Quote Of The Year

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

Thursday, February 18, 2010

Weekly Overseas Health IT Links 17-02-2010.

Here are a few I have come across this week.

Note: Each link is followed by a title and a paragraph or two. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or payment.



Monday, February 08, 2010

Provider-Sponsored PHRs Fail To Drive Patient-Centric Health Care

by Protima Advani

Industry experts believe that empowering patients in their own care -- by providing them with access to their medical information, along with appropriate resources to manage their health -- can significantly improve outcomes and even reduce health care costs.

So it is not surprising that engaging patients and families in care is one of the five goals of CMS’ recently proposed "meaningful use" definition. Specifically, to qualify for the meaningful use incentives, hospitals and physicians are expected -- among other requirements -- to provide patients with electronic copies of their record, discharge instructions and procedures.

While the stage 1 meaningful use requirements do not mandate any one medium for providing patients with access to their record, one could argue that personal health records are the ideal platform for engaging patients in care because, as defined by HHS, a PHR is "[a]n electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual."



How the Lack of Prescriptive Technical Granularity in HIPAA Has Compromised Patient Privacy

Tim Wafa

Loyola Law School Los Angeles

February 3, 2010


This paper argues that HIPAA legislation has a severe flaw within its architecture; a flaw which is severely compromising patient privacy. Although the drafters of the legislation recognized the importance of providing comprehensive privacy legislation at the federal level (to improve uniformity amongst states), they failed to recognize the importance highly specific ("granular") technical requirements play in facilitating improved privacy for patients.

This paper suggests that HIPAA rules surrounding technology implementation give too much latitude to covered entities. Consequently, the rules fail to provide adequate protection to protected health information.

HIPAA rules should be amended to mandate baseline technical granular standards to ensure uniform efficacy in the safeguarding of protected health information.



'Meaningful Use' -- You Can Do This!

By Rosemarie Nelson | February 09, 2010

Certified EHR technology used in a meaningful way is one piece of a broader Health Information Technology (HIT in techie jargon) infrastructure intended to reform the healthcare system and improve healthcare quality, efficiency, and patient safety.

Under the HITECH Act, the Medicare EHR incentive programs provide payments up to $44,000 over five years to eligible professionals who are "meaningful" users of certified electronic health records.

The Medicaid EHR program provides even bigger incentives -- up to $63,750 over five years to practices with a 30% or higher Medicaid population for efforts to adopt, implement, or upgrade certified EHR technology or for meaningful use in the first year and up to another five years. (Pediatricians need only a 20% Medicaid patient volume to qualify.)



Obama administration to announce HIT grant details

By Associated Press

Posted: February 12, 2010 - 10:30 am ET

The Obama administration is awarding $975 million in grants to help states and healthcare providers adopt health information technology.

The grant money being announced today during a 12 p.m. ET conference call comes from the economic stimulus legislation passed by Congress last year and is part of the administration's push to get doctors, hospitals and others to move from paper to computerized record-keeping. Administration officials say the grants are designed to provide savings down the road by eliminating duplicative tests and time-consuming paper work.



What The U.S. Can Learn From Denmark About Health Care

By Gina-Marie Cheeseman | February 12th, 2010

President Obama touted the merits of computerizing health records last year. “This will cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests,” said Obama. “It won’t just save billions of dollars and thousands of jobs — it will save lives by reducing the deadly but preventable medical errors that pervade our health care system,” he added. Obama pledged $19.5 billion from the stimulus to begin to computerize medical records by 2014. The funds will be used to provide incentives to doctors and hospitals that accept Medicare and Medicaid patients. Ninety percent of physicians and hospitals do accept Medicare and Medicaid patients. Kathleen Sebelius, Health and Human Services secretary, calls the plans to move to electronic record-keeping “one of the linchpins” of changing the country’s health care system.



Internet role in consumer healthcare reigns supreme

February 10, 2010 | Bernie Monegain, Editor

NEW YORK – The Internet has considerably more influence over consumer health decisions and actions than traditional channels like print, TV and radio, according to a new report from Manhattan Research.

