Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Tuesday, July 31, 2012

The Saga Of Under-Testing and Glitches With the NEHRS Seems To Just Be Endless. When Are We Going To See Some Accountability and Transparency?

The following article appeared yesterday.

Secret report finds bugs in new ehealth system

Date July 30, 2012

Mark Metherell

Mark Metherell is health correspondent

Glitches in patient identity details for Australia's new ehealth system have been found in about one third of cases nationally, according to a report the federal health department refuses to publish.
The secret report shows that patient identity information held by state public hospitals frequently fails to match the data which Medicare Australia holds on the same individuals. Differences in the spelling of names or other variations can pose a significant obstacle as the system requires an exact match before individuals can gain ehealth access.
The department has refused a request by Fairfax to release the report under the Freedom of Information Act, stating that the report was subject to confidentiality undertakings, given by the IBM company which prepared the document. The confidentiality undertakings are understood to have been made to state and federal agencies; no individual patient records were involved.
Insiders with some knowledge of the project say the refusal to reveal the information has more to do with avoiding government embarrassment about more setbacks in the problem-plagued ehealth development. A department spokeswoman said the report ''does not show up problems in relation to security and safety'' of the new personally-controlled electronic health record system, the PCEHR.
More here:
This outcome is utterly predictable and clearly, to me at least, the root problem lies in the fact that, at present, the Health Identifier Service is not being used as intended by the State Jurisdictions (i.e. States and Territories) who are reported as saying they will need up to three years to have their key systems using the Health Identifier Service. See here:

States not ready for e-Health system

GENERAL practitioners will have to wait up to three years to receive secure discharge summaries digitally signed by hospital doctors following more delays to the Gillard government's e-health system.
State and territory health departments say they are not ready to use healthcare providers' 16-digit unique identity numbers created for the national system to verify the identity of doctors or other medical staff creating a patient's discharge summary.

Healthcare providers individual identifiers - dubbed HPI-Is - were created and assigned to all registered doctors two years ago as part of the Healthcare Identifiers service launch, which also saw unique 16-digit identifiers allocated to every Australian enrolled on the Medicare database.

Use of local hospital or state health agency identity numbers instead of a uniform national identifier will impact their use for authentication and audit purposes within the personally controlled e-health record system.
Much more here:
Of course we must not lose sight of a Victorian Health Department assessment that the use of the IHI as a single identifier was just unsafe:

Sunday, February 13, 2011

NEHTA Releases A Set of Documents Describing Integration of the Health Identifier Service With the HealthSMART Program in Victoria. Not There Yet!

The most interesting to me is this document of the release is this one:
The document is one of a series of specifications and so on produced as part of a IHI Pre-Implementation Project between NEHTA and HealthSMART.
The full blog is here:
All in all this is shaping up as a bit of a mess. Just how all this is going to be resolved in a way that makes clinical documents developed in Hospitals (and GP surgeries) seamlessly and safely find their correct home in the NEHRS is feeling like a work in only very early progress.
It would be great to get hold of the IBM Report to be able to see just what it says and what other issues have been identified.
It really seems to be a bit of a shambles. It is interesting how there is a steady flow of these issues emerging. I wonder is this co-ordinated or whatever?
David.

Monday, July 30, 2012

Weekly Australian Health IT Links – 30th July, 2012.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

Overall, quite a lively week on the NEHRS front with the Health Department disagreeing with The Australian on just how badly they managed the system start-up. Right now I would suggest there is delayed delivery and the major bug that remains unfixed suggests (as of Sunday) the The Australian may be closer to the truth. As far as the specifics I am sure it will be ages before the details of exactly went on will come out.
It is interesting to note the total sign ups to the NEHRS are still really tiny in the context of the population.
Also of note it seems the COAG Meeting provided no clarity on NEHTA funding with the matter apparently having been referred to a committee.
Elsewhere we cover some small initiatives in Telehealth and Mental Health as well as some rather more left field things such as the Minority Report user interface and a seemingly pretty badly managed health provider privacy breech.
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Govt trumpets online e-health sign-ups

Summary: Amid reports of ongoing troubles with the implementation of the national e-health record system, the Department of Health has highlighted the success of the system, with 3563 signing up so far.
By Josh Taylor | July 25, 2012 -- 06:32 GMT (16:32 AEST)
The Australian Department of Health and Ageing has spruiked its success in signing up over 3500 users to its personally-controlled e-health record system in over three weeks, amid claims of issues plaguing the system since its launch.
In 2010, the government promised that it would create an electronic health record system by 1 July 2012, so that every Australian who wanted a record of their medical history online could sign up for one.
Despite there not being an online registration form made available when the system first launched, more Australians have signed up online for an e-health record than through any other method. According to stats provided to ZDNet, as of 24 July 2012, a total of 3563 people have signed up for e-health records, with 87 per cent (or 3099) of these registering online. The remaining 13 per cent (or 464) registered via phone, in writing or in person.
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Consumers favour online PCEHR registration

