Saturday, February 22, 2014

Weekly Overseas Health IT Links - 22nd February, 2014.

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.

NIST unveils cybersecurity framework

Posted on Feb 14, 2014
By Erin McCann, Associate Editor
To help organizations protect their data assets from the increasing number of cyber attacks, the Commerce Department's National Institute of Standards and Technology this week released a cybersecurity framework groups can use to create, assess or improve comprehensive cybersecurity programs.
The framework released is in response to a February 2013 executive order issued by President Barack Obama that called for the development of a voluntary, risk-based cybersecurity framework -- a set of existing standards, guidelines and practices to help organizations manage cyber risks. The framework, officials say, created through public-private collaboration, provides a common language to address and manage cyber risk in a cost-effective way, without placing additional regulatory requirements on businesses. 
"The framework provides a consensus description of what's needed for a comprehensive cybersecurity program," said Under Secretary of Commerce for Standards and Technology and NIST Director Patrick D. Gallagher, in a Feb. 12 press statement. "It reflects the efforts of a broad range of industries that see the value of and need for improving cybersecurity and lowering risk. It will help companies prove to themselves and their stakeholders that good cybersecurity is good business."

7 New Objectives Recommended for Meaningful Use Stage 3

FEB 14, 2014 4:47pm ET
The meaningful use workgroup of the HIT Policy Committee recently released a late-stage list of recommendations for Stage 3 of the electronic health records meaningful use program, which includes seven proposed new objectives that are not required in Stage 2.
The workgroup is accepting feedback before finalizing the recommendations and sending them to the Policy Committee in March. A list of workgroup members is here. The HIT Policy Committee and accompanying HIT Standards Committee both comprise industry stakeholders who advise federal officials on health information technology issues, particularly the meaningful use program. The committees wield significant influence in development of meaningful use criteria, although agencies within the Department of Health and Human Services have the final say.

FDA mandates electronic reporting for med device adverse events

February 14, 2014 | By Dan Bowman
The U.S. Food and Drug Administration this week posted a final rule in the Federal Register mandating that device manufacturers and importers submit adverse event reports for medical devices electronically.
According to FDA, the rule--which doesn't go into effect until Aug. 14, 2015--will help the agency to improve its data collection and analysis efforts. FDA says the rule is part of a greater initiative to adopt electronic technologies to boost operational quality.
"For over 20 years, FDA received postmarket MDRs in a paper format through the mail," the rule says. "This final rule to require the electronic submission to FDA of manufacturer and importer MDRs is an important step toward improving the Agency's systems for collecting and analyzing postmarket MDRs."

'Big Data' No Small Challenge for Health eHeart Study

Published: Feb 13, 2014
By Crystal Phend, Senior Staff Writer, MedPage Today
When Kristen Downing signed up for the University of California San Francisco's ambitious Health eHeart study after a heart checkup there, she was excited for what she thought was an opportunity to help others with adult congenital heart disease like her.
But then Downing, 45, started to realize what she had enrolled in wasn't what she thought.
"I was so excited about doing it but unfortunately as I got into it I realized it's highly geared toward acquired heart disease, which is a completely different animal," she told MedPage Today.
Another participant -- who, along with several others asked that her full name not be used -- came in through the study website where most of the planned 1 million participants will join and have their only contact with the study, but then accidentally indicated she had coronary heart disease instead of electrical problems with her heart in the online questionnaires.

Understanding the New Rule for Patient Access to Lab Results

FEB 12, 2014 6:44pm ET
Privacy and data protection attorneys Linn Freedman and Kathryn Sylvia of the Nixon Peabody firm have written a brief explanation of provisions under a new federal rule to give patients or designated representatives the right to receive copies of medical test results from most clinical laboratories:
Recently, the Final Rule to amend the Clinical Laboratory Improvement Amendments of 1988 and Health Insurance Portability and Accountability Act regulations, which will now allow patients and their personal representatives access to lab test reports and results from laboratories, was published in the Federal Register. This Amendment stems from collaboration between U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention and the Office for Civil Rights. HHS Secretary Kathleen Sebelius said, “The right to access personal health information is a cornerstone of the HIPAA Privacy Rule. Information like lab results can empower patients to track their health progress, make decisions with their health care professionals, and adhere to important treatment plans.”

