Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Friday, August 21, 2009

International News Extras For the Week (17/08/2009).

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

First we have:

Tories to let patients amend medical records online

Conservatives' plan to give the public easier access to their own NHS notes wins backing of GPs

By Jane Merrick and Nina Lakhani

Sunday, 9 August 2009

Patients could amend their own medical records and leave comments on symptoms, medication and treatment, under radical plans unveiled by the Conservatives today.

In a move which could be dubbed "Wiki-health", a Tory government under David Cameron will allow people to access online health records, which are currently restricted. Patients would be prevented from changing key details, but could amend personal medical information.

In a move that could prompt fears of invasion of privacy, patients could also share their data with third parties, such as gyms, private clinics or weight-loss groups, and join online "communities" of people with the same condition or illness to swap experiences and receive support.

The Tories have vowed to scrap the controversial NHS IT system, which has already cost more than £12bn and whose completion is years behind schedule. Instead, electronic medical records would be handled by a private internet giant such as Microsoft or Google, which has links to one of Mr Cameron's closest aides, Steve Hilton.

Some senior Tories, including the former shadow home secretary David Davis, expressed concern that Google would control private data. However, doctors' leaders last night welcomed any move to empower patients and make records more interactive.

The plans are in a review of the way medical records are handled, commissioned by the shadow health minister Stephen O'Brien. He said: "Giving patients greater control over their health records is crucial if we are to make the NHS more patient-centred. Labour's attitude to personal data is misguided. They seem to think they own it and, all too often, they have been appallingly careless in looking after it.

Much more here:

http://www.independent.co.uk/news/uk/politics/tories-to-let-patients-amend-medical-records-online-1769694.html

With an election due next year we are going to hear a lot more about all this. One really hopes we don’t wind up with a ‘baby and bathwater’ situation. There is some pretty good stuff that has been done!

Second we have:

Electronic health cards face resistance in Germany

Sindya Bhanoo, The Industry Standard

08.10.2009

In Germany, many in the medical field think that the government's push to roll out nationwide e-health cards may mean too much technology too fast.

Germany has already partially transitioned to electronic health records, and many hospitals are currently in the midst of a major transition to electronic records, said Martin Peuker, the deputy CIO of Charite Hospital in Berlin. He said that the electronic health cards would be interoperable with EHR programs in hospitals and store, as well as retrieve, patient medical history, insurance information and prescriptions on a microchip.

Beta versions of the the cards, which are currently being tested in northwest Germany, recently met national security and privacy regulations required for a national rollout, according to Gematik, a private company involved in the design of the card.

Still, some health IT experts expressed concern.

"It's a typically German project -- very complicated," Peuker said.

Peuker and his IT team are interested in the e-health card, but warn that convincing doctors to use technology can be a difficult task. According to Peuker, even before the card technology was tested, there were problems with the older EHR implementation. For several years, he said, Charite Hospital has been refining its EHR system. Doctors often protest having to use it. "Every day, we have this discussion," Peuker said. "They say, it would be so much faster to do it all on paper."

In April, German insurance companies announced they were ready to deploy e-health cards throughout the country, but faced resistance from doctors and pharmacists who refused to purchase the necessary card reading equipment.

More here:

http://www.thestandard.com/news/2009/08/10/electronic-health-cards-face-resistance-germany

It seems major international projects are having trouble all over!

Third we have:

Monday, August 10, 2009

Mobile Phones Drive Health IT Innovation in Developing Countries

by Paula Fortner, iHealthBeat Senior Staff Writer

Although the U.S. health care system has dominated the media spotlight in recent months, innovative mobile technologies are helping to fundamentally transform health care in many developing countries.

Last month, the Rockefeller Foundation announced a $100 million initiative to strengthen health systems in Africa and Asia by building capacity, supporting policy interventions and promoting health IT applications.

As part of its health IT strategy, the foundation intends to leverage mobile phone-based technologies to improve health care access, quality and efficiency.

Karl Brown, Rockefeller's associate director of applied technology, explained that the foundation sees mobile health technologies "as sort of the front lines of e-health." He said that although servers, databases and Web sites will be necessary to support the mobile phone applications, health workers can use the devices to extend their reach to regions that lack adequate health care infrastructure.