The latest figures released by the Department of Health and Ageing show consumers have a strong online preference when registering for an eHealth record.
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E-health records system went live despite known bugs

THE Gillard government knowingly launched the national e-health records system despite warnings from its own e-health agency that it had more than 60 high-severity and critical bugs.
The personally controlled e-health system was pushed live and accessible to the public without a back-up system that would have ensured patient data was available at all times.
The consumer portal, where people enter personal information, medical history and medication details, contained hundreds more bugs of different severity levels as the system went live, The Australian can reveal.
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Government fires back over safety of PCEHR

The federal government has responded to allegations the personally controlled electronic health record (PCEHR) system compromised patient safety in going live on July 1.
This week The Australian newspaper reported the federal government “knowingly launched the national e-health records system despite warnings from its own e-health agency that it had more than 60 high-severity and critical bugs.”
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Future of NEHTA funding a key issue at COAG meeting in Canberra

THE future of the National E-Health Transition Authority is likely to be settled at the Council of Australian Governments meeting in Canberra tomorrow.
The National Partnership Agreement on E-Health, which underwrote $218 million for NEHTA's operations in the past three years, expired on June 30.
Intended to support delivery of the healthcare identifier service and other national e-health objectives, the agreement provided commonwealth, state and territory funding on a 50:50 basis.
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Experts in the dark over patient e-health control

24th Jul 2012
THE chief clinical expert advising the government on its e-health record system has claimed doctors involved were not properly informed about the final design as efforts continue to overturn patients’ ability to delete documents from the record.
The National E-Health Transition Authority (NEHTA)national clinical lead Dr Mukesh Haikerwal said his “original understanding” was that patients who wished to remove specific documents from their record would do so in consultation with the doctor who created the document.
Instead, the system allows patients to “effectively remove” documents without providing any clue to a practitioner who later accesses the record that the document was ever there.
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Health Department to outsource PCEHR operations and management

  • by: Karen Dearne
  • From: Australian IT
  • July 25, 2012 3:31PM
THE Health Department wants to outsource its operational and management responsibilities for the personally controlled e-health record system to a single provider.
It has released a tender calling for "provision of project support services" for the PCEHR program, which went live earlier this month despite warnings that the system was unstable and plagued with known bugs.
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Aus Govt looks to outsource e-health record management

Summary: The Australian Government is looking to outsource the management of its Personally-Controlled E-health Record system.
By Josh Taylor | July 26, 2012 -- 00:15 GMT (10:15 AEST)
The Department of Health and Ageing has gone to tender for an organisation to support the operation of the Personally-Controlled E-Health Record (PCEHR) system.
The Federal Government's e-health record system was launched on 1 July after two years of planning and hundreds of billions of dollars worth of investment. Although it hasn't been a smooth start for the program, over 3500 people have so far registered for their own e-health record.
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Online GP guide for back pain launched

25 July, 2012 David Brill
A new online tool has been launched to guide GPs through the diagnosis and management of low back pain.
Back Pain Choices comprises a step-by-step guide to patient management, drawing on evidence-based guidelines from Australia, the US and UK.
It was launched Wednesday as a joint project by the NPS and the George Institute for Global Health.
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Pathways help Hunter doctors with patient referrals

Updated July 27, 2012 07:24:26
Hunter doctors taking up a new Pathways program, which gives local advice about referring patients to specialists.
An innovative web-based support program for Hunter region doctors is being rolled out across the Hunter, helping GPs ensure their patients get the right care from specialists.
Health Pathways is a collaboration between the Hunter Urban Medicare Local and Hunter New England Health, and was developed in response to feedback from doctors.
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Mouldy medical records no more

Updated July 27, 2012 07:08:25
Mouldy medical records have now been destroyed after months of scanning and transferring the data onto a computer system.
Around two years after mouldy records forced a staff walkout at a Newcastle medical storage facility almost all of the offending material has now been transferred to computer.
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New e-mental health tool all about real-time monitoring

A new free online tool based around the concept of self monitoring has been launched to assist people with mild-to-moderate anxiety and depression.
myCompass is an “interactive self-help service” that assesses user symptoms, then provides a personalised and interactive program designed to help a person work through their mental health issues. The initiative has been developed by a team of health professionals at the Black Dog Institute, and funded by the Australian Government.
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New e-Mental Health Tool Launched

