Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Thursday, March 26, 2009

International News Extras For the Week (23/03/2009).

Again there has been just a heap of stuff arrive this week.

First we have:

Certification Commission accelerates certification development

March 23, 2009 | Diana Manos, Senior Editor

CHICAGO – The Certification Commission for Healthcare Information Technology will accelerate its development of advanced technology certification programs to include clinical decision support, interoperability, quality and security in the upcoming 2009-2010 development cycle. Clinical decision support and security were not scheduled to be completed until 2011.

"We see evidence that the health IT programs under the Recovery Act will be implemented according to the ambitious schedules in the legislation," said Mark Leavitt, MD, Commission chair. "For CCHIT to ensure that a robust selection of certification options will be available when the HIT Policy and Standards Committees make their decisions later this year, our own schedule must be equally ambitious. That's why we have decided to develop all four of these advanced certification options at once."

More here:

http://www.healthcareitnews.com/news/certification-commission-accelerates-certification-development

Good news for improving systems in the US and ultimately here as well!

Second we have:

Tampa Bay Becomes First Community to Jump-Start America's E-Health Revolution

PaperFree Tampa Bay to Convert 10,000 Regional Physicians to E-Prescribing as First Step Toward Connected Electronic Health Records

TAMPA, Fla., March 16 /PRNewswire/ -- A new public/private partnership called PaperFree Tampa Bay, armed with strong Congressional support, today launched a plan to jump-start America's electronic health revolution. PaperFree Tampa Bay will deploy more than 100 "electronic healthcare ambassadors" with a goal to convert 100 percent of physicians in the Tampa Bay area from paper prescriptions, known to be the cause of costly medical errors, to electronic prescribing. The effort is a first step toward the implementation of Connected Electronic Health Records (EHR) to improve patient safety and reduce costs, and intends to leverage funding from the American Recovery and Reinvestment Act.

U.S. Rep. Kathy Castor (D-Tampa) voiced her support for the funding at a press conference announcing the initiative which was attended by a broad array of healthcare, business and government leaders from across the Bay area.

"The intent of the Recovery Act is jobs, jobs, jobs," Congresswoman Castor said. "The Recovery Act calls for the creation of short-term jobs in the community while providing long-term economic stability. If funded, this University of South Florida electronic prescriptions project will create more than a hundred jobs for people who will work alongside physicians in the 10-county area. That will help in the long term as well, especially by improving our healthcare system."

Much more here:

http://sev.prnewswire.com/health-care-hospitals/20090316/FL84043A16032009-2.html

No point in thinking small I guess!

Third we have:

KLAS Report Looks at eClinicalWorks’ Success

(3/13/2009)

Orem, Utah-based KLAS has released a report, “The Rise of eClinicalWorks: Separating Fact from Fiction,” examining why eClinicalWorks is gaining traction faster than any other ambulatory EMR vendor, and whether the company can sustain that growth and still effectively support existing customers.

The KLAS report found that the majority of providers interviewed were very satisfied with their eClinicalWorks EMR. Overall, 93 percent of customers stated that the EMR functionality met or exceeded their expectations, and 97 percent stated that the overall cost of adoption met or exceeded their expectations.

More here:

http://www.healthcare-informatics.com/ME2/dirmod.asp?sid=&nm=&type=news&mod=News&mid=9A02E3B96F2A415ABC72CB5F516B4C10&tier=3&nid=EC347B68978241EB9CAF832B31330A21

Seems the Wal Mart knew what they were doing in joining with eClinicalWorks to provide EHRs to the masses!

Fourth we have:

Practices paperless before 2012 could maximize Medicare bonuses

Physicians can earn tens of thousands in IT incentives, but they must act quickly to achieve the biggest benefit and avoid penalties.

By Chris Silva, AMNews staff. Posted March 16, 2009.

The recent economic stimulus package provides a significant investment in health information technology that could benefit many physicians. But the government is expecting doctors to do their part to implement health IT and is prepared to penalize those who don't.

Over the next decade, the federal government is projected to spend more than $35 billion on Medicare and Medicaid bonuses to physicians, hospitals and others that adopt certified electronic health records. Because of the Medicare penalties that eventually will apply to nonadopters, however, the net spending level will be only about $20 billion over 10 years.

