Quote Of The Year

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


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, March 05, 2010

Weekly Overseas Health IT Links 04-03-2010.

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.



FDA Considers Regulating Safety of Electronic Health Systems

By Fred Schulte and Emma Schwartz
Huffington Post Investigative Fund

Created 2010-02-23 19:03

Reports of Patient Harm Include Six Deaths in Two Years

Concerned about potential safety risks in health information technology, the U.S. Food and Drug Administration may be moving closer to regulating the systems for the first time.

In the past two years, the agency has received reports of six patient deaths and several dozen injuries linked to malfunctions in the systems, Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, said in testimony prepared for a government hearing on Thursday.

“Because these reports are purely voluntary, they may represent only the tip of the iceberg,” Shuren said.

The FDA has been studying the issue for several years. Its latest concerns are surfacing as the government ramps up an ambitious plan to spend as much as $27 billion in stimulus money helping doctors and hospitals across the country purchase electronic medical records systems that rely on digital software rather than paper medical charts.



Report: Physician EMR Market Has No Clear Leader


Despite the presence of companies such as IBM, 3M, Dell and Wal-Mart, no single vendor dominates the market for EMRs, according to a report from Kalorama Information, a healthcare market research publisher based in New York.

The report states that while the EMR market is estimated at $13.8 billion, at least 70 percent of that market represents sales to hospitals and health systems, with large IT companies such as McKesson, Cerner, Eclypsis and MediTech maintaining a fairly strong hold on that segment.



Five holes in your organization's IT security structure

February 24, 2010 | Nancy McCallum, Contributing Writer

Total security in an IT infrastructure is ideal, but it's not always the reality. According to Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, a 2009 study by the Ponemon Institute revealed that 80 percent of healthcare IT departments surveyed reported breaches.



EHR market forecast at $5.4B by 2015

February 25, 2010 | Bernie Monegain, Editor

SAN JOSE, CA – The market for electronic medical record systems in North America will exceed $5.4 billion by 2015, according to a new report from Global Industry Analysts.

The same report, "Electronic Medical Record Systems: A North American and European Market Report," pegs the European market at $1.4 billion by 2015.

Global Industry Analysts, Inc., (GIA) is a publisher of off-the-shelf market research. The company employs more than 800 people worldwide and publishes more than 1,100 full-scale research reports each year.



Surgeon General, Microsoft form PHR partnership

By Joseph Conn / HITS staff writer

Posted: February 25, 2010 - 11:00 am ET

The U.S. Surgeon General's Office has announced a collaboration with software giant Microsoft Corp., linking the government-developed and free My Family Health Portrait online health history development tool with Microsoft's HealthVault personal health-record platform.

The new government venture with Redmond, Wash.-based Microsoft “enables consumers to easily record their family health history and integrate the information stored in their My Family Health Portrait profile into a personal HealthVault account,” according to a news release.


Privacy experts predict what first CPO will face

By Joseph Conn / HITS staff writer

Posted: February 25, 2010 - 11:00 am ET

Healthcare information technology and privacy advocates generally approve of last week's announced selection of Joy Pritts, a Georgetown University researcher and lawyer, as the nation's first chief privacy officer, or CPO, within the Office of the National Coordinator for Health Information Technology.

Pritts' first day on the job was Feb. 16, said her new boss, David Blumenthal, who heads the ONC. The announcement came just as time was about to run down to a statutory deadline for the appointment. The position was created by Congress in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, which required the HHS secretary to make the appointment of a CPO within one year of enactment.



Thursday, February 25, 2010

Health IT Industry Still Waiting for Guidance on EHR Certification

A day before the Dec. 31, 2009 deadline for HHS to adopt an initial set of electronic health record standards, CMS and the Office of the National Coordinator for Health IT released a proposed rule describing how providers can demonstrate "meaningful use" of EHRs and an interim final rule describing the required certification standards for EHR technology. The interim final rule took effect on Feb. 12 -- 30 days after its publication in the Federal Register, and comments on the proposed rule are being accepted until March 15.

