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:
May 29, 2009 | Molly Merrill, Associate Editor
LEAWOOD, KS – A second round of preliminary findings from the American Academy of Family Physicians National Demonstration Project on the patient-centered medical home (PCMH) examines the use of healthcare information technology and chronic disease registries.
TransforMED, LLC, a wholly-owned subsidiary and redesign initiative of the AAFP, undertook the two-year pilot, which concluded in May 2008. The project included more than 36 practices across the nation and assessed the usefulness and impact on quality of care and business performance of the PCMH model.
A team of independent evaluators from The Center for Research in Family Medicine and Primary Care found that health information technology, such as EHRs, Web portals and chronic disease registries, can be implemented by a range of family practices, including small and rural practices.
Their findings included the following:
- Small, private practices were successful in implementing electronic health records.
- Rural practices were able to successfully implement a range of health information technology, including EHRs, patient portals and disease registries.
- Fourteen of the 31 practices successfully implemented patient Web portals, which enable patients to receive Internet-based services like secure e-visits and online lab results. Twelve of those 14 practices were small, private practices.
- Fifteen practices successfully implemented disease registries, 10 of which were small, private practices.
- While financial issues presented barriers, small practices needed assistance in making decisions about software capability and selecting an EHR and related technology.
- Some practices needed assistance in implementing an EHR and integrating new work processes into the practice routine. Nearly all of the NDP practices reported that implementing the EHR was more complicated and time-consuming than they anticipated.
The report is cited here:
Much more here (including links to many other articles, multimedia etc):
The full article is here:
Important stuff in my view.
Second we have:
Why your next physician's visit may be just a click away
By Kay Lazar, Globe Staff | June 1, 2009
You know the drill. You schlep to the doctor's office and wait for what seems like hours - despite having an appointment. As the time ticks away, your frustration level rises, along with the number of other commitments you are missing.
That's today. But tomorrow holds promise for virtual improvement - literally.
In the not-too-distant future, a doctor's visit may be just a click away. Imagine having your appointment conducted as you sit comfortably in front of your home computer screen, describing symptoms or asking questions of a doctor via videoconference, and having your doctor respond in kind from the office. Need a blood pressure reading? A special cuff downloads it directly into your computer - and to your doctor in real time, just like in a face-to-face appointment.
It may sound farfetched, but virtual medicine is already happening on a trial basis in Boston, and more broadly elsewhere in the country, with Hawaii leading the way. Also in development: widespread use of Web cameras, instant messaging, and other e-technology to help ease healthcare costs, and relieve the burden that scheduling often represents.
There are clearly some limits to the new technology. It can't, for example, be used for a gynecological check up, or many other physical exams. But adaptations - such as the special blood pressure cuff - make it possible to do things that heretofore seemed possible only in person.
Much more here with links :
A recent survey is found here on patient satisfaction:
Useful reading and survey results.
Third we have:
CCHIT at work on new timelines, new programs
June 01, 2009 | Bernie Monegain, Editor
CHICAGO – The Certification Commission for Healthcare Information Technology has published on its Web site the criteria and test scripts developed during 2009, along with a newly developed "Concise Guide to CCHIT Criteria."
The guide maps the criteria to the characteristics of a qualified electronic health record as specified in the American Recovery and Reinvestment Act of 2009 (ARRA) and highlights the 2009 criteria changes. The commission is also planning to transition its certification program timelines to adapt to the new requirements of ARRA.
The criteria, released on May 29, pertain to ambulatory (office-based), inpatient (hospital-based), enterprise and emergency department electronic health records. CCHIT also published criteria for the new stand-alone electronic prescribing certification, the ambulatory add-on options in child health and cardiovascular medicine. The accompanying "Concise Guide to CCHIT Criteria" is specific to the ambulatory and inpatient criteria.
The new material is available from the links in this paragraph from:
“CCHIT final materials from the 09 development cycle and a new Concise Guide to CCHIT Criteria are now available. The new guide maps the criteria to the requirements of an ARRA-qualified EHR and highlights the 09 changes.”
Invaluable reading I believe!
Fourth we have:
Carrie Vaughan, for HealthLeaders Media, June 2, 2009
There are two camps of technology leaders in healthcare. Chief information officers who are focused on more than technology (such as operations, construction, and strategic planning) versus IT directors who are exclusively focused on technology.
The CIOs who focus beyond technology are often the IT leaders who are part of the CEOs inner circle and a valuable member of the senior leadership team. They have demonstrated that they bring knowledge and a skill set to help the organization realize its overall business and clinical goals. The recession combined with the government's focus on health information technology has created a great opportunity for IT directors who are ready for more responsibility and an expanded role in the organization. Healthcare facilities are searching for ways to be more efficient and improve clinical outcomes and technology can play a huge role in improving hospital operations, which is the goal right now for many senior leaders. Surviving this recession in a manner that they can be successful on the other side.
A report by Scottsdale, AZ-based Carefx, the "Changing Role of the Healthcare CIO: Expanded Responsibilities in an Era of Economic Constraints" offers insight from five chief information officers on how to not only survive during a recession, but how to advance your career. Here's a sampling of the advice provided.
