Saturday, September 19, 2015

Weekly Overseas Health IT Links -19th September, 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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What You Need to Do Now to Avoid Cyber Attack

SEP 11, 2015 7:43am ET
Whether Excellus BlueCross BlueShield learned that it had suffered a cyber attack because the organization or a contractor was looking for signs of hacking, or learned from a law enforcement agency is not clear, as the company isn’t saying much about the incident outside of formal announcements.
But Mac McMillan, CEO at the privacy, security and compliance consultancy CynergisTek, believes there is a good chance that the company was being proactive. Since Blues plans started getting hacked, word has gotten out that plans need to get their act together and do forensic analysis, he says. But he wonders the degree to which other health insurers are being proactive.
What really bothers McMillan is the industry obsession, forced upon by the federal government to make sure that the I’s are being dotted and the T’s are being crossed on all the compliance requirements of HIPAA. “We’re focusing on HIPAA at the expense of just improving security,” he laments.
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Even with encryption, EMR data at risk

Posted on Sep 11, 2015
By Mike Miliard, Editor
A recent security report by Microsoft finds that, even when cloaked in encryption technology, "an alarming amount of sensitive information can be recovered" from electronic medical record databases.
For the report, "Inference Attacks on Property-Preserving Encrypted Databases," which included 200 hospitals, researchers from Microsoft, University of Illinois and Portland State University examined four types of cyberattacks targeted at EMRs.
Specifically, they probed the response of relational databases using the CryptDB design, which enables SQL queries on scrambled data.
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Providers' adoption, understanding of telemedicine grows in 2015

September 11, 2015 | By Katie Dvorak
Use of telemedicine continues to see an uptick, with 57.7 percent of providers adopting such tools this year, up from 54.5 percent in 2014, according to a new HIMSS Analytics study.
"One of the bigger things we found was not only the increase in adoption of these telemedicine services and solutions year-over-year, but also from my perspective the familiarity of these solutions; there are fewer people who are unsure about whether they use these types of solutions," Brendan FitzGerald, HIMSS Analytics Research Director, told FierceHealthIT in an interview.
The Web-based study included responses from about 270 C-suite executives, IT professionals, clinicians and department heads, as well as ambulatory physicians.
FitzGerald said that through the study they saw that the sector of technology itself remains fairly complex.
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Docs share mixed thoughts on Google's online medical data

September 11, 2015 | By Susan D. Hall
Google recently announced it's updating its health conditions feature to cover with information on more than 900 diseases, providing quick at-a-glance info on symptoms, treatment and more.
The effort will more than double the offerings in the feature, which it unveiled in February, according to a Google blog post. A recent spike in searches for information on Legionnaire's disease illustrates the kind of information people are looking for, the post, by product manager Prem Ramaswami, says.
Kapil Parakh, a cardiologist and former assistant professor in the Johns Hopkins Bloomberg School of Public Health, led the effort, and Google says the information also will be checked by doctors at the Mayo Clinic.
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When data goes bad: Even small errors matter

September 11, 2015 | By Susan D. Hall
Concerned that a long-time patient's record showed her name with two middle initials, Fred N. Pelzman, M.D., set to find out how this error happened.
Neither the front-desk staff, practice supervisors or IT administrators could explain how a second middle initial has appeared in patient records now five times, he writes in an article at MedPage Today. Yet he worries that somewhere down the line, lab or test results will not be matched up with that patient's record because of this computer problem.
"As we've created these massive databases, electronic systems that house our data, the risk of errors getting incorporated into it has multiplied, growing exponentially," he writes. "When we try to use our databases to create systems of quality, the quality of the data going in matters."
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10 most popular EHR products

