- Cost-containment pressures from the Affordable Care Act; and
- Attempts to reduce the inefficiencies and access issues that have long driven up care costs.
Saturday, September 13, 2014
Weekly Overseas Health IT Links - 13th September, 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.
SEP 4, 2014 9:13am ET
Open source software developer Amida, based in Washington, D.C., has released the second version of its Data Reconciliation Engine (DRE), a Blue Button-branded software component that supports the aims of the Blue Button Initiative.
"The DRE is the first production-ready, format-agnostic open source health record interface in the health IT market," company executives said. "The second release extends the kinds of formats that the DRE can ingest, and now includes the CMS Blue Button file. It also supports the ability to export a Consolidated CDA record. The release includes technical enhancements that improve record matching, insurance modeling, and its deployment scripts."
SEP 4, 2014 8:46am ET
Fast Healthcare Interoperability Resources (FHIR) from standards development organization Health Level Seven is gaining momentum as an open healthcare data standard.
That is the consensus of a joint Health IT Policy Committee and Standards Committee task force. The committees advise federal agencies.
In a Sept. 3 HITPC meeting, David McCallie and Micky Tripathi, co-chairs of the JASON Report Task Force created to analyze interoperability recommendations by an independent group of scientists, made the case that the “growing industry adoption of standards-based [application programming interface] work such as HL7 FHIR, focused on high-value use cases, is the most appropriate and sustainable path to accelerated use of standardized data-level APIs across the industry.”
September 5, 2014 | By Dan Bowman
Federal legislators should exercise caution in doling out more money for health IT interoperability efforts, as there is no guarantee that doing so will actually improve health data exchange, writes John Graham, a senior fellow at the National Center for Policy Analysis and the Independent Institute.
Graham, in a commentary for Forbes, called interoperability a "unicorn," saying that despite billions of dollars sunk into the Meaningful Use incentive program, data exchange between hospitals on disparate EHR systems remains difficult, if not impossible.
"[E]xchanging data with competitors is fundamentally against the self-interest of the part which created the data," Graham said. "Nobody would expect the U.S. Department of Transportation to set up a fund to incentivize car-makers to exchange data with each other, or the U.S. Department of Agriculture to set up a fund to incentivize grocery stores to exchange data with each other."
Friday, September 5, 2014
Telemedicine -- or telehealth, as it's broadly called -- and emerging mobile health technologies are progressing, despite challenges related to logistics, regulations and reimbursement. Telehealth is also reshaping the health care delivery landscape through integration with clinical practice, largely because of IT advances and innovation.
The drivers and contextual forces propelling the shift, on one hand, are the usual suspects:
But there's a new force spurring telehealth advances that may prove just as powerful: consumers. As consumers pay more for medical services amid benefit plans change, they are demanding more access to convenient, technology-enabled services.
SEP 3, 2014 10:08am ET
A smoking cessation program developed at Massachusetts General Hospital increased the proportion of hospitalized smokers who successfully quit smoking after discharge by more than 70 percent.
The system used interactive voice response technology--automated telephone calls--to provide support and stop-smoking medication for three months after smokers left the hospital. The program was the focus of a study published in JAMA.
The program developed by the MGH team provides smokers with a series of interactive automated telephone calls beginning two days after discharge and up to three months’ supply of the patients’ choice of any FDA-approved, stop-smoking medication. At each call, the automated system asked patients to indicate whether they were smoking, gave advice on staying smoke-free, encouraged the proper use of medication and offered medication refills. Participants requesting additional help received a call back from one of the program’s tobacco treatment counselors.
Posted on Sep 04, 2014
By Kip Sullivan, Contributing writer
In case you blinked, big data is the newest new thing in establishment health policy. The July 2014 edition of Health Affairs carries on its spine the title, “Using big data to transform care.” It was funded by IBM and the UnitedHealth Foundation, among others. Last year McKinsey & Company published a paper entitled “The big-data revolution in US health care” in which the authors predicted big data will cut American health care costs by 12 percent to 17 percent. A public-private group called Health Data Consortium, which includes the Institute of Medicine, Hewlett-Packard, and Emdeon, was formed in 2012 to promote the collection of all forms of health data.
A late July 2014 article in Fortune testifies to the power of the hype promoting big data. Although the article quotes two experts in biology who throw very cold water on the notion that big data can make substantial improvements in cancer care, the article also reports that two very smart 28-year-old guys with business degrees from the Wharton School of Business have raised $138 million, $100 million of it from Google Ventures, for a company that will attempt to divine new treatments for cancer from massive amounts of data about cancer patients. Someone is going to be proven wrong here. Who will it be? The info tech wizards and their wealthy backers, or the biology experts (one of whom discovered the first oncogene)?
Posted on Sep 04, 2014
By Tom Sullivan, Editor, Government Health IT
The Office of the National Coordinator for Health IT has been reshaping itself for the future and is working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST.
In all the efforts interopeability is critical.
