Saturday, October 05, 2013

Weekly Overseas Health IT Links - 6th October, 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.

3 Essentials for Selecting Your Next EMR

SEP 25, 2013 9:55am ET
So you are in the market for a new EMR and you quickly realize that there are hundreds of companies in this market. How do you choose? How can you identify which company and EMR will be the right match for your organization? What are the key factors you should be taking into consideration when approaching these companies? Let’s talk about a few things to consider:
Number 1: Look in the Mirror
Knowing and understanding your staff and how your practice operates is the critical first step. How large is your organization and are you owned by or affiliated with a health system or hospital? What is your medical specialty or are you a multispecialty clinic? Do you prefer having your billing staff complete your financial operations or are you comfortable outsourcing those to another company? Taking a good look in the mirror and intricately understanding how you operate is key to finding the right EMR system and company. Before diving into the EMR market, look in the mirror.

Mostashari: mHealth revolution ahead

Posted on Sep 27, 2013
By Eric Wicklund, Editor, mHealthNews
Farzad Mostashari, MD, the outgoing National Coordinator for Health IT, has been a champion of tapping into the mobile revolution to bolster patient-provider relationships and, ultimately, care delivery during his four-year tenure.
Last week, Mostashari spoke with mHealthNews Editor Eric Wicklund and other editors of the HIMSS Media Group. He discussed a range of topics, including his office’s proudest achievements in the mHealth arena, the one thing the ONC has strived to avoid, and his take on the debate about adding another agency to regulate mHealth.

Patient portals business means big money

Posted on Sep 27, 2013
By Diana Manos, Senior Editor
The U.S. patient portal market is booming and is expected to reach $898.4 million by 2017, up from $279.8 million in 2012 – representing a 221 percent increase, a new study says.
New analysis from Frost & Sullivan's "U.S. Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012–2017," has found that the majority of revenue will primarily result from increased demand driven by myriad forces including the need to meet Stage 2 meaningful use requirements, the growing move to clinical integration and accountable care, and increasing consumer demand for health information technology.
Approximately 50 percent of U.S. hospitals and 40 percent of U.S. physicians in ambulatory practice possess some type of patient portal technology, mostly acquired as a module of their practice management or electronic health record system, according to the study.

Brookings: Technology will fuel increased healthcare spending

September 27, 2013 | By Susan D. Hall
Expensive technology is the factor most likely to drive healthcare spending in the coming years, according to a Brookings Papers on Economic Activity analysis published this month.
Neither the recession; the Affordable Care Act, which hasn't kicked in yet; nor changes in reimbursement fully explain the slowdown in healthcare spending, it says.
The authors, from Harvard University and Dartmouth College, predict that healthcare costs will grow at gross domestic product plus 1.2 percent for the next few decades, a rate they characterize as "still on track to cause serious fiscal pain for the U.S. government and employees who bear the cost of higher premiums in the form of lower wages."

State Insurance Exchanges: Hospital IT's Next Challenge

As state insurance exchanges take hold, hospital IT departments must figure out how to keep up with patients' insurance eligibility, health status and benefits in fluid environment.
The launch of the state insurance exchanges on Oct. 1 is not top of mind for hospital CIOs, who are dealing with everything from Meaningful Use and ICD-10 to ACOs and value-based reimbursement. Nevertheless, the exchanges and the accompanying Medicaid expansion in some states will affect the IT departments of hospitals and health systems in a number of ways, say consultants and an official of the American Hospital Association (AHA).
First, the prospective coverage of millions of uninsured Americans will require changes to the revenue cycle management (RCM) systems that hospitals use for billing and collections. Hospitals already check eligibility electronically, but the advent of the exchanges will substantially increase the number of plans for which they must do this, noted Doug Hires, executive vice president of Santa Rosa Consulting.

