Saturday, August 02, 2014

Weekly Overseas Health IT Links - 2nd August, 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.

Google's New Moonshot Project: the Human Body

Baseline Study to Try to Create Picture From the Project's Findings

By Alistair Barr
July 24, 2014 7:56 p.m. ET
Google Inc. has embarked on what may be its most ambitious and difficult science project ever: a quest inside the human body.
Called Baseline Study, the project will collect anonymous genetic and molecular information from 175 people—and later thousands more—to create what the company hopes will be the fullest picture of what a healthy human being should be.
The early-stage project is run by Andrew Conrad, a 50-year-old molecular biologist who pioneered cheap, high-volume tests for HIV in blood-plasma donations.
Dr. Conrad joined Google X—the company's research arm—in March 2013, and he has built a team of about 70-to-100 experts from fields including physiology, biochemistry, optics, imaging and molecular biology.

The Evidence Is In: Patent Trolls Do Hurt Innovation

Over the last two years, much has been written about patent trolls, firms that make their money asserting patents against other companies, but do not make a useful product of their own. Both the White House and Congressional leaders have called for patent reform to fix the underlying problems that give rise to patent troll lawsuits. Not so fast, say Stephen Haber and Ross Levine in a Wall Street Journal Op-Ed (“The Myth of the Wicked Patent Troll”). We shouldn’t reform the patent system, they say, because there is no evidence that trolls are hindering innovation; these calls are being driven just by a few large companies who don’t want to pay inventors.
But there is evidence of significant harm. The White House and the Congressional Research Service both cited many research studies suggesting that patent litigation harms innovation. And three new empirical studies provide strong confirmation that patent litigation is reducing venture capital investment in startups and is reducing R&D spending, especially in small firms.

Personalized Medicine Has Promising Future, Say Health Experts

JUL 24, 2014 9:09am ET
Medical treatment based on an individual’s genetics is the future of medicine, according to government, academic and industry panelists participating at a July 23 roundtable held by the House Energy and Commerce Committee.
Developed at the molecular level, personalized medicine is a growing practice area that holds tremendous promise for providing patients with cures to diseases that are tailored specifically to their genetic makeup, say advocates. Not only does this “precision” medicine have the potential to improve patient care and result in better outcomes by increasing the ability to predict which medical treatments will be safe and effective, but at the same time it can lead to a more efficient U.S. healthcare system and control costs by identifying the right drug for a patient.   

FTC Warns About Data Broker Abuse of Consumer Health Data

Greg Slabodkin
JUL 24, 2014 12:23pm ET
Speaking in Washington on Wednesday, Federal Trade Commissioner Julie Brill voiced her concerns about potential risks to consumer health data from data brokers who are collecting and sharing sensitive information with third parties.
According to Brill, the Health Insurance Portability and Accountability Act of 1996 was enacted at a time “when it made sense to think about doctors, insurance companies and hospitals, who were covered by HIPAA and then their business entities. But, now what you have is data that’s flowing massively everywhere and it doesn’t really understand the silos that were created by these laws.”
FTC conducted a study of data brokers who obtain and share vast amounts of consumer information, typically behind the scenes, without consumer knowledge. What the commission discovered was that these data brokers collect and store billions of data elements covering nearly every U.S. consumer from which they build profiles on consumers.

VA, HHS hindered by IT complexity

Posted on Jul 25, 2014
By Government Health IT Staff
Federal government agencies, including the U.S. Department of Health and Human Services, the Department of Defense and the Veterans Administration, are being hindered in carrying out their missions due to growing complexity of their IT networks.
A recent report from MeriTalk surveyed 200 government IT executives on behalf of network solutions provider Brocade, and found that the agencies are struggling with increasing network complexity.
The study found that more than half of agencies believe the complexity of their networks has increased over the past year, and 68 percent of the respondents believe network complexity restricts their ability to implement new technologies, services or capabilities.

