Saturday, May 04, 2013

Weekly Overseas Health IT Links - 5th 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.

ONC Revokes MU Certification of EHRMagic Products

APR 25, 2013 4:49pm ET
The Office of the National Coordinator for Health Information Technology for the first time has revoked the electronic health records meaningful use certification of EHR products after determining the products did not meet criteria for which they were certified.
The products, which InfoGard Laboratories had certified, are the inpatient and ambulatory EHRs of EHRMagic Inc., Santa Fe Springs, Calif. ONC and InfoGard both received complaints that the products did not meet required functionality.

The Healthcare Help Desk Steps Up Its Game

Scott Mace, for HealthLeaders Media , April 25, 2013

This article appears in the April 2013 issue of HealthLeaders magazine.
Healthcare being a round-the-clock, up-to-your-elbows business, CIOs have recognized that the IT help desk must change—and at a few institutions, that change has already occurred.
"Typical service desk analysts are not skilled in clinical applications, which are very unique to this industry, probably more so than any other industry," says Chad Eckes, CIO of Schaumburg, Ill.–based Cancer Treatment Centers of America. "The minute a [clinical] topic comes up on an electronic health record, for example, the call is shut down, and the ticket then is passed on to your clinical applications team to provide that support, and amongst all that, you end up with this delay in providing an answer to that user, who probably has a patient in front of them."

Regional HIE outlines roadmap for protecting data upon dissolution

April 25, 2013 | By Marla Durben Hirsch
Health information exchanges considering closing their doors may wish to pay heed to how regional Wisconsin Health Information Exchange (WHIE) is protecting patient data in its possession now that it has ceased operations, according to a recent article.
The Milwaukee-based exchange, which had more than 1,000 user accounts, notified participants in advance that it was shutting down, then on April 1 disabled user access, according to executive director Kim Pemble. It then created a backup copy of its patient data archive to be securely locked up for six years, to comply with federal and state data retention requirements. The data will be destroyed at the end of the retention period, according to Pemble.

Newer EHRs with 'refinements' can improve prescription safety

April 25, 2013 | By Marla Durben Hirsch
Using a newer electronic health record system with extra guidance for prescribing can reduce prescription error rates over time, according to a study published this month in the Journal of American Medical Informatics Association.
A team of physician-scientists from Weill Cornell Medical College reviewed 1,905 prescriptions for more than 900 patients at an academic-affiliated ambulatory clinic in 2010 both before and after the clinic switched from an older EHR system to one with more prescribing support, such as drug-allergy interactions and alerts about inappropriate abbreviations that could harm patients. They found that after two years, the error rate dropped to 3.8 percent, significantly lower than the rate after one year.

EHR use provides Canadian docs billions in benefits

April 24, 2013 | By Marla Durben Hirsch
Electronic health records have proven very useful to Canadian physicians in community-based care, helping them to reap more than $1.3 billion in benefits since 2006, according to a new report by PwC.
The report, commissioned by Canada Health Infoway, involved review of over 250 research articles, surveys and other information. The researchers found a number of advantages to EHR use, including:
  • $800 million in administrative efficiencies in workflow as staff time is redeployed
  • $584 million in health system level benefits, such as the reduced number of duplicative tests
  • Improved outcomes and safety through preventive care and disease management, such as a 49 percent increase in pneumococcal vaccination rates with EHR reminders
  • Increased interactions and communications among providers and between providers and patients

6 steps to keep security issues at bay

By Bernie Monegain, Editor
Created 04/25/2013
Healthcare institutions should emulate best-of-breed privacy polices developed by financial services firms rather than other hospitals, recommends William Tanenbaum, partner at New York-based technology law firm Kaye Scholer LLP.
When it comes to privacy and data security, healthcare institutions face tremendous exposure to regulatory violations and monetary damages, Tanenbaum said in a news release. Tanenbaum advises clients on a wide range of technology and Internet issues, including data security and privacy.
“Criminals pay more for stolen personal health information than they do for stolen credit card information,” he said. "The top of a medical chart contains all the information needed for identify theft. While better IT is the solution, not all wheels have to be reinvented.”

