Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, May 03, 2014

Weekly Overseas Health IT Links - 3rd May, 2014.

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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Healthcare Role Eyed for Google Glass

APR 24, 2014
Since the release of smartphones and the iPad, the healthcare industry has taken a keen interest in adopting portable computing for a clinical environment. And just as quickly as mobility has arrived, those form factors may have to make space for another new gadget, Google Glass.
Over the past two years, clinical staffs have been dipping their toes in the water with a handful of small experiments using Glass, and recent successes have led to a greater interest in the product as a viable medical tool.  Not only are doctors and hospitals intrigued by the prospect of Glass, a number of startups have emerged with the goal of building healthcare-specific software to make the most of Google’s hi-tech headgear. 
Google Glass—from search engine giant Google Inc.--comprises a pair of glasses equipped with a camera, microphone and small LCD display that connects to the user’s phone. Glass enables its users to record video and make gestural commands using the camera, as well as give voice commands over its built-in microphone, all while showing the user what they need through the display. 
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73% of providers will continue on with ICD-10 despite delay

Author Name Jennifer Bresnick   |   Date April 24, 2014   |  
Nearly three-quarters of providers surveyed by Part B News aren’t letting the ICD-10 delay get them down.  The majority of respondents are more or less keeping to the plans they set in order to be ready for the new codes by 2014, even though they will have at least one extra year to prepare due to the recently mandated extension of the timeline.  While many of the 1100 providers cited financial outlay as one of their biggest concerns, average spending rates among the participants were far below the dire predictions made by the American Medical Association (AMA) earlier this year as they advocated for a pushback.
Among the most difficult obstacles encountered during the ICD-10 transition are documentation improvement (22%), staff reluctance to participate (19%), and a lack of testing opportunities (14%).  Scarce resources also made the list of serious concerns, and the delay is only compounding the worries over keeping the momentum going through another twelve months of preparation.
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Survey: CIOs Committed To Their Vendor, But With Eyes Wide Open

04/23/2014 By Kate Gamble
CIOs Happy With Their Core Vendor, But Keeping Close Watch
Vendors, take note: If you don’t deliver, you’re out.
With CIOs facing mounting pressures, the relationship with their core vendor is becoming increasingly critical. And although most are generally satisfied, they’re willing to make some noise — or even walk — if things go south, according to the April healthsystemCIO.com Snap Survey, which found that 69 percent of CIOs have a “very good” relationship with their core vendor, and 63 percent find their vendor to be “very responsive.”
But while most CIOs are getting what they need, it doesn’t always happen right away — or without a little nudging. “Much of the time, our core vendor is very responsive,” noted one respondent. However, “in some instances, we have to push hard or wait longer than we’d like to get attention or to get in touch with the right people there who can make things happen.”
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Physicians Find Security In The Cloud

4/24/2014 12:35 PM
Healthcare practices are increasingly partnering with trusted cloud service providers to provide enhanced data security along with improved efficiency of IT operations.
A growing number of healthcare practices are finding that cloud services, once feared by security-conscious providers, are now proving to be a safer option than on-premises alternatives.
While only 4% of healthcare providers adopted the cloud in 2011, use of the vertical cloud is now growing by 20% annually, according to MarketandMarkets. By 2017, the researchers predict, healthcare organizations will spend $5.4 billion on cloud services.
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Cyber Threats to Healthcare Systems, Medical Devices Rising

APR 23, 2014
Compared to other industries, healthcare is particularly vulnerable to cyber attacks with the threats to health information continuing to mount as the industry moves to adopt electronic health records. Earlier this month, the FBI's Cyber Division issued a notice warning that healthcare systems and medical devices are at risk for increased cyber intrusions for financial gain.
"Cyber actors will likely increase cyber intrusions against healthcare systems--to include medical devices--due to mandatory transition from paper to electronic health records, lax cybersecurity standards, and a higher financial payout for medical records in the black market," according to the FBI. "The deadline to transition to EHR is January 2015, which will create an influx of new EHR coupled with more medical devices being connected to the Internet, generating a rich new environment for cyber criminals to exploit."
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E-referrals to go live in November

24 April 2014   Lis Evenstad
The NHS e-referral service will go live in November this year, the Health and Social Care Information Centre has said.
At a recent supplier testing open day, the HSCIC gave a presentation on the service which will replace Choose and Book in order to make sure suppliers are prepared for the launch.
The system is based on open source technology and there will be a large focus on open standards, says the presentation.
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DH rolls back GP records access promise

23 April 2014   Sam Sachdeva
The government’s pledge to give patients online access to their GP records by March 2015 has been scaled back again, with practices now only required to have a plan to provide access by the deadline.
The Department of Health’s 2012 NHS information strategy said that all GP practices would be expected to provide electronic booking, cancelling of appointments, online prescriptions, electronic  online access to their record to anyone who wants it by 2015.
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500 GP practices to pilot care.data

