Just an occasional post when I come upon a few interesting reports and resources that are worth a download or browse. This week we have a few.
First we have:
Healthcare Information Technology Standards Panel Specifications Library
On-Line Specifications Library
Welcome to the web-based version of the Healthcare Information Technology Standards Panel Specifications Library.
This site contains HTML versions of the most current HITSP specifications as of July 15, 2009. These versions allow a user to easily navigate among the HITSP documents. The library is available on-line and with an off-line library available for download here. The download is a Winzip archive and can be extracted to a local directory for off-line browsing of the documents.
Much more and the full set of specifications here :
Clearly an important resource for all interested in how the US is going about standardising Health IT. The work is supported by ANSI.
Second we have:
Gov’t Advisors Call for HIE Certification
HDM Breaking News, July 20, 2009
The federal government should certify that networks and software facilitating health information exchange meet requirements for meaningful use of electronic health records, the Information Exchange Workgroup of the HIT Policy Committee recommends.
Such certification would ease the burden on providers for meeting and demonstrating adherence with meaningful use requirements, the workgroup contends. In its initial recommendations, the workgroup made the argument for setting HIE requirements that address meaningful use.
A lot of health information exchange happens today, but the vast majority occurs in a small number of transaction silos such as laboratory orders/results and electronic prescribing, according to the recommendations. “The market hasn’t responded as quickly and effectively as needed to have robust health information exchange today. Meaningful use can be strengthened and focused with some level of policy and technical requirements related to health information exchange.”
More here:
The Information Exchange Workgroup’s recommendations soon should be available at healthit.hhs.gov. Click on Public-Private Initiatives, then Health IT Policy Committee.
This makes pretty good sense to me.
Third we have:
Internet-Based Self-management Plus Education Compared With Usual Care in Asthma
A Randomized Trial
Archives of Internal Medicine
21 July 2009 | Volume 151 Issue 2 | Pages 110-120
Background: The Internet may support patient self-management of chronic conditions, such as asthma.
Objective: To evaluate the effectiveness of Internet-based asthma self-management.
Design: Randomized, controlled trial.
Setting: 37 general practices and 1 academic outpatient department in the Netherlands.
Patients: 200 adults with asthma who were treated with inhaled corticosteroids for 3 months or more during the previous year and had access to the Internet.
Measurements: Asthma-related quality of life at 12 months (minimal clinically significant difference of 0.5 on the 7-point scale), asthma control, symptom-free days, lung function, and exacerbations.
Intervention: Participants were randomly assigned by using a computer-generated permuted block scheme to Internet-based self-management (n = 101) or usual care (n = 99). The Internet-based self-management program included weekly asthma control monitoring and treatment advice, online and group education, and remote Web communications.
Results: Asthma-related quality of life improved by 0.56 and 0.18 points in the Internet and usual care groups, respectively (adjusted between-group difference, 0.38 [95% CI, 0.20 to 0.56]). An improvement of 0.5 point or more occurred in 54% and 27% of Internet and usual care patients, respectively (adjusted relative risk, 2.00 [CI, 1.38 to 3.04]). Asthma control improved more in the Internet group than in the usual care group (adjusted difference, –0.47 [CI, –0.64 to –0.30]). At 12 months, 63% of Internet patients and 52% of usual care patients reported symptom-free days in the previous 2 weeks (adjusted absolute difference, 10.9% [CI, 0.05% to 21.3%]). Prebronchodilator FEV1 changed with 0.24 L and –0.01 L for Internet and usual care patients, respectively (adjusted difference, 0.25 L [CI, 0.03 to 0.46 L]). Exacerbations did not differ between groups.
Limitation: The study was unblinded and lasted only 12 months.
Conclusion: Internet-based self-management resulted in improvements in asthma control and lung function but did not reduce exacerbations, and improvement in asthma-related quality of life was slightly less than clinically significant.
More here:
http://www.annals.org/cgi/content/abstract/151/2/110
I wonder why there were so few patients studied given the relative simplicity of the intervention. A study with more statistical power would have been more useful given the trends towards improvement.
There is a Reuters report here:
http://www.reuters.com/article/healthNews/idUSTRE56J5GW20090720
Web-based care may improve asthma control
Mon Jul 20, 2009 6:01pm EDT
By Amy Norton
Fourth we have:
Report Endorses Health Cost-Cutting Moves
HDM Breaking News, July 20, 2009
To cut health care administrative costs, providers and payers should move to standardized approaches for credentialing clinicians, verifying insurance, providing patient ID cards and confirming insurance authorization of radiology and pharmacy services, a new report recommends.
The report from the Healthcare Administrative Simplification Coalition contends that as much as a quarter of U.S. health care spending goes to administrative functions, which often are duplicative.
The report is entitled “Bringing Vetter Value: Recommendations to Address the Costs and Causes of Administrative Complexity in the Nation’s Healthcare System”
More here:
More information is available at simplifyhealthcare.org.
The key proposals are as follows:
“The simplification of clerical work would potentially reduce healthcare costs by at least 10 percent without affecting the quality of care or having any substantial negative effects. While even greater cost savings are conceivable, a 10 percent elimination of unnecessary clerical work would generate annual savings of as much as $57 billion on healthcare. Our recommendations for achieving savings in four key areas include:
- Encouraging Simplification of the Practitioner Credentialing Process
- Encouraging Simplification in the Healthcare Insurance Eligibility Process
- Encouraging Standardized, Machine-Readable Health Identification Cards
- Encouraging Simplification of Prior Authorization Processes”
Download the full report here:
http://www.simplifyhealthcare.org/repository/Documents/HASC-Report-20090717.pdf
This is the elephant in the room for the US Health system. The possible savings are just enormous!
Fifth we have:
National Health Information Exchange Survey Shows Increased Activity, Cost Savings, Positive Impact on Physician Practices
More Initiatives Exchanging Data Leads to New Improvements in Quality and Returns on Investment
WASHINGTON DC (July 22, 2009) The exchange of health information electronically between physicians, hospitals, health plans, and patients has increased substantially in the last year and is reducing the cost of care and positively impacting physicians, according to a new survey released by the non-profit eHealth Initiative (eHI) today. “Migrating Toward Meaningful Use: The State of Health Information Exchange,” a report based on eHI’s Sixth Annual Survey of Health Information Exchange, includes responses from 150 community-based initiatives and shows a nearly 40 percent increase in the number of advanced or “operational” initiatives exchanging information. Responses from operational initiatives demonstrate an increasingly positive impact on the efficiency of care while showing a return on investment (ROI).
“One of the greatest challenges has been our ability to spread best practices in health information exchange,” added Covich. “Cost savings and improved quality of care need to be better documented, so we can replicate what works and help create a health care system that connects clinicians and providers. We have a great opportunity to expand HIE efforts with the new funding coming out in 2009 and 2010 through the Recovery Act. We need to take advantage of this moment in time, when health information technology and health information exchange enjoy broad support. We might not get another.”
The release is found here:
http://www.ehealthinitiative.org/
The key findings from the 2009 survey are available here. Much more detail is available by following this link.
Lastly we have the:
Survey: Consumers Keen on Telemedicine
HDM Breaking News, July 23, 2009
Nearly three-fourths of U.S. consumers say they would use telemedicine, defined as remote monitoring to track their condition and vital signs, a new survey shows.
The online survey of 1,000 consumers was commissioned by the Health Research Institute unit of PricewaterhouseCoopers, a New York-based consulting firm.
More here:
The report is entitled “Jammed Access: Widening the Door to Health Care”
Go here to register and download.
Enough goodies for one week!
Enjoy!
David.
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