Provincial tweaking of interoperability standards impedes Canadian EHR network

September 24, 2013 | By Marla Durben Hirsch
The U.S. is not alone when it comes to road bumps toward a national electronic health record system: Canada also is struggling to create a nationwide interoperable EHR network, according to an article published this week in British Columbia's The Province.
The non-profit Canada Health Infoway, which provides funding for EHR projects throughout Canada, has set Pan-Canadian standards for EHR interoperability. However, the standards are not binding, and the provinces have adopted the standards in different ways for their own benefit, meaning they no longer line up to share data. 
Moreover, EHR vendors have had to customize their products to meet the different requirements, making interoperability even more elusive.

Mostashari: Health IT has evolved into an inevitability

September 23, 2013 | By Dan Bowman
For Farzad Mostashari, walking away from ONC after two-plus years as National Coordinator for Health IT just feels like the right thing to do.
"It wasn't really a scientifically driven process," he tells FierceHealthIT. "I listened to my heart on that one."

Array of factors involved in patient access to records

September 26, 2013 | By Susan D. Hall
Giving patients access to their own health data turns out to be more complicated than it sounds--and technological challenges are just one aspect of it, according to research published at the Journal of the American Informatics Association.
The study follows three regional health information exchanges in New York that were awarded grants to provide patients access to their data across healthcare providers. Due to technical, organizational, cultural, and other factors, all three projects were significantly scaled back, with less data provided to patients.

e-Health records no cure-all for healthcare challenges

Chee-Sing Chan
26.09.2013 kl 23:58 | Computerworld Hong Kong
Spending on healthcare IT is set to surge as governments around the world seek to reduce healthcare costs amidst aging population growth and also driven by a demand for healthcare systems integration, noted a report by research firm Markets and Markets.
Spending on healthcare IT is set to surge as governments around the world seek to reduce healthcare costs amidst aging population growth and also driven by a demand for healthcare systems integration, noted a report by research firm Markets and Markets.
The report forecasted that global healthcare IT spending will rise from 2012's US$40.4 billion to US$56.7 billion by 2017.

Health IT Advocates Press for Interoperability

Healthcare workers from around the country converge on Capitol Hill seeking greater pressure to align EHR industry around common standards so providers and healthcare systems can seamlessly share records.

By Kenneth Corbin
Mon, September 23, 2013
WASHINGTON -- The great promise of electronic health records (EHR) and health information exchanges -- that patients' health information can pass seamlessly among providers, vendors and health care systems -- will never be realized until those systems run on a set of common standards and achieve a greater level of interoperability.
That was one of the messages that scores of health IT advocates from around the country took to Capitol Hill last week as they met with lawmakers from their home states to press for congressional action on an array of issues concerning the use of technology in health care.

Johns Hopkins launches mHealth Evidence reference site

By: Neil Versel | Sep 25, 2013     136   49   21
As mobile health advocates clamor for scientific proof to support their emerging field, Johns Hopkins University has introduced mHealth Evidence, an online reference tool designed to help researchers quickly locate literature demonstrating the feasibility, usability and efficacy of mobile technologies in healthcare.
After a soft launch in June, the Center for Communication Programs at Johns Hopkins Bloomberg School of Public Health in Baltimore this week formally introduced mHealth Evidence via the school’s federally funded Knowledge for Health (K4Health) project. “We wanted to have one, designated site to bring together mHealth evidence,” Heidi Good Boncana, a program officer for strategic communication, ICT and innovation in the Center for Communication Programs, told MobiHealthNews.

ONC makes big changes at the top

Posted on Sep 26, 2013
By Anthony Brino, Editor, HIEWatch
HHS Secretary Kathleen Sebelius is searching for a new national coordinator for health IT -- and also for a new principal deputy coordinator, as David Muntz leaves the agency just as ONC chief Farzad Mostashari, MD, steps down. Jacob Reider, MD, director of ONC's Office of the Chief Medical Officer, will assume the position of acting national coordinator, starting Oct. 4.
Lisa Lewis, current deputy national coordinator for operations, will become acting principal deputy, and Joy Pritts will continue working as chief privacy officer.

