Saturday, May 10, 2014

Weekly Overseas Health IT Links - 10th May, 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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DirectTrust Reaches 200,000 Individual Accounts, Begins Testing

Greg Goth
MAY 2, 2014 1:04pm ET
A non-profit trade alliance that advances secure health information exchange via the Direct Protocol has expanded its trusted, national network to include 26 Direct exchange health information service providers. Washington, D.C.-based DirectTrust has also begun extensive HISP-to-HISP interoperability testing to ensure continued reliability of the network.
 The 26 HISPs now provide Direct exchange services to more than 5,000 healthcare organization--including medical practices, clinics, hospitals, pharmacies and laboratories-- with nearly 200,000 individual Direct accounts and addresses nationwide.
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What's necessary for a sustainable telehealth program?

May 2, 2014 | By Judy Mottl
Developing a telehealth program requires more than just hardware, software and network system capabilities and presents more than a few hurdles, from costs, to regulatory requirements to securing patient data and privacy.
As a new study reveals, creating a cost-effective sustainable teleheath strategy first requires providers and payers to understand the market and the three channels of engagement between providers, patients and communities.
"Telehealth programs are more likely to succeed when they integrate appropriate services across channels to build multi-faceted relationships with patients, referring physicians and health system partners," states a newly released EY report, called "Shaping Your Telehealth Strategy."
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Medical device safety: A path forward

May 2, 2014 | By Ashley Gold
The medical device community is far behind other fields in its ability to alert patients about safety concerns--there's no national system that identifies concerns about things like implantable devices and glucose meters, according to a post by Gregory Daniel, managing director for evidence development and innovation, at the Brookings Institution's Engelberg Center for Health Care Reform.
The article points out that patients are "bombarded" by news stories about device recalls, but have no exact way of knowing whether their device is a cause for concern unless they have its serial number at the ready. And because most medical device procedures take place in hospitals, providers often lack this critical information. 
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New ICD-10 Transition Date Set for Oct. 1, 2015

Written by Helen Gregg (Twitter | Google+)  | May 01, 2014
CMS has announced the ICD-10 transition will take place Oct.1, 2015.
A CMS spokesperson issued the following statement Thursday.
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Tech Preps Healthcare Organizations For Lawsuits

5/1/2014 09:06 AM
Healthcare organizations spend and worry more about litigation and regulations than their counterparts in many other industries, study finds. Specialized software helps.
When a Southern hospital fired its IT director for cause, the disgruntled ex-employee quickly countered by filing two lawsuits. That hospital is not alone: Healthcare organizations faced a growing number of investigations and litigation in 2013, according to a report from Norton Rose Fulbright, a multinational law firm.
The hospital's attorneys sought help from CynergisTek, a consulting firm focused on regulatory compliance in healthcare, said CynergisTek CEO Mac McMillan, who also is chair of the Health Information Management Systems Society (HIMSS) Privacy and Security Policy Task Force. The former IT director raised nine issues with the Department of Health and Human Services' Office of Civil Rights, McMillan told InformationWeek, but the hospital's best-practices, preparedness, and technologies ensured it quickly negated all but one of the ex-employee's claims.
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Why eHealth Isn’t a Magic Bullet for Patient Engagement

  • By Amy Bucher, Wellness & Prevention
  • 05.02.14 11:40 AM
One of the biggest pain points with a technology solution, particularly in the health and wellness area where I work, is getting people to engage. By this I mean not just enrolling and participating in a program initially — which you can often get people to do by offering an incentive — but staying with the program over time.
We measure this through usage metrics like click rates and logins, but as a psychologist, what I’m really concerned with is that people stick with lifestyle changes long enough to see the effects on their health.
On the surface, technology-enabled health solutions, what I’ll call eHealth, seem like they should solve a lot of the problems we have in getting people to engage with their health over the long term. Thinking back to the principles of self-determination theory, eHealth solutions should support fundamental human needs pretty well:
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Why Healthcare Struggles with Mobile Device Encryption

APR 30, 2014 11:19am ET
Just consider the following three cases: Advocate Health Care experienced the second biggest HIPAA data breach in the nation after four unencrypted laptops were stolen from its facility, compromising the personal health information of more than 4 million people; Concentra Health Services had an unencrypted laptop stolen from its Springfield Missouri Physical Therapy facility; QCA Health Plan reported that an unencrypted laptop containing files on 148 people was stolen from a worker’s car. 
The objective of encryption is to provide confidentiality protection for information. Since encryption is now provided either out-of-the-box or through add-on products, this no- or low-cost solution can significantly reduce the likelihood of breaches from occurring on mobile devices.  Encryption is available and enabled by default on iPhones, iPads and Windows Phone 8 and RT devices. It’s also built into BlackBerry and Android devices. BitLocker Drive Encryption became available in 2009 as part of the Windows 7 operating system. 
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10 Technologies on the Rise