Cerner sees record Q2 results

Posted on Jul 25, 2014
By Erin McCann, Associate Editor
Second quarter financial results were not a disappointment for EHR behemoth Cerner Corp., as officials announced Thursday afternoon a record "all time high" for Q2 results. 
As Chief Financial Officer Marc Naughton reported, Q2 2014 bookings stood at $1.08 billion, representing an increase of 15 percent compared to second quarter 2013 bookings of $935.0 million. The quarter was marked by a high number of go-lives and "strong results" of the company's population health platform. 
Revenue reached $851.8 million, up 20 percent from the second quarter last year, which stood at $707.6 million.  

Physicians prefer VistA, so should decision makers

Posted on Jul 24, 2014
By Edmund Billings, MD, Medsphere Systems Corporation
Let’s start simply with the results. The questions will come later.
In their 2014 EHR Report—a survey of 18,575 physicians on their EHR preferences—Medscape concludes that doctors like using the VA’s Computerized Provider Record System (CPRS), the core electronic record in the broader VistA platform, more than any other solution.
Here’s what they said.
The highest-rated EHR, with a score of 3.9, is the Veterans Administration EHR: VA-CPRS. It’s regarded as one of the best overall by our physician respondents.

Report: IT redefining management, sustainability of healthcare

July 25, 2014 | By Katie Dvorak
Healthcare IT is poised to be the driver of healthcare transformation--redefining the management and sustainability of health, according to Healthcare Growth Partners 2014 mid-year review.
HGP, an investment bank focused on health IT and services, in its report touched on three areas in health IT that will see major growth and innovation:
  • Establishment of software infrastructure: Tools such as electronic medical records, electronic information exchanges and practice management systems are crucial to value-based payment reform, the report says. It points out the rise of mergers and acquisitions in software infrastructure, as well as the Centers for Medicare & Medicaid Services' high registration data for EMRs, as signs of saturation for the aforementioned tools. These investments, the report says, show potential for disruption of current "heavy technology" by upstarts at the lower end of the market, with the report's authors saying they expect the disruption to move into larger facilities and providers.
July 24, 2014

Health Information Exchanges Can Improve Patient Care

Integrated health service models are helping hospitals across the globe increase efficiency while cutting costs and ultimately improving patient care. They are supporting care doctors can provide from within or outside hospitals and are helping create an infrastructure that is integrating the delivery of medical services.
These findings are supported by Frost and Sullivan's recent report, Technologies Enabling Home Medical Devices and Integrated Care Systems, describes health information exchanges as an integral part of developing healthcare models. As a broad description, HIEs facilitate the exchange of electronic information between a number of health providers which subscribe to the exchange. They are meant to help provide healthcare practitioners with easy access to relevant information about their patients so they can provide accurate, efficient care.
Within Frost and Sullivan's announcement of its latest report, it provided a quote from Technical Insights Research Analyst Bhargav Rajan who discusses the ramifications HIEs can have on the medical industry.

Standards key to mHealth success

Posted on Jul 24, 2014
By Jeff Rowe, Contributing Writer
No matter where you go, it seems, someone's talking up mHealth.  But according to two two officials with the Institute of Electrical and Electronics Engineers Standards Association, a healthy wariness is in order.
"mHealth technologies offer a bounty of benefits and advantages," they say, "including improved monitoring, faster diagnostics, greater flexibility and measurable cost-savings, for physicians and patients alike. However, with great promise also come great challenges, particularly for healthcare organizations and clinical practices."  Among those challenges are omnipresent HIPAA regulations and the never-ending increase in technological complexity.  So what's a doctor to do?

Halamka: Patient-generated data 'next key frontier'

July 24, 2014 | By Susan D. Hall
Patient-generated data is the "next key frontier" in care coordination, population health, and clinical research, John Halamka, CIO at Boston-based Beth Israel Deaconess Medical Center, says in a recent post to his blog.
Beth Israel, despite investing heavily in home care, care management, and telemedicine, has yet to step up to become a leader in patient-generated data, he says. He plans to explore data gathering through devices he owns, as well as its uses for Accountable Care Organizations and at the clinician level.

