Saturday, July 20, 2013

Weekly Overseas Health IT Links - 20th July, 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.
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States collaborate to exchange data during disaster

July 12, 2013 | By Susan D. Hall
Ten states are working on a health exchange so that if a widespread disaster occurs, they'll be prepared to provide records for people displaced from their homes.
"Through disasters like Hurricane Katrina and Hurricane Sandy and large tornadoes in Alabama and Joplin, Mo., in 2011 and more recently in Moore, Okla., we have learned the importance of protecting patients' health records through electronic tools like health information exchanges," Farzad Mostashari, national coordinator for health IT, said in an announcement. "Patients are better off when states and health information exchange organizations work together to ensure that health information can follow patients when they need it the most."
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ONC unveils new certification mark

Posted on Jul 11, 2013
By Mike Miliard, Managing Editor
As we reach the "tipping point" of electronic health record adoption, the Office of the National Coordinator has issued a mark for EHRs and other health IT products, meant to serve as visual proof that they can offer functionality, interoperability and security.
The new mark for certified electronic health records technology was unveiled Wednesday and will appear on EHR products that have been certified by an ONC-Authorized Certification Body, indicating that the product meets the 2014 Edition Standards and Certification Criteria, officials say.
Eligible professionals and hospitals must demonstrate meaningful use of EHR technology that has been certified under the ONC Health Information Technology Certification Program to qualify for Medicare and Medicaid EHR incentive payments.
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July 11, 2013, 10:43 p.m. ET

Hospitals Prescribe Big Data to Track Doctors at Work

Marnie Baker, a pediatrician whose job is to win over colleagues to data-tracking efforts, shows equipment to fellow doctor David Kim.
Marnie Baker, a pediatrician at California's MemorialCare Health System, has an easy manner and ready smile. Now, though, her job is to be the bearer of a serious and, for some of her colleagues, unwelcome message.
She's the voice of a program that digitally tracks their performance, informs them when they don't measure up—and cajoles them to improve.
MemorialCare is part of a movement by hospitals around the U.S. to change how doctors practice by monitoring their progress toward goals, such as giving recommended mammograms. It isn't always an easy sell. At one clinic earlier this year, physicians grilled Dr. Baker, who is director of performance improvement at a MemorialCare-affiliated physician group.
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Giving Patients a Role in Data Exchange

JUL 10, 2013 3:30pm ET
A pilot program at the University of Texas at Austin seeks to find the right processes for enabling patients to track who requests and receives their protected health information.
The pilot, being done under the umbrella of the Office of the National Coordinator for Health Information Technology, is designed to add transparency to the process of exchanging patient data. Providers have repositories within their electronic health records systems that can include signed patient consent directives for the use of their information, and the directives can be reviewed to determine what information to send. But these are closed information systems and patients usually do not know who has requested their information, what was sent and what was seen.
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Meaningful Use program loses 20% of attesting docs

July 8, 2013 | By Marla Durben Hirsch
The dropout rate for Meaningful Use has "soared" in the second year of the program, with a whopping 21 percent of family physicians who attested in 2011 failing to do so in 2012, according to a recent article in AAFP News Now, a publication of the American Academy of Family Physicians.
AAFP reports that in reviewing Centers for Medicare & Medicaid Services attestation statistics, 23,636 family physicians became first-time attesters in 2012, a 180 percent increase from 2011. But of the 11,578 family physicians who attested in 2011, only 9,188 stuck with the program and attested in 2012.
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ONC sets sights on Stage 3 HIE standards

Posted on Jul 11, 2013
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Health information exchange is emphasized in Meaningful Use Stage 2, and it’s set to get even more priority in Stage 3, as the ONC looks to enable a sort of nationwide health information exchange.
As the Health IT Policy Committee prepares proposals for Stage 3, which at the earliest will start in 2016, the committee’s Information Exchange Workgroup has issued preliminary recommendations on patient record queries and provider directories.
Micky Tripathi, founding CEO of the Massachusetts eHealth Collaborative and chair of the Information Exchange Workgroup, will be making formal recommendations to the HIT Policy Committee in August on queries, directories and data portability. But the Workgroup has mostly developed suggestions for record queries and provider directories, and shared them at a recent HIT Policy Committee meeting.
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A new view of VistA

