Saturday, November 23, 2013

Weekly Overseas Health IT Links - 24th November, 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.

Denmark’s leading eHealth system still faces challenges

Denmark’s eHealth system is a world-leader, with all GPs and all hospitals having electronic medical records (EMRs), and communication and standards managed through a central network, MedCom, with ownership shared between national, regional and local government authorities.
In a case study published in last month’s issue of the International Journal of Medical Systems, Danish researcher Patrick Kierkegaard outlined the country’s key eHealth challenges – which revolve around the fragmentation of EMRs and difficulties of interoperability.
Denmark has a population of just 5.6 million and one of the highest per-capita incomes worldwide, with a tax-funded universal health care system and strong primary-care and hospital infrastructure.

Status Check on Medical ID Theft: Going Up

Security research firm Ponemon Institute estimates that 1.84 million adult-aged Americans have experienced medical identity theft, with 313,000 becoming victims during the past year. That's a 19 percent increase compared with a 2012 Ponemon estimate of 1.52 million who have in recent years been victimized by medical identity theft, based on an annual survey conducted each March and April.

Homeland Security has tip for healthcare

Posted on Nov 15, 2013
By Erin McCann, Associate Editor
Data breaches and cybersecurity threats in healthcare are going to happen. It's virtually unavoidable. What can be avoidable, however, are the messy consequences of substandard risk assessment strategies and inadequate threat response.
Department of Homeland Security's Jason Gates, an analyst in the industry, engagement and resilience branch within the Office of Cybersecurity and Communications, spoke at a virtual event Thursday about how healthcare organizations can work to mitigate the effects of a cybersecurity attack and lessen the risk of actually having one.
The take-home message? "Risk management never ends," he said. "New cyber threats, vulnerabilities and consequences require the constant modification of risk management strategy."

CMS Eases Sharing Data with Researchers

NOV 14, 2013 2:45pm ET
The Centers for Medicare and Medicaid Services has announced a streamlined process for researchers to access and analyze the agency’s health care data. CMS is transitioning from preparing and shipping encrypted data files that have been requested, and now enables access from researchers’ own workstations with less cost to them and the agency. Here is the CMS announcement:
“In a move that advances the Obama administration’s work to make the health care system more transparent and accountable—and to help meet the pressing challenge of health care delivery system reform—the Centers for Medicare & Medicaid Services (CMS) today announced the launch of the CMS Virtual Research Data Center (VRDC) at the White House event Data to Knowledge to Action: Building New Partnerships.  Part of the President’s Big Data Research and Development Initiative, which aims to improve researchers’ ability to extract knowledge and insights from large and complex collections of digital data, the VRDC is a secure and efficient means for researchers to virtually access and analyze CMS’s vast store of health care data.  

EHR copy and paste? Better think twice

Posted on Oct 08, 2013
By Erin McCann, Associate Editor
Who would have thought that something so simple as copy and paste could have such serious consequences?
Speaking at the October MGMA annual conference in San Diego, Diana Warner, director at AHIMA, confirmed the seriousness of inappropriately using copy and paste functions in electronic health records. And the government agrees -- it's no laughing matter. 
Seventy-four to 90 percent of physicians use the copy/paste function in their EHRs, and between 20 to 78 percent of physician notes are copied text, according to a September AHIMA report

US and UK share health data via cloud

Posted on Nov 15, 2013
By Anthony Brino, Editor, HIEWatch
About half a century after epidemiology studies in Massachusetts and the United Kingdom helped build the world’s understanding of cardiovascular disease and health risks, public health and population data is being opened up by the U.S. and joining international datasets.
As part of the Obama Administration’s Big Data Research and Development Initiative, federal health agencies are contributing five-years worth of public datasets to a cloud-based research platform being used by life sciences researchers at universities and pharmaceutical companies to share population data along with other medical and biological data.

Charging for data: What is too much?

