Saturday, April 20, 2013

Weekly Overseas Health IT Links - 20th April, 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.

4 ways health IT can help minorities

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/10/2013
While the powers of healthcare IT to radically transform the health of a patient population are widely lauded, one thing that isn't discussed as much are the areas where the technology could do the most good but doesn't often reach to. Take Washington, D.C., for example: One of the richest, most tech-savvy cities in the nation, it also has remarkably low rates of obesity. Almost. Taking a closer look reveals that the 8th Ward, a predominantly lower income section of the city populated by minorities has a high level of obesity, skewing the district's numbers.
Ivor Horn, MD, associate professor of pediatrics at Children's National Medical Center and George Washington University School of Medicine says that there is a wide variety of health IT out there that can help tackle and manage the health crisis of obesity, but that much of it is not reaching the population groups where it can do the most good: minorities.
  • April 13, 2013, 2:17 p.m. ET

NYers can vote on design of patient portal

Associated Press
BUFFALO, N.Y. — New Yorkers are being invited to weigh in on the design of a website that will let them access their medical records online.
The New York eHealth Cooperative is working with the state Health Department in the shift toward electronic health records. From Saturday through April 23rd, the cooperative is asking people to vote on one of several "Patient Portal" designs at .

ONC proposes EHR vendor fee

By Bernie Monegain, Editor
Created 04/12/2013
Citing the crush of an increasing workload and dwindling government funding, the Office of the National Coordinator has proposed a health IT user fee that would be imposed on health IT vendors who certify their products through the ONC Health IT Certification Program.
The HIMSS EHR Association opposes ONC's proposal.
"EHR developers are already devoting extensive resources to successful implementation of the EHR Meaningful Use Incentive Program and other healthcare delivery reform efforts, including the significant fees associated with EHR product certification," the group said in a statement."
"The fee would be a separate and dedicated resource that ONC would put right back into the administration of the certification program; to maintain, upgrade, and develop new electronic testing tools; develop new standards; and to ultimately improve the certification experience by making it faster and more efficient for the health IT developers that go through the certification process," ONC spokesman Peter Ashkenaz told Healthcare IT News. "The President’s budget proposes that the fee would need to be equitable. If Congress supports this proposal, ONC will work with industry to ensure the proposed fee creates the most value through a notice and comment rulemaking process."

The future of mobile technology in healthcare

April 11, 2013 | By Greg Slabodkin
Mobile technology clearly is having an impact on healthcare, but questions still remain over how significant that impact will be in the near future. For instance, how big will the U.S. and global markets become? And how will healthcare providers take advantage of such innovations to truly improve patient care? 

Attracting, retaining health IT staff remains a problem

April 12, 2013 | By Ashley Gold
The U.S. healthcare industry is struggling to find sufficient numbers of skilled employees and the outlook isn't bright.
A new report from Towers Watson, which surveyed more than 100 healthcare providers, including hospitals, highlights the need for information technology (IT) professionals presents an immediate challenge, as hospitals and health systems strive to meet government requirements relating to EHR systems and Meaningful Use taking effect in 2014.
Two-thirds surveyed reported problems attracting experienced IT workers, and 38 percent reported retention issues.

When Your M.D. Is an Algorithm


ORLANDO, Fla.—Despite all that drug-enforcement agents and regulators are doing to fight prescription painkiller abuse, the most effective combatant might turn out to be a computer algorithm.
That became apparent at last week's National Rx Drug Abuse Summit in Orlando. Joining an audience of patient advocates, policy makers and law-enforcement officers were members of a burgeoning cottage industry: a swarm of firms that are taking a data-driven approach to the drug-abuse epidemic.
With the costs of abuse soaring, these firms are combining medical research and guidelines with computer analysis to guide some doctors about what prescription painkillers should be administered to which patients, and in what doses. Or, if at all.