"Health Influence Mapping: Benchmarking the Influence of Various Sources on Consumer Health Actions" points out that though the Internet's role in healthcare has soared over the past decade, healthcare professionals still have the strongest effect on consumer health behavior.



Work force issues to be examined in physician survey

Primary care doctors also are being asked how their practices have been impacted by the recession.

By Susan J. Landers, amednews staff. Posted Feb. 10.

About 9,000 primary care physicians nationwide are being surveyed to examine work force matters, medical homes and other practice issues.

One goal is to help determine whether there are enough primary care physicians to tend to the nation's needs -- especially if insurance coverage is extended to more people in a reformed health system.



CPOE challenging, but once done, physicians 'never go back'

February 11, 2010 | Kyle Hardy, Community Editor

WASHINGTON – Implementing a computerized physicians order entry system poses multiple challenges, with physician engagement at the top of the list.

“It is a complex and involved process,” said Leah Binder, CEO of the Washington, DC-based Leapfrog Group. “It involves a wide variety of clinical staff and you need to integrate with other systems. Also, the provider needs a CDS (clinical decision support) system that alerts physicians to potential errors, which there are a lot of.”

Implementing CPOE is a major requirement for Stage 1 meaningful use eligibility. Meaningful use Stage 1 requires providers to submit at least 10 percent of all orders using a CPOE system.



Halamka, Bates spotlight health IT use in Boston

February 10, 2010 | Mike Miliard, Managing Editor

BOSTON – Stressing the benefits of early action – and illustrating just how much farther ahead in adoption Massachusetts is than many other parts of the country – two significant local users of healthcare IT offered insights from their experiences in Boston on Tuesday.

Speaking at the Healthcare Stimulus Exchange Roadshow, John Halamka, CIO of both Beth Israel Deaconess Medical Center and Harvard Business School, and the chairman of the New England Health Exchange Network (NEHEN), and David Bates, chief of general internal medicine and the medical director for clinical and quality analysis at Partners HealthCare and Brigham and Women's Hospital, each spoke about their organizations' use of healthcare IT and and efforts to meet meaningful use requirements.

Bates opined that the entire country is on the cusp of a "major transformation of the healthcare information technology landscape." From his own perspective, he said he expected Partners to do well on that "ascension path," and indicated that Massachusetts at large was similarly well-postioned. For some other states and localities, however, he predicted that "it will be a challenge…. we're only in the position we're in because we started early."



Friday, February 12, 2010

Federal Officials Tout Importance of Health IT Adoption

by Kate Ackerman, iHealthBeat Editor

Last week, three high-level federal officials tasked with overseeing different areas of the Obama administration's agenda walked into the same conference room, stood at the same podium and touted the same thing -- health IT.

Chief Technology Officer Aneesh Chopra, National Coordinator for Health IT David Blumenthal and Agency for Healthcare Research and Quality Director Carolyn Clancy spoke at a joint plenary session of the National Health Information Exchange Summit, the Health IT Summit for Government Leaders and the Eighteenth National HIPAA Summit.



Few docs have IT to track language barriers: study

By Jennifer Lubell / HITS staff writer

Posted: February 11, 2010 - 10:45 am ET

Physicians are struggling to overcome language and cultural barriers in communicating with patients, according to a new national survey released by the Center for Studying Health System Change.

The survey, Modest and Uneven: Physician Efforts to Reduce Racial/Ethnic Disparities, funded by the Robert Wood Johnson Foundation, found that nearly half (48.6%) of all physicians in 2008 had reported minor communications problems associated with language or cultural barriers, affecting their ability to provide high-quality care. While less than 5% viewed it as a major problem, physicians' efforts to overcome communication barriers “are modest and uneven,” the survey stated.



RHIO setbacks haunt HIE users: study

By Joseph Conn / HITS staff writer

Posted: February 11, 2010 - 10:45 am ET

Throughout much of the previous decade, regional health information organizations were the cart before the horse of electronic health-record system implementations.