A new online mental health tool, myCompass, that assesses user symptoms, then provides a personalised support program, has been launched.
23 July 2012
Minister for Mental Health Mark Butler today launched a new online mental health tool designed to support people living with a mental health issue such as anxiety or depression.
Developed by a team of health professionals at the Black Dog Institute, and funded by the Australian Government, myCompass is an online tool that assesses user symptoms, then provides a personalised support program.
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Telehealth trial declared a success

Date July 24, 2012

Brad Howarth

Ease-of-use is emerging as the critical factor for the uptake of telehealth consulting in Australia.
A six-month trial implementation of telehealth at the Royal Children's Hospital in Melbourne has been declared a success, with more than 150 patients seen and countless hours saved for families and clinicians.
The director of neurology at the Royal Children's Hospital Professor Andrew Kornberg said previous telehealth attempts, including trial consultations via Skype, had not worked, as connection dropouts and scheduling difficulties led doctors to stop using it after just one or two bad experiences. The new system uses GoToMeeting, a web-based videoconferencing service from Citrix Online.
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PCEHR “soft” approach yields dividends

Department of Health and Ageing officials have dubbed the federal government’s “softly-softly” approach to PCEHR registrations a success.
According to eHealthspace.org calculations, an average of 135 individuals per day are signing up for an electronic record. The PCEHR was launched on July 1.
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Paternity firm slapped over privacy breach

THE largest Australian company in the field of drug, alcohol and paternity testing has been found to have breached the Privacy Act for displaying on the internet confidential, sensitive information about hundreds of customers and their orders for testing kits.
But Privacy Commissioner Timothy Pilgrim found Medvet had acted quickly last July to resolve the privacy breach, despite The Australian establishing the company had not fixed the problem after being told three months earlier that customers' information had become readily available on Google.
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Researchers work on biometric shoes for secure ID

  • From: AP
  • July 23, 2012 7:03AM
A LAB is working to perfect special shoe insoles that can help monitor access to high-security areas, like nuclear power plants or special military bases.
The concept is based on research that shows each person has unique feet, and ways of walking. Sensors in the bio-soles check the pressure of feet, monitor gait, and use a microcomputer to compare the patterns to a master file for that person. If the patterns match the bio-soles go to sleep. If they don't, a wireless alarm message can go out.
"It's part of a shoe that you don't have to think about," said Marios Savvides, head of Carnegie Mellon University's new Pedo-Biometrics Lab, in Pittsburgh.
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Physician robot to begin making rounds

The robot can be controlled by an iPad and can make hospital rounds while the doctor observes remotely
The maker of Roomba, the robotic vacuum, has stepped up its game and Tuesday unveiled a 5-ft., 4-in.-tall, 140-pound "telemedicine" robot aimed at aiding hospital patients in emergency situations, especially during nighttime hours when staffing is lower.
The robot, dubbed RP-VITA (Remote Presence Virtual + Independent Telemedicine Assistant), is the result of a collaboration between iRobot and InTouch Health, a telemedicine robotics vendor.
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'Minority Report' software hits the real world

Date July 24, 2012 - 9:18AM

Rob Lever

The software behind the film Minority Report, where Tom Cruise speeds through video on a large screen using only hand gestures, is making its way into the real world.
The interface developed by scientist John Underkoffler has been commercialised by the Los Angeles firm Oblong Industries as a way to sift through massive amounts of video and other data.
We think the future of computing is multiuser, multiscreen, multidevice. 
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New protein could rival antibiotics

Date July 29, 2012

John Elder

AUSTRALIAN scientists have made a breakthrough in finding a powerful alternative to antibiotics - at a time when the World Health Organisation is predicting a bleak future in which bug-killing drugs are so ineffective that ''a child's scratched knee or a strep throat could kill again''.
The threat of the world returning to a pre-antibiotic era has been fretted about for at least a decade because of microbes becoming increasingly resistant to drugs.
But Monash University researchers, in collaboration with Rockefeller University and the University of Maryland, have published a paper revealing the structure and workings of PlyC - a flying saucer-shaped protein that kills bacteria that cause infections from sore throats to pneumonia and streptococcal toxic shock syndrome.
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Enjoy!
David.

AusHealthIT Poll Number 132 – Results – 30th July, 2012.

The question was:
Should DoHA Provide The E-Health Community and Public With An Updated Plan For E-Health in Australia?
For Sure
-  23 (56%)
Probably
- 1 (2%)
Why - It Would Be A Fiction!
-  16 (39%)
No - It Is None Of The Public's Concern
-  1 (2%)
Votes : 41
Very interesting response. About half say a plan is needed and the other half reckon if would be a fiction - even if it were provided.
Again, many thanks to those that voted!
David.

