Saturday, February 01, 2014

Weekly Overseas Health IT Links - 2nd 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.

Docs Will Push Interoperability Ahead of Feds, Experts Say

Published: Jan 24, 2014
By David Pittman, Washington Correspondent, MedPage Today
WASHINGTON -- Providers are demanding interoperability of electronic health records long before they are required to have it under the government's "meaningful use" program, different health IT experts here said.
That's because providers need to be able to exchange patient information with other providers as health reform efforts -- such as accountable care organizations and penalties for hospital readmissions -- proliferate. That ability to trade information between various computer systems is called interoperability.
Because financial penalties now ensue from not knowing patients' medical whereabouts and health status, doctors and hospitals are "clamoring" for the data other systems may have about their patients, said Arien Malec, vice president at RelayHealth, a health information exchange solutions company in Atlanta.

Doctors spend third of time with patients looking at computer

Jan. 23, 2014 at 9:56 PM   | 
CHICAGO, Jan. 23 (UPI) -- Doctors spend about a third of their visits looking at a computer screen and as a result their communication with patients suffers, U.S. researchers say.
First author Enid Montague, an assistant professor at Northwestern University Feinberg School of Medicine and an assistant professor in industrial engineering at the McCormick School of Engineering and Applied Science, said when physicians spend too much time looking at the computer screen in the exam room, non-verbal cues might get overlooked and affect doctors' ability to pay attention and communicate with patients.
"It's likely that the ability to listen, problem-solve and think creatively is not optimal when physicians' eyes are glued to the screen," Montague said in a statement.

U.S., U.K. to collaborate on health IT, data projects

Posted: January 24, 2014 - 3:45 pm ET
HHS and health authorities in the United Kingdom agreed to collaborate on a broad scope of health information technology and health data projects and practices.
A six-page memorandum of understanding (PDF) was to be signed Friday by HHS Secretary Kathleen Sebelius, Chief Technology Officer Bryan Sivak, and their counterparts in the National Health Service of England and the U.K.'s healthcare data handling and standards development agency.

Telemedicine Emerging as Rural ICU Solution

Doug Desjardins , January 23, 2014

While the high startup costs associated with telemedicine programs have presented a barrier to many rural hospitals, data suggests they contribute to lower costs and lower mortality rates

Since the first programs were launched in the early 2000s, telemedicine has become a staple of nearly every area of care in the healthcare industry. But one area where it is just beginning to carve out a niche is intensive care.
ICU beds account for about 7% of total acute care hospital beds in the United States but generate 13.4% of total spending, with the cost of an inpatient stay ranging from $2,500 to $4,000 per day, According to the Society of Critical Care Medicine.

Health IT Czar: Make EHRs More Doc-Friendly

Published: Jan 23, 2014
By David Pittman, Washington Correspondent, MedPage Today
WASHINGTON -- Physicians' effective use of electronic health records will play a critical role in the development of payment and delivery reforms, the country's new health information technology (IT) czar said in her first public comments.
The reliance on EHRs and the information they can provide physicians is why it's critical for federal regulations that address the development and use of EHRs be tailored to optimize their potential, Karen DeSalvo, MD, MPH, the new national coordinator for health information technology, said Thursday.

KLAS: Many Larger Practices Unhappy With Their EHRs

JAN 22, 2014 2:33pm ET
Three electronic health records software vendors substantially separate themselves from others serving the ambulatory market for practices of 11 to 75 physicians, according to new report on customer satisfaction from KLAS Enterprises.
Epic Systems Corp. scores highest with 85.3 points out of 100, followed by athenahealth (83.5) and Greenway (81.3). The next highest is eClinicalWorks at 72.8 and the lowest of 12 products by 11 vendors is McKesson at 58.7.

Patients to add to medical record online

22 January 2014   Rebecca Todd
Patients will be able to contribute to their own medical record and switch GP practice online, NHS England’s director of patients and information Tim Kelsey has said.
Kelsey’s ‘patient and public voice’ report to NHS England’s board this week describes the vision to “unleash the power of people to manage their own conditions."
NHS England will do this by “providing them with applications that allow them to monitor their lifestyles, for example activity and diet - but with the added ability to view, merge and enhance their full NHS medical record with the information they are recording about themselves,” the report says.