Documents from JASON, conducted by independent scientists at The MITRE Group advising the Agency for Healthcare Research and Quality, and the President’s Council of Advisors on Science and Technology delve into health infrastructure and information exchange, essentially pointing to what needs to be done.
ONC’s HIT Policy Committee established a JASON Report Task Force and on Wednesday, co-chair Micky Tripathi suggested, among other things, that ONC cross-reference both PCAST and its own ONC Interoperability Roadmap when deciding how to move forward.
Posted on Sep 04, 2014
By Mike Miliard, Managing Editor
In part two of the Healthcare IT News Q&A with Micky Tripathi, he lays out the ways interoperability can finally be brought to fruition in the U.S. over the coming decade. Hint: the federal government and the private sector each have big jobs to do.
In our chat Wednesday with Tripathi, CEO of the Massachusetts eHealth Collaborative and co-chair of the joint HIT Policy and Standards Committee's JASON Task Force, he offered some perspective on how and why interoperability has historically been such a problem for healthcare – and discussed lessons that might be drawn from other industries that were able to make it happen.
With the Office of the National Coordinator for Health IT now redoubling its efforts to make seamless, wide-reaching data exchange a reality within the next 10 years, he gives some further thoughts on how it all might play out.
September 3, 2014 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT should consider some but not all of the findings of the JASON report in going forward with Stage 3 of Meaningful Use and interoperability, according to ONC's JASON task force.
In a report presented to ONC's Health IT Policy Committee on Sept. 3, the task force pointed out that the JASON report--which found Meaningful Use's Stage 1 and 2 had not achieved "meaningful interoperability" and stressed a need to create a unifying software architecture using application programming interfaces--is based on out-of-date data.
"Current EHR systems have much more functionality ... than JASON gives them credit for," said Micky Tripathi, co-chair of the task force.
September 4, 2014 | By Susan D. Hall
The switch to ICD-10 poses the risk of under-reporting and over-reporting adverse events due to mismatches in codes for Patient Safety Indicators (PSIs), according to research at the Journal of the American Medical Informatics Association.
The researchers, from the University of Illinois at Chicago, looked at 23 types of PSIs. They found three had straightforward mapping between ICD-9 and ICD-10, while 15 had convoluted mapping and five had no mapping at all.
They pointed at two--PSI-15 and PSI-25 "Accidental puncture or laceration"--that pose significant challenges.
September 4, 2014 | By Dan Bowman
As use of electronic health records by providers and health tracking devices by consumers becomes more ubiquitous, the health IT industry is gaining a reputation as an emerging sweet spot for technology investors, according to a Reuters report.
Several investors, according to Reuters, said they see health IT as more of a safe bet than an industry like biotechnology. While success in the former industry is linked to services and data being sold to insurers and providers, the latter's success hinges on the unpredictable drug market, the article notes.
"Healthcare is a massive market," Kevin Spain, a general partner at Emergence Capital Partners, tells Reuters. Spain says he invested close to $40 million in health technology startup companies like Augemedix, which is creating tools that can be used by providers wearing Google Glass to view EHRs.
EHR implementation may lead to a dip in patient volume but can boost revenue in the long term, according to a study in the Journal of the American Medical Informatics Association.
In the study, researchers compared patient volumes and revenues at 30 ambulatory clinics before and for two years after and EHR was implemented.
Over the two post-EHR years, patient volumes dropped across specialties to the tune of 108 patients less per quarter. However, the practices were billing for an average of an additional 94 ancillary procedures per quarter after the EHR implementation.
Posted on Sep 03, 2014
By Mike Miliard, Managing Editor
When Micky Tripathi and David McCallie deliver their draft recommendations to the Health IT Policy Committee today, they'll have some pointed things to say about the JASON report, and its ideas about the state of nationwide interoperability.
Tripathi, CEO of the Massachusetts eHealth Collaborative, and McCallie, senior vice president of medical informatics at Cerner, are co-chairs of the joint HIT Policy and Standards Committee's JASON Task Force – charged with digesting the report, "A Robust Health Data Infrastructure," prepared for AHRQ by the MITRE Corporation's JASON advisory group, and making suggestions to ONC about what to do with its findings.
In a presentation made to their own JASON Task Force on Sept. 2, Tripathi and McCallie offered their perspective about the dense, 69-page report, which assesses the U.S. healthcare's readiness for widespread and seamless data exchange.
How ready? JASON's verdict: not very.
September 3, 2014 | By Katie Dvorak
There a three big risks when it comes to data security, Chuck Podesta, CIO at Orange County, California-based UC Irvine Health, says in a recent interview with the Institute for Health Technology Transformation. Those risks include internal breaches, external breaches and physical theft of data.
As far as information protection goes, Podesta, who served as senior vice president and CIO of Burlington, Vermont-based Fletcher Allen Health Care at the time of the interview, says there is "no excuse for not encrypting." He points to the HITRUST Common Security Framework as a way to reduce risk.