23 April 2014   Lis Evenstad
Up to 500 GP practices will trial care.data in a phased roll out beginning this autumn, NHS England has announced.
In a letter to clinical commissioning groups and local area teams, NHS England’s director of patients and information, Tim Kelsey, says that the delayed roll out of the controversial programme, which will extract data from GP practices, will begin with a pilot.
“This will involve a cohort of between 100 and 500 GP practices to trial, test, evaluate and refine the collection process ahead of a national roll out,” he says.
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Tech could improve care for medically complex, low-income patients

April 24, 2014 | By Susan D. Hall
Focus groups concentrated on a key Medicaid population--medically and socially complex, low-income patients--revealed areas for which connected health initiatives could bring improvements, according to a blog post at Health Affairs.
The focus group participants were receiving services from case management/care coordination programs in New York state or Philadelphia.
These patients often have multiple conditions, including substance abuse and mental health issues, and have unstable living conditions. Many lack permanent housing, are homeless or live in shelters. 
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FBI warns healthcare of vulnerability to cyberattacks

April 24, 2014 | By Susan D. Hall
The FBI has issued two warnings this month that healthcare organization systems, including medical devices, could be vulnerable to cyberattacks.
"The healthcare industry is not as resilient to cyber intrusions compared to the financial and retail sectors, therefore the possibility of increased cyber intrusions is likely," it said in a "private industry notice," or PIN, issued April 8.
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Medical Informatics: A Formal Subspecialty Whose Time Has Come

April 21, 2014
Hospitals like Lucile Packard Children's Hospital are creating a professional pathway around clinical informatics
Things have been moving fast around the creation of a unique new subspecialty—clinical informatics. In 2011, the American Board of Medical Specialties (ABMS) approved clinical informatics as a clinical subspecialty, uniquely designed that physicians already boarded in virtually any specialty could sit for the clinical informatics examination.
The first examination was offered in the autumn of 2013, and also uniquely, the ABMS allowed for physicians to “grandfather” into the specialty via a practice pathway based on experience, or to qualify by earning a master’s degree program in the fi eld. That means that physicians already practicing as medical informaticists have until 2018 to grandfather in through experience and exam-taking.
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Data Governance Required For Healthcare Data Warehouse

Before implementing its ambitious data warehouse, OhioHealth focused on data governance to ensure data is accurate, clean, and usable.
4/23/2014 09:06 AM
For decades, the data OhioHealth staff collected resided in silos spread across its 10 hospitals and countless departments. Two years ago, the nonprofit healthcare organization began investing in data governance and an enterprise data warehouse to cleanse and safely store data so business users could access, analyze, and act on the critical information.
The advent of electronic health records (EHRs), e-prescriptions, accountable care organizations, and value-based payments that demand analysis of cost versus quality meant the family of eight hospitals and about 55 healthcare organizations could no longer continue treating data in this manner, said Dr. Mrunal Shah, a practicing physician and system VP for healthcare informatics at OhioHealth. It also meant the organization could not advance without a data warehouse -- a trusted, secure central repository for all information, he said in an interview.
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FDA Proposes Expedited Access Program for High-Risk Medical Devices

APR 23, 2014
The Food and Drug Administration is seeking public comment on a proposal to create a new program to provide earlier access to certain high-risk medical devices.
These are devices that are intended to treat or diagnose patients with serious conditions whose medical needs are not being met by current technology. However, some stakeholders are critical of the approach, labeling it as not new and benefiting only a handful of medical device companies.
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HIT leads list of top 10 safety concerns

Posted on Apr 23, 2014
By Erin McCann, Associate Editor
Health information technology systems have made their way to the No. 1 patient safety concern for healthcare organizations, according to the findings of a new ECRI industry report.
The report, which includes data on more than 300,000 safety event reports, underscores healthcare's top 10 patient safety concerns for 2014 and puts data integrity failures with HIT systems at the very top.
"Health IT systems are very complex," said James P. Keller, vice president of technology evaluation and safety at the ECRI Institute, in the report. "They are managing a lot of information, and it's easy to get something wrong."
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Has the Meaningful Use program run its course?