IT Is One of Obamacare's Weakest Links

By Megan McArdle Sep 26, 2013 5:36 AM ET
During the design and passage of the Affordable Care Act, its architects and supporters described a fantastic new system for buying insurance. You would go onto a website and enter some simple information about yourself. The computer system would fetch data about you from various places -- it would verify income with the Internal Revenue Service, check with the Department of Homeland Security to ensure that you were a citizen or legal resident, and tap a database of employer coverage to make sure that you were not already being offered affordable coverage (defined as 9.5 percent of your income or less) by your employer. Provided you passed all those tests, it would calculate what subsidies you were eligible for, and then apply that discount automatically to the hundreds of possible policies being offered on the exchange. You would see the neatly listed prices and choose one, buying it as easily as you buy an airline ticket on Travelocity.
  • September 25, 2013, 7:12 p.m. ET

Robots vs. Anesthesiologists

J&J's New Sedation Machine Promises Cheaper Colonoscopies; Doctors Fight Back

Anesthesiologists, who are among the highest-paid physicians, have long fought people in health care who target their specialty to curb costs. Now the doctors are confronting a different kind of foe: machines.
A new system called Sedasys, made by Johnson & Johnson, would automate the sedation of many patients undergoing colon-cancer screenings called colonoscopies. That could take anesthesiologists out of the room, eliminating a big source of income for the doctors. More than $1 billion is spent each year sedating patients undergoing otherwise painful colonoscopies, according to a RAND Corp. study that J&J sponsored.
J&J hopes the potential savings from using Sedasys will appeal to hospitals and clinics and drive machine sales, which are set to begin early next year. Sedasys "is a great way to improve care and reduce costs," J&J CEO Alex Gorsky said in an interview.

Patient privacy evangelist, analytics officer spar over data rights

Posted on Sep 25, 2013
By Erin McCann, Associate Editor
In healthcare, virtually nothing is black and white. From Obamacare to varying payment and care models, healthcare issues live in the land of gray and opaque where dissenting opinions reign. The idea of patient privacy and consent proves no exception. 
 This week at the HIMSS Media/Healthcare IT News Privacy and Security Forum in Boston, patient privacy advocate Deborah Peel, MD, of Patient Privacy Rights, and UPMC Insurance Services Division Chief Analytics Officer Pamela Peele took the stage to debate the highly-contested issue of whether patients should have full consent over how and with whom their personal health information records are shared. 
Pamela Peele, who maintains that multiple stakeholders have a right to access and use patient health information, framed her argument by starting off with an education analogy. Taxpayers and federal and state governments realized the economic value of educating the public and thus invested some $955 billion in funding education. "If you're not healthy enough to take that education into the workplace, what happened to our public investment?" asked Peele. 

How to survive (if not prevent) a breach

Posted on Sep 25, 2013
By Mike Miliard, Managing Editor
Security breaches are no fun. Your organization's name is splashed all over the news. Your reputation takes a hit. Your patients' trust is eroded. And the prospect of a hefty monetary settlement is something few want to think about. But it's not the end of the world.
At the HIMSS Media/Healthcare IT News Privacy & Security Forum in Boston on Tuesday, a hospital CIO, a compliance expert and a law enforcement official offered a primer for preparing for and, hopefully, preventing a security breach. They also offered some tips for making the most of the situation should the unwelcome event occur.
In a session titled, "Preparing Now for How to Respond to the Security Breach You Hope Never Happens," Forest Blanton, senior vice president and CIO at Hollywood, Fla.-based Memorial Healthcare System; Nicole Keefe, director of IT at Santa Barbara, Calif.-based compliance consultants Novacoast; and Steve Morreale, chair of the criminal justice department at Worcester (Mass.) State University – and a former special agent at U.S. Department of Health and Human Services' Office for Civil Rights – had some advice for healthcare organizations: prepare, and don't panic.

HL7 offers help with standards work

Posted on Sep 25, 2013
By Bernie Monegain, Editor
Health IT standards and interoperability organization Health Level Seven International has launched a set of expanded membership offerings that include services to make standards implementation and interoperability challenges easier.
In addition to existing benefits, new membership services include a professionally supported Help Desk; free members-only webinars; discounts on training -- including some free training for high-level memberships -- and user groups for peer learning and collaboration with other leaders in healthcare IT.
Also, newly published standards are immediately available to members, while non-members must wait 90 days. HL7 is also planning policy-related initiatives for member services.

