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, April 16, 2009

International News Extras For the Week (12/04/2009).

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

First we have:

Monday, April 06, 2009

HIMSS '09: Meaningful Use of Stimulus Money Is Key Theme

by George Lauer, iHealthBeat Features Editor

From a scary story of newborn twins struggling for their lives to a cinematic allusion of driving a car over a cliff, the central theme of the Healthcare Information and Management Systems Society's 2009 Annual Conference and Exhibition -- meaningful use of stimulus money to bring about change -- emerged loud and clear at the start of health IT's annual showcase.

"The stakes are extraordinarily high," said HIMSS Board Chair Charles Christian welcoming 25,050 participants to Chicago Sunday on the first official day of the four-day conference. Calling this a "momentous time," Christian pointed to Congress' passage of the American Recovery and Reinvestment Act as a major milestone for the health IT industry. The $19.1 billion in health IT spending in the bill represents "a huge opportunity and a significant challenge," Christian said.

Actor Dennis Quaid delivered the first keynote address Sunday, telling the saga of how his newborn twins almost died from medical errors at Cedars-Sinai Medical Center in California. The infants -- a boy and a girl -- survived two accidental overdoses of the blood anti-coagulant heparin, but others have died from similar mistakes. Quaid and his wife Kimberly established the Quaid Foundation to combat medical errors.

Lots more (with links) here:


The HIMSS Conference barely noticed the recession. Doubtless this was due to all the stimulus money being made available over the next few years. The US Health IT scene is going to be quite something to watch over the next decade.

More reporting on the HIMSS meeting is here:


HIMSS '09: Kolodner Sent Off With Standing Ovation

by George Lauer, iHealthBeat Features Editor

Robert Kolodner, soon-to-be-former national coordinator for health IT, got a standing ovation and then did some fancy dancing -- as promised -- at a town hall meeting Monday at the Healthcare Information and Management Systems Society conference in Chicago.

Kolodner's successor, David Blumenthal, whom President Obama named to head the Office of the National Coordinator for Health IT last month, takes over from Kolodner later this month. Blumenthal was conspicuously absent at the ONC's town hall meeting Monday.

Dave Roberts, HIMSS vice president for government relations, paid homage to Kolodner's work over the past two years after replacing David Brailer, the first coordinator of efforts to move the country's health system into the digital age.

Second we have:

CCHIT considers usability rating system, Leavitt says

By Joseph Conn / HITS staff writer

Posted: April 6, 2009 - 8:00 am EDT

Business is booming at the Certification Commission for Healthcare Information Technology.

The not-for-profit commission is, so far, the only game in town when it comes to testing and certifying electronic health-record systems.

And in February, President Barack Obama signed the federal stimulus legislation with tens of billions of dollars for provider subsidies to buy EHR systems—provided they are certified and afford providers "meaningful use."


A recent Health IT Strategist reader poll had 79% of respondents saying CCHIT should add system usability to its testing criteria.

Apparently, CCHIT has been hearing similar requests.

“We’re thinking of adding a rating system and give the data to the users,” Leavitt said. Its ratings could include evaluation by users regarding vendor support, implementation methodology, training capabilities, customer satisfaction as well as usability, which, Leavitt said, is difficult, but not impossible to do

More here (registration required):


The usability issue is clearly an important one. NEHTA certainly needs to keep it in mind if it ever gets its certification act together.

Third we have:

Open-source EHR developers, CCHIT leaders to meet

By Joseph Conn / HITS staff writer

Posted: April 6, 2009 - 8:00 am EDT

Members of the small but passionate community of healthcare open-source software developers and users are meeting with the leaders of the Certification Commission for Healthcare Information Technology at the 2009 Healthcare Information and Management Systems Society's conference in Chicago and will attempt to find rapprochement with the federally supported not-for-profit organization that could play an increasingly important role in the government’s IT booster initiative.

Under the American Recovery and Reinvestment Act of 2009, providers can receive subsidies as part of the stimulus initiative to purchase and use an electronic health-record system, but there are strings attached. One of them is that providers must use a certified EHR system to qualify for the federal subsidy. So far, CCHIT is the only game in town for EHR certification.