Sunday, July 29, 2012

Well It Is A Month Since The NEHRS Launch. How Has It Turned Out?

It is now almost a month since the magical launch day (on July 1, 2012) of the NEHRS / PCEHR.
The scope of the launch had been progressively wound back from what Ms Roxon (the former Health Minister) announced a little under two years ago.
Here is the blog that addressed that issue and the original plan that was published two months ago:
In the broadest terms I would suggest where we are now is as follows:
First the ‘soft launch’ has succeeded in preventing much in the way of public sign up - with only 4,000 or so people having managed to register so far. It is hard to know if this is due to lack of interest or lack of publicity effort. At this rate we will have only 50,000 or so users in the first 12 months rather than the half a million or so projected for the current financial year.
Second the consumer portal is just about a clumsy to access and use as it might be possible to design. Compared with commercial sites with similar levels of security (e.g. banks, maybe even pay-walled news sites and so on) the whole thing is really plain awful - especially for the funds involved. They really could not have tried harder to provide such utterly non-intuitive access.
Third, once logged in, from the consumer perspective the responsiveness of the system is really very poor. Compare the responsiveness and speed, as well as screen design with international sites (Amazon, Facebook, Twitter even Blogger) with vastly more users and further away show just how badly designed / provisioned the NEHRS is.
Fourth, a key challenge for clinical usability is going to be to deliver professional access to Shared Health Summary and other records with a reasonably easy access path followed by PC like responsiveness and speed. On the evidence we have so far that is going to be a major challenge.
Fifth, right now the value in the NEHRS is similar to using a MS Word document to store your medical history and a fair deal cheaper. This can change but right now the precise plans on what is going to happen when is pretty opaque.
Sixth, it is clear the Medical Profession and especially the AMA have not their concerns about the whole system allayed. Unless this is convincingly achieved ‘real soon now’ the whole Program . You can read the AMA President’s concerns here:
and here:
Lastly we have the on-going problem of the system having an obvious error and it having taken over two weeks for no action to be taken. If this is the Quality of Service we are to expect then the sensible thing to do would be not to get involved.
In summary, nothing of any value has been so far delivered, and any real delivery of Program remains an elusive fantasy.
With what is on offer right now it is a total waste of time to enrol in the system. I really wonder at what point this will somehow turn into a ‘change management strategy’ in the same what the HealthConnect Program did some five or six years ago.
It seems likely to me that the outsourcing approach being adopted by DoHA can only accelerate the process.
The goals set are utterly unrealistic and fanciful and lack any clarity as to the resourcing planned.
See here:
My view is that this whole Program is hanging on by its finger nails and may fall off the cliff anytime now.
David.

Now Here Is A Must Watch Ten Minute Video. Enough To Have One Cringe!

The following appeared a few days ago.

EHRs call for tech etiquette in the exam room

July 24, 2012 | By Susan D. Hall
Just as a teenager zoned out on texting instead of listening can drive parents crazy, doctors who ignore tech etiquette in the exam room do so at their peril, according to an article at amednews.com. And no, it's not OK to respond to texts during a patient visit. 
The way a physician handles the disruption caused by consulting an EHR "can absolutely make or break the relationship between doctor and patient," said Larry Garber, MD, an internist and medical director of informatics at the Reliant Medical Group in Worcester, Mass.
Suffice it to say that the doctor's focus should be on the patient, not a PC or tablet. 
in fact, the article says, some medical school have gone so far as to make tech etiquette part of their curricula. Among the tips it offers:
·         Pay attention to exam-room setup. Avoid having your back to the patient while consulting on a PC or tablet. A triangle design putting the doctor, patient and PC in three corners can allow the physician to face the patient even while consulting the EHR.
·         Consult the EHR before entering the room. Never go straight to the PC. First greet the patient and set an agenda for the consultation. Then make a transition, such as "OK, let me jot down a few notes."
.....
To learn more:
- read the article
- watch the YouTube video
More issues and examples here:
Enough said. Watch be video and be both educated and horrified about just how badly it can be done. Just love the patient attempting to prescribe her own major analgesics because the clinician did not log off!
Enjoy.
David.

