Saturday, July 12, 2014

Weekly Overseas Health IT Links - 12th July, 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.

Advanced EHRs cut hospital patient costs by close to 10 percent

July 3, 2014 | By Susan D. Hall
For hospitals using advanced electronic health records, per-patient costs were $731, or 9.66 percent, less than at hospitals without these systems, according to research from Medical University of South Carolina.
The study, published at American Journal of Managed Care, looked at records of 5 million patients treated at 550 U.S. hospitals. Only 19 percent were from advanced EHR systems, which the study defines as the stage 3 level of EHR implementation, including CPOE and clinical decision support.
The authors conclude that the costly investment in these systems in a way that meets Meaningful Use, is worth it, according to an announcement.

VA to modernize VistA EHR system

July 3, 2014 | By Dan Bowman
As part of an effort to modernize its Veterans Health Information Systems and Technology Architecture (VistA), the U.S. Department of Veterans Affairs this week awarded a $162 million contract to Accenture Federal Services company ASM Research.
While an internal audit released June 9 did not cite the VA's electronic health record system as a cause of the wait-time scandal that has plagued the agency this year, it did refer to the scheduling component of VistA as "antiquated" and "problematic." To that end, the VA said it is looking to the private sector to create a scheduling tool that would work within the confines of VistA.
Jim Trafficant, president of ASM, told Health Data Management that VistA's technology was old and costly to maintain, but added that his company's efforts were not related to the scheduling system effort. Trafficant said that data management efforts for VistA will become more centralized and involve more use of clinical analytics.

SCR reaches 40m patients

2 July 2014   Sam Sachdeva
The NHS Summary Care Record has hit the 40m patient mark, just over a year after low usage rates led to calls for it to be scrapped.
NHS England says it is “delighted” by the milestone, and is now focussing on rolling out the SCR in A&E, NHS 111, and GP out-of-hours services.
The SCR was one of the key projects of the National Programme for IT in the NHS.
It was intended to create the 'national' element of an integrated care records service that was otherwise to be delivered by the roll-out of detailed care record systems at trusts.
Posted on Saturday, June 28 2014 at 3:33 pm by Jon Neiditz

Why Healthcare Providers Should Take from Data Brokers, & Why Privacy Advocates & Regulators Shouldn’t Try to Stop Them

Many brilliant people with the very best of intentions felt or expressed dismay this week at a good article with the body-snatchers-invasion-class title, “Your Doctor Knows You’re Killing Yourself. The Data Brokers Told Her.” Surely the marauding hordes of data brokers (the targets of Federal Trade Commission investigations!), should be kept far away from the sacrosanct relationship between doctor and patient! The article ends with an ethicist intoning that the strategy “is very paternalistic toward individuals, inclined to see human beings as simply the sum of data points about them.”
I thought about that article and that ethicist yesterday as I sat with my family in a travel clinic giving us the shots we would need for a cultural exchange program in a village in India. The great doctor and nurse in the clinic knew nothing about us (Well, thanks to an electronic medical record, they knew about 1 pain med I didn’t even take a decade ago, which they dutifully asked me about). They didn’t even know any of the information we had entered on-line for them this week (The nurse explained that “On-line, you’re just a number.”).

Biomedical Data Analyses Can Predict Metabolic Risk

JUL 2, 2014 7:27am ET
Analyses of biomedical data from nearly 37,000 volunteer employees of a large company insured under Aetna shows a success rate of 80 percent to 88 percent in predicting risk of metabolic syndrome, which can cause chronic disease.
Metabolic syndrome means an individual has at least three of five biological characteristics that are out of normal range--waist circumference, blood pressure, elevated triglycerides, low high-density lipoproteins and increased insulin resistance--according to a report on the findings in The American Journal of Managed Care. Research published in 2006 suggests that almost a third of U.S. adults have three of the out-of-range characteristics and another 45 percent have one or two risk factors, the study notes. Individuals with metabolic syndrome are twice as likely to develop cardiovascular disease and five times more likely to get diabetes mellitus.

Data sheds light on IT purchasing, use

Posted on Jul 02, 2014
By Mike Miliard, Managing Editor
The Dorenfest Institute for Health Information has opened up new HIMSS Analytics data, offering insights into the IT usage patterns of thousands of U.S. hospitals and ambulatory clinics.
With an eye toward driving care improvement, Dorenfest Institute, which is managed by the HIMSS Foundation, provides academic researchers and local, state and federal government agencies with a variety of historical data and reports about information technology use in hospitals and health networks.
These newly-released numbers track IT use at some 5,400 U.S. hospitals and the more than 26,000 affiliated ambulatory practices. Data is now available from 1986 through 2012. To access it, organizations can submit an application at the Dorenfest website.

