Saturday, March 08, 2014

Weekly Overseas Health IT Links - 8th March, 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.
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CMS Gives Stage 2 Flexibility, Might Tone Down Stage 3

FEB 27, 2014
The Centers for Medicare and Medicaid Services announced Thursday at HIMSS14 the availability of hardship exemptions for compliance with Stage 2 electronic health records meaningful use requirements during 2014. Further, Stage 3 ambitions may be scaled back somewhat, as officials acknowledge the regulatory burdens that providers have with meaningful use, ICD-10 and health care reform.
The exemptions would forestall providers paying a penalty through reduced Medicare reimbursements--starting in 2015--for failure to meet meaningful use requirements.
CMS Administrator Marilyn Tavenner said she understands there have been concerns about providers being able to meet deadlines for collecting data during a 90-day reporting period in 2014, and then attesting for meaningful use. “We have tried to make changes in the schedule, pushing back Stage 2 as far as we could,” she said, referring to a previously announced third year for Stage 2 and a delay in Stage 3. “Now is not the time for us to stop moving forward.”
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Black Book names best of the best EHRs

Posted on Feb 28, 2014
By Erin McCann, Associate Editor
Black Book Rankings on Friday unveiled its top-ranked EHRs for 2014, scoring vendors across six different client experience categories. 
The highest ranking vendors across their respective categories include: Allscripts, Cerner, Epic Systems, GE Healthcare, HCS EMR, Healthcare Management Systems, Healthland, McKesson, MEDITECH, NextGen, Quadramed, Prognosis, RazorInsights and Siemens Medical across the survey acute care subgroups.
For hospitals with fewer than 100 beds, the Mobile, Ala.-based CPSI walked away with the highest award for customer-experience scores. This marks the fourth consecutive year CPSI has ranked as top vendor in this category, Black Book officials say. 
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Debate on mobile app regulatory oversight heats up

February 28, 2014
By Judy Mottl, for FierceMobileHealthcare
The mHealth Regulatory Coalition says a proposed law to eliminate oversight by the U.S. Food and Drug Administration  on mobile healthcare software poses serious risks to patients and that Congress must play a key role in ensuring FDA guidance on mobile applications.
The coalition's statement, released Thursday, is its latest salvo against the proposed Preventing Regulatory Overreach To Enhance Care Technology Act of 2014, a bill that aims to curb FDA regulatory power regarding mobile health apps.
The PROTECT Act, introduced into the Senate two weeks ago by Sens. Angus King (I-Maine) and Deb Fischer (R-Neb.), would put the National Institute of Standards and Technology in charge of technical standards regarding clinical software, and stipulates that the White House administration and Congress develop a risk-based regulatory framework. The bill is a companion bill to the SOFTWARE Act, introduced in the House of Representatives in October.
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HIMSS Survey: Providers Making mHealth Progress

February 26, 2014
Providers are using mobile devices to view patient information, but they are still early in their adoption and implementation of mHealth, according to a HIMSS Analytics survey published at the HIMSS 2014 conference. 
The survey findings offer examples of the progress made and hurdles that providers face when integrating mobile technologies into their facilities to improve patient care. Respondents indicated that the top benefit to having mobile technologies in their facilities was increased access to patient information and the ability to view data from a remote location.
According to the survey, 69 percent of respondents use a mobile device to view patient information, but only a third (36 percent) use mobile technologies to collect data at the bedside.
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At HIMSS Conference, Patients Emerge as Driving Force for 'Triple Aim' of Health Care

by Jane Sarasohn-Kahn Friday, February 28, 2014
In his keynote address at the Healthcare Information and Management Systems Society's 2014 conference, Aetna CEO Mark Bertolini called to move health care "as far away as possible from the hospital." Hospital providers are the core of HIMSS' membership, so the inspiring talk from volume-to-value was a call to arms ... might I even whisper the word, "disruption?" It's a world of doing more with less. Even health IT labor hiring, recently a tight market, appears to be loosening up.
We're now in the do-more-with-less era of health care. The fact is that CIOs are now thinking like CFOs: the number one challenge hospital CIOs cited in the 25th Annual HIMSS Leadership Survey was financial concerns: changing payment models, financial viability and lack of financial support, among other flavors falling under the cost-constraint umbrella.
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'Exciting' care.data info plan promised