Written by Akanksha Jayanthi (Twitter | Google+)  | September 10, 2015
As of 2014, 74 percent of all non-federal acute care hospitals had adopted an EHR, according to HHS data. Still, some providers are looking to replace their systems. Software Advice, an EHR comparison site, has released its rankings of the most popular EHR products.
Software Advice's ranking is based on its proprietary popularity metric that factors in the number of product users, how often the brand name and related information are searched for via Google each month and the social media presence of the brand.
"By combining all of these sources of information into a single score, we reveal not only which vendors have garnered the most users, but also how much customer loyalty and overall consumer interest these vendors have inspired," according to Software Advice.
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New Uses, Clients for IBM Watson Health

SEP 10, 2015 7:36am ET
IBM’s Watson Health supercomputer has two new services and four new partners.
The Watson Health Cloud for Life Compliance service, enables biomedical firms to build their own applications, products and analytics to support clinical trials management without having their own data center to manage, says Kathy McGroddy Goetz, vice president of partnerships and solutions at IBM Watson Health. The service was specifically designed to support a heavily regulated environment.
Watson Care Manager is a population health management system using Apple apps to enable consumers to collect and share data from Apple health apps with clinicians to support patient engagement. Leveraging IBM’s recent acquisitions of care management vendor Phytel and population health analytics vendor Explorys, Care Manager holds data on 90 million lives. Using Apple HealthKit, data can be moved from a device to a cloud application. Using Apple ResearchKit, providers can better manage the signing up of patients for clinical trials. In total, Care Manager supports development of personalized patient engagement programs to improve individual outcomes.
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ONC Reports 4x Spike in Providers Switching EHR Vendors

SEP 10, 2015 7:48am ET
The percentage of eligible professionals and hospitals that have switched EHR vendors quadrupled between Meaningful Use program years 2013 and 2014, according to new data from the Office of the National Coordinator for Health IT.
Dustin Charles, a public health analyst at ONC, reported to Wednesday’s Health IT Policy Committee meeting thatthe percentage of EPs that “ripped and replaced” their EHR between 2013 and 2014 jumped from 2 percent to 8 percent, while the rate for EHs increased from 0 percent to 4 percent.
“We don’t know why they decided to rip and replace. There are many reasons why providers would want to change their own vendor,” Charles said. “We just looked at this mostly from the certification perspective and we wanted to see whether or not the 2014 CEHRT was available and how many providers are using it. We found the majority are getting it from their current vendor without needing the switch. But, we would like to look more into those who did switch and understand what’s going on.”
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10 Million People Impacted by Data Breach at Excellus BCBS

SEP 10, 2015 7:31am ET
Excellus BlueCross BlueShield in New York is the latest health insurer to suffer a major cyber attack, this one affecting up to 10 million individuals.
The Blues plan on August 5 learned of the attack; as with other similar attacks the investigation found that intruders had accessed the network considerably earlier with the initial attack on December 23, 2013.
Cybersecurity firm Mandiant worked with the plan to investigate the hack and remediate vulnerabilities. The FBI is investigating. Compromised data includes names, dates of birth, Social Security numbers, mailing addresses, telephone numbers, member identification numbers, financial account information and claims information, according to Excellus.
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CIOs focused on gaining value from EHR investments

September 9, 2015 | By Susan D. Hall
A majority of hospital IT executives are focused on gaining more value from their electronic health record investments during the next year, according to a survey of members of the College of Healthcare Information Management Executives (CHIME) by the consultancy Impact Advisors.
More than 70 percent of respondents cited EHR optimization as a priority for the coming year, while only 8 percent said they were not focused on EHR optimization.
The survey defined optimization as "improvement to meet a defined set of objectives," which could take place before, during or after implementation. 
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Emergency stroke patients benefit from EHRs with decision support

