Just an occasional post when I come upon a few interesting reports that are worth a download. This week we have a few.
First we have:
New issue brief analyzes opportunities and recommends state action; Sacramento briefing scheduled.
February 23, 2009
The federal stimulus bill signed by President Barack Obama last week offers unprecedented opportunities to increase health information technology (health IT) adoption among California providers and facilitate the secure exchange of patient health information, according to a new issue brief published by the California HealthCare Foundation (CHCF).
"Used effectively, health IT can help improve the quality, safety, and efficiency of health care in California," said Sam Karp, CHCF vice president of programs. "But the State of California must take specific steps to assist physicians, hospitals, community health centers, and others to qualify for federal incentive payments to adopt and implement electronic health records, and to be competitive as various new federal grant programs become available."
The Health Information Technology for Economic and Clinical Health Act (HITECH), a component of the American Recovery and Reinvestment Act of 2009, provides roughly $36 billion in outlays for health information exchange infrastructure and incentive payments to physician practices adopting electronic health records (EHRs), chronic disease management systems, and other technologies. In California, the stimulus funding could add up to more than $3 billion, according to the issue brief.
Unlike most other industries that have implemented information technology advances, said Karp, "health care has retained many of the characteristics of a cottage industry." Despite decades of attempted automation, focus on quality and consistency, and modest investment in health IT, "health care practice remains largely unchanged, fragmented, inconsistent, and only intermittently automated. While many hospitals and large medical groups have adopted health IT systems, many more small hospitals and physicians in small practices or in underserved communities have not had the resources, financial incentives, or economies of scale to do so."
CHCF's issue brief outlines necessary steps to take advantage of these provisions and makes specific recommendations to Governor Schwarzenegger and the California Legislature to ensure that California successfully competes for and makes effective use of HITECH funds. The key recommendations include:
- Appoint a Deputy Secretary of Health Information Technology, within the Health and Human Services Agency, to coordinate and drive health IT and health information exchange planning and implementation.
- Appoint a nonprofit "state-designated entity" to apply for HIE implementation funding on behalf of the state.
- Establish policies, procedures, and information systems required to support Medi-Cal incentive payments for adoption of EHRs by physicians, hospitals, community health centers, and others.
- Actively engage with federal officials and policymakers to ensure California has a meaningful voice at the table during the regulatory process that will determine the HITECH Act's specific funding mechanisms.
- Appropriate funds in the amount required to match the federal funding authorized under the HITECH Act in order for California to take full advantage of the opportunities available through the Act.
- Take steps to educate patients, consumers, and the public on existing health privacy safeguards and new protections intended to ensure the confidentiality and security of personal health information.
"New financing and new information systems alone will not transform the health care system," said Karp. "Evidence has shown this will require better aligned financial incentives to improve clinical performance, greater innovation in the development of lower-cost care models, and engaged patient participation in their own care. But HITECH is a significant down payment on the infrastructure that will be required."
Thousands of new jobs will likely be created to support adoption and implementation of electronic health records, said Karp. "These jobs will be in software and hardware development and sales, system installation, and support of clinicians and office staff. More indirectly, companies in the supply chain -- for example, producers of routers and circuit boards -- should experience job growth. But there could be some job loss, too, for example in medical records management and transcription of physicians' notes."
For the past ten years, CHCF has worked to accelerate the adoption and effective use of new information technologies in health care, pushing for national data standards, interoperable systems (so providers and patients may effectively transfer information between electronic systems), development of patient privacy protections, and promoting use of patient-centered and patient-controlled tools for self-management of chronic conditions.
California HealthCare Foundation
Press release is found here:
The associated report can be downloaded from the following link.
More information here (report link in text):
Second we have:
As the global financial meltdown wreaks havoc on the economy and IT budgets are increasingly stretched, more than half of Australia's software projects are still failing, with botched, re-scoped, and cancelled projects wasting around $A197,000 per week, according to the Planit Testing Index. Planit surveyed 210 companies in Australia and New Zealand on their software testing practices. The surveyed organisations were mostly in the finance/insurance, telecommunications, and government sectors.
