Saturday, February 21, 2015

Weekly Overseas Health IT Links - 21st February, 2015.

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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Choose an open EHR, DoD is urged

Posted on Feb 13, 2015
By Bernie Monegain, Editor-at-Large
With fewer than five months before the Department of Defense is due to make a decision on its massive $11 billion electronic health record modernization project, a new report from a heavyweight think tank urges it to opt for an open system.
The DoD's $11 billion Healthcare Management Systems Modernization Electronic Health Record program would replace and modernize the existing EHR system, which supports more than 9.7 million beneficiaries, including active duty, retirees and their dependents. It serves patients and clinicians in 2,300 locations around the world.
Vying for the contract are four teams:
  • IBM and Epic
  • Computer Sciences Corp., partnered with HP and Allscripts
  • Cerner, Leidos, Accenture Federal and Intermountain Healthcare
  • PwC withGeneral Dynamics Information Technology, DSS Inc., Medsphere, and Google
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CMS Provides Meaningful Use Penalties, Payments Update

Author Kyle Murphy, PhD | Date February 12, 2015

The latest EHR Incentive Programs update from CMS estimates how meaningful use penalties will affect eligible professionals in 2015.

During the most recent meeting of the Health IT Policy Committee, the Centers for Medicare & Medicaid Services (CMS) provided financial figures for both meaningful use penalties and incentives.
The figures related to Medicare payment adjustments (i.e., meaningful use penalties), however, are only estimates. Elisabeth Myers of the Office of eHealth Standards and Services at CMS explained the rationale behind the decision to publish this information.
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Providers to ONC: Strategic plan needs more detail

February 9, 2015 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT's updated 2015-2020 strategic plan sets lofty goals, which provider groups say need to be more "refined."
The strategic plan includes five sweeping goals: expanding the adoption of health IT, advancing data sharing, strengthening healthcare delivery, improving patient engagement and advancing research and innovation.  
In a comment letter dated Feb. 6, the American Hospital Association (AHA) says that having broad goals is important, but data sharing and technical standards are "prerequisites" to some of the goals and should be priorities. AHA expressed concern as to how the goals would dovetail with expectations in the private sector, considering the "tremendous" burdens already being placed on it. The association also said that ONC should work on patient matching and make the plan more specific.
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Patient safety leader named CIO at Brigham & Women's

Posted on Feb 12, 2015
By Richard Pizzi, Editorial Director
David W. Bates, MD, an expert in patient safety, has been named senior vice president and chief innovation officer at Boston's Brigham and Women's Hospital.
Bates previously served as the chief quality officer at BWH. In his new position, he will focus on identifying opportunities to drive transformative change, with the goal of translating inventions, discoveries and new ideas into services and products that benefit patients and improve the delivery of care. He will also serve as executive sponsor of the Brigham Innovation Hub, or iHub, a catalyst of innovation across the hospital.
According to BWH's president Elizabeth G. Nabel, MD, was promoted to foster a culture of innovation and the establishment of infrastructure to support it across the institution. "Innovation is at the core of our academic mission," Nabel said.
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End of the Runway for Gadget Pageantry and Other Radical Health Predictions

by Jeff Margolis Thursday, February 12, 2015
Where is the consumer? This is not a game of "hide and seek" in health care, but rather the critical missing element needed to have a fully functioning health care system. Getting the consumer involved -- as a consumer, not just as a patient -- is essential to spur change. 
It's exciting to see consumers' role in health care evolve as they internalize the reality of taking on more financial responsibility for their health and, in turn, demanding greater affordability, convenience and choice. But what does this mean for the future?
As someone who is passionate about curing the health care system, I've spent significant time and energy strategizing about where we need to go from here. Here are three consumer health-centric predictions that may be a little surprising to some, a little irritating to others and hopefully stimulating to all.
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Experts warn 2015 could be 'Year of the Healthcare Hack'

NEW YORK/BOSTON Wed Feb 11, 2015 1:29pm EST
Credit: Reuters/Dado Ruvic
 (Reuters) - Security experts are warning healthcare and insurance companies that 2015 will be the "Year of the Healthcare Hack," as cybercriminals are increasingly attracted to troves of personal information held by U.S. insurers and hospitals that command high prices on the underground market.
Anthem Inc, the No. 2 U.S. health insurer, last week disclosed a massive breach of its database containing nearly 80 million records, prompting investigations by state and federal authorities. That hack followed a breach last year at hospital operator Community Health Systems, which compromised some 4.5 million records.
    "People feel that this will be the year of medical industry breaches," said Dave Kennedy, chief executive of TrustedSEC LLC.
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Optimizing the HL7 C-CDA?