Saturday, July 28, 2012

Weekly Overseas Health IT Links - 28th July, 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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Thursday, July 19, 2012

Informatics: The Future

From the report: "There is a seismic shift in the way information can improve the experience, quality and outcomes of health and care services. Quality information will empower patients and other service users. It will enable a culture of shared decision-making – ‘no decision about me without me’ – and it will help us all to make more informed choices about the way we live our lives.
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When Medical Informatics Clashes With Medical Culture

What's the sense of having IT systems in place that can help cut medical costs if physicians ignore the price tag of the care they provide?
Ever ask your family doctor how much the test she just ordered will cost? Chances are she doesn't know. Physicians have been trained to provide the best possible care and to order whatever procedures they deem necessary to diagnose and treatment disease, regardless of the cost.
That philosophy is consistent with the Hippocratic oath, but as the nation tries to cope with its runaway medical tab, that philosophy requires close scrutiny. And it's especially important given all the IT systems in place that can help contain medical costs. AdTech Ad
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iPad, secondary-class LCD monitors equal for medical imaging

July 17, 2012 | By Dan Bowman
Apple's iPad is just as accurate as a DICOM calibrated secondary-class monitor for reviewing MRI images, according to research featured in the August edition of the journal Academic Radiology.
For the study, 13 American Board of Radiology board-certified radiologists examined 31 cases on both devices. Thirteen of the cases contained one of four presentations: spinal cord compression, cauda equine syndrome, spinal cord hemorrhage, or spinal cord edema. The remaining 18 cases served as controls.
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California HIE in revamp mode

By Patty Enrado, Special Projects Editor
Created 07/20/2012
ROHNERT PARK, CA – California’s statewide health information exchange (HIE) is in transition again. But by the end of 2012, 75 percent of the Golden State’s counties will either have community-based operating HIEs or will be in the planning stages, according to the recently appointed state official tasked with taking over the program.
“Our mission has changed,” Pamela Lane, Deputy Secretary of Health Information Exchange for the California Health and Human Services Agency, told attendees at the sixth annual Redwood MedNet Conference – Connecting California to Improve Patient Care 2012. “We are about the business of HIE. We are not in state government to say no; we are there to get the barriers out of the way.”
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WorldOne Buys Sermo Physician Network

JUL 19, 2012 3:28pm ET
Health care survey and analytics firm WorldOne has acquired online physician network operator Sermo for an undisclosed sum.
WorldOne is a survey and analytics firm offering pharmaceutical firms and other health care businesses access to an online panel of 1.7 million physicians, health care professionals and consumers, including more than 1 million physicians in 80 nations.
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Why the EHR market is on the brink of mass consolidation

By Robert Rowley, MD, Healthcare and health IT consultant, practicing family physician
The number of vendors of Electronic Health Records products seems unsustainable. Stimulated by federal Meaningful Use incentives, plus the irresistible tide of pressures and encouragement from all sides (specialty societies, peers, licensing boards, insurance payers), the uptake of EHRs has been steadily increasing.
As a result, large established EHR companies, some of whom have been around for 15 years or more, are experiencing competition from a wave of smaller start-ups – some successful, others not. Two general categories of EHRs have emerged, rather distinctly: EHRs for ambulatory use, and EHRs for hospital use. These really do represent two different markets.
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Survey: Docs adopting health IT slowly

July 18, 2012 | By Marla Durben Hirsch
Physicians are adopting electronic health record systems and other health technology, but perhaps not as fast as the government would like, according to Physician Practice's 2012 technology survey.
According to the survey of 1,356 practices, a majority of independent practices (54 percent) reported that they have adopted an EHR. A slightly higher percentage (57.6 percent) said that their implementation is complete and that the system is being used. Less than a third (30 percent) said they are using patient portals, while more than 33 percent said they planned on joining a health information exchange for the sharing of data.
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Take EHR satisfaction reports with a grain of salt

July 18, 2012 | By Marla Durben Hirsch
One of the biggest problems for those who use or are considering adopting electronic health records is that the information out there can be very unreliable. It is becoming exceedingly difficult to accurately gauge what's occurring in the industry.
Just look at the spin accompanying some of the findings released this week.
The Centers for Disease Control and Prevention's National Center for Health Statistics reported that more than half of doctors in the United States (55 percent) were using EHRs by the end of 2011. It also found that almost four-fifths (77 percent) of those docs reported that their systems had met the criteria for Meaningful Use.
In the wake of the report--a follow-up analysis of a supplement to the 2011 National Ambulatory Medical Care Survey (NAMCS) of office-based providers--National Coordinator for Health IT Farzad Mostashari posted in a blog post that the physicians' experiences have been "largely positive."
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Humanizing eHealth tools boosts patient trust