“There are a number of people in the open-source community—some are folks that make software, some are just people involved in open source—(who) have taken a position that the CCHIT process, how can I put this in a diplomatic way, presents some obstacles for open source that it doesn’t for others,” said Joseph Dal Molin, a vice president of WorldVistA, a not-for-profit organization promoting an open-source version of the Veterans Affairs Department’s Veterans Health Information Systems and Technology Architecture EHR system.

WorldVistA, which helped develop a version of VistA for use in physician offices under contract with the CMS, has the only truly open-source software system to receive CCHIT certification.

Reporting continues here (registration required):


This is becoming an issue that will need to be addressed. It is not easy as so few of the available products are open source at present and few will follow if certification becomes crucial and the costs are not managed.

Fourth we have:

April 6, 2009

Owners of LOINC, NPU, and SNOMED CT Begin Trial of Cooperative Terminology Development

On April 6, 2009, the owners of three standards that contain laboratory test terminology – the Logical Observation Identifiers, Names, Codes (LOINC), Nomenclature, Properties and Units (NPU), and the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) – began an operational Trial of prospective divisions of labor in the generation of laboratory test terminology content. This Trial will provide practical experience and important information on opportunities to decrease duplication of effort in the development of laboratory test terminology and to ensure that SNOMED CT works effectively in combination with either LOINC or NPU.

During the Trial:

  • New laboratory test terminology content will be created by the Regenstrief Institute (RI) and the LOINC Committee, which own LOINC, OR by the International Federation of Clinical Chemistry (IFCC) and the International Union of Pure and Applied Chemistry (IUPAC), which own NPU, but not by the International Health Terminology Standards Development Organisation (IHTSDO), which owns SNOMED CT;
  • SNOMED CT modeling of such content will be done as a by-product of creating new content for LOINC or NPU and then incorporated into SNOMED CT; and
  • SNOMED CT codes will be used to represent appropriate parts of LOINC and NPU entities.

Designed to last 6 months or less, the Trial will also provide an opportunity to assess the robustness of the new SNOMED CT Observables Model as a structure for representing LOINC and NPU laboratory test terminology content; to gain a clearer picture of the differences between LOINC and NPU as background for future discussions about the feasibility of a more unified effort between them to further reduce duplication of effort; and to identify any country-specific aspects of laboratory test terminology that may not be suitable for inclusion in the International Release of SNOMED CT. During this period, users can continue to submit requests for laboratory test terminology to any of the three organizations involved in the Trial.

More here:


This work is important and has implications for the longer term approaches to laboratory test terminology used in Australia.

Fifth we have:

New Children's is a pioneer in paperless

(Pittsburgh Tribune-Review (PA) Via Acquire Media NewsEdge) Apr. 5--Wall-mounted flat-screen monitors glow in intensive care units, graphically representing each patient's blood pressure, medications, breathing, pulse and other vitals.

Nurses control computers on wheeled carts, recording patients' symptoms in a database. With a bar-code scanner, similar to a grocery store clerk's, they match a code on each patient's wristband to their medication.

Doctors type up prescriptions on laptops and electronically send requests to the pharmacy, through a system that cross-checks for allergies and correct dosages.

This is the paperless Children's Hospital of Pittsburgh.

"We built the hospital architecturally without any chart racks or spaces for charts to be," said Children's Chief Information Officer Jacqueline Dailey. "And we built a very small medical records department because we do not intend to move any paper records to the new campus. It's a completely digital hospital." A review commissioned by the U.S. Department of Health and Human Services found that adopting information technology improved the likelihood that doctors would remember to vaccinate at-risk patients by as much as 33 percent, cut problems associated with medications by at least half and reduced by 65 percent the time it takes to identify a hospital-acquired infection. Wait times for everything from getting X-rays to medication pickup fell by 24 to 73 percent.

