Saturday, May 02, 2015

Weekly Overseas Health IT Links - 2nd May, 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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Apr 23, 2015

The digital revolution in health care: A reading list

Sometimes the internet is not enough to stay updated on the latest trends, or sometimes information is too scattered to retrieve, which is why world-renowned experts often publish books that put together some of that thoughts, examples, case studies and predictions on what the future of medicine will be, and how will the digital revolution impact health care.
We thought that today of all days, 23th of April and World Book Day (and Saint George here in Barcelona, which we celebrate giving out books to our loved ones), was a good day to list some of the books you do not want to miss if you want to stay updated on digital health.
We have learned about some of them from their authors, from the impact they have caused, some others we have discovered browsing on Amazon. Here are some of the most remarkable, available either as an e-book or physical book:
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FDA to use EHR data for drug monitoring

Posted on Apr 24, 2015
By Bernie Monegain, Editor-at-Large
The FDA is offering a grant of up to $1 million to turn large amounts of EHR data into numbers the agency can use to gauge the effectiveness of FDA-approved drugs.
The intent is for the FDA to continually assess the drugs after they go to market, as mandated by law.
To that end, the FDA launched its Sentinel Initiative, a long-term program designed to build and implement an electronic system for monitoring the safety of medical products in the post market setting.
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Young physicians see promise for fully connected health ecosystem

April 24, 2015 | By Katie Dvorak
Physicians under the age of 40 are more likely to believe the industry will reach a fully connected technology environment soon, while those older than 40 think that move is at least five years away, according to a survey by MedData Point.
Of the 171 physicians responding to the survey, 61 percent older than 40 feel a connected environment won't happen until 2020 or later. Sixty-seven percent under the age of 40 said it would happen in the next one to five years.
Other findings the report uncovered include the following:
  • Two-thirds say costs is the biggest barrier to connected health, with 100 percent of dermatologists listing it as the No. 1 issue
  • Forty percent say they are closest to adopting patient portals, with 51 percent of large practices but only 27 percent of small practices saying they will adopt patient portals soon. Patients increasingly look for healthcare providers that offer digital services.
  • Only 29 percent say they are close to adopting interoperable electronic health records. However, interoperability is healthcare's biggest goal currently, and glimmers of hope are on the horizon, writes FierceHealthIT Senior Editor Dan Bowman.
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Remote monitoring cuts hospitalizations for heart failure patients

April 24, 2015 | By Susan D. Hall
Remote monitoring for heart failure patients resulted in fewer hospitalizations and deaths than a similar group of patients receiving usual care during a four-month study, but the benefits didn't last beyond the study period, according to an article published in the Journal of Medical Internet Research.
Researchers from Partners HealthCare Center for Connected Health and elsewhere sought to evaluate the effect of a heart failure telemonitoring program, Connected Cardiac Care Program (CCCP), on hospitalization and mortality in a retrospective database review of medical records of patients with heart failure.
In the study, 174 control patients receiving care at Massachusetts General Hospital were matched by age and gender with 174 patients enrolled in CCCP.
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Burwell, senators to identify priorities for fixing Meaningful Use by 2017

April 23, 2015 4:31 pm by Neil Versel | 1 Comments
Health and Human Services Secretary Sylvia Mathews Burwell has agreed to work with the Senate Health, Education, Labor and Pensions Committee to identify specific ways to fix the faltering Meaningful Use health IT incentive program, either legislatively or administratively. Burwell made the pledge to Sen. Lamar Alexander (R-Tenn.) during a hearing on the HHS 2016 budget before the Senate Appropriations Committee’s health subcommittee Thursday,
Alexander, who chairs the Senate Health, Education, Labor and Pensions Committee, said that he and Sen. Patty Murray (D-Wash.) formed a bipartisan working group on the HELP Committee “to identity five or six problems in the electronic health records system that we can address administratively … or legislatively if we have to.” He asked Burwell if she would commit to assisting the senators in building and acting on this list in the next 21 months.
Burwell responded, “Yes,” adding, “I think we’ve got a working group of staff ready to go, and we are committed to do that. I think that this is extremely important in and of itself, but [because of] all of the things it touches. We’re going to talk about so many things it touches.” Burwell noted that EHRs have an impact on use of opiods, precision medicine and overall reform of the healthcare delivery system.
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Technological Change Creates a 'Blind Spot' in Physician Credentialing

Tinker Ready, for HealthLeaders Media , April 24, 2015

A recent court ruling over liability for da Vinci robotic surgery gone wrong has sparked a debate over how physicians should train to use new devices. Do credentialing methods keep up with the pace of technological change?