April 23, 2014 | By Ashley Gold
Meaningful Use: It's just like high school, where you learned all the right facts for the test, but the knowledge didn't stick with you any longer than until the end of the semester. At least, that's the opinion of Dale Sanders, former CIO of Cayman Islands Health Services Administration and current senior vice president for strategy at Health Cataylst, writing in a post at healthsystemCIO.com.
"... [L]ike a teacher who 'teaches to the test,' the program created a very complicated system that might pass the test of MU, but is not producing meaningful results for patients and clinicians," Sanders writes. "It's time to put an end to the federal MU program, eliminate the costly administrative overhead of MU, remove the government subsidies that also create perverse incentives, and let 'survival of the fittest' play a bigger part in the process."
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Rand: Stress value with new medical technology

April 23, 2014 | By Susan D. Hall
The federal government should provide incentives for pharmaceutical companies and device makers to produce products that help cut spending and ensure that the benefits of costlier advances justify their added expense, according to a new Rand Corp. report.
"We spend more than $2 trillion a year on healthcare in the U.S.--more per capita than any other nation--and the financial incentives for innovators, investors, physicians, hospitals and patients often lead to decisions that increase spending with little payback in terms of health improvement," Steven Garber, a Rand senior economist and principal investigator of the study, says in an announcement.
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Supporting structure

The Royal College of Physicians would like structured letters to be created from structured records. That isn’t going to happen for a while yet, but digital dictation specialists are helping trusts and GPs to start moving in that direction. Fiona Barr reports.
Outpatient letters and discharge summaries created as structured documents from structured records are a tantalising prospect for the health service.
It is an idea that was set out by the Royal College of Physicians in its ‘Future Hospital’ report last year; and  one that is likely to be welcomed with open arms  by GPs.
It would mark a big change with the reality today; which is that outpatient letters are often unstructured, free text documents with large variations in content both between individual clinicians and within and between departments and hospitals.
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BaseHealth launches a wellness platform that melds genomics and devices

April 24, 2014
A startup called BaseHealth launched on Tuesday with a mission to deliver personalized wellness plans while keeping doctors very much in the picture. The company’s platform combines genetic data, lifestyle data and medical records to determine patients’ risks and how they can mitigate them.
Promising to reinvent preventative medicine by bringing genomic data, medical research and connected devices together in a single platform, a startup called BaseHealth launched on Tuesday. The company, which has raised $6.3 million from a group of investors led by RONA Holdings and Bobby Yazdani, hopes a personalized and predictive approach to will help patients identify their prospective problems and then take the right steps to prevent them.
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Report: 40% of EHR Buyers Replacing Current System

Written by Helen Gregg (Twitter | Google+)  | April 22, 2014
About 40 percent of providers shopping for a new electronic health record system during the first quarter of 2014 were seeking a replacement for their current EHR, according to a survey from EHR reviewer Software Advice.
The percent of prospective buyers looking for a replacement EHR has grown 30 percent since the first quarter of 2013.
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Health Systems First To Combine Radiology, EHR

The shared pediatric diagnostic imaging system that Children's Hospital of Philadelphia and New Jersey's Virtua have created goes beyond conventional health information exchange.
4/22/2014 10:05 AM
Going beyond health information exchange as a replacement for the fax machine, Children's Hospital of Philadelphia and Virtua, a Southern New Jersey health system, have unified their radiology operations across electronic health records systems and state lines.
By deeply integrating imaging systems and EHRs, the two systems have made it possible to create an integrated health record that includes images captured at a Virtua facility and read by pediatric diagnostic imaging specialists at the Children's Hospital of Philadelphia. Even though CHOP, as it's known for short, is an Epic shop, and Virtua uses EHR software from Siemens, patient records are then synchronized across the two systems, with access to radiology reports and diagnostic images available from either one.
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Physician Payment Data is Where the Action Is

Scott Mace, for HealthLeaders Media , April 22, 2014

Look beyond the EHR incentive program. A national effort to turn CMS's recent release of Medicare physician payment data into useful, actionable data visualizations is the hottest HIT challenge right now.

The days of building electronic medical record software are over.
Oh sure, EHRs will continue to get built, improved, "skinned," perhaps even reimagined.
But with the EHR incentive program beyond its peak, attention is shifting to other important aspects of the healthcare technology spectrum.
Last week in this space, I described how entire communities are engaging in friendly competition to leverage the many digital breadcrumbs that make up today's total population health picture.
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Simulated cyber attack finds gaps in preparedness

By Diana Manos, Senior Editor
A group ranging from healthcare payers to medical centers participated in a series of exercises that simulated real cyber attacks on healthcare organizations, to see how well they could hold up under such an event.
The simulated attacks, called CyberRx, were conducted in partnership with HITRUST, the U.S. Department of Health and Human Services.
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HSCIC admits to four HES data breaches

9 April 2014   Jon Hoeksma
The Health and Social Care Information centre has admitted to repeated data breaches involving the Hospital Episode Statistics.
Documents obtained by MedConfidential in response to a Freedom of Information Act request say the HSCIC has records of one data breach for every year between 2009 and 2012.
The pressure group says it submitted the request after NHS England’s director of patients and information, Tim Kelsey, told Radio 4’s Today programme that use of HES was covered by such strict rules that “in 25 years, there has never been a single episode in which the rules... have ever compromised a patient’s privacy.”
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EHR tool reduces diagnostic tests

