Quote Of The Year

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

Friday, March 13, 2009

Report Watch – Week of 08 March, 2009

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:

Stimulus broadens privacy disclosure accounting

By Joseph Conn / HITS staff writer

Posted: March 2, 2009 - 5:59 am EDT

Patient-privacy advocates have plenty to cheer about in the American Recovery and Reinvestment Act of 2009 signed into law last month by President Barack Obama.

Hospitals, physician offices, health plans, pharmacies, claims clearinghouses and other so-called “covered entities” under the Health Insurance Portability and Accountability Act of 1996, as well as their business associates—if they use electronic health-record systems—will be required to provide patients with a much broader accounting of the disclosures they make of a patient’s protected healthcare information.

In addition, the new law also will require covered entities to honor a patient’s request not to disclose to payers treatment information if the patient pays out-of-pocket for healthcare.

Both new privacy requirements will go into effect one year after enactment, according to the California Office of Health Information Integrity. Under the current HIPAA privacy rule, covered entities have only a limited duty to account for disclosures of patient information, since releasing records for the main uses—treatment, payment and other healthcare operations—are exempt from the disclosure accounting requirement.

Under the stimulus law, covered entities must provide a patient an accounting of disclosures, even for treatment, payment and other healthcare operations. It’s “a very positive step for privacy,” wrote Robert Gellman, a Washington lawyer and privacy consultant, in an 18-page analysis of the privacy provisions of the new law.

More here:


This is a report for those who want the details of how US Health Information Privacy Law has been changed (2nd link) and for the real numbers people the first report fits a huge amount in 7 pages.

Second we have:

EHRnews-at-Infoway from Canada Health Infoway.

Here are a few highlights from this issue:

4 Infoway launches certification process

Health information technology vendors entering the Canadian consumer health solution market can now apply for pre-implementation certification for their consumer health platforms from Canada Health Infoway.

5 Diagnostic Imaging Report

The Diagnostic Imaging Benefits Evaluation Report highlights the various benefits Picture Archiving and Communications Systems (PACS) provide to Canadians. The report shows that Canada’s investments in digital diagnostic imaging technology will generate between $850 million and $1 billion in annual radiology efficiencies and cost savings. Download the Report.

6 Infoway wins awards

In 2008, Canada Health Infoway received top recognition for the Infoway EHR Blueprint, outstanding leadership in health care and the Picture Archiving and Communications System diagnostic imaging project.

Visit our website to learn more about Infoway and its jurisdictional partners and their progress towards creating an interoperable pan-Canadian electronic health record for all Canadians.

The full report is found here:


Reading this report and following the links will give a useful update as to where Canada is up to as we speak!

Third we have:

State Governments to Play Critical Role in Health IT, Says Report

"The recent federal recovery bill ... will provide resources to states to take the lead in creating health information exchanges." John Thomasian, director of the National Governors Association Center for Best Practices (pictured)

With e-health initiatives across the country in various stages of development, state governments now have an opportunity to determine the best regulatory and governance framework to support and advance electronic health information technology (HIT)and health information exchange (HIE), according to a new report prepared for the State Alliance for e-Health by the University of Massachusetts Medical School.

The report, Public Governance Models for a Sustainable Health Information Exchange Industry, states that the adoption of effective HIT and HIE by states will help improve and transform the American health care system. Citing the significant burden of health care costs on state budgets, the imperative to improve the quality of health care delivery and the likelihood of accelerated investments being made in health information technologies in the near future, the report reiterates the critical need for state leaders to keep informed of the key issues involved and the strategies that might be used to effectively leverage investments in these technologies for health system improvement.

More here – and the link to the report is in the entry.


Fourth we have:

Free Course Covers I.T. in Stimulus

Washington-based Health IT Certification, a training firm for information technology professionals, is offering a complimentary online course on the health I.T. provisions in the American Recovery and Reinvestment Act.

The 69-page course is designed for those who need to quickly come up to speed on the law and how it affects health I.T.


To access the course, visit healthtitcertification.com.

--Joseph Goedert

More here:


Seems a useful course to offer – well done!

Fifth we have:

AMIA defines clinical informatics subspecialty

By Jean DerGurahian / HITS staff writer

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

The American Medical Informatics Association released details of its clinical informatics subspecialty that it says will enhance physicians’ ability to use health information technology to provide safe, effective and efficient patient care.

The content has been in development for two years, when AMIA first received a $300,000 grant from the Robert Wood Johnson Foundation to establish a base for defining the clinical informatics subspecialty and establishing medical training requirements for it. The organization this week released two white papers in the Journal of the American Medical Informatics Association defining the subspecialty’s core content and detailing the requirements of a clinical informatics fellowship program. AMIA said it is now reaching out to the American Board of Medical Specialties to formally establish the subspecialty.

AMIA executives said in the white paper that the work provides a starting point for developing clinical informatics as a way to help integrate the health professions. John Halamka, chief information officer of Boston-based Beth Israel Deaconess Medical Center and Harvard Medical School, said the group is working toward finding the right medical specialty through which to move the subspecialty forward. “There appears to be significant interest in supporting AMIA to achieve this goal,” he said in an e-mail.

More here:


The papers are found here:


and here:


and here:


Sixth we have:

MMR Inc. makes drug database available free of charge to PHR users

March 04, 2009 | Eric Wicklund, Managing Editor

LOS ANGELES – Last year’s drug overdose death of Australian actor Heath Ledger is being used as the rallying cry in efforts to improve PHR use.

The latest improvement comes from MMR Information Systems, Inc., of Los Angeles, the parent company of MyMedicalRecords, Inc., which provides online patient-controlled personal health records. MMR is making its comprehensive prescription drug database available free of charge on the MyMedicalRecords PHR site, allowing PHR users quick and easy access to data on potential adverse interactions across multiple prescription and over-the-counter drugs.

“As a company whose primary business is offering a low-cost, easy-to-use Personal Health Record, we believe it is important to make tools available for consumers to educate themselves about the potential dangers of the prescription drugs they take in the ordinary course of their life,” said Robert H. Lorsch, chairman and CEO of MMR, in a press release. “Knowledge about what is in your medicine cabinet may be just as important as keeping family members, and particularly children, away from the neighborhood drug dealer.”

More here!


MMR’s customized drug database offers detailed information on more than 20,000 drugs. Visitors to the MyMedicalRecords PHR site can access the Cerner Multum Drug Content Database, licensed by Cerner to MMR, to check for potential adverse reactions.

See here:


Seventh we have:

Comparing U.S., Canada I.T. Efforts

Sierra Systems, a British Columbia-based consulting firm, has released a brief report comparing the national health care information technology initiatives of Canada and the United States. The report also notes lessons learned in Canada for U.S. policymakers.


For a copy of the free report, "Realizing the Goal of Electronic Health Records in the United States--Lessons Learned from Canada," click here.

--Joseph Goedert

More here:


Link to report above.

Last we have:

Cloud computing: Don't get caught without an exit strategy

Before you trust your business to the cloud, be sure you know how to get out.

Mary Brandel 04/03/2009 08:34:00

When the IT world looks back at 2008, it will certainly remember the global financial crisis. But it will also likely link that time frame with the takeoff of cloud computing, the engine behind more conferences, conversations and marketing collateral than seemingly any other technology in development today.

And amid all the hubbub about whether and how to get into the cloud, there's growing concern about how to get out.

Vendor lock-in is one of the primary fears expressed by IT leaders considering a move to this setup. And the recent announcement that Coghead, maker of a cloud-based enterprise application development system, is shutting its doors has exacerbated that fear.

Cloud computing is an architecture in which companies consume technology resources as an Internet service rather than as an owned system. Much of the fear of lock-in is caused by misconceptions, says John Willis, a systems management consultant and author of an IT management and cloud blog. When people talk about lock-in, they often don't distinguish among the several cloud types that exist, each of which requires varying degrees of commitment.

Moreover, he says, the degree of lock-in needs to be weighed against the advantages of using the system. "People wind up saying things like, "'The cloud is dead because of lock-in,'" he says. "Well, what cloud are you talking about? I can give you five scenarios where lock-in is an issue and five others where it isn't."

But while some vendors debate whether lock-in exists, most agree there are technical reasons for concern.

In general, a lack of standards hampers the portability of data and applications between systems, says James Staten, an analyst at Forrester Research. While the popular hype implies that moving to the cloud doesn't require any heavy lifting, that's not true in some forms of cloud computing.

Particularly with software and platform as a service, vendors use unique and proprietary interfaces, application programming interfaces (API) and databases. To take full advantage of the system, users or third parties need to program to those specifications to varying degrees. If they grow dissatisfied with the service, or if the vendor goes under, data and/or applications would need to be reformatted in order to switch providers or move it back in-house, which could be complex and costly.

"If you deploy to any cloud out there, some degree of your deployment is tied to the vendor, through the unique virtual machine or unique APIs you write to, or the unique configuration or composition of the application," Staten says.

"You've made a choice to be involved in a certain ecosystem," notes Michael Crandell, CEO of RightScale, a cloud infrastructure provider. "There are APIs and platforms in the cloud world that create a walled garden. You get the benefits of that garden, but you're also restricted."

Much more here:


This is an interesting article on the possible traps with cloud computing. As part of the article we have this small section which is well worth grabbing to understand how it all is now being described and assembled.

“Lamia Youseff of the University of California at Santa Barbara offers an interesting look at the cloud computing landscape -- download PDF.”

Again, all these are well worth a download / browse.

There is way too much of all this – have fun!


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