Saturday, June 06, 2015

Weekly Overseas Health IT Links - 6th June, 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.

mHealth Market to Grow 33% Annually Over 5 Years

MAY 28, 2015 1:02pm ET
The global mobile health market, valued at $10.5 billion in 2014, is projected to grow at a compound annual growth rate of 33.5 percent between 2015 and 2020, according to a new report by Allied Market Research.
The firm predicts that blood pressure monitors will grab the largest share in the global mHealth device market, followed by blood glucose monitors and cardiac monitors—with all three devices collectively garnering 71 percent of the market share. The report attributes the sizable share of these monitors to increased affordability of mobile compatible devices, integration of innovative technologies in monitoring devices and the increasing prevalence of lifestyle diseases such as diabetes, stroke, and COPD.

Interoperability and the Trough of Disillusionment

Posted on May 27, 2015
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Every technology has an adoption journey. The classic Gartner hype curve travels from a Technology Trigger to the Peak of Inflated Expectations followed by the Trough of Disillusionment. It often takes years before organizations reach the Slope of Enlightenment and finally achieve a Plateau of Productivity.
Have you noticed that Congress and the popular press have entered the Trough of Disillusionment for EHRs and interoperability over the past month?
Congressional staffers writing the 21st Century Cures bill (which is not yet law) seem to have concluded:
1. We don't have interoperability (although no one is sure what exactly we have and do not have)
2. Therefore we need more standards and that will solve all the business, political, and policy barriers to health information exchange
3. The
Health IT Standards Committee must not be doing a good job because there are not enough standards
4. Therefore we should disband it and create a new politically appointed body
5. That new body will invent all the standards we need and then force vendors to stop their information blocking behavior (whatever that is), enabling precision medicine
USA Today, in one of the most one sided articles I’ve read, confuses ACA and HITECH, ignores the data about EHR adoption/health information exchange and concludes that EHRs “don’t talk to each other”, whatever that means.

What will EHRs look like in 2020?

Posted on May 29, 2015
By Bernie Monegain, Editor-at-Large
In an article published online today in JAMIA, the Journal of the American Medical Informatics Association, an AMIA task force takes on the thorny issues associated with the use of electronic medical record systems and offers recommendations for improvement.
“Health information technology is a key part of enhancing health and health care, and empowering patients to be first-order participants in their care," said Douglas B. Fridsma, MD, president and CEO of AMIA, in a statement. "As part of this report, we listened to our members who work closely with EHRs to understand the current challenges. We think these recommendations will improve the value that EHRs will provide to patients, and set the stage for more significant benefit in the future."
Members of the AMIA EHR 2020 Task Force on the Status and Future Direction of EHRs are: Thomas H. Payne, Sarah Corley, Theresa A. Cullen, Tejal K. Gandhi, Linda Harrington, Gilad J. Kuperman, John E. Mattison, David P. McCallie, Clement J. McDonald, Paul C. Tang, William M. Tierney, Charlotte Weaver, Charlene R. Weir and Michael H. Zaroukian.

Can a 'medical rounds robot' ease healthcare staffing woes?

May 28, 2015 | By Leslie Small
Clinician staffing levels are an increasingly prevalent issue in the healthcare industry, so Japan's Toyohashi University of Technology developed a unique, high-tech solution--the world's first medical rounds robot.
Researchers decided to develop the robot to address the pressures facing the healthcare infrastructure of countries like Japan as their populations age, and as shortages and uneven distribution of clinicians threaten the quality of patient care, according to an announcement from the university. They also sought to solve some of the thorny issues associated with healthcare data management.
Enter "Terapio," a robot that can help healthcare staff deliver resources and record information gathered during rounds with the goal of replacing the conventional medical cart, according to its developers. Terapio moves on its own as it "autonomously tracks a specified human," recording patients' vital signs and displaying data such as electronic health records. An operator can control the robot's movements as well as recognize and alter its three operation modes--"tracking," "power assist" and "rounds."

Stage 3 MU Rule Goes Too Far, CHIME Says

MAY 28, 2015 7:41am ET
In scathing formal comments submitted to the Centers for Medicare and Medicaid Services, the College of Healthcare Information Management Executives called the proposed Stage 3 electronic health records meaningful use rule from CMS “unworkable” and “too ambitious.”  
“Were all requirements finalized as proposed, we doubt many providers could participate in 2018 successfully,” argued CHIME in its comments. “And with so few providers having demonstrated Stage 2 capabilities, we question the underlying feasibility of many requirements and question the logic of building on deficient measures.”
CHIME is particularly concerned with patient action requirements related to care coordination and “unrealistic” thresholds for health information exchange requirements. In addition, the organization is troubled over the requirement that all providers must attest to meaningful use Stage 3 by 2018, regardless of prior participation and experience with the program.