Viet Nguyen, MD, Systems Made Simple,
As healthcare organizations move toward population health management and care coordination models, they are becoming increasingly dependent on technology to enable meaningful information exchange across the continuum.
Underpinning electronic information exchange is HL7’s C-CDA (Health Level Seven International’s Consolidated-Clinical Data Architecture), which defines the structure and semantics of key clinical documents to allow complete and accurate information sharing between healthcare organizations.  HL7 C-CDA Release 1.1 governs nine document types, which represent the major information resources for clinical care: Continuity of Care Document (CCD), Consultation Note, Diagnostic Imaging Report (DIR), Discharge Summary, History and Physical (H&P), Operative Note, Procedure Note, Progress Note, and Unstructured Documents.
At this time, most EHRs can only share one of the aforementioned reports externally—the CCD—which provides a patient snapshot, including past medical history, medications, the problem list and allergies. While sharing the CCD is a step toward interoperability, it is a relatively small one. EHR vendors have been focused on exchanging this particular report to meet Meaningful Use requirements, but they now need to take the next step and enable additional C-CDA documents that include more detailed and timely information.
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Nine in 10 Eligible Hospitals Achieve Meaningful Use in 2014

FEB 11, 2015 7:43am ET
The EHR meaningful use achievement rate for nearly 5,000 eligible hospitals is 90 percent through December 2014, according to the latest numbers from the Office of the National Coordinator for Health IT.
ONC’s Dawn Heisey-Grove told a Feb. 10 joint meeting of the HIT Policy and Standards Committees that of all eligible hospitals 90 percent have attested to some stage of meaningful use, 5 percent are adopting, implementing or upgrading (AIU) paid, 1 percent are registered and 4 percent are not participating.
“AIU paid” refers to hospitals that have been paid to adopt, implement, or upgrade to a certified EHR technology, but have not yet attested to meaningful use. Registered hospitals are those that have registered with the EHR Incentive Program, but have not attested or received payment. Non-participating hospitals are those that have not yet registered with the EHR Incentive Program.
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Vendors lagging with patient engagement technology

Posted on Feb 11, 2015
By Mike Miliard, Editor
Despite conditions across the healthcare industry that should be driving big changes in between-visit and post-discharge communications, most providers are still doing the "bare minimum" with regard to patient engagement, according to a new report from Chilmark Research.
Advances in mobile and cloud technologies, consumerization of care delivery, meaningful use incentive payments and a broader move toward value-based reimbursement would seem to be creating ripe conditions for more fruitful engagment initiatives. But Chilmark's 2014/2015 Clinical Patient Engagement Market Trends Report shows a healthcare industry "still struggling to catch up with basic consumer expectations set by banking, airline and other major consumer industries."
Part of the fault for that lies with vendors, the study shows, since many healthcare organzations lean heavily on their technology providers to help drive their patient outreach projects.
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Deloitte introduces Evergreen

Posted on Feb 11, 2015
By Bernie Monegain, Editor-at-Large
With the launch of Evergreen, billed as a new approach to EHR implementation and maintenance, consulting giant Deloitte claims it can help reduce EHR operating costs by as much as 30 percent.
Evergreen is designed to help reduce hospital system IT costs as healthcare moves to a value-based model more reliant on clinical and enterprise data, Deloitte executives said in taking its new methodology to market today.
Evergreen could help health systems save as much as 30 percent on EHR operating costs by using a global staffing model and a standardized design that works to improve clinical optimization, Deloitte says. Evergreen also leverages Deloitte's cyber risk services in providing advanced levels of data security and compliance.
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More Thorough Analysis of Health IT Adoption Needed, RAND Argues