Posted on Nov 13, 2013
By Mike Miliard, Managing Editor
As patient engagement gains momentum, and technology enables easier access to personal health information, many providers still charge money for copies of records. That's allowed under HIPAA and HITECH. But is it wise?  
At the recent AHIMA convention in Atlanta, Kim Murphy-Abdouch, clinical assistant professor at Texas State University, said it might be time to rethink policies and procedures related to patient access that may be holdovers from a paper-based way of thinking.
Even as "patients are becoming much more aware of their own healthcare, and much more savvy" about managing their health data, "cost could be a barrier to patient access," said Murphy-Abdouch.

Lessons from an HIE pioneer

November 15, 2013 | By Susan D. Hall
It has taken multiple efforts, but the latest effort at health information exchange that Joe Heyman, M.D., has been involved with is close to success, reports Medical Practice Insider.
Heyman, formerly an Americal Medical Association (AMA) board chairman and president of the Massachusetts Medical Society, runs a solo gynecology practice two days a week in Amesbury, Mass. The rest of the time he focuses on the data exchange created by Whittier Independent Practice Association in Newburyport, Mass. Earlier this year it began combining data from disparate sources into a single record for each patient.

IEEE, Continua Collaborate on Standards

November 13, 2013
IEEE Standards Association (IEEE-SA) and Continua Health Alliance have signed a strategic agreement to help accelerate and broaden the adoption of globally relevant standards-based technologies for the healthcare arena.
This collaboration brings together Continua, a Beaverton, Ore.-based organization dedicated to enabling end-to-end, plug-and-play interoperability for personal connected health, and IEEE-SA, the global standards-setting organization and developer of the IEEE 11073 family of standards designed for the entire healthcare continuum for personal health device communications.

3D printing is new face of medicine

By Sally Davies
Inside the pistachio-coloured walls of a London hospital, 16 fake eyeballs sit gleaming on a shelf next to a collection of noses. A man holds up a slice of green silicone in the shape of an ear.
“It’s a very early sample,” says Tom Fripp, managing director of Sheffield-based design consultancy Fripp Design and Research. The company is the first to directly print an object in medical grade silicone, a substance whose pliable texture is well-suited to soft tissue prosthetics.
In the next room London dentist and implant manufacturer Andrew Dawood shows a 3D printed copy of the vascular system of conjoined twins. They were separated in 2011 after doctors used Mr Dawood’s model to practice the surgery beforehand, improving the odds of success and reducing the risky time the patients spent under the knife.

HIMSS EHRA: Health IT framework needs more 'predictability'

November 12, 2013 | By Marla Durben Hirsch
Electronic health records, clinical decision support systems and health IT that focuses on transmission or storage of data should not be subject to traditional device regulation, but new risk-based oversight, according to the executive committee of HIMSS Electronic Health Records Association (EHRA).
That's one of the primary suggestions that EHRA made in a recent letter to U.S. Department of Health &Human Services Secretary Kathleen Sebelius regarding draft recommendations presented by the Food and Drug Administration Safety and Innovation Act (FDASIA) workgroup and approved by ONC's Health IT Policy Committee Sept. 4. EHRA also suggested that the new risk-based framework's criteria should be applied to health IT currently regulated to identify opportunities for more effective and appropriate oversight, and that health IT with lower or low risk should not be subject to additional health IT-specific oversight or regulation.

Birmingham to offer PICS licence-free

11 November 2013   Lis Evenstad
University Hospitals Birmingham NHS Foundation Trust will offer its Prescribing Information and Communication System to the NHS on a licence-free basis instead of “open-sourcing” it.
EHI reported last week that NHS England is working with four different organisations, one of which is Birmingham, to put their products on a new open source electronic patient record systems framework.
The trust’s medical director, Dr Dave Rosser, told EHI that Birmingham would not be offering its PICS e-prescribing system open source because it is too risky.
“We think open sourcing PICS would be dangerous. It’s too complicated a programme with very complicated code,” said Dr Rosser.
“It would be risky to say the least. It has 600,000 lines of code and it is all interactive. It’s very easy to make a change in one part that changes something in another part that not even the programmers can predict.”