"Do I think (health information technology) is the right thing to do? Absolutely, no question about it," said Nir Menachemi, an associate professor in the Department of Health Care Organization and Policy at the University of Alabama at Birmingham.

More here:


A great read to see where the real leaders are going. Sounds like they are pretty close to getting there!

Trend shows more spending: health IT survey

By Joseph Conn / HITS staff writer

Posted: April 5, 2009 - 4:00 pm EDT

The dam has broken.

By Congressional Budget Office estimates, the federal government is poised to pour as much as $38.3 billion into healthcare information technology support through 2015 under the American Recovery and Reinvestment Act of 2009. The following trends, based on data from the 19th annual Modern Healthcare/Modern Physician Survey of Executive Opinions on Key Information Technology Issues, reflect the impact the legislation might have on the industry.

Former President George W. Bush raised the profile of health IT to a national priority in 2004 when he created the federal Office of the National Coordinator and tasked the office and the healthcare industry with providing an electronic health record to most Americans by 2014. Bush, however, staked out the ideological position that the nation’s IT goals should be achieved largely through free-market activity and specifically ordered the ONC to “not assume or rely upon additional federal resources or spending” to accomplish adoption of interoperable health information technology.

According to survey results, an overwhelming majority of respondents aligned more with recent congressional intent and favored the government changing the game plan by providing direct financial support for a federal IT development program.

Asked if they thought the government should subsidize the cost of providing electronic health record systems to physicians, 80.6% of respondents said yes. Asked if the government should subsidize IT systems for hospitals and other healthcare organizations in rural and medically underserved areas, 89.7% of respondents said yes. And even when it came to subsidizing IT programs at community hospitals and other healthcare organizations, 74.2% said yes.

Lots more here (registration required):


This provides a useful review of present spending plans in the US. Clearly on the rise!

Seventh we have:

New online master's degree at DSU

MELANIE BRANDERT mbrander@argusleader.com

Dakota State University will start offering an online master’s degree in health informatics this fall.

The state Board of Regents approved this week the new degree program, which relates to the science of information, practice of information processing and engineering of information systems.

The new degree will help individuals for health care careers in occupations such as chief information officer, corporate health information manager or data analytics.

President Doug Knowlton said the program will support critical health-care related decision making in the state.

DSU will offer the new program without requesting new state funds or increased student fees by redirecting some existing resources, he said.

More here:


Altogether a good thing – the more courses that are available the better!

Eighth we have:

GE Threatens Philips With Push Into Home Health Care

By Marcel van de Hoef and Rachel Layne

April 3 (Bloomberg) -- General Electric Co.’s push into home health care threatens Royal Philips Electronics NV’s market leadership, as growth slows in the U.S. imaging equipment businesses that sell to hospitals.

GE, the world’s largest maker of medical-imaging equipment, and Santa Clara, California-based Intel Corp. said yesterday they will jointly spend $250 million over five years to develop home health-care products. Researcher Datamonitor Group predicts the market will more than double to $7.7 billion by 2012.

“GE is very strong in health care and has a lot of knowledge and technology in-house that they can leverage,” said Peter Olofsen, an analyst at Kepler Capital Markets in Amsterdam who has a “reduce” rating on Philips shares. “Philips will be facing the established names here as well.”

The home health-care market is forecast to outpace growth in the hospital business, making it a priority for Philips and GE. Aging populations will boost medical costs and force governments to move more care into homes. Sales to hospitals have been hurt since 2007 by the U.S. Budget Deficit Reduction Act, which has reduced reimbursement for imaging procedures and demand for such systems.

GE Healthcare, also the world’s biggest provider of digital health-record systems, will sell and market the Intel Health Guide, which the U.S. Food and Drug Administration approved last year. The machine collects vital signs and information, sends data to doctors and acts as a videoconferencing and e-mail link.

Full article here:


You can be sure this is only the beginning of major technology companies piling into this space!

Ninth we have:

E-health records hit Sam’s Clubs in three states

By Mass High Tech staff

E-health systems developed by medical software maker eClinicalWorks LLC and Dell Inc. are now available in Sam’s Club stores in Virginia, Illinois and Georgia. The companies said the e-health records could be available in Sam’s Club nationally later this year.

