Just an occasional post when I come upon a few interesting reports that are worth a download or browse. This week we have a few.
First we have:
Getting Health IT Right under ARRA
Markle Foundation announces broad agreement on principles for Getting Health IT Right under the American Recovery and Reinvestment Act (ARRA).
Read Achieving the Health Objectives under ARRA (PDF, 453K)
Read the news release.
The Report links are found here:
Markle are serious contributors and their report will be worth a close read. Australia – instead of the mindless e-PIP program should be having a similar debate about how to foster e-Health here!
Second we have:
Wednesday, January 28, 2009
A new report by the Deloitte Center for Health Solutions finds significant opportunities for the adoption of personalized medicine to produce a positive return on investment for key stakeholders in the U.S. healthcare system. The report also finds that consumers stand to gain the most significant ROI within the shortest time period.
The report, titled “The ROI for Targeted Therapies: A Strategic Perspective,” provides an analysis of personalized medicine’s economic value proposition. It examines the importance of ROI for multiple stakeholders--consumers, diagnostic companies, pharmaceutical and biotechnology companies, and payers.
This is an important area of future medical care that is very technology intensive.
Third we have:
April 24, 2009
Hospitals should consider changing their priorities when implementing electronic health records, automating documentation of physicians’ notes earlier in the game, a new report suggests.
The change in priorities would help hospitals provide adequate data for “core measures” that many payers demand, according to a new white paper from Computer Sciences Corp., a Falls Church, Va.-based consulting firm. The Centers for Medicare & Medicaid Services, other payers and some states often require hospitals to use a set of national quality performance measures for pay-for-performance programs and other projects.
To view the full report, “Core Measures: All About the Data,” visit csc.com.
An interesting perspective from CSC.
Fourth we have:
Effect of an Electronic Medication Reconciliation Application and Process Redesign on Potential Adverse Drug Events
A Cluster-Randomized Trial
Jeffrey L. Schnipper, MD, MPH; Claus Hamann, MD, MS; Chima D. Ndumele, MPH; Catherine L. Liang, MPH; Marcy G. Carty, MD, MPH; Andrew S. Karson, MD, MPH; Ishir Bhan, MD; Christopher M. Coley, MD; Eric Poon, MD, MPH; Alexander Turchin, MD, MS; Stephanie A. Labonville, PharmD, BCPS; Ellen K. Diedrichsen, PharmD; Stuart Lipsitz, ScD; Carol A. Broverman, PhD; Patricia McCarthy, PA, MHA; Tejal K. Gandhi, MD, MPH
Arch Intern Med. 2009;169(8):771-780.
and this article:
A Cluster-Randomized Controlled Trial
Jeffrey A. Linder, MD, MPH; Nancy A. Rigotti, MD; Louise I. Schneider, MD; Jennifer H. K. Kelley, MA; Phyllis Brawarsky, MPH; Jennifer S. Haas, MD, MSPH
Arch Intern Med. 2009;169(8):781-787.
Two interesting trials with full abstracts available on the site.
Additional reporting is found here:
Medication Errors Could Be Cut: Experts
Two reports show promise of computers, pharmacists for proper prescribing
By Steven Reinberg
Fifth we have:
Acceptability of a Personally Controlled Health Record in a Community-Based Setting: Implications for Policy and Design
Elissa R Weitzman1,2,4, ScD, MSc; Liljana Kaci1, BA; Kenneth D Mandl1,3,4, MD, MPH
1Children’s Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology, Children’s Hospital Boston, Boston, MA, USA
2Division of Adolescent Medicine, Children’s Hospital Boston, Boston, MA, USA
3Division of Emergency Medicine, Children’s Hospital Boston, Boston, MA, USA
4Department of Pediatrics, Harvard Medical School, Boston, MA, USA
Elissa R Weitzman, ScD, MSc
Children’s Hospital Informatics Program
One Autumn Street, Room 541
Boston, MA 02215
Phone: +1 617 355 3538
Fax: +1 617 730 0267
Background: Consumer-centered health information systems that address problems related to fragmented health records and disengaged and disempowered patients are needed, as are information systems that support public health monitoring and research. Personally controlled health records (PCHRs) represent one response to these needs. PCHRs are a special class of personal health records (PHRs) distinguished by the extent to which users control record access and contents. Recently launched PCHR platforms include Google Health, Microsoft’s HealthVault, and the Dossia platform, based on Indivo.