As health care providers and vendors ramp up in an effort to meet the regulations to qualify for Medicare and Medicaid incentive payments under the 2009 federal economic stimulus package, there is still one big missing puzzle piece -- guidance on the EHR certification process.



Survey: We're Not Ready for Meaningful Use

HDM Breaking News, February 24, 2010

A recent survey of C-level executives from 168 provider organizations, mostly hospitals, shows only a third of respondents expect to meet the first deadline for receiving Medicare/Medicaid incentive payments for meaningful use of electronic health records.

The survey also shows nearly half of respondents expect the meaningful use deadlines to be extended. Beacon Partners, a Weymouth, Mass.-based consulting firm, commissioned the survey. Aloft Group, an independent market research firm in Newburyport, Mass., conducted the survey.


Full survey results are available at beaconpartners.com/ehradoption/BeaconPartners_EHR_AdoptionStudy.pdf.

--Joseph Goedert



CSC: More hospitals are promoting 'integrated' EHRs in their communities

February 25, 2010 — 2:28pm ET | By Neil Versel

Meaningful use of EHRs undoubtedly will require interoperability of electronic health information between care settings, as well as coordination of care. With physician practices largely "still on the fence" about investing in EHR technology, according to a new Computer Sciences Corp. report, the time seems right for hospitals and health systems to take the lead in promoting "integrated EHRs" that go beyond their own facilities to serve physician offices in their communities.

"For health organizations, the ability to help with electronic health records is becoming a competitive edge," Dr. Todd Rothenhaus, senior VP and CIO at Caritas Christi Health Care in Boston, says in the CSC report. "The ones that look away from this miss an opportunity to align with a physician who might go to another hospital system because they are supporting an EHR.


For more:

- download the CSC report (.pdf)



CHW ups total EMR investment to $1 billion

February 25, 2010 — 2:49pm ET | By Neil Versel

Following a successful EMR implementation at eight California hospitals, Catholic Healthcare West will invest another $419 million to bring electronic records to its entire 27-hospital network and affiliated physicians over the next seven years. The additional outlay will bring the total project cost to slightly more than $1 billion.

The Cerner EMR, which includes CPOE and bar-coded medication administration, will help standardize care delivery, improve patient safety and broaden physician access to patient data. "This financial commitment is about preparing for a future that better integrates patient data with care delivery. Electronic health records will help ensure that we are able to provide quality, affordable healthcare in a compassionate setting," CHW President and CEO Lloyd Dean says, according to the San Francisco Business Journal.



HHS awards $100M for pediatric e-health records

Grants will go to 10 awardees in 18 states

Pediatric electronic health records are getting a boost from the Health and Human Services Department. HHS is handing out $100 million in grants to states through 10 awards for innovations in children’s health data.

Eight of the 10 awardees will collect and analyze data on children’s health care quality measures. HHS’ eventual aim is to establish a nationwide system for measuring the performance of children’s health care providers.



Information exchanges have positive effect: GAO

By Rebecca Vesely / HITS staff writer

Posted: February 24, 2010 - 11:00 am ET

Electronic personal health information exchanges are helping providers better coordinate patient care and root out abuse, concludes a report by the Government Accountability Office.

The review of four health information exchanges indicates that they are having a positive effect on quality of care, the GAO said in the report issued this month.

The GAO is required to conduct reviews of these exchanges under the Health Information Technology for Economic and Clinical Health Act, or HITECH, portion of the American Recovery and Reinvestment Act signed by President Barack Obama in 2009.



Mayo to Study Home Telehealth

HDM Breaking News, February 23, 2010

Mayo Clinic will conduct a year-long telehealth study to assess if use of patient monitoring devices in the home can reduce emergency department visits and hospitalizations.