Physicians with approved EHRs in place before 2011 or 2012 will be eligible for the maximum Medicare incentive payments allowed by the stimulus. They will receive bonuses equal to 75% of their allowed Medicare Part B charges -- up to a sliding cap -- in each of the five years after adoption. The maximum of $18,000 in the first year phases down to $2,000 in the fifth year for a total five-year bonus of up to $44,000 for early adopters.

More here:

http://www.ama-assn.org/amednews/2009/03/16/gvsa0316.htm

I just posted this to show the amounts being used to provide adoption incentives in the US and to point out the laggards will actually suffer cost penalties – not only miss out on rewards!

Fifth we have:

Stimulus Package Aims To Spur Adoption Of E-Health Records

The American Recovery and Reinvestment Act makes $2 billion available immediately to help health care providers implement e-health records and to fund research into the use of health systems.

By Marianne Kolbasuk McGee, InformationWeek
March 14, 2009
The federal economic stimulus bill signed into law last month contains several financial incentives that could get laggard doctors and hospitals to adopt IT-based tools that can cut costs and save lives.

The $787 billion American Recovery and Reinvestment Act makes $2 billion available immediately for loans and grants to help health care providers implement electronic health records systems and to fund research into the use of various health systems. It also provides more than $17 billion for new programs rewarding doctors and hospitals over the next five years for the "meaningful" use of e-health records systems.

Exactly what constitutes meaningful use will be spelled out by the new secretary of health. Basic requirements specified so far mandate that health care providers use certified e-records products and e-prescriptions, and that they be able to electronically exchange clinical data and report data about the quality of clinical care to government health agencies.

Lack of funding is the biggest obstacle keeping cash-strapped doctors and hospitals from adopting electronic health record and related technologies. These systems can reduce medical errors, paperwork, redundancies, and other problems, but the financial rewards from them mostly go to health payers like insurance companies, health plans, and government programs such as Medicare and Medicaid, not to the doctors and hospitals that pay for them.

More here:

http://www.informationweek.com/story/showArticle.jhtml?articleID=215900057

This is a useful summary for the detailed figures for the ARRA stimulus in E-Health.

Health professionals must focus on what really matters to customers

Published by Leon Paternoster for Institute of Customer Service in Local Government , Central Government , Health

Friday 20th March 2009 - 10:58am

In striving for excellent customer care in health care, organisations must first understand what really matters to patients, the first Institute of Customer Service health care forum has been told.

An audience of close to 60 ICS members and non-members spanning the National Health Service, private medical insurance, the pharmaceutical industry, health charities and other related organisations discussed the customer care challenges that now face the health sector.

Opening the event, chairman ‘JD’ Glover, director of operations for UK iSOFT, the world’s largest provider of healthcare IT solutions, set the tone for the day when he said “What all of us need to remember is that it is not about the product we provide, it is about the service we provide. We need to drive that understanding into every square millimetre of our respective organisations.”

This challenge was particularly acute in the health sector, he added, because the drive from central government for personalisation of the customer experience came at a time when the demands of an increasingly ageing population were being supported by a smaller number of working people.

“This means that in future we will have to do things faster, better and cheaper,” he added.

All the speakers were united in their view that the key to good customer or patient care was the need to know what really mattered to their audiences.

There was a great danger of simply collecting more data on patients, said Mandy Wearne, director of service experience at NHS North West. “We are on the cusp of going data crazy when what we need to do is say that there is some basic stuff that we need to get right,” she said.

“Good customer insight has to be more than the absence of complaints. We are asking people what we could do better for the next person when what we really need to do is to find out how we can get it better now.”

Mandy stressed that one of the many challenges in ‘putting service back into the NHS’ was staff engagement. “The health service is very competency driven, so we go for people who have all the right experience, but forget that the key skill is actually being able to talk to people.”

More here:

http://www.24dash.com/news/Local_Government/2009-03-20-Health-professionals-must-focus-on-what-really-matters-to-customers

Sensible advice here, it seems to me on how to get the most out of Health IT investments.

Seventh we have:

Mobile phones to deliver health messages in Qatar

By Joanna Hartley

Monday, 16 March 2009

Public health information will be made available from Qatar’s Sidra Medical and Research Centre via people’s mobile phones, according to its chief research adviser.

David Kerr said the centre was keen to exploit e-health schemes such as SMS alerts that would be an effective form of communication between clinicians and the public in a country where almost everyone has a mobile phone.

Kerr was speaking to Qatar daily Gulf Times prior to the start of roundtable sessions on health sciences being held ahead of Monday’s official opening of the Qatar Science and Technology Park - where the centre is based.