September 3, 2014 | By Dan Bowman
Expansion to telemedicine coverage for Medicare beneficiaries recommended by the Centers for Medicare & Medicaid Services in its proposed update to the Medicare Physician Fee Schedule for 2015 generally was praised in comments recently submitted by industry stakeholders, including the American Telemedicine Association (ATA) and the American Hospital Association (AHA).
ATA CEO Jonathan Linkous, in a letter sent to CMS Administrator Marilyn Tavenner, said his organization "strongly supports" the recommendations, which include proposed coverage of annual wellness visits and psychotherapy. He added that ATA "appreciates CMS making explicit that two CPT codes for computer-based psychological testing are payable in the same way as other physicians' services, and not as telehealth services with accompanying severe restrictions."
Linda Fishman, senior vice president of public policy analysis and development at AHA, said her organization was "especially pleased" to see "certain behavioral health services" receive more attention.
SEP 1, 2014
An illustrated look at some of the more offbeat ICD-10 codes is starting to go viral. A group of Madison, Wis.-based health IT experts and artists combined to produce "Struck By Orca: ICD-10 Illustrated," a guide to some of the humorously obscure examples
Posted on Mar 12, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Over the past few months, Beth Israel Deaconess has been the pilot site for a new approach to clinical information technology, wearable computing.
In the Emergency Department, we’ve developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.
Here’s how it works.
When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall. Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.
By Government Health IT Staff
Ending months of anticipation, the U.S. Department of Defense (DoD) released its official request for proposals to modernize its Electronic Health Records (EHR) system and enable the DoD to share health data with the private sector and the Department of Veterans Affairs.
The massive and ambitious project, called DoD Healthcare Management Systems Modernization (DHMSM), could cost as much as $11 billion and, Department officials hope, transform the DoD into a national healthcare technology leader.
Major technology companies and consultanices, among them IBM, HP, Computer Sciences Corp., and Epic Systems, have been gearing up and forming alliances for months to prepare to enter the RFP. The sense is that that DHMSM is more than a healthcare RFP, but a transitional step that will determine much of the future for IT in healthcare.
1 September 2014 Lis Evenstad
Just over half of GP practices in Scotland let patients order repeat prescriptions online or by email, a report by Reform Scotland shows.
EHI reported last week that figures from the Health and Social Care Information Centre suggest that only 5.6% of English patients have been “enabled” to use the same functionality.
The report from the Scottish think-tank shows that 51% of GP practices let patients order repeat medication electronically. It also says that 10% of Scottish GP practices let patients book appointments online.
29 August 2014 Lis Evenstad
Fewer than 3% of patients have access to their GP medical records online, according to figures from the Health and Social Care Information Centre’s indicator portal.
Patient access to medical records has been promoted by successive governments. The present administration promised that patients would have access to their full medical records online by April 2015.
However, the target has been scaled back, first to access to GP records, and then to access to a subset of the GP record; the information in the Summary Care Record.
September 2, 2014 | By Katie Dvorak
By Katie Dvorak
As the summer winds down and fall approaches, it's time to head back to school. For health IT professionals, or those looking to start a career in the industry, there are many education options.
Colleges and universities across the country now offer a wide variety of courses in healthcare information technology and healthcare information security. These courses, which range from certificate programs to graduate degrees, focus on the most current trends in healthcare IT--from health IT policy to data analytics. They offer students the opportunity to begin work as healthcare IT professionals or to take their careers to a new level.
Posted on Sep 02, 2014
By Bernie Monegain, Editor
The Department of Health and Human Services published a final rule for Stage 2 meaningful use August 29 that offers hospitals and physicians flexibility for 2014. CHIME and professional organizations had asked for even more flexibility. "Millions of dollars will be lost due to misguided government timelines," said CHIME CEO Russell Branzell.
Branzell went on to state: "Now the very future of meaningful use is in question.
The new rule allows eligible providers to use the 2011 Edition of certified EHR technology or a combination of 2011 and 2014 Edition for the 2014 Medicare and Medicaid EHR Incentive Programs.
Tuesday, September 2, 2014
In 2014, health care record-keeping and communication are finally emerging from the Stone Age and entering the 21st century, moving away from the pen-and-paper processes abandoned by the rest of the modern world decades ago.
This revolution is driven primarily by the HITECH Act and accompanying meaningful use program. These initiatives drove greater adoption of electronic health records by doctors and hospitals in the last five years than in the previous 40. According to one estimate, EHR adoption by physician practices rose from 17% in 2008 to 48% in 2013 and hospital EHR adoption increased from 13% to 70% during the same time period. These EHRs will play a central role in the move to accountable care and population health management.
As summer begins to lose its grip, the Meaningful use Stage 2 deadline continues to close in on U.S. hospitals.
Few are prepared.
As of August, only 3.1% of hospitals had cleared the Stage 2 threshold, according to industry analyst Frank Kelzon. And yet, a full reporting year begins in less than 30 days, on October 1.
Posted by Dr David More MB PhD FACHI at Saturday, September 13, 2014