An Environment Ripe for Mobile Health

According to Brown, mobile health tools are particularly suited to meet the needs of developing countries. "The thing that is very compelling about the mobile phone is that it's an infrastructure that is growing very fast of its own accord, and it exists for the most part in a lot of these countries," Brown said. He added, "The mobile phone is much more suited to a lot of these environments in some cases than a computer or a laptop or an Internet connection because it doesn't use a lot of power."

At the AED Satellife Center for Health Information and Technology, staff members work with local and international nongovernmental organizations to develop mobile data collection and dissemination tools. Andrew Sideman, Satellife's associate center director, says many regions of developing countries do not have reliable access to the Internet or even electricity.

"One of the reasons that we were interested in using PDAs, and now mobile phones is that they are very stingy with power," Sideman said. "Because the batteries can last for seven or eight hours between charges, and then they charge very quickly from a solar charger, we can circumvent the issues of not having a strong electric grid infrastructure."

Despite limitations in Internet and electricity access, most developing countries have some degree of mobile phone coverage. According to the U.N. Foundation, about 80% of the world's population lives in a region with mobile phone coverage and about 64% of all mobile phone users live in the developing world.

Brown explained that many people in developing countries already possess mobile phones and are familiar with basic functions such as making phone calls and sending text messages. Therefore, he said, it doesn't take long to train people to use new mobile phone applications such as Internet browsers or information systems.

Reporting continues here (with links):

http://www.ihealthbeat.org/Features/2009/Mobile-Phones-Driving-Health-IT-Innovation-in-Developing-Countries.aspx

Interesting material indeed.

Fourth we have:

Hospitals slow to use technology to halt errors

Don Finley, Hearst Newspapers

Monday, August 10, 2009

(08-10) 04:00 PDT San Antonio -- At a nurses station at busy Metropolitan Methodist Hospital, Dr. Randy Panther pauses to check the Caller ID on his incessantly ringing cell phone. Then he uses a high-tech device called an electronic prescription pad to order antibiotics for a patient's infection.

On the screen, a pop-up window warns that the patient has a drug allergy. The computer suggests a safer choice.

Down the hall, nurse Esther Garcia is distributing medication from a cart topped with a laptop computer and a hand-held bar code scanner - the kind used by supermarket clerks on bulky items like 20-pound bags of dog food.

First she scans the bar code label on a dose of medicine prepackaged by the hospital pharmacy. Then she scans the bar code on a patient's hospital bracelet. The laptop informs her she's giving the patient the prescribed dose.

These systems were designed to prevent errors where they commonly occur in a hospital - on the doctor's prescription pad and during the nurse's medication rounds. Some research suggests that hospitals using both systems could eliminate most medication errors, innocent mistakes that can cause grievous injury to some patients and kill others outright.

But few hospitals use the new technology. A recent survey suggests that only 17 percent of U.S. hospitals use the electronic prescription pad, more formally known as the computerized provider order entry system, or CPOE. Other surveys have found even fewer hospitals use bar coding.

Cost is a major factor - a computerized entry system can cost a major hospital upward of $11 million, according to published estimates. But experts say hospitals have had other reasons to drag their feet.

Steep adoption curve

The Hospital Corporation of America, the nation's largest private health care chain, uses bar coding in all of its 163 hospitals. CPOE, the more expensive technology, is used in about 20, including Metropolitan Methodist. But that system is still voluntary for physicians, and only a handful of the hospital's doctors use it. The rest continue to scribble on paper, putting patients at risk of misread prescriptions.

"We're looking at a very steep curve of adoption of CPOE," said Dr. Jonathan Perlin, chief medical officer of the chain.

Doctors are slow to embrace computer innovations because some recent medical software technologies "really weren't built with a professional friendliness," Perlin said.

In addition, there's debate in the profession about whether the new systems do more harm than good. When Children's Hospital of Pittsburgh launched its computerized provider order entry system in 2001, the death rate actually rose for five months. Critics blamed poorly designed software.

Nevertheless, Dr. Robert Wachter, professor of hospital medicine at UCSF and an expert on medical errors, sees promise in new systems, especially bar coding. He says it might eliminate egregious errors like the overdose of blood thinner that almost killed the newborn twins of actor Dennis Quaid in 2007.

Much more here:

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/08/09/MNN9191UJC.DTL

This is a good summary of the adoption issues of best practice in error prevention – including Health IT!