26 February 2014   Lis Evenstad
NHS England will use the six month delay to care.data to launch a re-engagement programme to get the public on board.
Giving evidence about the programme to combine hospital, GP and other data to the Commons’ health select committee yesterday, Tim Kelsey, NHS England’s director of patients and information, acknowledged there had been problems communicating the project.
“We had a lot of confusion, suspicion and anxiety,” Kelsey told MPs. “We are going to be launching a very exciting programme which specifically articulates the purpose of this programme. That is why we have this extension.”
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Hillary Clinton: Technology provides healthcare reform with necessary evidence

February 26, 2014 | By Ashley Gold
Debates in Washington, D.C., may sometimes feel like they take place in an "evidence-free zone," but healthcare information technology provides the evidence needed to achieve better healthcare for all, Hillary Clinton said Wednesday during a keynote address at the Healthcare Information and Management Systems Society's annual conference in Orlando, Fla.
Clinton--former secretary of state, New York state senator and first lady (pictured right)--spoke to a crowd of nearly 6,000 and talked about how technology enables better care, helping the healthcare industry see what's beyond the horizon and allowing for better-informed decision making.
"Scare tactics have not helped us understand how to improve care and lower costs," Clinton said. "That's precisely why we need health information technology so badly--to give back to evidence-based policy debates."
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A Decade of ONC: Past and Present National Coordinators Weigh In

by Kate Ackerman, iHealthBeat Editor in Chief Thursday, February 27, 2014
ORLANDO -- A decade after the creation of the Office of the National Coordinator for Health IT, four of the five individuals who have headed up the agency came together on Wednesday to discuss the health IT progress made over the last 10 years, work that remains and how ONC's role may change in the future.  
In his State of the Union address on Jan. 20, 2004, President George W. Bush announced a goal to ensure that most U.S. residents have electronic health records within the next 10 years. He told the country, "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs and improve care."
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ONC chiefs compare notes on past decade

Posted on Feb 27, 2014
By Tom Sullivan, Editor, Government Health IT
David Brailer, MD tracks the bipartisan nature of health IT back to a single night.
When President Bush was running for reelection in 2004, John Kerry’s campaign struck Bush with criticisms about healthcare, and Bush’s people called Brailer for some talking points.
"I’m sorry David Blumenthal isn’t here because he was advising (ONC) but he was also advising Kerry when he ran against Bush," Brailer said at at gathering of four former national coordinators at HIMSS14 on Wednesday. "We spent the entire night trying to get two teams to back off of each other. We both agreed the next morning we made health IT bipartisan," by keeping it out of the election campaigns. "I don’t think I’ve ever told that story."
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The Debate Over ‘Re-Identification’ Of Health Information: What Do We Risk?

Posted By Daniel Barth-Jones On August 10, 2012
Dateline: May 18, 1996 – The collapse and attack. Massachusetts Governor William Weld wasn’t feeling well under his commencement cap and gown. He was about to receive an honorary doctorate from Bentley College and give their keynote graduation address. But, unbeknownst to him, he would instead make a critical contribution to the privacy of our health information. As he stepped forward to the podium, it wasn’t what Weld said that now protects your health privacy, but rather what he did: He teetered and collapsed unconscious before a shocked audience.
Weld recovered quickly and the incident might have passed quietly but for an MIT graduate student. Latanya Sweeney’s studies had brought to her attention hospital data released to researchers by the Massachusetts Group Insurance Commission (GIC) for the purpose of improving healthcare and controlling costs. Federal Trade Commission Senior Privacy Adviser Paul Ohm provides a gripping account of Sweeney’s now famous re-identification of Weld’s hospitalization data using voter list information in his 2010 paper “Broken Promises of Privacy [1].”
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Spanish hospital finds ROI in IT

Posted on Feb 25, 2014
By Frank Irving, Editor, Medical Practice Insider
Hospital Marina Salud de Denia, described as a model for what the hospital of the future should look like, is well on its way to fulfilling its promise.
Newly opened in 2009, the facility reached 100 percent paperless status in three years and received the highest rating — Stage 7 — on HIMSS Analytics' EMRAM scale, which evaluates a hospital's digitization level. Marina Salud, which serves a population of more than 150,000, is the first hospital in Spain, and the second in Europe, to attain Stage 7 status.
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ONC Proposes 2015 Edition of EHR Technology Certification Criteria