July 19, 2012 | By Dan Bowman
Humanizing decision-support computer aids for patients helps to increase trust of such tools, according to new research out of Clemson University.
Design and look of an aid are important, according to Clemson psychology associate professor Richard Pak, who found that, for instance, adding an image of a person to an electronic support tool "significantly alters [patient] perceptions" for the better. As a result, decision-making reaction time of patients becomes quicker.
"A plausible explanation is that the increase in trust led to an increased dependence on the aid, which led to faster performance," Pak said, according to a university announcement.
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INSIDE THE BOX: Solutions for Data Sharing in Life Sciences

By Ari Berman  
July 16, 2012 | Inside the Box | Sharing scientific data is as fundamental to the progression of science as the research design itself. Without data sharing, experiments cannot be peer-reviewed, and scientists cannot perpetuate existing findings by taking the next steps in the laboratory.   
Unfortunately, data sharing is becoming more and more difficult. Compare scientific papers published in the early 90’s to those published in 2012 -- the differences are striking. Back then, any and all data associated with a project could fit in a figure or two, so the paper itself was the point of data sharing. Today, more and more papers are published with reams of supplementary data, e.g. PDF tables can reach hundreds of pages and are themselves a distilled and reduced version of the original data. (New initiatives such as the journal GigaScience and its associated database should help address this issue.) This illustrates the crux of the issue: modern research produces tons of data and publications are no longer a viable medium for sharing all those data.
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'Most Connected' hospitals of 2012 announced

By Erin McCann, Associate Editor
Created 07/18/2012
WASHINGTON – U.S. News & World Report on Tuesday published its 2012 list of the Most Connected Hospitals. The list includes 156 U.S. hospitals nationwide, ranked according to their advancement in electronic medical record (EMR) adoption.
Over the past few years, the EMR has become part of the daily routine of medical professionals throughout the country. The promise of the EMR is often widely lauded among those in the healthcare profession. Some experts say the technology could prove to make the delivery of healthcare safer and more efficient in addition to providing healthcare providers and patients with better access to health data.
The federal government, through its incentive payments to physicians and hospitals that demonstrate meaningful use of EMRs, has played a central role in spurring the technology's adoption. A burgeoning number of hospitals have embraced EMRs beyond the government benchmarks. 
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Top 12 reasons organizations pay too much for health IT

By Tom Sullivan, Government Health IT
Created 07/17/2012
Healthcare pays more than any other industry for information technology. At least according to a new survey.
"Our analysis shows healthcare organizations pay an average 17 percent more than that of the other 29 industries we sampled," write the authors of a paper by Net(net), which bills itself as a consultancy specializing in IT optimization, "and 33 percent more than the industry with the lowest average costs (food service).”
And that reality spans the gamut of IT, including financial applications, Microsoft desktop productivity licenses, networking equipment, servers, storage – even vertical applications specifically for healthcare from vendors including Epic, McKesson and Cerner.
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Bloody good show

The haematology unit at Bart’s Health NHS Trust has embraced electronic working with Cerner Millennium. Rebecca Todd took a look at the electronic patient record system in action.
11 July 2012
In some hospitals, it is piled high in reception areas or being ferried across carparks in shopping trollies, but here there is not a scrap of paper in sight.
I feel a little like an interloper with my reporter’s notebook and pen in hand, as I head down the sparse corridors of the unit to meet the health professionals that have overseen this digital transformation.
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5 ways telemedicine is driving down healthcare costs

By Steff Deschenes, New Media Producer
Created 07/16/2012
Telemedicine and mHealth have the potential to help the healthcare system meet the Institute of Healthcare Improvement's triple aim to simultaneously increase the quality of care, improve the health of populations and reduce the per capita cost of care.
"Collectively, investments in telemedicine and mHealth have great potential to reduce healthcare system costs," said Adam C. Powell, president of Payer+Provider Syndicate, a consulting firm that uses techniques from health services research to bring about change in the health insurance and hospital industries.
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Most office-based docs satisfied with their EHR system: survey

Posted: July 17, 2012 - 6:45 pm ET
About 55% of office-based physicians responding to a government-sponsored survey said they use some form of electronic health-record system, and by and large, they're a satisfied lot, according to a report on the survey.
The overwhelming majority (85%) of those who said they use an EHR also indicated that they were either very satisfied (38%) or somewhat satisfied (47%) with their systems. More than 7 in 10 said they were happy enough with their selection that they would purchase the same EHR system again. The Centers for Disease Control and Prevention's National Center for Health Statistics conducted the nationwide survey last year; findings were discussed in an HHS news release and on the CDC's website on Tuesday.
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Research: CPOE Industry to Hit $1.5 Billion