Fifth we have:

Surescripts looks to cash in on push for e-prescribing

Posted: August 10, 2009 - 5:59 am EDT

A little over a year after the merger of the two largest electronic prescribing exchanges, SureScripts and RxHub, the merged for-profit company is in line to benefit from the federal government's financial push for physicians to e-prescribe.

The privately held company, which now goes by Surescripts, already is growing quickly as a result of recent uptick in e-prescribing and from the economies of scale that resulted from the merger of the two competitors.

“E-prescribing volume has just skyrocketed, and we've handled that without adding a lot of new people,” says Surescripts President and CEO Harry Totonis. “We're processing twice as many transactions with relatively the same number of people. The efficiency we get is benefiting everyone.” Surescripts declined to provide financial data on the company.

The merger pooled the resources of two companies whose sponsors are either directly or indirectly still battling for market share in prescription drug sales. Both SureScripts and RxHub were formed in the aftermath of the 2000 bursting of the dot-com bubble that wiped out several e-prescribing startups.

In February 2001, the then three largest pharmacy benefit manager companies, AdvancePCS (later acquired by CareMark Rx, now CVS Caremark), Express Scripts and Medco Health Solutions formed RxHub to serve as their e-prescribing gateway.

Much more here (registration required):

http://www.modernhealthcare.com/article/20090810/MODERNPHYSICIAN/308109997

This is a useful discussion of the state of e-Prescribing in the US.

NZ e-records bill could be US$300m

The Dominion Post

Last updated 05:00 10/08/2009

A nationwide electronic health records system will cost at least US$300 million (NZ$447m), according to one of the world's largest health software providers.

Such a system would hold a record of a person's health history, and could be accessed by all health providers and patients themselves.

The projection comes as seven district health boards gear up to buy such a system, which could be introduced throughout the country.

ISoft chief executive Gary Cohen says given the United States with a population of about 300 million has allocated US$19 billion towards the development of electronic health records, New Zealand would have to pay at least US$300m to establish a nationwide system.

"I don't believe a proper system across the country can be done for less than that."

More here:

http://www.stuff.co.nz/technology/2734004/NZ-e-records-bill-could-be-US-300m

I am not sure why this discussion is being had. Seems to me it is a ‘how long is a piece of string’ sort of discussion. It will cost what is needed to put in place what is needed.

Seventh we have:

Health IT will be critical for data-rich decisions

By Mary Mosquera

Friday, August 07, 2009

The adoption of health information technology is aimed at improving the quality of healthcare. It will also be critical to handling the volume of patient data that will rapidly multiply as healthcare becomes more personalized, according to Dr. John Glaser, an advisor to the Office of the National Coordinator for Health IT as well as chief information officer of Partners Healthcare in Boston.

Glaser, together with ONC head Dr. David Blumenthal and Obama administration chief technology officer Aneesh Chopra, spoke at an Aug. 6 meeting of the President’s Council of Advisors on Science and Technology.

“When we look into the future, one of the things we see is the sheer volume of data that has to be sorted through,” Glaser said. “I might have hundreds of notes to go through for a patient, and I don’t have time to do that. Which are the notes most relevant to my hypothesis about the patient?”

Clinicians need business intelligence and analysis for that to occur, Glazer told the group. Similarly, physicians need to determine the true set of medications that a patient who gets care from multiple physicians across multiple organizations, is using.

More here:

http://govhealthit.com/newsitem.aspx?nid=71956

Eighth we have:

SSA to expand electronic health record project

By Mary Mosquera

Monday, August 10, 2009

The Social Security Administration announced Friday it has $24 million available for contracts with hospital networks and health information exchanges willing to electronically share the health records of patients seeking disability benefits from the agency.

SSA posted a request for proposals Aug. 7 to expand the number of healthcare organizations that will participate in the project, which links providers electronically to SSA via local HIEs and the nationwide health information network (NHIN). Responses are due Sept. 18. Contracts, which are funded through the stimulus law, will be fixed price and last 12 months.

The RFP can be found at:

https://www.fbo.gov/?s=opportunity&mode=form&id=df343db1bf298ef9336bb8da0e723863&tab=core&_cview=0

SSA in February began electronically collecting medical data from MedVirginia, a central Virginia health information exchange that links several hospitals. SSA is linked to MedVirginia via the federal CONNECT gateway, a tool that enables agencies to access the NHIN. With the new RFP, SSA wants to build on its successes with MedVirginia.