Hospitals don't factor in full cost of EHR implementation

February 13, 2014 | By Susan D. Hall
Hospitals may not be fully prepared for the full cost of EHR implementation, according to research published by Journal of the American Medical Informatics Association seeking to help organizations better understand the total bill.
Researchers from the United Kingdom and Boston identified four main cost categories: infrastructure (such as hardware and software); personnel (such as a project managers and training teams); facilities (furniture, fittings and space) and other (such as training materials).
"With cost considered one of the most significant barriers, it is important for hospitals and governments to be clear from the outset of the major cost categories involved and the factors that may impact on these costs," the authors said. Otherwise, health organizations risk failure.

Global EMR market to hit $17 billion by 2017

February 10, 2014 | By Marla Durben Hirsch
The global EHR market is expected to grow "significantly" from $10.6 billion in 2012 to $17 billion by 2017, at a compounded annual growth rate (CAGR) of 9.8 percent, according to the latest report from research and consulting firm GlobalData.
The report reveals that McKesson is the market leader with health IT software and services revenue at $3.3 billion. Cerner and Allscripts follow, with revenue at $2.6 billion and $1.4 billion, respectively.
EMR vendors also are offering revenue cycle management so that providers can use the same platform for clinical and financial information, according to an announcement.

Pharmacies set to go big on Blue Button

Posted on Feb 13, 2014
By Anthony Brino, Editor, HIEWatch
In efforts to guarantee patient access to their lab tests, the nation's largest pharmacies are now promising to adopt the Blue Button personal health record. 
Walgreens, Kroger, CVS, Rite Aid, Safeway and pharmacies with the National Association of Chain Drug Stores are pledging to start standardizing patient prescription information within the next year to accommodate applications and services using the Blue Button.
"These steps will help patients access their prescription information and further empower millions of Americans to better manage their healthcare," U.S. deputy CTO Nick Sinai and and HHS Presidential Innovation Fellow Adam Dole wrote on the White House Office of Science and Technology Policy blog.

Teledermatology as reliable, efficient as in-person consults

February 13, 2014 | By Ashley Gold
Remote consultations from dermatologists using a smartphone app have proven reliable and efficient at prioritizing inpatient consultations for patients with skin conditions.
Outlining their study results in JAMA Dermatology, researchers in the Perelman School of Medicine at the University of Pennsylvania concluded that this method can help deliver dermatology care more efficiently in busy hospital settings. 
The study compared assessments of 50 hospitalized patients at the Hospital of the University of Pennsylvania. When the inpatient dermatologist recommended that a patient be seen that day, the teledermatologists independently agreed 90 percent of the time, and 95 percent of the time when the inpatient dermatologist recommended a biopsy. What's more, the doctors completely agreed on a diagnosis 82 percent of the time, and partially agreed in 88 percent of cases.

HHS Regulations Expose Scope of Data Breach Problem in Healthcare Sector

Written by Helen Gregg (Twitter | Google+)  | February 12, 2014
Of the 619 data breaches recorded by the Identity Theft Resource Center, 43 percent (267 breaches) occurred in the healthcare sector.
For the first time since the center began tracking breaches in 2005, the healthcare sector accounted for more breaches than the business sector (210 breaches, 34 percent of total).

ECRI Cautions Hospitals About Tech Hype

Cheryl Clark, for HealthLeaders Media , February 12, 2014

Independent research from the non-profit ECRI Institute aims to distinguish between must-have hospital technologies and manufacturer hype.

A device that allows untrained nurses to sedate colonoscopy patients without an anesthesiologist, hospital gowns woven with infection-fighting copper, and oral drugs embedded with sensors are among the emerging technologies senior executives may be pressured to bring into their hospitals and healthcare systems.
But the 2014 edition of the ECRI Institute's annual "Top 10 Hospital C-Suite Watch List" aims to distinguish between must-have technologies and hype.
The Pennsylvania-based non-profit group conducts independent research to verify manufacturers' claims, regulatory compliance, and any emerging safety or efficacy issues associated with emerging technologies, especially those that cost a lot of money.

Do Doctors Need EHR 'Scribes'?

