Saturday, December 07, 2013

Weekly Overseas Health IT Links - 7th December, 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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EHRs a top priority in 2014 OIG strategic plan

November 22, 2013 | By Marla Durben Hirsch
The security and integrity of electronic health records will be one of the U.S. Department of Health & Human Services Office of Inspector General's highest priorities in 2014 and beyond, according to the OIG's latest strategic plan.
The plan, released Nov. 21, identifies EHRs as one of the OIG's "key focus areas" until at least 2018. Its focus on EHRs is part of a larger priority of addressing long term operational and program vulnerabilities in health IT that also includes the securing the accuracy and completeness of Medicaid data and the privacy and security of personally identifiable information.
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Project to unify LOINC, Radlex

Posted on Nov 27, 2013
By Bernie Monegain, Editor
RSNA and the Regenstrief Institute have begun work to harmonize and unify terms for radiology procedures. The intent is to improve the quality, consistency and interoperability of radiology test results in electronic medical record systems and health information exchange.
The work is funded by a contract from the National Institute of Biomedical Imaging and Bioengineering.
RSNA, which owns and maintains the RadLex medical terminology for radiology, and the Regenstrief, which owns and maintains the Logical Observation Identifiers Names and Codes, or LOINC, terminology standard for medical tests and measurements, share the contract and will collaborate on the endeavor to produce a single unified source of names and codes for radiology procedures.
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Patient safety reporting overhaul

27 November 2013   Lis Evenstad
The NHS is developing the National Reporting and Learning System to become an integrated reporting route for patient safety incidents.
The system was previously run by the National Patient Safety Agency and is used to report and analyse patient safety incidents such as falls or surgical errors.
However, it has taken a back seat since the closure of the agency in June 2012, when responsibility was transferred to NHS England.
There are two national reporting systems for patient safety in the NHS; the NRLS and one run by the Medicines and Healthcare Products Regulatory Agency. This causes inconsistency as some incidents will be reported to both systems, while others will only be reported to one of them.
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Pew: Online resources a 'significant supplement' for chronic condition patients

November 27, 2013 | By Ashley Gold
A new survey from the Pew Research Center and the California HealthCare Foundation finds that while people with chronic conditions are now more likely than ever before to seek health information online, seeking information from a physician remains the most preferred mode for such patients.
Surveying 3,104 adults living in the U.S., Pew researchers found that Internet users are more likely than other online adults to:
  • Obtain information about medical problems, treatments and drugs online
  • Consult online reviews about drugs
  • Read or watch things online about someone else's health experience
"Our research makes it clear that when the chips are down, people are most likely to get advice from a clinician, but online resources are a significant supplement," Susannah Fox, lead author of the study and an associate director at the Pew Research Center, said in an announcement. "Just as significantly, once people begin learning from others online about how to cope with their illnesses, they join the conversation and also share what they know."
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4 super-sized healthcare trends

November 27, 2013 | By Ilene MacDonald
Healthcare leaders must adapt to regulatory, technology, medical and market changes that are forcing the re-invention of healthcare. A report from Mannett Health Solutions identifies 10 "megatrends" and the smaller movementsand sub-trends supporting these super-sized developments.
Here are four of interest:
Patients take control of their care: Consumers are becoming more informed about healthy living and how to manage their own health. In addition, healthcare exchanges now offer Americans more insurance options and many patients will choose high-deductible and cost-sharing plans, the report notes.They will demand more information on upfront costs, as well as information on chronic diseases and treatment options. Expect explosions in the growth in self-monitoring technologies.
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AHRQ Releases Report on Technology and Ambulatory Quality

Written by Ellie Rizzo | November 26, 2013
The Agency for Healthcare Research and Quality has released "Findings and Lessons From the AHRQ Ambulatory Safety and Quality Program," which has found correctly implemented technology systems have the potential to support quality in ambulatory care.
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Report: Bulk of iEHR funds spent on support services

Beth Walsh
Nov 25, 2013
More than $300 million in funding for an integrated EHR system at the departments of Defense and Veterans Affairs was spent on support service contracts in 2012, according to a report from the Interagency Program Office (IPO).
IPO is charged with modernizing the military health system's EHR software.
In 2009, DOD and VA first launched an effort to create a joint integrated EHR designed to allow every service member to maintain a single EHR throughout his or her career and lifetime. In February, however, DOD and VA officials announced plans to halt the iEHR project and focus on making their current EHR systems more interoperable instead.
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EHI Round Table: How to implement an effective EPR

Sponsored by Aura Healthcare as part of The Big EPR Debate

Introduction

In October 2013, EHI convened the second roundtable in The Big EPR Debate that it launched to debate the future of electronic patient record systems in response to health secretary Jeremy Hunt’s call for the NHS to become ‘paperless’ by 2018.
The event in Leeds, sponsored by Aura Healthcare, moved on from earlier discussions about the building blocks of an EPR, and instead gave participants time to explore the best way to implement an effective EPR.
At its simplest, this boils down to a seemingly simple division: work incrementally using ‘best of breed’ systems or go for one system, or at least a set of core systems, from a ‘single supplier’? But as the debate showed, there is more to it than that.
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More seniors expect digital health options