February 10, 2015
Despite increasing adoption rates of electronic health records and other health information technology systems, a new RAND Corporation analysis argues that our knowledge about their value is not advancing.
Researchers from the RAND Corporation, a Santa Monica, Calif.-based nonprofit organization, say that studies have not done an adequate job evaluating health IT over longer periods of time to see its cost and benefit to patients. Most studies, RAND researchers say, have only looked at health IT adoption over a short period of time, which ignores downstream benefits.
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Joe’s view: An SCR iPhone App?

Apple’s latest operating system comes with an emergency medical screen for users to fill in. Joe McDonald wonders why it doesn’t link to the Summary Care Record; or even a detailed care record.
10 February 2015
A few of you might recall that a couple of years ago I suggested that pending the widespread availability of the Summary Care Record it would be wise for those with a serious condition or adverse drug reactions to improvise one.
I suggested that people in this position should make an SCR visible on the front of their iPhone; writing it in the notes app and then screen-shotting it so that it could be set as the lock screen. It gladdened my heart that quite a few of you took the trouble to follow my advice.
When I downloaded iOS 8 to my iPhone, I was delighted to see that the new HealthKit  app now includes the ability to click through the phone’s lock screen to an emergency medical  record, ‘Medical ID’ (pictured).
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Google, Mayo Clinic partner to enhance Web searches for health information

February 10, 2015 | By Katie Dvorak
As more people turn to the Internet to search for health information, Google is trying to redefine what they will see when using its search engine.
In partnership with Mayo Clinic, the technology giant is looking for a way to present that information in a better format and more accurately, according to an article at MedCity News.
Doctors from the clinic will OK the information, which also will be verified by an average of 11 physicians, according to the article. The information will be displayed in a box on the right-hand side of the screen during Google searches. The same holds true for Google's app, which will display even more details related to the illness or disease.
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AHA to ONC: Prioritize goals to achieve strategic federal health IT plan

Written by Akanksha Jayanthi (Twitter | Google+)  | February 09, 2015
In a letter addressed to National Coordinator Karen DeSalvo, MD, the American Hospital Association suggests the ONC prioritize certain goals to help make progress in health IT.
The ONC's Federal Health IT Strategic Plan outlines five goals: expand adoption of health IT, advance secure and interoperable health information, strengthen healthcare delivery, advance the health and well-being of individuals and communities and advance research, scientific knowledge and innovation.
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ECRI's Watch List for Hospital Execs Highlights Technology

Cheryl Clark, for HealthLeaders Media , February 10, 2015

Implantable devices that fight obesity and diabetes and 3D printers that produce human tissues and organs are among the technologies and strategies healthcare executives should be considering, according to the ECRI Institute.

From 3-D printing of body parts to special clinics for teens with cancer, the fifth annual ECRI Institute Hospital C-Suite Watch List report lists 10 healthcare strategies it says executives should consider implementing.
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Anthem Breach Puts Data Security in the Spotlight, Again

Scott Mace, for HealthLeaders Media , February 10, 2015

But will the massive data breach really signal that business as usual is over when it comes to healthcare data security?

That sound you hear is the lingering sound of last week's breach of 80 million member and employee records from Anthem sucking all the oxygen out of the healthcare IT conversation.
Anthem faces a minimum of $100 to $200 million in costs to fix the harm done by unknown criminal hackers who managed to exfiltrate names, social security numbers, and income data of customers and employees.
That financial liability could go much higher. USA Today reports that attorneys have filed lawsuits in four states: Indiana, California, Alabama and Georgia. Others are certain to follow.
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Why Anthem Must be a Turning Point for Security

