Saturday, May 18, 2013

Weekly Overseas Health IT Links - 18th May, 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.

Global healthcare IT market estimated to reach $56.7B by 2017

May 10, 2013 | By Ashley Gold
The global healthcare IT market is estimated to reach $56.7 billion by 2017--up from $40.4 billion in 2012--due to the demand for clinical information technology, administrative solutions and services, according to a new analysis by MarketsandMarkets.

Most U.S. docs use EHRs

May 10, 2013 | By Susan D. Hall
Doctors in the U.S. are embracing electronic health records, even if reluctantly, with 93 percent reporting they actively use an EHR system, according to a new report from Accenture.
In addition, nearly half (45 percent) of U.S. doctors surveyed said they regularly access clinical data outside their own organization, illustrating the growing momentum of health information exchange. That's a 32 percent increase since last year, according to an announcement.
In all, 3,700 physicians in eight countries were polled: Australia, Canada, England, France, Germany, Singapore, Spain and the U.S.
Seventy-six percent of doctors in all countries reported that EHRs and HIE have had a positive impact on their practice, such as via reduced medical errors (76 percent) and improved quality of data for clinical research (74 percent). U.S. doctors, however, were the least likely (38 percent) to report that using EHRs and HIE reduced their organization's costs. They also cited cost as the single greatest barrier to technology adoption.

At ATA, optimism is high amidst many challenges

By: Jonah Comstock | May 8, 2013
While attending the American Telemedicine Association (ATA) meeting in Austin, Texas this week, Dr. Andrew Watson, a colorectal surgeon and executive director of telemedicine at the University of Pittsburgh Medical Center, stumbled across a petting zoo. His young daughter wasn’t with him, but he wished she was. Luckily, he was in a telemedicine mindset.
“I took my daughter on a tour of the petting zoo via FaceTime on my iPad this morning,” he told the crowd at ATA. “Who knows what the point of care is anymore? But it’s certainly not in the offices and the ERs and the ORs. It’s going to be in the home and in the cloud.”
Video visits, remote monitoring, and better data integration are moving us into a world where we don’t think of distance as an impediment to care. And many of the stories told at ATA were stories about scaling telemedicine to meet the growing needs of hospitals to cut costs and reduce readmissions. But medical practices implementing telemedicine still face challenges around licensure, reimbursement, and regulation, as well as challenges about how best to implement and scale their programs.
Health Care

Glimpsing the Future of E-Health Care From a Rio Favela

Your doctor may not be the biggest fan of the coming electronic health care wave, but marrying mobile technologies with medical know-how has the potential to save lives, dramatically improve patient care, and slash significant costs, even in the poorest urban communities in the world, a new study finds.
Researchers at the New Cities Foundation, a nonprofit organization in Paris that seeks to tackle the most intractable issues facing the world’s fastest-growing cities, joined by a small team of health-care workers from Rio de Janeiro, recently concluded an 18-month trial in one of the poorest parts of the city, the favela of Santa Marta, a community of 8,000. Santa Marta was chosen for its unique geography and its remoteness—the rows of shanty homes appear to tumble down this hillside community where, until recently, there was no sewage, running water, or electricity to the upper reaches of this slum community, and access to even basic health care for the sick and elderly almost always involves an arduous slog downhill and up again.

Health IT Execs' Top Worries: Security, BYOD, Cloud

Personal mobile devices still present huge security challenge, say HIMSS Analytics focus group participants.
Seven senior IT executives who participated in a focus group conducted by analyst group HIMSS Analytics cited data security concerns -- especially those related to the growing use of personal mobile devices -- as among their top challenges. Other pressing issues included the growth in data storage needs and health information exchange.
Although the focus group was small, what the participants said reflected the IT infrastructure priorities of the industry, as represented in a recent survey by the Health Information Management and Systems Society (HIMSS), according to a report on the focus group. AdTech Ad
The IT executives lamented their loss of control over device management in a "bring your own device" (BYOD) environment. As one participant noted, "you can't lock down [providers'] personal e-mail."

