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 26, 2010

Weekly Overseas Health IT Links 23-03-2010.

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.



Study: E-prescribing greatly improves accuracy, less so for safety

March 18, 2010 — 11:53am ET | By Neil Versel

It's a small study group, but the results are eye-opening nonetheless: Primary-care practices cut their prescription error rates from 42.5 percent to 6.6 percent in a one-year period by adopting e-prescribing technology.

That's the finding of researchers at Weill Cornell Medical College in New York City, as reported in the Journal of General Internal Medicine, who studied the prescribing accuracy of 12 primary-care practices in New York state. Six of the practices wrote prescriptions electronically, resulting in the major reduction in errors, while the half-dozen practices in the control group that stuck with paper prescription pads had a small uptick in their error rate, from 37 percent to 38 percent.



Broadband plan aims to improve HIT infrastructure

By Shawn Rhea / HITS staff writer

Posted: March 19, 2010 - 11:00 am ET

The Federal Communications Commission has laid out an ambitious 10-year plan for drastically improving broadband connectivity and usage that, among other goals, aims to improve healthcare delivery, patient outcomes and control medical costs nationwide.

In a chapter dedicated to healthcare information technology infrastructure and usage, the National Broadband Plan offered 11 recommendations for how the government could incentivize healthcare providers' use of e-care technology, which FCC officials estimated would save the country $700 billion over the next 20 years. The recommendations include reimbursement incentives that pay providers for adoption and use of e-care services, such as remote diabetes monitoring and mobile medical applications, that are proven to improve patient outcomes and save money. The agency also proposes setting up a dedicated healthcare broadband access fund that would help providers pay for broadband services in areas where connectivity is more expensive because of a dearth of available service providers.



Letter tells CMS to set more specific EHR goals

By Jennifer Lubell / HITS staff writer

Posted: March 18, 2010 - 11:00 am ET

To successfully implement the broad use of electronic health records, the CMS needs to make its health goals and targets more explicit, according to public comments submitted by healthcare leaders from 56 organizations on the agency's meaningful-use rule.

The Markle Foundation, the Center for American Progress and the Engelberg Center for Health Care Reform at Brookings were the three organizations that coordinated these comments and submitted them to the CMS in response to several rules governing meaningful use and certification of EHRs.

The rulemaking originated from the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, which provided billions of dollars in federal subsidy payments to hospitals and office-based physicians for the purchase of EHR systems. HHS plans to administer the new subsidies beginning in 2011.



Catering staff given access to electronic health records

The Irish Independent says that catering staff were able to access confidential patient information held on a £54m health service record system which is being rolled out across Ireland.

The disclosure, under the Freedom of Information Act, has implications for the roll-out of Summary Care Records in England, as part of the NHS IT programme, NPfIT.

Smartcards for access to the Summary Card Records and other NPfIT systems are issued on the basis of "role-based" access. The idea is that only those staff with a legitimate professional relationship with the patient can use their smartcards to access that patient's records.

But local operational procedures may require that secretaries and reception staff who collect information on patients have smartcards.



Getting Physicians and Patients Connected

The EHR rollout process has been a gradual - and successful - one for Kaiser Permanente.

By Mark McGraw

It's no secret that the concept of electronic health records (EHRs) hasn't been universally embraced throughout the physician community.

Despite the inevitable move to a digital health care environment, some doctors are holding on to the idea that EHRs will bog down their practices, limit the number of patients they see each day and depersonalize the doctor/patient relationship.

The findings of a recent Nuance Healthcare Solutions survey echo those concerns. The poll of nearly 1,000 physicians found that 96 percent of respondents expressed fear "about losing the unique patient story with the transition to point-and-click (template-driven) EHRs."

The survey also found that 93 percent of doctors "disagree" or "strongly disagree" that using an EHR has reduced time spent documenting care.

It's unlikely that many physicians at Kaiser Permanente share those sentiments, however, at least according to Jack Cochran, MD, executive director of The Permanente Federation, the national umbrella organization for the regional Permanente Medical Groups.



AHA Recommends Changes to EHR Standards, Implementation

Andrea Kraynak, for HealthLeaders Media, March 16, 2010

Adding its voice to the EHR standards debate, the American Hospital Association asked for changes to proposed EHR standards, implementation, and certification.

The AHA sent its recommendations and comments regarding the interim final rule specifying the initial set of standards, implementation specifications, and certification criteria for EHR technology to the National Coordinator for Health IT in a March 15 letter.



