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.
By Bob Brewin 03/23/2010
The historic health care reform bill President Obama signed into law on Tuesday calls for development of states' health care exchanges that eventually will allow Americans to compare insurance through Web portals as easily as they price and book airline tickets.
The exchanges, as the president outlined in a June 2, 2009, letter to the late Sen. Edward Kennedy, D-Mass., a decades-long champion of universal health care, will create a "market where Americans can one-stop shop for a health care plan, compare benefits and prices, and choose the plan that's best for them."
By John Loonsk
Wednesday, March 17, 2010
The HITECH stimulus funds have created great buzz in health and health IT. Providers are contemplating electronic medical record (EMR) implementations, vendors are scurrying to be “meaningful use” compliant, and states and others are planning for Medicaid, health information exchange, training and other related services.
This environment should be ripe for movement, yet there are numerous signs that the movement that comes will be begrudging and fragmented - not the kind explosive, coordinating movement that has characterized other major information technology advancements like the Internet.
Projections for physician adoption rates, the timeframe expressed by the “meaningful use” phases, and the push-back received on the first “meaningful use” criteria all point to such a trajectory.
The architecture work of the Nationwide Health Information Network (NHIN) anticipated this situation. The work recognized that to be successful it must leverage the ongoing work of many organizations to develop trust and security in health information exchange. It also recognized that these state, local and federal level organizations each need to build information exchange capabilities that suit their own immediate needs, but also to come together into a “ring” of connected networks that is compelling to join.
March 24, 2010 | Molly Merrill, Associate Editor
CAMBRIDGE, MA – The remote health management market (RHM) is the smallest, but fastest growing segment of the home health management (HHM) market, according to global strategy consulting firm, Scientia Advisors. But to reach its full potential health insurers must broaden their reimbursement practices to encourage greater physician adoption, the firm says.
Harry Glorikian, Scientia Advisors' managing partner, says many physicians are reluctant to embrace RHM because government and private health insurers reimburse only for its use in specific disease states or rural populations.
By John Moore
Thursday, March 25, 2010
The Drug Enforcement Administration’s interim final rule on e-prescribing controlled substances calls for providers to use two-factor authentication but introduces a twist: the use of biometric technology as one of the methods.
The rule, set to be published March 31 in the Federal Register, aims to address a gap in the government’s e-prescribing push. DEA currently bans the e-prescribing of controlled substances -- a restriction that covers some 10 percent of all prescriptions.
That prohibition compels physicians who e-prescribe to maintain a separate paper-and-fax system for controlled substances. Healthcare executives contend the situation has created a nuisance for e-prescribers and has discouraged wider adoption of e-prescribing.
Laurie Barclay, MD
March 24, 2010 — Electronic clinical documentation may help prevent diagnostic errors, according to a perspective published in the March 25 issue of the New England Journal of Medicine.
"The United States is about to invest nearly $50 billion in health information technology...in an attempt to push the country to a tipping point with respect to the adoption of computerized records, which are expected to improve the quality and reduce the costs of care," write Gorden D. Schiff and David W. Bates from Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health in Boston, Massachusetts. "A fundamental question is how best to design electronic health records (EHRs) to enhance clinicians' workflow and the quality of care. Although clinical documentation plays a central role in EHRs and occupies a substantial proportion of physicians' time, documentation practices have largely been dictated by billing and legal requirements."
Posted: March 26, 2010 - 11:00 am ET
Patients should decide who gets to see their healthcare data, said Alfred Spector, Google vice president of research and special initiatives, during a question-and-answer session held after his presentation March 25 at the American College of Healthcare Executives' annual congress on healthcare leadership in Chicago.
When asked if a patient has the right to delete information from a personal health record so one physician can't see what another entered, Spector said he wasn't sure about this at first, “But now it's clear to me; the answer is ‘yes.' ”
“A patient has a right to a second opinion that's not biased by the original diagnosis,” Spector explained, adding patients should also be able to correct errors or annotate information entered by their physician. For example, they may type in a line about not having a cholesterol problem, and explain that their high cholesterol reading was the result of eating a pound of bacon before their doctor's visit.
