Saturday, March 23, 2013

Weekly Overseas Health IT Links - 23rd March, 2013.

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 incentive payments top $12 billion

By Mary Mosquera, Senior Editor
Created 03/15/2013
With some healthcare providers now into their second year of meaningful use reporting, Medicare and Medicaid electronic health record payments were estimated at $12.3 billion paid to a total of 219,000 physicians and hospitals through February since the program’s inception.
The Centers for Medicare & Medicaid Services will post final figures for February later this month as it captures more complete data, said Robert Anthony, a specialist in CMS’ Office of eHealth Standards and Services at Thursday’s Health IT Policy Committee meeting, which was broadcast live.
In February, 27,500 Medicare physicians received $425 million; 5,500 Medicaid clinicians and eligible professionals, $100 million; and 90 hospitals in either program, $200 million, for a total of $725 million to 33,090 providers.

Report: 1.7B to download health apps by 2017

By: Jonah Comstock | Mar 14, 2013
Mobile industry analysts Research2Guidance have come out with a new report on health apps, predicting that in 2017, worldwide mobile health market revenue will total $26 billion.
The report categorizes the mobile health market as growing in three phases: an initial trial phase, a commercialization phase, and an integration phase. We are currently in the second phase, the report said, which is “characterized by a massive increase of offered solutions, the creation of new business models and the concentration on private, health-interested people, patients and corporations as major target groups.”

Software updates can be hazardous to a health IT system's health

March 15, 2013 | By Mike Bassett
A study published online in the Journal of the American Medical Informatics Association demonstrates how a simple software update can create unintended consequences that can have an adverse impact on patient care
Doctors from Boston's Brigham and Women's Hospital in Boston, led by Adam Landman, M.D., were inspired to explore the problem when the hospital's information systems help desk was inundated with calls from physicians who could no longer access a web-based image viewer from the emergency department's tracking board.
The link from the ED tracking to the web-based image viewer was lost on workstations running Microsoft Explorer 6. It turned out the cause was a security update Microsoft had released days earlier.

With e-prescribing, doctors choose cheaper drugs

March 15, 2013 | By Susan D. Hall
Physicians who have electronic access to their patients' formularies, including copays, are more likely to prescribe a less-expensive drug for Type 2 diabetes and hypertension, according to a survey from research and advisory firm Decision Resources.
Seventy primary care physicians, 70 endocrinologists, and 25 managed-care organization (MCO) pharmacy directors were polled for the report "E-Prescribing and Electronic Health Records: Impact of Technology on Prescribing for Hypertension and Diabetes."
"Physicians are now more acutely aware of MCOs' formularies and are therefore more likely to prescribe more favorably reimbursed drugs as well as better identify undiagnosed patients, sharply impacting their prescribing decisions for diabetes and hypertension therapies," the report states.

EHR implementation in Malawi brings additional challenges

March 13, 2013 | By Susan D. Hall
Implementing an electronic medical records system in Malawi included the usual challenges, such as having tech staff available, selling clinicians on its value and training them to use it. But there were additional challenges, including power outages, low computer literacy in some areas and co-existing with a paper-based system, according to a new study published in PLOS Medicine.
According to researchers, an open source records system--Surveillance Programme of IN-patients and Epidemiology or SPINE--was installed at a major referral hospital, Queen Elizabeth Central Hospital, in the African nation. With the high rate of HIV infection, readmission is common. Fifteen percent of those admitted died in the hospital.

EHR use puts physicians between a rock and a hard place

March 14, 2013 | By Marla Durben Hirsch
The electronic health record landscape is pretty gloomy for physicians these days. For every report that says that physicians are adopting EHRs in record numbers, there seems to be one that relates to a problem with EHR adoption. Only 12 percent of physicians have attained Meaningful Use. Physician practices continue to suffer from usability and financial woes in making the transition. They suffer increased muscle strain when using the tools. Physicians who use EHRs are even perceived by some patients as less capable.
And now a study published this month in Health Affairs says that EHRs are not worth the investment for physicians, with the average physician losing nearly $44,000 over five years and just a fourth of practices seeing a five year positive return on investment. This study blames physicians for the losses for not changing their operations to take advantage of the benefits that EHRs offer. For instance, almost half of the physicians examined didn't obtain savings in part because they were still using paper records; many weren't using their EHRs to increase revenue, according to the study.