One doc's take on why PHRs speed secure data exchange

April 25, 2013 | By Dan Bowman
Personal health records represent a faster, more patient-friendly method for health information exchange than actual HIE solutions, according to David Mendelson (pictured), a professor of radiology at Mount Sinai Medical Center in New York.
Mendelson, speaking at the Information Management Network Hospital Cloud Forum in New York on April 16, said that PHRs are "less cumbersome … for exchanging health information," as they eliminate the need for multiple business association agreements while encouraging patient engagement, according to an article published this week by Health IT Security.

Health IT salaries lag behind overall IT industry

April 25, 2013 | By Susan D. Hall
While demand for IT talent in healthcare remains high, salaries appear flat according to InformationWeek's 2013 U.S. IT Salary Survey.
The demand, however, indicates continuing upward pressure on salaries, the report says.
It finds no rise from a year ago in median annual base pay at $83,000, compared with $87,000 for IT pros across all industries. Healthcare IT managers received a slight boost in average base pay to $112,000, up from $109,000 in 2012, more than the industry average of $110,000.

Meaningful use spurs progress, concerns

By Erin McCann, Associate Editor
Created 04/23/2013
Meaningful use will bring about the most significant improvements in the health information technology arena, say health IT executives, who are working tirelessly to meet industry deadlines. However, a new survey finds it's still a trying task, with officials citing regulation ambiguity and competing IT projects as the biggest barriers to moving forward with MU.
The survey, conducted by the Stoltenberg Consulting firm, includes insight from HIT management, physicians, clinicians, government agencies and HIT vendors who attended the 2013 HIMSS Annual Conference and Exhibition in New Orleans.
Thursday, April 25, 2013

Rethinking Readmissions: The Importance of Improving Communication

by Andrew Brooks
Despite having one of the most technically advanced health care systems in the world, the United States continues to struggle with the most basic of tasks -- efficient communication and care coordination amongst different providers. Poor communication shows up most glaringly with readmissions, which the Wall Street Journal recently described as "a vexing problem" that costs Medicare an estimated $26 billion a year and affects nearly one in five beneficiaries.
Transitioning a patient from the hospital to the home is a tenuous time, and not enough focus is given to this seemingly mundane period in the care of a patient. As an orthopedic surgeon, I can state unequivocally that the post-hospitalization period is a vulnerable time that requires rethinking. The current mindset is to get the patient out of the hospital and hope their discharge follow-up magically works to transition them seamlessly into outpatient care.
This couldn't be further from the truth. Patients do not get what they need, and the lack of communication and coordination falls squarely on the hospital and providers.

FDA Probes Docs Over da Vinci Robot Problems

Joe Cantlupe, for HealthLeaders Media , April 25, 2013

No medical device dominates the news as much as the multi-armed robot, particularly the da Vinci, which is at once fiercely loved and incredibly despised.
Some doctors tell me it's the greatest tool they've got to improve efficiencies in the operating room. Others say it's a disaster waiting to happen. In some instances, they believe it already has. While some hospitals are counting on the robot for higher ROI, a growing number of lawsuits is taking center stage over allegations of improper procedures.
In the meantime, the federal Food and Drug Administration has launched a survey to evaluate the robot, focusing on physicians' opinions about the device.

Women promise new tide for health IT

By Erin McCann, Associate Editor
Created 04/24/2013
In health IT, it's a man's world. Although women account for more than 47 percent of the U.S. labor force, they hold a paltry 25 percent of senior health IT roles nationwide. Don't get used to this trend, however, say female industry leaders who are working to make the realm of information technology more accessible to women. 
After analyzing more than 3,000 health IT positions nationwide — such as chief information officers and vice presidents of IT — Healthcare IT News found that 75 percent are occupied by men. 
Although data from the U.S. Department of Labor finds that the number of women holding various IT positions across all industries is significantly lower — estimated at 17 percent — 25 percent of women in senior health IT roles, to many in the industry, is still no number meriting celebration. 

Hospitals remain ill-prepared for ICD-10

By Erin McCann, Associate Editor
Created 04/24/2013
The pace at which hospital administrators, health information professionals and compliance employees are moving toward the ICD-10 transition has elicited concern among industry leaders, according to a new survey that finds some 20 percent of small- and mid-sized hospitals have yet to begin any education or training for what's been billed as one of the biggest shifts U.S. healthcare organizations have ever faced.
The survey, conducted by Health Revenue Assurance Associates, included the responses from more than 120 hospitals and found that nearly half are lagging behind on the Centers for Medicare & Medicaid Services timelines for ICD-10 preparation.