Each year, SSA makes more than 15 million patient-authorized requests for medical information from providers who have treated them. The use of health IT will vastly improve the efficiency of this still largely paper-based process, said Michael Astrue, Social Security commissioner.

“With these competitive contracts, Social Security continues to be a leader in the use of health IT to improve service to the American public,” he said.

Full article here:

http://govhealthit.com/newsitem.aspx?nid=71959

This is important standards based progress. Really quite exciting given the scale of the problem.

Ninth we have:

Big Loss for Eclipsys

HDM Breaking News, August 7, 2009

Hospital software vendor Eclipsys Corp. had a large loss during the second quarter of 2009 as revenue slightly dipped.

The Atlanta-based company recorded a net loss of $4.1 million, or seven cents per share, compared with net income of $8.5 million during second quarter of 2008. Investment analysts expected earnings per share of 12 cents. Quarterly revenue fell 1.7% to $129.8 million.

For the first six months of 2009, Eclipsys lost nearly $5 million compared with profit of $8.7 million a year ago. Half-year revenue rose 1.4% to $260 million.

Much more here:

http://www.healthdatamanagement.com/news/financial_performance-38784-1.html?ET=healthdatamanagement:e966:100325a:&st=email

Surprising a major Health IT provider is not doing better.

This report is just above water also.

http://www.healthdatamanagement.com/news/financial_performance-38785-1.html?ET=healthdatamanagement:e966:100325a:&st=email

Earnings, Revenue Down for QuadraMed

Tenth we have:

Doctors Get Better Decision Support Tools

Christus Health, a large hospital operator, deploys five clinical support offerings from Elsevier.

Christus Health, which operates about 40 U.S. healthcare facilities, is rolling out clinical decision support software from Elsevier to about two dozen of its Texas hospitals.

The non-profit, Catholic health system is based in Dallas but has hospitals, physician offices, and clinics in 70 cities in Texas, Arkansas, Louisiana, Oklahoma, Utah, and Mexico.

Christus is rolling out five Elsevier online clinical support offerings, including Clinical Pharmacology, which provides drug information. It's also using Elsevier's ToxED 2.0, which helps treat drug overdoses; First Consult, which offers point-of-care, evidence-based decision support; MD Consult, which integrates several medical resources in an online service; and Mosby's Nursing Consult, which helps nurses quickly find answers to clinical questions.

More here:

http://www.informationweek.com/news/healthcare/clinical-systems/showArticle.jhtml?articleID=219100660

It would be good to roll something like this out in Australia – for all clinicians - as recommended by Deloittes.

Eleventh for the week we have:

Online Treatment May Help Insomniacs

By AMANDA SCHAFFER

You can do almost anything on the Internet these days. What about getting a good night’s sleep?

It might be possible, some researchers say. Web-based programs to treat insomnia are proliferating, and two small but rigorous studies suggest that online applications based on cognitive behavioral therapy can be effective.

“Fifteen years ago, people would have thought it was crazy to get therapy remotely,” said Bruce Wampold, a professor of counseling psychology at the University of Wisconsin. “But as we do more and more things electronically, including have social relationships, more therapists have come to believe that this can be an effective way to deliver services to some people.”

The first controlled study of an online program for insomnia was published in 2004. But the results were hard to interpret, because they showed similar benefits for those who used the program and those in the control group. The two new studies, from researchers in Virginia and in Canada, advance the evidence that such programs can work.

In the Virginia study, called SHUTi, patients enter several weeks of sleep diaries, and the program calculates a window of time during which they are allowed to sleep. Patients limit the time they spend in bed to roughly the hours that they have actually been sleeping.

The goal is to consolidate sleep, then gradually expand its duration — the same technique that would be used in face-to-face therapy, said Lee Ritterband, a psychologist at the University of Virginia, who developed the program.

Stella Parolisi, 65, a registered nurse in Virginia and a patient in the study, said sticking to the restricted sleep schedule was hard, “but toward the end, it started to pay off.”

“Before, if I was exhausted, I would try to get to bed earlier and earlier, which was the wrong thing,” she said. “It just gave me more time to toss and turn.”

But after using the program, she began to sleep for at least one four-hour stretch a night.