2/12/2014 09:06 AM
Doctors should hire assistants to fill out electronic health records for them -- tagging along on exams if necessary -- to avoid job burnout, says ScribeAmerica.
Is the electronic health record falling short of its promise and contributing to physician burnout because it saddles doctors with ever-increasing administrative tasks?
Yes, thinks Dr. Michael Murphy, an ER physician who co founded ScribeAmerica a decade ago.

Open Data

Jeffrey M. Drazen, M.D.
N Engl J Med 2014; 370:662February 13, 2014DOI: 10.1056/NEJMe1400850
In the fall of 2013, the Institute of Medicine (IOM) convened a committee, on which I serve, to examine the sharing of data in the setting of clinical trials. The committee is charged with reviewing current practices on data sharing in the context of randomized, controlled trials and with making recommendations for future data-sharing standards. Over the past few months, the committee has prepared a draft report that reviews current practices on data sharing and lays out a number of potential data-sharing models. Full details regarding the committee's charge and the interim report are available at

Hospitals Use Tablets as Extension of EHRs

Published: Feb 10, 2014
By David Pittman, Washington Correspondent, MedPage Today
Some leading hospitals are increasingly turning to tablets -- iPads and iPad-like devices -- as a way to improve access to patient health records for providers walking the hospital halls.
Such devices are seen as a way to work around clunky desktops and make greater use of an electronic medical record's (EMR) capabilities.
"Tablets, in our experience, are very effective if you need not the entire EMR, but a slice of information," Will Morris, MD, associate chief medical information officer at the Cleveland Clinic, told MedPage Today.

Data Analytics Takes on Medication Management

Scott Mace, for HealthLeaders Media , February 11, 2014

The expansion of e-prescribing and data analytics is leading to improved outcomes, reduced costs, and enhanced patient engagement. And technology is allowing providers to earn hard cash for meeting medication adherence targets.

This article appears in the January/February 2014 issue of HealthLeaders magazine.
Billions of dollars are wasted and thousands of lives lost each year through inefficient or ineffective medication management. It has been estimated that the misuse of prescription drugs in our healthcare system is up to a $300 billion problem annually.
From the doors of the emergency room to the drawers of patients' home nightstands, medications are mixed up, misremembered, overdosed, underdosed, and laboriously documented or misdocumented.

Is big data already outpacing health IT?

By Diana Manos, Senior Editor
Call it super-mega big data. Taking just one example, cancer research, highlights how far the healthcare industry has yet to go to actually make sense from the mountains of information that already exist.
The enormous opportunity in this case is precision management of human cancers. Indeed, the ability to study cancerous tumors on the genetic level and formulate trends on how to treat and cure the disease are within grasp, said Joe Gray, associate director for translational research at the Knight Cancer Institute at the Oregon Health & Science University.
Genomic cancer study today is exciting because it offers the ability to optimize treatment for an individual, Gray said at the Health Care Innovation Summit in Washington, DC last week. Once the genetic features of a cancer are known, doctors could scan a cancer patient’s whole body for the genetic material of that cancer, finding where it might have spread, or is in the process of spreading. And in theory, researcher and doctors could then find what treatment is best suited to the patient and how treatment could be best combined to get durable responses.

Partners keeps tabs on patients at home

Posted on Feb 11, 2014
By Bernie Monegain, Editor
With an eye on reducing hospital readmissions and boosting patient care coordination, Partners HealthCare at Home, a division Partner's HealthCare in Boston, is rolling out new telemonitoring technology.
The technology, from Royal Philips, will be employed to provide improved clinical oversight for newly discharged patients and those with chronic conditions, such as congestive heart failure, diabetes and chronic obstructive pulmonary disorder.
Monitoring patients at home makes it possible for the nursing staff of Partners HealthCare At Home to track vital signs and intervene earlier with medical attention when it’s needed.
The goal is to reduce costly hospital readmissions, and the savings can add up to millions of dollars, as Partners has shown.

Re-identifying illegal

7 February 2014   Rebecca Todd
NHS England’s director of patients and information Tim Kelsey
There is a “theoretical risk” that data released to researchers from the programme could be used to re-identify patients, but this would be a criminal offence, NHS England’s director of patients and information has said.
Tim Kelsey spoke at a Cambridge Health Network event in London on Wednesday evening with health secretary Jeremy Hunt, where he fielded a number of questions about
The programme will link an expanded set of Hospital Episode Statistics with a new monthly collection of GP data to create Care Episode Statistics.