The clinic, with partner GE Healthcare, will implement the Intel Health Guide devices of Santa Clara, Calif.-based Intel Corp. in the homes of 200 older, high-risk patients who receive care at Mayo's facilities in Rochester, Minn. Patients on a daily basis will measure such vital signs as blood pressure, pulse and weight, and respond to questions specific to their condition.



February 15, 2010

Beat the Odds

By Selena Chavis

For The Record

Vol. 22 No. 3 P. 20

Automating the emergency department is crucial to efficient hospital operations, but successfully implementing and managing an EDIS has proven to be a difficult endeavor.

Consider the following statistics: In the United States, the annual number of emergency department (ED) visits jumped from 90.3 million in 1996 to more than 119 million in 2006, a 32% increase, according to the most recent Centers for Disease Control and Prevention (CDC) National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary.

At the same time, the number of EDs fell from 4,019 to 3,833, and the percentage of nonobstetric hospital admissions that came through EDs climbed from 36% in 1996 to more than 50% in 2006. And according to industry professionals, that trend is not expected to change in the near future, further elevating the need for effectively automating ED systems and workflows to mesh efficiently into providers’ overall success.



Applying Transformative Technology

UPMC achieves successful data-sharing with technologies that render clinical information meaningful.

By G. Daniel Martich, MD, and William A. Fera, MD

The University of Pittsburgh Medical Center (UPMC) has long been at the forefront of innovation, both in clinical practice and deployment of IT solutions. But when UPMC abandoned its plan for a monolithic approach to IT in favor of a best-of-breed strategy, the organization had no way of knowing it would become a poster child for health care data interoperability.

In the June 2009 issue of ADVANCE for Health Information Executives, UPMC shared insight into its adoption of an interoperability platform designed to support the meaningful exchange of data originating from diverse systems, delivered to clinicians at the point of care. UPMC's 2006 decision to build a singular interoperability platform around its current and projected clinical IT capabilities was based on a belief that such an approach would accelerate provider adoption, increase utilization and, therefore, be the most economical option in the long run.

In the months that followed, UPMC's leadership received confirmation from a number of indicators that its approach is sound and highly successful. The model has expanded within its user base, involving an ever-increasing range of clinical systems and data sources, and delivering additional patient information directly to the bedside and exam room.



Technology Outlook 2010

Health care executives share their views on technologies that will make a difference in 2010 and beyond.

Over the past several weeks, ADVANCE has been gathering opinions on what will be the most significant technologies for health care during 2010. We asked health care IT experts to highlight areas that have the potential to make a real impact on their respective organizations this year. Read on for a sampling of the executive comments from facilities across the country. And please add your perspective by using the "Comments" function at the end of this article.



GPs back cuts to NHS Direct and NPfIT

23 Feb 2010

NHS Direct and the National Programme for IT in the NHS are both appropriate targets for cuts in the current economic climate, according to GPs.

A survey of almost 900 GPs by the GP newspaper Pulse found that 59% thought the health helpline NHS Direct should take a funding cut while 52% thought the national programme should have its budget reduced.



23 February 2010

eHealth Worldwide

:: Australia: Australia to mandate health ID number (17 February 2010 - eHealth Europe)
The Australian government has said it will mandate a new national e-health number for all citizens. The move to mandate the unique 16-digit health ID number, to be introduced from July, comes despite an earlier Government promise the new "e-health" system would be on an opt-in basis. While the new health ID number will not hold information, it is intended to form the basis of a planned new system of electronic health records.



Posted date: 2/22/2010

Electronic Records Translate to Better Patient Care, Doctors Say

HEALTH CARE: Convenience, Reduced Errors Balanced By Privacy, Security Issues


In the near future, more medical practices in San Diego County are likely to adopt electronic systems of their patients’ medical records.