FEB 26, 2014
A proposal for the 2015 Edition of electronic health record technology certification criteria was published today in the Federal Register by the Office of the National Coordinator for Health IT. Speaking at a HIMSS14 panel session, ONC's Federal Policy Division Director Steve Posnack said it has been about two years since there was proposed rulemaking for EHR technology certification criteria. However, that's about to change with the 2015 Edition, which signals a new approach. 
Going forward, ONC intends to update certification criteria editions every 12 to 18 months in order to provide smaller, more incremental regulatory changes and policy proposals.
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Incentives to Promote Technology Use in Healthcare Working

Marcia Frellick
February 25, 2014
Government incentives to accelerate technology use in healthcare are working, results from the latest Healthcare Information and Management Systems Society (HIMSS) leadership survey suggest.
More than 90% of hospital leaders report that their hospitals have already qualified for the first stage of meaningful use, which focuses on electronically capturing health information in a standardized format and using that information to track clinical conditions. The majority report that they expect to achieve the more rigorous requirements of the second stage of meaningful use this year.
The findings, released at the HIMSS Annual Conference and Exhibition in Orlando, Florida, show that this year marked a shift in priorities. Last year's focus was on achieving meaningful use of electronic health records; this year's focus is on support for physicians. That emphasis includes computerized physician order entry and clinical decision support solutions.
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Incentives to Promote Technology Use in Healthcare Working

Marcia Frellick
February 25, 2014
Government incentives to accelerate technology use in healthcare are working, results from the latest Healthcare Information and Management Systems Society (HIMSS) leadership survey suggest.
More than 90% of hospital leaders report that their hospitals have already qualified for the first stage of meaningful use, which focuses on electronically capturing health information in a standardized format and using that information to track clinical conditions. The majority report that they expect to achieve the more rigorous requirements of the second stage of meaningful use this year.
The findings, released at the HIMSS Annual Conference and Exhibition in Orlando, Florida, show that this year marked a shift in priorities. Last year's focus was on achieving meaningful use of electronic health records; this year's focus is on support for physicians. That emphasis includes computerized physician order entry and clinical decision support solutions.
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Industry Groups Urge Sebelius to Hold Off on MU

Lena J. Weiner, for HealthLeaders Media , February 25, 2014

In a letter citing concerns for patient safety and a lack of vendor support, more than 40 physicians groups and medical associations are urging HHS Secretary Kathleen Sebelius to allow more time for Meaningful Use attestation.

A coalition of more than 40 physicians groups and medical associations is calling for additional time to meet the goals of the Meaningful Use program. In a letter to U.S. Health and Human Services Secretary Kathleen Sebelius Friday, the group asked for "additional time and new flexibility" to implement electronic health record systems.
The letter was released as the 2014 HIMSS conference was about to begin in Orlando, FL.
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State of health IT interoperability: An upward climb

February 24, 2014 | By Ashley Gold
Healthcare organizations are working toward improving interoperability--and know it is vital to their survival and growth in the evolving healthcare market, according to a new HIMSS Analytics report, released at the organization's annual conference this week.
In the report, a focus group of hospital and health system executives identified key interoperability trends and discussed barriers to sharing information with other organizations.
One of the biggest: the inability of some statewide health information exchanges (HIEs) to accept certain data sets that hospitals are required to provide under Meaningful Use.
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Care.data should be opt-in - Jarman

25 February 2014   Rebecca Todd
The care.data programme should be opt in not opt out, well-known health data expert Professor Brian Jarman has said.
Professor Jarman is director of the Dr Foster Unit at Imperial College London and developed the methodology for the Hospital Standardised Mortality Ratio.
In an interview with EHI, he said the care.data programme, which is being developed to link hospital and GP datasets and share information with researchers and others, should be set up on an opt-in basis.
He has shared his views with NHS England’s chief data officer Geraint Lewis and director of patients and information, Tim Kelsey. However, he does not sense much enthusiasm for the idea.
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HIMSS14: Regulatory Showdown Looms Over Mobile Health

FEB 25, 2014
A legislative showdown is brewing between Congress and the U.S. Food and Drug Administration over the right balance between promoting innovation in a fledgling mobile health industry and protecting patient safety. 2014 could be the year that several laws are passed with significant implications for health I.T., according to a HIMSS14 panel discussion on congressional affairs.
"You have the FDA rule that came out in 2013 which basically said they will regulate mobile apps as a medical device if they see fit. So, that is a cause for some concern," said Mitchell Vakerics, Legislative Counsel for Congresswoman Renee Ellmers (R-N.C.), who sits on the House Energy and Commerce Committee where she serves on the Health, Communications and Technology Subcommittee. 
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It's 'time to dance' with your patients

By Diana Manos, Senior Editor
Patient engagement is a critical part of almost every aspect of the Affordable Care Act and HITECH, and yet cultural attitudes, fears and logistical obstacles hold back the reform set up by these laws.
“Start learning to dance with your patients, instead of wrestling with them,” said Russell Kohl, MD, a speaker at the all-day HIMSS14 workshop on transforming healthcare delivery through the patient-centered medical neighborhood.
“As doctors, we like to think we’re Fred Astaire, moving the patient smoothly through the care process,” Kohl said. “But, don’t forget that Ginger Rogers did everything backwards and in high heels. It’s not so smooth for the patient.”
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Should doctors bend to EHRs, or EHRs meet doctors needs?

By Diana Manos, Senior Editor
The ultimate question comes down to: are EHRs made to help physicians or are physicians being made to work with their EHRs? That's the question asked yesterday in a HIMSS14 session aimed at getting rid of some of the frustrating bugs that can lead to discomfort, if not out-right catastrophe in medical care.
Imagine the unwelcome surprise a patient receives when they needed Tylenol at the hospital, the doctor ordered it electronically, and in walks a nurse with a Tylenol suppository.
This happens all the time, said Zach Hettinger, MD, director of Informatics Research for MedStar Health's National Center for Human Factors Engineering in Healthcare.
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Nursing informatics adds value as healthcare is transforming

Posted on Feb 23, 2014
By Richard Pizzi, Editorial Director
Over the past decade, nursing informaticists have moved from a supporting role at hospitals to one that is mission-critical, said three of the profession’s leaders on Sunday at HIMSS14.
The state of the nursing informatics workforce was the primary topic of discussion at the opening panel of the Nursing Informatics Symposium here, as nursing informaticists discussed the results of the fourth edition of the HIMSS Nursing Informatics Workforce Survey and the future of the profession.
“There is an expanding universe of nursing informatics practice,” said Ruth Schleyer, chief nursing informatics officer at Providence Health & Services, a Renton, Wash.-based health system. She said the challenges confronting the profession – including new delivery models for communities, an increasing emphasis on patient engagement and genomics-driven care – would offer more career opportunities for CNIO aspirants.
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Meaningful Use Timeline Concerns Continue To Be a Hot Topic at HIMSS14

by Kate Ackerman, iHealthBeat Editor in Chief Tuesday, February 25, 2014
ORLANDO -- Attendees at the Healthcare Information and Management Systems Society's annual conference and exhibition on Monday were abuzz about a call by a large coalition of provider organizations to delay the timeline of the meaningful use incentive program and to offer providers more flexibility. The letter, which was sent to HHS Secretary Kathleen Sebelius, comes amid rumblings that the federal government could make an announcement at the conference that could offer providers some "relief" on meaningful use.
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HIMSS: Providers View IT as a Revenue Generator

Scott Mace, for HealthLeaders Media , February 25, 2014

Cleveland Clinic is increasing its ROI on the EHR infrastructure it has invested in by working toward becoming, in effect, the new data center for a growing number of other, otherwise non-affiliated, providers.

Traditionally, information technology has been one of healthcare's more expensive cost centers. But for some large players, and even a few smaller ones, that is changing, and at HIMSS this week we are seeing birth of healthcare IT as a revenue center for those providers.
The first clue I received this week was when I was briefed on an announcement between Cleveland Clinic and Dell made at the show in Orlando.
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Medical Homes May Not Be the Answer

Published: Feb 25, 2014
By David Pittman, Washington Correspondent, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania

Action Points

  • This is a study of volunteering primary care practices that participated in a medical home pilot project over a 3-year period.
  • Pilot participation was associated with statistically significantly greater performance improvement, relative to comparison practices, on only one of 11 investigated quality measures.
  • Pilot participation was not associated with statistically significant changes in utilization or costs of care.
A patient-centered medical home (PCMH) demonstration project did little to reduce costs and utilization or improve the quality of care, researchers found.
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Carilion Clinic Pilot Emphasizes Predictive Analytics

February 21, 2014
The Roanoke, Va.-based Carilion Clinic has identified 8,500 patients at risk for developing heart failure in a pilot project that could lead to early intervention and better care for these patients.
The pilot was completed in collaboration with IBM and Epic. The results were achieved through predictive modeling of data in Carilion Clinic’s electronic medical record (EMR), including “unstructured” data such as clinicians’ notes and discharge documents that are not often analyzed.
Using IBM’s natural language processing technology to analyze and understand these notes in the context of the EMR, the inclusion of unstructured data provides a more complete and accurate understanding of each patient, officials say.
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ONC proposes 2015 CEHRT criteria