In a guest column, VistA sceptic Ewan Davis argues the US open source system might have something to offer the NHS – but not if it becomes an open source NPfIT.
10 July 2013
There is much, widely publicised interest from NHS England in encouraging the development and implementation of open-source software in the NHS.
In general, this has been welcomed. However, there has been a fierce debate about whether that encouragement should extend to Anglicising the US Veterans Health Administration’s open source electronic patient record, VistA.
EHI editor Jon Hoeksma has argued that NHS England should look closer to home  before it spends some of the £260m Technology Fund on a VistA pilot or VistA projects; and a lot of EHI readers have agreed with him.
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BMI documentation often lacking in primary care patient EHRs

July 9, 2013 | By Marla Durben Hirsch
More than two-thirds of U.S. adults are overweight or obese, but many primary care physicians are failing to record body mass index (BMI) in their electronic health records or include these conditions in their electronic patient problem lists, according to a research letter published July 8, in JAMA Internal Medicine.
For the study, the researchers, from Brigham & Women's' Hospital and other Boston-area institutions, examined the EHRs of 219,356 patients in a large network. They found that diagnoses and documentation of obesity sorely lacking, even though recording of vital signs such as body mass index are a requirement of the Meaningful Use incentive program.
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Survey: Patients Want Online Access to X-rays, Radiology Reports

Written by Helen Gregg | July 10, 2013
Social Sharing
The vast majority of patients want online access to their X-rays, radiology reports and other medical images, according to a survey conducted by healthcare marketing company IDR Medical.
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ONC sorting out HIE query standards for Stage 3

By Anthony Brino, Associate Editor
Health information exchange is emphasized in Meaningful Use Stage 2, and it’s set to get even more priority in Stage 3, as the ONC looks to enable a sort of nationwide health information exchange.
As the Health IT Policy Committee prepares proposals for Stage 3, which at the earliest will start in 2016, the committee’s Information Exchange Workgroup has issued preliminary recommendations on patient record queries and provider directories.
Micky Tripathi, founding CEO of the Massachusetts eHealth Collaborative and chair of the Information Exchange Workgroup, will be making formal recommendations to the HIT Policy Committee in August on queries, directories and data portability. But the Workgroup has mostly developed suggestions for record queries and provider directories, and shared them at a recent HIT Policy Committee meeting.
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IT Assists Research and Communication To Cut Readmissions at El Camino Hospital

by Fred Bazzoli Thursday, July 11, 2013
El Camino Hospital sits in what would appear to be an enviable position for a health care facility -- squarely in the middle of the Silicon Valley, near San Francisco. It's not shocking that the community hospital is fairly advanced when it comes to the use of IT.
But when the 443-bed acute care facility looked to tackle patient readmissions, IT made its contribution by playing a supportive role, assisting researchers in making better decisions and helping caregivers communicate more effectively. Through the combined use of data analytics and advanced telecommunications, El Camino Hospital has seen a dramatic reduction in readmissions through its initiatives.
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Meet the Mother of All Patient Registries

Cheryl Clark, for HealthLeaders Media , July 11, 2013

The Agency for Healthcare Research and Quality is building a massive patient database to help healthcare providers identify effectiveness projects years before researchers get around to publishing their analyses.
When news of this federal project first popped into my inbox last week, it sounded like government redundancy at its best:  The Registry of Patient Registries, or RoPR, for short, was now available online, it said.
Taxpayer dollars at work, creating the mother of all patient databases? Now that's an ambitious effort.
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Mostashari proud of progress so far

Posted on Jul 10, 2013
By Diana Manos, Senior Editor
National Coordinator for Health IT Farzad Mostashari, MD, told members of the Health IT Policy Committee on Tuesday to remain steadfast, bask in the progress made over the past four years, but continue to "react and respond to the world as it is, while striving to make the world as it should be."
The July 9 meeting marked the 50th meeting of the Health IT Policy Committee, and Mostashari’s fourth year in government service.
"It’s remarkable to look back at where we were four years ago and take stock, measured through these meetings, how far we have come and what the complexity of the policy issues that we’ve had to consider as we reach toward our goals – and to hold those goals to better health, better care and lower costs firmly in mind," he said.
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Not all is sunny in Robert Wood Johnson report on health information technology