HDM Breaking News, March 25, 2010
The Office for Civil Rights in the Department of Health and Human Services has added five more organizations to a Web page listing covered entities that have reported breaches of unsecured protected health information affecting more than 500 individuals. OCR launched the page in February with the listings of 47 organizations.
The posting is mandated under the HHS breach notification rule that was authorized under the HITECH Act. Under the rule, notification within 60 days to HHS and the media is required when a breach affects more than 500 individuals. Smaller breaches must be annually reported to HHS. Business associates of HIPAA-covered entities must notify the affected covered entity of breaches.
A former model who is now chronically ill and struggles just to shower says the people she has met online have become her family. A quadriplegic man uses the Web to share tips on which places have the best wheelchair access, and a woman with multiple sclerosis says her regular Friday night online chats are her lifeline.
For many people, social networks are a place for idle chatter about what they made for dinner or sharing cute pictures of their pets. But for people living with chronic diseases or disabilities, they play a more vital role.
“It’s really literally saved my life, just to be able to connect with other people,” said Sean Fogerty, 50, who has multiple sclerosis, is recovering from brain cancer and spends an hour and a half each night talking with other patients online.
Pamela Hartzband, M.D., and Jerome Groopman, M.D.
Medicine has built on a long history of innovation, from the stethoscope and roentgenogram to magnetic resonance imaging and robotics. Doctors have embraced each new technology to advance patient care. But nothing has changed clinical practice more fundamentally than one recent innovation: the Internet. Its profound effects derive from the fact that while previous technologies have been fully under doctors' control, the Internet is equally in the hands of patients. Such access is redefining the roles of physician and patient.
Information traditionally flowed from doctor to patient; the physician described the genesis and course of a disease and the options available for treating it. Often, pamphlets were provided to reinforce the doctor's explanation and advice. The patient might then receive additional input from family and friends, usually in the form of anecdotes about people who faced similar clinical situations.
Friday, March 26, 2010
by Protima Advani
As hospitals continue to wait for the final definition of "meaningful use" one year after passage of the American Recovery and Reinvestment Act of 2009, one critical requirement outlined in the HITECH Act is off the table for now -- Health Information Exchanges.
Recognizing the lack of or inadequate state-level infrastructure needed to facilitate health information exchange between regional care providers, CMS' recently proposed meaningful use definition does not require hospitals to participate in HIEs to demonstrate meaningful use in Stage 1. However, future stages of meaningful use will not offer such concessions -- hospitals aiming to collect the federal incentives associated with meaningful use will have to actively participate in HIEs.
HHS panel considers central authority for health IT vocabulary
Advisers examine who will decide the vocabulary and resolve disputes
- By Alice Lipowicz
- Mar 25, 2010
A federal advisory task force is considering whether a central authority is needed to define and enforce medical vocabulary terms to be used in health care messaging, records and data exchange.
The Health and Human Services Department’s Vocabulary Task Force heard testimony from the National Library of Medicine, Centers for Disease Control and Prevention, National Cancer Institute, Joint Commission, and several other organizations March 23. The goal was to review options for creating and updating a common vocabulary for health information systems.
Cloud computing enables Ohio State University Medical Center to drastically change and improve the transit of medical images.
By Philip Larkin and Coyt Watters
In early 2006, the Ohio State University Medical Center (OSUMC)'s department of imaging informatics consolidated the imaging management of radiology and cardiology into a single management site. It was then that our institution began looking for a feasible method of sharing images between providing hospitals. The process of discussing imaging issues began almost immediately. It became evident early on that the two separate imaging entities had very similar problems and that both had ideas about solving them.
Being a university-based research institution with digital imaging experience dating back to the early 1990s, we felt that we should have the ability to develop and implement a solution without resorting to outside assistance. For the better part of two years discussions continued with university hospital IT departments. In the end, the lack of resources, commitment to the project, high cost, long implementation timelines and Web development restrictions proved to be hurdles that were very difficult to clear.