ECRI report IDs health IT safety issues for provider execs

July 2, 2014 | By Katie Dvorak
Two associations are teaming up to help healthcare executives remain aware of technology safety issues, according to a recent announcement.
The Association for the Advancement of Medical Instrumentation (AAMI) and ECRI Institute have released a report, "Executive Insights on Healthcare Technology Safety," to identify safety-related issues. It gives recommendations on alarm systems, Luer connectors, cybersecurity, batteries and recalls.

Clinical mHealth Devices to Surpass Consumer-Facing Devices by 2023

Written by Akanksha Jayanthi (Twitter | Google+)  | July 01, 2014
Currently valued at $5.1 billion, the mHealth device market is projected to reach $41.8 billion by 2023, according to a Lux Research news release.
Researchers project clinical mHealth devices, such as clinical vital signs monitoring devices and in vitro diagnostic devices, will grow at a compound annual growth rate of 46 percent and reach $16 billion by 2023, growing more quickly than consumer-facing devices, which will grow at an 11 percent CAGR and reach $7 billion by 2023

Success of Blue Button Initiative Tied to MU Program

Greg Slabodkin
JUL 1, 2014 10:30am ET
The Office of the National Coordinator for Health IT this fall will launch a national campaign to boost consumer use of Blue Button technology to securely access their health records electronically.
Originally launched in 2010 by the Veterans Administration, the Centers for Medicare and Medicaid Services and the Department of Defense, Blue Button has expanded to include both public and private health record “data-holders”--including provider organizations, health plans, and pharmacies--yet is still not well known by most Americans.   
The national Blue Button campaign, which runs from Sept. 15 to Oct. 6, will include public service announcements posted on partner websites to get the word out on how consumers can access their own health data. According to Lygeia Ricciardi, director of ONC’s Office of Consumer eHealth, a lack of public demand for digital health records is among the greatest obstacles to increased consumer engagement in their own health.

Healthcare Data Analytics Gone Wrong

7/1/2014 10:28 AM
Healthcare providers need to keep their eye on the right patients as they look for ways to boost revenue and reduce risk.
Ever since the Centers for Medicare and Medicaid Services (CMS) decided to penalize hospitals financially for avoidable readmission of patients within 30 days of their discharge, health systems have been coming up with inventive ways to keep patients out of the hospital while also trying to bring in more revenue.
Most of these approaches make sense. They've created population health management programs that analyze patient data to spot those at high risk for readmission, for instance, and then offer preventive measures to those patients. They've created care-coordination systems to make sure discharged patients arrive safely at their next destination, whether it be their home, a rehabilitation unit, or a nursing facility. Most hospitals have also redoubled their efforts to educate patients at discharge so that they understand how to take their medications and see the value of making follow-up appointments with their primary care physicians.

Interoperability in real life

Posted on Jul 01, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
On June 23 my wife was speaking with my 82 year old father-in-law, when he began speaking in word salad - not slurring his words, but clearly speaking words that made no sense. He had no numbness or weakness, no confusion, and no change in consciousness. After 5 minutes all symptoms resolved.
My wife called me and after hearing the history, I knew he was having a transient ischemic attack (TIA). Given that he was stable, I recommended that we coordinate an immediate hospitalization at a site suggested by his primary care physician (PCP) rather than take an ambulance to a random nearby location.     My wife called his PCP and was given a choice of two hospitals - one with IT systems I control and one with IT systems I do not. She drove him to the hospital that offered care coordination via interoperable IT systems.

CHIME urges changes to meaningful use

Posted on Jul 01, 2014
By Bernie Monegain, Editor
The College of Healthcare Information Management Executives, which represents more than 1,400 CIOs and IT leaders, is calling on CMS and ONC to make some changes -- and add some flexibility -- to Stage 2 meaningful use.
More flexibility is needed because changes proposed for the incentive program were only first released in late May, limiting the amount of time providers have to react to them, CHIME executives wrote in comments submitted to CMS and ONC on June 27.
"CHIME supports the new pathways as defined in the proposed rule," the letter reads. "We believe these options will provide needed flexibility for EHR optimization, encourage continued participation in the program and help maintain the upward trajectory of EHR adoption in the US."

Hunt calls for shared records and data

27 June 2014   Lis Evenstad
The NHS will not reach its full potential without sharing of electronic patient records across health and social care, Jeremy Hunt has said.
Speaking at the Health + Care conference in London yesterday, the health secretary set out four “basic things without which we will not reach the potential that is possible” in the NHS.
“We need to be able to share electronic health records across the entire system so that patients feel that they are receiving absolutely integrated care,” he said.
His second essential was real time health and social care costs for every individual for whom care is commissioned.