Jr doctor creates ward problems app

24 September 2013   Lis Evenstad
A junior doctor working in Watford created an app to flag up problems and inefficiencies on hospital wards.
The MediShout app alerts the relevant person when there is a problem on a ward such as lack of stock or computers and broken equipment.
Created by trainee surgeon Ashish Kalraiya, the app has been trialled by 15 doctors on the surgical wards at West Hertfordshire Hospitals NHS Trust's Watford General Hospital, where it has been championed by the surgical matron, Karen Bowler.
Kalraiya said the trial had been limited to use by doctors, but that ideally the app would be for all healthcare professionals.

Report: Small Physician Practices Switching EMR Systems

September 24, 2013
Small physician practices are leaving their vendors at an unprecedented rate as electronic medical record (EMR) software systems have failed to meet rising expectations, according to a new report from Orem, Utah-based research company, KLAS research.
The main reasons providers are switching over to a new software system include poor service, product gaps, poor usability, and coding issues. Quick and easy implementations were the main reasons various vendors had succeeded in this segment.

More HIPAA enforcement coming

Posted on Sep 24, 2013
By Erin McCann, Associate Editor
When Office for Civil Rights Director Leon Rodgriguez took the stage Monday to talk HIPAA at the HIMSS Media and Healthcare IT News Privacy and Security Forum, the timing was perfect.
With the HIPAA Omnibus Final Rule taking effect Sept. 23, Rodgriguez talked to the increased enforcement to come, the importance of properly safeguarding patient privacy and the what-not-to-dos, or the breach blunders that have resulted in hefty monetary penalties for some groups who failed to take patient privacy and security seriously.
"Today is a critical day for the Omnibus," said Rodriguez, who explained that the agency is working to strike a balance between effective enforcement and clearly communicating what all the rules are surrounding patient privacy and security.

Health data exchange: Paper's not dead yet

September 24, 2013 | By Dan Bowman
Despite increased participation in health information exchanges, U.S. hospitals are struggling to share patient data with each other in "meaningful ways," according to a new report published this week by HIMSS Analytics.
For the report, HIMSS Analytics surveyed 157 senior hospital IT executives; 51 percent of survey respondents were CIOs, and 39 percent identified themselves as IT or information services directors. While 73 percent of respondents said they participated in a health information exchange, only 20 percent said that data sharing improved patient safety at their facility; even fewer (12 percent) said that data sharing resulted in time savings for clinicians.
Close to half the respondents (49 percent) said that the biggest challenge of sharing data with an HIE was that other participating organizations were not sharing data "robustly." Respondents also pointed to lack of staffing (44 percent) and limited financial resources (40 percent) as hurdles to HIE participation.  

Reports provide rosy mHealth forecast for remainder of decade

September 22, 2013 | By Greg Slabodkin
Global mHealth revenue is projected to reach $9 billion by the end of 2014 and is expected to grow at a compound annual growth rate (CAGR) of almost 40 percent over the next six years, despite barriers relating to regulation, patient acceptance and privacy concerns, finds a new report from SNS Research. 
"As healthcare providers seek to maximize their patient outreach while minimizing costs, many view mobile healthcare as the solution to improve healthcare cost-efficiency," states the report. "Mobile network operators also view mHealth as a lucrative opportunity for the monetization of their mobile connectivity services. Given that most operators have established themselves as reputable consumer brands, they are also eyeing on opportunities to offer services beyond simple connectivity. Many operators already offer branded or co-branded end-to-end mHealth solutions to their customer bases."

Farzad Mostashari Looks Back as He Steps Down

Scott Mace, for HealthLeaders Media , September 24, 2013

The departing National Coordinator for Health IT reflects on the effect of the sequester, says meaningful use Stage 2 is a done deal, and lauds the free market for EHRs.