Market for EMRs still strong

Posted on May 28, 2015
By Bernie Monegain, Editor-at-Large
Two reports from two separate research firms – Kalorama and Black Book Rankings – indicate the market for EMRs is still healthy, even as incentives for meaningful use dwindle and a large shift in vendor market share occurs.
The 490-page Kalorama Information report, EMR 2015: The Market for Electronic Medical Records, focuses on the U.S. as the largest healthcare market and the most incentivized for EMR conversion.
The U.S. EMR market is competitive, they find, with over 400 providers; however, increasing mergers and acquisitions in the industry will result in the reduction in the number of competitors, Kalorama expects. Companies remain competitive by offering high-quality platform packages to private practices and hospitals, according to Kalorama. However, there is still ample opportunity for other companies and new entrants. There is still not a single system that is complete with true interoperability. The main drawback for smaller companies is the cost to enter the market with a certified product.

EHRs can ID inpatients at high risk of readmission

May 23, 2015 | By Marla Durben Hirsch
Electronic health records can help predict which inpatients are at high risk for readmission, and do so in real time, according to a new study in BMC Medical Informatics and Decision Making.
Hospital have increasingly been pressed to improve patient outcomes by reducing the readmission rates of discharged patients, but have not achieved as much success as has been hoped. Current claims-based models for predicting which patients may be at high risk of readmission can only be used at patient discharge and were limited to specific diseases or patient types.
The researchers, from the University of Texas Southwest Medical Center and elsewhere, sought to determine if EHR-based risk models could identify patients at high risk for readmission within 30 days of discharge, and how those models would compare to existing, claims-based models currently used to identify these high-risk patients.

Medical malpractice: How EHRs are changing the game

May 27, 2015 | By Marla Durben Hirsch
We're familiar with the multitude of laws that dictate when and how to adopt and use electronic health records. There are 2,000 statutes and regulations related to electronic health information, according to Tara Ramanathan, a public health analyst with the Centers for Disease Control and Prevention, who spoke on a May 26 webinar sponsored by the American Bar Association Health Law Section.
But now we've begun to focus more on EHRs in the other legal venue: the courtroom.  
The move was inevitable.
For years, people have been lamenting the "unintended consequences" of EHRs having an adverse effect on patient safety. So it makes sense that the patients suffering these consequences would start filing medical malpractice lawsuits against the providers using the EHR. The number of EHR-related malpractice problems has hit "critical mass," according to HL7's Reed Gelzer.

Electronic health information creating new legal issues

May 26, 2015 | By Marla Durben Hirsch
Electronic health records are creating a digital revolution, but also have created a unique set of legal issues, according to a webinar held May 26 by the American Bar Association's Health Law Section.
In addition to concerns about safeguarding the privacy and security of electronic health information, medical malpractice issues and concerns about EHRs abetting billing fraud--which affect providers using electronic health information--there also are new legal issues involving public health.

Data breach costs rise 23 percent since 2013

May 28, 2015 | By Katie Dvorak
The cost of a data breach on a company is $3.8 million, a jump of 23 percent from 2013, according to a Ponemon Institute report sponsored by IBM.
The study looks at the cost of data breaches at 350 companies in 11 countries. The cost for each record stolen that contained sensitive information was about $145-$154; stolen healthcare records were the most costly, reaching as high as $363 per record, according to the report.
The reasons for the increase, Ponemon Institute founder Larry Ponemon says in an announcement, include the growing number of cyberattacks on all industries, the financial consequences of losing consumers after an attack and the cost of investigations into breaches.

This Chip Could Analyze Your Blood and Send the Data to Your Phone

Jamie Condliffe

This centimeter-long lump of silicon could soon be inserted under your skin to measure the chemical make-up of your blood—then send the results straight to your phone.
The new device has been created by a team of researchers from École Polytechnique Fédérale de Lausanne in Switzerland. As well as measuring the pH and temperature of blood, it can also sense molecules like glucose, lactate and cholesterol, as well as the presence of some drugs.

Get with the programme

After years of encouraging and promoting patient level costing, Monitor has decided to get tough. The regulator has set up a programme to move all NHS organisations onto patient level costing from next year, and told them they must use accredited patient level information costing systems. Daloni Carlisle reports.
Patient level costing is about to take root. At the end of March, Monitor gave the green light to its Costing Transformation Programme, which will eventually see all NHS organisations moving to patient level costing.
The benefits cited by Monitor are many and various, but are built around the notion that accurate patient level costing will help to support the sustainable delivery of high quality patient care.
The regulator recognises that trusts are at different starting points in their journeys and has set in train both a staggered implementation timetable (with acute trusts going first, followed by mental health and finally ambulance and community organisations) and a support programme.

Middleware may provide interim step toward HIE

Jeff Rowe
May 25, 2015
Interoperability is right up there with population health as one of the most oft-discussed topics in healthcare, these days, but a recent survey by Black Book Research revealed that 94 percent of providers, payers, patients and agencies remain “meaningfully unconnected.”
So what to do?  According to Donald M. Voltz, MD, department of anesthesiology and medical director of the main operating room at Aultman Hospital in Canton, Ohio, healthcare stakeholders should consider middleware.  He describes middleware as “software that is used to connect one or more different software applications; it has been simplified as the glue or plumbing used to pass data between applications.”  He adds that middleware is currently being used in sectors such as retail, banking and transportation to connect completely unrelated software into a single user-friendly interface, and also to connect legacy and emerging technology that have been developed using different designs, data models or architecture.