ONC initiative looks to curb prescription drug abuse

November 14, 2013 | By Dan Bowman
A new Standards & Interoperability Framework initiative launched today by the Office of the National Coordinator for Health IT aims to create a common technical standard to allow prescription drug monitoring programs (PDMP) to share data with health IT tools used by providers for clinical decision support.
The initiative, described in a post to the Health IT Buzz blog, would be a boon to efforts to curb prescription drug abuse, writes Jennifer Frazier, a behavior health subject matter expert with ONC.

Docs blame EHRs for lost productivity

Posted on Nov 14, 2013
By Mike Miliard, Managing Editor
Nearly 60 percent of ambulatory providers surveyed for a new IDC Health Insights report say they're unsatisfied with their electronic health records, citing frustrations with usability and workflow.
IDC's new study, "Business Strategy: The Current State of Ambulatory EHR Buyer Satisfaction," polled 212 ambulatory and hospital-based providers. It found that while the adoption of EHRs is widespread, the experience of most who use them "is one of dissatisfaction."
According to results, 58 percent of ambulatory providers surveyed were dissatisfied, very dissatisfied, or neutral about their experience with ambulatory EHRs.

EHRs can't do everything

Posted on Nov 14, 2013
By Zack McCartney, Contributing Writer
Like many other industries, healthcare is becoming more consumer-focused. As Eric Wicklund and Mike Miliard have recently documented for Healthcare IT News, patients and doctors alike have spoken out against EHR solutions for interfering with rather than facilitating doctor-patient interactions. While thorough data collection and analysis, where EHRs offer great value, feeds research at the population level, it seems that the apparent failure of current EHRs to accommodate patients as unique cases has sparked this shift in attitude in the health IT industry.
The issue may not be so much the failure of EHRs, as their falling short of unduly high expectations -- expectations not only from the people who use them, but also the vendors themselves.
“I think it’s a myth that EHR vendors are going to be able to provide everything.  Every other industry has proven this wrong, says Joanne Rohde, CEO of Axial Exchange, in an interview with Healthcare IT News.  

EMR Market to Grow 7.5% Annually Through 2016

Written by Helen Gregg (Twitter | Google+)  | November 13, 2013
The global market for hospital-based electronic medical records is expected to grow at a compound annual growth rate of 7.46 percent through 2016, according to a TechNavio report.

Non-Profit Releases Education Material for Health IT-related Patient Safety

November 13, 2013
The National Patient Safety Foundation, a Boston-based non-profit organization, has released educational materials that aim to help healthcare professionals align their health information technology goals with patient safety.
The educational material, titled Health Information Technology through the Lens of Patient Safety, is geared towards physicians, pharmacists, nurses, and patient safety and health quality professionals.

CMS Launches New Data Sharing Tool

November 13, 2013
The Centers for Medicare & Medicaid Services (CMS) has announced the launch of a new data sharing tool to help researchers virtually access and analyze CMS’ store of healthcare data.  
The tool—the CMS Virtual Research Data Center (VRDC)—was unveiled on November 12 at the White House event “Data to Knowledge to Action: Building New Partnerships” as part of President Obama's Big Data Research and Development Initiative.
Researchers using the VRDC will access CMS data from their own workstations and will be able to perform analyses and manipulate data within the VRDC.  Historically, CMS has filled researchers’ data requests by preparing and shipping encrypted data files.  However, given the rapidly-growing demand for timelier Medicare and Medicaid data, the agency needs a less resource-intensive means of responding to data requests from researchers.  The VRDC will help CMS meet these demands while also ensuring data privacy and security and reducing the cost of data access for most users, according to CMS officials.

What's Wrong With Healthcare Quality Measures? Part I

Cheryl Clark, for HealthLeaders Media , November 14, 2013

We need to measure the hell out of healthcare to help us compare one organization or system with others. I believe measuring quality helps healthcare systems improve. But I also believe that we can measure healthcare quality a lot better than we do.