Last week I held a final conversation with Farzad Mostashari, MD, before his tenure as National Coordinator for Health Information Technology in the federal Office of the National Coordinator (ONC) ends. In two years as the nation's health IT czar, Mostashari has become the face of meaningful use and an advocate for health information exchange. Here is part one of our conversation.

Experts offer health IT help in new book

Posted on Sep 23, 2013
By Stephanie Bouchard, Managing Editor, Healthcare Finance News
In The Healthcare Information Technology Planning Fieldbook: Tactics, Tools and Templates for Building your IT Plan, ($72, Healthcare Information and Management Systems Society), authors George T. Hickman, executive vice president and CIO at Albany Medical Center in Albany, N.Y.,  and Detlev (Herb) Smaltz, a board member of Health Care DataWorks, known as HCD, provide a practical guide for developing an IT strategic plan. The pair talked to Healthcare Finance News, a publication owned by HIMSS, about their book.
Q: Please give us a brief description of your book, and share with us what you think is its most important take away for readers.
A: With the constant introduction of new medical and information technologies and system, regulation and changes driven by reform, the healthcare provider industry is in high need for the effective application of IT. Most health systems of even a modest size have unique transaction-based information systems (IS) that number nearly 100 strong; in academic medical centers, the number often is 400 or more unique ISs. Much of the information milieu did not evolve historically from enterprise-level planning but rather from tactical year-to-year needs, yet, today we have great cause to elevate our data and information capabilities to meet our missions.

ACP launches online decision support

Posted on Sep 23, 2013
By Diana Manos, Senior Editor
The American College of Physicians announced Monday the release of its ACP Smart Medicine, a web-based clinical decision support tool.
 The tool,developed specifically for internal medicine physicians, containing 500 modules that provide guidance and information on a broad range of diseases and conditions.
 "ACP Smart Medicine offers physicians high-quality, easy-to-access clinical information that is rigorously peer-reviewed and continually assessed for currency and accuracy,'" said Steven Weinberger, MD, ACP's executive vice president and CEO, in a news release. "It is a versatile tool that runs the gamut from providing evidence-based guidance to facilitating CME credit, and is the only clinical decision support tool developed by a physician medical society."

What should we do with old PACS images?

The national programme to provide English trusts with picture archiving and communications systems is now ten years old, and hospitals are starting to look for their own solutions. But what should they do with the old images? Imaging informatics editor Kim Thomas investigates.
16 September 2013
In the pre-digital age, healthcare providers took a pragmatic approach to dealing with old film.
Storage space was costly, and the silver recovered from the back of film could be sold, returning money to the health service. So as a general rule, if the film was more than eight years old, and the patient hadn’t made any more visits to hospital in that period, the film was destroyed.
If there was a need to keep an image for longer (because it related to an oncology patient, for example), it could be dealt with by a phone call to the film filing clerk. They would put a sticker on the film to indicate that it was not to be destroyed, and that was that.
The implementation of digital picture archiving and communications systems should have changed things. But because most trusts implemented PACS through the National Programme for IT, they could put off worrying about how to manage old images.

FDA bases final med app guidance on risk

By Anthony Brino, Associate Editor
The U.S. Food and Drug Administration has issued final guidance for mobile medical application developers, promising limited regulation for most health and wellness apps while applying risk-based standards to diagnostic and quasi-medical device apps.
The FDA will exercise “enforcement discretion,” under the Federal Food, Drug & Cosmetic Act, for the majority of mobile apps “as they pose minimal risk to consumers,” the agency said in a media release. Among those are apps helping patients self-manage their disease or conditions “without providing
specific treatment or treatment suggestions,” such as for tracking exercise and diet, automating health tasks or communicating with providers via EMRs.
Instead, the FDA will focus “on a subset of mobile medical apps that present a greater risk to patients if they do not work as intended,” such as apps designed to detect melanoma. The FDA is generally categorizing medical apps it will regulate into those intended for use as a medical device accessory (like an app that lets clinicians view medical images on a smartphone or tablet) and those using mobile platforms as a medical device (like an app that use a smartphone as an ECG to detect abnormal heart rhythms).