Survey: Companies Across Industries Don’t Learn from Breaches

APR 23, 2013 12:14pm ET
A new multi-industry survey shows many companies don’t sufficiently take steps to improve security and mitigate future incidents following a significant data breach.
Security research firm Ponemon Institute conducted the survey of 471 respondents, with health care among the most represented industries, under contract with the data breach resolution unit of Experian, a credit bureau. All responding organizations had experienced at least one breach, with 52 percent having two or more.

CIO highlights health IT lessons learned from Boston bombings

April 24, 2013 | By Susan D. Hall
Who would think that when your hospital's database administration team decides to volunteer as a group at a local event, such a gesture could put the facility at risk? That's just one of the lessons for Beth Israel Deaconess Medical Center after the bombings at the Boston Marathon, CIO John Halamka (pictured), a FierceHealthIT Editorial Advisory Board member, said in a recent post to his Life as a Healthcare CIO blog.
Seven members of BIDMC's IT staff were working at the medical tent or finish line when the bombs exploded April 15, according to Halamka. They were unhurt, and were among the first to help those impacted by the blasts. However, risk planning in the future requires considering the potential ramifications of that, Halamka said.

CO Beacon shows progress amid hurdles

By Anthony Brino, Associate Editor
When the ONC launched the Beacon Community grants in 2009, several health organizations in western Colorado, which five years earlier formed the HIE Quality Health Network, saw the program as a natural extension of their work towards IT-enabled hospital and primary care improvements.
With a three-year $11.9 million federal grant, the Mesa County Independent Practice Association, Rocky Mountain Health Plans and St. Mary’s Regional Medical Center formed the Colorado Beacon Consortium, aiming to help physicians and hospitals establish local medical neighborhood models and use EHRs, information exchange and analytics.

Government driving health IT in Asia-Pac

By Mike Miliard, Managing Editor
Created 04/23/2013
Taking a cue from U.S. stimulus initiatives such as HITECH, Asia Pacific countries are seeing a big uptick in electronic health record adoption thanks to government investment, according to a new report from Frost & Sullivan.
A combination of regulations and incentives is spurring adoption of EHR systems in Asia-Pacific countries as the region's healthcare industry moves towards digitization, according to Frost & Sullivan. Governments, non-profit entities and the private sector are aggressively investing in health IT projects at both regional and local levels in an effort to achieve seamless information exchange and recognize cost savings and improved clinical outcomes.

Just 61 practices offer records access

17 April 2013   Rebecca Todd
Just 61 GP practices in England are offering patients full online access to their patient records.
The government has said on a number of occasions that all patients who want online access to their GP-held records should have it by 2015.
This pledge was one of the few commitments in the ‘Power of Information’ strategy published last year, and will be mandated for suppliers in the GP Systems of Choice framework replacement due by the end of the year.

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.

Personalized medicine 'arms race' continues rapid escalation

April 23, 2013 | By Dan Bowman
Joining an ever-growing list of healthcare facilities looking to improve personalized medicine, Oregon Health & Science University this week announced a partnership with Intel Corp. aimed at speeding genomic analysis efforts. Through the collaboration, OHSU and Intel researchers and engineers will work to create "next-generation computing technologies" that streamline the process of sorting through large amounts of biomedical data.
Initially, researchers will tailor their efforts toward cancer analysis. They plan to work on creating a "highly detailed circuit diagram of the genome" that will enable comparisons between individual patients and healthy genomes. That, in turn, will allow for isolation of genetic abnormalities, which then can be studied for links to cancer.

CPOE alerts help to reduce unnecessary CT scans

April 23, 2013 | By Ashley Gold
Computerized physician order entry with decision-support alerts can help to curb unnecessary CT scans, according to new research published this week in JAMA Internal Medicine.
According to the study, conducted at Brigham and Women's Hospital in Boston, researchers entered all CT orders initiated in the hospital's CPOE system from Jan. 1, 2010 through May 31, 2010, that had results displaying an intravenous contrast risk questionnaire when they were entered. A duplicate decision support (DDS) alert told the ordering provider about a potentially redundant CT, with radiology reports and images. After getting the alert, the user could then proceed with, cancel or abandon the order.