By AuntMinnie.com staff writers

April 22, 2014 -- A health information exchange (HIE) tool in electronic health record (EHR) software can help avoid a significant number of diagnostic tests and procedures, according to researchers from Allina Health.
In a study published in the current issue of Applied Clinical Informatics (Vol. 5:2, pp. 388-401), a team led by Tamara Winden of Allina Health found that the Care Everywhere tool in their Excellian EHR software (Epic Systems) avoided 560 potentially duplicative diagnostic procedures, such as blood work and medical imaging exams, over a six-month period at four emergency departments (EDs).
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Cloud choice no longer 'pie in the sky'

Posted on Apr 21, 2014
By John Andrews, Contributing Writer
Seems like the sky is the limit for cloud computing, whether it is to replace servers, manage mobile apps or handle system recovery. Cloud vendors are constantly coming up with new ways to utilize a platform that seemed like little more than vapor five years ago.
It was just that long ago that Alex Brown, CEO of Chicago-based 10th Magnitude, saw the cloud’s potential and became an evangelical about it. He concedes it was a tough sell at first.
“Initially people were skeptical and there were a lot of barriers,” he said. “It was hard getting traction with it – no one budged. But eventually small and mid-sized organizations realized they could reach their visions with the cloud because its affordability allowed them to finally compete with the big guys. Initially, they were our market.”
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Privacy, security constant themes in DeSalvo's 2014 agenda

April 21, 2014 | By Ashley Gold
What's vital for 2014 on National Coordinator for Health IT Karen DeSalvo's agenda?
Privacy and security, she told HealthcareInfoSecurity in a recent interview.
"We consider privacy and security an important part of the work that we do," DeSalvo said. "It's increasingly complex as we think through care models, mobile health, e-health, telehealth and the broader issues of big data and how we make certain that people's health information is first and foremost there to improve their care wherever they are ... but, as they desire, is also available [for research] to help advance the health system and population health overall."
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Data-driven approach heads off alarms at Boston Children's

April 21, 2014 | By Ashley Gold
Seeking a way to confront a "quiet cacophony" of beeping, alarming bedside monitors, Boston Children's Hospital has tapped into predictive analytics to forecast changes in patients' conditions before alarms sound.
The Boston Globe reports that the hospital joined forces with a startup to analyze the data monitors put out, like vital signs or respiratory rates, and assess whether the patient's condition is at risk of getting worse.
"There are so many pieces of data coming at the physician. With almost 30 ICU patients, we're just inundated," Joshua Salvin, a pediatric cardiologist at Boston Children's, told the Boston Globe. "If we had something that could tell us where the hot spots are on the floor, we could direct resources to the most sick patients."
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Managing Diabetes with Telemedicine

Diabetes afflicts more than 22 million Americans, or 7 percent of the total population, and the number of people diagnosed every year is skyrocketing.
At a cost of $245 billion in 2012, the disease’s toll on the economy has increased by more than 40 percent since 2007, according to a recent report from the American Diabetes Association.
Mississippi, which ranks second after West Virginia in the percentage of residents affected by the chronic disease, is taking steps to reduce devastating effects on the state economy and the overall health of Mississippians. Nearly 9 percent of Mississippians were diagnosed in 2012 with diabetes, and the $2.7 billion annual cost of diabetes represents nearly 3 percent of the state’s economy (gross state product).
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Digital health startup pivots from wellness app to chronic condition care plans

April 18, 2014 6:00 am by Scott Wooldridge 
Everyone knows how to stay healthy – eat less, move more. It’s actually making those changes to daily life that is the hard part.
The same is not true for people living with diabetes or heart failure or kidney trouble. Treatment plans are complex and often hard to remember, particularly if you’re not feeling well.
Filament Labs is building a Patient IO to make it easier for sick people to take care of themselves.
Launched at the end of February, the app takes complex treatment plans and makes them digital. It offers patients and providers tools to ensure that care plans are followed, including medication reminders and vital sign tracking, such as blood pressure.
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New Report Calls for MU3 to Foster Interoperability, National Health IT Architecture

Written by Helen Gregg (Twitter | Google+)  | April 18, 2014
A report recently released by JASON, an independent group of science and technology experts that often advises the federal government, calls on HHS to use meaningful use stage 3 to promote a standardized, national health IT architecture that would be a significant step toward interoperability.
"The criteria for stage 1 and stage 2 meaningful use, while surpassing the 2013 goals set forth by HHS for electronic health record adoption, fall short of achieving meaningful use in any practical sense," according to the report. HHS has the opportunity with meaningful use stage 3 to un-silo data with national standards that would foster data exchange for the national improvement of healthcare.
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Review of Q1 2014 Federal Health IT Activity

by Helen R. Pfister, Susan R. Ingargiola and Dori Glanz, Manatt Health Solutions Monday, April 21, 2014
The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the first quarter of 2014.