Behind the drive is a push by the Obama administration, which began with the previous Bush administration, to have electronic health records for every American by 2014 as a way to improve health care and cut costs. Several local physicians, who already use electronic medical records systems, find electronic record-keeping offers major advantages. Among them, convenience, efficiency, elimination of duplicate procedures and reduction of medical and billing errors.



Chilmark Needs to Chill Out on CCR/CCD Findings

Posted by Vince Kuraitis on · Filed in EHRs/PHRs, Information & Communication Technologies (ICT) · Comments

John Moore of Chilmark Research and I agree on things 90+ percent of the time. He even thanked me personally for our collegial relationship in a Thanksgiving Day essay on his blog.

However…I can’t help but comment on John’s misleading story “CCD Standard Gaining Traction, CCR Fading” in The Health Care Blog. He writes:

In a number of interviews with leading HIE [Health Information Exchange] vendors, it is becoming clear that the clinical standard, Continuity of Care Document (CCD) will be the dominant standard in the future. The leading competing standard, Continuity of Care Record (CCR) appears to be fading with one vendor stating that virtually no client is asking for CCR today.



EMR Adoption: Starting to Evolve or Still Stuck in the Past?

Gienna Shaw, for HealthLeaders Media, February 23, 2010

In preparation for my new beat as technology editor for HealthLeaders Media, I've been reading back issues of HealthLeaders magazine.

One story in particular caught my eye: a 2007 cover story called EMR Pushback with the catchy subhead "Will physicians ever give up their paper?" A good question at the time—and still relevant today. In the article, we listed the top five reasons physicians groups were resisting EMRs, according to the Medical Group Management Association:

  • Lack of support from members
  • Lack of capital resources
  • Concern about the ability of physicians to input data
  • Concern about the loss of productivity during transition
  • Inability to easily input historic data



Criteria for Accrediting HIEs Released

HDM Breaking News, February 22, 2010

The Electronic Healthcare Network Accreditation Commission has released for public review and comment much of the criteria for its upcoming Health Information Exchange accreditation program.

Industry-sponsored EHNAC, based in Farmington, Conn., presently operates nine accreditation programs for transactions processors and other service providers. The organization will accept comment on the HIE criteria through April 23. The criteria are available at ehnac.org/ehnac/AccreditationProcess/Criteria.aspx. EHNAC is seeking beta candidates for the HIE accreditation program.



HHS Posts Data Breach Notifications

HDM Breaking News, February 23, 2010

The Office for Civil Rights in the Department of Health and Human Services has launched a Web page listing covered entities that have reported breaches of unsecured protected health information affecting more than 500 individuals.

The posting is mandated under the HITECH Act, and comes as the grace period for enforcement of the data breach notification rules has passed. Breach notification rules from HHS and the Federal Trade Commission (covering personal health records vendors) have been in effect since late September. Officials at both agencies used enforcement discretion to not impose sanctions for failure to report breaches until Feb. 22.



Tuesday, February 23, 2010

Employers Must Drive Health Care Innovation and Efficiency -- Apparently Nobody Else Will

Spiraling health care spending threatens the long term economic solvency of the U.S. government as well as the global competitiveness of American corporations. Where health care goes, so goes the economy. By now you've probably heard this repeated over a thousand times.

To Whom Should We Look for Solutions?

Despite the largest Democratic majority in a generation, Congress was for the past year unable to pass health care reform legislation. And even if they had, the proposed reform was more oriented towards improving access than containing costs.

In a recent interview with The New Yorker, Harvard Health Care Economist David Cutler -- the senior health care adviser to the Obama presidential campaign -- described Medicare as "a robotic program that collects bills and pays, collects bills and pays," adding that, "Medicare has been essentially brain dead, not doing a thing to promote quality."




AMIA receives $630K for global e-health training program

Written by Editorial Staff

February 22, 2010

The Rockefeller Foundation has awarded a $630,100 project support grant to the American Medical Informatics Association (AMIA) to support the initial implementation of a global e-health training program in sub-Saharan Africa designed for primary care providers, technical staff and health policymakers.

