Saturday, October 17, 2009

Report and Resource Watch – Week of 12, October, 2009

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:

Three Barriers to Effectively Using Information Stored in EHRs

Carrie Vaughan, for HealthLeaders Media, October 6, 2009

The healthcare industry won't realize the full value of its investment in electronic health records until it finds secondary uses for all of the data being captured, such as predicting public health trends and improving patient care, according to a report by PricewaterhouseCoopers Health Industries Group.

Seventy-six percent of the more than 700 healthcare executives surveyed in June 2009 said that the information gathered in EHRs will be their organization's biggest asset in the next five years. But very few healthcare organizations are building systems and care delivery processes to effectively use the billions of gigabytes of data being collected.

"I'm surprised that more thought hasn't been given to the broader idea of using the clinical and administrative data to do continued improvement and process improvement in the industry," says Dan Garrett, head of the health IT practice at PricewaterhouseCoopers. "People are so busy doing the basic digitization of the whole industry that they haven't had time to think through what they will do with all of this data, and so it has not been taken into consideration in the deployment of some of these larger systems."

Healthcare executives should be thinking beyond implementing EHRs to how they want to use this data after the technology is in place. "If you know that you are going to try and aggregate the data and make statistical sense out of it, you are going to do it in a very different way than if you are designing a transactional CPOE," explains Garrett.

Much more here:

http://www.healthleadersmedia.com/content/240117/topic/WS_HLM2_TEC/Three-Barriers-to-Effectively-Using-Information-Stored-in-EHRs.html

“There are some organizations that are already working through these obstacles, and the report "Transforming Healthcare through Secondary Use of Health Data," highlights the experiences of these five industry leaders.”

An interesting and useful piece of research and set of case studies.

Link in text above.

Second we have:

AHIMA Introduces a Bill of Rights

HDM Breaking News, October 5, 2009

The American Health Information Management Association has unveiled a Health Information Bill of Rights, a set of seven principles for protecting health care consumers.

The Chicago-based association introduced the document during its annual convention, being held Oct. 3-8 in Grapevine, Texas. The association in November will make available for downloading via its Web site a wall poster of the rights for display in waiting areas, and a certification that an organization pledges to upload the seven principles.

More here:

http://www.healthdatamanagement.com/news/consumers-39164-1.html

The details are found here:

http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_045343.pdf

Third we have:

Meaningful Use for Hospitals: The Top Ten Challenges

Author:

Jane Metzger, Erica Drazen, Beverly Bell

Summary:

Much is at stake for U.S. hospitals as they advance the implementation of the inpatient EHR, not just the financial incentives of HITECH, but also the urgent need for the EHR as an enabler of the efficient, reliable, high-quality care that positions the organization to thrive in the future, regardless of the approach to health care reform. Achieving meaningful use represents a huge clinical and operational change project on a compressed timeline. We believe that hospitals that learn from the experience of others and succeed on the top ten challenges defined in this white paper will be well on the way to achieving meaningful use.

Download Meaningful Use for Hospitals: The Top Ten Challenges.

More here:

http://www.csc.com/health_services/insights/34489-meaningful_use_for_hospitals_the_top_ten_challenges

A worthwhile contribution from CSC on the US plan to require ‘meaningful use’.

Fourth we have:

Associations Between Structural Capabilities of Primary Care Practices and Performance on Selected Quality Measures

Mark W. Friedberg, MD, MPP; Kathryn L. Coltin, MPH; Dana Gelb Safran, ScD; Marguerite Dresser, MS; Alan M. Zaslavsky, PhD; and Eric C. Schneider, MD, MSc

6 October 2009 | Volume 151 Issue 7 | Pages 456-463

Background: Recent proposals to reform primary care have encouraged physician practices to adopt such structural capabilities as performance feedback and electronic health records. Whether practices with these capabilities have higher performance on measures of primary care quality is unknown.

Objective: To measure associations between structural capabilities of primary care practices and performance on commonly used quality measures.

Design: Cross-sectional analysis.

Setting: Massachusetts.

Participants: 412 primary care practices.

Measurements: During 2007, 1 physician from each participating primary care practice (median size, 4 physicians) was surveyed about structural capabilities of the practice (responses representing 308 practices were obtained). Data on practice structural capabilities were linked to multipayer performance data on 13 Healthcare Effectiveness Data and Information Set (HEDIS) process measures in 4 clinical areas: screening, diabetes, depression, and overuse.

Results: Frequently used multifunctional electronic health records were associated with higher performance on 5 HEDIS measures (3 in screening and 2 in diabetes), with statistically significant differences in performance ranging from 3.1 to 7.6 percentage points. Frequent meetings to discuss quality were associated with higher performance on 3 measures of diabetes care (differences ranging from 2.3 to 3.1 percentage points). Physician awareness of patient experience ratings was associated with higher performance on screening for breast cancer and cervical cancer (1.9 and 2.2 percentage points, respectively). No other structural capabilities were associated with performance on more than 1 measure. No capabilities were associated with performance on depression care or overuse.