Beth Walsh
Feb 23, 2014
The Office of the National Coordinator for Health IT (ONC) has issued proposals for the 2015 edition of EHR certification criteria.
This is the first time ONC is proposing certification criteria separate from the Centers for Medicare & Medicaid Services' Meaningful Use regulations, according to a release, which signals the agency's new regulatory approach of more incremental and frequent rulemaking. This will enable ONC to update certification criteria more frequently to reference improved standards, officials say, and allow for regulatory clarity, with more comments solicited on potential proposals.
"The proposed 2015 Edition EHR certification criteria reflect ONC's commitment to incrementally improving interoperability and efficiently responding to stakeholder feedback," said National Coordinator Karen DeSalvo, MD, MPH, MSc, in a statement. "We will continue to focus on setting policy and adopting standards that make it possible for healthcare providers to safely and securely exchange electronic health information and for patients to become an integral part of their care team."
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Continua, HIMSS introduce Personal Connected Health Alliance

Posted on Feb 24, 2014
By Tom Sullivan, Editor, Government Health IT
HIMSS Board Chair and Partners HealthCare deputy CIO Scott MacLean on Monday revealed a new collaboration between the Continua Health Alliance, HIMSS and the mHealth Summit.
“Health care is clearly moving in the direction of greater consumer engagement and delivery outside of traditional care settings,” said H. Stephen Lieber, president and CEO of HIMSS WorldWide.
Increasing consumer engagement is the catalyst for what the three founding members christened as the Personal Connected Health Alliance.
PCHA’s overarching mission, Lieber explained, will be to “promote the adoption of technology designed to produce highly informed and integrated solutions,” or what PCHA described as personalized health tools that meet lifestyle needs.
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Healtheway convenes Carequality to take HIE to the next level

Posted on Feb 24, 2014
By Tom Sullivan, Editor, Government Health IT
What will it take to ratchet health information exchange up to the next level?
The answer that anyone paying attention would fire back: interoperability.
Which is not to suggest it will be easy.
“We’ve seen substantial progress in enabling HIE and connecting networks,” said Mariann Yeager, executive director for Healtheway. “But it’s time to have an interoperability framework that will allow exchange to occur in a way inclusive to all industry stakeholders.”
A cadre of those stakeholders, in fact, approached Healtheway asking it to be the conveyer of such a framework.
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Avoiding MU Pitfalls Starts with Following Fundamentals

Christopher Cheney, for HealthLeaders Media , February 21, 2014

Building electronic health record systems that comply with the federal Meaningful Use program is a daunting task for providers large and small. But basic "regulatory compliance is a far larger day-to-day challenge" than fighting fraud, says one health system CIO.

When it comes to meeting Meaningful Use requirements, picking the right partner and setting the right policies are the best ways to avoid running afoul of the law or federal regulators, according to a pair of healthcare chief information officers.
"You're making a multimillion dollar investment," said Brian Sandager, CIO at Circle Health, the corporate parent of Lowell General Hospital in Massachusetts. "You want to select a partner who's going to be with you for a very long time."
Finding an EHR partner with longevity potential is particularly important because Meaningful Use is a three-stage process, the Circle Health CIO said. "I can't imagine health systems that are dealing with vendors that are consolidating. To be forced into change has to be an awful feeling as a CIO," he said. "Healthcare is complex enough."
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Hospitals Have New Tool to Save Money

'Waste Index' Lets Them Target Areas Where Costs Appear to Be Out of Whack

By Laura Landro
Updated Feb. 23, 2014 5:03 p.m. ET
America's hospitals need to go on a diet.
Hundreds of billions of dollars are wasted in our health-care system each year. In 2009 alone, $750 billion was spent in the U.S. on unnecessary health services, according to a 2012 report from the Institute of Medicine.
Now, a "waste index" developed for hospitals is giving them the information they need to eliminate waste without compromising care.
The waste index was developed by Premier Inc., a purchasing alliance among hospitals that conducts quality-improvement programs for its members. The index was created to calculate the average savings that could be generated each year by a typical 200- to 300-bed hospital in each of 15 efficiency measures, including labor productivity, overuse of blood transfusions and unnecessary lab tests.
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Enjoy!
David.

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