Clinical decision support's role in radiology

July 24, 2014 | By Mike Bassett
By Mike Bassett
Concerns about overutilization of imaging, its appropriateness in all cases, and its costs in terms of healthcare dollars and exposure to ionizing radiation has led to an increasing emphasis on clinical decision support.
And the extent to which policymakers have latched onto the concept of CDS as a tool to address overutilization and rising costs is demonstrated by the fact that the "Protecting Access to Medicare Act of 2014"--the Sustainable Growth Rate "patch" legislation--contains language requiring that physicians consult appropriateness criteria before prescribing advanced imaging procedures for Medicare patients.
July 23, 2014

iPatientCare Releases New Patient-Centered Apps

In conjunction with the healthcare industry moving towards a more digital delivery model that is both patient-focused and value-based, medical informatics company iPatientCare has unveiled three new apps that are intended to keep individuals on course with their health needs.
These apps, which are available as a free download for iPhones and iPads, are miMeds, miCalc and miWater.
The miMeds application was created considering Medication Adherence, and serves as a tool to remind individuals to take medications and nutritional supplements. Users can input medication and supplement schedules and the app allows for a historical tracking of the medications and supplements a person takes.

Health Care Providers Look To Improve Security Incident Response

by John Moore, iHealthBeat Contributing Reporter Thursday, July 24, 2014
The clock starts ticking on damage control whenever a security breach takes place.
Indeed, the time it takes to suss out and contain a security lapse determines how big of a hit an organization will take in cost and reputation. A computer security incident response plan, however, can blunt that impact. Such a plan describes a process for dealing with security issues that can spell the difference between a headline grabbing meltdown and a quick recovery.
The health care sector, however, has ample room to improve its incident response time. BitSight Technologies -- a Cambridge, Mass.-based firm that rates companies' security performance -- recently ranked health care and pharmaceuticals as the lowest performing industry. A key contributor to that dubious distinction is the amount of time it takes those organizations to contain a security breach. BitSight, which studied Standard & Poor's 500 companies, noted that the health care sector experienced "the longest average event duration of all industries we analyzed, a worryingly high 5.3 days."

FDA Mobile Apps Loophole Hazardous For Healthcare

7/23/2014 09:06 AM
The FDA's reluctance to overregulate medical apps opens a pitfall for healthcare organizations that innovate too far ahead of the curve.
The FDA's recent guidance on mobile medical apps creates a gray area in which the agency will not automatically require approval for all new mobile medical apps, but may exercise "enforcement discretion," depending on how the app functions, the risks it introduces to patients/consumers, and its intended use.
In a previous post, I discussed the some of the regulatory issues with mobile medical apps and the FDA's new approach toward them, illustrating an uncertainty the agency has about placing all new medical software innovations under the regulatory umbrella. Some interesting scenarios came up during an FDA-focused event earlier this year, which I've discussed with Ken Block, head of Ken Block Consulting. Block has written extensively on the FDA's history of evaluating software and firmware innovations.

Wednesday, April 30, 2014

Right almost by accident: The JASON Report on HealthIT Infrastructure

I've finally read through the most recent JASON report on A Robust Health Data Infrastructure.  It fails to live up to one pundit's description as the "Son of PCAST" widely reviled by the Healthcare industry.  It failed to live up to its billing.  The PCAST report had some semblance of professionalism about it.  However, the JASON report is amateurish by comparison, full of outdated references, pedantic writing and unjustified opinions.  Even so, its more right than wrong, but probably for the wrong reasons.
My favorite quote from the most recent JASON Report is:
Innovation in health care appears to be frozen by a deluge of overly ambitious, insufficiently practical, and often conflicting advice
Never have I seen such a well qualified self-referential statement statement in a report before, and I have to completely agree with it.  In this case, I'd also have to add confusing advice.

Not worth the RISk?