Hospitals as Software Service Providers

Health systems are stepping into a new role, offering software as a service to realize value from EMRs.

It's no secret that small physician groups and community hospitals are going to be hard-pressed to meet the meaningful use requirements in 2011. Not only do they lack resources—financial and workforce—to purchase, implement, maintain, and use these systems effectively, but their options for electronic medical record products are limited, as well. Many of the vendors that support smaller hospitals began by offering financial systems and now are adding the clinical components to those systems.

There are approximately 4,000 hospitals with fewer than 250 beds, and the products for those hospitals will take a lot of heavy lifting to get them certified for meaningful use, says Chuck Podesta, senior vice president and chief information officer at Fletcher Allen Health Care, a 562-licensed-bed academic medical center in Burlington, VT. "These smaller systems don't have a good clinical track record—especially with computerized physician order entry," he says.



Device Manages Care Online For Chronic Disease Patients

Mar 17, 2010

The Cleveland Plain Dealer: A pilot project at the Cleveland Clinic that monitored 250 patients with chronic diseases showed patients were able to increase the number of days between visits. The study used a medical device that shared daily patient data online with doctors and nurses and found that patients better managed their care using the system.



Sutter hospitals to invest in electronic health records system


Published Tuesday, Mar. 16, 2010

Sutter Health said Monday it will push forward with converting to electronic health records at its hospitals after delaying the project to save money during the recession.

The health system expects to spend $400 million over the next five years to expand its digital medical system, with Sutter Medical Center going online in 2013, when expansion of its 28th Street campus is complete.

While the economy is still very unpredictable, the hospital system will go forward with the project, said Pat Fry, the chief executive officer for Sutter Health.

"There's never going to be a great time, so let's give the value to our patients as quick as we can," Fry said.



Scots GPs say paper should guide portals

16 Mar 2010

GPs in Scotland have demanded that a series of security measures are introduced to protect patient confidentiality when their records are accessed electronically.

Last week’s Scottish Local Medical Committees’ conference heard that GPs are coming under increasing pressure to share information from their records with the introduction of clinical portals across Scotland.

However, GPs agreed that secondary care clinicians should not have access to the whole of the GP record. Instead, they agreed that only information that would normally be shared on paper should be available to them electronically.



Scots MPs criticise slow progress on IT

11 Mar 2010

The Scottish Parliament's Health and Sport Committee has criticised the Scottish Government for the slow roll-out of its clinical portal and limited progress on telehealth.

In a two part report, ‘Clinical portal and telehealth development in NHS Scotland,’ the committee praises several Scottish health boards for developing clinical portal projects to enable greater access to patient information.

However, it says that: “The committee is disappointed that, given the differing states of readiness of various portal systems, clear timescales have yet to be established for the development of portal technology across Scotland.”

It also calls for the Clinical Change Leadership Group and the Clinical Portal Programme Board to work closely with the Scottish Academic and Research Community to design “a nationwide portal infrastructure.”



Patients' medical records go online without consent

Patients’ confidential medical records are being placed on a controversial NHS database without their knowledge, doctors’ leaders have warned.

By Kate Devlin, Medical Correspondent

Published: 10:20PM GMT 09 Mar 2010

At present 1.29 million people have had their details placed on the system. A further 8.9 million records are due to be added by June

Those who do not wish to have their details on the £11 billion computer system are supposed to be able to opt out by informing health authorities.

But doctors have accused the Government of rushing the project through, meaning that patients have had their details uploaded to the database before they have had a chance to object.



NHS database raises privacy fears, say doctors

GPs say patients' rights are being overlooked

Doctors' leaders are warning government ministers that the NHS is jeopardising its relationship of trust with patients by creating a vast database of personal medical records. GPs say they fear patients' rights are being overlooked, that "scaremongering" is being used to get people's agreement for the database, and that hackers could illegally access the central computer.

The NHS wants more than 50 million people in England to agree to the creation of an individual summary care record (SCR). The idea is to improve the quality and safety of treatment provided by hospital staff and out-of-hours doctors by giving them access to information usually only held by a patient's doctor.



Doc, hospital groups press CMS on meaningful use

By Andis Robeznieks / HITS staff writer

Posted: March 16, 2010 - 11:00 am ET

To facilitate meaningful use of electronic health records, the CMS should abandon its all-or-nothing approach to awarding financial incentives, eliminate goals and measures that don't directly apply to EHR adoption, and widen the eligibility for certain hospital-based physicians, according to a letter sent to acting CMS Administrator Charlene Frizzera. The letter was signed by the American Medical Association and 95 other state and specialty medical societies.

