to opt out are all open questions.
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Enjoy!
David.

1 comment:

Trevor3130 said...

Two more articles point at the problems that confront successful implementation of NEHR in this country.
Obesity strategy a 'wasteful failure' quotes Paul Zimmet, "To spend more than $40 million on social marketing campaigns without having an integrated strategy is a waste of money." Citizens may recall receiving a paper measuring tape from DoHA. I wish someone in the social sciences would analyse this "initiative" & someone with credibility and power would name those responsible for pulling off a fast one on the taxpayer. The saga tells us, though, quite a lot about how laypersons see "data" and their perceptions of measurement. That DoHA could get away with such an ill-founded nonsense is a dire sign for establishment of the essential underpinnings of NEHR.
In A Hospital War Reflects a Bind for Doctors in the U.S. we read how corporatised & vertically-integrated health "care" finds ways to rip off the taxpayer dollar. For example, Laser eye surgery ... can cost $738 when performed by a hospital-employed doctor, compared with $389 when done by an unaffiliated doctor, according to national estimates by the independent Congressional panel that oversees Medicare. An echocardiogram can cost about twice as much in a hospital: $319, versus $143 in a doctor’s office.
The best protection against the monopoly power of specialists is to ensure all costs billed to government are made available for comparison in good time. Data, again, but that's the Achilles heel at DoHA. Wouldn't it be easier to just go ahead and farm out procedures to private enterprise, then let them analyse their own performance and award them the medal for their good work at a government-funded gala occasion?
Instead, maybe Ms Plibersek could put her job on the line and promise to show the cost-benefit analysis of just one procedure performed in public & private, before Xmas (any year).