Saturday, September 14, 2013

Weekly Overseas Health IT Links - 14th September, 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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Estimated HIPAA compliance time toll a whopping 32.8 million hours

September 6, 2013 | By Susan D. Hall
Healthcare organizations will spend 32.8 million hours complying with the modified HIPAA omnibus rule, according to the Department of Health and Human Services' Office for Civil Rights.
The bulk of that time--30.655 million hours--involves the dissemination and acknowledgement of privacy practices at provider offices, a notice published in the Federal Register reveals.
"Much has changed in healthcare since HIPAA was enacted over 15 years ago," HHS Secretary Kathleen Sebelius said in when the new HIPAA  Omnibus rule was unveiled. "The new rule will help protect patient privacy and safeguard patients' health information in an ever expanding digital age."
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3 Ways To Foster Healthcare Innovation

As some organizations struggle to innovate in today's complex regulatory landscape, others forge ahead.
Technological innovation is why many CIOs decide to pursue a career in healthcare technology. But the question has shifted in recent years from what to innovate to how to innovate -- particularly in an environment dominated by regulatory standards.
Regulatory and financial pressures, combined with the ultimate goal of delivering quality care, can make it inherently tough to innovate.
There's a flipside, however.
"In healthcare, it's often the regulatory changes and constraints that create the opportunities," said Elliot Menschik, the managing director of DreamIT Health, a health IT startup accelerator. "Regulations often change how we behave. Healthcare is a heavily regulated industry, but the regulations can create a roadmap for new entrances into the market."
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EHR adverse events data cause for alarm

Posted on Sep 05, 2013
By Erin McCann, Associate Editor
After analyzing more than 300 event reports related to EHR software default values, more than 3 percent were found to result in unsafe conditions or prolonged hospitalization for patients, according to a new report by the Pennsylvania Patient Safety Authority. 
The report analyzed 324 EHR default values – which are the preset medication, dose and delivery – that led to events, with the aim of giving state healthcare facilities valuable data to avoid EHR events such as wrong-time and wrong-dose errors in the future. 
"Default values are often used to add standardization and efficiency to hospital information systems," said Erin Sparnon, patient safety analyst for the Pennsylvania Patient Safety Authority, in a news release. "For example, a healthy patient using a pain medication after surgery would receive a certain medication, dose and delivery of the medication already preset by the healthcare facility within the EHR system for that type of surgery."
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Workgroup: Stage 3 must 'connect the dots' between functionality, outcomes

September 4, 2013 | By Marla Durben Hirsch
To meet the goal of Meaningful Use's Stage 3 to improve outcomes, the functional objectives need to be linked to the outcomes, according to the Health IT Policy Committee's Meaningful Use Workgroup. The question is how best to "connect the dots."
The workgroup, presenting at the committee's Sept. 4 meeting, reported that it is revising the objectives from Stages 1 and 2 to include functionality and outcomes goals in Stage 3, prioritized to improve outcomes. For instance, patients not only would have online access to their health information--a functionality goal--but they also would understand their disease and treatment, and participate in shared decision making--an outcome goal.
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Survey: More medical students look to mobile first for reference

By: Jonah Comstock | Sep 4, 2013
For the next generation of doctors, 66 percent turn to the Internet or a mobile device first for clinical answers, according to a recently released survey by physician reference app maker Epocrates.
In their eighth “Future Physicians of America” survey, the company, which is now an athenahealth subsidiary, talked to 1,026 current medical students about a number of topics, including digital habits. The survey was conducted online in July and respondents came from over 200 medical schools in all 50 states and included first- through fourth-year students.
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Halamka: Regulatory uncertainty looms large for hospital CIOs

September 5, 2013 | By Dan Bowman
Regulatory uncertainty and a continuing decline in available resources are among a handful of issues John Halamka (pictured), CIO at Boston-based Beth Israel Deaconess Medical Center, anticipates will keep him up at night in the months ahead.
In the most recent entry to his Life As A Healthcare CIO blog, Halamka, a FierceHealthIT Editorial Advisory Board member, wonders whether the federal government will hold steady on announced timelines for initiatives like ICD-10 and Meaningful Use Stage 2, particularly in the face of looming challenges.
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Why Hospitals Still Build Their Own Health IT