RHIOs were extensively promoted by federal and state governments—and a fair share of not-for-profit organizations—as the preferred means to achieve the desired end of interoperability of electronic health information.

That may no longer be the case—both semantically and operationally—as the current buzz phrase for much the same thing as a RHIO is the health information exchange/organization, or HIE/HIO. And the federal emphasis, based on dollars, at least, is now on a program to subsidize the adoption of EHRs and their “meaningful use.” Information exchange is just one of several meaningful-use criteria.

But the same basic problems that beset those early RHIO pioneers remain unsolved for many HIE participants today, according to a newly released study of the commercial IT systems used by HIEs. The survey was conducted by health IT market watcher KLAS Enterprises, Orem, Utah.



Microsoft tapping current product line for personal health IT

Posted by Dana Blankenhorn @ 7:14 am

Most computing for personal health takes place on gadgets, often custom-made.

Microsoft is looking to change that. They have tasked senior researcher Desney Tan with finding ways to integrate their existing product line — including phones and game machines — with health data.

The XBox, for instance, is a computer, and costs less than a PC. The main XBox site advertises systems starting at $199.



Survey: Older, wealthier patients more likely to see docs with EMRs

February 11, 2010 — 2:11pm ET | By Neil Versel

The conventional wisdom is that younger doctors are more likely to use EMRs than their more senior counterparts--at least when the relative newcomers have a say in the buying decision. But does patient age matter when it comes to EMR adoption? A new survey seems to suggest just that.

In a survey of 1,000 U.S. adults conducted by GfK Roper Public Affairs & Media on behalf of EMR vendor Practice Fusion, nearly 53 percent of those over the age of 65 reported that their primary-care physicians kept records electronically of their last visit, compared to just 40 percent in the 24 to 34 age group. Overall, 48 percent of respondents said their primary-care physicians had EMRs, seemingly backing up estimates by the American Academy of Family Physicians, which has said for several years that perhaps half of all family practitioners were using EMRs.



Kibbe: New ONC standards make CCHIT process 'irrelevant'

February 11, 2010 — 1:37pm ET | By Neil Versel

The Certification Commission for Healthcare Information Technology has had its fair share of critics. Some have been the kind of anonymous Internet ranters with either a personal axe to grind or perhaps a screw loose, but many have been both respectful and professional in airing their grievances.


Doctors Use Of EHRs Growing

The government's healthcare IT stimulus package seems to be having a positive impact on electronic health record adoption.

By Antone Gonsalves, InformationWeek

Feb. 11, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=222700824

The number of doctors replacing paper with electronic health record systems has grown since the government's healthcare IT stimulus package was signed into law, a study released Wednesday showed.

More than 48% of the people surveyed by GfK Roper for IT vendor Practice Fusion said their doctor or specialist stored medical records electronically in the examination room, as opposed to writing information on paper charts. Of those patients, more than 45% said their doctor made the switch in the last two years, and more than 14% said the switch occurred in the last six months.



Kiosks: Self-serve Patient Satisfaction

Technology can be a differentiator for health care organizations.

By Kathleen Gaffney

They're not new. We see them everywhere -- in airports, banks, hotels, etc. But how often do we see kiosks in our doctor's office? Not so often. However, their usage in health care is on the uptick. One study predicted that kiosks are approximately two years away from mainstream adoption.1 Why this drive toward adoption? According to a recent health care consumer survey2:

  • consumers want more convenience and control;
  • 37 percent surveyed said they were "extremely" or "very" interested in using a self-service kiosk to help them check in for medical appointments more quickly; and
  • more than 43 percent said they have chosen one medical provider over another because he/she offered self-service.



Act now

The Information Commissioner’s Office can now fine data controllers £500,000 for serious breaches of the Data Protection Act. Yet NHS organisations continue to breach the act on a more or less monthly basis. Daloni Carlisle looks for solutions.

Given the wall to wall press coverage devoted to data breaches, you might have thought that the NHS was now security aware and that we had seen the end of lost laptops and USB sticks containing unencrypted patient records.

But Simon White, associate solicitor at Browne Jacobson Solicitors, and the man that many NHS trusts turn to when things go wrong, says not.