Understand how the economy affects your job. It is essential to demonstrate that you understand the big picture—how the recession is impacting the organization and that you are willing to help and contribute, even if that means putting a favorite IT project on hold. It's also the perfect opportunity to showcase what skills you have as a leader by driving efficiency and staying current on IT innovations that can help the organization save money or improve care. During the past several months, many hospitals have been forced to lay off staff members, a large portion of whom were from the administrative offices. Organizations are cutting back on the number of executives they have so it is essential for IT leaders to demonstrate that they can take on more than technology projects.
Rest of the advice samples here:
There is a link to the white paper (details required for download) in the text.
Fifth we have:
Posted: June 2, 2009 - 11:00 am EDT
One side says hospitals have “dropped the ball” when it comes to physician oversight, while another argues that the lack of disciplinary actions being reported to the National Practitioner Data Bank could be evidence that methods for early identification and intervention of potential problems are working.
In a new study that states that the “failure of hospitals to discipline and report doctors endangers patients,” the Health Research Group of the consumer advocacy organization Public Citizen reports that nearly half of all U.S. hospitals have failed to file a single report to the federal database that collects information on incidents in which a doctor’s hospital-admitting privileges were revoked or restricted for more than 30 days because of issues of competency or conduct.
The NPDB was launched in 1990 and, as of December 2007, only 11,221 incidents had been reported—which is one-eighth of what the government estimated would be collected when the database was created under the Health Care Quality Improvement Act of 1986, the report said. According to Public Citizen, 2,845 out of 5,823 U.S. hospitals (49%) had never submitted a privilege sanction report in the 17 years covered by the study.
Although a slight increase in the number of reports filed was seen in 2007 (551 compared with 531 in 2006), there has been a general downward trend since a record 830 reports were filed in 1991 and the recent high of 687 reports in 2002.
Noting that “it is literally inconceivable” that so few disciplinary actions had occurred in U.S. hospitals during the duration of the study, Sidney Wolfe, the founder and director of the Health Research Group and acting president of Public Citizen, declared, “They are obviously playing games.”
The Public Citizen study cites a 1994 report that alleged hospitals had purposely imposed disciplinary periods shorter than 31 days in an effort to sidestep the reporting requirements.
In a letter to HHS Secretary Kathleen Sebelius, Wolfe and the study’s author, Alan Levine, of Public Citizen, linked “this dangerously low number of hospital-based disciplinary reports” to “lax hospital peer review.”
Much more here:
A link to the study is in the text. Certainly sounds like more work is needed! A basic rethink to assist capturing the information needed to identify struggling
Sixth we have:
Posted: June 3, 2009 - 11:00 am EDT
The Food and Drug Administration needs to develop a plan with specific milestones for addressing privacy and security challenges in its new post-market risk-analysis system, the Government Accountability Office recommended.
FDA in May 2008 launched its Sentinel Initiative, a post-market risk-identification and analysis system based on electronic health data. Although a preliminary design for making medical product safety-related queries has been developed, the FDA has yet to act on other key decisions such as a developing a governance model for oversight and enforcement of relevant policies, and setting privacy and security policies, the GAO stated.
The links to the GAO report are in the text.
Seventh we have:
HDM Breaking News, June 5, 2009
The Health Information Security and Privacy Collaboration has released a how-to guide for state cooperation in health care privacy and security issues.
Under the collaborative, 42 states and territories have worked on projects to address and harmonize privacy and security issues related to health information exchange. Durham, N.C.-based Research Triangle Institute International has managed the collaboration under a federal contract.
The 45-page manual is available at http://healthit.hhs.gov/HISPC. Click on Action and Implementation Manual in the top right corner.
There is a lot of interesting material to be found here.
Last we have:
HDM Breaking News, June 4, 2009
U.S. hospital spending on information technology will hit $4.7 billion this year and grow to $6.8 billion by 2014, according to a new report from HIMSS Analytics, Chicago. Spending will grow at a compounded annual growth rate of 7.5%, the report says.
This healthy growth will be fueled, in part, by incentive payments for electronic health records under the federal economic stimulus. In addition to increases in spending on clinical automation, other factors contributing to I.T. spending growth will be the new ICD-10-CM codes for claims as well as the new 5010 standards for electronic claims formats, according to a summary of the report.
More detail here:
The report can be purchased in its entirety or by chapter, with fees varying widely depending on whether the purchaser is a member of HIMSS or a customer of HIMSS Analytics. More information is available at himssanalytics.org.
A slightly different view is provided here:
June 04, 2009 | Bernie Monegain, Editor
NEW YORK – The market for electronic medical record data transfer equipment and applications, valued at $575 million in 2008, is forecast to reach $1.6 billion in 2013, according to a study by research firm Kalorama Information.
Driven by the growing use of EMRs in hospitals and physician offices, this segment of the patient monitoring market will grow 23.3 percent annually through 2013, notes the report, "High-Tech Patient Monitoring Systems Markets (Remote and Wireless Systems, Data Processing, EMR Data Transfer)."