FEB 9, 2015 11:37am ET
80 million? Is a breach of protected health information at Anthem for upward of 80 million individuals enough to push America’s healthcare industry and its regulators to get more serious about encryption?
It wasn't so long ago that the HIPAA privacy and security rules were updated, and yet today they are already wildly outdated. We need another rework and soon; the onslaught of organized and sophisticated hacking for profit by criminal enterprises compels it.
These hacks are not new, but the intensity and size of these breaches continue to grow. So far, the Department of Health and Human Services hasn’t made the jump to flat-out mandate encryption of PHI at rest whenever possible--even though it should have done this long ago. Now it really has no choice, but the question remains: Does the industry have the fortitude to enforce such a mandate?
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Anthem hack: Employee access, not encryption, the problem

February 11, 2015 | By Katie Dvorak
As the investigations and lawsuits roll in over the breach of health insurance company Anthem, the industry is taking a closer look at the company's security practices.
Some initial reports on the cyberattack, which impacted about 80 million current and former Anthem consumers, cited lack of encryption as a possible failing on Anthem's part. However, just because the information wasn't encrypted doesn't mean it wouldn't have been compromised anyway, according to an article in MIT Technology Review.
HIPAA currently doesn't require encryption, it only encourages it. However, in the wake of the Anthem breach, federal officials plan to review whether encryption should be a requirement. The Senate Health, Education, Labor and Pensions committee on Friday said it will take up the matter as part of a bipartisan review of health information security.
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Anthem Hack: Lessons For IT Leaders

There are two key lessons that IT can learn from the Anthem breach.
2/12/2015 12:06 PM
Joe Stanganelli
Commentary
When Anthem became the latest high-profile hack victim to grace headlines last week, it would be impossible not to wonder what would happen at your own organization should a similar breach occur. There are two key lessons that IT can take away from the Anthem breach.
The first is to remember that the business decisions you're making today about whether or not to encrypt data can have significant and oftentimes unintended consequences. The second is to ask yourself whether you and other decision-makers in your organization truly understand the value of your data. While those working in retail and financial services have long been on the front lines on the cyber security wars, the breach of medical information is a wake-up call to the fact that other types of data are also valuable to criminals. It's time to audit the data you have on your customers (and your employees), examine who in your organization has access to that data, and consider whether the things you consider to be low-risk might, in fact, be coveted by hackers.
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Google plays doctor with answers to your health questions

As more people rely on the Web for health information, the company's search results will now start to display greater details in response to your health-related queries.
Have a question about a specific medical condition? You may now be able to find the answers you seek via Google.
Obivously, you've always been able to search for health and medical information at Google. But now the search giant will start showing more "relevant medical facts" right off the bat, Google product manager Prem Ramaswami said in a blog post Tuesday. The information appears in the Knowledge Graph side panel alongside Google's regular search results and allows you to drill down to get specific information on symptoms, treatments and other facts about that condition you're fretting about.
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SCR reaches 50m patients

9 February 2015   Sam Sachdeva
The NHS Summary Care Record has reached the 50 million patient mark, with more than 30,000 record views now occurring each week.
The milestone is the latest demonstration of the SCR’s growing use, after it was initially bedevilled with criticisms about confidentiality and low viewing levels.
The Health and Social Care Information Centre announced last week that there are now 50 million people with an SCR created from their GP records, meaning that 90% of the population is now covered.
The record provides a core set of required clinical data, including allergies, medications and adverse reactions, pulled from GP systems, which can be viewed by health professionals involved in a patient’s care.
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Patient-Centered Medical Homes on Right Track

FEB 9, 2015 7:59am ET
A Patient-Centered Primary Care Collaborative analysis of the effectiveness of primary care patient-centered medical homes reveals the PCMH movement results in lower costs and decreased utilization.
The report, "The Patient-Centered Medical Home’s Impact on Cost and Quality, Annual Review of Evidence, 2013-2014," is the third annual Milbank Memorial Fund-supported report on the topic from the organization. It analyzes new evidence from primary care PCMH initiatives taking place in both public and private markets throughout the United States. The publication includes an aggregation of PCMH outcomes from a combination of 28 peer-reviewed studies, state government program evaluations, and industry reports.
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Lawmakers to rethink requiring encryption in HIPAA