If you really think about it, the way we measure hospital quality of care is pretty darn primitive. That's what I've concluded after a few days contemplating today's methods and practice of measurement.
The way we think we know how good we are at providing high value care is really flawed.

5 overrated, overpriced healthcare technologies

November 13, 2013 | By Ashley Gold
By Ashley Gold
There's never a shortage of companies and healthcare providers claiming to have invented the next big thing that will transform patient treatment and care as we know it. From new types of surgery, to multi-million dollar cancers centers and implantable heart devices, healthcare technology has the power to transform patient care.
But how does a consumer, hospital executive or physician clear the hype--and be able to tell what's really worth the money, and what's better off being left to traditional means? With that in mind, FierceHealthIT examined five overrated and overpriced healthcare technologies. From surgery to heart monitoring, we explore what brings value for its price tag.

First National Physician-Owned HIE Launches

Written by Helen Gregg (Twitter | Google+)  | November 12, 2013
OnePartner HIE, the first nationwide, physician-owned health information exchange, has opened to physicians.
The HIE aims to connect providers with various electronic medical record systems and help physicians achieve the meaningful use stage 2 requirements for data exchange.

IPhone App Wipes Out Population to Show Contagion Risks

November 11, 2013
The idea of Plague Inc. is to build a bug and exploit countries’ vulnerabilities -- climate, population density, poverty -- to help it spread. Source: Ndemic Creations via Bloomberg
The plague started in Indonesia. A viral infection, it spread quietly at first, making its way from person to person with coughing and sneezing its only symptoms. Then someone infected with the virus got on a plane.
As the disease spread around the globe, fever gave way to sweating, nausea, vomiting. Hundreds infected turned to thousands. The virus developed drug resistance. Thousands became millions.
It was all part of Ian Lipkin’s plan.

The Wild West Becomes Less Wild: States Fill Privacy Gap Left by Congress

by Alice Leiter Wednesday, November 13, 2013
Every day, consumers introduce more and more personal health data into the commercial space -- through mobile applications, social networking sites and personal health records. Yet the U.S. does not have a comprehensive, baseline privacy law that protects such data. As a result, states are increasingly taking matters into their own hands, passing laws that both provide important protections for consumers and exacerbate the problematic patchwork of sometimes conflicting state laws that hamper easy, secure data sharing on a nationwide basis.
Although HIPAA is the nation's central, federal health privacy law, it applies only to covered entities (physicians, hospitals and health plans, for example) and entities providing services on their behalf. HIPAA's regulations were designed to protect patient privacy while still meeting the data collection and disclosure needs of health care providers and health plans. They do not address the unique privacy risks facing consumers and patients using health tools offered by commercial vendors. The vast majority of the digital health data zipping around the Internet are not protected by U.S. law, beyond the policies of individual companies and a handful of state laws.

MU payments sail by $16 billion

By Diana Manos, Senior Editor
As of the end of September, the federal government now reports that a significant number of hospitals and eligible providers are now actively participating in the electronic health record incentive program, with 425,000 registered for the program and 325,00 unique providers having received some kind of incentive payment so far.
At the Nov. 6 meeting of the HIT Policy Committee, Rob Anthony, deputy director at the CMS Office of E-Health Standards and Service, said registration in September represents a slight decrease from other months, but this is expected. “This is the calm before the storm,” Anthony said. “We will continue to see an upward trend of these numbers as we move into January and February.”

4 innovation trends shaping healthcare's future

November 12, 2013 | By Susan D. Hall
Meaningful Use, the switch to ICD-10, security and interoperability issues are consuming many healthcare IT leaders' attention, but they mustn't overlook trends that will shape healthcare in the future, according to an article at
The article examines four trends that will shape future advances in healthcare, based on discussion from last month's Center for Connected Health Symposium in Boston.

Groups throw support behind MU legislation

Laura Pedulli
Nov 11, 2013
Nine specialty societies are expressing their support for legislation that would allow participation in clinical data registries to meet the quality reporting component of the Meaningful Use (MU) program.
In a letter to EHR Improvements Act (HR 1331) sponsor Rep. Diane Black (R-Tenn.), the Northern American Spine Society and eight other groups lauded the bill but suggested an expansion to allow all physicians who utilize certified EHR systems to participate in registries as having met the MU criteria.

'Late Adopters'—How Small Hospitals Can Navigate Meaningful Use

Scott Mace, for HealthLeaders Media , November 12, 2013

Hospitals and health systems just now getting around to meaningful use have clearer guidance from CMS, a better selection of off-the-shelf EHR software, and the cautionary lessons learned from HMA.

Judging by last week's readership on, more than a few of you were keenly interested in HMA's $31 million giveback to the Centers for Medicare & Medicaid Services last week for failing to tell the truth about its meaningful use attestation.
While we ponder the fallout at HMA, how can you avoid being next?
The good news is, CMS now has a web page to help you navigate your way around (or through) a meaningful use audit.

Health IT Could Reduce Demand For Physicians

Comprehensive use of IT in 30% of physician offices would have major impact, but that is not expected to occur for 5 to 15 years, says study.
If health IT were fully implemented in 30% of community-based physicians' offices, the gains in efficiency would reduce demand for physicians by 4% to 9%, according to a new study in Health Affairs.
Using health IT to support the delegation of work from physicians to midlevel practitioners and from specialists to primary care doctors could reduce demand for physicians by 6% to 12%. And increasing the amount of IT-enabled remote care and asynchronous care could cut the percentage of overall care that physicians provide by 2% to 5% and 4% to 7%, respectively, the study found.
If 70% of office-based physicians adopted comprehensive health IT -- including interoperable EHRs, clinical decision support, provider order entry and patient Web portals with secure messaging -- the impact on physician workforce requirements would be twice as large, the study said.

One big HIE hurdle still stands

Posted on Nov 11, 2013
By Anthony Brino, Editor, HIEWatch
Interoperability among disparate systems continues to be one of the biggest challenges facing health information exchanges today, according to the findings of a new industry survey. 
"Despite the incorporation of new meaningful use policies, it is clear that interoperability issues are still stifling organizations' ability to connect," the Washington-based eHealth Initiative wrote in its 10th annual HIE survey. "The survey results reveal that interoperability remains a great hurdle with little relief in sight."
The of 199 health information exchanges around the country also revealed that HIEs do have large opportunities to support health reform, and many already are, but to do that they have to support patient portals and self-service -- an area HIEs and hospitals too are lagging in.

Look at app

Ten years ago, Shawn Larson, then an agency radiographer at St Thomas’s Hospital, had the idea of creating a software application to allow medical professionals to practise using x-ray equipment in a 3D environment.
28 October 2013
 “I saw a need for something to address the basic psychomotor skill of moving the table and moving the equipment,” he says.
“I thought: ‘There has to be a better way of doing this than learning on the job, on real patients, using radiation, when there are so many simulators around. When you think of games like Tomb Raider, they provide a learning element, so why not transfer that to something real?’”
After developing a version for PC in 2003, Larson returned to the idea a few years later, and Virtual Cath Lab was launched as a mobile app in 2011. It has now been downloaded 10,000 times from Apple’s app store, in countries as far away as Vietnam and Mexico, as well as the UK.
Feedback has been positive, says Larson. “It delivers the basics. It gets you to the stage where you can operate the real equipment, and look at the anatomy with some intelligence, and hit the ground running.”

Blue Button Plus, other identifiers can reverse 'information asymmetry'

November 11, 2013 | By Susan D. Hall
Providing patients with access to their own information and reasserting the primacy of the physician-patient relationship can reverse the "information asymmetry" that favors big healthcare corporations at the expense of patients and individual physicians, according to a post at The Health Care Blog.
Adrian Gropper, M.D., chief technical officer of the nonprofit Patient Privacy Rights writes that information asymmetry drives $3,000 in annual waste per citizen amid a health IT "certification" process that seems designed to drive small vendors and open-source software out of the market.