When a patient suffered a cascade of complications after robotic surgery, his lawyers thought the doctor, the hospital, and the device maker should be liable. But in a malpractice case involving the da Vinci Surgical System, the courts disagreed.
The 2013 decision that Intuitive Surgical, the maker of da Vinci, was not responsible for the action of a poorly trained doctor may be good news for the medical device makers. The ruling is under appeal, but the case raises a question for hospitals, according to a recent commentary published in the Journal of the American Medical Association: Do hospitals need to strengthen traditional credentialing programs to ensure that doctors are adequately trained in the use of new devices?
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The Value of Apple Watch in Advancing Outcomes

APR 23, 2015 7:14am ET
Following weeks of hype, Apple hosted a 90 minute event in mid-March introducing the Apple Watch, a new MacBook, and new features to the world. From a healthcare perspective, this was more than an average launch day for Apple. The announcements introduced its most significant investment in health to date. As the dust continues to settle, here are the standouts from the event.
1. What’s Your Glance?
You heard it here first—the next overhyped buzzword is going to be “Glances,” which is a feature of the Apple Watch that provides scan able summaries that users seek most frequently, such as weather, calendars, and maps. “Glanceability” is critical for devices and apps looking to stand out in a competitive market. In one quick look at their wrist, users can see what is important to them, which also eliminates the need to physically pull out their phones every five minutes. Designing for a glance, similar to the effects of responsive web design, will continue to push designers to simplify and focus on what is critically important to the customer—speed to need. There are many opportunities to connect health literate visual design to this new flow of “glanceable health data.” Observing and curating the new wave of health, “Glances” will help inform familiar product design and establish a new set of data visualization standards.
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Mobile Survey Finds App-Enabled Patient Portals Lacking

APR 23, 2015 7:57am ET
Nearly 90 percent of providers are using mobile devices for patient engagement, according to results of a new HIMSS survey. And, while respondents were most likely to engage patients with app-enabled portals (73 percent), only 36 percent indicated that use of these portals is a highly effective means of engaging patients.
With nearly two-thirds of Americans owning a smartphone, app-enabled portals are often seen by providers as a natural medium for creating an engaging patient-centric tool. However, the 2015 HIMSS Mobile Technology Study of 238 providers released at HIMSS15 is the latest evidence that healthcare organizations “continue to struggle to effectively engage patients using existing mobile devices,” states the report.
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CDS tools can reduce ordering of imaging tests

April 20, 2015 | By Marla Durben Hirsch
Clinical decision support in electronic health records can cut down the amount of diagnostic radiologic imaging ordered, according to a new study in the Annals of Internal Medicine.
Over-testing increases healthcare costs, and in some cases provides no value to the patient or even causes harm. The study, funded in part by the Department of Veterans Affairs, conducted a review of 23 studies on the effect of clinical decision support (CDS) on diagnostic radiology test ordering in adults.
Of the 23 studies, 21 provided moderate quality evidence that EHR-based interventions can improve the appropriate use of diagnostic testing and reduce overall use by a small amount. There also was "low quality" evidence that interventions that include a "hard stop--prohibiting the ordering in certain instances and ordering in an integrated care delivery setting--may be particularly effective. Auditing and feedback may also help, but the studies did not provide sufficient data for that conclusion.
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3 vendors best at driving patient portals

Posted on Apr 23, 2015
By Bernie Monegain, Editor-at-Large
With a meaningful use requirement for healthcare organizations to drive at least 5 percent of their patients to an online portal, KLAS finds that three vendors have more than 20 percent of their customers' patients accessing the portal, a number that far surpasses the 5 percent meaningful use requisite.
The three vendors KLAS deemed most effective at helping their clients drive patient portal adoption are: athenahealth, Epic and Medfusion.
Many healthcare organizations have expressed anxiety concerning the patient portal mandate, saying they are concerned about being responsible for a mandate that relies on what other people (the patients) do.
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Redirecting ONC's interoperability roadmap

Posted on Apr 23, 2015
By John Andrews, Contributing Writer
The draft interoperability roadmap released by the Office of the National Coordinator for Health IT contains so many details in its 166-pages that has been called "meaningful use on steroids."
The roadmap draft appeared in late January to coincide with the ONC National Meeting, which focused largely on interoperability. The document's language indicates that agency officials appear set to get the healthcare industry to once again place a high priority on becoming interoperable, says Dan Golder, principal of Naperville, Ill.-based Impact Advisers.
"The roadmap is meaningful use on steroids," he said. "There is quite a bit in there, but every page has a lot in it that is worthwhile. It is still a draft, so it is influenced by comments. It will be interesting to see how that plays in the next couple of months."
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Value of apps and wearables questioned