Health IT leaders face hiring woes

By Erin McCann, Associate Editor
Created 04/11/2013
U.S. healthcare providers nationwide have continued to experience difficulties with hiring and retaining experienced information technology professionals needed for the evolving healthcare environment, according to new research conducted by global professional services company Towers Watson. 
The Towers Watson survey, which included responses from more than 100 healthcare providers and hospitals, found that two-thirds (67 percent) are having difficulties attracting experienced IT workers, and 38 percent are reporting retention concerns. Officials say the staffing problems prove even greater for Epic-certified professionals, with nearly three-quarters (73 percent) of the respondents reporting difficulty hiring these individuals, whose specialized skills are essential to meet new electronic medical record requirements under healthcare reform.

Proposed 2014 HHS Budget Kind to Health I.T. Initiatives

APR 10, 2013 5:13pm ET
Federal spending levels for health information technology initiatives generally get a boost in the Department of Health and Human Services’ proposed budget for fiscal year 2014.
The operational budget of the Office of the National Coordinator would rise from $61 million in fiscal 2013--the same as in 2012--to $78 million next year. The increase will enable ONC to continue investments in several programs as HITECH funds run out. These include core standards development, health information technology certification, new tools and resources to support electronic health records meaningful use and HIT workforce curricula, work with stakeholders on governance of health information exchange, address new privacy and security policy issues to support a national cybersecurity program, and launch a patient safety plan.

Take part in The Big EPR Debate

11 April 2013  
When health secretary Jeremy Hunt makes speeches about his desire to see a paperless NHS by 2018, he likes to joke that his advisors have applauded him for his “brave” vision.
Ever since ‘Yes, Minister’ aired in the early 1980s, this has been taken as code for a minister doing something that his aides think deeply misguided and sure to end in tears.
Yet the aim of a paperless NHS – which the minister has further defined as one that uses electronic patient records and communications – is one that is worth aiming for.

Full Access to EHRs Mostly Beneficial for Patients, Study Says

Written by Anuja Vaidya  | April 09, 2013
Viewing their electronic health records empowers patients and enhances their contributions to their own care, according to a study published in the Journal of Medical Internet Research.
Thursday, April 11, 2013

When it Comes to ICD-10 Physician Documentation: Collaborate and Educate

Most hospitals and health systems have made progress related to the ICD-10 transition, but there undoubtedly is still more work to be done. Many have completed their readiness assessment, identified ICD-10 leadership, assembled their ICD-10 workgroups, planned coder, documentation specialist and other staff education, identified necessary IT infrastructure requirements and recognized the need to renegotiate payer contracts that reference ICD-9 codes. Still, even if all the above elements are in place, on time and functioning well, ICD-10 holds the potential to devastate a hospital's revenue cycle integrity leading to short-term, if not long-term, losses in revenue.
Another critical piece missing from the list above is: Assuring that your medical staff is ready for the ICD-10 transition. Although many argue ICD-10 is a coding issue requiring coding solutions, we see time and time again surveys that identify physician education as the most difficult challenge in preparing for ICD-10. Why the inconsistency? It actually makes sense from an operational perspective. We can mandate that coders attend necessary education, purchase computer-assisted coding (CAC) solutions and negotiate with vendors to assure that all IT platforms are ICD-10 compliant. But how do you mandate appropriate documentation for ICD-10 from your independent physicians? Short answer... you don't. It won't work. That is the most likely reason many health systems have turned a blind eye to the issue of physician documentation for ICD-10. There is a better answer -- don't mandate; collaborate and educate. 

DH gives exclusive insight into CSC deal

8 April 2013   Lis Evenstad
The man in charge of the Department of Health’s interim deal with CSC says it wants to normalise the health IT market and expects no more than 20 trusts to take Lorenzo under the new agreement.
In an exclusive interview with EHI, the senior responsible owner for local service provider programmes at the DH, Tim Donohoe, went into never-released- before detail about the deal.
He also promised a more transparent approach moving forward.

Joe’s view of the end of CfH

NHS Connecting for Health did not get a public send off as it finally ceased to exist on 1 April. Which is a shame, as Joe McDonald had his funeral oration all ready…
10 April 2013
I went to my first HANDI meeting before Christmas. HANDI, for anybody who doesn’t know, is the Healthcare App Network for Development and Innovation; it’s a community interest outfit that wants to promote the rapid development and deployment of “beautiful tools” that “play nicely together” and do useful stuff.
The weather in Gateshead was filthy and many roads were flooded on the day chosen for the inaugural meeting of the North East HANDI cluster.
But an interesting crowd turned up, including several clinicians, a couple of local government officials, some app developers, and some IT types who spoke a different language to the rest of us (but who could speak to each other in what I took to be fluent Klingon).