Highlights

The first quarter of 2014 saw a number of important developments:
  • Final Rule Gives Patients Right to Access Laboratory Test Results. On Feb. 6, CMS, CDC and the Office for Civil Rights jointly issued a final rule that gives patients direct access to their laboratory test results. The final rule amends both the HIPAA Privacy Rule and the Clinical Laboratory Improvement Amendments of 1988 regulations.
  • HHS Strategic Plan Highlights Meaningful Use. On March 14, HHS released its five-year strategic plan for 2014 through 2018. The plan includes performance goals related to meaningful use, including increasing the number of primary care physicians that use electronic health records. The plan also identifies strategies to advance EHRs, such as using incentives, certification and grants to help increase EHR adoption.
  • ONC Releases Proposed Rule on 2015 EHR Certification Criteria. On Feb. 26, the Office of the National Coordinator for Health Information Technology, released a proposed rule that would specify the voluntary certification criteria that EHR developers and providers qualifying for the Medicare and Medicaid EHR Incentive Programs may adopt starting in 2015. The 2015 criteria would clarify, update and add to the 2014 criteria and simplify the certification of certain EHR modules. The 2015 criteria proposed in the rule would be voluntary. No EHR technology developer that has certified its EHR technology to the 2014 Edition would need to recertify to the 2015 Edition in order for its customers to participate in the EHR Incentive Programs. Furthermore, eligible professionals, eligible hospitals and critical access hospitals would not need to upgrade to EHR technology certified to the 2015 Edition in order to have EHR technology that meets the Certified EHR Technology definition. The proposed rule introduces the beginning of ONC's more frequent approach to health IT certification regulations. Under this approach, ONC intends to update certification criteria editions every 12 to 18 months in order to provide smaller, more incremental regulatory changes and policy proposals.
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UK doctors launch new 'heart age' tool

Posted on Apr 11, 2014
By Dillan Yogendra, Managing Editor, HIMSS Europe
Risk calculators for cardiovascular disease (CVD; conditions that affect the heart and blood vessels) are nothing new – the Framingham risk calculator has been available for years. But the new JBS3 has many benefits:
  • Easily accessible online.
  • Provides what is considered an accurate risk estimation of experiencing a serious CVD event such as a heart attack or stroke.
  • Is of use to younger adults who could be on the route to a stroke or heart attack due to unhealthy lifestyle choices, even if short-term risk is low.
The calculator includes ‘heart age’ estimates and predicts the years they can be expected to enjoy without developing CVD. It also shows the benefits that people would experience if they made changes to their lifestyle such as stopping smoking or reducing blood pressure or cholesterol levels. The ultimate aim is to empower people to reduce their risk of CVD.
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Facebook your doctor: the future NHS?

Posted on Mar 25, 2014
By Dillan Yogendra, Managing Editor, HIMSS Europe
ParkinsonNet is a dedicated website that links Dutch Parkinson’s disease sufferers with doctors and nurses who specialize in that disease area. It behaves like a Facebook for Parkinson’s patients. The professionals communicate and collaborate on the website, a place where patients can locate information about treatment, about the professionals themselves and what they do. If required, they can also request an at-home consultation via video link.
Since it was introduced in 2004, ParkinsonNet has expanded into 66 regional networks and links nearly 3000 professionals from 15 different disciplines to Parkinson’s patients all over The Netherlands.
Evidence presented by the researchers, from the Radboud University Medical Centre, suggests that the website ‘empowers patients, improves the quality of care, shifts care away from institutions and into the community and lowers healthcare costs’. The researchers concluded that the model could be successfully transferred to patients with other long-term conditions such as diabetes and breathing problems.
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Enjoy!
David.

Friday, May 02, 2014

Google Glass Getting More Focus In The Health Sector - Interesting Things Are Coming I Suspect.

A number of interesting reports recently.
First.