New disease registry puts patients in control of data

March 14, 2013 | By Susan D. Hall
A new disease registry aims to line up more people for clinical trials by giving patients ultimate control over the use of their information.The website--dubbed Reg4All--is the brainchild of Genetic Alliance, a nonprofit that advocates for people with rare genetic disorders. It will launch April 4, reports Technology Review.  
"The usual way of recruiting people is astoundingly bad," Sharon Terry, president and CEO of Genetic Alliance, told Technology Review. The consent forms used by many current biobanks and DNA databases give participants little control over the data.

Debunking the Top 10 I.T. Usability Myths

MAR 12, 2013 11:58am ET
The usability of health and other information technology systems has long been a challenge.
And there are a number of common misconceptions as to why the problem persists, according to  Nancy Staggers, RN, a professor of Informatics at the University of Maryland’s School of Nursing, and Lorraine Chapman, Director of Use Experience Research at Macadamian Technologies, a user experience design and software development firm that does work in the health care field.
But if the IT community is going to solve its usability issues, it must first acknowledge, and then dispel, these wrongly held beliefs. As a first step in that process, Staggers and Chapman at HIMSS13 presented a list of the top 10 usability myths:
Myth No. 1:  Clinicians are uncomfortable with technology
Vendors often say there is nothing wrong with their systems that more training can’t fix. But the reality, said Chapman, is that doctors and other health care providers like technology, they just don’t like processes that hinder their job performance.
Thursday, March 14, 2013

Security Questions Loom as Health Care Takes on Analytics

by John Moore, iHealthBeat Contributing Reporter
"Big Data" analytics projects have arrived in the health care space and so too have security and privacy concerns.
Enterprises in a range of markets now build analytics platforms in hopes of finding useful and actionable information hidden in their vast data stores. Those systems generally consist of a central data repository, tools for moving data into that repository and a front-end component that lets users work with the data and generate reports.
In health care, the growing use of electronic health records means that many organizations have more data to work with than ever before. Hospital networks and academic medical centers may use analytics platforms to yield insight into how to improve patient care or make better decisions regarding disease outbreaks.

Four Ways to Make Your Company More Secure

Rachael King


Cybersecurity is now a national threat on a par with terrorism, according to top U.S. intelligence officials.
While the Obama administration is ramping up warnings regarding cybersecurity, such warnings only “admire the problem.” They don’t do much to actually mitigate future attacks on businesses, said Alan Paller, founder of cybersecurity research and education organization SANS Institute, speaking at the RSA Conference in February. For companies that want to dig into the real work of increasing security, Paller suggests starting with some critical tasks. Those include creating an inventory of hardware and software on the network, creating secure configurations for hardware and software and quickly repairing newly discovered software vulnerabilities.

Docs Urged to Be Patient with EHRs

By Kathleen Struck, Senior Editor, MedPage Today
Published: March 13, 2013
Electronic health records (EHRs), although they may be frustrating now, will become more than just legible medical records and will provide more robust tools for improving patient care, predicts an information technology expert.
"Improvements in the documentation process hold promise for more than simply efficient data entry and legible notes," wrote James J. Cimino, MD, in a Viewpoint article published online in the Journal of American Medical Association. "If impressions and plans can be captured within EHRs as explicit data elements, using standard terminology rather than being buried in the narrative text of a note, clinicians could use this information to better support clinical workflow."
Furthermore, a "problem or diagnosis entered in this way could allow an EHR to provide a suggested list of appropriate tests and treatments, based on best available evidence," wrote Cimino, chief of Laboratory for Informatics Development at the National Institutes of Health Clinical Center in Bethesda, Md.

Tiger Team aims to remove HIE barriers

By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Created 03/13/2013
The day before the ONC’s privacy and security subcommittee met to discuss policy recommendations for health information exchange query and response issues, Epic Systems CEO and subcommittee member Judy Faulkner got an email from a doctor in Madison, Wisconsin.
“I have a patient who moved to Chicago,” the doctor said, as Faulkner recounted at the subcommittee Tuesday. “She needs a bladder biopsy at Northwestern, which as you know is on Epic. She wanted me to look at the records, but I couldn’t unless she came to Madison and signed a release.”
That’s the protocol Northwestern Memorial Hospital has been using, not necessarily the norm. “Everybody can set it up in different ways,” Faulkner said.