New software and devices are reshaping the way physician groups conduct business operations, clinical assessments and patient interactions.
Medical Practice Insider compiled summaries of 10 such technologies with a focus on how they enhance the physician experience or business operations within a small or midsize practice.
Spanning integrated mobile communications, cloud computing, innovative form factors or customization capabilities, we asked the developers what makes their device or app unique in the market. And they framed their growth plans for the next two years.
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Docs give short shrift to vital signs, lab results in electronic notes

April 29, 2014 | By Marla Durben Hirsch
Physicians do not devote the same amount of attention to all of the information in an electronic note, virtually ignoring medication lists, vital signs or lab results, according to a new study in Applied Clinical Informatics.
Researchers from Baystate Health in Springfield, Massachusetts, and elsewhere, conducted a study to determine how physicians distribute their visual attention when reading electronic notes, measuring the time spent on different parts of the note and the reading rates. They used an eye tracking device to assess the attention patterns of 10 hospitalists. They then compared the visual analysis with the content of simulated verbal hand-offs for each note and debriefing interviews.
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King's Fund warns crisis "inevitable"

1 May 2014   Lyn Whitfield
A financial crisis in the NHS is “inevitable” by 2015-16 or even sooner, the King’s Fund has warned.
In a report due to be launched this morning, the think-tank effectively says that the NHS as a whole will fail to meet the ‘Nicholson challenge’, while some organisations will need emergency support.
The Nicholson challenge was set out by the just-retired chief executive of NHS England, Sir David Nicholson, in 2008.
He warned that the NHS could face a funding gap of £20 billion by 2015-16 as a result of flat funding and rising demand, caused by an ageing population and a growing burden of chronic disease.
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California Hospitals Use EHR Systems to Reduce Medical Errors

Greg Slabodkin
APR 30, 2014 2:28am ET
Acute care hospitals in California are combating some of the most common and harmful medical errors by leveraging the power of electronic health records, according to a new staff report released by U.S. Senator Barbara Boxer (D-Calif.).
In a survey conducted by her office, Boxer wrote to 283 California hospitals asking them what steps they are taking to reduce medical errors, of which nearly 53 percent--149 hospitals--responded to the query, many of whom noted the benefits of EHRs at their facilities.
One of the most common type of medical errors are preventable adverse drug events which affect nearly 5 percent of hospitalized patients. However, using barcode technologies and EHRs with computerized prescriber order entry, hospitals are able to eliminate errors due to illegible hand-writing and through the standardization of medications and dosages. In addition, pharmacists are actively involved throughout a patient’s hospitalization, from reviewing the medications a patient is on at admission to reviewing a patient’s EHR for prescribing errors.
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A healthcare IT security spending wish list

April 30, 2014 | By Susan D. Hall
Where should healthcare organization focus their security spending in 2014? With cyber attacks growing more sophisticated and with more severe regulatory enforcement in place, it's a vital question, John D. Halamka (pictured right), chief information officer of Boston's Beth Israel Deaconess Medical Center, writes on his "Life as a Healthcare CIO" blog.
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Survey: Docs increasingly use online search engines to make clinical decisions

April 30, 2014 | By Ashley Gold
Doctors are Googling a lot more than you might think. A majority of physicians--78 percent--who responded to a survey from MedData said they use search engines to help them make clinical decisions.
And the biggest hurdle to the "Health 2.0" movement is that patients often misinterpret what they read online, causing tension in the doctor-patient relationship. Web-based resources having inaccurate content comes closely behind, according to the survey, which had 164 responses.
Of web-based tools used by physicians in supporting their medical decision-making process, search engines were the top choice--trailing much further behind were informational or industry-specific email, HIPAA-secure online physician communities and social media, which had the lowest response.
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Can Google Glass Get Any HIPAA?

Lena J. Weiner, for HealthLeaders Media , April 30, 2014

Google Glass is a hip new accessory gaining acceptance in clinical settings, but before widespread adoption can take place, organizations must ensure that the wearable device is HIPAA-compliant.