“About once a quarter an NHS doctor puts patient data onto their own laptop. It’s not password protected or encrypted and then the laptop gets stolen,” he says. Then the trust calls him.



6 February 2010

eHealth Worldwide

:: Canada - Reaching agreement for an Aboriginal e-health research agenda: the Aboriginal telehealth knowledge circle consensus method (27 January 2010 - Rural and Remote Health)

In Canada, telehealth has been successfully implemented in a number of Aboriginal communities with subsequent improvements to access to health care and quality of life. However, there are many knowledge gaps that limit our understanding of the broad range of Aboriginal e-health issues; a research agenda is urgently required. The objective of this research was to develop an Aboriginal e-health research agenda designed to address the substantial knowledge gaps that impede e-health deployment and adoption particularly in rural and remote Aboriginal communities in Canada. A consensus method based on Aboriginal culture, values and approaches to consensus was developed to achieve this.



VA solicits health IT innovations from employees

By Mary Mosquera

Tuesday, February 09, 2010

The Veterans Affairs Department has launched a competition among its employees to see who can come up with the best ideas for how to use health IT to improve the agency’s healthcare practices and treatments.

VA will choose 100 of the ideas and invite their authors to submit full proposals.



Most fed health plans offer PHRs, but few use them

By Mary Mosquera

Monday, February 08, 2010

More health insurance plans are offering federal employees personal health records (PHRs) and other health IT for keeping track of records or to compare cost and quality, according to the Office of Personnel Management.

But despite the wide availability of PHRs from these plans, few federal employees actually use them, OPM said in an annual report published Feb. 5.



Better medicine – with bar codes

Health: MultiCare uses advances in technology to offer better care to patients and to save money

KELLY KEARSLEY; Staff writer

Published: 02/07/1012:04 pm | Updated: 02/07/1012:04 pm

As nurse Jeremy Copeland chats up patient Wilhelmine Erickson on a recent afternoon at Tacoma’s Allenmore Hospital, he also quickly waves a bar-code reader over her wristband then scans the medication he is giving her.

The action is barely noticeable – seamlessly entwined with Copeland’s questions to Erickson, 85, about how she’s feeling, his flushing of her IV line and handing her a dose of Tylenol.

But the technology at work is significant. Scanning Erickson’s bar code brings up her medical chart on a nearby, portable computer. The electronic system notes that she’s been given the Tylenol – and would alert Copeland if the medication or dose was wrong.



Soft 4Q for Cerner Beats Expectations

HDM Breaking News, February 10, 2010

The stock price of Cerner Corp. rose slightly during early trading on Feb. 10 after the software vendor reported lower earnings in the fourth quarter of 2009 that still beat investment analyst expectations.

Kansas City, Mo.-based Cerner had fourth quarter net income of $60.5 million, down 15 percent from the same period a year ago. Adjusted earnings per share of 75 cents were three cents higher than anticipated.



Electronic Release of Clinical Laboratory Results: A Review of State and Federal Policy

The National Academy for State Health Policy

January 2010

Health information exchange (HIE) -- in particular the electronic sharing of laboratory results -- is the subject of this paper from The National Academy for State Health Policy. State and national initiatives using HIE are gaining momentum in the wake of the American Recovery and Reinvestment Act of 2009 (ARRA), which provides over $40 billion to promote health information technology, including electronic health records (EHRs) and HIE.



Health Affairs: Common ground scarce in global e-health adoption

The full potential of e-health to meet both U.S. and global health objectives is not being tapped, which will remain the case until a conducive environment and appropriate global e-health policy are in place, according to an article in the February issue of Health Affairs.

“Attention needs to be directed toward policy issues that will enable and facilitate patient mobility, data mobility and sharing across both international borders and regional boundaries within countries,” wrote Maurice Mars, MD, head of the department of telehealth at the Nelson R. Mandela School of Medicine at the University of KwaZulu-Natal in Durban, South Africa, and Richard E. Scott, PhD, from the department of community health services at the University of Calgary in Canada.