Much, much, more here:

http://www.nytimes.com/2009/08/11/health/11slee.html?_r=2&ref=health

Interesting approach to getting to sleep – browsing a web site!

Twelfth we have:

AAFP subsidiary unveils networking site for docs

By Andis Robeznieks / HITS staff writer

Posted: August 11, 2009 - 11:00 am EDT

TransforMED, a wholly owned, for-profit subsidiary of the American Academy of Family Physicians, has developed a networking Web site for helping primary-care practices implement the medical home model of care.

Called Delta-Exchange, the site will provide case studies, how-to articles and other resources that provide information on topics such as developing team-based care, maximizing office space and managing change, a news release said.

Users will be charged a $30 monthly fee and will be able to post documents, share images and videos and create wiki pages. The functions of Delta-Exchange are said to be based on the findings of a two-year, medical-home national demonstration project.

More here (registration required):

http://www.modernhealthcare.com/article/20090811/REG/308119989

This is a good idea to expand Health IT use in the US GP world.

Thirteenth we have:

Elsevier launches online tool to help nurses avoid 'never events'

August 11, 2009 | Diana Manos, Senior Editor

PHILADELPHIA – Elsevier has launched an online tool to help nurses prevent the 10 "never events" identified by the Centers for Medicare and Medicaid Services.

According to officials of the Philadelphia-based healthcare information services provider, the tool empowers nurses to prevent "never events," or hospital-acquired conditions (HAC), in the quest to improve care quality and maximize hospital reimbursement.

Elsevier will make the tool available on its Mosby's Nursing Consult Web site in the CMS never events section.

"CMS Never Events supports nurses in proactively preventing avoidable incidents and ensuring that patients receive the safe, high quality and efficient care they expect from hospitals," said Eileen Robinson, director of nursing continuing education for Elsevier. "Professional nurses have a responsibility to prevent adverse events as part of a broader effort to improve quality, enhance the patient care experience and increase the hospital's financial stability."

Nursing Consult's contributors developed CMS Never Events in response to CMS' 2008 decision that it would no longer pay for adverse events that could be prevented through the application of specific evidence-based protocols. In addition, CMS does not permit patients to be billed for the cost of these events.

More here:

http://www.healthcareitnews.com/news/elsevier-launches-online-tool-help-nurses-avoid-never-events

Sounds like a good initiative.

Fourteenth we have:

Certification Recommendations OK'd

HDM Breaking News, August 14, 2009

Multiple entities could provide certification services that attest an electronic health records system meets meaningful use requirements under the American Recovery and Reinvestment Act, according to recommendations adopted today by the HIT Policy Committee.

The recommendations now go to the Department of Health and Human Services for consideration as federal officials write the rules that will implement the Medicare/Medicaid incentive programs for meaningful use of EHRs.

The recommendations also mean that the Certification Commission for Healthcare Information Technology soon could have competition. The workgroup recommends that multiple organizations be accredited to perform "HHS Certification" testing and provide certification. HHS Certification means a certifying process that is limited to the minimum set of criteria necessary to meet functional requirements of ARRA and achieve the law's meaningful use objectives.

Much more here:

http://www.healthdatamanagement.com/news/stimulus-38815-1.html?ET=healthdatamanagement:e975:100325a:&st=email

I hope having multiple groups doing this work – actually improves things.

Fifteenth we have:

AGENCY'S FORMER CEO SPEAKS OUT

Here is the statement by former eHealth Ontario CEO Sarah Kramer:

Since leaving eHealth Ontario in June, I have refrained from public comment about my time as CEO, or the controversy that prompted my departure from the organization.

However, in the last few days, a number of media reports have appeared, filled with new and misleading allegations. In these circumstances, I now feel compelled to make the following comments.

The Auditor General of Ontario is currently conducting a review of the consultant fees and all other financial matters relating to my time at eHealth Ontario – and the period that preceded me at Smart Systems for Health Agency (SSHA).

These latest media stories are an attempt to pre-empt that report and its findings.

The simple fact is that when I took over as CEO at eHealth Ontario last year, I was charged with turning around a failing behemoth – SSHA – which had already run through more than $600 million dollars with hardly anything to show for it in terms of moving Ontario closer to the goal of eHealth, and modernizing and improving the quality and safety of health care for Ontarians.

