Saturday, April 11, 2015

Weekly Overseas Health IT Links - 11th April, 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.

HIMSS weighs in on Interoperability Roadmap

Posted on Apr 03, 2015
By Mike Miliard, Editor
Noting that it builds on an approach that it "actively supports" – standards to lay the groundwork for interoperability, and processes to test and certify that IT systems implement those standards – HIMSS has offered qualified support for ONC's Interoperability Roadmap.
In an April 3 letter sent to National Coordinator Karen DeSalvo, MD, HIMSS submited its comments on ONC’s "Connecting Health Care for the Nation: A Shared Nationwide Interoperability Roadmap."

Epic makes another play for mHealth access to EHRs

April 02, 2015Eric Wicklund - Editor, mHealthNews
In some hospitals, administrators might soon be able to check the EHR to determine if a patient's bed has been made.
That's the upshot of a partnership announced between Epic and Vocera Communications that ties the latter's mobile communications capabilities into the former's EHR platform. And it marks just the beginning of an ambitious plan to add mHealth-based clinical capabilities to the EHR.
The partnership is the latest in a string of recent projects focused on enhancing the EHR platform with mHealth tools. They range from the likes of eClinicalWorks and Cerner moving to add connectivity with mobile devices to Epic's decision to launch its own app store.
The deal with Vocera starts simple. Vocera is integrating its two-way communications functions to Epic's EHR to enable housekeeping staff in a healthcare system to provide real-time updates on bed cleaning status and availability. Using a Vocera device, a staff member can dictate voice messages into the Epic EHR, updating management and improving the patient experience and workflow efficiency.

ONC launches online tools for State Innovation Models initiative

Written by Elizabeth Earl | April 02, 2015
The ONC has introduced a number of tools and resources on its website designed to help states participating in the State Innovation Models initiative.
The initiative, which currently includes 34 states and three territories as well as the District of Columbia, supports states in planning or implementing a proposal capable of creating statewide health reform. The reforms focus on Medicare, Medicaid and Children's Health Insurance Program beneficiaries, according to a news release.

HR: Your Buddy to Stop Snooping

APR 1, 2015 12:47pm ET
Is your organization conducting “proactive security audits” by searching for instances of employees improperly accessing protected health information?
If not, that’s something you need to be doing, and you need not do it alone, says Mark Combs, assistant CIO and a certified HIPAA security specialist at six-hospital West Virginia United Health System. Engaging the human resources department as a partner to offer continuing education on data security will help raise awareness, and keep it high, among employees.
Proactive audits search millions of data access events, looking for key patterns, such as an employee searching for the record of a patient with the same last name or same street, or employees currently hospitalized. Because HR makes sure that everyone knows about the audits, employee snooping usually drops significantly, Combs says.

Inherent Risks of Health IT, EHRs Putting Patients in Peril

APR 2, 2015 7:53am ET
As the adoption of health information technology continues to grow industry-wide, the potential for health IT-related harm to patients and even death will increase unless risk-reducing measures are put into place by healthcare organizations.
That’s the dire warning of a new alert from The Joint Commission that identifies specific types of sentinel and adverse events, describes their common underlying causes, and recommends steps to reduce risk and prevent future occurrences. According to the alert, health IT has inherent risks. Specifically, the document cites “incorrect or miscommunicated information entered into health IT systems” and “interfaces built into the technology” as contributing to adverse events, which “may occur through the use of electronic health records and related technologies.”

eClinicalWorks integrates wearables into EHRs

March 30, 2015 | By Marla Durben Hirsch
Ambulatory health IT vendor eClinicalWorks can now integrate fitness trackers and other wearables data into its subsidiary healow (health and Online Wellness) patient portal product.
The initiative, announced March 27, will enable consumers to include this data "seamlessly" into their personal health records (PHRs) via and mobile apps and track their activities and other habits. Several of the industry's leading wearables and fitness trackers have joined up, including Fitbit, Jawbone, Withings and ihealth.

Patient safety takes one-two punch

Posted on Apr 02, 2015
By Bernie Monegain, Editor-at-Large
A report from the Office of the Inspector General at the U.S. Department of Health and Human Services and a sentinel alert from the Joint Commission issued in succession this week hit patient safety hard.
The OIG issued its Compendium of Unimplemented Recommendations. The Joint Commission delivered Sentinel Event Alert No. 54, which focuses on the safe use of health information technology.
The March 2015 Compendium from OIG takes on topics such as payment policies and practices, contractor oversight, fraud, grant programs, financial stewardship  – and quality of care and safety.