Sealed with a KIS

The team behind Scotland’s Key Information Summary won the award for ‘excellence in major healthcare IT development’ in the EHI Awards 2013 in association with CGI. Daloni Carlisle reports on a project that ran early, and without the consent rows that have bedevilled English projects.
21 January 2014
Few NHS IT projects are implemented ahead of schedule: especially when they involve sharing information across multiple providers using systems from multiple software suppliers.
Yet the Scottish Key Information Summary reached a milestone set for the end of 2014 in the summer of 2013.
Real improvements to real lives
The KIS is an electronic patient summary record created in primary care that, with the help of the patient, is shared across organisations in Scotland.

CHIME: Health IT regulation promises to be big story in 2014

January 23, 2014 | By Susan D. Hall
The growing debate over how and whether the FDA should regulate health IT will be one of the big stories of the year, Jeff Smith, assistant director of advocacy for College of Healthcare Information Management Executives (CHIME), said in a podcast at
"There are factions that want the FDA to have more defined and even tighter control over health IT, and then there are others who would rather have a self-regulatory regime. And as to which side is going to ultimately win out, it's not at all clear," he said.

Health data breach count tops 800

January 23, 2014 | By Ashley Gold
The "wall of shame" for health data breaches at the Department of Health and Human Services has seen a lot of action this month.
In the month of January alone, more than 70 health data breach incidents affecting more than 500 individuals have been added, according to Healthcare Info Security.
"HHS is performing maintenance to the online report, and there will be some fluctuations over the next few months in the public-facing reporting tool, which is unrelated to timeliness of reporting by covered entities," says Rachel Seeger, an OCR spokesperson, according to Healthcare Info Security. "The site is constantly being updated, so these numbers can, and will, fluctuate. As such, there may be additional 2012 breaches added to the list in the future."

HL7, Sparx issue tooling challenge

Posted on Jan 22, 2014
By Bernie Monegain, Editor
Standards organization Health Level Seven International, which bills itself as the global authority for interoperability in healthcare information technology, has partnered with Sparx Systems, which sells modeling tools based on open standards, to launch the second annual tooling challenge.
Developers are invited to produce a design specification for a tool that can be used to create Reference Information Model-derived information models. The challenge requires defining an updated HL7-UML profile for HL7’s Model Interchange Format static models using Sparx Systems Enterprise Architect.

Clinical decision support, CPOE get thumbs up from academics

Author Name Jennifer Bresnick   |   Date January 22, 2014 |
Formal academic studies about the implementation of clinical decision support (CDS) and computerized provider order entry (CPOE) are generally positive, according to a study of studies targeting the meaningful use of EHRs and associated technologies.  The report, published in the Annals of Internal Medicine, found that for the most part, health IT implementations were successful in reducing adverse events and increasing efficient and effective processes of care.  However, many key aspects of IT adoption have been underreported, including the reasons why implementations go awry, leading to significant gaps in the ability to study the industry’s progress.
Funded by the ONC, the research team found that at least 78% of studies focused on medication safety found positive effects from CPOE use.  The automated dose calculation features of the software helped reduce dosage errors anywhere between 37% and 80%.

Social media users would share health data, but only with privacy safeguards

Posted: January 23, 2014 - 3:00 pm ET
A vast majority of U.S. social network users who have health conditions would be willing to share their health information to help doctors improve care and to help other patients like them—if their privacy is protected.
That's according to the results of two online surveys reported in what is being billed as a discussion paper by the Institute of Medicine.
Indeed, 94% of social media users who have medical conditions would be willing to share their health data with doctors to improve medical care, provided they were afforded “appropriate anonymity,” said the 27-page report, “Social Networking Sites and the Continuously Learning Health System: A Survey.”

Physician EHR Adoption Leaps 21% In 2013

1/22/2014 01:25 PM
Healthcare providers and EHR vendors are making strides toward updating systems to qualify for Meaningful Use Stage 2.
Adoption of basic electronic health record (EHR) systems by office-based physicians increased 21% from 2012 to 2013, according to an issue brief from the National Center for Health Statistics (NCHS), a unit of the Centers for Disease Control and Prevention. Last year, 48.1% of physicians had basic EHRs, versus 39.6% in 2012.
Basic EHR systems, as the NCHS defines them, include functions for patient history and demographics, patient problem lists, physician clinical notes, comprehensive lists of patient medications and allergies, computerized orders for prescriptions, and the ability to view lab and imaging results electronically.