More here:

http://www.arabianbusiness.com/549685-mobile-phones-to-deliver-health-messages-in-qatar

Seems e-Health is breaking out all over!

Eighth we have:

NWT hospitals to go filmless

March 16, 2009 (Yellowknife, NWT) - Over the course of the next three to four months, Stanton Territorial Hospital, Inuvik Regional Hospital, H. H. Williams Hospital and the Fort Smith Health Centre will go filmless. Physicians and technologists will no longer have to create or view diagnostic images using film. Instead, they will be using the Diagnostic Imaging Picture Archiving and Communications System (DI/PACS) to capture, store, distribute and review all patient diagnostic images.

There are numerous benefits of moving to DI/PACS technology:

  • faster report turn-around times which results in faster diagnosis and decisions relating to treatment;
  • flexible viewing for physicians and hospital staff (clinicians can consult on images at the same time from different locations);
  • no longer will we have the costs associated with “hard copy” film, developing and storage; and
  • no lost or misplaced images resulting in unnecessary duplication of exams.

DI/PACS is a digital system. Just like a camera that used to use film and now generates digital images that are viewed on a home computer, DI/PACS operates by using equipment to produce and view digital images on computers.

Full article here:

http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/412-nwt-hospitals-to-go-filmless

A good summary list of why you do DI/PACS. It works!

Ninth we have:

Paperless is the way to go to eliminate errors, say Detroit Medical Center chiefs

March 13, 2009 | Bernie Monegain, Editor

DETROIT – The Detroit Medical Center is touting its 100 percent medication verification system in the wake of actor Dennis Quaid's March 10 appearance on "The Oprah Winfrey Show" to discuss medication safety.

Quaid, whose twin babies received a nearly fatal dose of blood thinner while hospitalized at Cedars-Sinai Medical Center in Los Angeles in 2007, told the audience that computerized recordkeeping and barcoding in hospitals could have prevented the medication error that nearly killed his children. He called for a paperless system of "medication verification" that could eliminate such dangerous medication mistakes in hospitals.

An electronic medical record is already in place at Detroit Medical Center - as it is at many hospitals across the country - and medication verification scanning began in April 2006, with all DMC hospitals completing the project in May 2007.

The system requires that physician orders, test results and other patient records be collected and processed online. The new technology reduces the risk of potentially dangerous medication errors by as much as 90 percent, since it prohibits all handwriting in the prescribing and dispensing of drugs, according to DMC executives.

The new 100 percent electronic medication verification for managing medications calls for repeated scanning of electronic barcodes by caregivers, with verified accuracy checks when the medication is ordered, dispensed and given to the patient.

In May 2007, the DMC's paperless record-keeping system, powered by Kansas City, Mo.-based Cerner, became fully operational in all eight hospitals.

Much more here:

http://www.healthcareitnews.com/news/paperless-way-go-eliminate-errors-say-detroit-medical-center-chiefs

Good to see the technology in place and working – at least for some!

Tenth we have:

Bad Bet on Medical Records

By Stephen B. Soumerai and Sumit R. Majumdar

Tuesday, March 17, 2009; A15

President Obama's proposed health-care reforms include investing $50 billion over five years to promote health information technology. Most notably, paper medical records would be replaced with linked electronic records to try to improve quality of care and lower medical costs. The recently enacted stimulus package included $20 billion for health IT, and, indeed, the $50 billion the administration initially earmarked is almost twice the annual budget of the National Institutes of Health. Yet while this sort of reform has popular support, there is little evidence that currently available computerized systems will improve care. In short, it's the wrong investment to make at this time.

The assumption underlying the proposed investment in health IT is that more and better clinical information will improve care and save money. It is true that computerized records in some settings might improve care, such as by preventing duplicative prescriptions, medical errors caused by illegible handwriting and even inappropriate treatments. But the benefits of health IT have been greatly exaggerated. Large, randomized controlled studies -- the "gold standard" of evidence -- in this country and Britain have found that electronic records with computerized decision support did not result in a single improvement in any measure of quality of care for patients with chronic conditions including heart disease and asthma. While computerized systems seek to reduce the overapplication or misuse of care, they do little to prompt greater and more widespread health-care practices that are known to be effective. Health IT has not been proven to save money. Moreover, personal financial ties have been found between some researchers and the companies that produce these systems, and as far back as 2005 studies have shown that health IT developers are about three times more likely to report "success" than evaluators who had no part in system development.