Emis widens data sharing ambitions

2 April 2015   Sam Sachdeva
Emis is set to follow up its data sharing deal with TPP by expanding its interoperability agreements to cover the other suppliers in the market.
Emis is set to follow up a data sharing deal with TPP with new interoperability agreements to cover the other suppliers in the market.
The company says it is preparing to sign an agreement with INPS and Microtest to offer direct interoperability between clinical systems, allowing practices to ‘call’ a patient’s record directly from any system.

5 lessons for primary care docs using health IT to improve quality

April 2, 2015 | By Susan D. Hall
Primary care practices, even small ones, can use health IT to support quality improvement (QI), according to a new paper from the Agency for Healthcare Research and Quality, which offers guidance for doing so.
The paper highlights the efforts of two primary care practices--a small, independent practice, Foresight Family Physicians in Grand Junction, Colorado; and an academic one, the University of Missouri Health System in Columbia--as well as a health information network working with safety net clinics and small practices, OCHIN in Portland.
"Using health IT for QI requires purposeful and thoughtful planning, effort, and allocation of resources, all of which entail significant costs to primary care practices in terms of capital, clinician and staff training, and time," the paper states.

4 ways to balance health privacy, data sharing

April 2, 2015 | By Susan D. Hall
Health consumers want to know their data will be used for helpful purposes, yet seek assurances of privacy and protection against breaches, according to a new report from the Robert Wood Johnson Foundation.
The report, "Data for Health, Learning What Works," was based on "listening sessions" the foundation held in five cities last fall--Philadelphia, Phoenix, Des Moines, Iowa, San Francisco, and Charleston, South Carolina--in which people were asked to talk about their hopes, aspirations, worries and concerns when it comes to using digital data to improve health.
In the discussion to build a national health data infrastructure, such as the JASON report and interoperability roadmap, the voices of members of the public have not been heard, foundation member Michael W. Painter wrote at PLOS Blogs. These sessions aimed to rectify that.

Anesthesia Meets Automation

Tinker Ready, for HealthLeaders Media , April 2, 2015

The emergence of the SEDASYS system, the McSleepy, and other automated monitoring and drug delivery devices may herald the age of automation in anesthesia.

This article appears in the March 2015 issue of HealthLeaders magazine.
Increasingly, a colonoscopy team includes not just a gastroenterologist but also an anesthesiologist. Not content with conscious sedation achieved through a combination of intravenous drugs, more patients and gastroenterologists are opting for deep sedation that only an anesthesia professional can deliver.
That scenario is about to change. After years of research, debate, and Food and Drug Administration review, the SEDASYS system is now available. The device, the federal agency states, will allow nonanesthesia professionals to administer propofol during colonoscopy and esophagogastroduodenoscopy procedures, "provided they have training that meets the requirements and in settings having immediate availability of an anesthesia professional as defined in the labeling."

The Good, the Bad, and the Ugly of Health IT

APR 1, 2015 7:33am ET
While health information technology is too often viewed through rose-colored lenses as the cure for all that ails the healthcare industry, it has intended and unintended consequences, according to Robert Wachter, M.D., a professor in the Department of Medicine at the University of California, San Francisco.
Wachter, who first coined the term “hospitalist” and is generally considered the “father” of the hospitalist field, spoke to Health Data Management about his new bookThe Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine's Computer Age—which comes out today in hardcover. Though for years medicine stubbornly resisted computerization, with the passage of the HITECH Act and  after more than $30 billion in EHR incentives paid to providers by the federal government, Wachter asserts that healthcare has finally gone digital. Yet, once clinicians started using computers to actually deliver care, he says they started to realize that something was deeply wrong.

3 ways providers can mitigate health IT harm

April 1, 2015 | By Susan D. Hall
Electronic health records introduce new kinds of risks into an already complex healthcare environment, according to a new Sentinel Event Alert published this week by the Joint Commission.
The alert addresses several socio-technical factors at work with health IT that could lead to sentinel events, including usability issues leading to data-related errors; workflow and communication issues; internal/organizational policies; and hardware/software problems, among others.
To that end, suggested actions should focus on three areas, according to the Joint Commission:
  1. Safety culture: Efforts should include creation of an organization-wide "collective mindfulness" focused on identifying, reporting, analyzing and reducing health IT-related hazardous conditions, close calls or errors; comprehensive systematic analysis of each adverse event causing patient harm to determine whether health IT played a role; and shared involvement and responsibility for the safety of health IT.