Imagine being able to find and view a patient's electronic health record with a simple nod of the head, or being able to maintain eye contact with patients while reviewing their records, or being able to check in on a patient from a remote location as if you were both in the same room.
This technology is already in use by healthcare providers and may be more widespread than you think. If it hasn't already made a debut in an emergency department near you, it will soon. Boston's Beth Israel Deaconess Medical Center and Brigham and Women's Hospital, Rhode Island Hospital, UC Irvine Medical Center, and Indiana State University Hospital are just a few of the organizations that are using Google Glass at least an experimental basis.
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Tips for getting physician buy-in to new IT

By Diana Manos, Senior Editor
“If you build it,” Edith Dees said of technology and doctors, “they won’t necessarily come.”
Many healthcare organizations learned that while implementing electronic health records systems and those lessons will come in handy when bolting on newer technologies, such as analytics and clinical decision support tools.
Dees, the CIO of Holy Spirit Health System, explained that getting doctors up to speed on new IT products and services takes coordination, diplomacy and empathy. What’s more, doctors don’t like to think they need to be told to do anything, according to Susan Kressly, MD, founding partner at Kressly Pediatrics. 
“It’s like herding cats to get doctors to change, so be careful how you engage doctors and create a partnership with them,” she says. “Pretend it’s an 80-20 partnership in the doctor’s direction and you’ll get where you want to go.”
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HIE at a crossroads

By Anthony Brino, Associate Editor
In the five years since the HITECH Act brought funding for public health information exchanges, the technology and the organizations that offer it have seen a varied evolution. Today, HIE as a whole is at a crossroads, with much of the public funding running out, but health data exchange services are more important than ever.
“The current landscape in health information exchange around the country is a bit disjointed, because the cooperative agreement programs have wound down now,” said Brian Ahier, a long-time healthcare technologist who recently took a job as director of standards and government affairs at Medicity, Aetna’s population health and HIE business.
“We’re looking at a number of public HIEs that are in some cases sort of scrambling for business models that are going to carry into the future. The jury is obviously still out on the long-term prospects of a lot of these organizations around the country,” said Ahier. “I think you’re going to see over the next couple of years that those HIEs that are providing value to their membership, to the hospitals and physicians that need to share information, are really going to succeed.”
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EMR market surpasses $23 billion

Posted on Apr 29, 2014
By Bernie Monegain, Editor
The global market for electronic medical records has shot up to $23.2 billion in 2013, according to a new report from research firm Kalorama: EMR 2014: The Market for Electronic Medical Records.
Government incentives and the increasing use of electronic medical records for quality of care and cost-saving reasons continue to drive the market, researchers found. They also noted that upgrading is also a factor in the booming market, in addition to new purchases.
 “We think adoption and upgrading activities will still be stimulating growth in 2014-2018," said Mary Ann Crandall, Kalorama analyst and the author of the report, in a press statement. "As new systems are sold, companies will still earn revenues from existing clients in servicing and consulting services."
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Another view: of transforming primary care

Neil Paul says ‘Transforming Primary Care’ is an important document, but more will need to be done to help GPs ‘save the NHS.’ And that will include the development of some very different IT.
28 April 2014
Last week, a group I have been working with failed to win a slot on the Prime Minister’s Challenge Fund for improving access to GP services, and an important document called ‘Transforming Primary Care’ was published.
What about the public? What about foundation trusts?
Essentially, it says the NHS is broke, nobody is going to put more money in, and that leaves us with a problem, as the population is aging and demand for investigations is rising. So we need to find savings and productivity gains.
To do this we need to work in a different way. A lot of the proposed “solution” comes from Barbara Starfield’s work, in which generalists working in the community act as gatekeepers in a holistic, pro-active, case management way, to keep people away from hospital specialists and their expensive investigations and treatments.  
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Joe’s view: Lorenzo revisited

Joe McDonald had a terrible time with Lorenzo but now, he says, the electronic patient record is coming good, thanks to the “magnificent madmen and madwomen” in the NHS and CSC who have stuck with it; and a very good CCIO.
25 April 2014
Standing on stage, microphone in one hand, bottle of lager in the other, a familiar jangling piano riff fired up on the PA system as I regarded my late night audience; which was a little the worse for wear.
For almost two years, I had worked with this extraordinary group of people. The team had decided that I would be required to give a Karaoke performance at my own leaving “do” from the Lorenzo Delivery Team.
The team had picked what I had to sing to the unsuspecting people of Solihull, who packed the bar. Backed by two female project managers who shall remain nameless (you know who you are) I duly murdered ‘Like a bat out hell I’ll be gone when the morning comes’; the Meatloaf classic.
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Digital health investment tops $1.35B in first quarter of 2014