The overall impact of using Accelarad's commercial cloud computing solution SeeMyRadiology.com that ultimately was employed has been very positive for our physicians and patients. The ability to move images between institutions, sometimes hours apart, gives our physicians the opportunity to provide important information to the physician initiating the treatment. This gives physicians the ability to consult, before transfer, or prepare for treatment prior to patient arrival at our institution. The ability to assess previously performed studies also has the advantage of eliminating reimaging the patient due to lost or incompatible image disks.
Even HL7 development efforts can benefit from an emphasis on reusability and an SOA approach.
By John Joseph
Many health care CIOs are feeling a little uncomfortable these days. And, who can blame them? Governmental, economic, consumer and other forces are putting pressure on hospitals and health care delivery networks to make major changes to their IT infrastructure, and to do so in the face of enormous market, policy and financial uncertainties.
Agility and responsiveness have never been more important for a health care organization. This is causing some CIOs to turn to service-oriented architecture (SOA) to help them gain an edge.
SOA isn't a new term, but it requires further definition. Despite the general impression that SOA is a technology choice, SOA isn't a technology platform or standard at all. It's an approach -- one that can be phased in over time and one that requires you to commit to reuse of software elements across the organization. An SOA approach requires that you design elements with an eye toward reuse, using standard interfaces/messages so that the elements can be connected easily, making those elements available across a distributed network, and reusing those elements whenever possible. The benefits of this approach are speed of assembling new applications and interoperability that leads to easier connections, restructurings, upgrades and replacements.
23 Mar 2010
A rescue plan that promises to save the NHS £1 billion and realign the NHS IT programme to support health service reform, has been published by health think tank 2020health.org.
The report argues that getting NHS IT right is “critical” for a new government, but that it should resist clarion calls to scrap the late-running NHS IT programme.
It argues that new IT-enabled ways of working are essential to enable the NHS to meet ever-growing health demands, while also being able to achieve tough productivity targets.
Veterans want features such as chat for the My HealtheVet Web portal
- By Doug Beizer
- Mar 23, 2010
Veterans Affairs Department officials plan to add social-media style tools to the portal veterans use to access health records, a VA official said today at the 2010 FOSE conference.
Veterans use the My HealtheVet to access records, keep health diaries and reorder prescriptions, according to Gail Graham, deputy chief officer of health care information management at the VA.
The president says electronic systems will reduce costs and improve quality, but they could undermine good care if people are afraid to confide in their doctors.
I learned about the lack of health privacy when I hung out my shingle as a psychiatrist. Patients asked if I could keep their records private if they paid for care themselves. They had lost jobs or reputations because what they said in the doctor's office didn't always stay in the doctor's office. That was 35 years ago, in the age of paper. In today's digital world the problem has only grown worse.
A patient's sensitive information should not be shared without his consent. But this is not the case now, as the country moves toward a system of electronic medical records.
In 2002, under President George W. Bush, the right of a patient to control his most sensitive personal data—from prescriptions to DNA—was eliminated by federal regulators implementing the Health Insurance Portability and Accountability Act. Those privacy notices you sign in doctors' offices do not actually give you any control over your personal data; they merely describe how the data will be used and disclosed.
Posted: March 24, 2010 - 11:00 am ET
This story is part one of a three-part series.
Like pixie dust sprinkled on the healthcare industry's woes, references to healthcare information technology are found throughout the Patient Protection and Affordable Care Act, the healthcare reform legislation that President Barack Obama signed into law Tuesday.
In fact, the keywords “information technology” were mentioned 44 times in the law, first on page 3 and last on page 821. The law also is laced with additional references for electronic health records and IT standards.
The Health Care and Education Reconciliation Act of 2010, the companion “fix it” bill that also passed the House on Sunday, 220-211, is pending before the Senate.
HDM Breaking News, March 23, 2010
France-based Withings, which sells a body scale with built-in Wi-Fi connectivity, has integrated the product with Microsoft Corp.'s HealthVault consumer portal.
HDM Breaking News, March 23, 2010
A new study from the HIMSS Analytics research unit of the Healthcare Information and Management Systems Society shows many hospitals use electronic commerce in their purchasing process but have a ways to go before getting full value from e-commerce.
The Chicago-based firm surveyed 199 hospital purchasing officers for the study, which Louisville, Colo.-based e-commerce vendor GHX sponsored. Results show that 95 percent of acute care facilities with more than 150 beds electronically order at least some medical-surgical supplies.