The 37-page letter stated that “physicians are deeply supportive and committed to incorporating well-developed EHRs into their practices,” but the “aggressive” criteria included in the proposed requirements for federal EHR-investment subsidies will deter many physicians from participating in the incentive program, which was included in the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.


Computer-Controlled Pancreas Could Close the Diabetes Loop

Gienna Shaw, for HealthLeaders Media, March 16, 2010

Aaron Kowalski is the vice president for glucose control research at the Juvenile Diabetes Research Foundation. He also has type 1 diabetes and, like many others who have the condition, he sometimes struggles to regulate his blood sugar levels.

"I'm a scientist and I work in the field and I don't achieve perfect glucose control," he says.

In that he is not alone: Some studies have found that even highly-managed diabetes—those who test their blood sugar more than eight times a day, still spend almost 70% of their day out of normal blood ranges—an average of more than eight hours with high blood sugar levels and two hours with low.



EHTEL calls for local action

16 Mar 2010

The European Health Telematics Association has called for more regional and local level approaches to eHealth across Europe.

Speaking to E-Health Europe at the World of Health IT conference and exhibition in Barcelona, a spokesperson for the non profit organisation, said that eHealth needs to be done from the bottom-up.

The spokesperson said: “We need to look at the level that we can start doing real things with eHealth and that is at regional level.

"It isn’t at member state because it’s too big. It can only be at regional or below because otherwise there are too many people and it’s too complex.”

The organisation’s comments come ahead of its board meeting and coincided with the signing of a declaration by European eHealth ministers.



EU ministers sign ehealth declaration

15 Mar 2010

European Union health ministers have signed a declaration that recognises the strategic value of eHealth and commits to greater collaboration across Europe.

The declaration was signed at the high-level ministerial conference on eHealth in Barcelona, which is part of the World of Health IT conference being held this week.

It was driven the Spanish presidency of the EU, which wants eHeath to be an integrated part of European policies.

As part of the declaration, the ministers responsible for eHealth said that they recognised the “importance of fully integrating digital healthcare into the European policy portfolio and the development of the post 2010 European strategy.”



EC urges bigger thinking in eHealth

17 Mar 2010

The European Commission has called for a change in the "mentality" that leads to thousands of small scale pilots being run in eHealth.

Speaking in Barcelona, at the World of Health IT conference and exhibition, Zoran Stančič, deputy director general of the European Commission’s DG INFSO, said that while the Commission is committed to support for eHealth in the future, smaller pilots need to be stopped.

Stančič said: “We need to think in terms of new mechanisms and instruments to foster innovation and deployment rather than just relying on small pilots. In order to do this, we need the strong political commitment, which has to be driven by deployment and a clear leader framework.



FCC broadband plan targets e-health expansion

By Brian Robinson

Tuesday, March 16, 2010

The Federal Communications Commission formally adopted and forwarded to Congress a plan to significantly upgrade U.S. broadband connections that could greatly boost the adoption rate of health IT.

The National Broadband Plan was mandated by the 2009 American Recovery and Reinvestment Plan, and is the result of an unprecedented level of public workshops, hearings and online interaction. The process to get to the plan generated some 75,000 pages of public comment.

The health care chapter of the plan (http://www.broadband.gov/plan/10-healthcare/) includes substantial changes to the FCC’s existing Rural Health Care Program, which already funds some broadband improvements. It has authorized funding of $400 million a year, but only a fraction of that is actually used.



At Bronx clinic, the eyes are windows to medical records

By Madison Park, CNN


  • Bronx clinic uses iris scanners to identify patient to his/her medical records
  • Clinic serves needy and had trouble with duplicative names
  • Clinic has cut down on duplicating records and prevent medical frauds

(CNN) -- Rafael Fernandez walks into the Bronx, New York, medical clinic, with his eyes wide open.

Checking Fernandez in, a clinic employee scans his eyes using a handheld camera. Within seconds, the camera reads his iris patterns, and a computer locates his medical record.

Such iris identification technology is usually seen in international airports to allow registered passengers to fast-track through passport checks and immigration.

But far from the sleek European airports, the South Bronx clinic that receives federal funding and operates in one of the most impoverished U.S. areas uses the instruments to prevent medical record mishaps.