September 8, 2015 | By Marla Durben Hirsch
Integrating electronic health records with clinical decision support and computerized physician order entry (CPOE) enabled almost double the number of emergency department patients with acute ischemic stroke to receive timely clot dissolving treatment, according to a new study in the Annals of Emergency Medicine.
The researchers, with the Kaiser Permanente Division of Research, studied 16 Kaiser Permanente Northern California Medical Centers from 2007-2012. The facilities introduced CPOE with a special electronic template, or "order set," embedded in it to help physicians make clinical decisions about stroke, including the use of intravenous tissue plasminogen activator (IV tPA) to dissolve clots for eligible patients.
Of 10,081 patients studied, 66.3 percent were treated in centers where the CPOE had been implemented. The IV tPA was administered in 8.9 percent of these patients, compared to 3.3 percent in centers without the technology. When the stroke order set was used in conjunction with the CPOE, the administration of IV tPA increased to 12.7 percent.
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Bryant puts paperless future on CCGs

Rebecca McBeth
3 September 2015
Clinical commissioning groups have overall responsibility for delivering a paperless NHS by 2020 and will manage any funding made available to support this ambition, NHS England has said.
Speaking at the NHS Expo in Manchester today, Beverley Bryant, director of digital technology at NHS England, said the definition of paper-free is that all patient and care records will be digitally interoperable and real time by 2020.
CCGs will need to submit digital roadmaps by next April, showing how they will achieve this within their defined geographic area.
Bryant said CCGs have been chosen to lead on the roadmaps because they are best placed to manage the health economy and drive a focus on interoperability.
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Care.data on hold again

Rebecca McBeth
7 September
Controversial patient data collection programme care.data has been put on hold again while a review of the opt-out model is completed.
Four care.data pathfinders were due to start testing various materials related to the programme, starting with Somerset Clinical Commissioning Group, this month.
However, NHS England has written to the pathfinders to let them know the pilot testing cannot go ahead until Dame Fiona Caldicott has provided advice on the wording of the opt-out.
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Despite growth in testing, providers still lukewarm to lab systems

September 10, 2015 | By Susan D. Hall
Labs are more complex and contain more patient data than ever before, according to a report from Peer60 on laboratory information and digital pathology systems.
The global laboratory information systems market is predicted to reach $1.1 billion by 2019, and the global digital pathology market to reach $5.6 billion by 2020, it says, citing other research.
It finds molecular and genetic testing growing at 47 percent of responding organizations.
Meanwhile, 51 percent of respondents reported that they plan to move away from their current LIS vendor--and were lukewarm about recommending them. The average ranking they gave their current vendor was 5.2 on a scale of 0 to 10, with larger organizations more likely to recommend their vendor.
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Report: Healthcare accounts for 21 percent of data breaches worldwide

September 10, 2015 | By Katie Dvorak
In the first half of 2015, there were more than 245.9 million records breached worldwide--with the largest impacting consumers of health insurance company Anthem.
The number of breaches so far this year has hit 888, according to a report from Breach Level Index, compared to 803 in the first half of 2014.
"The healthcare industry historically has had the highest number of data breaches, and that was no different in the first half of 2015," the report's authors write.
Healthcare accounted for 21.1 percent of the total breaches, according to the report.
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Data Security: Hunkering Down at NYU Langone

September 9, 2015
In May, when the Michigan-based Ponemon Institute released the results of its fifth annual survey about privacy and security issues facing healthcare organizations, it found that for the first time, providers reported that the No. 1 root cause of their data breaches was criminal and malicious attacks, surpassing mistakes and employee negligence. Ponemon also found that the rate of data breach is remarkably high, with 91 percent of providers experiencing one or more breaches in the last year, and 40 percent of respondents had more than five data breaches over the past two years.
While these were the statistics that drew the biggest headlines, it should also be noted that the survey found that healthcare organizations spent an average of more than $2 million to resolve the consequences of a data breach involving an average of almost more than 2,700 lost or stolen records. Another study from Ponemon and IBM revealed that healthcare emerged as the industry with the highest cost per stolen record with the average cost for organizations reaching as high as $363. “Based on our field research, we identified three major reasons why the cost keeps climbing," Dr. Larry Ponemon, chairman and founder, Ponemon Institute, said in a statement at the time of this report. “First, cyberattacks are increasing both in frequency and the cost it requires to resolve these security incidents. Second, the financial consequences of losing customers in the aftermath of a breach are having a greater impact on the cost. Third, more companies are incurring higher costs in their forensic and investigative activities, assessments and crisis team management."
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Healthcare Hacks Account for Most Data Breaches in 2015