Objective: To understand the acceptability, early impacts, policy, and design requirements of PCHRs in a community-based setting.
Methods: Observational and narrative data relating to acceptability, adoption, and use of a personally controlled health record were collected and analyzed within a formative evaluation of a PCHR demonstration. Subjects were affiliates of a managed care organization run by an urban university in the northeastern United States. Data were collected using focus groups, semi-structured individual interviews, and content review of email communications. Subjects included: n = 20 administrators, clinicians, and institutional stakeholders who participated in pre-deployment group or individual interviews; n = 52 community members who participated in usability testing and/or pre-deployment piloting; and n = 250 subjects who participated in the full demonstration of which n = 81 initiated email communications to troubleshoot problems or provide feedback. All data were formatted as narrative text and coded thematically by two independent analysts using a shared rubric of a priori defined major codes. Sub-themes were identified by analysts using an iterative inductive process. Themes were reviewed within and across research activities (ie, focus group, usability testing, email content review) and triangulated to identify patterns.
Results: Low levels of familiarity with PCHRs were found as were high expectations for capabilities of nascent systems. Perceived value for PCHRs was highest around abilities to co-locate, view, update, and share health information with providers. Expectations were lowest for opportunities to participate in research. Early adopters perceived that PCHR benefits outweighed perceived risks, including those related to inadvertent or intentional information disclosure. Barriers and facilitators at institutional, interpersonal, and individual levels were identified. Endorsement of a dynamic platform model PCHR was evidenced by preferences for embedded searching, linking, and messaging capabilities in PCHRs; by high expectations for within-system tailored communications; and by expectation of linkages between self-report and clinical data.
Conclusions: Low levels of awareness/preparedness and high expectations for PCHRs exist as a potentially problematic pairing. Educational and technical assistance for lay users and providers are critical to meet challenges related to: access to PCHRs, especially among older cohorts; workflow demands and resistance to change among providers; inadequate health and technology literacy; clarification of boundaries and responsibility for ensuring accuracy and integrity of health information across distributed data systems; and understanding confidentiality and privacy risks. Continued demonstration and evaluation of PCHRs is essential to advancing their use.
(J Med Internet Res 2009;11(2):e14)
Medical records; medical records systems, computerized; personally controlled health records (PCHR); personal health records; electronic health record; human factors; research design; user-centered design; public health informatics
Full paper is here:
Very important material given what the NHHRC is proposing here in Australia – needs a close read.
Last we have:
By Chuck Salter
In March, President Obama identified "the biggest threat to our nation's balance sheet." Not major banks on the brink of insolvency. Not paralyzed credit markets. Not a bailout tab in the trillions. The biggest threat, he warned, "by a wide margin," is "the skyrocketing price of health care."
Health care accounts for $1 in every $6 spent in the United States -- and costs are climbing at twice the rate of inflation. Every year, an estimated 1.5 million families lose their homes because of medical bills. Although we have the world's most expensive health-care system, 24 countries have a longer life expectancy and 34 have a lower infant-mortality rate, according to the latest United Nations report.
But some physicians and surgeons have been quietly rethinking and reinventing medicine for the 21st century. Often collaborating with innovative companies, these pioneers are experimenting with cutting-edge technologies, from software to robots, that have the power to revolutionize the medical landscape -- producing better outcomes, lower costs, broader access, and greater convenience. And advances on a far greater scale could emerge from the stimulus package and the $634 billion the Obama administration proposes to invest in health-care reform; the much-discussed expansion of electronic medical records (see Why Electronic Health Records Are Worth the Hype--and the Price ) is just the beginning. As these breakthroughs come together, they will change the world for patients, doctors, insurers, regulators -- all of us.
The doctor of the future will see you. Now.
Vastly more here:
So much to read – so little time – have fun!