16 April 2015   Thomas Meek
The potential for smartphone apps and wearable devices to have an effect on health outcomes has come under question in an article published by the BMJ.
In the head to head piece, Des Spence, a GP from Glasgow and former BMJ columnist, comments that there is a lack of evidence to back the use of these personal health tools as part of a wider healthcare plan.
“The truth is that these apps and devices are untested and unscientific, and they will open the door of uncertainty,” he says.
While Spence acknowledges that most of the tens of thousands of health apps currently available are “harmless (and likely useless)”, he suggests risks lie in their use alongside wearable devices, such as fitness tracking wristbands.
He proposes that the widespread use of medical apps in this way could lead to a tendency for over-diagnosis and anxiety for their users from an “unhealthily health obsessed generation”.
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Meaningful Use Stage 3 Proposed Rule Targets Ongoing Security Concerns

by Nicole Lewis, iHealthBeat Contributing Reporter Thursday, April 23, 2015
Reaction has been mixed to the new security recommendations CMS included in its proposed rule for meaningful use Stage 3.
As health care delivery organizations prepare their systems for interoperability, the Stage 3 proposed rule recommends new procedures that modify the security risk analysis timing and review requirements.  
The proposed rule -- published March 20 along with the Office of the National Coordinator for Health IT's 2015 Edition Health IT Certification Criteria proposed rule -- attempts to address questions surrounding the security risk assessment of patient data stored in electronic health records and further clarifies what hospitals, physician offices and critical assess hospitals should do to mitigate the risks of patient data theft.
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The Status of Medical Errors Among Health IT Systems

Author Vera Gruessner | Date April 22, 2015
While adoption of EHRs and health IT systems has been stressed among federal agencies and the medical industry in order to improve patient care and health outcomes, some issues within the health IT sector may be actually leading to medical errors among healthcare staff.
For instance, a survey from West Health Institute showed that about 50 percent of polled nurses noticed a medical error because a device or EHR system was not integrated adequately within the hospital or practice. Lack of EHR interoperability or integration may make it more difficult for doctors, nurses, and other healthcare professionals to provide effective care and avoid medical errors.
For example, if at the end of a long shift, a professional has to spend an additional two hours entering in data through an EHR or other system, he or she is more likely to make a mistake. In fact, 74 percent of respondents in the survey claimed that it was troublesome to coordinate data stored in a variety of medical devices.
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Critics Take Joint Commission Sentinel Events Alert to Task

APR 22, 2015 7:53am ET
The alert issued recently by The Joint Commission, citing the risks and socio-technical factors leading to health information technology “sentinel” events, has spawned both supporters and detractors.
On the one hand, the Office of the National Coordinator for Health IT points to the alert as “an objective” finding on the topic of HIT and patient safety that should serve as a “baseline” for future studies. But, critics charge that the alert cites a very limited number of sentinel events reported over a three-year period.
Funded by ONC, the alert identifies specific types of sentinel, adverse events and high-risk conditions, describes their common underlying causes, and recommends steps to reduce risk and prevent future occurrences. While the alert’s suggested actions center on safety culture, process improvement and leadership, The Joint Commission found that “incorrect or miscommunicated information entered into health IT systems may result in adverse events” and “in some cases, interfaces built into the technology contribute to the events.”
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Path dependency

Healthcare economies are finally forming hub and spoke models for pathology, as recommended by the Carter report. This has triggered change in the supplier market; and more is on the way as digital pathology becomes a reality. Daloni Carlisle reports.
It does sometimes feel as though the Carter recommendations to consolidate pathology services came from another era. But there are signs that the shift is starting to happen.
Over the past year or two, a number of health economies have signed contracts and begun the move to ‘hub and spoke’ working.
The idea is to create ‘cold’ hubs handling routine work, including work from GPs, and ‘hot’ spokes handling specialist, urgent or out of hours work, all supported by a central database allowing doctors to access results wherever they are.
Examples up and running include South West Pathology and The Pathology Partnership in the East of England. Then there are the more recently announced collaborations in Bristol and Essex. Soon, there will be many more.
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In small study, ER patients prefer doctors consult via Google Glass, not phone