iHT2: Use creative IT for Lean initiatives

September 23, 2013 | By Susan D. Hall
Health IT can help organizations apply the Lean process-improvement strategy, but it might take some creativity, according to a new report from the Institute for Health Technology Transformation (iHT2).
EHRs don't provide most of the necessary tools, and there are few off-the-shelf applications available to support Lean, says the report. Most organizations have to devise workarounds--but it doesn't have to be expensive. In some cases, cloud computing can step in to support your Lean initiatives--it can be a great way to do ICD-10 testing, for instance.
The report is chock-full of ways organizations have used Lean to improve processes to boost the efficiency and quality of care. One suggestion is to start by identifying who your customers are and how the processes you use add value. That might not be as simple as it sounds, the report points out. At a hospital, doctors might be important customers because they bring in business. Nurses, might be, too, because they provide most of the care. Improving processes that make these workers' lives easier, however, could benefit the end customer--the patient--in myriad ways.
Sep 20, 2013, 2:33pm CDT

Local snags Vandy's $10K prize in health app challenge

In response to its global health app challenge launched in May, Vanderbilt University Medical Center got responses from as far away as India. The winner, though, was one of its one.
Kevin Wilson, a software engineer with the Vanderbilt Institute of Imaging Science, won with his app that transforms patient clinical summaries into easy to understand personalized health information. Vanderbilt Medical Center will begin testing Wilson's app in a small patient population for feedback, and then will modify and implement it for all of VUMC over the next six months.
Eventually, the app will be incorporated into the My Health at Vanderbilt patient portal.

ONC: EHRs Meeting MU Criteria Viewed More Favorably by Physicians

Written by Helen Gregg (Twitter | Google+)  | September 20, 2013

Electronic health records meeting meaningful use criteria are seen by physicians as more beneficial and convenient, according to an infographic released by the Office of the National Coordinator for Health IT. The benefits of the EHR are also seen to increase with increased usage.
According to survey results, 79 percent of physicians using an EHR that does not meet meaningful use criteria feel the EHR produces clinical benefits for their practice. This increases to 88 percent of providers using an EHR that does meet meaningful use criteria, and 92 percent of providers who have been using a meaningful use-attested EHR for more than two years.

U.S. FDA issues final rule on medical device identifier codes

Fri, Sep 20 2013
(Reuters) - The U.S. Food and Drug Administration issued a long-awaited rule on Friday requiring companies to include codes on medical devices that will allow regulators to track the products, monitor them for safety and expedite recalls.
The codes, known as unique device identifiers, or UDIs, will be entered into a database that the agency will maintain as a publicly searchable reference catalogue.
"A consistent and clear way to identify medical devices will result in more reliable data on how medical devices are used," Dr. Jeffrey Shuren, director of the FDA's medical device division, said.

Health-Care Costs Are Driven By Technology, Not Presidents

By Megan McArdle - Sep 20, 2013
Yesterday I attended Brookings Papers on Economic Activity to watch some of the smartest economists in America debate some of the most interesting papers. The very first paper presented is of particularly timely interest: “Is This Time Different? The Slowdown in Healthcare Spending.”
Those of you who do not spend many happy waking hours parsing health statistics may be unaware that the rate of increase in health-care spending has slowed in recent years. The administration and not a few people in the press are fond of claiming this as a victory for President Barack Obama's Patient Protection and Affordable Care Act, aka Obamacare. The program is so fantastic on cost control, the argument goes, that providers have naturally started to control costs in preparation for the actual implementation. Authors Amitabh Chandra, Jonathan Holmes and Jonathan Skinner dismiss this explanation. Most of the cost controls haven’t kicked in yet, while one cost-increasing factor (the expansion of private insurance coverage to children under 26) has already taken effect. More importantly, as they note, “the downturn in health-care cost growth began in 2006, back when Barack Obama was still a relatively unknown senator from Illinois.”


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