The Rockefeller grant will support Health Informatics Building Blocks (HIBBs), a program developed by the Bethesda, Md.-based AMIA in which distance-learning supports clinical and health informatics training in low-resource countries where greater understanding and use of informatics and databases can enable better support of community care and public health services, according to the New York-based foundation.



Intelliware Development Inc. to showcase e-Health Interoperability Suite at HIMSS Conference

2010-02-23 01:14:28 –

Intelliware Development Inc. will exhibit at the Healthcare Information and Management Systems Society annual conference and exhibition taking place March 1-4, in Atlanta, Georgia.

Toronto, Canada. February 23, 2010 –

Intelliware will be showcasing the Intelliware e-Health Interoperability Suite, including the Test Level 7 (TL7) interoperability and conformance testing product and the HL7 v3 Validation Tool. These products will highlight Intelliware’s HL7 expertise and its capabilities in the development, integration and interoperability testing of e-Health applications for healthcare clients, partners and providers. To accelerate your e-Health development project, drop by booth 1407 at HIMSS10 or visit www.intelliware.ca/ehealth.



Sky's the limit for B.C.'s e-health spending

Failure to meet national standards on electronic record-keeping has kept federal dollars from flowing

By Vaughn Palmer, Vancouver SunFebruary 23, 2010

The B.C. Liberals adopted the promise of electronic health records in their first term, joining a national plan that came with federal funding in exchange for helping to develop a single, nationwide system.

Electronic records were supposed to be completely portable -- from family doctor to specialist, laboratory to hospital, clinic to emergency room, and from community to region to province.

But universal compatibility, while understandable in terms of the original vision for the project, is turning out to be one of the greatest and most costly complications of the drive for e-health.

For as B.C. Auditor-General John Doyle noted in a report released last week, the province faces a big challenge in meeting federally dictated standards to access those federal dollars.



Government, With Billions In Loans, Bets Electronic Medical Records Can Improve Care

The New York Times reports that electronic health records hold potential for major improvements in health outcomes for patients as the federal government puts a renewed emphasis on implementing and digitizing patients' information. "President Obama's economic stimulus included $19.2 billion for health information technology, and a number of hospital systems around the country are taking advantage of this financial incentive and investing their own money to foster the creation and use of electronic records that are expected to improve the quality, efficiency and safety of medical care." Digital records avoid duplication of tests, reduce errors, make surgery safer and encourage better self-care but privacy concerns remain (Brody, 2/22).



Federal Committee Recommends Changes to EHR Meaningful Use Rule

Andrea Kraynak, for HealthLeaders Media, February 22, 2010

The conversation continues regarding the effectiveness, appropriateness, and reasonableness of the EHR meaningful use criteria proposed earlier this year.

The Health Information Technology (HIT) Policy Committee, a federal advisory committee, recommended many changes, some significant, to the EHR meaningful use proposed rule in a recent draft letter to National Coordinator for Health Information Technology David Blumenthal.



Texas docs grow more bullish on EHRs, survey finds

By Andis Robeznieks / HITS staff writer

Posted: February 22, 2010 - 11:00 am ET

Physician use of electronic health records continued to grow in Texas last year, with younger doctors and primary-care physicians leading the charge with indirect access specialists—such as anesthesiologists and emergency medicine doctors—lagging behind, according to a survey by the Texas Medical Association.

The survey also found that purchase, training and implementation costs are dropping and that almost 60% of the respondents reported interest in qualifying for the EHR subsidies included in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.



New Obama Health Plan Has I.T. Angles

HDM Breaking News, February 22, 2010

President Obama has released a detailed summary of a new health care reform plan that includes several proposals that would use information technology to reach specific goals. Many of the I.T. proposals target waste, fraud and abuse in the industry.

The President's proposal, however, does not appear to include a provision that was in the House and Senate reform bills that called for adoption of "operating rules" that would augment the HIPAA transaction standards.