More here:

http://www.washingtonpost.com/wp-dyn/content/article/2009/03/16/AR2009031602618.html

Good to see we have a few luddites left. Reading the full article it seems pretty clear these authors feel their pet projects were more important than what Presidents Obama and Bush proposed – and what the evidence actually does support.

For evidence based rebuttals go here:

http://geekdoctor.blogspot.com/2009/03/letter-to-editor.html

and here:

http://geekdoctor.blogspot.com/2009/03/letter-to-editor-ii.html

Enough said!

Eleventh for the week we have:

Making e-health benefit everyone

Public Service Review: Science and Technology Issue 2

Tuesday, March 17, 2009

Despite numerous problems in the UK’s e-health efforts, European Commissioner Viviane Reding explains to Public Service Review in an interview the benefits reaped by effective e-health and the challenges faced in implementation

Technology has been a power tool of healthcare transformation across Europe. This has been evident in new design approaches, advanced information records and new ways of disseminating public health information.

But problems remain, a result of both geographical barriers and communication difficulties. High profile security concerns surrounding patient records and other sensitive information, failures to implement the right infrastructure, and ineffective funding decisions are just some of the issues that have obstructed the development of healthcare systems that meet the increasing demands of European citizens.

The technology exists that would enable Europe to achieve the goal of uniform and equitable healthcare services for European citizens – and to extend these services to people suffering in the developing world. But there are tough challenges to which healthcare providers and politicians must now rise to achieve this, as Viviane Reding explains.

More here:

http://www.publicservice.co.uk/feature_story.asp?id=11436

This is an interesting interview showing the commitment to e-Health held by the European Commission

Twelfth we have:

Wal-Mart, eClinicalWorks Deal Exposes Need For EMR Price Transparency

Kathryn Mackenzie, for HealthLeaders Media, March 17, 2009

The big health information news is that Wal-Mart's Sam's Club is partnering up with electronic medical record vendor eClinicalWorks and Dell Inc. to sell electronic medical records to physicians.

Sam's Club will offer the package this spring starting at under $25,000 for the first physician in a practice and $10,000 for each additional doctor. Ongoing costs will be $4,000 to $6,500 per year.

The package will include a Dell desktop or tablet PC installed by Dell technicians and software-as-a-service applications from eClinicalWorks. The price also includes five days onsite training by eClinicalWorks technicians.

The reaction to the news of an "EMR-in-a-box" has been remarkable. From the New York Times to a plethora of tech blogs, everybody is talking about what has been called a potential game changer for the EMR market.

More here:

http://www.healthleadersmedia.com/content/229907/topic/WS_HLM2_TEC/WalMart-eClinicalWorks-Deal-Exposes-Need-For-EMR-Price-Transparency.html

Hard to argue with that perspective!

Thirteenth we have:

Kaiser to cut 860 information technology jobs

Bernadette Tansey, Chronicle Staff Writer

Tuesday, March 17, 2009

Kaiser Permanente is cutting 860 information technology jobs nationwide under a realignment that includes a $500 million deal giving IBM management duties at Kaiser's medical records data centers.

The Oakland health maintenance organization, which has spent as much as $5 billion over the past five years building up its electronic records system, said Monday it has inked a seven-year deal with IBM to maximize the performance of its data processing units.

But the agreement with IBM puts 700 Kaiser jobs in jeopardy at data centers in California and Maryland. Phil Fasano, chief information officer for Kaiser Permanente, said a good portion of those workers could become IBM employees. "Forty percent of those will find jobs in IBM during a transition period of six months," Fasano said.

In a separate action, Kaiser is eliminating an additional 160 information technology jobs scattered across 30 locations as it pares back spending due to the impact of the economic downturn.

More here:

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/03/16/BUD016GO3C.DTL

In another life I actually visited the Kaiser Data Centre – back then they had a whole tunnel full of huge IBM Mainframes and (this was 1987) also had robots controlling the tape backup systems. Was like nothing I had seen – and still have seen nothing like it. Makes sense they have gone with IBM to manage their environment now!

Fourteenth we have:

No Mayo data in HealthVault; PHR questions linger

By Joseph Conn

Posted: March 16, 2009 - 5:59 am EDT

The Mayo Clinic, Rochester, Minn., one of the nation’s premier and best-known healthcare organizations, has yet to deploy the HealthVault personal health record from Microsoft Corp., despite a big-splash publicity notice linking the two organizations more than a year ago, according to Mayo spokesman Karl Oestreich.