September 9, 2015
In the first half-period of 2015, the healthcare industry had the highest number of data breaches, with 187 breaches, accounting for 21 percent of the total number of incidents, according to the Breach Level Index by digital security company Gemalto.
However, that figure is down from recent half-periods, both in the number of breaches and in the share of breaches among industries, according to the findings of the Breach Level Index.  As a result of these data breaches so far in 2015, the healthcare industry also led the way in number of records breached by industry with 84.4 million records, or 34 percent of the total.
This represents a dramatic shift from the past few years when healthcare had relatively small numbers of records involved in data breaches, according to the report. In the second half of 2014, for example, healthcare accounted for only 5.2 percent of stolen records as the number of records involved in data breaches were mostly in retail and financial services industries.
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Many ONC-certified EHRs actually fail to meet certification standards

Posted on Sep 09, 2015
By Erin McCann, Managing Editor
Is your electronic health record ONC certified? Turns out, even if your EHR vendor and product is "certified" as meeting certain usability requirements, they might in actuality not be meeting those said requirements, according to new analysis.
Researchers at the MedStar Health's National Center for Human Factors in Washington decided to take a closer look at 2014 certification for 50 of the largest EHR vendors, and it turns out a significant number of "widely-used" EHR platforms failed to meet ONC requirements, despite being officially certified by third parties as having met those requirements. 
The team, led by Raj M. Ratwani, scientific director at MedStar Health's National Center for Human Factors, analyzed EHR products that accounted for the lion's share, 90 percent, of meaningful use provider attestations between April 2013 and November 2014.
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Patient portals more useful than many realize

Posted on Sep 09, 2015
By Sherree Geyer, Contributing writer
Kaiser Permanente engages 45 percent of its more than 9 million members through online portals, which provide secure physician-patient email and access to KP HealthConnect, a comprehensive electronic health record to empower patients to manage care.
"Kaiser, given their capitated model, has a direct, financially-driven incentive to ensure patients remain active members within their health maintenance network," says Julie Yoo, chief product officer at Kyruus, a Boston-based developer of patient access tools. "Patient portals are likely highly used by Kaiser physicians to this end."
She adds: "Kaiser also has been known to invest heavily in marketing campaigns to raise awareness and drive adoption of patient portals among members."
But Kaiser stands in contrast to a 2014 EHR survey from Xerox indicating that 64 percent of patients don't use portals and 35 percent don't know about them. Adding to the confusion, 31 percent said physicians never told them about the online tools.
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Pret a portal

The drive for digital and patient-focused services is driving interest in patient portals. Daloni Carlisle hears that these come in three flavours; services that deliver simple information and support, transactional services for specific conditions or use-cases, and services with bigger ambitions to make patients ‘co-producers’ of their care.

There is a lot of activity in the first two areas, while the third is where everybody wants to go. But the integration challenges are formidable.
NHS England wants more health services to move into the digital era – and wants them to involve patients. One way of doing both is to create a patient portal.
But what exactly is a patient portal? Do ambitions for portals outstrip the technology or is the technology ready and waiting for the information governance to catch up? And do we really know what patients want from a portal?
Andy Clegg, who leads Emis’ integration and transformation consulting practice, says patient portals will be a “significant part” of integrated care in future; but adds that there is a degree of confusion about definitions.
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Monday, September 7, 2015

Technology Will Transform Care for Older People: Truth or Hype? (Hint: HYPE)