By: Jonah Comstock | Apr 21, 2015
Patients are overwhelmingly satisfied with dermatology consults via Google Glass, even preferring them to consultations over the phone, according to a feasibility study recently published in JAMA dermatology. MobiHealthNews wrote about the study last year when Rhode Island Hospital first began to investigate Google Glass, working with Glass startup Pristine.
The study was conducted on emergency room patients who presented with a rash or other skin condition. Normally, those patients would get a dermatology consult by phone, with a picture of the affected skin emailed to the consulting dermatologist in some cases. The 31 patients who completed consultations in the study went through that standard procedure, but also had a second consult with an emergency room physician wearing Google Glass, who could stream images directly to the specialist.
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ONC: 76% of Acute Care Hospitals Have Basic EHR System

APR 21, 2015 7:32am ET
Seventy-six percent of non-federal acute care hospitals in 2014 adopted at least a basic electronic health record system with clinician notes—a 27 percent increase from 2013—according to new data from the Office of the National Coordinator for Health Information Technology.
“While fewer hospitals used basic EHR systems without clinician notes, significantly more adopted systems with clinician notes,” states the ONC brief based on data from the American Hospital Association IT supplement to AHA’s annual survey. “Additionally, over a third of hospitals were using more advanced EHR functionality.”
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Lib Dem manifesto promises GPs by Skype

15 April 2015   Lyn Whitfield
The Liberal Democrats have promised to open up access to GPs by using phone and Skype appointments in their manifesto, launched this morning.
The party is the only one of the big three political parties in England to mention alternatives to traditional, physical appointments in its plans to “ensure easier access to GPs”, which seems, unexpectedly, to have become a hot election issue.
The pledge also appears to represent Liberal Democrat plans to “set aside £250 million from the sale of redundant NHS assets” to fund a “digital revolution” in the health service that were unveiled at the end of last week.
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FDA Unveils $1 Million Postmarket Surveillance Grant

April 21, 2015
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The FDA is offering a grant of up to $1 million to turn large amounts of electronic health record data into usable figures highlighting postmarket risks of various drugs. The goal is for the agency to be able to perform continuous risk/benefit assessments of drugs after they hit the market.
Eligibility for the grant is limited to the Reagan-Udall Foundation through its Innovations in Medical Evidence Development and Surveillance-Methods program.
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Glimmers of hope on the interoperability horizon

April 21, 2015 | By Dan Bowman
He was authoritative and direct; the forceful yin to DeSalvo's optimistic yang.
Slavitt called for a "more modern infrastructure;" one that's less flashy ("I think we could do with a little less innovation on shareable and wearables") and more focused on ensuring care coordination between providers. And he expressed disappointment in the current lack of interoperability between the electronic health records systems of disparate care facilities, sharing his opinion about a recent visit to a federally qualified health center unable to track patient care beyond its own four walls.
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Home health technology market to skyrocket

April 21, 2015 | By Susan D. Hall
The number of consumers using home health technologies globally will grow from 14.3 million in 2014 to 78.5 million by 2020, according to market intelligence firm Tractica.
Home health technologies allow providers to remotely monitor patients with chronic conditions, improve care for elderly people and conduct virtual visits with a physician. At the same time, home health devices and applications are taking advantage of improved residential broadband and growing smartphone use to help consumers manage their own health and wellness.
Rising healthcare costs, aging populations and a rise in the number of people living with chronic diseases are among the factors driving this market, according to the report; however, regulatory issues, data security and privacy, and technology interoperability and integration issues remain barriers to growth.
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In Remaining HIT Priorities for 2015, Payers, Not Patients, Will Get the Love

Scott Mace, for HealthLeaders Media , April 21, 2015

At this year's HIMSS conference, the patient engagement provision of meaningful use stage 2 was a major casualty. Is that a problem?

Another HIMSS conference has come and gone, and what do we know now that we didn't before?
Without even a hint of a new ICD-10 delay, I will go out on a limb and predict that the transition will occur as scheduled this October 1. Payers will love it. Providers will endure the pain and the vast majority will survive unscathed.
Meaningful use stage 2 rules will be relaxed, as proposed in the CMS/ONC NPRM released just before HIMSS, to permit 90-day attestation in 2015, avoiding many payment penalties throughout healthcare. Providers will endure the pain of meeting the 90 days of compliance, and the vast majority will survive unscathed.
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DeSalvo: Three Items Needed to Achieve Interoperability