July 16, 2012
According to research from the San Jose, Calif.-based Global Industry Analysts (GIA), the computerized physician order entry market is poised for tremendous growth over the coming year. The report, titled “Computerized Physician Order Entry (CPOE) Systems: A Global Strategic Business Report,” says by 2018, the global market for CPOE systems will be valued at $1.5 billion. GIA says factors in this growth include the rising inclination towards patient safety, the acceptance of IT solutions in healthcare, and the growing use of EHRs.
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On Trak in Scotland

Within 20 months of signing a contract to provide Scotland with a patient management system, InterSystems had gone live with its TrakCare product in five health boards. Rebecca Todd reports.
5 July 2012
Scotland has been quietly getting on with what must count as one of the largest NHS IT deployments ever seen: the roll-out of InterSystems TrakCare to five NHS boards.
The project started when the five boards (Greater Glasgow and Clyde, Lanarkshire, Ayrshire and Arran, Borders and Grampian) formed a consortium in January 2008 to procure a new Patient Management System for Scotland.
After an 18-month procurement process, InterSystems won. It went on to build a country edition of TrakCare for Scotland with the common functionality and processes required by all the boards, which reduced the need for localisation on each deployment.
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EMIS Web roll-out accelerates

13 July 2012   Rebecca Todd
The accelerated roll out of EMIS Web has reached 747 GP practices and thousands of practices are in the familiarisation process.
EMIS Group today released a trading update for the six months ended 30 June 2012.
It shows that during the first half of the year, the roll-out of EMIS Web accelerated dramatically, with 121 practices moved onto the new system last month.
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NHS commissioning to shed 20,000 jobs

16 July 2012   Fiona Barr
The NHS Commissioning Board has set out plans to complete its employment of 4,000 staff by January 2013.
The vast majority will be transferred from primary care trusts, strategic health authorities and arms’ length bodies.
A further 7,000 NHS staff are expected to be employed by 23 commissioning support services, which are due to be authorised by the end of the year.
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Desktops still dominate at physician offices

Despite rising adoption of tablets and smartphones, a survey shows three in four doctors use a desk computer for practice management tasks.

By Emily Berry, amednews staff. Posted July 16, 2012.
More people are turning to computer tablets and other new forms of technology, but pediatric hospitalist Rishi Agrawal, MD, MPH, favors a desktop computer for doing his job.
It’s not that he’s a technophobe. It’s that using the desktop makes more sense to him: He can easily and quickly access the hospital’s electronic health record system. The computer has a large monitor that allows for multitasking, and it’s secure.
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Senior home monitoring set to drive wearable wireless device market

By Mike Miliard, Managing Editor
Created 07/16/2012
LONDON – A growing senior demographic, combined with other economic, social and technological developments, are driving investment and demand for home monitoring devices that can extend and improve in-home care, says a recent study from ABI research.
As the market transitions from safety-focused offerings toward health monitoring and extending and enhancing the comfort, safety and well-being for seniors living in their own homes and care homes, monitoring devices will grow to more than 36 million units in 2017, up from under 3 million units in 2011 – a compound annual growth rate of 55.9 percent.
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Joint Commission offers guidelines for scribes

Posted: July 16, 2012 - 2:45 pm ET
The Joint Commission has an online guide for critical-access hospitals that use unlicensed scribes to help physicians and other licensed healthcare professionals document patient encounters in an electronic health-record system.
The guide is presented as a list of frequently asked questions and is contained in the Joint Commission's comprehensive accreditation manual for critical-access hospitals.
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AHRQ Offers Guidance on Implementation of Preventive Health Records

Written by Jaimie Oh | July 16, 2012
The Agency for Healthcare Research and Quality has released a new handbook that offers practical guidance on the implementation of interactive preventive health records.
In an article published in the Annals of Family Medicine, researchers found that patients who used IPHRs were more likely to be up-to-date on all preventive services compared with nonusers, especially in the areas of screening tests and immunizations.
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CHIME Certification Gives HIT Leaders a Boost

Scott Mace, for HealthLeaders Media , July 17, 2012

If there's one thing I've learned in writing about healthcare and technology, it's that the learning never stops.
The pace of medicine, technology, regulation and business is non-stop. Watershed developments can occur weekly.
For instance, last week I learned that doctors at Orlando Health are now using software on iPads to remotely control Polycom video cameras (with startling clarity) to zoom in on the eyes of potential stroke victims.  The doctors can be anywhere on the planet..
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ONC announces guidance for reporting lab results for Direct

By Diana Manos, Senior Editor
Created 07/13/2012
WASHINGTON – The Office of the National Coordinator for Health Information Technology (ONC) announced on July 12 guidance for reporting laboratory results using Direct Project specifications.
ONC officials said the guidance was developed by the Direct Laboratory Reporting Workgroup to address the Clinical Laboratory Improvement Amendments (CLIA) requirements for the reporting of clinical laboratory results using Direct Project standards and specifications.
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Big data software combs database for cancer research