By Anne-Marie Tobin (CP) – 4 hours ago
TORONTO — As Donna Hammill-Chalk undergoes treatment for breast cancer, she can log onto the website at Sunnybrook Health Sciences Centre in Toronto, type in a username and secure password, and gain access to her medical records.
In Prince Edward Island, her mother, who was diagnosed with breast cancer in December, doesn't have electronic records - but if they existed, it would be easier for her to share updates on her condition and treatment with her four grown children living in different parts of the world.
"Cancer - you lose all control and you can get some control back by having access to your information," Hammill-Chalk said in an interview Wednesday from her home in Markham, Ont., where she is recovering from a mastectomy.
Whitehall officials have little idea what to do if the all-important go-live of Lorenzo 1.9 at Morecambe Bay doesn't happen in the near future.
The Guardian's website has a long piece on the NPfIT, saying that the programme is "close to imploding, potentially triggering a deluge of legal claims against the taxpayer running into billions of pounds, which could start to emerge weeks before a general election".
It says that there is intense political pressure from Whitehall now falling on Morecambe Bay NHS Trust and a software "go-live" deadline set for the end of this month. This is some of what The Guardian says:
"Preparatory testing at Morecambe Bay is believed to have failed some weeks ago, though iSoft, the firm behind Lorenzo, last week insisted testing was "on track" and dismissed as "media speculation" suggestions that the deadline was in jeopardy.
Submitted by Rasik Sharma on Wed, 03/24/2010 - 10:12
The Labour government's £12.7 billion NHS National Programme for IT is on the brink of collapse just before the general elections.
The potential collapse of the project has been mounting pressure on Morecambe Bay, which is meant to be the first place to pilot Lorenzo patent management system.
However, Morecambe Bay NHS Trust CEO Tony Halsall said, “Throughout the entire project, patient safety has always been our top priority and we have developed a rigorous testing regime as part of the project.”
04 Mar 2010
Gifford Batstone, national clinical Lead for pathology, NHS Connecting for Health, says that interoperability is the key to modernising pathology IT – and lots of work is underway to make sure it happens.
Pathology is important to all clinicians, as it is a pivotal element of 70-80% of all clinical decision-making, disease monitoring and response to treatment.
When treatment decisions are made through clinical networks, it becomes vital that patient identification is consistent and that the results of pathology investigations can be interpreted safely, even when they come from more than one source.
Lord Carter, in his Independent Review of NHS Pathology Services, recognised that the modernisation of these services required an end-to-end approach, with IT developments to support this way of working.
Pathology is now at a watershed with respect to IT. My specialty was one of the first to grasp and use the potential of IT through laboratory information management systems.
Posted: March 23, 2010 - 11:00 am ET
“Early detection” has long been the buzzword in cancer care. So when computer-assisted detection, or CAD, software hit the marketplace 12 years ago, manufacturers and providers alike envisioned a day when the technology would become so sophisticated it might all but eliminate the possibility of missing an early cancer.
Today CAD, which uses computer-generated markings to draw a radiologist's attention to questionable areas on an image, is far from being flawless in its function or ubiquitous in its use. But a growing number of provider organizations are making the technology part of their image-reading options and protocol.
According to a February 2005 study published in the American Journal of Roentgenology, 10% of mammography facilities in the U.S. had adopted CAD technology within three years of the U.S. Food and Drug Administration's approval of the first CAD device in 2002.
23 March 2010
Mobile phones may be a key weapon in the war against HIV and AIDS in Africa according to the UNAIDS chief. Mobile phone technology has a key role to play in a continent plagued by inadequate health centres and dilapidated infrastructure as this kind of epidemic cannot be beat with mere facility based approach. A major mobile telephone operator in Nigeria runs a toll-free call scheme that links callers to counsellors on HIV-AIDS concerns. The advantage is that the patients do not have to move from their places to the medical centres. Free communication and quality advice can be rendered on the phone. With basic intensive training and armed with mobile phones, local community or village workers could be a part of the health service delivery system.