APR 20, 2015 6:57am ET
Health IT is just beginning to show success in the exchange of health information, but clarity, standards and practical solutions remain as the major issues standing in the way of interoperability, said National Coordinator for HIT Karen DeSalvo, M.D., during the closing keynote at HIMSS15.
Through feedback to ONC’s proposed roadmap to interoperability and DeSalvo’s national listening tour, ONC has listened and sought practical solutions, she said. But to get to interoperability as quickly as possible, DeSalvo said the following must be achieved:
*Establishing standards, including APIs;
*Achieving clarity on the trust environment, with “shared expectations found around data security and privacy;” and
*Understanding how incentives will apply to the use to of electronic health records.
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NIH to spend $20B on health IT

Posted on Apr 20, 2015
By Bernie Monegain, Editor-at-Large
The National Institutes of Health's Information Technology Acquisition and Assessment Center is awarding $20 billion in IT work. The money will be disbursed among 65 companies across the country.
NIH announced the government-wide acquistion contract, which it refers to as GWAC, April 17.
Of the 65 companies awarded what NIH calls a CIO-CS contract, 44 are small businesses across multiple socioeconomic categories. There are eight HUBZones, 14 women-owned, six 8(a), seven economically disadvantaged women-owned small businesses and six service-disabled veteran-owned small businesses. All awardees went through a competitive source selection process to ensure the most technically capable and competitively priced solutions will be available over the next 10 years, according to NIH.
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Telemedicine Maturity Adoption Model Unveiled at HIMSS15

By Jennifer Bresnick on April 17, 2015
Ernst & Young, in conjunction with industry telemedicine experts, have developed a telemedicine maturity adoption model intended to help plot a course towards robust, cost-effective remote care.  The model, announced at HIMSS15 in Chicago this week, mirrors similar efforts by other healthcare stakeholders to measure the adoption of health IT infrastructure such as EHRs, continuity of care, and healthcare data analytics.
“As interest in telemedicine intensifies, it is critical that an industry standard be adopted for assessing and describing the maturity of various telemedicine programs,” said Bill Fera, MD, a principal in the Health Care Advisory practice at Ernst & Young LLP and the leader of the National Telemedicine Nomenclature Advisory Council.
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EMR market reaches $25B: 4 things to know

Written by Akanksha Jayanthi (Twitter | Google+)  | April 17, 2015
In 2014, the EMR market was valued at $24.9 billion, according to a Kalorama Information report.
Here are four things to know about the burgeoning EMR market.
1. Between 2012 and 2014, EMR sales grew 10 percent as more hospitals and providers acquired or updated EMR systems.
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Hospital Health Information Exchange Up 23% in 2014

APR 20, 2015 6:37am ET
Health information exchange among U.S. acute care hospitals grew significantly last year, according to new data from a nationwide American Hospital Association survey released by the Office of the National Coordinator for Health IT.
In 2014, three-quarters of hospitals reported that they electronically exchanged health information with outside ambulatory providers or hospitals—a 23 percent increase since 2013 and an 85 percent increase since 2008, the year the AHA started collecting data. AHA’s survey captures information on exchange of health information between hospitals and ambulatory providers that are not part of the hospital’s organization.
Last year, more than six in ten hospitals electronically exchanged health information with outside hospitals, a one-year increase of 55 percent. In addition, nearly seven in ten hospitals (69 percent) exchanged health information with outside ambulatory providers, a 21 percent increase.
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IBM CEO: Watson Health is ‘Our Moonshot’ in Healthcare

APR 20, 2015 7:08am ET
A new IBM business unit launched last week to help physicians, researchers, insurers and patients use big data, analytics and mobile technology to achieve better health outcomes is being described by the company’s chief executive officer as their “moonshot” in healthcare.
“If you go back in time, we have participated in some of the most glorious moments of history, whether it might have been the first systems that ever did census and landing a man on the moon,” said Ginni Rometty, chairman and CEO of IBM, on PBS’s Charlie Rose talk show. “I’m telling you our moonshot will be the impact we will have on healthcare. It has already started. We will do our part to change the face of healthcare. I am absolutely positive about it.”
Last week, IBM announced a new business unit—Watson Health—that will offer cloud-based access to its Watson supercomputer for analyzing healthcare data. Big Blue has partnered with Apple, Johnson & Johnson and Medtronic to make it easier for healthcare organizations to store and analyze patient data by leveraging Watson’s cognitive capabilities and creating “new health-based offerings that leverage information collected from personal health, medical and fitness devices” providing “better insights, real-time feedback and recommendations to improve everything from personal health and wellness to acute and chronic care.”
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Enjoy!
David.

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