The end of national digital imaging contracts was an opportunity for trusts to change suppliers and refresh their IT. But few have chosen to try and implement something as essential and complex as a new RIS. Those that have tried have found the going hard – but they are now seeing benefits that others may want to emulate. Kim Thomas reports.
It’s been a year since the first contracts for picture archiving and communications systems and radiology information systems negotiated under the National Programme for IT came to an end. 
Under the National PACS Programme, delivered by NPfIT in 2004, 128 English trusts that needed new systems were divided into four regional clusters.
They were then allocated to three local service providers (CSC, Accenture and BT), which set up regional data stores and supplied RIS from just two vendors.
HSS supplied the RIS for the two clusters managed by CSC and the cluster managed by Accenture. In London, BT supplied trusts with a RIS from iSoft.

Court Says Breach Lawsuit Needs to Prove Harm

JUL 23, 2014 7:44am ET
Sutter Medical Foundation is at least the third provider organization in California to beat back a class action lawsuit following a data breach by arguing that no harm to affected individuals was established.
The organization potentially faced $4 billion in damages--$1,000 for each of about 4 million affected patients--following the theft of a password-protected but unencrypted computer from its administrative offices in October 2011.
A lower trial court previously ruled that Sutter Medical violated the state’s Confidentiality of Medical Information Act and plaintiffs could plead for a cause of action without alleging that medical information on the computer had been seen. Sutter Medical, which argued there could be no cause of action because harm was not established, appealed and a three-judge panel of the Third Appellate District in the Court of Appeal of the State of California agreed.

Leapfrog: Hospital dangers still lurk

Posted on Jul 23, 2014
By Bernie Monegain, Editor
On the up side, more hospitals are adopting computerized physician order entry, which has proven to reduce medication error. On the down side, hospitals can't seem to get a handle on certain hospital-acquired infections.
The benefits – and dangers – of hospital stays are highlighted in the most recent report from healthcare watchdog organization Leapfrog in "Results of the 2013 Leapfrog Hospital Survey," which it completed with Castlight.
More than 1,400 hospitals participated in the survey – 1,437, to be exact, a record number, according to Leapfrog, and one that adds up to 37 percent of hospitals nationwide.

Patient data security: How hospitals keep pace

July 18, 2014 | By Susan D. Hall
By Susan D. Hall
In their efforts to secure patient data, hospital executives continue to worry about mobile devices--and are employing technology to help. But they acknowledge that the human factor remains the trickiest part of data security.
"There's this expectation that you should have access to everything, everywhere," Peter Odegard, information security officer at Children's Hospitals and Clinics of Minnesota, told FierceHealthIT of his concerns about the consumerization of mobile devices.

CMS: Clinical decision support not limited to pop-up alerts

July 23, 2014 | By Marla Durben Hirsch
The Centers for Medicare & Medicaid Services, evidently concerned about some of the negative outcomes involving intrusive pop-up clinical decision support (CDS) alerts, has issued a tip sheet and answers a FAQ to clarify that the Meaningful Use incentive program is not limited to this type of notification.
CDS tools are a "centerpiece" of the program, CMS says in the tip sheet. In Stage 1, providers must implement one CDS rule. In Stage 2 providers must implement five CDS interventions and enable and implement functionality for drug/drug and drug/allergy interaction. But the program does not require pop-up notifications.
CMS says that CDS "is not simply an alert, notification, or explicit care suggestion." It adds that providers can meet the program's objective via other kinds of CDS, including clinical guidelines, condition-specific order sets, focused patient data reports and summaries and diagnostic support, among other options.

Could health apps save your life? That depends on the FDA

July 21, 2014 11:26 AM
Mark Sullivan
The Food and Drug Administration (FDA), which regulates everything from heart monitors to horse vaccines, will soon have its hands full with consumer health apps and devices.
The vast majority of the health apps you’ll find in Apple’s or Google’s app stores are harmless, like step counters and heart beat monitors. They’re non-clinical, non-actionable, and informational or motivational in nature.
But the next wave of biometric devices and apps might go further, measuring things like real-time blood pressure, blood glucose, and oxygen levels.
You’ll begin to see these more advanced biometrics as we move from single-purpose fitness trackers like FitBit to more all-purpose devices like Apple’s upcoming “iWatch.”