July 10, 2013 | By Ashley Gold
A lot has changed since 2006, when the Robert Wood Johnson Foundation published their inagural report on Health Information Technology in the United States: The Information Base for Progress. The Office of the National Coordinator for Health Information Technology had a small budget and few hospitals had functional electronic health records, for example. 
Since then, federal support has spurred major strides in electronic health record adoption by providers, according to the 2013 Robert Wood Johnson Foundation annual report, as FierceEMR reported Monday. But a deeper look into the report shows that while providers have made significant process, there is still a way to go.
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Developers creating apps to treat mental health issues

By Sanjena Sathian

Globe Correspondent  
July 08, 2013
“Treasure of Bell Island,” from Blue Marble Gaming Co., is a video game designed to help people who have had a traumatic brain injury.
Late at night, in the middle of a panic attack, 25-year-old Zoe Quinn used to get out of bed to play video games. By the light of her computer screen, she immersed herself in another universe, and her anxiety slipped away.
Now, the Dorchester woman wants to make gaming for others what it was for her: a therapeutic, purposeful way out of dark times. Her passion makes her part of a growing movement among gamers and doctors alike to use the medium to educate the public and diagnose, and even treat depression or anxiety.
Quinn has created a simple, free, Web game called “DepressionQuest.” Players click through the deeply realistic narrative of a first-person character, making choices for the character about work, friends, and family. The game shows options for dealing with depression, such as seeking therapy or medication, or reaching out to friends.
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Positive future for health information exchange on the way?

Author Name Kyle Murphy, PhD   |   Date July 8, 2013
Even with the increased adoption and meaningful use of EHR technologies, current attempts at healthcare reform will not avoid history repeating itself unless the EHR adopters participate in health information exchange (HIE). Otherwise, it is simply the condition of adding new solutions to those that came before them.
Recent developments in healthcare and health IT are beginning to inspire confidence that HIE is trending in the right direction. Earlier in the year at HIMSS13 came the announcement of the CommonWell Health Alliance aimed at increasing EHR interoperability and data liquidity, and more recently came word that Healtheway, the operator of the eHealth Exchange (née NwHIN Exchange), had named its nine founding members and intentions to make ubiquitous HIE a reality.
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Online Health Searches Not Always Anonymous

Published: Jul 9, 2013
By Cole Petrochko, Staff Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

  • Online searches through health-related websites may leak users' search information to third parties.
  • Note that among five of the 13 sites with tracking elements, social media-related tracking elements were embedded that shared a user's data with a social media site whether or not the user was logged into a given social media site, and regardless of whether user chose to interact with the social media feature.
Online searches through health-related websites may leak users' search information to third parties, a researcher found.
Of 20 free-to-use medical information websites, all of them had at least one -- and as many as six or seven -- third-party elements, 13 of which included some form of tracking elements, according to Marco Huesch, MBBS, PhD, of the University of Southern California in Los Angeles.
Among sites with a tracking function by third parties, five also included a social media "share" button that tagged a user's search even if the user did not click the button, Huesch wrote online in a JAMA Internal Medicine research letter.
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RWJF sees 'unprecedented' IT growth

Posted on Jul 09, 2013
By Mike Miliard, Managing Editor
The HITECH Act has had its desired effect so far, according to the latest annual report from the Robert Wood Johnson Foundation, which finds heartening adoption levels of health IT across the board, from small physician practices to academic medical centers, over the past three years.
The study, “Health Information Technology in The United States: Driving Toward Delivery System Change, 2013," was co-authored by Mathematica Policy Research and the Harvard School of Public Health. It shows that in 2012, 44 percent of hospitals reported having a basic electronic health record system – up 17 percentage points from 2011.
Indeed, since 2010 – when providers started getting federal stimulus funds – the proportion of hospitals with at least a basic EHR system has nearly tripled, according to the RWJF report.
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Government to mandate NHS digitisation

8 July 2013   Lis Evenstad
The government wants to mandate NHS England to support the health service to go digital by 2018.
It also plans on extending the Friends and Family Test to GP practices.
As part the celebration of the NHS’ 65th anniversary, the government has launched a consultation on a ‘refresh’ of its mandate to NHS England, which was announced in November last year.
The consultation reflects developments such as the publication of the Francis Enquiry and health secretary Jeremy Hunt’s challenge to go paperless by 2018.
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Network neutrality key to health information exchange

July 9, 2013 | By Susan D. Hall
Network neutrality is central to planning for health information exchange, and potential regulation has implications for healthcare providers that use or provide services, according to research published at the Journal of the American Medical Informatics Association.
The paper discusses the need to establish the concept of "common carriage," similar to that of a utility that serves the public good as the Nationwide Health Information Network (NWHIN) is established. Last fall, however, the Office of the National Coordinator for Health IT turned that effort over to the public-private partnership Healtheway, which just named nine founding organizations in its efforts to move forward.
According to the authors, HIE must be "non-discriminatory in content, ownership, source address and destination address" to be truly "neutral and open."
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HIEs struggle to develop sustainable business models

July 9, 2013 | By Susan D. Hall
Though the number of health information exchanges is growing, most still struggle to become self-sustaining, according to research from the University of Michigan.
The study, published in Health Affairs, found 119 operational exchange efforts nationwide--a 61 percent increase from 2010. It also found that 30 percent of U.S. hospitals and 10 percent of doctors' offices are involved in an HIE.
However, 74 percent of the exchanges reported that they're struggling to develop a sustainable business model. That poses a problem, since federal backing for HIEs ends in January 2014.
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4 reasons the federal e-prescribing incentive program works

July 9, 2013 | By Dan Bowman
Federal incentive dollars have been instrumental in significantly increasing doctor use of electronic prescribing tools, according to research published this week in Health Affairs.
The study, conducted in tandem by officials from the Office of the National Coordinator for Health IT and electronic health record vendor Surescripts, found that as of December 2010, roughly 40 percent of e-prescribers adopted the tools as a result of government incentives. The research examined data from Surescripts' e-prescribing network between May 2006 and the end of 2010, with the first two years of research categorized as a "pre-intervention period," and the time period from Aug. 1, 2008 through Feb. 28, 2009 categorized as a "peri-intervention" period.
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U.S. Hospitals Triple Use of Electronic Health Records: Report

System allows sharing of latest information on patients' test results, treatments and meds

July 8, 2013
By Dennis Thompson
HealthDay Reporter
MONDAY, July 8 (HealthDay News) -- U.S. hospitals have made major progress in adopting electronic health records systems over the past three years, according to a new report.
The number of hospitals with a basic electronic health records (EHRs) system tripled from 2010 to 2012, with more than four of every 10 hospitals now equipped with the new health information technology, according to the report scheduled for Tuesday release by the Robert Wood Johnson Foundation.
"Given the size of our country, that's amazing progress in a very short time period," said report co-author Dr. Ashish Jha, an associate professor with the Harvard School of Public Health.
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Seeking Patient Engagement, Payer Curates Mobile Apps

Scott Mace, for HealthLeaders Media , July 9, 2013

Aetna is rounding out its mobile strategy by selecting more than 20 Web-based healthcare applications for its own CarePass wellness app, which pulls data from various sources and presents visualizations of progress toward goals.
Most patients think of their health insurance company as a source of never-ending paperwork and denied claims. Aetna, through technology, is working to bust that stereotype.
The insurer's latest move is to effectively become a curator of mobile and Web-based healthcare apps, rounding out the company's mobile strategy, which already includes iTriage, the popular mobile phone app the company acquired last year.
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10-Point ONC Safety Plan Seeks to Improve EHR Use

Cheryl Clark, for HealthLeaders Media , July 9, 2013

New federal guidelines aim for electronic health record systems to be used in a way that improves care and patient safety, and to ensure that system designs don't make certain types of errors more likely to happen.
Providers will make fewer medical errors that can harm patients—at least in theory—after implementation of a federal health IT safety plan unveiled this month. The plan recommends prohibitions of so-called vendor contract gag clauses and says demonstration of electronic health record systems' safety features should be a prerequisite for certification.

The 10-point plan, issued by the Office of National Coordinator for Health IT, seeks to resolve problems highlighted in the Institute of Medicine's November, 2011 report,
Health IT and Patient Safety: Building Safer Systems for Better Care, by allowing electronic health record system users to report on problems using the Common Formats protocol, under development by the Agency for Healthcare Research and Quality.
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From Health Affairs: Trends in the Adoption of Health Information Technology

 Bethesda, MD -- The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted in 2009. Since then, Health Affairs has published many articles about the promise of health information technology (IT) and the challenges of broad adoption. Today the journal has released three new Web First articles, focusing on the latest trends in health information technology adoption among US health care providers and hospitals. The articles, which will also appear in the journal's August issue, were supported by the Robert Wood Johnson Foundation (RWJF) and are a companion to RWJF's annual report, "Health Information Technology in the United States: Driving Toward Delivery System Change, 2013."
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Microsoft launches Bing health and fitness app

By: Aditi Pai | Jul 3, 2013     195   63   30

Last week, Microsoft announced Bing Health and Fitness, an app that tracks diet, health and exercise, according to an official Microsoft website,
Bing Blogs. The app syncs to Microsoft HealthVault, which brings in data from other health trackers such as blood glucose monitors, electronic scales, and activity and medical monitors. Bing Health and Fitness is a part of the Windows 8.1 Preview, a pre-release of Windows 8.1, the OS that runs on all Windows devices including computers, tablets and phones.
Along with Health and Fitness, the preview also includes a Food & Drink app and updates to the Bing Maps app. According to an official Windows blog post, Windows 8.1 will launch later this year through the Windows store.
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Know your options when buying a new Electronic Health Records System

July 2, 2013 3:52 pm by Mary Brislin 
There appears to be a growing number of physician practices that are dissatisfied with their current electronic health records system (EHR). How does one who is dissatisfied with their current system move to replace their entire system? How do you guarantee that your next EHR meets both your practice’s current as well as future needs?
When researching whether to purchase or subscribe to a new system, a practice needs to recognize what is not working in their current system. Meet with your team to find out what they like or dislike about your system. Maybe your current system is no longer interfacing with the hospital. Maybe your practice is looking for more advanced features like patient tools ’ portals or ad-hoc reporting. When you are shopping for the replacement system, use the benefit of seeing the deficiencies in the current system. A cost-benefit analysis should provide additional insight into your needs.
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IT security standards in the making

Posted on Jul 08, 2013
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
The National Institute of Standards and Technology is circulating a draft of voluntary standards it is developing for the critical infrastructure of IT security. The framework, when fully developed, will outline security functions and standards based on a risk-management approach in five areas, summed up by the adage “Know, Prevent, Detect, Respond, Recover.”
In large part the framework is geared toward helping organizational IT leaders understand how they can prevent cyber attacks or find, stop and recover from one.
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Health IT Funding Boost Needed To Enhance CDC's Infection Tracking Network

by Bonnie Darves, iHealthBeat Contributing Reporter Monday, July 8, 2013
CDC has operated a health care-associated infection (HAI) tracking system for decades, first as a paper-based voluntary reporting program involving 100 hospitals and now as a Web-based system that now includes the National Healthcare Safety Network (NHSN) and the Prevention Epicenters Program, an affiliated research entity.
Although the current system works reasonably well, and compiles and reports infection data from thousands of health care facilities annually, it is woefully understaffed, seriously underfunded and technologically under-powered, industry experts contend. That recognition, underscored by the disturbing economics of HAIs -- the infections increase U.S. health care expenditures by an estimated $30 billion each year- -- led to a recent request by two dozen health care organizations that Congress increase the program's annual budget to $31.5 million.
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July 5, 2013

How Should Doctors Share Impossible Decisions with Their Patients?

Posted by Lisa Rosenbaum
On a Friday evening a few months ago, my mom broke her arm. A doctor in the E.R. told her it was a simple fracture, and put her arm in a sling. The following Monday, though, she called me. She had consulted two surgeons who had a different assessment: the bone was broken in four places, surgery would be quite involved, and the rates of complications were high.
“How high?” I asked.
“Twenty-to-fifty-per-cent risk of avascular necrosis,” she said.
“And the alternative?”
“No surgery,” she said. “Good chance of immobility and arthritis for the rest of my life.”
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Enjoy!
David.

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