Quote Of The Year

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

Friday, April 09, 2010

Weekly Overseas Health IT Links 07-04-2010.

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.



Obama in Maine to tout health reform, governor calls IT critical

April 01, 2010 | Mike Miliard, Managing Editor

PORTLAND, ME – President Barack Obama roused an enthusiastic crowd in support of his landmark health reform in Maine on Thursday, touting a new course that will "build on the system of private health insurance that we already have," making coverage "more secure and more affordable" for those who already have it, and allowing those who don't have coverage to "finally be able to get it."

As it does, he pledged, "costs will come down for families, businesses, and the federal government, reducing our deficit by more than $1 trillion over the next two decades."

The president's speech was primarily about the tax breaks that will allow small businesses to provide coverage to their employees (see more at Healthcare Finance News), and the new regulations that will set rules for who insurance companies must allow onto their rolls.



HIE Connection Promotes Quality Care, Community Focus

Collaborative data-sharing among physician practices and Doylestown Hospital advances patient care.

By Richard D. Lang, EdD, and Rita Moran

A strong community connection has been evident at Doylestown Hospital in Doylestown, Pa., since its founding in 1923 by a local women's civic organization. Today, that organization is the only women's club in the nation to own and operate a community hospital.

Located near Philadelphia, Doylestown Hospital, a 208-bed facility, is on the leading edge of community benefit and involvement through the creation of the Doylestown Clinical Network (DCN). DCN is a health information exchange (HIE) that seeks to advance patient care through collaborative data-sharing among area physician practices and our hospital.

Our path down this road began in the late 1990s, when community physicians approached the hospital for help after realizing that billing systems for its practices could not make the Y2K transition. We decided to set up a separate applications services provider (ASP) organization, through which our medical staff could purchase a new practice management (PM) system at cost(should we say at "fair market value")?


NHIN Direct Focus Is Health Data Exchange Specs

Nationwide Health Information Network (NHIN) Direct aims to develop interoperability specs, but not to replace statewide and regional health information exchanges.

By Marianne Kolbasuk McGee, InformationWeek

March 30, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200787

The Nationwide Health Information Network (NHIN) Direct project unveiled last month will coexist with and not replace the federal government's ongoing vision for a robust, secure, and comprehensive national health data exchange, said a top government official.

NHIN Direct aims to develop interoperability specifications for simple, direct one-on-one data exchange between healthcare providers.

Earlier this month, the U.S. Department of Health and Human Services' Office of National Coordinator (ONC) for Health IT unveiled the NHIN Direct Project, an initiative to develop specifications and easy processes for local healthcare providers to exchange health data directly with other providers -- such as labs exchanging data with a doctor's office, or a primary care physician electronically sending a patient referral to a specialist.



Most HITS readers would consider open-source EHR

By Joseph Conn / HITS staff writer

Posted: April 2, 2010 - 11:00 am ET

Nearly two thirds of Health IT Strategist readers responding to our latest poll indicate they are keeping an open mind when it comes to open-source software.

Asked: “Would you consider using an open-source electronic health-record system in your hospital or physician office?” 93 of the 139 poll takers, or almost 67%, indicated “yes,” while 47 (not quite 34%) responded, “no.” (The percentages don't add up to 100 because of rounding.)



St George’s gets Cerner for Easter

29 Mar 2010

St George’s Healthcare NHS Trust has gone live with Cerner Millennium, the strategic electronic patient record system provided by London's local service provider, BT.

In a statement, chief operating officer Patrick Mitchell said: “The first phase of the Cerner Millennium deployment at St George’s Healthcare NHS Trust went live as planned on Monday 29 March.



New Mexico First with HIE Plan

HDM Breaking News, April 1, 2010

The Office of the National Coordinator for Health Information Technology has approved New Mexico's strategic plan for health information exchange, making it the first state to get such approval.



Federal panel wants national reporting on EMR software, data errors

April 1, 2010 — 12:18pm ET | By Neil Versel

The Adoption/Certification Workgroup of the federal Health IT Policy Committee wants to require hospitals and physicians to report "hazards and near-misses" as a result of software malfunctions, beginning in 2013. Reporting would become part of demonstrating "meaningful use" of EMRs and thus a condition for receiving Medicare and Medicaid bonus payments.

While some would like to see a database on EMR and data glitches up and running sooner than that, some patient-safety advocates believe 2013 is unrealistic. "I think it will take a while to do this right," UCSF physician Dr. Robert M. Wachter tells the Huffington Post Investigative Fund. "The problem here is that there are potentially dangerous systems and we have no mechanism to figure out what they are or to force them to improve," he adds.



Is 'Speak No Evil' a Contract Clause?

Sen. Charles Grassley frets that vendors use contractual clauses to hide software flaws - but he might not be getting the full story.

By Joseph Goedert

Health Data Management Magazine, 04/01/2010

Are electronic health records flawed and dangerous products sold by vendors that use onerous contractual provisions to absolve themselves of responsibility and muzzle user complaints? Or is an influential United States Senator barking up the wrong tree?

Sen. Charles Grassley (R-Iowa), ranking member of the Finance Committee, is investigating reports he has received that EHRs and computerized physician order entry systems are plagued with flaws that can result in patient or financial harm. The investigations is being conducted as federal officials implement provisions of the American Recovery and Reinvestment Act that will make tens of billions of dollars available to providers to significantly increase the adoption and use of EHRs.