With the clear direction and full support of the Board and the government, I worked hard to jumpstart what, as SSHA, had been a moribund and deeply troubled and dysfunctional organization.

An essential part of this was shedding an internal culture that prized process above results. This had two important consequences: ruffling the feathers of an entrenched and ineffective bureaucracy, and bringing on outside consultants – among the most respected eHealth experts not just in Canada, but the world.

As with any major change, our efforts were met with strong, intractable resistance and outright hostility in some quarters, including within the Ministry of Health and among a few other vested interests in the health care sector.

Indeed, much of the sensationalized media coverage over the last several months has been based on the unchallenged accounts of those interests who opposed and sought to forestall these essential reforms which the government had mandated me to implement.

The immense opposition which confronted us made the work of outside health care and eHealth experts even more essential. The sums involved in recruiting this expertise were not negligible.

But I – with the full support of the Board of Directors – believed that was an essential investment in turning around what was a badly drifting organization.

Given the many hundreds of millions that were squandered under the auspices of SSHA, it is ironic that the much smaller amounts spent on these consultants have garnered so much attention.

These are the facts.

Rather than a continuation of these misleading and destructive news stories, I look forward to the Auditor General’s report.

Source:

http://www.thestar.com/news/ontario/article/681162

Since Ms Kramer has spoken out – it seemed fair to let people judge if her comments balance the other reports we have carried. Some of this has the ring of truth to me.

Fifth last we have:

AHRQ plans $48 million in grants for patient registries

By Mary Mosquera
Wednesday, August 12, 2009

The Agency for Healthcare Research and Quality plans to make available in the fall details of grant opportunities worth $48 million for developing national patient registries for researching the long-term effects of treatment strategies and collecting data on under-represented populations.

Beside the patient registries, AHRQ plans grants and contracts amounting to $300 million in total for comparative effectiveness projects funded by the economic stimulus. Among the projects, the agency of the Health and Human Services Department will provide grants for a coordinated national effort to study and measure the treatment benefits in routine clinical practice. AHRQ will initially concentrate on 14 common conditions, including diabetes, obesity, and heart and blood vessel conditions.

More here:

http://www.govhealthit.com/newsitem.aspx?nid=71963

First get the data and then you can make the changes!

Fourth last we have:

No, Don't Buy an EMR Now! Yes, Buy an EMR Now!

Gregory A. Hood, MD; Joseph E. Scherger, MD, MPH

Published: 08/05/2009

Introduction

Electronic medical records (EMRs) evoke strong reactions, from anger to enthusiasm. The US Government considers EMRs vital to controlling healthcare costs and improving patient care, but adoption is lagging. Doctors cite cost, work slowdown, potential problems and difficulties, and other issues as reasons to avoid an EMR. Medscape invited 2 experts to present their points of view on whether doctors should buy an EMR now.

On "point," we welcome Gregory A. Hood, MD, internist with Drs. Borders and Associates, PSC, in Lexington, Kentucky, and Governor-Elect of the American College of Physicians, Kentucky chapter. On "counterpoint," we have Joseph E. Scherger, MD, MPH, Clinical Professor of Family & Preventive Medicine at the University of California, San Diego School of Medicine California, and Medical Director of Quality and Informatics at Lumetra in San Francisco, California.

Debate here (registration required):

http://www.medscape.com/viewarticle/706725?src=mp&spon=18&uac=17738FT

Good debate – issue is timing – not whether to proceed!

Third last we have:

A Virtual Repository for Patient Records
AVPR enables health care providers to extend the reach of limited EHR systems.

By Libby Bucsi

As a health care provider, you face challenges similar to those in industries such as manufacturing, telecommunications, retail and others -- "stovepiped," non-integrated systems that store only part of the information your organization creates. Virtually all functional areas of a hospital or clinic may have their own systems, each organized around the function they support -- such as admissions, surgery, radiology, laboratory, pharmacy, HR, anesthesiology, and others -- rather than around the patient they serve.

Electronic health record (EHR) systems (which for the purposes of this article include EHRs, EMRs and EPRs) -- used by most health care organizations and designed to help manage some of this information -- often contain only 30 to 50 percent of a patient's information, either clinical or financial. The rest of this data exists in multiple locations and in varied forms, often paper. A substantial amount of patient data resides in proprietary information silos of electronic systems such as surgery, radiology, pharmacy, or even e-mail, to which EHR systems do not have access.