Google Glass to Assist Parkinson's Patients

Google Glass is being trialled in an effort to find new ways in which the smartglasses can be used to support people with long-term conditions such as Parkinson's disease and dementia.
Researchers at Newcastle University have been working with Parkinson's patients to investigate ways the wearable technology can be used as an assistive aid for people suffering from the condition.
Currently only available to developers and Glass Explorers, five pairs of the smartglasses were donated by Google to the university to assist in the research.
Early days
The technology is being used to provide prompts to the wearers for key behaviours typical of Parkinson's, such as reminding them to swallow to prevent dribbling and to speak louder.
For those suffering from conditions like dementia, it is thought that Glass can be used as a personal reminder for things like medication and appointments.
"Glass opens up a new space for exploring the design and development of wearable systems," said Dr John Vines, leader of the trial.
"It is very early days. Glass is such a new technology we are still learning how it might be used but the beauty of this research project is we are designing the apps and systems for Glass in collaboration with the users so the resulting applications should exactly meet their needs."
Lots more here:
Second.

5 ways Google Glass will innovate healthcare

April 11, 2014 | By Ashley Gold
Google Glass--no longer just a hopeful idea or cool trend--is slowly but surely disrupting healthcare for the better as various innovators come up with creative ways to use the technology and get results.
Most notably, as reported earlier this week, in the latest post to his Life As a Healthcare CIO blog, John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston and a FierceHealthIT Advisory Board member, discusses how Google Glass improves the lives of patients at BIDMC.
Over the past four months, Halamka says, he and his colleagues piloted projects that they believe will improve the quality, safety and efficiency of patient care. One of his colleagues, emergency physician Steve Horng, M.D., calls the user experience "fundamentally different" than tablet or smartphone usage. "As a wearable device that is always on and ready, it has remarkably streamlined clinical workflows that involve information gathering," Horng tells Halamka.
But Google Glass also impacts healthcare in other ways. In a postBionicly outlines eight advancements--here are a few:
  1. Mobile access to patient images and information: OneDx, a software platform, allows physicians to access medical reports, inpatient location and exam information on Glass. Docs can download studies, reports and exams on the go.
  2. Glass can receive EHRs on the go: Augmedix is building clinical applications for Glass to allow doctors to retrieve and input information into a patient's medical record, Bionicly reports.
  3. Getting fit with Glass: An augmented reality app in development, called Race Yourself, lets users run against themselves and beat personal fitness goals.
  4. Glass in class--for medical education: Christopher Keading, M.D., at the Ohio State's Wexner Medical Center, was one of the first to livestream an operation when he performed knee surgery on a 47-year-old woman, Bionicly reports. Clinicians can use Glass to teach medical classes to students geographically far from a professor.
  5. Glass for Parkinson's sufferers: According to Bionicly, Newcastle University in the U.K. is developing a new app for Glass to help Parkinson's patients. The app provides the patients with prompts while they're outdoors, contacts relatives in emergencies and has reminders in the user's field of vision--such as when to take their medication--to help them gain independence.
More here:
Third.

Beth Israel Deaconess Deploying Google Glass in ED

APR 9, 2014
Google Glass technology developed by San Francisco- and New York-based startup Wearable Intelligence (WI) has been deployed in the emergency department at Beth Israel Deaconess Medical Center, Boston after a successful pilot.
In an April 9 entry in his "Life As A Healthcare CIO" blog, BIDMC CIO John Halamka, M.D., wrote the hospital had been piloting the technology for four months.
"After several months of testing, we have deployed the product to clinical providers in the ED and are completing the first IRB approved study (to our knowledge) of the technology’s impact on clinical medicine," Halamka wrote.
"I believe that wearable tech enables providers to deliver better clinical care by supporting them with contextually-relevant data and decision support wisdom," he also said.
Google Glass is a wearable computer with an optical head-mounted display that shows information in a smartphone-like, hands-free format.
Lots more here:
Interesting times I reckon!
David.

Customised Google Glass Delivers In Spades For A Major Emergency Department. Fascinating Story!

These two articles appeared a little while ago.
First we have:

Wearable computing at BIDMC

Posted on Mar 12, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Over the past few months, Beth Israel Deaconess has been the pilot site for a new approach to clinical information technology, wearable computing.
In the Emergency Department, we’ve developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor.
Here’s how it works.
When a clinician walks into an emergency department room, he or she looks at bar code (a QR or Quick Response code) placed on the wall.  Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient in that room to the glasses, appearing in the clinician’s field of vision. The clinician can speak with the patient, examine the patient, and perform procedures while seeing problems, vital signs, lab results and other data.
Beyond the technical challenges of bringing wearable computers to BIDMC, we had other concerns—protecting security, evaluating patient reaction, and ensuring clinician usability.
Here’s what we’ve learned thus far:
Patients have been intrigued by Google Glass, but no one has expressed a concern about them. Boston is home to many techies and a few patients asked detailed questions about the technology. Our initial pilots were done with the bright orange frames—about as subtle as a neon hunter's vest, so it was hard to miss.
Staff has definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed.
We have fully integrated with the ED Dashboard using a custom application to ensure secure communication and the same privacy safeguards as our existing web interface. We replaced all the Google components on the devices so that no data travels over Google servers. All data stays within the BIDMC firewall.
We have designed a custom user interface to take advantage of the Glass’ unique features such as gestures (single tap, double tap, 1 and 2 finger swipes, etc.), scrolling by looking up/down, camera to use QR codes, and voice commands. Information displays also needed to be simplified and re-organized.
We implemented real-time voice dictation of pages to staff members to facilitate communication among clinicians.
Google Glass does not appear to be a replacement for desktop or iPad—it is a new medium best suited for retrieval of limited or summarized information. Real-time updates and notifications is where Google Glass really differentiates itself. Paired with location services, the device can truly deliver actionable information to clinicians in real time.
Lots more here:
also we have this report.
  • March 13, 2014, 4:06 PM ET

Hospital Okays Google Glass in the Emergency Department

Beth Israel Deaconess Medical Center has modified Google Glass wearable computers so they can be used to treat patients in its emergency department without running afoul of privacy regulations. Using software from a startup, the hospital ensures no data travels over Google’s servers, says Dr. John Halamka, the hospital’s CIO.
“We have total control of all data flowing to and from Glass,” said Mr. Halamka in an interview Thursday.
With Glass, physicians can call up patient data through voice commands and view it on the screen mounted on the device’s eyeglass frame. The setup lets physicians keep their hands free while treating patients.
But Google Inc., which stores Glass-generated data on its cloud, won’t sign the contract hospitals are required to obtain from cloud vendors to meet requirements of the Health Insurance Portability and Accountability Act. HIPPAA requires that cloud vendors accept responsibility for managing patient information in accordance with the law’s privacy rules. This has prevented hospitals such as the Cleveland Clinic from using it.
Beth Israel has found a technological solution to those regulatory concerns. Thanks to software from Wearable Intelligence, a startup in stealth mode, the patient information accessed via Glass stays within the hospital’s computer systems, says Mr. Halamka. Patient records are stored on the hospital’s clinical systems and accessed via an encrypted Web connection. A cache-less browser is used to ensure that no patient data is stored on the device. As a result, if someone removes Glass from the hospital, they won’t be able to access patient data.
Encrypting devices doctors use to treat patients upholds privacy and security provisions in “meaningful use,” a set of government objectives for optimizing the use of electronic health care record software, said Mr. Halamka. Hospitals that meet these objectives are eligible for government incentives.
Lots more here:
I have little to add - rather than being delighted to see how a new tool can be effectively shaped to meet a need that is clearly now shown to exist.
Great fun and hopeful stuff for improved user interfaces and so on!
David.

Thursday, May 01, 2014

I Think This Is A Real Biggie! An New Approach To Risk Management In Health IT From The US Regulators.

This appeared a little while ago.

HHS publishes FDASIA framework for health IT

April 3, 2014 | By Dan Bowman
The U.S. Department of Health & Human Services, on Thursday, published the long-awaited proposed strategy and draft recommendations for a health IT risk-based framework mandated by the Food and Drug Administration Safety and Innovation Act.
The 34-page draft report--a collaborative effort by officials from the FDA, the Federal Communications Commission and the Office of the National Coordinator for Health IT--outlines a strategy that identifies three categories of health IT: administrative health IT functions; health management health IT functions; and medical device health IT functions. Risk and corresponding controls, the report's authors said, should focus on the functionality of health information technology, as opposed to the platforms on which that functionality lives.
"The proposed strategy and recommendations reflect the Agencies' understanding that risks to patient safety and steps to promote innovation: 1) can occur at all stages of the health IT product lifecycle; and 2) must consider the complex sociotechnical ecosystem in which these products are developed, implemented and used," the authors said.
The authors stressed a more narrow approach health IT guidance equally reliant on private sector capabilities and activities coordinated by ONC, but without additional oversight by the FDA.
"We believe a better approach is to foster the development of a culture of safety and quality; leverage standards and best practices; employ industry-led testing and certification; and selectively use tools such as voluntary listing, reporting and training to enable the development of a healthcare environment that is transparent and promotes learning to foster continual health IT improvement," they said.
Four areas prioritized by the report's authors for the report include:
  • Promotion of the use of quality management principles
  • Identification, development and adoption of standards and best practices
  • Leveraging conformity assessment tools
  • Creation of an environment that focuses on learning and continual improvement
Lots more here with links:
There is a lot of coverage to be found:
First here:

Fed HIT Report Provides Few Details on Clinical Decision Support Software

APR 4, 2014
In a risk-based regulatory framework for health IT released April 3 by federal agencies, clinical decision support software got major billing. In fact, an entire section of the draft report, developed by the Food and Drug Administration in coordination with the Office of the National Coordinator for Health IT and Federal Communications Commission, was devoted to CDS software. However, the level of detail in the report is lacking.    
"Frankly, just about everything in the CDS section was already known, except for maybe two or three of the examples that they gave of unregulated CDS. Basically there just wasn't much new there," Bradley Merrill Thompson, an attorney at Washington, D.C.-based law firm Epstein Becker Green who counsels medical device companies on FDA regulatory issues, told Health Data Management. 
The proposed FDA/ONC/FCC strategy divides health IT products into three categories--administrative health IT, health management heath IT, and medical device health IT--based on function and risk. Under the proposed framework, most clinical decision support software would fall into the health management heath IT category based on functions that "are of sufficiently low risk and thus, if they meet the statutory definition of a medical device, FDA does not intend to focus its oversight on them." Instead, the draft report proposes relying primarily on ONC-coordinated activities and private sector capabilities that highlight quality management principles, industry standards and best practices. The draft report also proposes to rely on tools for testing, certification and accreditation of this category of products.
Lots more here:
Second here:

Feds Want Ideas on Assuring HIT Products are Safe

APR 3, 2014
Certification, accreditation, conformity assessment; call it what you will, but some type of program to assure health information technology products meet certain benchmarks for safety is coming. And the federal government, while being a player and helping to facilitate, clearly is throwing the ball to stakeholders to get it done.
The new proposed regulatory framework for HIT safety favors a voluntary program that can be performed by the private sector or government. Private sector assessments may have advantages such as increased efficiency, promotion of consumer transparency and economic competition, and reduced government costs, according to the report from the Food and Drug Administration, Office of the National Coordinator for HIT and Federal Communications Commission. But government assessments may be more appropriate in assuring the safety and health of consumers. Which way to go should be decided with broad input from stakeholders, report authors say.
“Importantly, the agencies do not propose that new or additional mandatory conformity assessments be required prior to the production, marketing or use of a specific health IT product or service. Instead, we recommend that these tools should be used and applied in a risk-based manner to distinguish high quality products and organizations from those that fail to meet basic performance standards or requirements. The agencies seek input on the value and role of voluntary conformity assessment tools for various health IT stakeholders during the different stages of the health IT product lifecycle, and whether various types of conformance testing can support innovation, such as by providing assurances during development phases to reduce risk.”
Lots more here:
Last here:

HHS proposes new HIT software regulation

By AuntMinnie.com staff writers

April 3, 2014 -- The U.S. Department of Health and Human Services (HHS) on Thursday released a report that recommends a new regulatory framework for healthcare IT software.
The goal of the proposed framework is to improve the federal government's regulation of healthcare IT applications by promoting product innovation while maintaining patient protection and avoiding regulatory duplication. The report was developed by the U.S. Food and Drug Administration (FDA), in collaboration with the Office of the National Coordinator for Health IT (ONC) and the Federal Communications Commission (FCC).
The report proposes a regulatory framework that would divide healthcare IT software into three categories, based on functionality and risk.
  1. Low-risk software that performs administrative healthcare IT functions, such as applications for billing and claims processing, scheduling, and practice and inventory management.
  2. Medium-risk software with health management IT functions, such as software for health information and data management, medication management, provider order entry, knowledge management, electronic access to clinical results, and clinical decision support.
  3. Higher-risk software that could pose a greater risk to patients if it does not function as intended. Applications in this category include computer-aided detection (CAD) software, applications for bedside monitor alarms, and radiation treatment software.
More here:
This is a draft report that needs to read by all interested in the topic.
David.

It Seems We Are All Going To Be Stuck With The PCEHR. What An Ill-Considered Farce!

This appeared today.

Health Minister Peter Dutton to let private health pay for seeing doctor

  • May 01, 2014 1:24AM
  • By Sue Dunlevy National Health Writer
  • News Corp Australia
GENERAL Practitioners could be paid more to treat the sickest patients under a major overhaul being planned by the Federal Government.
…..
The $1 billion e-health plan funded by the previous government has so far been a flop with most doctors refusing to upload patient records onto the system and only a tiny portion of the population has signed up for a record.
Mr Dutton last year commissioned an inquiry into the scheme and the report has been on his desk since December.
Today he will commit to the continued roll out of the record “with practical application and a genuine desire to work with and not against doctors”.
……
Full article is here:
I will leave you to work out what that actually means. Of course we still have not seen the PCEHR Review.
The Commission of Audit report (released today) and the Budget (12 days away) will show just how serious a commitment exists.
I suspect we may see another move to a ‘change management strategy’ as we did with HealthConnect.
Time will tell.
David.

Post Script:

Here is another link with more detail.

http://www.itnews.com.au/News/384244,dutton-confirms-govt-will-keep-pcehr.aspx

D.