Survey shows readers wary on

11 February 2014   Rebecca Todd
Around two thirds of respondents to EHI’s survey on say they plan to opt themselves out of the data-sharing initiative.
EHI received 145 responses to its online survey over the past week, of which more than one third said they work in primary care.
More than 66% of respondents said they will be opting themselves out of the programme, which involves linking a new GP data set with hospital data to create Care Episode Statistics. This is even higher than a recent poll by GP magazine Pulse, which found that more than 40% of GP respondents would opt out.
The online survey was self-selecting, but provided a snapshot of views of NHS IT professionals on the privacy issues surrounding 

Hackers attack prominent med device makers' networks

February 11, 2014 | By Dan Bowman
Computer networks at three prominent medical device makers--Medtronic, Boston Scientific and St. Jude Medical--were hacked in the first half of 2013, and may have lasted several months, according to a report this week from the San Francisco Chronicle.
The attacks--which went undetected by the respective companies until they were brought up to speed by the feds--may have been conducted by hackers in China, according to newspaper, citing an anonymous source. All three have created task forces to examine the breach internally.

Open source robotic surgery system in the works

February 11, 2014 | By Susan D. Hall
While the Da Vinci surgical system is the only robot with U.S. Food and Drug Administration (FDA) approval--and the target of plenty of criticism--researchers are looking to develop surgical robots based on open source technology, reports Scientific American.
Taking a page from software development, it would involve a basic design that wouldn't change from device to device and involve a community of developers to improve it and create their own innovations.
Researchers from the University of California, Santa Cruz, and the University of Washington say that by using open source, the multimillion-dollar price of the system would fall, as would the learning curve for using it.

How BI is Lowering Healthcare Costs

Scott Mace, for HealthLeaders Media , February 11, 2014

Putting business intelligence in the form of cost accounting data directly into the hands of physicians can start rich dialogues within or between service lines to make healthcare more predictable, more consistent, and less expensive.

In this year of Meaningful Use Stage 2 and ICD-10 deadlines, CIOs are consumed by the effort of meeting the high bars set by government to achieve compliance with these mandates. Wouldn't it be great if technology could also control escalating healthcare costs?
It might happen sooner than anyone thinks.
John Kenagy, PhD, CIO of Legacy Health, may just be the catalyst to making that happen, not only at his own five-hospital system in Portland, Oregon, but far beyond those walls.
A year ago at HIMSS, Kenagy conducted a kind of shuttle diplomacy between Epic and Strata Decision, two vendors with large installed bases. Epic's reputation precedes it, and its own new business intelligence software, Cogito, is being adopted widely. Strata Decision is less well known, but its financial management and cost accounting software is installed in one of five hospitals in the U.S., more than 170 healthcare systems overall.

Stage 3 MU now in the making

Posted on Feb 10, 2014
By Anthony Brino, Editor, HIEWatch
The ONC’s Meaningful Use Workgroup is submitting draft recommendations for Stage 3 of the Meaningful Use EHR Incentive Program to the Health IT Policy Committee on Feb. 14. So far, the workgroup has developed a number of ideas that have consensus, but clinical quality measures may not be as easy to include in digital systems as previously thought, and Congress may end up stepping in.
While health IT stakeholders consider the potential challenges of Stage 3 over the next year, Congress may end up coming back into the process with new ideas — and redesign the entire system for how Medicare pays and provides incentives for  physicians.
Provisions being floated for the new Medicare doc payment reform legislation would create a Merit-Based Incentive Payment System to streamline current incentive programs in 2018, gradually offering increases and incentives for entering altnernative payment models and also ending Medicare penalties, including those for not participating in meaningful use, in 2017. Different components of the existing incentive program might continue, though, such as EHR certification.