What Executives Should Know About Open Data

JAN 21, 2014 3:42pm ET
Not all data that’s valuable is internal and proprietary. New initiatives by governments as diverse as those of the United States, Mexico, and Singapore are opening the spigots of readily usable public data. Corporate information too is becoming more “liquid,” moving across the economy as companies begin sharing data with their business partners and, sometimes, consumers. Also surging is the richness of the information from data aggregators, which are assembling, rendering anonymous, and selling (to interested third parties) a wide range of data flows. Then add huge volumes of data from social-media interactions, available from providers of digital platforms such as Twitter and Facebook.
These new sources of open data represent an expanding trove of largely unexploited value. One everyday illustration of open data at work is a smartphone app that uses real-time data (provided by transit authorities) to tell commuters when the next bus or train will arrive. Using open or pooled data from many sources—all the businesses in a particular sector, for example—often combined with proprietary big data, can help companies develop insights they could not have uncovered with internal data alone.

John Halamka: How Karen DeSalvo can 'polish' ONC's strategy

January 22, 2014 | By Dan Bowman
While Beth Israel Deaconess Medical Center CIO John Halamka believes that Karen DeSalvo is the "right person" to lead the Office of the National Coordinator for Health IT at this point in time, there are several elements of the agency's strategy he says should be changed.
In a new post to his Life as a Healthcare CIO blog, Halamka (pictured)--who also serves as vice chair of the Health IT Standards Committee that makes recommendations to ONC--first and foremost, says that the electronic heath record certification program is in need of a redesign.

Merger of Michigan HIEs to create one of nation's largest exchanges

January 22, 2014 | By Susan D. Hall
Michigan's two largest health information exchanges plan to merge, creating one of the largest such organizations in the country, reports Crain's Detroit Business.
In October, the two organizations--Michigan Health Connect, based in Grand Rapids, and Great Lakes Health Information Exchange of East Lansing --announced an agreement to share data. At that time, it said members included 3,000 physician offices and 96 hospitals.

Telestroke lowers costs, improves outcomes

Laura Pedulli
Jan 20, 2014
Telestroke—or utilizing telemedicine to deliver stroke care—is an effective means to delivering quality emergency stroke care to remote hospitals and improving patient outcomes, according to a Mayo Clinic study appearing in the American Journal of Managed Care. Telestroke also appears cost-effective for society, the research found.
In telestroke care, a telestroke robot allows a patient with stroke to be examined in real time by a remote neurology specialist who consults via computer with an emergency room physician at another site, usually a rural hospital, which may not have neurology specialists. Mayo Clinic provides telestroke care by acting as a single source of specialized care to connect a network of multiple hospitals spokes.

Why Aren't Doctors More Tech-Savvy?

Email access, online scheduling, and electronic records would all make healthcare easier for patients. Here's why some doctors are still reluctant to modernize.
Olga Khazan Jan 21 2014, 8:30 AM ET
Whenever I feel like taking a trip back in time, I save myself the trouble of building a time machine and instead just head over to a doctor’s office. For a Millennial, or really anyone who lives a modern lifestyle, getting medical care is a rare departure from an otherwise technology-fueled existence.
First comes making the appointment, which usually requires a phone call. My gynecologist's office, for example, doesn’t use online booking, so scheduling a visit means calling them from my "open plan" office and describing what, if any, "the issue is." Layered on top of this indignity, my last name is basically impossible to spell or pronounce. “Yes, once again that’s K-H-A-Z-as-in-zebra-A-N.”
Filling out forms in triplicate in the waiting room is, for me, relatively painless. By now, I've perfected my ability write my address, insurance ID number, and the words "allergies to most plants and animals" in about 15 seconds or less.

ONC issues new guidance for more reliable EHRs

By Mike Miliard, Contributing Editor
The Office of the National Coordinator for Health IT hopes to make electronic health records safer through a new suite of checklists and recommended practices designed to help care providers and affiliated organizations optimize EHR safety. 
ONC officials say the checklists, Safety Assurance Factors for EHR Resilience (SAFER), are an important component of the Health IT Patient Safety Action and Surveillance Plan issued by the Department of Health and Human Services this past July.
"A basic premise of the Health IT Safety Plan is that all stakeholders have a shared responsibility to make sure that health IT is safely implemented and that it is used to improve patient safety and care," said Jacob Reider, MD, chief medical officer at ONC, in a press statement.

EU rule makes research 'impractical'

17 January 2014   Rebecca Todd
New data protection rules being proposed for the European Union would make conducting research using data in the EU “impractical”, the Department of Health says.
A proposed General Data Protection Regulation would require researchers to request explicit and time limited consent from citizens for using either identifiable, pseudonymised or linked data.
A report from DH deputy director of research information and intelligence, Peter Knight, to the Informatics Services Commissioning Group, says current UK health legislation means researchers conducting research in the public interest do not have to get consent for access to sensitive personal data in an identifiable form.