The volume of patient data is great and the variety of the data makes the situation even more complex. Patient data can include:

· contracts, claims and invoices;

· physical referrals, admissions questionnaires and patient-consent forms;

· test results, incident reports and consultation summaries;

· Web pages, e-mail and instant messages;

· audio, video, and picture archiving and computer systems (PACS) images; and

· enterprise application data, corporate records and procedure manuals.

The result of all this complexity? Siloed, hard-to-access digital information and scattered, poorly managed physical information, ultimately resulting in reduced quality of patient care, inefficiencies and non-compliance.

Virtual repository for patient records

To address these issues, health care providers are turning to virtual repositories for patient records (VPRs). A VPR is a central repository for all unstructured content. A VPR is not a replacement to EHR systems, but a vital adjunct. It is an adapter-based solution that complements and enhances industry-standard medical information systems such as McKesson, Epic, Picis, GE, PeopleSoft, and others that often have limited interoperability.

A VPR provides a single, consolidated, patient-centric view of information -- clinical and non-clinical -- delivered by a platform that bridges the gap between disparate systems, enables regulatory information to be managed via automated business rules, streamlines clinical and administrative processes, and effectively deals with paper. Rather than further complicating an already complicated information infrastructure, a VPR is accessed through the familiar interface of an EHR system.

Much more here:

http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=204619

This is an interesting idea. Worth a read. It seems EMC have one for sale if you are interested!

Second last we have:

Getting It Right the First Time
Testing and validation are crucial steps to take before going live with electronic health records.

By Robin Tardif

Paper-based medical charts are quickly being replaced by electronic health records (EHRs), and for good reason. EHRs allow patient records to flow seamlessly and securely across hospitals, labs and physician practices. This decreases redundant entries and clerical errors while enabling facilities to add to the existing patient record. In turn, complete and accurate information is delivered expediently, improving the delivery of health care. Additionally, since the American Recovery and Reinvestment Act of 2009 (ARRA) provides incentives for health care organizations to make meaningful use of EHRs, there is even more reason to do it quickly, and to do it right.

EHRs are still big-ticket items. Depending on the number of physicians and patients, desired interfaces, required hardware, hired consultants, and myriad options and variables, EHRs can cost hundreds of thousands of dollars, if not more. To justify that sort of expense, the return on investment (ROI) needs to be as large as possible.

EHRs bring with them a new set of rules, including access protocols, and processes/policies for the sharing and securing of patient information (not to mention expanded HIPAA regulations under ARRA). As organizations become reliant on this technology, it is crucial that it works correctly and accurately.

One of the most important methods for ensuring that your new EHR holds accurate data, works properly and will maximize your investment is to perform thorough, exhaustive testing and validation prior to implementation. Implementing an efficient system with high user retention and short transition times will help ensure that your organization's EHR meets expectations and optimizes your ROI.

Much more here:

http://health-care-it.advanceweb.com/Editorial/Content/Editorial.aspx?CC=204616

Amen to that – sensible read indeed!

Last, and very usefully, we have:

Can digital health protect your privacy?

As hospitals begin to more widely adopt electronic health records, it will take more than technology to secure your privacy.

By David Goldman, CNNMoney.com staff writer

Last Updated: August 11, 2009: 3:27 PM ET

NEW YORK (CNNMoney.com) -- Digitizing health records. A good idea say most experts, but it will take a feat of policy, technology and education to ensure your records don't get into the wrong hands.

It all starts with one basic question: Who actually owns your health records?

"Right now, hospitals assume the liability, but the model has to shift to one where the patient controls the data and whether it is put online," said Dr. David Brailer, chairman of Health Evolution Partners and former health tech czar under President Bush. "The people who hold your data control your data."

Controlling the dissemination of patient data is becoming more of a hot-button issue as the push to go digital heats up. The Obama administration is spending $20 billion on incentives to hospitals and physician offices to ensure that a national digital health network is formed by 2014.

Much more here:

http://money.cnn.com/2009/08/11/technology/electronic_health_records_privacy/?postversion=2009081115

Just a reminder that it will be both technology and people that get this done! The people need to be sure their private information will stay just that – private!

There is an amazing amount happening. Enjoy!

David.

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