UCLA, IBM team to use big data to prevent brain swelling

March 13, 2013 | By Mike Bassett
Researchers at the University of California Los Angeles are using an experimental software system that uses big data analytics to test the effectiveness of a real-time alarm designed to predict the development of brain swelling in trauma cases.
The system--the result of a partnership between physicians in the UCLA Department of Neurosurgery and IBM and Excel Medical Electronics--analyzes in real time the vital signs obtained from a patient's bedside monitor in order to detect changes in the patient's pulse, blood and intracranial pressure, heart activity and respiration.
Current alarm systems are designed to alert caregivers when these vital signs pass a critical threshold, forcing physicians into action if the condition is considered to be life threatening or could cause brain damage.

Lack of healthcare IT workers slows tech progress

Tech workers skilled in informatics are the most-sought

Lucas Mearian
March 12, 2013 (Computerworld)
The U.S. healthcare industry is facing an even more significant IT worker shortage than previously thought, and that shortage is slowing efforts to roll out electronic health systems.
A new analysis by PricewaterhouseCoopers (PwC) Health Research Institute showed that the shortage of health IT (HIT) workers has healthcare providers scrambling to fill the talent void by recruiting technology specialists from other industries.
The PwC report cited a recent survey by the College of Health Information Management Executives (CHIME) that showed 67% of healthcare CIOs are experiencing IT staff shortages, up from 59% in 2010.

Health IT worker shortage looms

By Bernie Monegain, Editor
Created 03/12/2013
A significant and growing shortage of health information technology workers appears greater than previously estimated, according to a new analysis by PwC's Health Research Institute. The report, Solving the talent equation for health IT, finds that the healthcare industry is vying for a limited number of IT professionals - and many companies are scrambling to fill the talent void by recruiting technology specialists from other industries.
"The challenge for healthcare is not just a shortage of people with technical skills. It's also a shortage of people with the skills to marry technological savvy with business strategy as healthcare becomes more connected, coordinated and accountable," said Daniel Garrett, principal and PwC's Health Information Technology practice leader, in a news release. "Despite billions of dollars spent investing in HIT, the lack of qualified professionals could slow progress toward quality and efficiency. The benefits of HIT will not be realized until organizations can ensure information is unlocked and integrated in a way to best inform critical business and clinical decision-making."

Cloud gets high marks on security

By Bernie Monegain, Editor
Created 03/12/2013
With an average satisfaction score of 4.5 out of 5 on security, cloud users feel safe. Non-cloud users though remain at bay-particularly with many questions still looming around the future of cloud computing in healthcare. The conclusions are from a recent report from research firm KLAS.
Cloud Computing Perception 2013: The Hybrid Cloud in Healthcare looks at the evolution of the cloud in healthcare, provider concerns, as well as vendor performance.

Tele-ICU guidelines developed for critical care nurses

March 12, 2013 | By Dan Bowman
As more and more hospitals turn to remote intensive care units to boost care for critical patients, provider roles will need to be clearly defined to ensure quality and safety. With that in mind, the American Association of Critical-Care Nurses just unveiled a new document outlining practice guidelines specifically geared toward tele-ICU nurses.
The document, meant to serve as a "framework" for the practice of tele-ICU nursing, outlines three guidelines, including:
  • Establishing an environment that promotes effective communication, collaboration, and collegiality
  • Demonstrating proficiency in specific knowledge, skills, and competencies to contribute to patient outcomes
  • Engaging in measuring and analyzing outcomes to ensure ongoing improvement in patient care and tele-ICU nurses' contribution to care.

Survey: EHR Satisfaction Declines Steadily

March 11, 2013
According to a survey from the American College of Physicians (ACP), user satisfaction of electronic health records (EHRs) has decreased steadily since 2010. The study, from 4,279 responses to multiple surveys developed and analyzed by ACP and AmericanEHR Partners, found that user satisfaction has fallen 12 percent from 2010 to 2012, while the number of those who say they are “very dissatisfied” has increased 10 percent during the same time period.
“Dissatisfaction is increasing regardless of practice type or EHR system,” Michael S. Barr, M.D., head of ACP’s medical practice, professionalism & quality division, said in a statement. “These findings highlight the need for the Meaningful Use program and EHR manufacturers to focus on improving EHR features and usability to help reduce inefficient work flows, improve error rates and patient care, and for practices to recognize the importance of ongoing training at all stages of EHR adoption.”
March 11, 2013