Individuals worry EHRs, data exchanges worsen privacy, security

April 1, 2015 | By Susan D. Hall
Healthcare organizations must address consumers' concerns about individual control and privacy of their information to make health information exchanges (HIEs) and distributed research networks work, according to new research published this week in the Journal of the American Medical Informatics Association.
For the study, researchers from the University of California, Davis and the University of California, San Diego polled 800 randomly selected Californians in early 2013 to gather their views about the privacy and security of an electronic HIE, a research network and whether attitudes differed between the two. More than three-quarters of respondents, who were contacted by phone, rated security and privacy the most important factor in their willingness to participate.
The researchers found that 40.3 percent of respondents think an HIE worsens privacy while 42.5 percent believe it worsens security. More than half of respondents (52.4 percent) believe EHRs worsen privacy and 42.7 percent believe EHRs worsen security.

Poor, minority patients access patient portals less frequently

Written by Elizabeth Earl | March 31, 2015
Providing patients with access to their personal health records may encourage engagement, but poor and minority patients may be at a disadvantage for accessing the portals.
A study published in the American Journal of Managed Care found that nonwhite patients and patients who spoke Spanish as a primary language tended to access their personal health records less frequently than white, English-speaking patients. The study used a retrospective design including nearly 3.2 million adult patients in the Kaiser Permanente health system, measuring the number of times they accessed the patient portal from December 2010 through the present.
The researchers found that of the entire participant base, 56 percent were registered for the portal. The most likely members to register for the portal were women, non-Hispanic white individuals and people 30 years old or older. Race and ethnicity were the strongest predictors of portal registration, followed by the number of annual office visits, age and language preference. Asian and Pacific Island individuals were 23 percent less likely than white individuals to register, Hispanic members were 55 percent less likely and black individuals were 62 percent less likely.

Boston Children’s Hospital Loses EHR for 5 Days Due to Storage Issue

MAR 31, 2015 7:46am ET
Earlier this month, the electronic health records system at Boston Children's Hospital experienced an outage for five days, forcing the hospital to use paper and personnel to order diagnostic tests and medications as well as track test and treatment results.
Despite the five-day outage, caused by an unspecified hardware issue related to storage, all surgeries at the pediatric hospital continued as scheduled and with fewer than five elective medical admissions having to be postponed, according to an article in The Boston Globe. The newspaper also reported that digital imaging, patient registration, and scheduling were unaffected by the EHR shutdown.

FHIR poised for interoperability prominence

Posted on Mar 30, 2015
By Rick Cook, Contributing Writer and Frank Irving, Editor, Medical Practice Insider
It appears that FHIR is about to blaze through healthcare.
The standard – christened as Fast Health Interoperability Resources and pronounced “fire” – facilitates interoperability by providing an implementation framework combining Web technologies with Health Level 7’s existing offerings.
"The whole purpose of FHIR is to make it simple to exchange health information accurately, particularly for people who aren't technical," explained David Hay, product strategist for Orion Health. "FHIR grew out of the fact that existing standards such as CDA are not that straightforward to use. CDA is a document paradigm, but it doesn't really talk about how you can actually be exchanging documents."
And at HIMSS15, Health Level Seven will be demonstrating the latest version of its next generation standards framework for healthcare, according to HL7 CEO Charles Jaffe, MD. 

Govt hopeful on patient access target

26 March 2015   Rebecca McBeth
The government is optimistic about meeting an April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
The government is optimistic about meeting its April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
Health secretary Jeremy Hunt has pledged that all patients who want it will have online access to their GP record by 31 March 2015. The government scaled back the pledge in October 2013, requiring GP practices to provide access to only the brief information held on their Summary Care Record.

Framework needed for Internet of Things policies

March 31, 2015 | By Susan D. Hall
While the Internet of Things promises to be a major disruptive force across various industries, policymakers should address common issues among them, according to a whitepaper from the Telecommunications Industry Association.
The number of connected "things" could reach 50 billion worldwide by 2020, the paper says, generating global revenue of $8.9 trillion.
In healthcare, remote patient monitoring using smart electronic devices presents one scenario for IoT devices. Across industries, however, leaders must address common issues of interoperability, privacy, security, data storage, and spectrum and bandwidth.