HHS to survey Medicare patients on PHR use

By Mary Mosquera
Sunday, February 21, 2010

The Health and Human Services Department plans to survey 500 Medicare beneficiaries this fall about difficulties and benefits they may have experienced using personal health record (PHR) systems.

The Centers for Medicare and Medicaid Services last year began offering PHR tools to Medicare fee-for-service patients in Arizona and Utah to help them track their health and healthcare services.



Fast Company selects top innovators in healthcare

February 19, 2010 | Bernie Monegain, Editor

NEW YORK – GE, athenahealth, and Sermo are among the top 10 innovative healthcare companies named by Fast Company. Kaiser Permanente is the sole healthcare provider on the list.

GE was recognized for its Healthymagination initiatives, athenahealth for its work on the physician billing, practice management and medical records front, and Sermo for its online physician community.

"This recognition is emblematic of a culture and spirit at Kaiser Permanente that enables the transformation of healthcare," said Kaiser Permanente CIO Philip Fasano. "Our electronic health record and Garfield Health Care Innovation Center are exciting examples of the innovation fostered throughout our organization and are the starting point in our journey to deliver real-time, personalized healthcare."



ER App Documents Medical Necessity

HDM Breaking News, February 17, 2010

Picis Inc. has introduced software to document medical necessity decisions when a patient is held for observation in the emergency department or admitted to the hospital.

The LYNX CareBridge application integrates with version 5.0 of the Wakefield, Mass.-based vendor's Picis ED PulseCheck emergency department information system. CareBridge enables hospitals to document the decision of where to place a patient and bill appropriately, with documentation later available to defend admissions decisions if an audit is started, according to the vendor.



Understand Your Environment

A patient registry at the foundation of your HIT infrastructure allows you to leverage existing systems.

By Lorraine Fernandes, RHIA

Whether your organization has health information technologies (HIT) in place today or preparations for meaningful use are just beginning, the time is now to understand your environment, locate where patient information exists today and prioritize your needs. Enterprise data management is complex and even further complicated by the data quality and political governance challenges that arise when organizations attempt to share or exchange information.

To understand your ability to create a patient centric record that is complete, timely and accurate, ask the following questions:

· Can patient information be retrieved without a unique patient identifier such as Social Security number?

· Can updates to this information be shared with outside facilities or between inpatient and outpatient facilities?

· Are there gaps in the information due to its location in specialty systems or practices outside your organization's four walls?

· How much time does your staff spend seeking information to facilitate care coordination?

· Can you achieve a single view of patient data across your organization to report quality measures?



Policymakers speed work on broadening NHIN

By Mary Mosquera

Friday, February 19, 2010

A Health and Human Services Department advisory panel has stepped up its efforts to identify standards and services that would open up the nationwide health information network to providers who need simple ways to share health data.

Providers as well as states need advice on how to set up health information exchange systems as soon as possible, said Dr. David Blumenthal, the national health IT coordinator. His office recently announced financial awards to state organizations to develop health information exchange systems.

“I don’t have to tell you about the pressure that organizations and providers in the field are under to exchange information,” he said at a meeting of the Health IT Policy Committee Feb. 17.



Survey: Top CMIO focus is on reducing errors

February 22, 2010 — 12:43pm ET | By Neil Versel

Chief medical information officers and other medical informatics directors tend to love their jobs and want to stick around for a while, even though this is a relatively new position for many organizations, according to a survey of this discipline by CMIO magazine.

Two-thirds of the 118 CMIOs who took the online survey said they were "very satisfied" or "somewhat satisfied" with their compensation and 86 percent indicated they had no immediate plans to leave their jobs. The majority of CMIOs earn between $180,000 and $300,000 annually in base salary, though a third of survey respondents make less than $180,000 a year. Nearly half did not receive a bonus in 2009, reflecting the moribund economy, though 56 percent say they expect to get one this year.




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