Lippincott Williams & Wilkins Releases Mobile, Interactive 'Clinical Anesthesia'

Written by Heather Linder | April 22, 2013
Lippincott Williams and Wilkins, a Wolters Kluwer Health company, launched an interactive, mobile version of the anesthesiology text "Clinical Anesthesia, Seventh Edition."

A Prosthetic Arm, Controlled By Your Thoughts

The future of artificial limbs is one where they act just like parts of the human body and can be moved by our brains.
Researchers have shown how brain-computer interfaces could allow the disabled to move objects using nothing more than thoughts. By placing a small sensor in the brain’s motor cortex, interfaces can pick up on electrical activity, and translate it into commands that control a robotic arm. The person simply needs to think she/he is doing something for the arm to move, as you can see from the video below.
Now scientists have gone a step further. Instead of a wired brain-arm link, they have now developed a wireless connection powerful enough to work at a distance of three feet. The technology has been tested on two pairs of pigs and monkeys, and the signal has remained constant for more than a year.

Patient email satisfaction starts with managed expectations

Now that patients can send messages at any time, physicians need to determine how timely responses should be — especially when they're not in the office.

By Pamela Lewis Dolan — Posted April 22, 2013.
As more patient-physician communication moves to Web-based messaging systems, patients have the ability to contact their doctors at any time, day or night. So now physicians face the question of whether they need to assign call duty to the practice's electronic mail system.
Surveys have found that a large majority of patients are interested in online communication with their physicians. But other studies have found that patient satisfaction rates could take a significant dive if the messages aren't responded to in an appropriate period of time. Researchers at Mayo Clinic found that although family physicians generally respond to messages during the week in a timely fashion, the weekends are a different matter.

Q&A: Kaiser Permanente's CIO on Technology's Role in Redefining Healthcare

Scott Mace, for HealthLeaders Media , April 23, 2013

Healthcare is transforming, says Philip Fasano, CIO and executive vice president of Kaiser Permanente, the nation's largest not-for-profit health plan and healthcare provider, with annual operating revenue in excess of $42 billion. He oversees 6,000 employees, who work to support the organization's 14,600 physicians. KP serves more than 8.8 million members.
I recently sat down for an extended conversation with him Fasano as he was making the rounds promoting his new book, Transforming Health Care, The Financial Impact of Technology, Electronic Tools, and Data Mining.In part one of our conversation, Fasano talks about technology's role in redefining healthcare, and why cloud computing isn't quite ready for the task.

Regenstrief licenses software to HIE

By Bernie Monegain, Editor
Created 04/22/2013
The Regenstrief Institute, an electronic medical records and health information exchange research group, is licensing its Indiana Network for Patient Care and DOCS4DOCS clinical results delivery software to a subsidiary of the Indiana Health Information Exchange. Officials are billing the licensing agreement as the single most significant transfer of discovery out of an academic medical informatics research setting to a commercial enterprise in the history of Indiana's HIT sector and the national evolution of health information exchange.
The INPC is among the largest and longest-running health information exchanges in the United States. Since 2004, IHIE has been responsible for increasing the number of Indiana hospitals (currently 94) and physicians (currently more than 25,000 in 17 states) using the INPC and DOCS4DOCS while creating a sustainable business model, operating independent of grant funding. Created by Regenstrief Institute's Center for Biomedical Informatics, the INPC handles, on an average day, more than half a million secure transactions of clinically important data -- including medical histories, laboratory test results, medication records, treatment reports -- in a standardized, electronic format.

Benchmarks: Changes are afoot for clinical and business intelligence

By Mike Miliard, Managing Editor
Created 04/22/2013
A study earlier this year from the University of Missouri showed that most patients took a dim view of doctors who make use of clinical decision support technology.
Researchers found that patients saw physicians who use CDS as somehow less capable than those who don't. They saw the IT tools as impersonal, and thought the systems were a barrier between them and their caregivers.
That's the wrong way to think about it, says John Hoyt, executive vice president, HIMSS Analytics.
"They just need to understand it's not taking the place of their physician," he says. "It's an aid and reminder of the latest peer-reviewed advice and best practice alerts, etc."
It can "touchy," says Hoyt, because it may suggest, "subconsciously, that your physician is flawed, that he has a human brain – that may be a shock to some people."