Big data not a 'magic weapon' for healthcare

July 1, 2014 | By Katie Dvorak
Earlier this week, Google founder Larry Page touted the impacts of big data, saying that more information transparency could save 100,000 lives this year alone.
However, big data isn't a "magic weapon that can solve all our problems," Eerke Boiten, a senior lecturer at the School of Computing and Director of Interdisciplinary Cyber Security Centre at University of Kent, writes in an article at The Conversation.
Boiten points to the UK's debacle--a program announced through a leaflet left in mailboxes by the National Health Service on an effort to make health records available to researchers--and Page's comments as false visions for big data. He says that no case review has shown that large data collection would "get the right knowledge to the right person."

Experts Discuss 4 Major Barriers to Telehealth Adoption

While technology has reached a level where high-quality virtual consultations with physicians can take place, policy issues have slowed the expansion of telehealth practices in the U.S.

by Brian Heaton / June 27, 2014 0
Consulting with a doctor through video conferencing isn’t new – the practice has been around for years. But while the technology has steadily improved and social acceptance of online communication has grown, experts have identified four policy issues that continue to plague widespread adoption of telehealth in the U.S.
Cross-state licensing for doctors is one of those challenges. State medical boards require a doctor practicing medicine to have a license in each state in which he or she has appointments with patients. The same requirement applies for telehealth visits.
It’s a huge problem, particularly for providers in border states, said Ed Bostick, executive director of the Colorado Telehealth Network. He explained that many times physician referral patterns include offices outside state geographical delineations. For example, referrals from Colorado doctors may include physicians in Utah, New Mexico or other locations outside state lines. That can complicate things if a doctor is willing to do a virtual appointment with a patient.

Data sheds light on IT purchasing, use

Posted on Jul 02, 2014
By Mike Miliard, Managing Editor
The Dorenfest Institute for Health Information has opened up new HIMSS Analytics data, offering insights into the IT usage patterns of thousands of U.S. hospitals and ambulatory clinics.
With an eye toward driving care improvement, Dorenfest Institute, which is managed by the HIMSS Foundation, provides academic researchers and local, state and federal government agencies with a variety of historical data and reports about information technology use in hospitals and health networks.
These newly-released numbers track IT use at some 5,400 U.S. hospitals and the more than 26,000 affiliated ambulatory practices. Data is now available from 1986 through 2012. To access it, organizations can submit an application at the Dorenfest website.

Study: Majority of Hospitals Don’t Participate in HIE

June 30, 2014
The majority of hospitals do not engage in the electronic exchange of health information, according to the findings of a study by researchers from the University of Michigan and Harvard University.
This finding is despite strong federal policies being designed to encourage these exchanges and a substantial investment in health IT, say the study’s authors, Julia Adler-Milstein from the University of Michigan and Ashish K. Jha, of Harvard. The study, “Health information exchange among U.S. hospitals: who’s in, who’s out, and why?” appears in the current issue of the quarterly publication Healthcare, the Journal of Delivery Science and Innovation.

Digital health funding in 2014 has already surpassed 2013 total

By: Aditi Pai | Jun 30, 2014        

In the first half of 2014, digital health funding reached $2.3 billion, according to a
report from accelerator Rock Health. The report included data from 143 digital health companies that have raised over $2 million during the past six months.
Funding in the first two quarters of 2014 surpassed total funding for all of 2013, which was $1.97 billion. Deal growth was driven by early-stage companies and year-over-year growth has reached 64 percent so far. In April, Rock Health reported that digital health funding reached nearly $700 million in the first quarter of 2014, and first quarter funding grew 87 percent compared to the first quarter of 2013. 

ONC-Led Coalition Successfully Exchanges Behavioral Health Data

Written by Helen Gregg (Twitter | Google+)  | June 30, 2014
The ONC, several states and the Substance Abuse and Mental Health Services Administration have announced the successful test exchange of behavioral health data across state lines using Direct messaging.
The exchange of behavioral health data is subject to more privacy restrictions than the exchange of other health data that go beyond HIPAA requirements, such as requiring written patient consent for each exchange.