Study: Telemedicine not optimal for palliative care

January 21, 2014 | By Ashley Gold
Telemedicine is not preferable for optimal palliative care, though patients do have a positive attitude toward using it, a new study published in the journal Telemedicine and e-Health finds.
The basis of the study results were four semi-structured group interviews with 17 health professionals in three different palliative care teams in Denmark, taking place from 2009-2010.
According to the study, participants were concerned about the ethical and practical concerns of modern telecommunication; particularly, they felt strongly against permanent telemonitoring in the patient's home.

Big growth expected for telehealth

Beth Walsh
Jan 20, 2014
Telehealth services will jump significantly in the next few years, with the number of patients worldwide using the services estimated to rise from fewer than 350,000 in 2013 to about 7 million in 2018, according to a report published by IHS Technology.
Worldwide revenue for telehealth devices and services also is expected to increase--from $440.6 million in 2013 to $4.5 billion in 2018, according to the report, " World Market for Telehealth – 2014 Edition ." 

Do providers have the EHRs for Stage 2 Meaningful Use?

Author Name Jennifer Bresnick   |   Date January 20, 2014 |
Providers may be lacking one big, basic ingredient for a successful Stage 2 attestation: a certified EHR capable of meeting the Meaningful Use objectives.  The National Center for Health Statistics (NCHS) has released a new data brief that highlights the relatively small number of providers operating on an updated EHR as the industry enters the second stage of the EHR Incentive Programs.
While 69% of office-based physicians reported that they intended to participate in meaningful use during a survey in 2013, only 13% of those providers also had an EHR system capable of supporting 14 of the Stage 2 core and menu objectives.  While this number seems exceedingly low, one should note that the survey was conducted between February and June of 2013, long before the majority of EHR vendors had even finished developing their 2014 ONC certified technology.

mHealth Regulations: What's in Store?

by Rebecca Vesely, iHealthBeat Contributing Reporter Tuesday, January 21, 2014
2014 is shaping up to be an important year for the regulation of mobile health applications -- with increased clarity expected on which apps will face regulatory scrutiny and who will take charge of the process, industry experts said.
A new report to Congress is expected by March, and further guidance on aspects of mobile health apps, including interoperability, could come this summer. In addition, several pieces of pending legislation seek to further delineate the regulation of the industry.
The stage was set in September 2013, when FDA released long-awaited final guidance on mobile medical apps. The guidance laid out the agency's current thinking on this fast-evolving space and made clear that it would only apply its regulatory oversight to a subset of mobile apps that can transform a mobile platform into a regulatory medical device.
----- Security Concerns Won't Go Away

Scott Mace, for HealthLeaders Media , January 21, 2014

At least one critic is calling for the federal health information exchange website to be shut down until a complete security audit can be conducted. Since that's unlikely to happen, let's hope the government is judiciously reinforcing its data breach prevention policies.

For months, Republicans in Congress have been feeding fears of a massive data breach at Given the site's many, many shortcomings, would appear to be a prime target for some sort of data compromise. Its sheer size is reason enough for the bad guys to perpetually keep trying to break in.
And yet, to date, no breaches of any significance have occurred.

How can confidentiality of digital patient records be ensured?

Posted on Dec 16, 2013
By Dillan Yogendra, Managing Editor, HIMSS Europe
As reported last week, the benefits of better data are clear and NHS Lothian, as the example, does not intend to place unnecessary restrictions on clinical staff needing to access critical information to save lives and to respond to the needs of the 800,000-strong patient population. However the public is growing concerned about how their information is shared and how access to it is controlled.
With this in mind, NHS Lothian is the first of 14 health boards in Scotland to bring in automated privacy monitoring. Suspected breaches can be stopped before they can escalate into serious incidents, and better internal intelligence means staff can be addressed on awareness and cultural issues head on.

MU creates 'medical bridges to nowhere'

Posted on Jan 15, 2014
By Erin McCann, Associate Editor
As far as Patrick Soon-Shiong is concerned, the $34 billion health IT and electronic medical record incentive program was a grave misstep for the healthcare industry -- but not necessarily for the reasons one might think. 
Soon-Shiong, MD, who serves as chairman and chief executive officer of healthcare IT company NantHealth and heads the Chan Soon-Shiong Family Foundation, said one of the biggest failures that led to the creation of the Meaningful Use EHR Incentive Program was an inherently flawed mindset of how we view the healthcare industry. 
"Nobody has looked at healthcare as a systems approach," he said, speaking at the Clinton Foundation's 2014 Health Matters Conference Tuesday. 