Dashboard technology holds potential as patient clinical decision aid

April 22, 2013 | By Ashley Gold
An interactive decision dashboard format developed by researchers at the University of Rochester (N.Y.) School of Medicine & Dentistry can be adapted to create a clinically realistic prototype patient decision aid, according to an article published this week in BMC Medical Informatics and Decision Making. Such findings, the researchers say, represent the potential of interactive decision dashboards for fostering informed decision making. 

PACS/RIS refresh reaches London

15 April 2013  
The shake-up of England’s PACS/RIS market is well underway, with trusts in London becoming the latest to start work on plans to exit from the national programme contracts drawn up a decade ago.
The latest research from EHI Intelligence shows that the refresh is taking place in clearly defined waves as the result of the different contract end dates and intervention by the former Department of Health and NHS Supply Chain.
It also suggests that the refresh is opening up new opportunities for suppliers, particularly PACS vendors shut out of the National PACS Programme, and, to a lesser extent, storage suppliers looking to supply vendor neutral archives to trusts leaving the national data stores.

Changing Behavior through Electronic Prescribing

One of the greatest challenges facing the health care system is how best to influence and change both individuals’ and clinicians’ behaviors.   Over the past 50 years, whole industries have sprouted up around exercise, nutrition, obesity control, and smoking-cessation programs.   Despite notable set-backs — especially with obesity — tobacco use has declined by 55% over the last 50 years (sidenote:  did 42 percent (!) of American adults really smoke in 1965?) and greater attention is now paid to health and wellness than ever before.  While progress has been incremental, the trend lines are encouraging.
In a similar way, health insurance plans, large employers, and public programs have spent the past several decades working hard to align incentives in benefit design, including pharmacy benefit design.  This work has taken many forms, including expanded use of generic alternatives; new pharmacy options, such as the mail-service pharmacy option; and the expanded use of electronic prescribing. 

EMR Market Exceeds $20B in 2012

Written by Anuja Vaidya  | April 19, 2013
The market for electronic medical records exceeded $20 billion in 2012 and will see robust sales in 2013, according to a report called "EMR 2013: The Market for Electronic Medical Records," by Kalorama Information, a publisher of medical markets research.

Nearly one-third of women don't fill new osteoporosis prescriptions, study finds

Kaiser Permanente study finds problem particularly acute among older women and those who have visited emergency rooms
April 18, 2013 | By Alaric DeArment
PASADENA, Calif. — A new study by Kaiser Permanente finds that a large percentage of women with osteoporosis fail to pick up new prescriptions for the condition.
The study, which was based on the electronic health records of 8,454 women ages 55 years and older who were Kaiser Permanente Southern California members between December 2009 and March 2011 and were prescribed a new bisphosphonate medication, found that 29.5% of them did not pick up their prescription within 60 days of the order date.

VA leaders: 'Next generation' EHRs need enhanced usability

April 22, 2013 | By Marla Durben Hirsch
The "next generation" of electronic health record systems need to make more than "incremental" changes and move beyond the concept of serving as computerized paper charts, according to a new study of leaders in the Department of Veterans Affairs, published in the Journal of the American Medical Informatics Association.
The researchers, from the VA, interviewed 14 VA operational, clinical and informatics leaders for their vision on the future needs of EHRs. The leaders recommended that a number of design and other changes were needed, including:
  • Better integration of information and space on the EHR's interface
  • Changes to support clinical workflow
  • 'Actionable' cognitive support
  • Better integration of structured data capture with a narrative style of documentation
  • Better support of interdisciplinary teamwork
  • Better interoperability
  • Enhanced usability
  • Better filtering and management of information
Monday, April 22, 2013

ONC Seeking Public Input on Federal Consumer e-Health Strategy

by Helen R. Pfister and Susan R. Ingargiola, Manatt Health Solutions
Pointing to studies showing that patients who are more involved in their own health are more likely to have better health outcomes, the federal government and others have been directing substantial efforts toward increasing consumer engagement in health care through health IT. The Office of the National Coordinator for Health IT is currently seeking public input on how to update the consumer e-health-related sections of the Federal Health IT Strategic Plan.


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