Don't ignore optimization during health IT go-lives

April 10, 2013 | By Dan Bowman
Technology projects such as the implementation of an electronic health record system, no doubt, come with their share of headaches. CIOs that think that such work merely consists of installing new software or hardware, however, are in for a rude awakening, according to Ilene Moore, a physician advisor for Elmhurst, Ill.-based healthcare professional services firm Dearborn Advisors.
"[H]ospitals often focus all of their resources around the go-live event itself," Moore writes in a recent post for Executive Insight. "Dismissing optimization or assuming that it's simple can lead to disaster."
According to Moore, several pitfalls often plague such projects, and can have lingering effects if they aren't addressed in a timely and appropriate manner. For instance, she says, end users like doctors and nurses must have a say in process adjustments both before and after a project's completion.

Practice Fusion Launches Doctor Appointment/Review Portal for Patients

April 9, 2013
Practice Fusion, the San Francisco-based provider of free EHR software, is launching a site that will allow patients to book an appointment, read a review of a doctor, and view their personal health record.
The site, Patient Fusion, gives patients access to a listing of 27,000 doctors, who are using the company’s EHR and can be categorized based on specialty and location.  There will also patient written “reviews” of the doctor on the site, Practice Fusion says. This could be a well-timed release for Practice Fusion since according to a recent report from PwC’s Health Research Institute (HRI), healthcare consumers are searching for reviews and ratings to guide their decision-making – but haven’t found what they need yet.

mHealth tools need to be financially self-sustainable, report finds

By Paul Cerrato, Contributing Writer
As mobile health gains ground as a way to improve population health and curb healthcare costs, models for making mHealth financially sustainable are topmost in the minds of stakeholders in the U.S. and across the globe.
“Mobile is a global game changer,” according to David Collins, senior director of mHIMSS, a globally-focused mobile initiative of HIMSS, the parent company of Government Health IT.
In Collins’ view, there are just too many mobile health projects that are having a real impact on healthcare delivery for investors to ignore. These initiatives offer a value proposition to the Samsungs, Verizons and AT&Ts of the world, said Collins.

5 reasons to consider clinical analytics

By Benjamin Harris, New Media Producer
Welcome to the data world. Many secrets are hidden in big data, and now, with the computing power to unearth them, analytics promises to deliver transformative power wherever it is put to work. Still, the technology is a relative newcomer in the healthcare world. Brett Furst, CEO of Arbormetrix, says there is nothing to fear – and that analysis of clinical data has much to offer the medical world. Here, he shares his top five requirements to succeed with, or at least get excited about, the power of clinical analytics.
1. Know the difference between solutions. Analytics solutions vary widely in size and shape. Furst says it is important to know what the different kinds are, and how to apply each one to specific problems, whether they have to do with population health and disease management, episodic delivery or post-acute care. Population health and disease management focuses on "improving the general health of a population and keeping them out of a hospital," according to Furst. Think screening a database to find people who might be at risk for a certain condition and reaching out to them. Episodic analytics "focuses on identifying variation in the delivery and associated outcomes of specialty and acute care." This kind of analytics is about looking back and finding ways to improve care in the future based on how it was provided previously, says Furst. Post-acute analytics centers around "utilization management so patients receive the appropriate level of care after hospitalization, with a focus on cutting down on wasted resources." Essentially, the three flavors Furst outlines could be seen as the analytical equivalents of before, during and after.