EMR and HIE see big adoption numbers

By Mike Miliard, Managing Editor
Created 05/09/2013
The number of U.S. physicians using electronic medical records has topped 90 percent, and nearly half of the doctors polled for a new Accenture survey say they now use health information exchange technology – an uptick of 32 percent.
The Accenture poll – which queried the health IT usage of 3,700 physicians in the U.S., Canada, England, France, Germany, Spain, Singapore and Australia – found that 93 percent of American docs are now using EMRs, and that 45 percent said they routinely access clinical data from outside their own organization.
U.S. physicians have posted the most impressive increase in adoption, showing a 32 percent annual increase in the routine use of health IT capabilities, compared to an average increase of 15 percent among doctors in the other countries surveyed, according to the survey.

Framework aims to scale state's HIE trust agreements

May 9, 2013 | By Susan D. Hall
The California Office of Health Information Integrity wants to create standards for establishing trust among health information organizations in the state, reports Government Health IT.
It has published a trust framework that can apply to other HIEs or Regional Health Information Organizations without those organizations having to draft separate data-sharing agreements with each partner. It's called the Model Modular Participant Agreement and designed to comply with the business associate provisions of HIPAA.
"Point-to-point agreements are obsolete. Trust must be scalable," Robert Cothren, technical director of California Health eQuality, a program of the University of California-Davis Institute for Population Health Improvement that's overseeing state HIE efforts, said in an announcement.
Thursday, May 09, 2013

In Record Time: How an EHR Changed My Patient Experience

by Doug Thompson
I'll be the first to admit it, I was a bit put off when the receptionist said, "You need to call back the day you'd like to see the doctor." With such short notice would I even get to see my new family doctor, or would I be triaged to one of his colleagues? Given the highly computerized nature of his practice, would I spend my day filling out forms? Or, worse yet, would the doctor be so focused on data entry that he'd lose sight of me, the patient?
Yes, in spite of my professional experience with the value of electronic health records, I was personally skeptical of what they look like in practice.
What I found instead? Shorter waits and better service: in the waiting room, in the exam room, in the pharmacy and for test results. 

HIMSS: IT pros share network struggles

By Erin McCann, Associate Editor
Created 05/08/2013
Health information technology leaders generally cite similar infrastructure priorities and challenges faced within the industry, but they disagree on approaches to addressing network scalability, executive support and cloud computing security, according to a new HIMSS Analytics study released Monday. 
IT leaders who participated in the study, conducted as a focus group at HIMSS13, underscored the top four interrelated IT infrastructure priorities as being: use of mobile devices; security; data storage and information exchange.

AHIMA helps consumers maximize mHealth

By Mike Miliard, Managing Editor
Created 05/07/2013
American Health Information Management Association has launched a best practice guide to help consumers better evaluate the merits of specific mobile health apps.
AHIMA's "Just Think App Mobile Health Apps 101: A Primer for Consumers" is part of the association's website, which offers consumers guidance on how to set up and manage their personal health information. Medical professionals can direct patients to the site to learn guidelines for using health apps.
“A sound app can give the consumer a way to easily track their daily condition and keep all the information in one convenient place, which can then be shared directly with their doctor,” said Marsha Dolan, co-chair of AHIMA’s Consumer Health Practice Council, in a press statement.

New Choose and Book by end of year

8 May 2013   Rebecca Todd
NHS England plans to have a redeveloped Choose and Book service operating by the end of this year.
Industry leaders are concerned that the re-platforming of the electronic booking service is being rushed to meet an impossible timescale.
NHS England's new business plan for 2013-14 – 2015-16, 'Putting Patients First', says it will have a new NHS e-referrals service operational by December 2013.
It says the re-launch of Choose and Book is part of the ‘Paperless NHS’ programme and aims to make electronic referrals “universally and easily available to patients and their health professionals for all secondary care services by 2015."

NHS England to publish IT strategy

7 May 2013   Rebecca Todd
The front cover of the business plan
NHS England is developing an NHS Technology Strategy and Roadmap, setting a national direction for NHS IT.
NHS England has published its Business Plan for 2013-14 – 2015-16 called 'Putting Patients First', which explains how it will deliver its mandate from the government.
One of the plan’s key targets in relation to IT is to have 95% of trusts using the NHS Number as the prime identifier in clinical correspondence by January 2015.
'Putting Patients First' says NHS England will “set the direction for NHS technology and informatics so that commissioners, providers and suppliers can make informed investment decisions.

Can patients cherry-pick health information to be exchanged?