London SCR roll out complete in a year

09 Feb 2010

NHS London is aiming to create Summary Care Records for 100% of the people living in the capital that want one by March 2011.

This week, the strategic health authority kicked off its ambitious roll-out strategy by launching its Public Information Programme for 1.5m Londoners in five primary care trusts.

NHS London told EHI Primary Care that Public Information Programmes (PIPs) for the rest of the capital’s residents will be launched shortly, with the aim of ensuring that all patients in London will have received information about the SCR by mid-April.



Blumenthal: Meaningful use must stretch – not break – providers

By Mary Mosquera

Friday, February 05, 2010

Dr. David Blumenthal, the national health IT coordinator, said that he wants to “stretch” the healthcare community but not “break” it in setting the conditions under which providers can qualify for financial incentives to use health IT.

That’s how he described how his office will determine how high to set the bar for physicians and hospitals to become “meaningful users” of electronic health records. Blumenthal spoke at a joint presentation of the Health IT Government Leaders, Health Information Ex change and HIPAA summits Feb. 4.



TPG Capital, CPP Investment to acquire IMS Health

By Shawn Rhea / HITS staff writer

Posted: February 9, 2010 - 11:00 am ET

Shareholders of the healthcare market research company IMS Health, Norwalk, Conn., have approved an acquisition deal that calls for the company to be purchased by investment funds managed by TPG Capital and CPP Investment Board, according to a news release.


Does Anybody Care About HIPAA Anymore?

Gienna Shaw, for HealthLeaders Media, February 9, 2010

HIPAA got a big boost from the 2009 HITECH act, which extended privacy rules to business partners, threatened steeper penalties for violations, and promised periodic audits. But even with the beefed-up rules, these days HIPAA just doesn't seem to be that big a priority—to anyone.

One reason HIPAA elicits the big ho-hum is that, despite the fact that Health Information Technology for Economic and Clinical Health (HITECH) Act purports to be very serious about privacy violations, there hasn't been a lot of governmental follow-through. It's like dad telling the kids he's going to count to three and then saying, "One . . . two . . . two and half . . . two and three quarters . . ."



KLAS Counts 89 Real HIEs

HDM Breaking News, February 9, 2010

Axolotl Corp., Epic Systems Corp. and Medicity Inc. have the largest market shares of live, "validated" health information exchanges, according to a new report from KLAS Enterprises, a vendor research firm.

In its first look at HIE technology, Orem, Utah-based KLAS validated 89 live HIEs using commercial applications to exchange data. KLAS defines validation as meaning these HIEs are using the technology to share patient data that is being viewed by doctors, and exchanging data among facilities that are not owned by the same organization.



Docs using scribes to ease EHR transition

By Joseph Conn / HITS staff writer

Posted: February 8, 2010 - 11:00 am ET

Part one of a two-part series:

Scribe. The word might conjure up images of an ancient, white-bearded man, bent over papyrus scrolls, scratching away with quill pens.

And the profession has to be older than Methuselah, since what we know of Noah's 969-year-old grandfather was written down by succeeding generations of scribes.

Today, however, organizations seeking to implement the latest wrinkle in medical record-keeping, electronic health-record systems, are looking to new generations of scribes—to increase physician productivity and to overcome the pitfalls of the still typically clunky physician/EHR interface, and to ease the strain of EHR implementations and replacements.

“The word is biblical,” said Linda Pierog, practice manager for Emergency Medicine Services of Orange County, or EMSOC, and its ScribeMD service, which provides scribes as part of its emergency room physician staffing program.



Implementing EHR in a Hurry

HDM Breaking News, February 8, 2010

A new report from ECRI Institute, a Plymouth Meeting, Pa.-based research firm, lays out 10 steps hospitals should take to select and implement an electronic health record system on an accelerated timetable.


The report, "Investing in an Electronic Health Record," is in ECRI's January Health Devices magazine, available here. The cost is $285.

--Joseph Goedert



FCC to promote mobile health apps

February 05, 2010 | Mary Mosquera, Government Health IT

WASHINGTON – The Federal Communications Commission wants to foster the use of wireless devices and applications in healthcare as part of a national broadband plan the agency expects to release next month, according to a senior FCC official.