Health industry struggling to keep up with growing ID theft problem

February 10, 2014 | By Dan Bowman
The rise in medical identity theft in the U.S. in recent years--and in particular, theft involving a breach in technology--has been swift and has left many concerned about the effectiveness of privacy regulations, according to a recent Stateline report.
"It's almost impossible to clear up a medical record once medical identity theft has occurred," Washington, D.C.-based health attorney James Pyles--who has worked on privacy measures both for HIPAA and the HITECH Act--told Stateline. "If someone is getting false information into your file, theirs gets laced with yours and it's impossible to segregate what information is about you and what is about them."
According to a recent survey published by Identity Theft Resource Center--a San Diego, Calf.-based nonprofit--more than 40 percent of all records breaches involving personal information nationwide were of the medical variety in 2013, Stateline reported. That number exceeded breaches that took place in various other industries, including banking, the government and education.

Medical identity theft most potent kind

Posted on Feb 11, 2014
By Kaiser Health News
By Michael Ollove, Stateline
If modern technology has ushered in a plague of identity theft, one particular strain of the disease has emerged as most virulent: medical identity theft.
Last month, the Identity Theft Resource Center produced a survey showing that medical-related identity theft accounted for 43 percent of all identity thefts reported in the United States in 2013. That is a far greater chunk than identity thefts involving banking and finance, the government and the military, or education. The U.S. Department of Health and Human Services says that since it started keeping records in 2009, the medical records of between 27.8 million and 67.7 million people have been breached.
The definition of medical identity theft is the fraudulent acquisition of someone’s personal information – name, Social Security number, health insurance number -- for the purpose of illegally obtaining medical services or devices, insurance reimbursements or prescription drugs.

Healthcare informatics grows more sophisticated, more practical

February 10, 2014 | By Susan D. Hall
Applied informatics aims to take data being collected in electronic systems and bring it into the day-to-day work of healthcare professionals to improve care and reduce costs, according to an article at Journal of AHIMA.
It can be used at a "30,000-foot level" for national healthcare policy, the article says, at the local and institutional levels or even the individual patient level.
The healthcare informatics professional's role has grown more sophisticated in recent years; these days, it's focused on providing "healthcare intelligence" used in decision-making.

Reaching More Patients With Telecardiology

From an echocardigraphy network to medical outreach, telecardiology can improve productivity
By: Raissa Rocha
February 7, 2014
Advancements in technologies are paving the way for many healthcare providers to connect with patients outside their hospitals more quickly and efficiently. For cardiology departments, technologies that allow for video collaboration, rapid transmission of scans and images and other forms of telemedicine are supporting the initiative to improve productivity, an initiative many are striving for as the U.S. healthcare landscape continues reform.
Bringing Rural Patients to the Experts
Telemedicine, or telecardiology when speaking specifically about the specialty, is gradually making waves in a variety of forms. From use within a single hospital to implementation in a regional network of medical centers and clinics, it is allowing clinicians to provide patients with more efficient and convenient care in an era where “time is money,” said Richard Marcus, M.D., cardiac ultrasound lab director at Iowa Heart Center (IHC) in West Des Moines, Iowa.

Will Providers Have Certified EHRs for Meaningful Use Stage 2?

Monday, February 10, 2014
Last September, CMS was seriously worried about how many electronic health record vendors would get their products certified under the 2014 Edition of the government's certification criteria before the launch of meaningful use Stage 2 in January. CMS had a solid reason for its concern: As a report released by the National Center for Health Statistics showed, in the first half of 2013, only 13% of physicians both intended to participate in the EHR incentive program and had systems capable of supporting 14 of the 17 Stage 2 core objectives for meaningful use.
The situation has changed significantly since then, however. According to statistics recently issued by the Office of the National Coordinator for Health IT, 86% of eligible hospitals that attested in meaningful use Stage 1 had a primary vendor offering a 2014 Edition product that met ONC's base EHR definition as of Dec. 31, 2013. Seventy percent of eligible professionals fell into the same category, including 80% of surgeons, 81% of primary care doctors and 72% of medical specialists.

'Big Brother' database will grab children's health records but parents are being kept in the dark

Leaflets about the scheme don't say children's records will be harvested

Doctor fears the data grab will 'undermine trust' in the medical profession

Children's medical records will be automatically uploaded to the controversial new ‘Big Brother’ NHS database – but parents have not been told.
The records of some ten million youngsters in England will be taken from GP surgery computers this spring to be part of the project.
Leaflets about the scheme contain no mention that children’s records will be ‘extracted’. It is only revealed in NHS guides for patients and GPs on the internet.


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