May 8, 2013 | By Susan D. Hall
What if the possibility that sensitive information could be disclosed in non-targeted queries kept patients from allowing any of their health information to be exchanged?
The ONC's Health IT Policy Committee has decided that scenario requires more study, reports HealthcareInfoSecurity. The committee in April approved recommendations from its Privacy and Security Tiger Team, including:
  • A provider's targeted query for information from another provider when directly treating a patient
  • Targeted queries between providers in states with privacy laws more stringent than HIPAA
However, a third scenario was presented at a meeting on Tuesday, in which a provider asks a health information exchange for all records on a patient when the providers are not known.

Get Ready for New HL7 Standards

MAY 7, 2013 3:57pm ET
Health Level Seven International is well along in development of its next-generation integration standards, called Fast Health Interoperable Resources, or FHIR.
The new standard is being balloted as a Draft Standard for Trial Use. If sufficient HL7 members approve, it will be available for testing in real-world applications to gather information on necessary enhancements.

Study: Pagers, Outdated Communication Tech Costing Hospitals

May 7, 2013
According to a new study from the Traverse City, Mich.-based Ponemon Institute, collectively, U.S. hospitals are losing $8.3 billion annually due to the use of pagers and outdated communicates technologies. These technologies, the study’s authors say decrease clinician productivity and increase patient discharge time.
Ponemon Institute surveyed 577 healthcare professionals for the study, which was sponsored by the Lexington, Mass.-based security software company, Imprivata. What they found was the average clinician wastes 45 minutes per day as a result of inefficient communication systems. Translated, Ponemon’s researchers found, this costs the average hospital nearly $1 million annually. Furthermore, increased patient discharge times due to these communication failures can cost a hospital more than $550,000 per year in lost revenue.

GPSoC will fund records access

2 May 2013   Rebecca Todd
Patient records access functionality will be centrally funded via the new GP Systems of Choice contract.
Draft documents on the Health and Social Care Information Centre website indicate that practices will be able to choose to buy the service from third-party vendors, or from their core GP system supplier.
GPSoC is a framework contract which funds GP IT systems for more than 80% of practices in England.

EHR dissatisfaction: A tech or people problem?

By Kimberly Martini, Division vice president, AMN Healthcare
A percolating problem is beginning to boil over: doctors and nurses really don’t like their new electronic health records systems. And, as EHR implementations increase ahead of government deadlines for incentive dollars, dissatisfaction among clinicians is growing.
The problem might be that EHR implementation is treated as a purely technological issue when in reality it is a workforce issue. Several years before federal incentives began for healthcare providers to adopt EHRs, leading healthcare informatics organizations strongly recommended that workforce training and readiness must be a top priority in the national transformation from paper to electronic health records.
While the benefits of EHRs to patient care have been established, persistent user issues may be impacting the technology’s effectiveness. Many surveys and studies show that user satisfaction with EHRs is headed in the wrong direction. An American College of Physicians survey, released this spring at the HIMSS13 conference, showed that overall EHR user satisfaction fell 12 percent from 2010 to 2012, while those who said they were “very dissatisfied” rose by 12 percent.

Texas Children's unlocks data power

By Bernie Monegain, Editor
Created 05/07/2013
Charles Macias, MD, always believed in the power of data to make a difference in delivering high quality care to patients, but at Texas Children’s Hospital in Houston, where he is an attending physician and serves as director of the Center for Clinical Effectiveness and the Evidence-Based Outcomes Center, he knew the hospital could do better. He just didn’t realize how much better it could do.
Until recently, with the introduction of new technology from Health Catalyst, Macias said, it would take six months to pull enough of the right data from the hospital’s Epic electronic health record system to see if a specific medical intervention was making a difference. He and his team wanted to track outcomes to determine what worked best for the patient, but it had always been laborious and slow – often as long as six months for his team to get information the clinicians could use.
Once Health Catalyst was up and running that “six-months of waiting was reduced to 23 hours and 59 minutes – no longer than one day,” Macias said in a recent interview. “It’s amazingly powerful.”