July 16, 2012 | By Susan D. Hall
New tools developed by the National Cancer Institute will allow any researcher to compare data from large collections of genomic information against thousands of drugs to find the most effective treatments for cancer, according to a study published at Cancer Research.
The software, called CellMiner, was built for use with NCI-60, the institute's massive collection of cancer cell samples used to test potential anti-cancer drugs. The free tools provide access to the 22,379 genes catalogued in the NCI-60 and to 20,503 previously analyzed chemical compounds, including 102 U.S. Food and Drug Administration-approved drugs.
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Gulf between health IT potential and reality remains large

July 16, 2012 | By Ken Terry
As the Meaningful Use Work Group of the Health IT Policy Committee prepares its recommendations for Meaningful Use Stage 3, its members should take a long hard look at the difference between the potential and the reality of health IT. If they ask for too much, many providers will be unable to keep up, and there will be pushback. If they ask for too little, many providers will be content to do the minimum required for incentives without using technology's full potential to improve quality of care.
While much has been achieved in a relatively short period of time, physicians and hospitals are making uneven progress toward the long-term goal of a fully digital, connected healthcare world. More than 100,000 providers have attested to Meaningful Use, but that doesn't mean they're all using their EHRs meaningfully.
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How To Break Into Healthcare IT

University degrees and certificate training both are valuable, but you must think strategically when choosing between them.
There's no end to the debate about the best way to break into healthcare information technology. One of the most contentious issues facing job candidates is the university degree versus certificate debate. Put another way: Are you more likely to land a position--and be better qualified to work in health IT--if you get a master's degree in the field or complete a shorter certification program?
Students I've spoken with who are enrolled in master's programs at major universities have many positive comments about what they've learned. But some also complain that there's too much theory and high-level conceptualization, and not enough hands on training. AdTech Ad
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Report: HIE Vendor Market Fragmented, Moving Toward Packaged Solutions

July 12, 2012
Today, the Framingham, Mass.-based IDC Health Insights released a new MarketScape report evaluating Health Information Exchange (HIE) packaged solution offerings. The comprehensive study, IDC MarketScape: U.S. Health Information Exchange Packaged Solutions 2012 Vendor Assessment, outlines the changing market landscape and profiles ten vendors, including Caradigm, Carefx, Certify Data Systems, eClinicalWorks, Infor, Informatics Company of America (ICA), Medecision, Medicity, MobileMD a Siemens Solution, and PatientKeeper.
IDC Health Insights found the market for HIE technology is fragmented with IT suppliers providing solutions with diverse origins ranging from integration engine platforms, portals, clinical messaging, composite applications, information management, and managed network services. New market entrants and merger and acquisition activity continue to change the technical and competitive landscape. Furthermore, the report cited the enterprise market as the fastest growing market segment for HIE technology, given the ability to demonstrate meaningful use and pursue a collaborative care strategy will require the ability to exchange health information across the enterprise.
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HIE markets evolve, shifting priorities to actionable data

By Erin McCann, Associate Editor
Created 07/16/2012
FRAMINGHAM, MA – A new report highlighting the evolving nature of health information exchanges (HIEs) found that the HIE market is shifting its priorities from that of connecting the ecosystem with exchange data and meaningful use incentives to turning data into “actionable information.” 
The IDC MarketScape study, "U.S. Health Information Exchange Platform Solutions 2012 Vendor Assessment," evaluated 16 vendors that offer a platform solution – which IDC Health Insight officials define as having development tools, published APIs, education of technical staff, a broad ecosystem of partners and professional services – for HIE and how those platforms have evolved. 
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5 Ways to Improve EHRs for Pediatric Providers

Written by Kathleen Roney | July 12, 2012
The National Institute of Standards and Technology has released "A Human Factors Guide to Enhance EHR Usability of Critical User Interactions when Supporting Pediatric Patient Care" to address the lag of electronic health record adoption by pediatric care providers.
NIST developed the guide because pediatric patients have unique characteristics that translate to higher complexity for providing care with paper-based charts and EHRs. According to the report, the unique characteristics of pediatric patients may be a factor in the low adoption of EHRs by pediatric providers. For this reason, the report details recommendations to enhance EHR usability when supporting pediatric patient care.
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Monday, July 16, 2012

Federal Gov't Continues With Health IT Activity in Q2 2012

The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the second quarter of 2012. Below is a summary of key developments and milestones achieved between April 1and June 30. 
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Enjoy!
David.