Hospitals expand monitoring to catch subtle warnings

May 27, 2015 | By Zack Budryk
Healthcare providers are expanding their methods for 24-hour patient-monitoring, factoring in subtle but important signs of worsening conditions, the Wall Street Journal reports.
Patients recovering from surgery or hospitalized due to illness are particularly vulnerable to potentially lethal complications such as depressed breathing, which can lead to cardiac arrest. Hospitals typically monitor intensive care unit patients 24/7, but not patients on general surgical floors, despite the fact that patients can show "decompensation"--signs of post-surgical deterioration--up to eight hours before a cardiac arrest. Moreover, data from the Joint Commission found 29 percent of hospital narcotic-related adverse drug events between 2004 and 2011 were related to improper monitoring, according to the article.

Do You Have a Breach Response Plan?

MAY 26, 2015 7:13am ET
Two years ago, health law attorney Daniel Gottlieb would counsel clients to focus data security efforts on human errors that can cause data breaches, such as leaving a laptop on an airplane or in the back of a car.
Now, he talks of two types of cyber criminals—those engaged in collecting Social Security numbers and other health data for common theft, and those engaged in espionage such as economic crimes and backed by nation states. And he talks of having a breach response plan—now.
More than ever, providers, insurers, clearinghouses and business associates—whether or not covered under the HIPAA security rule—need to regularly conduct a comprehensive risk assessment that covers information technology, physical security, policies and procedures and other factors, Gottlieb says.

What exactly is 'population health,' anyway?

Posted on May 26, 2015
By Tom Sullivan, Executive Editor, HIMSS Media
As anyone who either attended HIMSS15 or followed the ensuing conversation can attest, population health is currently all the rage. While reporting from the show floor, in fact, it seemed just about every vendor, from all walks of life, was trumpeting "population health" in one form or another.
What has become eminently clear is that defining population health depends on whom you ask.
So I kept at it, posing the question to a hospital CEO and some of the technology vendors staking a claim to the expanding population health space.

Linking EHRs with medication cabinets for improved safety

Posted on May 26, 2015
By Anthony Vecchione, Contributing Writer
Increasingly hospitals are recognizing the value of interoperability between electronic health records and automated dispensing cabinets, or ADCs. In addition to eliminating redundancies during the medication ordering process, linking them helps to reduce medication errors at the point-of-care.
Hackensack University Medical Center recently unveiled this interoperability between its ADC from Omnicell and its Epic EHR.
Now nurses are able to easily interface with the complete medication management system within one application at the patient's bedside, said Nilesh Desai, director of pharmacy at HackensackUMC.

Health IT should rely on design, not engineering

May 26, 2015 | By Katie Dvorak
When creating new technology for healthcare, new tools should not be engineered so users have to conform to them, but designed with how it will be used in mind, according to Leonard D'Avolio, director of Informatics at Ariadne Labs, a joint venture of Brigham and Women's Hospital and the Harvard School of Public Health.
The need for systems to be re-designed, as opposed to re-engineered is urgent, D'Avolio writes at InformationWeek. Designers, he says, must take the needs of users such as physicians and patients in mind when creating systems.

The FHIR Train Leaves the Station

by Ken Terry, iHealthBeat Contributing Reporter Tuesday, May 26, 2015
Fast Healthcare Interoperability Resources (FHIR), a new standards framework from HL7, is starting to get traction in the industry as the latest focus of interoperability efforts. According to proponents of the rapidly evolving approach, FHIR promises to facilitate health information exchange, broaden the capabilities of electronic health records and accelerate innovation in mobile health applications.
In essence, FHIR uses snippets of data known as resources to represent clinical entities within EHRs. Certain application programming interfaces (APIs), otherwise known as plug-ins, can connect applications to FHIR-enabled EHRs without customized interfaces. A security standard known as OAuth gives patients the ability to access the EHR data themselves or grant access to providers and others.

AMA Pushes for More Delay, But ICD-10 is Necessary

Scott Mace, for HealthLeaders Media , May 26, 2015

A CMIO says 'We've got to do this.' Why ICD-10 is so important, what costs it brings, and why health IT vendors play such a critical role.

Thomas Selva, MD, is chief medical information officer at the University of Missouri Healthcare. Last week we spoke about the last-minute attempt by the American Medical Association to once again halt ICD-10 adoption through Congressional legislation, and about how University of Missouri Health is using new technology to meet the challenge of ICD-10.
HealthLeaders: We've seen this movie before. What do you think?
Selva: AMA is a political voice for the physicians. They're responding to their constituency and their constituency is saying, We're not ready. Big institutions like ours can bring tremendous amounts of resources to bear, and we're still concerned.


1 comment:

Terry Hannan said...

David, I think I made the comment that related to the PCEHR statistics made available late last year or earlier this year, that the numbers followed the classical Gartner Hype Cycle and the project was in the "Interoperability and the Trough of Disillusionment"