Telemedicine shows ROI at ATA

By Mike Miliard, Managing Editor
Created 05/07/2013
Ironically, Andrew Watson's first telemedicine procedure was with a rural patient who was a Mennonite. At first, the patient and physician looked at each other warily. 
"He didn't have a TV," said Watson, a colorectal surgeon and vice president at Pittsburgh-based UPMC, with a wry laugh. "And I'd never done this."
The procedure worked. And it was worth it. "He didn't drive," Watson said. "And I spared him an expensive trip to Pittsburgh."
But that's far from the only value derived from telemedicine. In a session Monday at the ATA's 18th Annual International meeting & Trade Show titled "The Telemedicine Value Proposition: ROI & Sustainability," Watson laid out the numbers, so far, for UPMC's forays into virtual care since 2009.

E-prescribing up, but challenges persist

May 7, 2013 | By Marla Durben Hirsch
More physicians than ever have embraced electronic prescribing, but the road to adoption still has some bumps in it, as indicated by Surescripts' newly released annual National Progress Report and Safe-Rx Rankings.
According to the report, a record 788 million prescriptions (44 percent) were routed electronically in 2012, up from 570 million (36 percent) in 2011. What's more, more than 38,000 physicians (69 percent) used e-prescribing in 2012. Nearly half of all office visits (48 percent) resulted in electronically generated medication history requests, up from 31 percent in 2011.  

Panel: Cloud, mobile use among biggest health IT challenges

May 7, 2013 | By Dan Bowman
Concerns about the viability and security of mobile devices were among several issues brought up by health IT leaders with regard to network challenges and barriers as outlined in a newly released HIMSS Analytics report. The report, which was based on a small focus group convened at HIMSS13 in March, also found that while the participants shared similar infrastructure priorities, they differed in their plans for taking action on those priorities.
With regard to a bring-your-own-device policy, for instance, while one panel member talked about taking a "slow approach" to implementation, another said that organizations would have no choice but to evolve as employee demand grows.

Why telemedicine must become 'integral' to mainstream care efforts

May 7, 2013 | By Dan Bowman
Telemedicine must move to the forefront of medical efforts in the U.S. for domestic care efficiency and quality improvements to be considered anything better than "marginal," according to an editorial published this month in the journal Telemedicine and e-Health.
Rashid L. Bashshur (pictured), director of telemedicine at the University of Michigan Health System and the commentary's author, says that now is the time to establish telemedicine as "integral" to care efforts, particularly in conjunction with other information technologies like electronic and personal health records.

10 Most Common Mistakes Physicians Make With Their EHRs

Written by Anuja Vaidya  | May 02, 2013
Social Sharing
A recent Medscape article listed the 10 most common mistakes made by physicians with regard to their electronic health records.
A survey, released by the American College of Physicians and AmericanEHR Partners in March, showed that EHR user satisfaction fell by 12 percent from 2010 to 2012. According to the Medscape report, mistakes that physicians make also contribute to the overall sense of dissatisfaction with EHRs.

HHS Outlines Voluntary HIE Guidelines

'Trust Principles' Spell Out Consumers' Rights

By Marianne Kolbasuk McGee, May 6, 2013
The Department of Health and Human Services has released voluntary guidelines for health information exchange that include "trust principles" for security and privacy.
The new "Governance Framework for Trusted Electronic Health Information Exchange" document also includes organizational, business and technical principles.
The framework, for example, calls for providing patients with privacy and security policy notices; giving patients the opportunity to decide whether to have their data exchanged; and allowing patients to access their health data and request changes to it.
David Whitlinger, executive director at New York eHealth Collaborative, which oversees New York's statewide HIE, says that the trust principles of the ONC governance framework are in line to what many HIE efforts are already doing. "They're not being too prescriptive," he says.

Technology Tackles the Pressure Ulcer

Scott Mace, for HealthLeaders Media , May 7, 2013

When healthcare technology is really on point, it provides a quick return on investment, improves quality, and usually disrupts business as usual. This week, I have the perfect candidate.
The Agency for Healthcare Research and Quality estimates 2.5 million people in the US develop pressure ulcers per year, 60,000 of whom die from complications. Despite advances in bed technology and many aspects of wound care, the number of hospitalizations for pressure ulcers reported to the Centers for Medicare & Medicaid Services increased 80 percent between 1993 to 2006, despite an increase of only 15 percent more patients.
One of the causes of HAPU, or hospital-acquired pressure ulcers is too much time spent in one position. A study in the February 2013 issue of the journal Wounds, "Pressure Map Technology for Pressure Ulcer Patients: Can We Handle the Truth?" found that a new pressure-sensing technology, deployed on beds, improved the timeliness of patient turning improved greatly.