California HIE adopts iBlueButton app to connect providers, patients

July 22, 2014Eric Wicklund - Editor, mHealthNews
A California HIE is partnering with Humetrix to allow physicians in that state to transmit medical records directly to their patients via mobile devices.
The partnership between California Direct and the developer of the iBlueButton app enables participating physicians and healthcare networks to quickly and securely send healthcare data to patients, officials said, as well as giving those patients a way to call up those records on mobile devices when needed.
"iBlueButton adds enormous value to California Direct by giving our physicians the capability to empower their patients," said Bill Beighe, general manager of Axesson, the technology provider behind California Direct, in a press release. "With the ability to push medical records to patients' mobile devices, participating doctors and health systems improve communications and allow patients to actively manage and drive their own healthcare decisions. We are using several standards including Direct Messaging, Blue Button+ and Consolidated CDA to facilitate the interoperability with modern health technology that is deployed or being deployed by providers and hospitals across the country."

How Big Data Can Identify At-Risk, Potential Patients

Marianne Aiello, for HealthLeaders Media , July 23, 2014

Carolinas HealthCare System is using predictive modeling to identify high-risk patients who might benefit from preventative care. In Ohio, Dayton Children's Hospital is using Google products to target potential patients.

I've found, over the years, that many hospital CEOs are visual thinkers—especially when it comes to marketing campaigns. It's the CEOs who tend to push for that extra highway billboard or that additional magazine ad-buy; it's something they can glance at on their drive to work or flip past when they're perusing articles.
Of course, this penchant for the tangible can be problematic for data-driven marketers.
I recently came across a Forbes article listing ten things about social media and marketing that every hospital leader needs to know. The most important, in my opinion, is buried down in the eighth spot:  "Targeted, content marketing costs 62% less than traditional marketing, and, per dollar spent generates about three times as many leads. "

Meaningful Use EHR Audits: When, Not If

7/22/2014 08:50 AM
Paul Cerrato
So your organization has accepted the feds' financial incentive. Now it's time to prove you're entitled to it.
Regardless of how much clinicians complain about their EHRs, if a hospital or medical practice accepts federal money to put them in place, it must prove it's using these electronic tools in a meaningful way, as defined by the Centers for Medicare and Medicaid Services. "When you pay $21 billion for a government program, you have to conduct appropriate oversight," Robert Anthony of the CMS said at the Healthcare Information and Management Systems Society (HIMSS) 2014 conference.
The CMS is performing pre-payment and post-payment audits on 5-10% of healthcare providers, choosing some of them randomly and others based on a CMS risk profile of suspicious or anomalous data. It's easy to get complacent when there's only a one in 10 chance of being audited, but that statistic is misleading. If 10% of all incentive recipients are audited in 2014, another 10% in 2015, and so on, eventually your organization will be targeted. As Tony Panjamapirom of the Advisory Board Co. put it in a separate HIMSS presentation: "I encourage you to think of the Meaningful Use audit as a matter of when you will get audited, not whether."

ePrescribing momentum begets momentum

By Mike Miliard, Contributing Editor
ePrescribing has taken off in the last decade, with the latest report from the Office of the National Coordinator for Health IT finding more 70 percent of physicians taking up the practice.
Thanks in large part to two federal initiatives – first the Medicare Improvements for Patients and Providers Act of 2008, or MIPPA, and later meaningful use – e-prescribing has made huge gains through the first quarter of 2014, the report from ONC's Meghan Hufstader Gabriel and Matthew Swain shows.
Using data from Surescripts, the nation's largest e-prescription network, the study shows a steep and steady climb for eRx – from 7 percent in 2008, when MIPPA was passed, to 24 percent in 2011, when meaningful kicked off, to 70 percent today.