Patient safety must start in classroom: report

By Andis Robeznieks / HITS staff writer

Posted: March 15, 2010 - 11:00 am ET

Healthcare delivery continues to be unsafe and will probably remain that way for some time unless medical schools make substantial improvements in how they teach patient safety, according to Unmet Needs: Teaching Physicians to Provide Safe Patient Care, a new report issued by the National Patient Safety Foundation's Lucian Leape Institute.

The report charges that medical schools do an inadequate job of developing student understanding of concepts such as systems thinking, problem analysis and team collaboration that will help them become architects of patient-safety and quality improvement efforts.

Information technology does not get mentioned much in the report, but its importance is noted.

“They must realize the value of information technology in helping them deliver up-to-date, evidence-based care, and be able to use information technology tools to find pertinent literature, review guidelines, calculate patient risk factors, and apply clinical pathways,” the report states in a section that talks about doctors being life-long learners.


Group develops guidelines for CPOE standards

By Shawn Rhea

Posted: March 15, 2010 - 5:59 am ET

The Institute for Safe Medication Practices has developed a set of guidelines aimed at helping providers create drug-prescribing standards for their computerized physician order entry systems.

The guidelines, according to a news release, will address drug-safety problems that hospitals and other providers often encounter. They will allow providers to set well-defined prescribing standards for common patient conditions.



It’s official: Hampton Roads is next VLER community

By Peter Buxbaum

Tuesday, March 09, 2010

The Department of Veterans Affairs and the Department of Defense yesterday officially inaugurated Hampton Roads, Va., a nexus of veterans and active-duty military as well as government and purchased healthcare providers, as the next site of its Virtual Lifetime Electronic Record (VLER) community pilot project.

The Virginia project will bring together DoD, VA, and commercial healthcare providers Sentara Healthcare, Riverside Health System and Bon Secours Medical Group.

The new project, dubbed “Phase 1b” of VLER by its government sponsors, follows on Phase 1a, a San Diego, Calif.-based project began last year to test the exchange of electronic health records between the VA and the private Kaiser Permanente health network.



HIMSS: HMS launches HMS Connex, showcase ambulatory EHR

Healthcare company Healthcare Management Systems (HMS) revealed its new interoperability product HMS Connex at the 2010 annual HIMSS conference in Atlanta. HMS Connex will enable the exchange of clinical data between third party systems, health information exchanges and public registries while assisting in qualifying for the American Recovery and Reinvestment Act (ARRA) of 2009 HITECH stimulus funds, according to the company.

Built around IT company Mirth’s open source technology platform and customized for the HMS product suite, HMS Connex is designed to help customers achieve Stage 1 meaningful use interoperability requirements; specifically reporting hospital quality measures to CMS, exchanging key clinical information among providers of care, submitting lab results to public health agencies and submitting data to immunization registries, according to HMS, of Nashville.



HHS group proposes national EHR safety database

By Mary Mosquera

Friday, March 12, 2010

A Health and Human Services advisory panel today proposed creating a national database into which clinicians could report patient data errors and unsafe conditions they encountered in their use of electronic health records.

Clinicians could use the system to report instances – noticeably inaccurate patient data or an EHR technical glitch, for instance – that they believed might compromise patient safety.



Five features missing from most EHRs

March 12, 2010 | Nancy McCallum, Contributing Writer

While EHRs are increasingly essential for healthcare providers, their efficacy can be constricted by the nature of their design, their use and the interpretation of data.

Jerry Buchanan, Program Manager and Scrum Master at eMids Technologies, Inc., an IT and BPO consulting company, weighs in on some features that are missing from EHRs:

1. Information, not data

While EHRs hold data, that's not the same as holding information, Buchanan notes. Data needs to be converted into relevant information to be of practical use. However, there's also the possibility that EHRs can get overloaded with information. The goal, Buchanan says, is technology that organizes data in a way that assists healthcare providers most efficiently and effectively in making clinical decisions. This includes EHRs capable of providing alerts and alarms about patient conditions, given to caregivers in real time.



Monday, March 15, 2010

'Defining Moment' for Health Information Exchange in California

by George Lauer, iHealthBeat Features Editor

California achieved two major milestones last week on its march toward a digital future in health care.

On Monday, state officials unveiled a new private organization to fit the state's needs to manage California's health information exchange.

On Thursday, that new organization -- Cal eConnect -- had something of a coming-out party with stakeholders from all over the state and from all parts of the health care industry convening to discuss strategic and operational plans.

"This is a defining moment for California in many ways," said Jonah Frohlich, deputy secretary for health IT at California's Health and Human Services Agency and principal architect of the new not-for-profit.




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