Although organisations are still completing just 46 per cent of their software projects on time and on budget, it is heartening to see a slight improvement (up from 42 per cent) on the 2007 results, said Chris Carter, Planit's managing director.
"There's no denying the project success rate in the Australian/New Zealand region still has a long way to go, however the index revealed organisations are starting to look seriously at how they can increase their chances of a successful software project," he said. "For instance, 57 per cent of companies now rate testing as a critical element in producing reliable software, compared to 50 per cent in 2007.
Rust Report – 27 February, 2009
This is an important short report which can be downloaded from here:
The full documentation is available for purchase and certainly would make valuable reading for those in the areas covered.
Third we have:
Are Health IT Designers, Testers and Purchasers Trying to Kill People?
In effect through arrogance and complacency, they just might be, along with the people who approve EMR's, CPOE's and other clinical IT for sale, as well as those who actually purchase this IT for healthcare organizations.
The title of this post is deliberately provocative because the stakes of the issues addressed are so high, not to mention a personal angle. My father died as a result of informational errors at a major hospital that could have been prevented with an effective EHR. These posts are dedicated to his memory.
Clearly more "inclusive" approaches by clinicians towards addressing these issues have not succeeded.
I've recently been conversing with a number of correspondents at major healthcare systems about just how bad health IT is. EMR's and CPOE's that confound and intimidate and look as if designed by amateurs.
5 linked blog posts here:
Start here and work backwards. Fascinating stuff on a range of issues around design of Health systems from Scot M Silverstein MD. Some serious issues to be thought about here. When read is essentially a report card on where some major problems lie.
Fourth we have:
February 23, 2009
Integrated delivery systems are stepping up the pace to develop unified information technology platforms, a new report suggests.
The report, “Leading Healthcare CEOs Sound Off on the Financial Crisis,” is based on interviews with nine health system CEOs. C-Suite Resources, a new Minneapolis-based market research firm, prepared the study, focusing on seven topics.
Among the CEOs quoted for the report, Chris Van Gorder of Scripps Health in San Diego said, “We were very silo-oriented but today we’re system-oriented. Our information technology is standardized across the enterprise to improve quality, safety and performance. I expect information technology spending will increase, rising to 5 percent from less than 2 percent, in the next few years.”
The complete report is available at c-suiteresources.com following registration.
Fifth we have:
Technology Review presents its annual list of 10 technologies that can change the way we live.
Adam Cheyer is leading the design of powerful software that acts as a personal aide.
Han Cao has designed a nanofluidic chip that could lower DNA sequencing costs dramatically.
Stuart Parkin is using nanowires to create an ultradense, rugged memory chip.
Michel Maharbiz's novel interfaces between machines and living systems could give rise to a new generation of cyborg devices.
George Whitesides has created a cheap, easy-to-use diagnostic test out of paper.
Donald Sadoway conceived of a novel battery that could allow cities to run on solar power at night.
A new way of fueling reactors could make nuclear power safer and less expensive, says John Gilleland.
Zhong Lin Wang thinks piezoelectric nanowires could power implantable medical devices and serve as tiny sensors.
Vivek Pai's new method for storing Web content could make Internet access more affordable around the world.
Nick McKeown believes that remotely controlling network hardware with software can bring the Internet up to speed.
The full report can be browsed here
Sixth we have:
The introduction of the 2009 economic stimulus law has set off many speculations about ways funds will be distributed. As with any new federal policy, some opportunists will be trying to make a fast buck off gullible buyers. Reports of scams are already being received from people getting erroneous spam emails from the IRS and telephone calls offering services on how to receive stimulus rebates from the government in exchange for a fee or personal information. Many may recall all the nonsense and scams when HIPPA was first introduced. Remember when contractors offered to build out medical record safe rooms for protecting “all that PHI?”
This article focuses on truth, based on what is known to date, about the economic stimulus law and technology and sorts through some false claims and promises to help buyers beware. More information will be released over the next few months.
Much, much more here!
A useful exploration of the issues around selection of clinical system – and a discussion of the ‘not so obvious’ that needs to be considered. A good read.
Seventh we have:
Posted: February 26, 2009 - 5:59 am EDT
As states consider ways to develop and expand health information technology, a new report conducted by the University of Massachusetts Medical School outlines three public-governance models that could lead to sustainable health information exchange.
The report was prepared for the State Alliance for e-Health, a consensus-based, executive-level body of state elected and appointed officials who are responsible for reviewing the health IT and electronic HIE issues of state governments. The National Governors Association Center for Best Practices established the alliance in 2006. Last year, the alliance awarded the University of Massachusetts a contract to conduct research that would examine financing, accountability and oversight models to sustain HIE. The 65-page report released this week represents the findings of a team of researchers from the University of Massachusetts Medical School, the National Opinion Research Center, the National Governors Association Center for Best Practices and an advisory committee of national experts in HIE, public policy and public utilities regulation.
The report can be found at the first link.
Eighth we have:
World Privacy Forum claims that cloud-based services may pose risks to data privacy
Companies looking to reduce their IT costs and complexity by tapping into cloud computing services should first make sure that they won't be stepping on any privacy land mines in the process, according to a report released this week by the World Privacy Forum.
The report runs counter to comments made last week at an IDC cloud computing forum, where speakers described concerns about data security in cloud environments as overblown and "emotional." But the World Privacy Forum contends that while cloud-based application services offer benefits to companies, they also raise several issues that could pose significant risks to data privacy and confidentiality.
"There are a whole lot of companies out there that are not thinking about privacy" when they consider cloud computing, said Pam Dixon, executive director of the Cardiff, Calif.-based privacy advocacy group. "You shouldn't be putting consumer data in the cloud until you've done a thorough [privacy] review."
According to the World Privacy Forum's report (download PDF), the data stored in cloud-based systems includes customer records, tax and financial data, e-mails, health records, word processing documents, spreadsheets and PowerPoint presentations.
Much more here (report link in text).
Ninth we have:
By Gautham Nagesh 02/19/2009
Story updated on Feb. 23, 2009
The federal government must educate citizens about the benefits of electronic medical records to justify the trade-off between patient privacy and health care improvements, according to a report released on Wednesday by the National Academy of Public Administration.
The report, "A National Dialogue on Health Information Technology and Privacy," is the result of an online discussion the academy led last fall on how to use IT to improve care and protect patient information.
The weeklong discussion attracted more than 2,800 visitors and hundreds of ideas and comments from health care IT officials and stakeholders, including Vivek Kundra, who is being considered for the position of e-government administrator at the Office of Management and Budget. OMB, the General Services Administration and the Federal Chief Information Officers Council asked the National Academy of Public Administration to moderate the debate.
Report link again in the text.
Last we have:
Encouraging adoption of new health IT tools like SimulConsult by those left out of the current hidebound system is a path toward change for all
President Obama has advocated spending $20 billion to modernize the medical records and information systems of health-care providers, the vast majority of whom remain tied to their error-prone and inefficient pen-and-paper systems of yesteryear. The benefits of updating our health information infrastructure seem clear: It will reduce preventable medical errors, avoid the costs of unnecessary or duplicate testing, and cut into some of the paperwork and red tape that continues to drive frustrated clinicians out of practice.
And the power of health IT goes beyond simple record-keeping. The ability to mine vast amounts of data much more easily would be a boon for research and development of new therapeutics, as well as post-launch monitoring. It was 's expansive clinical database that allowed its researchers to identify problems with Merck's (MRK) Vioxx well before the drug was pulled off the market in 2004.
Much more here:
Interesting slide show here:
Again, all these are well worth a download / browse.
There is way too much of all this – have fun!