By Anthony Brino, Associate Editor
More and more seniors are interested in using digital health tools in their home, a finding that both health organizations and policymakers might consider as they look for improvements and savings in Medicare, according to a new study.
In a survey of Americans 65 years and older by the consulting and IT company Accenture, more than half said they think it’s important to have the option of emailing their doctors and providers, and almost 70 percent think it’s important to be able to book appointments and request prescription drug refills online.
Yet among the seniors surveyed, access to those kinds of digital choices are still limited among hospitals and physician practices.
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5 ways to avoid HealthCare.gov mishap

Posted on Nov 26, 2013
By Diana Manos, Senior Editor
To say an IT project like HealthCare.gov was a large-scale, complex behemoth undertaking is an understatement, to say the least. All the myriad elements of the project must be successfully interconnected for it to function properly, which clearly did not occur. 
Neglect any one of these elements and it can lead to "outright failure," says Richard Spires a consultant who formerly served as the Department of Homeland Security's chief information officer.
At a Nov. 13 House oversight hearing, Spires offered tips to be gleaned from HealthCare.Gov's difficult launch. Spires, who left DHS in May 2013, said he based this advice solely on information about the project he learned from listening to Congressional hearings and from news stories, rather than internal knowledge.
Here are Spires' five tips for launching a winning IT project.
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Incomplete data hits Hants record use

22 November 2013   Rebecca Todd
Leading users of the Hampshire Health Record have expressed frustration with the growing problem of incomplete data on thousands of patients, caused by GPs switching to TPP’s SystmOne.
Data is incomplete because SystmOne does not currently provide daily extracts to the record, but TPP says it is working on a solution.
Established in 2005, the HHR is one of the best-known shared record projects in the country. It receives data feeds from GP practices, acute and community trusts, using the Graphnet CareCentric portal.
Now run by NHS South Commissioning Support Unit, it covers 1.9m patients and is available to view by anyone involved in a patient’s care.
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ONC's Joy Pritts on breach prevention: Encryption is key

November 26, 2013 | By Ashley Gold
Encryption is the single most essential technology to use for breach prevention, according to Joy Pritts, chief privacy officer at the Office of the National Coordinator for Health IT.
Pritts, in a recent interview with Healthcare Info Security, said that encryption is "much more advanced" than it was five years ago, and necessary as patient privacy issues continue to persist.
"We still see the largest impact of breaches has been from lost and stolen technology," Pritts said. "[T]here really is not a good reason at this point, if you're purchasing new technology, not to make sure that you can encrypt it."
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How IT changes the medical thought process

November 26, 2013 | By Gienna Shaw
Healthcare is a fun and rewarding field, says Steven Steinhubl, M.D., director of the Digital Medicine program at the Scripps Translational Science Institute (STSI). But with pressure to see more and more patients in a fee-for service world and an abundance of new technologies that can improve care but also disrupt workflow, doctors don't always feel that way.
"It's understandable but I find it very depressing," he told FierceHealthIT in an exclusive interview at the STSI offices in La Jolla, Calif.
"It's just one symptom of a broken healthcare system. We definitely have the tools to fix it but we have to figure out exactly how. And the healthcare system is so recalcitrant to change that we have to supply the evidence that will help move that."
To that end, STSI's research projects examine the clinical and financial benefits of mHealth.
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Senate Bill Would Expand Access to Medicare Data

NOV 25, 2013 3:46pm ET
New legislation introduced in the U.S. Senate would expand availability of Medicare data to industry stakeholders and make access and utilizing the data more user-friendly.
Sens. Tammy Baldwin (D-WI) and John Thune (R-SD) sponsor S. 1758, “The Quality Data, Quality Healthcare Act,” referred to the Finance Committee and soon available at congress.gov.
“Congress and the Administration have taken initial steps to make Medicare data more widely available,” according to a fact sheet from the senators. “One of the more promising efforts is the Quality Entity (QE) program, which permits organizations to access and analyze Medicare data for select purposes. The QE program has the potential to empower our nation’s health care decision makers to make better choices. However, current law is far too restrictive on which organizations can participate in the QE program, what QEs can do with the Medicare data once they have received it, and the degree to which QEs can support their own data maintenance infrastructures.”
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Displaying Lab Prices on EHR Systems Cuts Costs

John Commins, for HealthLeaders Media , November 26, 2013

Evidence is mounting that when physicians know the laboratory costs of tests prior to ordering them, they show a decrease in ordering rates, and not only for high-cost tests.

A new study adds to a growing body of evidence suggesting the potential for significant healthcare cost reductions when physicians know the up-front cost of ordering routine lab tests.
The latest study involved 215 primary care physicians at Atrius Health, an alliance of six non-profit medical groups, and a home health and hospice agency in Massachusetts that uses an integrated electronic health record system. Physicians in an intervention group received real-time information on laboratory costs for 27 tests when they placed their electronic orders, while physicians in a control group did not.
Changes in the monthly laboratory ordering rate between the intervention and control groups were compared for 12 months before and six months after the intervention started. Six months after the intervention, all physicians taking part in the study were asked to assess their attitudes regarding costs and cost displays.
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Google Glass Passes IRB Muster, Assists in Cardiothoracic Surgeries

Scott Mace, for HealthLeaders Media , November 26, 2013

Surgeons are justifiably excited by the possibilities of using Google Glass in the operating room. Despite Wi-Fi hurdles, privacy concerns, and speech recognition issues, this device will inevitably become another indispensable tool in healthcare.

Forget the new iPhone. The gift every healthcare technologist wants under his or her tree next month is Google Glass.
Suddenly, talk of Glass in healthcare is snowballing. It's the newest bright shiny object in tech, and we're hearing it could be a panacea for all that ails healthcare—unusable software, patients irritated by doctors glancing at their screens or iPhones, even infections spread by lack of handwashing and further spread by the vector of the keyboard.
Whoa. Not so fast.
Google Glass is undoubtedly a cool step forward in healthcare technology. For one thing, it's the latest marketing tool for the very modern hospital. Second, it's from Google – a company that has already changed the practice of medicine forever. Show me a physician who hasn't Googled something as part of their day's work, and I'll show you an out-of-touch physician.
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Docs tap EMR data for disease research

Posted on Nov 25, 2013
By Erin McCann, Associate Editor
In the realm of modern healthcare, data is king. And, in many cases, the electronic medical record has proven itself a valuable source to extract that data. Most recently, researchers are using the EMR in conjunction with genetic data to discover new disease associations, which may have huge implications for future medical treatments. 
The first large-scale phenome-wide association, or PheWAS, study conducted by researchers at Vanderbilt University Medical Center and co-authors from the Electronic Medical Records and Genomics Network, was released today in Nature Biotechnology.
Traditionally, genetic studies begin with one disease and examine one or many genotypes. PheWAS, officials say, does the inverse by instead examining several diseases for a particular genetic variant or genotype.
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Telemedicine consults may reduce errors at rural ERs

NEW YORK Mon Nov 25, 2013 12:32am EST
 (Reuters Health) - Emergency rooms in rural areas don't see many very sick or badly injured children each year. When they do, bringing in a pediatric critical care specialist by videoconference to help with treatment could prevent errors, a new study suggests.
Researchers found rural ER doctors made errors in administering medication - such as giving the wrong dose or the wrong drug altogether - just 3 percent of the time when they used so-called telemedicine to connect with a specialist.
That compared to an 11 percent error rate when local doctors talked with a specialist by phone and a 13 percent error rate when they didn't consult with a specialist at all.
"We know that we make a difference by being able to see the patient," Dr. James Marcin said. The study's senior author, he is on the telemedicine team at the University of California Davis Children's Hospital in Sacramento.
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Patient-Reported Functional Status Data May Soon Be Included in EHRs

by Ken Terry, iHealthBeat Contributing Reporter Monday, November 25, 2013
In our tech-obsessed era, remote patient monitoring is often viewed as the most promising method of obtaining in between physician visits data on patients who have chronic diseases or who have been recently discharged from the hospital. Yet lower-tech approaches to getting feedback from patients on their functional status are likely to have more impact on health care providers and patients, at least in the short term, than home and mobile monitoring will.
Functional status can be evaluated through clinical observations, patients' verbal reports to caregivers and/or functional status surveys completed by patients. It has been described as essential to outcomes measurement, transitions of care and care management, especially of geriatric patients. Yet until recently, functional status information has not been well documented in electronic health records or in paper records. With a push from the Office of the National Coordinator for Health IT, however, that may change dramatically in the next few years.
Kevin Larsen, medical director of meaningful use for ONC, said that incorporating patient-reported data, including functional status information, in certified EHRs "has been a high priority for us from the beginning, and it continues to be a high priority for us now."
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Analysis of huge data sets will reshape health care

Kelly Kennedy, USA TODAY 5:32 p.m. EST November 24, 2013

The analysis of huge data sets can help researchers and physicians develop more effective medical treatments.

Story Highlights

  • Analysis will guide physicians on which drugs are most effective
  • The Affordable Care Act provisions for electronic records have created more data to analyze
  • Genome research coupled with data analysis the next frontier
WASHINGTON — Insurers will soon reassess how they predict costs; patients will let doctors know what medications won't work with their particular genomes; and researchers will look at hospital records in real time to determine the cheapest, most effective ways to treat patients — all because of developments in what is known as big data.
Driven by industry trends and the Affordable Care Act, the analysis of large sets of data, such as medication usage or hospital readmissions, has enabled health care providers and policymakers to make smarter decisions and predict future trends. Electronic medical records and decisions by governments and companies to share data have made for smarter decision-making that can save money and provide better care, experts say.
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Enjoy!
David.

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