The Minister for Health and Ageing, the Hon Nicola Roxon, and the Minister for Finance and Deregulation, the Hon Lindsay Tanner, have welcomed the report of the Review of Health Technology Assessment in Australia(HTA Review). The HTA Review has recommended key improvements to the way new health technologies, procedures and services are assessed for public and private funding in Australia, in line with international best practice. The media release is also available.
Posted on: March 23, 2010 8:01 AM, by Jessica Palmer
In response to a 2009 mandate from Congress, the FCC has released a new National Broadband Plan - including an entire chapter on e-health in its various manifestations. The plan puts forth a suite of recommendations to improve health care through technology: reducing barriers to electronic health record usage, incentivizing health IT adoption, promoting the creation of "converged communications and health care devices" (like health apps for smartphones), establishing data-sharing protocols for medical researchers, ensuring sufficient broadband connectivity to support all that electronic traffic, and passing legislation to ensure that patients have access to their own medical data and test results (in many cases, they're not "authorized" to get it).
Some of these recommendations are addressed to Congress, some to administrative agencies (HHS, FDA, CMS, FCC), and some to state governments (for example, the report suggests modernizing state regulations that pose barriers to health technology adoption). Cooperation between various government actors, the FCC argues, is necessary to help the US catch up to other nations, who are making more effective use of health technologies:
Posted on March 19, 2010 at 10:00 am
As we wait for the federal government to finalize important sections of the Health Information Technology for Economic and Clinical Health Act (HITECH), there is a lot of talk about the financial incentives for implementing electronic health records (EHR). And understandably so. Practices that implement an EHR under the federal government’s guidelines stand to gain nearly $50,000 in incentives over the next five years.
A topic that hasn’t been as hotly discussed is using information gleaned from EHR software to participate in clinical trials. We think this should play a larger role in deciding whether or not a practice should purchase EHR software. Why? Participation in clinical trials has the potential to net a profit of hundreds of thousands of dollars per year. Now that’s an incentive to purchase an EHR.
March 19, 2010 | Bernie Monegain, Editor
OVERLAND PARK, KS – The market for mobile health technology will reach an estimated $4.6 billion by 2014, according to a report released Friday by CSMG.
CSMG is the strategy division of consulting firm TMBG Global.
mHealth is already a $1.5 billion market according to CSMG, and it is expected to grow over the next five years at a 25 percent CAGR (compound annual growth rate). If certain broad healthcare reforms are instituted, such as pay-for-performance, adoption could accelerate.
The report mHealth: Taking the Pulse asserts that while the opportunities in the market are high, the market is so fragmented across many solutions and device types that it will be hard for a single player to take advantage of the opportunities.
By Mary Mosquera
Friday, March 19, 2010
The Office of the National Coordinator for Health IT plans to conduct a nationwide survey of public opinion about electronic health information exchange and the privacy and security of personal data that is shared.
“Little is known about individuals' attitudes toward health information exchange and the extent to which they are interested in determining by whom and how their health information is shared,” according to an announcement by the Health and Human Services Department in the March 19 Federal Register.
HDM Breaking News, March 19, 2010
The National Institute of Standards and Technology has released the first of four installments, called Waves, of new test methods and related software for ensuring electronic health records systems comply with meaningful use requirements.
NIST, part of the Department of Commerce, is partnering with the Healthcare Information Technology Standards Panel and the Office of the National Coordinator for Health Information Technology on the initiative.
Posted: March 23, 2010 - 11:00 am ET
The National Institute of Standards and Technology has posted to its Web site its first shot thus far at developing testing criteria to be used by certification bodies to test electronic health-record systems for acceptability in the federal information technology subsidy program of the American Recovery and Reinvestment Act of 2009, also known as the stimulus law.
The law requires the Office of the National Coordinator for Health Information Technology at HHS, in consultation with the NIST, to come up with a methodology to recognize EHR certification organizations. Hospitals and physicians must use certified EHRs in a “meaningful manner” to qualify for subsidies estimated to range from $14.1 billion to $27.3 billion.
After more than eight years and $4 billion, Kaiser Permanente announced that the implementation of its electronic medical record system is complete.