Electronic medical records have hit obstacles in the form of costs, according to a statement by Sam’s Club senior vice president Charles Redfield. Now, users can access the records through the Internet, using a software as a service (SaaS) model.

More here:


The roll out of the Wal-Mart clinical record system begins.

Tenth we have:

Building Health 2.0 Into The Delivery System

April 6th, 2009

by John Halamka

View Author Bio

Over the past few months, I’ve seen a convergence of emerging ideas that suggest a new path forward for decision support and information therapy. I believe we need Decision Support Service Providers (DSSP), offering remotely hosted, low cost knowledge services to support the increasing need for evidence-based clinical decision making.

Beth Israel Deaconess Medical Center has traditionally bought and built its applications. Our decision support strategy will also be a combination of building and buying. However, it’s important to note that creating and maintaining your own decision support rules requires significant staff resources, governance, accountability, and consistency. Our Pharmacy and Therapeutics Committee recently examined all the issues involved in maintaining our own decision support rules and it’s an extensive amount of work. We use First DataBank as a foundation for medication safety rules. We use Anvita Health to provide radiology ordering guidelines based on American College of Radiology rules. Our internal committees and pharmacy create and maintain guidelines, protocols, dosing limits, and various alerts/reminders. We have 2 full time RNs just to maintain our chemotherapy protocols.

Many hospitals and academic institutions do not have the resources to create and maintain their own best practice protocols, guidelines, and order sets. The amount of new evidence produced every year exceeds the capacity of any single committee or physician to review it. The only way to keep knowledge up to date is to divide the maintenance cost and effort among many institutions.

More here:


Amen to this plea. I hope it can be quickly and sensibly progressed.

This paragraph requires special attention.

“Based on my review of the literature, I believe decision support liability is a new area without significant case law. The good news is that there are no substantive judgments against clinicians for failing to adhere to a clinical decision support alert. As a licensed professional, the treating clinician is ultimately responsible for the final decision, regardless of the recommendations of a textbook, journal, or Decision Support Service Provider. However, as Clinical Decision Support matures and becomes more powerful and relevant, I believe that there could be greater liability for not using such tools to prevent harm.”

Eleventh for the week we have:

Health IT is set to grow - and consolidate

Mon Apr 6, 2009 4:21pm BST

By Debra Sherman - Analysis

CHICAGO (Reuters) - As interest in the health information technology sector swells ahead of government funding to modernize the U.S. healthcare industry's record-keeping system, consolidation cannot be far behind.

The U.S. stimulus package includes $20 billion to create computerized systems that can easily communicate with one another, replacing reams of disparate, paper records.

Both large and small companies are likely to join forces to increase the scope of their offerings, while others are looking to enter this potentially lucrative business.

Some 225 companies are exhibiting for the first time at the annual Health Information Management Systems Society meeting this week, which has drawn more than 23,000 health IT professionals.

"You can't dangle billions of dollars in front of an industry and not expect more people to try and get involved," HIMSS Chief Executive Stephen Lieber told Reuters.

More here (registration required):


That last paragraph has the ring of truth – we will need to be careful and watch out for charlatans!

Twelfth we have:

Computerized Physician Order Entry May Be a Key Indicator in the 'Meaningful Use' of Electronic Medical Records

New KLAS report on CPOE looks at which EMR solutions are achieving the most adoption among physicians.

CHICAGO, IL, April 06, 2009 /24-7PressRelease/ -- As healthcare providers throughout the nation evaluate the impact of the 2009 American Recovery and Reinvestment Act, provisions in the package that call for the "meaningful use" of electronic medical records (EMRs) are driving much of the debate. In light of these challenging questions, a new report from healthcare research firm KLAS may offer a useful resource in determining just what constitutes meaningful use.