The FCC plan will describe “where government has a role to reduce some of the hurdles to these technologies both in connectivity and to promote innovation in applications,” said Mohit Kaushal, MD, digital healthcare director of the FCC’s Omnibus Broadband Initiative.



February 1, 2010

Do Privacy Hurdles Impede Data Exchange?

By Elizabeth S. Roop

For The Record

Vol. 22 No. 2 P. 14

The industry searches for middle ground in the debate over how to exchange protected health information without violating patients’ privacy rights.

The passage of the American Recovery and Reinvestment Act (ARRA) brought with it a bevy of new regulations governing the protection and use of protected health information (PHI) designed to strengthen HIPAA and sharpen the teeth of state-level privacy laws. It also added fuel to an already heated debate that pits some privacy advocates against those who champion the unfettered exchange of deidentified PHI to improve healthcare access, quality, and safety, as well as to advance medical research.

Central to this debate are questions regarding a patient’s right to privacy vs. the industry’s need to advance technologically and scientifically. Specifically, are privacy laws that restrict the sharing of PHI preventing effective data exchange and impeding the scientific research necessary to advance the practice of medicine?

“Privacy laws aren’t hindering anything. In fact, privacy laws are exactly what enable your information to be shared with the people and places you want it to be shared with,” says Deborah C. Peel, MD, founder and chairman of Patient Privacy Rights, a medical privacy watchdog organization. “The myth that consumer control over PHI is an obstacle was dreamed up by the insurance industry, the vast health data-mining industry, and those who want to use and sell data without our permission.”



Blumenthal: EHRs will become 'an absolute requisite' for docs

February 05, 2010 | Diana Manos, Senior Edito

WASHINGTON – It may seem unlikely today, but within the next 10 years there will be widespread use of electronic health records across the country, the nation's health IT chief predicted Thursday.

David Blumenthal, MD, the national coordinator for health information technology spoke at the 18th National HIPAA Summit in Washington DC, where other federal officials and stakeholders said the adoption of healthcare IT is urgent.

"History has shown that things that improve healthcare become part of what is used," Blumenthal said. "I propose to you that in a few years doctors will all support EHRs," he said. "Using EHRs will become a core competency for physicians. And once we've established that, it will be considered an absolute requisite."



National IDs 'out this year', says authority By Bernard Lugongo

The national identity cards will start to be issued before the end of the year, the National Identification Authority (Nida) said yesterday.

Nida executive director said in Dar es Salaam that the process of engaging the company that would produce the IDs was in the final stages.

The $176 million (about Sh200 billion) project has been delayed for decades now with documents, meetings and tendering moving from one office to the other. And now it has attracted the international community, including the World Bank.



JAMA: EHR adoption timeline too aggressive

The push is on for healthcare providers to make the switch to EHRs but it is hard to tell how well these complex health IT systems are being implemented and used, according to a Feb. 3 commentary in the Journal of the American Medical Association.

To improve monitoring, co-author Dean Sittig, PhD, an associate professor at the University of Texas School of Health Information Sciences at Houston, and David Classen, MD, associate professor of medicine at the University of Utah School of Medicine in Salt Lake City, have called for coordinated oversight by both the healthcare providers implementing these systems and by government authorities.


February 08, 2010

EMR Pioneer: Mobile Health Is Overtaking E-Health

Peter Waegemann, vice president of the Boston-based mHealth Initiative, made some bold and controversial statements at the opening and closing sessions of the mHealth Networking Conference in Washington, D.C. last week.

Waegemann, an international pioneer in the use of electronic medical records or “EMRs,” was the founder and long-time CEO of the Medical Records Institute, where he worked with Claudia Tessler to promote the adoption of EMRs for 25 years before he decided to focus primarily on mobile health developments. In his keynote address, Waegemann summed up the lessons learned from that decades-long effort, concluding that eHealth movement a universal failure and proclaiming a new era of “mHealth.”




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