The Biggest Big Data Myths of 2013

JAN 17, 2014 3:30pm ET
Big data plagued businesses in 2013. The IT community should expect no less in 2014, as businesses of all sizes face the challenges big data presents and seek out ways to manage data growth.
Many companies succeed in implementing a strong information management strategy that aides in processing all of this information, while others stumble with big data management. But how these businesses should be handling big data seems to change depending on the expert, creating confusion around what the best data management strategy may be. While the topic of big data has existed for many years, several myths continue to perpetuate and add to the already complex nature that surrounds it . Here we take a look at five myths about big data that I hope cease to exist as we move into the New Year.

Glaser reflects on decade of health IT

Posted on Jan 20, 2014
By Bernie Monegain, Editor
To say that John Glaser has had a front-row seat in the health IT arena over the past 10 years – and the 10 years before that – would be wrong. He’s been in the trenches, sleeves rolled up. Glaser has advocated for the adoption of EHRs through his work with CHIME, HIMSS, AMIA, the eHealth Initiative, Markle Foundation and before congressional committees. He also did a stint as adviser at the ONC. As CIO of Partners HealthCare in Boston, he guided the health system into the digital age – long before many other care providers across the country could even conceive the possibilities. Today, he continues his HIT work through these many channels also as CEO of the Health Services Business Unit of Siemens Healthcare.

HIE reduces repeat imaging in the ER

Posted on Jan 20, 2014
By Anthony Brino, Editor, HIEWatch
The benefits of reduced imaging from the use of health information exchange have largely been the stuff of anecdote and theory, until now.
In one of the first large-scale empirical studies on the links between HIE participation and imaging in hospital emergency departments, researchers from Mathematica Policy and the University of Michigan found redundant CT scans, X-rays and ultrasounds decreased fairly significantly — with savings in the millions of dollars.
Mathematica researcher Eric Lammers and colleagues compared the rates of repeat CT scans, chest x-rays and ultrasounds at 37 EDs connected to an HIE to the rates at 410 EDs not connected to an HIE in California and Florida between 2007 and 2010. The team used the state emergency department database and HIMSS Analytics’ listing of hospital HIE participation, and defined repeat images as those given to patients for examining the same region of the body and performed within 30 days at unaffiliated emergency departments.

IEEE Partners With Software Company to Foster Interoperability Through Middleware Application

Written by Helen Gregg (Twitter | Google+)  | January 17, 2014
The Institute of Electrical and Electronics Engineers has signed a memorandum of understanding with software company ICUcare to develop an industry-standard format and middleware application programming interface to allow providers to map data from medical devices into electronic health record systems.
The data format standards and API would help create a more open market for devices and systems integration throughout the healthcare sector, increasing interoperability while reducing costs.

Study: Male med students find EHRs easier to use

Beth Walsh
Jan 19, 2014
Male medical students were more likely than their female counterparts to report that EHRs were easy to use, according to a study published in the AHIMA Foundation's Perspectives in Health Information Management.
The high ease-of-use scores were associated with high scores of computer self-efficacy, openness to change and high levels of "conscientious personality," according to the researchers, who were affiliated with the University of Florida. The study included the responses of 126 third-year medical students. They also wrote that determining medical students' individual beliefs about the usefulness and usability of EHRs can enable medical schools to better tailor EHR training and improve clinicians' acceptance of the systems.

Kaiser Permanente to Aid Health IT Startups

January 17, 2014
DreamIt Ventures has announced the slate of nine healthtech startups entering its Baltimore accelerator—which is designed to speed the growth and success of early-stage health IT companies—as well as the addition of Kaiser Permanente as a strategic partner for the program.
Kaiser will join industry leaders Johns Hopkins University and Northrop Grumman Corporation, and economic development organization BioHealth Innovation as partners for the program.

Few Docs Ready for Stage 2 'Meaningful Use'

Published: Jan 17, 2014
By David Pittman, Washington Correspondent, MedPage Today
WASHINGTON -- Roughly one physician in eight has an electronic health record (EHR) system capable of supporting most requirements for Stage 2 of the "meaningful use" program, a government survey found.
Only 13% of office-based physicians reported an intention to participate in the EHR incentive program and had a system meeting 14 of the 17 Stage 2 core objectives, according to a report released this week from the CDC's National Center for Health Statistics (NCHS).
About 56% of all physicians intended to participate in the EHR incentive program but didn't meet the core objectives the NCHS asked about.


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