February 9, 2015 | By Susan D. Hall
In light of the cyberattack against Anthem, federal officials plan to review whether HIPAA should require encryption, according to the Associated Press.
The Senate Health, Education, Labor and Pensions committee on Friday said it will take up the matter as part of a bipartisan review of health information security.
"We need a whole new look at HIPAA," David Kibbe, CEO of DirectTrust, a nonprofit working to create a national framework for secure electronic exchange of personal health information, told the AP.
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3 ways data analytics can transform healthcare

February 9, 2015 | By Katie Dvorak
Analytics can and will change healthcare as we know it--but several obstacles remain, according to David Lee Scher, M.D., director at DLS Healthcare Consulting LLC.
Currently, data collected by healthcare entities is "warehoused in a contextual vacuum," Scher writes in his blog, "The Digital Health Corner." To truly make use of the data, analytics tools are needed to put all the pieces together, he says; to do that, data needs to be delivered in real-time while being included in workflows.
Some ways Scher says data analytics should be used in healthcare include:
  • Turning big data into "actionable data": Remote patient monitoring is growing, and it's a great way for systems to incorporate analytics, Scher says. Those kinds of data sets could help suggest ways to change a patient's lifestyle or care. "This is a far cry from the provider receiving a deluge of useless data for analysis," he writes. "This type of analytics can also incorporate clinical decision support based on evidence-based medicine."
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GAO: CMS on target with ICD-10 readiness efforts

February 9, 2015 | By Katie Dvorak
The Centers for Medicaid & Medicare Services has taken positive steps to help prepare the healthcare industry for ICD-10, but every organization must prepare in advance if the transition is to be successful, according to a report published late last week by the Government Accountability Office.
In its review, GAO looked at the agency's activities to support the transition, as well as stakeholders' biggest concerns about preparation for the system and how those concerns were addressed. Additionally, GAO gave a draft of the report to the U.S. Department of Health and Human Services--which agreed with the findings.
Those findings, for which GAO spoke with 28 stakeholders, include:
  • Educational material CMS has for covered entities on its website were found helpful by all 28 stakeholders
  • CMS' ICD-10 website to aid small practices, Road to 10, was found helpful by 17 of the 28 stakeholders
  • Tools to help providers know which codes to use in the new system were only found helpful by six of the stakeholders
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CDS buyers need more info to make good decisions

February 9, 2015 | By Susan D. Hall
Buyers of clinical decision support systems need more and better information to make informed purchase decisions, according to an article published online this week in the Journal of the American Medical Informatics Association.
While some groups--including the Healthcare Information and Management Systems Society, the Leapfrog Group, the ECRI Institute and others--offer some guidance on their websites, it may be too general to be truly useful, the authors say.
Research on the systems largely has focused on safety and efficiency, while there's little evaluation of outcomes, including morbidity, length of hospital stay and adverse events.
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FDA makes official its hands-off approach to regulating health apps and medical software

February 6, 2015 10:26 AM
Mark Sullivan
The Food and Drug Administration today issued its final guidance on the regulation of health apps and other software, and health tech developers should be breathing a sigh of relief.
The FDA confirmed that it’ll take a hands-off approach to most medical device data systems (MDDS), or software that conveys data to and from a medical device (like a glucose meter, for example).
“This guidance confirms our intention to not enforce regulations for technologies that receive, transmit, store, or display data from medical devices,” the FDA statement reads. “We hope that finalization of this policy will create an impetus for the development of new technologies to better use and display this data.”
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Many HIEs Face Questions of Sustainability

by Heather Drost, iHealthBeat Associate Editor Monday, February 9, 2015
In July 2014, the Connecticut Health Information Exchange (HITE-CT) was effectively shut down by the state Legislature, without ever performing any health information exchange services.
The quasi-public agency was created in 2010 and was partially funded by the Office of the National Coordinator for Health IT's State HIE Cooperative Agreement Program, created under the HITECH Act.
The group aimed to create and manage a statewide HIE that would be used by Connecticut's health care providers. Its 20-member board of directors included several high-level public officials, such as the lieutenant governor, the commissioner of the Department of Public Health and other stakeholders.
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Enjoy!
David.

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