AHIMA calls for coding guidelines

By Diana Manos, Senior Editor
Created 05/06/2013
Electronic health records, when used correctly, produce more accurate documentation leading to more complete coding, and ultimately, more accurate reimbursement claims, according to Sue Bowman, senior director of coding policy and compliance of the American Health Information Management Association.
Bowman presented May 3 at a listening session hosted by Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology at the Department of Health and Human Services, according to a news release issued by AHIMA.
The session, “Billing and Coding with Electronic Health Records,” convened stakeholders including providers, health association leaders, health information technology vendors and others to discuss EHRs, increased billing for some services and appropriate coding in an increasingly electronic environment.

AMA: EHRs create 'appalling Catch-22'

By Tom Sullivan, Editor, Government Health IT
Created 05/03/2013
As the healthcare industry moves to EHRs, the medical record has essentially been reduced to a tool for billing, compliance and litigation that also has a sustained negative impact on doctors' productivity, according to Steven J. Stack, MD, chair of the American Medical Association’s board of trustees. 
“Documenting a full clinical encounter in an EHR is pure torment,” Stack said during the CMS Listening Session: Billing and Coding with Electronic Health Records on Friday. 
EHRs are also driving the industry toward charts that look remarkably similar because they’re based on templates created by the technology vendors — that includes often using the same words. And that threatens to make doctors appear to be committing fraud by the practice of record cloning, or cutting and pasting from one record to another, when they are not, in fact, acting fraudulently. Alongside the federal mandate to implement an EHR under threat of a monetary fine, that creates what Stack called “an appalling Catch-22 for physicians.”

ONC unveils framework for HIE governance

May 6, 2013 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT is shoring up health information exchange efforts with the long-awaited release of the "Governance Framework for Trusted Electronic Health Information Exchange." The agency says the framework will provide a "common foundation" for all types of HIE governance models.
The three-page document "reflects what matters most to ONC when it comes to national Heath Information Exchange governance and the principles in which [the office] believes," Farzad Mostashari, head of the Office of the National Coordinator for Health IT, wrote in a recent post to the Health IT Buzz blog.

Premier Survey: I.T. Top Capital Investment for Hospitals

MAY 3, 2013 1:42pm ET
In the Spring 2013 Economic Outlook from provider alliance Premier Inc. that included surveying 530 hospitals and health systems, 43 percent of respondents expect health information technology and telecommunications to be its largest capital investment during the next year.
That’s up 21 percent from two years ago, according to Premier, and reflects the need for increased health information exchange. Thirty-two percent of respondents are unable to share data across the continuum of care.

Hospitals Ramp Up Capital Spending on IT

Rene Letourneau, for HealthLeaders Media , May 6, 2013

When I read in the Premier healthcare alliance's recent spring 2013 Economic Outlook that 43% of survey respondents indicated that their organization will make its biggest capital investment in healthcare information technology and telecommunications in 2013, up 21% from two years ago, I wasn't surprised.
In the HealthLeaders Media 2013 Industry Survey, 36% of the executive respondents said they expect major increases in IT spending over the next 3 years, and another 44% expect a minor increase. And at our most recent CFO Exchange, "clinical and information technology upgrades" was one of the top 3 spending priorities for the assembled CFOs.
Monday, May 06, 2013

Federal Health IT Activity Continues in Q1 2013

by Helen R. Pfister, Susan R. Ingargiola and Christine D. Chang, Manatt Health Solutions
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 first quarter of 2013.

Govt moves to roll out ambitious e-health plan

G Rajiv, TNN | May 5, 2013, 10.46 PM IST
THIRUVANANTHAPURAM: The health department has invited expression of interest for its ambitious e-health project, which envisages an electronic health card for all the people who seek treatment in government hospitals across the state.
The expression of interest has been invited from the entities for integrated e-health solutions covering the entire health sector of the state. It would capture the demographic data, automate hospital process and bring all information into a centralized state health information system through the network to ensure continuity in health care.
The Centre has sanctioned Rs 96 crore for the project which is expected to be completed within two years of launch. In the first phase, the database of those in Thiruvananthapuram would be documented. The project will be extended to six other districts in the second phase. The remaining districts will be covered in the third phase.


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