Limitation: Structural capabilities of primary care practices were assessed by physician survey.

Conclusion: Among the investigated structural capabilities of primary care practices, electronic health records were associated with higher performance across multiple HEDIS measures. Overall, the modest magnitude and limited number of associations between structural capabilities and clinical performance suggest the importance of continuing to measure the processes and outcomes of care for patients.

More here:

http://www.annals.org/cgi/content/abstract/151/7/456

Links to full paper here above if have subscription. More good news on the impact of Health IT

Fifth we have:

Healthcare Featured Article
October 05, 2009

Healthcare Information Technology Systems Market to Reach $53.8 Billion by 2014: Report

By Anamika Singh, TMCnet Contributor

According to a new report by MarketsandMarkets, a research and consulting firm, healthcare information technology systems market will be worth $53.8 billion by 2014.

The healthcare information technology report presents the size of global healthcare information technology market over the period 2009 to 2014. The report studies the healthcare IT market with emphasis on key trends of the market.

The report segments the global healthcare information technology market by components and geographic regions. It analyzes the key market drivers, restraints and opportunities of the global healthcare information technology market.

According to the research, the healthcare information technology market is estimated to grow at a CAGR of 16.1 percent. The market is expected to grow because of the growing demand for general applications, which includes electronic medical records, electronic health records, computerized physician order entry system and non clinical systems. Also, it is expected that the market for general applications will rise at an overall CAGR of 13.0 percent from 2009 to 2014.

More here:

http://healthcare.tmcnet.com/topics/healthcare/articles/65756-healthcare-information-technology-systems-market-reach-538-billion.htm

Seems it is growing like topsy! The vendors will be pleased! Link is in the text to summary. Full report costs real dollars!

Sixth we have:

ONC releases patient data ‘preferences' draft

By Joseph Conn / HITS staff writer

Posted: October 7, 2009 - 11:00 am EDT

HHS' Office of the National Coordinator for Health Information Technology has released for public comment a 42-page draft document intended to ultimately guide and perhaps even control healthcare organizations in how patients' can express their “preferences” on the use of their medical records and healthcare data.

The so-called Consumer Preferences Draft Requirements Document is equivalent to what was called a “use case” during the Bush administration. Use cases were chosen by the then-guiding health IT advisory body, the American Health Information Community, and then handed over to the Health Information Technology Standards Panel, or HITSP, for identification and harmonization of needed standards to carry out the tasks outlined in the use case.

As in the Bush administration, patients are called “consumers” throughout the latest ONC document under the leadership of David Blumenthal, President Barack Obama's choice as national coordinator. Then as now, selection of the specific standards to implement the patient choices in the draft document was left in the draft document for others to make. The level of control patients will have over the use of their medical information also was left open in the draft document, but its authors at least contemplate applying whatever constraints are chosen to the concept of “meaningful use.” Only providers that use electronic health record systems in a “meaningful" manner may qualify for the estimated $34 billion in federal subsidies to purchase and operate EHRs under the American Recovery and Reinvestment Act of 2009, or stimulus law. Fleshing out what constitutes "meaningful use" remains a work in progress at HHS and the CMS, the latter of which will be responsible for administering the bulk of the EHR subsidy program and will set the final meaningful use standards.

Much more here:

http://www.modernhealthcare.com/article/20091007/REG/310079988

These are important issues and the range of choices and options should be looked at closely

Lastly we have:

6 October 2009

eHealth Worldwide (Intelligence Report)

:: Brazil: Brazil-Based Subsidiary to Serve Regional Offshore Medical Market (16 September 2009 - Reuters)

...will offer 24/7 services from its offices in Rio de Janiero, with Brazilian physicians providing care to personnel on offshore rigs and remote sites in the region. Through the InPlace Medical Solutions’ unique video-telemedicine medical service, physicians examine and diagnose ailments of offshore workers remotely.

:: Europe: Annual EU healthcare index puts The Netherlands in “uncontested leadership” (28 September 2009 - Health Consumer Powerhouse)

The Euro Health Consumer Index 2009 groups 38 indicators of quality into six categories: Patient rights and information, e-Health, Waiting time for treatment, Outcomes, Range and reach of services provided and Pharmaceuticals

Heaps of other links here:

http://www.who.int/goe/ehir/2009/6_october_2009/en/index.html

Other reports worth knowing about.

Smartcards and Identity Management.

The paper is available at smartcardalliance.org/pages/activities-councils-healthcare.

And here:

The white paper

"The State of US Hospitals Relative to Achieving Meaningful Use Measures,"

is available at himssanalytics.org/docs/HA_ARRA_100509.pdf?hpr20091007.

Good stuff!

Enjoy!

David.

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