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:
Kaiser gets good marks for EHRs
The Commonwealth Fund published a series of case studies this week that reviewed the ‘best practices’ of several health communities and their efforts to integrate care, reduce cost and improve outcomes. With respect to health care information technology, Kaiser Permanente, the largest not-for-profit integrated health care delivery system in the US serving over 8 million members, stands out as an example of how health care technology may positively affect the provision of care over the long term. The case study was drawn from Kaiser sites in North Carolina and Colorado.
The case study lists “information continuity” as an attribute that is vital to overall health care delivery success. According to findings from the study sites, the criteria necessary to achieve information continuity include electronic health records that integrate physician order entry, clinical decision support, population and patient management tools, appointment, registration and billing systems. Additionally, Kaiser views the EHR as a double-sided entity, with patient access on the flipside offering online access to resources, visit history, appointment scheduling, prescriptions, lab test results and secure messaging with providers. Wow—that is quite an agenda. So, does it work?
While electronic health records are a new and exciting prospective market for patients, providers and policy analysts, Kaiser is an experienced healthcare IT user. Having implemented an EHR system in the early 1990s, Kaiser is now a decade plus into the use of EHR technology as a vehicle to improve care and reduce costs. In 2003, it launched a $4 billion dollar effort to connect all of their sites nationwide, aiming for an interoperable platform that enabled all of their providers to share information despite their physical location. This system is called KP HealthConnect.
Lots More here:
http://ohmygov.com/blogs/general_news/archive/2009/06/25/kaiser-gets-good-marks-for-ehrs.aspx
The report is available at the link.
Second we have:
Study: Safety-net hospitals need health information exchange help
June 21, 2009 — 6:30pm ET | By Anne Zieger
In theory, just about any facility can benefit from setting up a health information exchange with other local providers. In reality, however, some providers--notably safety-net hospitals--just don't have the means to support them properly.
The new study by Mathematica Policy Research, which was funded by the Agency for Healthcare Research and Quality, concluded that there are several ways HIEs can improve care quality and cut costs, including allowing emergency care teams to access an unconscious patient's records; improving care for patients without primary care homes; and cutting down on duplicate tests for patients seeing varied providers.
- read this iHealthBeat piece
More here:
To learn more about this issue read the Mathematica report (.pdf)
http://www.mathematica-mpr.com/publications/PDFs/health/healthinfoexchangeIB.pdf
More here (registration required):
Third we have:
Study: PHRs Give Docs New Insights
HDM Breaking News, June 19, 2009
Collecting data about observations of daily living through personal health records can give physicians and patients insights unattainable from information captured only from clinical encounters, according to a new study.
The Robert Wood Johnson Foundation and California HealthCare Foundation in 2006 launched Project HealthDesign, an effort help consumers better use information within PHRs. Now researchers, including nine teams that built prototypes of technologies to support personal health records, have published a report of findings.
More here:
http://www.healthdatamanagement.com/news/PHR-38509-1.html
The initial report, "Project HealthDesign: Rethinking the Power and Potential of Personal Health Records," is available at projecthealthdesign.org/overview-phr.
Further reporting is here:
http://www.healthcareitnews.com/news/report-daily-health-habits-are-important-part-phr
Report: Daily health habits are an important part of a PHR
June 19, 2009 | Molly Merrill, Associate Editor
Fourth we have:
June 22, 2009
Canada Health Infoway’s 2008-2009 Annual Report: Building a Health Legacy Together
This is now available online.
This past year has been one of continued implementation and collaborative work with our jurisdictional partners to move the country forward in implementing electronic health records.
It has also been a year, where Infoway expanded our reach into the domain of consumer health solutions, through the certification of vendor products.
While work on electronic health solutions continues across the country, some jurisdictions are already reporting successful implementations of diagnostic imaging and drug information systems which speed diagnosis and access to care for patients. This year’s Annual Report highlights these success stories as well as solutions for improving patient safety, emergency and self-managed home care.
We invite you to read about our performance for the past year in areas including project approvals, communications, privacy, operations, standards and architecture. This information, combined with our financial statements, offers a complete overview of Infoway and our continued work towards our mission in 2008-09.
For more information, please visit: www.infoway-inforoute.ca
Release found here:
http://www.infoway-inforoute.ca/lang-en/about-infoway
Reports are here:
Annual Report
2008-2009: Building a Health Legacy Together
Business Plan
2009-2010: Making health information work better for Canadians
Fifth we have:
Test Result Notification Hindered by Combining EHRs, Paper Records
A new study suggests that physician practices using a combination of electronic health records and paper records are less likely to inform patients of abnormal test results than practices using a single system, Modern Healthcare reports.
The study, published Monday in the Archives of Internal Medicine, was funded by the California HealthCare Foundation (Vesely, Modern Healthcare, 6/23). CHCF is the publisher of iHealthBeat.
More here:
http://www.ihealthbeat.org/Articles/2009/6/24/Test-Result-Notification-Hindered-by-Combining-EHRs-Paper-Records.aspx
The full paper is found here:
http://archinte.ama-assn.org/cgi/content/full/169/12/1123
It is important to note some of the headlines on this study have not reflected properly the detail of what the paper says - which is that you get better outcomes with either fully paper or fully electronic records with electronic preferred. Problems come when you mix paper and electronic records in the same practice.
Sixth we have:
Health Information Technology: The Case for a Sound Federal Policy
by Tevi Troy, Ph.D.
Backgrounder #2289
Congress, through its enactment of the "stimulus" bill, is committed to spending $787 billion on various projects, including $20 billion to encourage doctors and hospitals to adopt electronic health records (EHRs). This new spending is a component of the Obama Administration's health care agenda, which includes the promotion of health information technology (HIT).
President Obama was quite vocal on the importance of HIT on the campaign trail last year, and called for a taxpayer "investment" of $20 billion to $50 billion. While the question of whether to make this commitment of taxpayer dollars was answered when the President signed the stimulus bill, there are still a number of unanswered questions about how to implement EHRs so that they create the maximum benefit for patients and the minimum disruption for America's already stressed health care system.
Pages more here:
http://www.heritage.org/Research/HealthCare/bg2289.cfm
The case for Health IT (with 24 references) from the Heritage Foundation (To the right of Atilla the Hun!). Good stuff!
Seventh we have:
Peeping
Moritz College of Law of the Ohio State University
Berkley Technology Law Journal, Forthcoming 2009
Abstract:
This article explores the phenomenon of employee snooping, which I call “peeping.” The essay draws on mythology and literature to show the ancient roots of the phenomenon of peeping, and hopefully encourages discussion and raises awareness of peeping throughout the academic community.
Part I of the essay discusses recent political and celebrity peeping incidents, such as the passport records of candidate Obama.
Part II describes three, increasingly harmful, types of peeping; "the gaze," "the gossip," and "the grab." The “gaze” occurs simply when a person looks at another person without permission, such as Peeping Tom gazing at Lady Godiva or a modern-day Peeping Tom sneaking a peek into a database. The “gossip” occurs when the person tells other what he or she has seen. The “grab” is even more serious. It occurs when an employee grabs the personal information for profit, often at the behest of an outsider. A recent example is where the National Enquirer paid an employee at the UCLA Medical Center to turn over celebrities’ medical records on over 30 occasions.
More here:
http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1418091
This is an interesting discussion on snooping and peeping. Health Information seems to be a major target!
The full paper is downloadable from the link.
Enough for one week!
Enjoy!
David.
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