Survey gives NHS Number another push

22 July 2014   Lyn Whitfield
NHS England has launched a survey on the use of the NHS Number, which is once again being promoted as the primary identifier for patient information in England.
The commissioning board says the survey will “enable NHS England to create a comprehensive picture of the use of the NHS Number in digital care” and, in particular, in digital correspondence.
Trusts are being asked to complete the survey by the end of the month, so NHS England can put together a progress report by September, and then offer organisations “targeted support”.

Stress health IT's role in care innovation, not adoption

July 22, 2014 | By Susan D. Hall
Rather than stressing adoption of health IT, the industry should be focused on how technology can be part of innovative new strategies to improve care, according to a Health Affairs blog post.
The current Meaningful Use program "has obscured the creative opportunity for clinicians to explore how to use EHRs to improve care, and to see their own actions as part of the solution to effective implementation," write the authors, who encourage rethinking incentives for physicians.
They advocate for approaches focused on technology that support high quality, team-based care that can improve outcomes at the patient and population levels and lead to provider satisfaction.

As HIPAA Breaches Accelerate, Tools Lag

Scott Mace, for HealthLeaders Media , July 22, 2014

For hospital and health system boards, CIOs, and CISOs, better data breach analysis tools, or more consistent legislation cannot come soon enough.

Earlier this month, the HHS Office for Civil Rights issued its Annual Report to Congress on Breaches of Unsecured Protected Health Information, the second such annual report. The findings are sobering.
From September 2009 to December 2012, OCR received 710 breach reports affecting approximately 22.5 million individuals. The frequency of those breach reports, according to one tally, is spiraling upward, up nearly 46% in the period between January 2014 and May 2014 over the same period in the previous year.
Another recent report notes that more and more organizations are learning of breaches by phone calls from, among others, the FBI.

IT, patient-centered research key to pushing disease prevention efforts

July 21, 2014 | By Dan Bowman
Information technology will be crucial to pushing disease prevention efforts in healthcare, according to a recent viewpoint published in the Journal of the American Medical Association.
A "widespread uptake" of personalized health technology, the researchers say, is needed to "reduce the burden" of chronic diseases such as heart disease, cancer or diabetes. For that to occur, they say, a framework that encourages basic technology use is necessary.
"Investing in prevention should be a strategic national priority to help improve the lagging population of the United States compared with peer countries," say authors Derek Yach of the New York-based Vitality Institute and Chris Calitz of the Bloomberg School of Public Health at Johns Hopkins University. "Increasing federal funding for prevention science and fostering stronger public-private partnerships are important steps toward providing policy makers with evidence-based tools to use limited resources effectively and efficiently."

The Convergence of Provider Creativity and Health IT

by Donald Voltz Monday, July 21, 2014
Medicine is not often thought of as a creative industry. We focus instead on science and evidence. Behind the science is a group of driven individuals who are focused on problem solving.
The patient's chart is a collection of information and a record of the thoughts and decisions of those who interact with that patient. Gone is the day of a literary description of a patient's ailments, the physician's thoughts and evidence to support the diagnosis and treatment plan. The medical record was a place to follow the often winding path of patient care. 
Medical documentation records the history of a patient's illness and the interventions one goes through on the path to healing. It is something we physicians take seriously, not only to meet legal and professional obligations, but also to record our thoughts. The record captures the creative or artful side of medicine. 

Hazards tied to medical records rush

Subsidies given for computerizing, but no reporting required when errors cause harm

By Christopher Rowland

 July 20, 2014
Dr. Larry Gordon and medical assistant Amanda Naimo discussed a procedure at the nurses’ work station at Family Medicine Associates in Hamilton. Some doctors say their data software is confusing to use.
Theresa Robertson’s bedside oxygen alarm sounded at 2:52 a.m., sending an urgent beep through the South Shore Hospital emergency room.
The alarm came as something of a surprise. The 46-year-old visual artist from Weymouth, who suffered from diabetes, congestive heart failure, and other serious health problems, had arrived at the nearby community hospital complaining of shortness of breath the previous afternoon. But by midnight, her vital signs were stable and she was resting peacefully.


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