"Though EMR technology has yet to be deployed at many community hospitals and most physician practices, the vast majority of hospitals with more than 200 beds have already chosen a strategy and a solution for electronic medical records," said Jason Hess, general manager of clinical research for KLAS and author of the new CPOE study. "For those larger facilities, the goal now becomes one of proving that their EMR solutions will actually be used by physicians, replacing paper-based orders and instructions with computerized physician order entry."

More here:


Certainly a suggestion worth considering. Of course DoHA and NEHTA in Australia have totally missed the point and got it wrong in my view with our PIP program!

This other release is also worth a quick browse.


Ambulatory EMR Market Poised for Significant Growth

Legislative changes, new hosted solutions and a proliferation of vendors accelerating buying decisions.

Thirteenth we have:

Feds release open-source NHIN gateway software

By Joseph Conn / HITS staff writer

Posted: April 7, 2009 - 9:00 am EDT

The open-source movement in healthcare was afforded significant federal affirmation this week as the software code to create a gateway between multiple federal organizations and the proposed national health information network has been made available for downloading and public use, according to an HHS announcement made at the 2009 Healthcare Information and Management Systems Society meeting in Chicago.

More here (subscription required):


It is worthwhile being aware such software has become available via the US Government.

Third last we have:

Exclusive: Billing glitch led to mental health closures

BY ALEX PARKER / Staff Writer

April 07, 2009 | 7:00 AM

The Chicago Department of Public Health lost more than $1 million in state funding by failing to fix computer problems with its billing system, public records show, sparking a funding crisis and the scheduled closure of four South Side mental health centers today.

City officials have previously blamed the closures in large part on state budget cutbacks.

But a trail of official paperwork, obtained by the Daily News through the Freedom of Information Act, shows that the department’s new computerized billing system was so flawed that patient bills weren’t submitted to the state for six months in 2008.

Billing the state was crucial to getting funds because of the way the state allocates dollars for mental health services.

The city's current-year state payments are based on monthly reimbursements for service. When the state received no bills from the city for the last four months of the previous fiscal year, it amended the contract it had with the city to reflect the city's apparent lesser need for funds.

The city's public health chief, Terry Mason, declined to answer questions for this article. Carlo Govia, CDPH’s chief financial officer did not respond to a request to be interviewed. Nor did Cerner Corp., the Kansas City, Mo.-based company that developed the city's software.

Much more here:


Sounds like a bit of a mess! – Seems a few too many people have not tried hard enough to co-operate and get things fixed!

Second last for the week we have:

EHTEL helps Swedish government review e-health

07 Apr 2009

The Swedish government and healthcare authorities have called upon the European Health Telematics Association to discuss their national e-health strategy.

The discussion took place in a two-day meeting in Stockholm last week and was the first time that e-health industry body EHTEL had been asked to advise a national government.

EHTEL president, Martin Denz, told E-Health Europe: “They asked us to review their strategy as we could provide a full staff of e-health specialists and any stakeholder they needed, from IT professionals to software architects.

“The whole process meant that they were not being scrutinised but instead receiving structured criticism.”

EHTEL received extensive information on Sweden’s e-health strategy before the meeting so that they could prepare for discussions on how it could be to improved.

More here:


Where do we sign up!

Last for this week we have:

eHealth agency 'out of control'

Antonella Artuso

Sun Media Queen's Park Bureau

April 7, 2009

TORONTO -- A provincial health-care agency that tallied up well over $200,000 in meal and travel expenses during a few months deserves much greater scrutiny, Tory MPP Elizabeth Witmer says.

Staff members and consultants with eHealth Ontario, which is developing the province's electronic health records, spent $39,235 on meals, $108,489 on travel and $18,327 on accommodation between October 2008 and January 2009.

Another $48,257 was spent catering "off-site" meetings.

"These people are out of control and nobody is providing any oversight," Witmer said yesterday. "And how the minister can accept this extravagant spending is beyond I think most of the people in this province . . . it's a flagrant abuse of hard-earned taxpayers' money."

More here:


Sounds like a bit of profligacy here! I hope they are doing good work if they are eating so well!

There is an amazing amount happening. Enjoy!


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