Big Data Helps Insurer Pinpoint At-Risk Patients

6/30/2014 09:00 AM
Aetna and GNS Healthcare use analytics to predict patients at risk for metabolic syndrome.
Analyzing big data can predict patients' future risk of metabolic syndrome and allow individuals and clinicians to work together on preventative steps that save lives and money.
While organizations have used a lot of big data projects to discern trends, a study conducted by Aetna and GNS Healthcare analyzed data from almost 37,000 members of an Aetna employer customer who opted in for screening of metabolic syndrome -- which can lead to chronic heart disease, stroke, and diabetes. GNS analyzed information such as medical claims records, demographics, pharmacy claims, lab tests, and biometric screening results from a two-year period.

Tech Thoughts from a Hospital Bed

Scott Mace, for HealthLeaders Media , July 1, 2014

After emergency surgery, a few observations on the clinical narrative, the value of the medical record in any form, and the small miracles that make our healthcare system hum.

On Monday, June 16, I was preoccupied, preparing to head to the annual Computer-Physician Symposium run by AMDIS in southern California. But I had a scheduled doctor's appointment to tick off my to-do list first.

Fortunate thing.
A block from my doctor's office, as I was crossing a street in Alameda, California, I felt like my guts had been sliced open. I doubled over in pain and, with effort, continued to my doctor's doorstep.
In the exam room, my doctor found my abdomen distended and me generally feeling like I wasn't going anywhere but the emergency room.
The staff called me a taxi, and 15 minutes later, I was at Alameda Hospital, gladly accepting a wheelchair ride. The pre-op history report told the story: "CT scan shows acute appendicitis."

ICD-10 Implementation Not as Costly as Feared

The cost for physician practices to implement ICD-10 medical diagnosis and in-patient procedure codes may not be anywhere near as high as feared, according to recent data from the American Association of Professional Coders.
According to AAPC’s Rhonda Buckholtz, vice president of education and training, a clinet analysis has found that “ICD-10 ready” medical practices with fewer than 10 providers have spent approximately $750 per person to prepare for the mandate," as reported in a podcast. "And the cost is even less for practices with 10 to 49 providers. To put this into context, AAPC has trained over 90,000 people toward some piece of ICD-10 implementation, making this cost information all the more compelling."

Key challenges facing EHR vendors

Posted on Jun 26, 2014
By Yoganand Sundararajan, Senior manager, business consulting at Virtusa
According to the Center for Medicare and Medicaid Services, “An Electronic Health Record (EHR) is an electronic version of a patient’s medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person’s care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.”
The advantages of using EHR over paper/file based documents are multi-fold. Some of the significant benefits include:
  • Improves patient care by limiting human and medical errors, because medical history, allergy, treatment and other information is available over time
  • Reduces inefficiencies and improves accuracy and clarity of medical records
  • Streamlines the clinician’s workflow and allows them to track patient health over time

Study: Advanced EHR use brings 9.6% cut in patient costs

Author Name Jennifer Bresnick   |   Date June 27, 2014   |  
Use of an advanced EHR system can produce significantly lower per-patient costs in hospitals, says a study published today in the American Journal of Managed Care, with healthcare organizations seeing nearly ten percent in savings from each hospital admission.  While EHR adoption and the EHR Incentive Programs have been billed as a way to save billions of dollars for the healthcare system, concrete evidence of a true return on investment has been lacking, leading some providers to question the purpose of the massive and complex implementation process.
The research team from the Medical University of South Carolina used data from the National Inpatient Sample (NIS) and HIMSS to analyze data from more than five million patient cases at 550 hospitals.  Advanced EHR users, defined as those with health IT systems that meet meaningful use criteria, made up 18.9% of the sample.  “When controlling for patient and hospital characteristics in the multivariable model, the mean cost per patient admission for hospitals without advanced EHRs was $7938,” the authors write. “The mean cost per patient admission for hospitals with advanced EHRs was $7207,” representing about $730 in savings attributable to EHR use.

Critics Attack Meaningful Use Program, but Disagree on Solutions

by Ken Terry, iHealthBeat Contributing Reporter Monday, June 30, 2014
There's widespread agreement across the health care industry that the government's meaningful use electronic health record incentive program needs to be revamped. Even the program's strongest supporters acknowledge there are problems with its current direction. But the critics disagree over what needs to be done.
Some people argue that the meaningful use program should stop after Stage 2, which began on Jan. 1 of this year, and that Stage 3 should be eliminated. Others say that the three stages laid out by the Office of the National Coordinator for Health IT should continue but with more flexible requirements and longer timelines.
Observers also are divided over the proper role of the government in shaping the development of health IT and in determining how EHRs will be used. In the view of some commentators, the meaningful use and EHR certification requirements are burdensome and counterproductive; the market, they contend, should replace government policy as the arbiter of this technology. Others argue that there are certain things that only the government can do, such as establishing and enforcing interoperability standards.


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