The clinic is still evaluating whether it needs to enter into a business associate agreement under the Health Insurance Portability and Accountability Act of 1996 with Microsoft to comply with the health information technology privacy and security provisions of the new American Recovery and Reinvestment Act of 2009, the Mayo spokesman said.

Meanwhile, the Cleveland Clinic, a big-name healthcare industry partner recruited in the development of a rival PHR by Google, called Google Health, also is evaluating its position under the new law, according to a Cleveland Clinic spokeswoman.

In February, President Barack Obama signed into law the stimulus bill, which, among its many healthcare IT and privacy components, included language that seemed aimed at bringing certain PHR systems providers under the privacy and security provisions of HIPAA.

Much more here (registration required):

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090316/REG/303169937

It seems it is unclear whether PHR providers are in the money from the stimulus package and how the new privacy regulations will impact current PHR providers.

Third last we have:

Wash. health records 'bank' pilots set to launch

By Joseph Conn / HITS staff writer

Posted: March 18, 2009 - 5:59 am EDT

Three Washington state healthcare organizations backed by a state grant are launching what they call a consumer-managed, health-record-bank pilot project in their areas that a state official says he hopes will prime the pump for additional federal funding for health information technology.

The three pilots will be run by the St. Joseph Hospital Foundation and the Critical Junctures Institute, Bellingham; Community Choice Healthcare Network, Cashmere; and Inland Northwest Health Services, Spokane.

The pilots received $1.7 million in startup funds from the state under the Washington State Health Care Authority and will use personal health-record platforms from Microsoft Corp. and Google, according to an announcement from the state agency.

More here:

http://www.modernhealthcare.com/article/20090318/REG/303189994

This is another approach that is emerging in some parts of the US. Will be interesting to follow.

Second last for the week we have:

Online Records Get Patients Involved in Care

By LAURA LANDRO

If all the talk in Washington about using electronic medical records to cut health-care costs makes your eyes glaze over, it might help to consider the experience of Holly Jacobson.

For two years, the 41-year-old employee of an educational nonprofit in Sacramento, Calif., has been using the My Health Manager Web site provided by her health plan, Kaiser Permanente, to access her electronic medical records. When she has her cholesterol checked, or one of her two children is tested for strep throat, she goes there to click on links that explain the test results. She views a graph showing her cholesterol readings over time -- "a good motivational tool" to watch her diet and exercise, she says. And she regularly emails her doctor with routine questions on managing one of her children's asthma. After she sprained an ankle last year, her physical therapist electronically sent her all the instructions for home follow-up care.

The system, Ms. Jacobson says, has led to "a significant shift in my ability to become more of an advocate for my own health care."

An online program offers health-plan members tips on lower-back pain.

Large managed-care groups like Kaiser Permanente and Group Health Cooperative are increasingly using electronic medical-record systems to help solve the age-old problem of getting patients to take better care of themselves. The trend, known as information therapy, involves delivering reliable health information directly to patients to help them manage their conditions and make treatment choices. Health plans also are offering online self-management programs and virtual coaching sessions for a wide range of health issues.

More here (Wall St Journal Subscription Required):

http://online.wsj.com/article/SB123733342732563543.html?mod=djemHL

The other side of EHRs that needs to be more explained.

Last for this week we have:

Patient-run PHRs integral to Wash. e-record pilots

By Joseph Conn / HITS staff writer

Posted: March 19, 2009 - 5:59 am EDT

A personal health record that affords patients fine-tuned control over who sees their medical records or even portions of their records will be used in two of the three state-supported pilot projects in Washington.

The PHR software used by St. Joseph Hospital Foundation and the Critical Junctures Institute, based in Bellingham, and the Community Choice Healthcare Network, Cashmere, grew out of a community health program in Bellingham that developed a Web-based PHR software system called the Shared Care Plan. The Shared Care Plan PHR software was developed under a grant from the Robert Wood Johnson Foundation and is available free of charge.

The PHR initiatives in Bellingham and Cashmere will align themselves with the Microsoft Corp. HealthVault platform launched by the software giant in October 2007. Their PHR is developed on Microsoft’s .net software development framework and is a proprietary second-generation version of the Shared Care PHR software offered by Congral, a software development company.

Very much more here:

http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090319/REG/303199994/1029/FREE

This provides more details on the Washington State initiative.

There is an amazing amount happening (lots of stuff left out). Enjoy!

David.

No comments: