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"


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

Thursday, March 26, 2009

Report Watch – Week of 23 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:

N H I N Trial Implementations Now Available

Work products from the NHIN Trial Implementations are now available on the HHS web site:


This set of materials includes technical, data content and use case specifications, as well as testing materials and trust agreements developed during the Trial Implementations. The NHIN Trial Implementations focused on developing, testing and demonstrating a core set of capabilities for the Nationwide Health Information Network.

More information about these materials and current and upcoming NHIN activities will be featured during several sessions at the HIMSS Annual Conference the first week of April.

Sunday, April 5th: Lighting up the NHIN: What it Means for YOU

Tuesday, April 7th: “Plugging into the NHIN”

Nancy A. F. Szemraj, Communications and Outreach Manager, Office of the National Coordinator for Health Information Technology

This is useful material indeed which has taken a lot of investment to develop. A useful resource for all those wanting to understand how a National Health Information Network (NHIN) might be developed from a technical perspective.

Second we have:

Massachusetts Studies Reveal Importance of Incentives in Healthcare Technology Adoption

State Leads the Way in Healthcare IT, Showcases Best Practices for Hospitals Nationwide

FALLS CHURCH, Va., March 17 /PRNewswire/ -- The success of Massachusetts hospitals and physicians to incorporate information technology (IT) into healthcare demonstrates the importance of incentives, according to two studies conducted by CSC (NYSE: CSC) and sponsored by Blue Cross Blue Shield of Massachusetts (BCBSMA).

The studies, "Adoption of Advanced Clinical Systems in Massachusetts Hospitals" and "Adoption of Electronic Health Record Capabilities in Massachusetts Physician Practices," examine the progress Massachusetts hospitals and physician practices have made in implementing advanced clinical IT systems. Analysis includes areas where the state leads the nation and next steps toward improving patient care through electronic access to information.

According to the reports, adoption of computerized physician order entry (CPOE) among hospitals in Massachusetts is nearly double the national average, and the use of e-prescribing is the highest in the nation. In addition, more than one-third of ambulatory physicians are using at least basic electronic health record (EHR) capabilities, a rate more than two times the national average. The studies show these statistics are the direct result of incentives. These include incentives from health plans, a campaign by the Massachusetts Technology Collaborative to educate hospitals on the value of new technologies and a state-mandated deadline to have CPOE implementation in all hospitals within four years.

Some health plans wrote CPOE implementation incentives into hospital contracts; others provided free e-prescribing software to physicians and offered incentives to encourage continued usage. Partners Community Healthcare Inc., a network of 1,000 primary care providers and 3,500 specialists, set a deadline for use of an EHR system as a condition for network participation.

"This data reveals that incentives are making a dramatic difference," said Deward Watts, president of CSC's Global Healthcare Sector. "While Massachusetts has a distinct advantage in terms of support from the state government and stakeholder groups, this successful model can be replicated nationwide to create a healthcare infrastructure that significantly improves patient outcomes."

"The research clearly shows the progress that has been made in the state to increase adoption of clinical information technology," said Greg LeGrow, director of e-Health Innovation for Blue Cross Blue Shield of Massachusetts. "We still have a ways to go, but the results are encouraging and demonstrate the impact aligned efforts can have to further the use of technology that improves the quality and affordability of care delivered."

Hospitals at varying levels of tech adoption

The hospital study (www.csc.com/hospital_study_09) gauges adoption and meaningful use of advanced clinical systems, which include electronic CPOE with clinical decision support, and electronic physician and nursing documentation systems.

The survey revealed that 18 percent of hospital CIOs and executives who responded claimed CPOE is "in routine use," while another 33 percent reported that an implementation is in progress, and 20 percent reported that it has been budgeted but not yet implemented.

Massachusetts hospitals are also in various stages of implementing "next generation" clinical systems. One-third of hospitals report using IT for infection management tracking. The state is operating near the national average in electronic medication reconciliation with 57 percent of hospitals accomplishing at least some portion of this activity electronically.

Basic EHRs in use by nearly half of Massachusetts doctors

The physician study (www.csc.com/physician_study_09) examines physicians' use of basic and advanced EHR capabilities.

Of those surveyed, 36 percent said they use all "basic" EHR capabilities outlined in the survey, including electronic medication and problem lists, and functionality to order prescriptions electronically. Five percent claimed adoption of all "advanced" EHR capabilities, including disease management and health maintenance functionality.

Close to three-fourths of physicians surveyed said they order prescriptions electronically for at least some of their patients, while almost two-thirds regularly transmit prescriptions electronically to pharmacies via fax or computer. The survey shows that these levels reflect efforts by payers to provide physicians with e-prescribing software.

The surveys were conducted in the summer of 2008. They include responses from 519 physicians, or roughly 3 percent of the physician population of Massachusetts, and 27 CIOs and hospital executives representing 43 facilities, or approximately 60 percent of the hospitals in the state.

Massachusetts has a heritage of medical innovation that includes development of EHR systems and institution of universal healthcare coverage. Most health plans that serve the state are regional and there is a history of collaboration between providers and payers. For example, the New England Healthcare Electronic Data Interchange (EDI) Network has been exchanging data between health plans and providers since 1998.

CSC's Global Healthcare Sector, which serves healthcare providers, health plans, pharmaceutical and medical device manufacturers, and allied industries around the world, is a global leader in transforming the healthcare industry through the effective use of information to improve healthcare outcomes, decision-making and operating efficiency.

Full press release is here:


The links are in the text.

Third we have:

E-prescribing savings will offset the $19 billion feds will spend for health IT

Consulting firm predicts 75 percent adoption of e-prescribing by 2014

The stimulus law’s incentives for providers to adopt health information technology will double the rate of e-prescribing and result in a $22 billion reduction in drug and medical costs in the next decade, according to a study commissioned by the Pharmaceutical Care Management Association.

If the study’s authors at consulting firm Visante are correct, the e-prescribing savings alone will more than pay for the $19 billion in adoption incentives and other health IT promotion activities required under the stimulus law.

By 2014, more than three-quarters of prescribers will be using e-prescribing, the researchers said. That is double the number anticipated after passage of the Medicare Improvements for Patients and Providers Act of 2008, which includes incentives to encourage Medicare providers to adopt e-prescribing.

Today, fewer than 15 percent of prescribers use e-prescribing, according to Visante’s report.

The report said e-prescribing saves money by:

  • Informing doctors at the point of prescribing about the cost and clinical characteristics of medication options and letting doctors choose the best and most affordable drugs, including more generic drugs.
  • Giving doctors the patient’s medication history so that harmful drug interactions and duplicate prescriptions can be avoided.
  • Notifying doctors of pharmacy options, including mail-order and retail drug stores, to help them hold down patients’ out-of-pocket costs.
  • Transmitting the prescription to the pharmacy electronically, thereby reducing waiting times and errors associated with illegible handwriting.

Besides cutting the federal government’s costs by $22 billion, the report states that health care payers will save a total of $56.2 billion under the stimulus law, titled the American Recovery and Reinvestment Act of 2009.

More here:


The report is available online (.pdf).

Fourth we have:

Survey: Consumers Want More Online

Some 57% of consumers want a secure Internet site that would enable them to access their medical records, schedule office visits, refill prescriptions and pay medical bills, a new survey shows.

The Deloitte Center for Health Solutions, the research arm of Deloitte LLP, a New York-based consulting firm, conducted the survey in October. The firm polled a representative sample of 4,000 adults using a Web-based questionnaire. Among the other findings:

* 55% of consumers want to communicate with their doctor via e-mail to exchange health information and get answers to questions.
* 42% want access to an online personal health record connected to their doctor’s office. But only 9% now have a PHR, compared with 8% in the same survey a year earlier.


More information on the survey, which covers a broad range of health care topics, is available at deloitte.com.

More here:


The link is in the text above.

You can access it directly here:


Fifth we have:

GAO: Internet Remains at Risk

Six years after President Bush called for a national strategy to secure the nation's information infrastructure, the task is far from complete, according to recent congressional testimony.

For instance, the Government Accountability Office, a congressional investigatory agency, in 2006 made nine recommendations to the Department of Homeland Security to aid recovery of the Internet following a major disruption. The department has only implemented two of them. "To date, an integrated public/private plan for Internet recovery does not exist," David Powner, GAO's director of information technology management issues testified on March 10.


Powner's complete testimony and the panel recommendations are available in a new GAO report, "National Cybersecurity Strategy: Key Improvements are Needed to Strengthen the Nation's Posture." Dated March 10, the report is available at gao.gov.

More here (report link in text):


General information but important to be aware of!

Sixth we have:

Health Information Technology (Health IT)

Office of Health Information Technology Transformation

Established within the Department of Health (DOH) in 2007, the Office of Health Information Technology Transformation (OHITT) is charged with coordinating health IT programs and policies across the public and private health care sectors. Its goal is to enable improvements in health care quality, increase affordability and improve health care outcomes for New Yorkers. These programs and policies will not only ensure that medical information is in the hands of clinicians and New Yorkers so that it guides medical decisions and supports the delivery of coordinated, preventive, patient-centered and high-quality care but also support clinicians in new prevention and quality-based reimbursement programs and new models of care delivery.

OHITT is responsible for advancing New York's Health Information Infrastructure as a key underpinning to many DOH health reforms. The total investment to date in New York's Health Information Infrastructure is approximately $400 million, $160 million in funding through the Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program, $200 million in private sector matching funds and $40 million in other state and federal programs.

Key Building Blocks and Activities

More here:


Not quite a report – but browsing around there is a lot of useful information! Seems the State of New York is serious about Health IT.

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

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


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