There's a lot of pressure to use off-the-shelf technology such as Epic and Cerner for electronic health records. Here's why some providers still build their own software.
Building in-house healthcare technology is a daunting task, especially in a market dominated by off-the-shelf options like Epic and Cerner. But those options can be expensive and disruptive to existing physician workflow, leading a number of health organizations to start from scratch.
"We found the IT solutions in the open market were not going to meet our needs," said Landmark Hospitals CEO William Kapp. Landmark needed an electronic health record (EHR) that would function not only as a medical record, but also as a health information exchange (HIE) between its five long-term acute care hospitals. "We couldn't find a solution that made any sense for us and the existing options were prohibitively expensive."
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Work Habits of the 21st-Century Intern

Abigail Zuger, MD reviewing Block L et al. J Gen Intern Med 2013 Aug.
A time-motion study showed that medical interns spent far more time with their computers than with their patients.
The limitations placed on house staff work hours during the past decade have required program directors to devise increasingly creative schedules and have raised intense interest in understanding exactly how house staff spend their workdays and nights. Baltimore researchers devised a time-motion study of internal medicine interns that was performed in January 2012. They used specially trained undergraduate observers to shadow a convenience sample of 29 interns in two Baltimore hospitals with different day/night coverage patterns; the observers recorded activities on hand-held devices during both day and night shifts.
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Docs flock to cloud to save bottom line

Posted on Sep 04, 2013
By Diana Manos, Senior Editor
Eighty-seven percent of all physician practices agree their billing and collections systems need upgrading, according to a new survey. The majority favor moving to a fully integrated practice management, EHR and medical software product, accessible through the cloud on any browser or device.
The first of eight revenue cycle management studies to be released by Black Book, the "Top Physician Practice Management & Revenue Cycle Management: Ambulatory EHR Vendors," is an analysis of the convergence of the replacement EHR market with the needs of physician practices to upgrade patient billing processes.
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Without sharing, big data is nothing

Posted on Sep 04, 2013
By Zack McCartney, Contributing Writer
With all the hype surrounding big data, pinning down its ideal usage is important for planning the development and expanding uses. What goal should the healthcare industry have in mind as it explores the possibilities for improved care and lowered costs that big data presents?
“People that talk about big data often talk about…creating an open source network that somehow aggregates all this data and we can get better outcomes,” Zach Landman, MD, and CMO at DoctorBase, told Healthcare IT News in a recent interview.
Landman went on to draw an analogy to Facebook.  He suggested that “more and more people over time could potentially be open to the idea of sharing their information for the greater good,” although he noted that it is unlikely that patients would agree to share their patient data in a public manner similar to how people share personal information on the popular social network.
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Hunt announces £1 billion for health IT

4 September 2013   Rebecca Todd and Lis Evenstad
Health secretary Jeremy Hunt has announced another £240m for the Technology Fund that will see the government and NHS organisations invest £1 billion in IT over the next three years.
In a statement released today, the Department of Health says the money will be used to improve patient care and ease pressures on A&E departments.
The £260m Safer Hospitals Safer Wards Technology Fund was announced by Hunt earlier this year.
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The 7 Simple Practices Of Data Governance

09/03/2013 By Dale Sanders
Data is now one of the most valuable assets in any healthcare organization, especially as we transition into a more analytically driven industry. Data is the longest lasting asset in any organization, outliving facilities, devices and people.
In the past few years, as the value and longevity of data have become better realized, the term ‘data governance’ has emerged to describe the concept of managing and influencing the collection and utilization of data in an organization. The adoption and creation of ACOs is motivated as much by the acquisition of more data to manage risk and understand outcomes, as it is by the acquisition of clinicians, patients, and facilities. If we accept the assertion that healthcare is a knowledge delivery industry, it is our obligation to exploit the data assets in our environment to augment and optimize that knowledge.
While information and data security is a long-standing body of practice and knowledge in corporations, data governance is less mature, especially in healthcare. As a result, there is a tendency to operate in extremes, with either too much governance or too little. Over time, as data and analytic maturity increases, the healthcare industry will find a natural equilibrium. For example, in the Healthcare Analytic Adoption Model, a robust data governance function is required in order to achieve Level 5 maturity.
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HIT Policy Committee: Use existing regulation to scrutinize health IT

September 4, 2013 | By Susan D. Hall
The HIT Policy Committee said there's no need for substantial new regulation of health IT, but closer scrutiny according to regulation already in place--with cross-agency collaboration, of course. It said technology should be assessed according to level of risk and it called for greater transparency in the process.
Compiling its recommendations for the Food and Drug Administration Safety and Innovation workgroup, the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 requires the secretary of Health and Human Services to report by January 2014 on a proposed risk-based strategy for developing a regulatory framework for health IT that promotes innovation, protects patient safety, and avoids regulatory duplication. The FDA, ONC and Federal Communications Commission will write the final framework.
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Study: E-Consultation Service Beneficial to 90% of Patients, Reduces Office Visits

Written by Helen Gregg (Twitter | Google+)  | September 03, 2013
An e-consultation service earned more than a 90 percent approval rating from providing physicians while reducing in-office visits, according to a study in Telemedicine and e-Health.
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Putting Technology on Lofty Pedestal Won't Transform U.S. Health Care System

by Rahul K. Parikh Tuesday, September 3, 2013
A recent iHealthBeat Perspective -- titled "Tapping Social, Online Tools To Transform Health Care Delivery" -- missed the mark for me. It's not that the tools Wendy Sue Swanson, a practicing pediatrician, blogger and writer, highlights -- which include the Web, social media and consumer tracking devices -- don't have the potential to transform care. It's that putting technology on such a lofty pedestal without a deeper consideration of the patient-doctor relationship won't generate meaningful change in U.S. health care. 
Idolizing technology is a common pitfall for many doctors and health care thinkers. We get enamored by the latest and greatest toys. I would like to propose a better approach: Start by asking, "What's the problem?" and follow up with, "What, if any technology, can help solve it?" Such an approach creates discipline and focus that can drive meaningful and lasting progress in U.S. health care.
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Using Data Analytics for Better Financial Outcomes

Rene Letourneau, for HealthLeaders Media , September 3, 2013

To make the best use of the massive amounts of data being collected by hospitals and health systems, CFOs are turning to powerful analytics tools to find revenue cycle efficiencies and other cost savings.
This article appears in the July/August issue of HealthLeaders magazine.
As healthcare becomes increasingly data-driven, provider organizations find themselves inundated with more information than ever before. Figuring out what to do with all the data may not be easy, but for healthcare finance executives it is a challenge worth tackling because the hospitals and health systems that successfully implement a data analytics program can significantly enhance their economic outcomes and fiscal stability.
The use of data analytics in healthcare is on the rise. Global business consulting firm Frost & Sullivan released a report last year predicting that the adoption of advanced health data analytics in U.S. hospitals would increase from 10% to 50% between 2011 and 2016, a 37.9% compound annual growth rate. Likewise, the February HealthLeaders Media Intelligence Report indicates that 62% of healthcare organizations plan to increase their spending on financial analytics over the next three years; only 3% plan to spend less.
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Infographic: Informatics at the intersection of healthcare and IT

By Tom Sullivan, Editor
50,000 healthcare informatics professionals will be needed in the next 7 years.
That’s according to the University of Illinois at Chicago's Online Health Informatics Program, which published an infographic asserting that the industry needs new ways to provide improved care, sans errors.
And healthcare informatics is where that potential resides. But what do healthcare informaticists actually do? What are the sub-disciplines of the practice? And just how do they enhance care delivery?
Scroll down to find out.
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Is the right EHR even out there yet?

Posted on Sep 03, 2013
By Tom Sullivan, Editor, Government Health IT
When Mike Taylor was shopping for a new electronic health record system, vendors boldly sat across the table from him and said flat-out that they won't integrate with other EHRs. 
For Taylor, CIO at Roper St. Francis, a Charleston, S.C.-based health network, a McKesson shop with Allscripts installed at hospice and home health environments, the next question met a similar fate. What about the interfaces?
“We don't interface with Allscripts,” Taylor recounted being told by a major vendor. “You just have to buy our product.” Taylor added “obviously that didn’t work for us.”
And that is just one of many harsh realities prospective customers face when trying to choose an EHR.
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Another view

GP columnist Neil Paul is still not convinced about predictive risk modelling; but would like to know if some mass, technology-assisted screening could do what it claims to do.
3 September 2013
I was lucky enough to attend most of a recent Nuffield Trust conference on predictive risk in London. It was quite interesting, but left me with the overall feeling that it was all a waste of time.
Statistics only get you so far
The basic idea of predictive risk is simple. You get a lot of population-level data analysed using a statistical model that aims to identify those people who might benefit from a specific health intervention or initiative.
Most commonly, the aim is to try and identify people who might be at risk of an expensive hospital admission, and who could be put on a virtual ward or given some other kind of support to stop that happening.
So, the Nuffield Trust conference had an interesting talk on a London experiment in which GPs were being paid extra to spend up to an hour with identified high risk patients in order to reduce their admission rates.
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Glasgow gets shared child records

29 August 2013   Rebecca Todd
Greater Glasgow Child and Adolescent Mental Health Services staff are using a shared electronic record to improve the care of 'at risk' children.
More than 250 professionals across 10 CAMHS teams are using Emis Web to share patient information on more than 5,000 children and teenagers.
The teams - including psychologists, psychiatrists, nurse therapists and speech and language therapists - have a shared view of each other’s concerns and are able to contribute to a multidisciplinary chronology of 'significant events' for children in their care.
This is expected to help speed up decision-making, especially around child protection interventions, as staff previously relied on colleagues sharing information from paper records.
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DH reveals final NPfIT benefits

2 September 2013   Lis Evenstad and Rebecca Todd
The Department of Health released its final report on the benefits of NPfIT in June, six days before it told the Public Accounts Committee that it would not be available until September.
EHI has discovered that the DH website says the ‘Final Benefits Statement for Programmes Previously Managed Under the National Programme for IT’, was published on 6 June.
The statement is the DH’s response to a request by the committee in August 2011.
At a meeting on 12 June, PAC chair Margaret Hodge asked Tim Donohoe, the senior responsible owner for the local service provider programmes at the DH, when the benefits statement would be made public.
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Online tools may boost breast cancer patients' mood

Fri, Aug 30 2013
NEW YORK (Reuters Health) - Women with breast cancer who created a personal website about their health reported feeling less depressed, more positive and having a greater appreciation for life in a small new study.
Though cancer patients have long benefited from support groups made up of fellow patients and survivors, researchers said, they may still have trouble talking about their experiences with family and friends - who may also feel uncomfortable broaching the subject.
The websites in this study were especially helpful for women to "be able to truly tell their story, express emotions and communicate with others without having to repeat information about their diagnosis and treatment," said lead author and psychologist Annette Stanton of the University of California at Los Angeles.
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Diabetes Apps Among Top 10 Doctors Recommend to Patients
Other apps include ones assessing cardiac risk, monitoring IBS symptoms, locating nearby hospitals
FRIDAY, Aug. 30 (HealthDay News) -- Apps for managing diabetes and calculating the risk of cardiovascular disease are among the top 10 apps doctors recommend to their patients, according to researchers at Medical Economics.
Many of the apps recommended by doctors are related to diabetes management, including Diabetes, iCookbook Diabetic, Diabetes In Check, and Glucose Companion, all of which allow patients to monitor their condition, track their food consumption, access diabetes-friendly recipes and plan meals, and track their blood sugar and weight. The apps also allow patients to create a record of their tracking results to share with their doctor.
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Jitterbug Touch 2 offers seniors more health apps

By: Jonah Comstock | Aug 30, 2013
GreatCall announced the launch of Jitterbug Touch 2, its second generation smartphone offering for older Americans. GreatCall’s Jitterbug phones offer simplified user interfaces, cheaper data plans, and built-in health apps, all specifically geared to the older, less tech-savvy demographic.
The company, which recently partnered with Bosch Healthcare, launched the Jitterbug Touch in October 2012. Prior to that it offered only feature phones. With the Touch 2, the company has eliminated the slide-out QWERTY keyboard, but otherwise most of the first generation features remain. Like it’s predecessor, the Touch 2 is an Android phone.
Jitterbug worked with AARP to conduct a survey of older Americans to find what they wanted in a smartphone and based improvements on that data. For instance, the user interface has all the available apps listed with their full names in large letters, rather than relying on small icons. The survey also found that most older people were concerned about the price of data plans, so the Jitterbug 2 allows users to see their current data usage and fees at any time. Rates start at just $2.49 per month.
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Three ways EHR adoption can improve the patient experience

Author Name Pat Wolfram   |   Date August 30, 2013   |  
There are many key players integral to the patient experience. One specific triad of relationships that significantly affects the patient experience is the relationship between labs, practices, and electronic health records (EHRs).
While more than half of all doctors have adopted EHRs to improve workflow and enhance patient care, most orders for diagnostic tests are still made outside of the EHR, and many healthcare groups do not fully realize the benefits of connecting to multiple labs through the EHR. Connecting practices to all labs and radiology services with which they regularly work provides three significant benefits: better patient care, improved workflow, and easy access to data.
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HHS Promotes Digital Strategy With Consumer-Facing Apps

Written by Helen Gregg (Twitter | Google+)  | August 30, 2013
HHS has released 33 consumer-facing apps designed to foster consumers’ engagement with their healthcare, a key part of the department’s digital strategy.
The apps have a variety of different functionalities, from calculating a user’s body mass index to finding the nearest federally funded health center to helping a user quit smoking.
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We Need a Moore’s Law for Medicine

Technology is the primary cause of our skyrocketing health-care costs. It could also be the cure.
Moore’s Law predicts that every two years the cost of computing will fall by half. That is why we can be sure that tomorrow’s gadgets will be better, and cheaper, too. But in American hospitals and doctors’ offices, a very different law seems to hold sway: every 13 years, spending on U.S. health care doubles.
Health care accounts for one in five dollars spent in the United States. It’s 17.9 percent of the gross domestic product, up from 4 percent in 1950. And technology has been the main driver of this spending: new drugs that cost more, new tests that find more diseases to treat, new surgical implants and techniques. “Computers make things better and cheaper. In health care, new technology makes things better, but more expensive,” says Jonathan Gruber, an economist at MIT who leads a heath-care group at the National Bureau of Economic Research.
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Say So Long to PCs in Hospitals

Scott Mace, for HealthLeaders Media , September 3, 2013

The personal computer has done a lot of good for clinicians in hospital settings, but its days are numbered. Zero-client terminals are quieter, safer, and cheaper to buy and to maintain.
Look around the modern U.S. hospital, and you'll see fewer and fewer traditional personal computers.
That's a good thing. PCs helped bring technology to the masses and powered electronic medical records in a way that previous computing had barely dented. But that was then, and this is now, and as aged PCs get refreshed, they are being moved out for "zero-client" terminals that IT organizations simply plug in.
Behind the scenes though, is a complex set of technologies that allow users to continue to use the same desktop and apps as before. But things are different:
  • Zero clients have no hard disks, and in fact, usually run only a small kernel of Linux software in flash memory, and thus require almost no updating.
  • With no spinning hard disks, cooling requirements are minimal, so the hardware is longer-lasting and quieter.
  • Virtualization technology, coupled with proximity technology that senses a user's name badge not unlike modern door access systems, allows a user's desktop to follow him or her around a facility while requiring the user to enter a user ID and password only once during a shift.
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The Randomized Registry Trial — The Next Disruptive Technology in Clinical Research?

Michael S. Lauer, M.D., and Ralph B. D'Agostino, Sr., Ph.D.
September 1, 2013DOI: 10.1056/NEJMp1310102
The randomized trial is one of the most powerful tools clinical researchers possess, a tool that enables them to evaluate the effectiveness of new (or established) therapies while accounting for the effects of unmeasured confounders and selection bias by indication. Randomized trials, especially huge megatrials, have transformed medical practice. Thanks to randomized trials, we no longer, for example, treat acute myocardial infarction with lidocaine and nitrates. Instead we use rapid revascularization, anticoagulants, and antiplatelet agents, and during long-term follow-up we routinely prescribe statins, beta-blockers, and angiotensin-converting–enzyme inhibitors. But the reputation of randomized trials has suffered of late,1 owing to reasonable concern about excess complexity, expense, and time required to recruit study participants, as well as inadequate representativeness. What good are trials if the results aren't applicable to real-world patients and if, because of excessive expense, they can be used to answer only a tiny fraction of our important clinical questions?
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Enjoy!
David.

1 comment:

Trevor3130 said...

If Google is confident to migrate from MySQL to MariaDB
http://www.theregister.co.uk/2013/09/12/google_mariadb_mysql_migration/
are there implications for Health IT? Will hospital CIOs be more, or less, likely to lock up their data in MSAccess?
The Chief Operating Officer @ DoHA-NeHTA keeps a register of all databases in public hospitals, right?