I seem to keep hearing stories about how fancy new technologies will transform care for older persons.  Living in the Bay Area, it is kind of uncool to not claim excitement about the possibilities.
So, I guess I will avoid admitting that I am just not getting jazzed up about the possibilities.  I suppose one day something transformative will come along.  But, what older people really need, especially those facing the disabilities and frailties of old age, is more high touch.  Not high tech.
Here are a few ideas I have heard pitched over the past year that create a big yawn:
1) Monitoring Grandma and Grandpa:
I suppose many of you have heard this idea.  You are worried about your older parent/grandparent, so you put sensors in their home.  With home monitors, you can now get a text on your iPhone so you know what time Grandma has woken up, when she has eaten, whether she has taken her medicine, when she leaves the house, and when she comes back.  If anything is amiss, you can take action.
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ACP Supports Expanding Telemedicine in Primary Care

Marcia Frellick
September 08, 2015
Telemedicine can broaden access to care, improve outcomes, and reduce care costs, but risks and benefits must be carefully evaluated for both patients and physicians, say authors of a new position paper from the American College of Physicians (ACP).
The paper, published online September 8 in the Annals of Internal Medicine, offers more than a dozen recommendations — and the rationale behind them — for successful telemedicine, which the ACP says should be held to the same standards of practice as in-person medicine.
Among the most important recommendations is establishing a relationship. "ACP believes that a valid patient–physician relationship must be established for a professionally responsible telemedicine service to take place. A telemedicine encounter itself can establish a patient–physician relationship through real-time audiovisual technology," the authors write.
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OpenNotes initiative hits 5 million patients (infographic)

 Sep 8, 2015 at 1:13 PM
The OpenNotes initiative now reaches more than 5 million patients nationwide, according to new data and an infographic released just before the long Labor Day weekend. That covers participants in all Department of Veterans Affairs hospitals nationwide, as well as private organizations in 20 states.
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EHR Satisfaction Sinks Among Providers

Alexandra Wilson Pecci, for HealthLeaders Media , September 9, 2015

The percentage of healthcare clinicians who say they wouldn't recommend their electronic medical record system to a colleague has grown from 24% in 2010 to 51% in 2014.

Electronic health records systems are failing to live up to clinicians' expectations in terms of cost savings, efficiency, and productivity, and clinician satisfaction with EHRs/EMRs is on a southbound track.
That's according to a survey data gathered by AmericanEHR Partners in conjunction with the American Medical Association, the American College of Physicians, and American Academy of Family Physicians.
According to several years' worth of survey results, physicians, nurse practitioners, and physician assistants are growing increasingly disenchanted with their EHR/EMR systems each year. The 2010 survey, for instance, shows that 39% of respondents were satisfied and 22% were very satisfied with their EHRs/EMRs, compared to 22% and 12%, respectively, in 2014.
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Identity access management tips from the security pros

Posted on Sep 01, 2015
By Erin McCann, Managing Editor
Here's a challenge: Overseeing identity access management for a 163-hospital health system that spans 20 states and the U.K. But despite the myriad challenges – and they're growing more prevalent these days – HCA's Bobby Stokes is ahead of the game and has a few tips for those looking for guidance.
Stokes, the AVP of identity access management at Nashville, Tennessee-based HCA, says protecting data is akin to that of playing Donkey Kong. "We're like Mario," he said. All those barrels being thrown at us that we have to work around represent government regulations and an ever-changing landscape – think ACA, updated HIPAA and meaningful use.
Stokes is charged with the not-so-light task of managing a single sign-on implementation that today has 130,000 users every month.
Add to that the complexity of those users. New employees come in; some leave.
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Deven McGraw: Health data access, ownership a priority for OCR

September 8, 2015 | By Dan Bowman
Access to and ownership of health data is a top-of-mind issue for the Department of Health and Human Services Office for Civil Rights, and one that will be addressed via pending guidance, according to Deven McGraw, deputy director of the agency's Health Information Privacy Division.
Speaking last week at the "Safeguarding Health Information Building Assurance through HIPAA Security" conference hosted by OCR and the National Institute of Standards and Technology in the District of Columbia, McGraw pointed out that issues such as patients' rights to choose which third parties can receive their data and fees around electronic access will be covered in the guidance, which she predicted could be out by the end of October.
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EHR 'overreliance' led to release of Ebola patient at Texas Health Resources

September 8, 2015 | By Katie Dvorak
Overreliance on its electronic health record system was one of the mistakes Texas Health Resources made that led to the misdiagnosis and release of a patient later confirmed to have Ebola, according to a report from an expert panel convened by the Dallas-based health system.
The report outlines the mistakes that lead to the release of Thomas Eric Duncan from the hospital last October--who later died from the disease--and improvements Texas Health can make to avoid mistakes from happening again.
One of the mistakes, according to the report, was "inadequate communication processes and overreliance on the electronic health record to convey critical information."
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Expert panel on what went wrong at THR

Posted on Sep 08, 2015
By Bernie Monegain, Editor-at-Large
If only the care team had talked among themselves, the crises surrounding a patient eventually diagnosed with Ebola at a Texas Health Resources hospital last year, might have been averted, a panel of experts called in to review the case has concluded.
The expert panel brought in by top leaders at Texas Health Presbyterian Hospital in Dallas to assess the Ebola virus events that began Sept. 25, 2014, after Thomas Eric Duncan arrived at the emergency department at the hospital.
"There are underlying quality concerns about the evaluation that was conducted when Mr. Duncan arrived at the ED the first time," the expert panel wrote in its 15-page report. "The expert panel is concerned that the care provided to Mr. Duncan during his first ED visit may reflect larger organizational issues."
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New device reduces time to diagnose infections

IANS  |  New York  September 6, 2015 Last Updated at 12:10 IST
A team of US engineers has developed a new device that significantly reduces the amount of time necessary to diagnose tissue infections.
While tests currently in use take about an hour or more to determine the nature of infections, the device may accomplish it just three and half minutes and that too at a low cost, the study said.
"We have developed a completely different type of system than what exists out on the market," said Dustin Harshman, scientist at US-based Ventana Medical Systems, a global leader in tissue diagnostics.
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Research: Smartphone Owners More Likely to Use Patient Portals

September 4, 2015
Digital health device owners are five times more likely to regularly use a patient portal to access personal health information than non-device owners, according to research from Parks Associates, which indicates that device ownership can be a driver for online engagement.
The research found that 27 percent of device owners regularly use a patient portal versus only 5 percent of non-owners.
“Monthly usage of patient portals is increasing among U.S. broadband households, but 50 percent of U.S. broadband households do not regularly use these online health resources and 23 percent do not use health portals at all,” Harry Wang, Director, Health and Mobile Product Research,  Parks Associate said in a statement. “Device ownership can be a driver for online engagement, and innovations with open or private APIs are enabling partners from different industries, such as device makers and patient portal developers to collaborate for new consumer health and wellness experiences.”
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Health IT Experts Getting Their Own Health Data, or at Least Trying

by John Sharp Tuesday, September 8, 2015
The recently released OpenNotes study -- which demonstrated how patient access to doctors' notes increased safety and improved patient engagement -- shows just how powerful patient portals can be. As patient portals continue rolling out nationally, health IT professionals are beginning to use them for their own personal care or that of their family, and they have high expectations.
Their stories are being recorded for the public on blogs and are worth a review. Who are better critics of new technology than the technologists themselves? What does this say about the next generation of patient portals and interoperability?

Brian Ahier

A well-respected interoperability/health information exchange expert, Brian Ahier, writes about his experience after a medical emergency when he was traveling out of town. When he tried to access his records from that hospital to share with his primary care physician at home, he had to print his record since he was told, "The only way to export this information from the portal is to use the print option. There is no option to save this information to another document/system. Also, your complete medical record is not available on the portal." In addition, he was not told of his rights under HIPAA to access his medical record electronically.
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Enjoy!
David.

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