Royal Philips Electronics Unveils Graphical Dashboard to Expand its eICU Telehealth Services

Royal Philips Electronics, a diversified well-being and health company, has launched its advanced IntelliSpace eCareManager 3.9 health care platform that is powered by orb.
Philips unveiled its latest offering at the Healthcare Information and Management Systems Society (HIMSS) 2013 exhibition and conference. Philips included its latest offering, orb, in its eICU program, which is an advanced graphical dashboard that is certified by over 100 clinical rules to efficiently analyze, visualize, and process clinical data in real time. At the same time, it has the ability to tell precisely about what is happening with a particular patient and in a more vivid, “visually digestible form.”

GPSoC to mandate online patient access

7 March 2013   Rebecca Todd
The IT necessary to provide patients with online access to their GP records needs to be mandated via the GP Systems of Choice contract, a new report states.
The government has made a commitment that by 2015 all patients will have secure online access to their GP record if they want it.
All practices must also make transactional services available online such as booking appointments and ordering repeat prescriptions.
The government asked the Royal College of GPs to lead on the development of guidance to make this goal a reality.

Cerner and TPP show NHS Blue Button

11 March 2013   Jon Hoeksma
The NHS looks set to copy the hugely successful US Blue Button initiative, which enables patients to very easily download their electronic records by pressing an eponymous online blue button.
EHealth Insider can exclusively reveal that the NHS Commissioning Board will demonstrate a UK implementation of Blue Button this week.
The pilot, involving patient downloads of records from TPP for primary care and Cerner for secondary care, will be showcased at this week’s NHS Innovation Expo.

Informatics Pioneer Says Healthcare Needs Better Systems

Dr. Lawrence Weed continues his longstanding advocacy for computer-aided healthcare and revamping medical education.
Numerous reports have shown that the medical profession is responsible for hundreds of thousands of preventable deaths a year, according to medical informatics pioneer Dr. Lawrence L. Weed.
"Where's the outrage? You get one plane crashing and it's on the evening news for days. Well, there's no outrage. No one's investigating it," Weed said during a rare appearance at the Healthcare Information and Management Systems Society (HIMSS) last week in New Orleans. AdTech Ad
Weed, 89, has been advocating -- often to deaf ears -- for the computerization of healthcare because he strongly believes the human mind simply is not capable of remembering every nuance of medicine and disease without assistance from what we now know as clinical decision support systems.

HIMSS Review: Technology Priorities and Realities

Scott Mace, for HealthLeaders Media , March 12, 2013

Another HIMSS conference is history. The technology cart, however, may be getting ahead of the horse. Everywhere I turned, vendors touted their technology solutions to transform existing healthcare providers into ACOs. Many of these solutions tackle the worthy challenge of correlating claims data coming from payers with clinical data coming from providers, in an effort to create longitudinal records of care for any patient who walks through the provider's doors. In this way, providers will catch comorbidities they are missing today, eliminate duplicative tests, reduce readmissions, and increase patient satisfaction, all in one fell swoop.
At least, that's the theory. But wait—if the brave new technology future is at hand, why are the Pioneer ACOs petitioning CMS to ease up on demanding early results?
I think I now understand why the pioneers are freaking out.
The ACO concept only works if health information exchange between providers is mature enough to handle what the ACOs require. And I'm here to report that health information exchange still has a long way to go.

Intermountain takes on readmissions

By Bernie Monegain, Editor
Created 03/11/2013
Researchers at the Intermountain Heart Institute at Intermountain Medical Center have developed a tool designed to eliminate 30-day hospital readmissions for heart failure patients and improve the quality of medical care a patient receives in the hospital, Intermountain announced March 9.
The tool, known as the IMRS-HF, was adapted from the Intermountain Risk Score that has been used at Intermountain Medical Center to predict mortality rates in trauma patients.
Heart researchers discovered that by using the IMRS-HF, they could more accurately evaluate a patient’s condition prior to discharge, and ensure there is less risk of the patient being readmitted for the same condition within 30 days.