Trends in EHR vendor strength in 6 charts

By Robert Rowley, MD, Healthcare and health IT consultant, practicing family physician
On April 2, 2013, the federal Centers for Medicare and Medicaid Services (CMS) made available their updated data table for EHR Incentive Program (Meaningful Use) attestations, with specification as to which EHR products were used. The initial file, published on in 2012, showed the first year of experience of Meaningful Use, and allowed the relative comparison of vendors in the EHR arena.
The data table disappeared from the site in the middle of 2012, but has now been updated and re-posted (after some prompting at last month’s HIMSS conference). The updated data shows all the Meaningful Use attestation to date, and can show both first-year attesters for 2011 and also 2012, as well as second-year attesters in 2012 who started their first-year attestation in 2011. Given that this comes from actual reported Meaningful Use attestation to the government (for the Medicare version of the program), it is arguably the most accurate source, free from vendor hyperbole.

Orion to build shared record portal

4 April 2013   Rebecca Todd
The Bristol, North Somerset and South Gloucestershire health community has signed with Orion Health to develop a shared patient record.
The programme will deliver a local portal, which will integrate clinical and social health data from a variety of sources.
It is key to the community’s Connecting Care programme - a commitment between NHS providers and local authorities across Bristol, North Somerset and South Gloucestershire to share more information.
Director of informatics and business intelligence for Best West Commissioning Support and Connecting Care programme chair Andy Kinnear said patient information had been held in silos for too long.

Health Information Exchange: Start with the right structure to find success

April 9, 2013 | By Gienna Shaw
As health information exchanges across the nation gain momentum, challenges remain. The first is choosing a model that fits within state guidelines and the culture of the community. The trial-and-error approach to HIEs led to some early failures. But jumping over that first hurdle and choosing the right structure also is the first step to long-term success.
In this exclusive interview, FierceHealthIT talked to Joy Duling (left), executive director of Central Illinois Health Information Exchange and Laura McCrary (right), executive director of the Kansas Health Information Network and about their organizations' strategies, goals and challenges--including how to get both patients and providers to participate in data exchange.

Joint Commission outlines dangers of alarm fatigue

April 9, 2013 | By Susan D. Hall
The Joint Commission this week issued a warning that healthcare workers can become numb to the incessant beeping of medical devices, creating life-threatening situations for patients.
The hospital accreditation body based the warning on events reported to its Sentinel Event database, which tracks serious safety-related events, though it has been sounding the alarm on this issue for years.
Indeed, "alarm fatigue"--when workers tune out alarms that just create more workplace noise--again topped the ECRI Institute's 2013 list of health technology hazards.

'Alarm fatigue' endangers patients

By Bernie Monegain, Editor
Created 04/09/2013
The constant beeping of alarms and an overabundance of information transmitted by medical devices such as ventilators, blood pressure monitors and ECG (electrocardiogram) machines is creating "alarm fatigue" that puts hospital patients at serious risk, according to a Sentinel Event Alert issued April 8 by The Joint Commission.
The Joint Commission Alert urges leaders at hospitals to take a focused look at this patient safety issue.
Over a recent four-year period, a U.S. Food and Drug Administration database shows that there were more than 560 alarm-related deaths, and The Joint Commission's sentinel event database includes reports of 80 alarm-related deaths and 13 serious alarm-related injuries during a similar period.

Online interventions for teens effective in improving care

April 9, 2013 | By Ashley Gold
Teens, no doubt, are attached to their phones and love consuming electronic media--and a new study shows that electronic media-based health interventions can actually promote health behavior change among youth populations.
Published in JAMA Pediatrics, the study aimed to assess the type and quality of the studies evaluating the effects of electronic media-based interventions on health and safety behavior change.
Using searches in MEDLINE and PsychInfo through 2010, the review included published studies of electronic-media tailored interventions, focusing on health behavior changes in children 18 years of age or younger.

Big data could mean big savings in health care – but here’s what has to happen first

Apr. 5, 2013 - 3:29 PM PDT
A new report from McKinsey estimates that big data could save the health care industry up to $450 billion, but it has to overcome a few obstacles first.
Properly exploiting big data in health care could mean up to $450 billion in savings health care organizations and consumers according to a recent report from consulting firm McKinsey. But don’t get too excited yet – that data-optimized future isn’t just going to fall in our laps.