How to improve clinical decision support drug interaction alerts

March 31, 2015 | By Susan D. Hall
Clinical decision support (CDS) alerts for drug interactions need major improvements. A paper published at the Journal of the American Medical Informatics Association offers some recommendations.
The paper is based on conclusions made by the federal Usability Workgroup, which conducted a series of meetings over 13 months to develop specific recommendations to improve the quality of drug-drug interaction (DDI) decision support. Twenty-four clinical, usability and informatics experts took part in the meetings.
They recommend DDI alerts include seven components:
  1. Drugs involved
  2. Seriousness
  3. Clinical consequences
  4. Mechanism of the interaction
  5. Contextual information/modifying factors
  6. Recommended action
  7. Evidence

Survey: 97 percent of patients OK docs’ using technology during a visit

By: Jonah Comstock | Mar 30, 2015
A new survey conducted by voice recognition software company Nuance Communications shows that patients don’t have a problem with their doctors using technology during visits, as long as technology doesn’t get in the way of a meaningful interaction with their physician.
Nuance surveyed 3,000 patients in three countries: the United States, the UK and Germany. They found that 97 percent of patients approved of their doctor using technology (including desktop computers and mobile devices) during a consultation, and an additional 58 percent said technology positively impacts their overall experience, especially when it’s “used collaboratively to educate or explain.” 
But technology does cut into the already short span of face-to-face time patients have with their doctor. More than 33 percent of patients said they spent less than 10 minutes during in-office visits with a provider, and 40 percent said they felt rushed during their appointments.

A Field Guide to Interoperability at HIMSS

Scott Mace, for HealthLeaders Media , March 31, 2015

Healthcare interoperability has a long way to go, but at HIMSS15, the CommonWell Alliance and others will demonstrate an increasing capability to locate patients and their records across previously incompatible electronic health records systems.

The buzz at the HIMSS15 conference in Chicago April 12 – 15 will be about interoperability, which will join the remaining noise and buzz from last year's HIMSS about population health. The two are linked: No interoperability, and pop health will never scale. Without population health as an outcome, interoperability is just a lot of expensive infrastructure-building without ROI.
Healthcare has always had some level of interoperability, but historically it's been expensive and had great difficulty keeping up with changing technology and business demands.

Mount Sinai to digitize glass slides

Posted on Mar 30, 2015
By Bernie Monegain, Editor-at-Large
Mount Sinai Health System tapped Royal Philips to create a state-of-the-art digital image repository of patient tissue samples. Today, the samples are  available only on glass slides.
The work aims to advance clinical research and ultimately enable better care for complex diseases, including cancer.
Pathology, including the examination of patient tissue samples, is recognized as one of the cornerstones of modern medicine.
The Mount Sinai Health System comprises seven hospital campuses serving approximately 170,000 inpatients and 2.6 million outpatients annually. Over the years, these sites have collectively stored hundreds of thousands of tissue samples on glass slides.

Canadian EHR Infrastructure Has Trouble Like U.S.

MAR 30, 2015 7:57am ET
The United States isn't alone in suffering from a lack of interoperability between electronic health records. Our neighbors to the north are experiencing similar difficulties with their EHR systems.
A new report from a Toronto-based policy research group, the C.D. Howe Institute, reveals that only 12 percent of physicians are notified electronically of patients’ interactions with hospitals or send and receive electronic referrals for specialist appointments, and fewer than three in 10 primary care physicians have electronic access to clinical data about a patient who has been seen by a different health organization.
This limited exchange of e-health records in Canada has negatively impacted the ability of primary care physicians to carry out higher order functions such as e-prescribing, receiving discharge summaries, receiving reports from specialists, receiving lab results electronically, preventative care follow-up, generating a medications list, providing clinical summaries and sending reminder notices, according to institute officials.

Patient EHR Access Can Increase Provider Workloads

MAR 27, 2015 7:34am ET
Giving hospitalized patients access to their electronic health records during hospitalization increases provider workloads, but not as much as anticipated.
That is the finding of a hospital-based study conducted at the University of Colorado in which 50 patients were provided with tablets during their hospital stays and were able to view their EHRs via a patient portal. The results of the study, published in JAMA Internal Medicine, show that enabling patients to view their EHRs did not create additional work for doctors or nurses.

ONC's New CMO Talks Meaningful Use, EHR Implementation Strategies & More

by Kate Ackerman, iHealthBeat Editor in Chief Monday, March 30, 2015
In late February, Thomas Mason took over as CMO at the Office of the National Coordinator for Health IT. In his new role, Mason oversees ONC programs and clinical coordination within the agency.
Before joining the agency, Mason was the chief medical informatics officer of the Ambulatory and Community Health Network of Cook County Health and Hospitals System. He's a board-certified internist who has led multiple electronic health record implementations and has a strong background in public and population health.
In an exclusive interview with iHealthBeat, Mason discussed how his experience using an EHR system on a daily basis has helped prepare him for this new role, how the meaningful use program is working on the ground and what he hopes to accomplish in his first year at ONC. 


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