The Oakland, Calif.-based physician, hospital and health plan company says its HealthConnect system, considered the largest private EMR system in the world, is now completely online, with more than 8.6 million patients across nine states connected.
March 16, 2010 | Bernie Monegain, Editor
OREM, UT – Nearly one in five smart pump customers say they would not buy their current pump again, with one exception, according to a new report from healthcare market research firm KLAS.
The survey elicited responses from 348 providers.
The report, Smart Pumps: Avoiding Buyer's Remorse, notes that roughly 20 percent of customers who purchased the B. Braun Outlook or the new Hospira Symbiq pump say they would not buy the same pump again, nor would 17 percent of those using the small Baxter Sigma pump, which is billed as user friendly.
Job Demand for Health Care IT Expanding in 2010 and Beyond
By: Don E. Sears
Hospitals, medical clinics, doctor's offices and other health care organizations are facing government-mandated deadlines in a host of areas such as electronic medical records, clinical systems and new privacy and medical-coding standards. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.
It's not uncommon to hear about the high demand of medical-related jobs such as nursing. With an aging Baby Boomer population, the expectation for growing demand in health care jobs is real, according to the Department of Labor's Bureau of Labor statistics, which predicted "3.2 million new wage and salary jobs between 2008 and 2018, more than any other industry, largely in response to rapid growth in the elderly population" in an updated February report. IT is expected to reap some of the benefits of this health care growth spurt. Evidence from a couple of new reports from health care IT industry organizations shows demand for health care-related technology jobs is on the rise.
Monday, March 22, 2010
On March 2, the Virginia Legislature unanimously approved a bill (SB 675) that would require private health insurers, health care subscriptions plans and HMOs to cover for the cost of health care services provided through telemedicine technology.
Virginia Gov. Bob McDonnell (R) is expected to sign the bill into law, making Virginia the 12th state in the country to adopt mandates for the coverage of telemedicine.
State Sen. William Wampler (R) and state Delegate Clarence Phillips (D) introduced similar legislation in 2009, but that bill was referred to the Special Advisory Commission on Mandated Health Insurance Benefits.
22 Mar 2010
Swedish online national youth clinic, UMO, has reached 1.5m for unique visitors to the site.
The website, launched in November 2008 as part of the Swedish strategy for E-Health, has now received the same amount of unique visitors as the number of Swedish citizens in its target age group.
Love Nordenmark, head of UMO.se told E-Health Europe: “This is great news for us. The site is aimed at providing a clinic for young people aged 13-25. It focuses on key issues such as sexuality, health, relationships and drugs.
22 Mar 2010
E-Health Europe reporter Sarah Bruce reports from Barcelona on the World of Health IT and ministerial conference that made up eHealth week 2010.
Last week, the World of Health IT conference in Barcelona opened its doors to more than 2,500 visitors. The event was, for the first time, coupled with the high level ministerial conference on eHealth; and one of its highlights was the signing of a new eHealth declaration by the European Commission.
This enhanced the Commission’s commitment to a “new era of eHealth” and to practical action to make it happen. The declaration set the tone for the remainder of the conference, which also stressed the importance of interoperability and the need to prepare for Europe’s ageing population.
By Katie Leavitt | Monday, March 22, 2010 10:34 AM ET
Technology may soon provide one more way for our lives to become easier and cheaper with e-health initiatives.
It is impossible not to recognize the way technology has changed our lives, and soon, it may help save our lives. The chairman of the Federal Communications Commission has devised a plan to provide a widespread broadband network, covering 20 million homes in the US. Even better? The plan includes provisions to extend broadband to medical facilities, even in most rural areas.
Connecting health care providers could allow a patient in one location to receive care from a specialist in another location via telecommuting. This process would not only benefit the patient by providing her the best care in an urgent manner regardless of distance, but it would also save money in transportation costs, and staffing costs for doctors.
On a basic level, implementation of a secure, nation-wide electronic health record system would make access to a patient's complete record available to health care providers across the nation, saving time and money. It would also help doctors to prescribe proper medication by determining drug interactions, previous health conditions, or alerting them to the patient's status regarding vaccinations or allergic reactions.