Administration pushes toward electronic medical records

By Ben Goad - 04/08/13 05:30 PM ET
The Obama administration is moving to ease the national transition from paper to electronic health records through a pair of proposed rules to be published this week.
The rules, to hit Tuesday’s Federal Register, would update and extend existing regulations surrounding the sharing of patient electronic records.
Federal law generally prohibits hospitals from giving medical record software to doctors who would then use it to refer patients back to the facility for treatment. Violations can be charged as felonies and are punishable by prison time and fined up to $25,000.

Joint Commission Issues Alert on Medical Device Alarm Fatigue

APR 8, 2013 12:19pm ET
The Joint Commission on April 8 issued a Sentinel Event Alert to hospitals, imploring leaders to take a focused look at the serious risk caused by “alarm fatigue” from medical devices.
“These alarm-equipped devices are essential to providing safe care to patients in many health care settings; clinicians depend on these devices for information they need to deliver appropriate care and to guide treatment decisions,” according to the Joint Commission message. “However, these devices present a multitude of challenges and opportunities for health care organizations when their alarms create similar sounds, when their default settings are not changed, and when there is a failure to respond to their alarm signals.”

ONC forges partnership for HIE standards

By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Created 04/05/2013
Rather than trying to create new information exchange governance standards, the Office of the National Coordinator is pursuing the goal of nationwide HIE interoperability and security via a cooperative agreement with Direct Trust and the EHR/HIE Interoperability Workgroup to build on current successes, while sorting out ongoing barriers.
Direct Trust, a nonprofit devoted to secure exchange, and the Interoperability Workgroup, a New York eHealth Collaborative-led coalition, will be working with ONC to develop interoperability accreditation standards and businesses practices aimed at reducing implementation costs and improving privacy and security.
It’s part of the ONC’s Exemplar HIE Governance Program, which launched late last year, as the agency looked for alternatives to new HIE governance regulations.

What's your strategy for big data deployment?

April 8, 2013 | By Dan Bowman
Big data optimism is at a fever pitch in the healthcare industry, and with good reason. According to a recent analysis by consulting firm McKinsey & company, use of such tools and processes could help to save U.S. citizens as much as $450 billion in healthcare costs; as in, close to half a trillion dollars.
What's more, some big-name healthcare organizations are buying in. Last month, the University of California Los Angeles and IBM announced a partnership revolving around the use of big data analytics to test the effectiveness of a real time alarm designed to predict brain swelling in trauma cases. A month earlier, Salt Lake City-based Intermountain Healthcare announced plans to collaborate with Deloitte Consulting with an emphasis on making the former's data use experience commercially available to other healthcare organizations. UnitedHealth and Mayo Clinic also unveiled earlier this year a partnership in which the two entities will combine their data for more than 110 million patients to research methods for improving care while lowering costs.
Monday, April 08, 2013

Requiring Electronic HIE as a Condition of Participation in Medicare

In conjunction with the release of its 2013 agenda to bring down costs and improve quality of care through health IT, HHS issued a request for information on ways to accelerate electronic health information exchange within the health care industry. The RFI seeks input on potential policy and programmatic changes to further advance interoperable HIE beyond what is currently being done through Office of the National Coordinator for Health IT and the electronic health record incentive programs.
One of the policy changes HHS is considering is to require that health care organizations engage in electronic HIE in order to participate in Medicare. That is, HHS is considering making electronic HIE one of the Medicare Conditions of Participation (CoPs). 

ONC Responds to HIE Criticism with Grants

Scott Mace, for HealthLeaders Media , April 8, 2013

The federal Office of the National Coordinator (ONC) for Health Information Technology, stung by a negative report on health informati on exchanges (HIEs) last month, responded last week, handing out nearly a half million dollars to spur private efforts in the area.
ONC awarded DirectTrust and the EHR/HIE Interoperability Workgroup (IWG)each Exemplar HIE Governance Program Cooperative Agreements to continue to support their work advancing the governance of health information exchange.
"We will work closely with each of these entities and their partners to develop policies, interoperability requirements, and business practices that align with national priorities, overcome interoperability challenges, and reduce implementation costs," says Claudia Williams, director of ONC's State Health Information Exchange Program.


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