April 29, 2014 | By Ashley Gold
Investment in digital health topped $1.35 billion in the first quarter of 2014, according to new report from StartUp Health.
Digital health funding has hit $7.4 billion with 1,393 deals since 2010, according to a presentation StartUp Health gave last week. And its more than doubled in the first quarter of this year since last year's first quarter. Most funding took place in Northern California and the Northeast.
Last year, big data dominated health IT deals--112 deals got $712 million investments. This year, StartUp Health predicts patient engagement and sensors to grow the most.
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State Guidelines for Telemedicine Practice Developed

April 28, 2014
The Federation of State Medical Boards (FSMB) has approved state guidelines for practicing medicine through the use of telemedicine technology.
The guidelines, from the FSMB, which represents state medical boards, state the standards of care that have historically protected patients during in-person medical encounters must apply to medical care delivered electronically. Telemedicine care providers must establish a credible “patient-physician relationship,” according to these guidelines, thus ensuring that patients are properly evaluated and treated and that providers adhere to well-established principles guiding privacy and security of personal health information, informed consent, safe prescribing and other key areas of medical practice.
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AHIMA Joins ECRI Institute Project to Enhance Patient Safety

April 28, 2014
Ensuring safer healthcare by understanding and mitigating health IT hazards and safety events
The American Health Information Management Association (AHIMA) and the ECRI Institute are partnering in a pilot project to promote patient safety and quality care through the reduction of health IT risk, and enhancing health IT innovation. The project, the Partnership for Promoting Health IT Patient Safety, will create a national framework to proactively identify and resolve health IT safety issues based on various HIT events and hazards.
Under the project, AHIMA will join ECRI Institute’s variety of partners, including healthcare providers, health IT vendors, public policy organizations and other professional organizations, to collect health data, analyze it and report results to improve patient safety within health IT. AHIMA will support the adaptation and dissemination of lessons learned to its members and other stakeholders.
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Sports Medicine Turns to Telemedicine

Scott Mace, for HealthLeaders Media , April 29, 2014

Advances in telehealth technology are revolutionizing how healthcare providers respond to the hard knocks and head injuries athletes sustain on the football field, soccer pitch, and ice rink.

It may be baseball season, but I've got football on my mind.
Not the game itself, but the injuries that can result from it, and specifically, how new technology can help detect concussions, those hard knocks that can do so much damage and yet be so difficult to detect.
Sensor technology and telehealth technology are revolutionizing how the healthcare system responds to the football field's hard knocks, and the same technology could apply to other sports such as hockey, soccer, and anywhere else where sharp blows to the noggin are part of the game.
In January at the International CES show in Las Vegas, I got to see technology up close from a firm called MC10, that forms the basis for Reebok's CheckLight, which collected a CES Innovations 2014 Design and Engineering Award.
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Case for dropping MU Stages 2 and 3

Posted on Apr 28, 2014
By Dale Sanders
Federal meaningful use requirements are well intentioned, but like a teacher who “teaches to the test,” the federal meaningful use program created a very complicated system that might pass the test of meaningful use stages, but is not producing meaningful results for patients and clinicians.
As reported on April 14, 2014 in MedScape (free log-in required), a formal study published in the April 2014 issue ofJAMA Internal Medicine shows no correlation between quality of care and meaningful use adherence. This study validates what common sense has told many of us for the last few years.
Meaningful Use Stage 1 was a jump-start for EMR adoption in the industry. That’s a good thing, I suppose, although meaningful use also created a false market for mediocre products. It’s time to put an end to the federal meaningful use program, eliminate the costly administrative overhead of meaningful use, remove the government subsidies that also create perverse incentives, and let “survival of the fittest” play a bigger part in the process. Let the fruits of EMR utilization go to the organizations that commit, on their own and without government incentives, to maximizing the value of their EMR investments toward quality improvement, cost reduction, and clinical efficiency.
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'Jury still out' on HIE sustainability