Therapeutic at-home 3D video game for stroke patients developed

By ANI | ANI – 19 hours ago
Washington, Nov 11 (ANI): Researchers have developed a therapeutic at-home gaming program for stroke patients who experience motor weakness affecting 80 percent of survivors.
Constraint-induced movement therapy (CI therapy) is an intense treatment recommended for stroke survivors, and improves motor function, as well as the use of impaired upper extremities. However, less than 1 percent of those affected by hemiparesis receives the beneficial therapy.
"Lack of access, transportation and cost are contributing barriers to receiving CI therapy. To address this disparity, our team developed a 3D gaming system to deliver CI therapy to patients in their homes," said Lynne Gauthier, assistant professor of physical medicine and rehabilitation in Ohio State's College of Medicine.

EHR group weighs in on FDA work

Posted on Nov 08, 2013
By Bernie Monegain, Editor
The Electronic Health Record Association, which represents 40 EHR developer companies whose products are in use at a majority of hospitals and physician practices today, applauds an FDA workgroup recommendation that healthcare technology, such as EHR systems, should not be treated as medical devices and should remain unregulated.
However, the group, in a Nov. 6 letter to HHS Secretary Kathleen Sebelius, asked for clarification on a number of topics, including clinical decision support, medical device accessories, reporting of safety event and post-market surveillance and "Class 0."
"We are not convinced that most HIT not regulated as a medical device should receive a new 'Class 0' device classification by the FDA. Such a classification and application for a formal regulatory approach to HIT is not warranted in our view," stated the letter signed by the EHR Association Executive Committee members, whose chair is Michele McGlynn, senior director, strategy and operations at Siemens.

EHR group weighs in on FDA work

Posted on Nov 08, 2013
By Bernie Monegain, Editor
The Electronic Health Record Association, which represents 40 EHR developer companies whose products are in use at a majority of hospitals and physician practices today, applauds an FDA workgroup recommendation that healthcare technology, such as EHR systems, should not be treated as medical devices and should remain unregulated.
However, the group, in a Nov. 6 letter to HHS Secretary Kathleen Sebelius, asked for clarification on a number of topics, including clinical decision support, medical device accessories, reporting of safety event and post-market surveillance and "Class 0."
"We are not convinced that most HIT not regulated as a medical device should receive a new 'Class 0' device classification by the FDA. Such a classification and application for a formal regulatory approach to HIT is not warranted in our view," stated the letter signed by the EHR Association Executive Committee members, whose chair is Michele McGlynn, senior director, strategy and operations at Siemens.

Overrides of Clinical Decision Support Alerts Persist, Groups Try To Address Issue

by Bonnie Darves, iHealthBeat Contributing Reporter Monday, November 11, 2013
Efforts are underway to streamline electronic prescribing clinical decision support (CDS) systems to avoid over-alerting physicians, as alert fatigue results in clinicians overriding warnings. However, a recent study by Boston-based Partners HealthCare shows that the problem persists.
The researchers analyzed more than 157,000 CDS alerts involving more than two million medication orders and 1,718 outpatient providers and found that 52.6% of the alerts were overridden. Further, they found that 53% of those overridden alerts were clinically appropriate -- meaning that the particular drug combinations or patient factors, if overlooked, had the potential to cause patient harm.
The study's lead author Karen Nanji, an anesthesiologist and quality and safety researcher, said that the study's results confirm that the problem of alert overrides -- whether driven by alert fatigue or other factors -- persists and needs more attention.



Trevor3130 said...

Clay Shirky's and the Gulf Between Planning and Reality is attracting lots of interest. Reading the third comment, from "Fran" on Nov19, I wonder how Ms Halton's execution of the "efficiency dividend" will cut into resources for NEHR.

Anonymous said...

At the Nov 20 Senate estimates Ms Halton - claims being ripped off by big vendors. When she adds in the efficiency dividend she will have the perfect excuse to blame everyone and everything bar herself won't she? Yes Minister.