Mostashari: 3 interoperability questions

By Bernie Monegain, Editor
Created 03/11/2013
Interoperability was one of the most talked about topics throughout HIMSS 2013 Annual Conference and Exhibition last week. The Interoperability Showcase proved to be as popular as ever with many use cases on display, recurring tours and speakers slated every half hour. There was also the recent announcement that interoperability testing would occur year-round at HIMSS Innovation Center in Cleveland. At the conference, six EHR vendors staged a news conference to spotlight their commitment to interoperability with the formation of the CommonWell Health Alliance.

The HIT Approach to Big Data

MAR 1, 2013
Like "The Cloud" last year or "Mobile Apps" the year before, it's the I.T. catchphrase that's considered so big it's deemed worthy of double capitalization. Computers are capturing stray scraps of information on everyone's medical conditions, shopping habits, driving records, and weekend partying patterns; data architects in every business are struggling with how to put it all together to answer big questions.
No business has bigger questions than health care, which is being pressured as never before to provide better care to more people at lower cost.
But what the heck is Big Data? What makes it different from the small data that populates spreadsheets on so many departmental desktop PCs? "Volume, velocity, variety," says Elizabeth McGlynn, director of the Kaiser Permanente Center for Effectiveness and Safety Research. Kaiser, with 9 million members in eight regions, has the volume: 30 petabytes of patient data, which McGlynn says is more than three times the amount of digitized storage at the Library of Congress.

EHR dissatisfaction on the rise

March 11, 2013 | By Susan D. Hall
We've known that many providers are unhappy with their electronic health record systems, but the level of dissatisfaction appears to be growing, according to a survey by the American College of Physicians and AmericanEHR Partners, web-based resource for EHR system selection and implementation.
Overall, user satisfaction dropped by 12 percentage points between 2010 and 2012 and the "very dissatisfied" group grew by 10 percentage points.
The findings represent 4,279 responses to multiple surveys developed by ACP and AmericanEHR Partners between March 2010 and December 2012. The surveys were conducted in conjunction with 10 different professional societies. Seventy-one percent of respondents were in practices with 10 physicians or fewer, according to an ACP announcement.

82% of Physicians Want Patients to Update Their Own EHRs, But Few Want Them to Have Full Access

Written by Anuja Vaidya  | March 08, 2013
Social Sharing
A new survey, by Accenture, shows that a majority of U.S. physicians want patients to participate in their own healthcare by updating their electronic health records, but only a few of them believe that a patient should have full access to his or her EHR.
Accenture surveyed 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States.
Monday, March 11, 2013

A Fork in the Road at HIMSS13: How Patients & Payment Are Forcing 'Open' Health IT

by Jane Sarasohn-Kahn
At the recently concluded annual Healthcare Information and Management Systems Society conference in New Orleans, 34,696 got to experience a yin and yang vibe that embodies the disruption that the health care IT industry is undergoing. That is, the full-on face-off between developers of health IT that have been long-closed to data liquidity and those vendors innovating on open standards and cloud-based platforms.
The culmination of this was the announcement of the not-for-profit organization called the CommonWell Alliance, an affiliation of six health IT vendors who are planning to adopt, promote and certify standards for interoperable health information. The first vendors committing to the CommonWell pledge were Allscripts, athenahealth, Cerner, Greenway, McKesson and RelayHealth.
The group's press release stated that "this historic effort is aimed at improving the quality of care delivery while working to lower costs for care providers, patients and the industry as a whole." While an announcement doesn't equal outcomes at this early stage, it was a signal that the times, they are a'changin, especially with the name "Cerner" attached to the project.      

Home care, tele-medicine cut health costs

Florida programs reduce unnecessary hospital stays

By William E. Gibson, Washington Bureau
6:54 a.m. EDT, March 11, 2013
To understand how the health-care system sometimes fails patients and often wastes money, consider the case of a South Florida nursing-home patient who developed a cough and slight fever.
"The nurse notifies the doctor, who doesn't get much information and says, 'Send her to the emergency room,'" recounts Joseph Ouslander, associate dean for geriatric programs at Florida Atlantic University. "She has tests in the emergency room, some of which are falsely positive, and is admitted unnecessarily to the hospital, where she gets acute confusion and breaks her hip.
"It happens every day: An episode that could have cost Medicare a couple hundred bucks turns into one that costs closer to $20,000. So you are creating human misery, and you're spending money."


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