Posted on Apr 28, 2014
By Anthony Brino, Editor, HIEWatch
In the five years since the HITECH Act brought funding for public health information exchanges, the technology and the organizations that offer it have seen a varied evolution. Today, HIE as a whole is at a crossroads, with much of the public funding running out, but health data exchange services are more important than ever.
“The current landscape in health information exchange around the country is a bit disjointed, because the cooperative agreement programs have wound down now,” said Brian Ahier, a long-time healthcare technologist who recently took a job as director of standards and government affairs at Medicity, Aetna’s population health and HIE business.
 “We’re looking at a number of public HIEs that are in some cases sort of scrambling for business models that are going to carry into the future. The jury is obviously still out on the long-term prospects of a lot of these organizations around the country,” said Ahier. “I think you’re going to see over the next couple of years that those HIEs that are providing value to their membership, to the hospitals and physicians that need to share information, are really going to succeed.”
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ACR wants CPOE to incorporate appropriateness-guided CDS

April 25, 2014 | By Mike Bassett
The American College of Radiology on April 24 submitted comments on the Office of the National Coordinator for Health IT's proposed rule containing voluntary electronic health record technology certification criteria for 2015.
In it's comments, ACR said it supports ONC's proposal to separate the order types in previous computerized physician order entry (CPOE) certification criteria into three distinct criteria encompassing medications, lab-tests and radiology/imaging.
"A standardized certification criteria from CPOE of radiology/imaging will allow more specialized, robust order entry software to achieve modular certification for use in the EHR Incentive Program without having to add unrelated medication and lab-test functionality," said Paul Ellenbogen, chair of ACR's board of chancellors, and Keith Dreyer, chair of ACR's IT and informatics committee.
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Exclusive: FBI warns healthcare sector vulnerable to cyber attacks

Wed, Apr 23 2014
BOSTON (Reuters) - The FBI has warned healthcare providers their cybersecurity systems are lax compared to other sectors, making them vulnerable to attacks by hackers searching for Americans' personal medical records and health insurance data.
Health data is far more valuable to hackers on the black market than credit card numbers because it tends to contain details that can be used to access bank accounts or obtain prescriptions for controlled substances.
"The healthcare industry is not as resilient to cyber intrusions compared to the financial and retail sectors, therefore the possibility of increased cyber intrusions is likely," the Federal Bureau of Investigation said in a private notice it has been distributing to healthcare providers, obtained by Reuters.
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Home Care Agency Leverages Tablets To Improve Care Delivery, Patient Outcomes

by Fred Bazzoli Monday, April 28, 2014
Finding the right technology for the right purpose to meet the needs of the people using it -- is it just serendipitous happenstance?
At Sutter Care at Home, some of that came into play. But for the most part, the success of its latest project to give useful computing devices to caregivers in the field took time, persistence and the ability to learn from the experiences of the past decade.
The organization believes that its current technology approach -- providing Android-based tablets with 4G capabilities for mobile Internet access -- meets a variety of needs for its mobile workforce. It placed a big bet, giving tablets to more than 1,300 caregivers in more than 23 counties who serve a population base of more than 100,000.
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Enjoy!
David.

1 comment:

Bernard Robertson-Dunn said...

An interesting article David's found at http://www.fierceemr.com/story/docs-give-short-shrift-vital-signs-lab-results-electronic-notes/2014-04-29.

This is formal scientific evidence that doctors pay limited attention to medical records and notes.

This suggests two questions:
1) If doctors pay little attention to health records, what value is the PCEHR?

2) What plans do NEHTA and DOHA have to address this issue and avoid even greater amounts of money being wasted?

The article:

Docs give short shrift to vital signs, lab results in electronic notes
Fierce EMR
April 29 2014
Marla Durben Hirsch

Researchers from Baystate Health in Springfield, Massachusetts, and elsewhere, conducted a study to determine how physicians distribute their visual attention when reading electronic notes, measuring the time spent on different parts of the note and the reading rates. They used an eye tracking device to assess the attention patterns of 10 hospitalists. They then compared the visual analysis with the content of simulated verbal hand-offs for each note and debriefing interviews.

The analysis found that physicians spent the most time in the "impression and plan" section of the notes--which they read very slowly--and very little time on medication lists, vital signs or lab results--which they read very quickly--even if those sections contained more content than the impression and plan section.

Only 9 percent of the content of the physicians' verbal hand-off was found outside the impression and plan section.

"Physicians in this study directed very little attention to medication lists, vital signs or laboratory results compared with the impression and plan section of electronic notes," the authors concluded. "Optimizing the design of electronic notes may include rethinking the amount and format of imported patient data as this data appears to largely be ignored."

EHR design has long been a concern to physicians, who find that they impeded workflow and the ability to interact with patients. Studies have found that this is one of the primary reasons why physicians tend to dislike using the systems.

To learn more: read the summary
http://aci.schattauer.de/en/home/issue/special/manuscript/21088/show.html