That investigation took a sharp turn in late February when Grassley sent signals (see sidebar, page 30) that he might be considering Food and Drug Administration regulation of clinical information systems. Grassley, in letters sent to Health and Human Services Secretary Kathleen Sebelius, and the influential Healthcare Information and Management Systems Society trade association, asked for their views on a 1997 position paper that called for voluntary industry oversight of the integrity of clinical systems rather than regulation (see sidebar, page 30). The paper was published in the Journal of the AmericanMedical Informatics Association. The FDA, which started considering regulation in 1996, ultimately declined to do so amid industry opposition.

Grassley's also concerned with contractual "hold harmless" provisions that absolve vendors of responsibility for harm, and "gag orders" more commonly known as confidentiality or nondisclosure provisions that prohibit providers from publicly disclosing problems with their software. It should be noted that various types of confidentiality and hold harmless clauses are in virtually all I.T. contracts in all industries, consultants and attorneys who negotiate these contracts say. Grassley, however, wants to know if these clauses can be worded in a way that potentially could jeopardize patient safety.



‘High touch' tops tech with preventive care: study

By Andis Robeznieks / HITS staff writer

Posted: March 31, 2010 - 11:00 am ET

Primary-care practices who rely more on “high touch” principles such as patients seeing the same doctor and scheduling a “well visit” are likely to deliver more preventive services than those that rely on “high tech” principles such as using clinical decision-support tools and performing continuous quality improvement, according to a study in the Annals of Family Medicine journal of the American Academy of Family Physicians.

Researchers examined the records of 568 patients at 24 New Jersey primary-care practices participating in a study on improving colorectal cancer screening and concluded that the “relationship-centered aspects” of the medical home model “are more highly correlated with preventive service delivery” than were “information technology capabilities.” Of the practices in the study, 46% used electronic health records, though it's unknown what functions were used and how long the systems were in place.



The 2009 EHR User Satisfaction Survey: Responses from 2,012 Family Physicians

Robert L. Edsall; Kenneth G. Adler, MD, MMM

Posted: 03/19/2010; Family Practice Management. 2009;16(9):10 © 2009 American Academy of Family Physicians

Abstract and Introduction


If you're shopping for an EHR system, you might appreciate this advice from a couple of thousand colleagues.



HHS awards PR firm $26M for health IT campaign

By Mary Mosquera

Monday, March 29, 2010

The Health & Human Services Department awarded public relations firm Ketchum Inc. a contract for $26 million to create a publicity campaign to educate the public about the privacy and security of their personal information contained in or managed by health IT systems.

The HITECH Act called for public education efforts to help drive the adoption and meaningful use of electronic health records. .



Study names 100 top-performing hospitals

March 29, 2010 | Bernie Monegain, Editor

ANN ARBOR, MI – On Monday, Thomson Reuters released its annual study identifying the 100 top U.S. hospitals based on their overall organizational performance. The 10 areas measured, such as adherence to clinical standards and patient safety, are boosted by the use of information technology.

The Thomson Reuters 100 Top Hospital: National Benchmarks study evaluates performance in 10 areas: mortality, medical complications, patient safety, average length of stay, expenses, profitability, patient satisfaction, adherence to clinical standards of care, and post-discharge mortality and readmission rates for acute myocardial infarction, heart failure, and pneumonia. The study has been conducted annually since 1993.

"This year's study magnified the value that 100 Top Hospital award winners provide to their communities," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters. "Even during the economic downturn, the 100 Top Hospitals maintained a profit from operations while raising the bar for clinical quality and patient satisfaction. The insistence of these hospitals' leaders – their boards, executive teams and medical staffs – on overall excellence makes the difference."


Accenture Exec: EMR Targets Unlikely To Be Met

Today, only six percent of U.S. office-based physicians use a fully functioning electronic medical record system.

By Nicole Lewis, InformationWeek

March 29, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200662

The government's goal to provide every citizen with an electronic medical record by 2014 is not likely to be met, according to Dr. Kip Webb, who leads Accenture's clinical transformation practice.

In an interview with InformationWeek, Webb noted that based on a recent survey, a substantial number of physician practices with 10 or fewer employees have said they will not embark on a program to adopt electronic medical records.

Asked if he felt the government's EMR goals were achievable, he replied, "I don't."



BT may win new Cerner ‘greenfield’ deal

31 Mar 2010

BT could be on the verge of being awarded a lucrative deal to install Cerner Millennium at three new hospital trusts in the south of England.

E-Health Insider understands a new deal is currently with Treasury pending approval, and the completion of the local service provider contract resets.



ICN and IHTSDO team up

25 Mar 2010

The International Council of Nurses has teamed up with the International Healthcare Terminology Standards Development Organisation to advance the use of standardised terminology and interoperability in healthcare IT.

The collaboration will see ICN actively work with the IHTSDO to facilitate involvement of the nursing community through the IHTSDO Nursing Special Interest Group.

David Benton, chief executive of ICN said: “ICN will embrace this collaboration as an important means of supporting nurses in providing quality care.



Choose and Book reaches 20m referrals

30 Mar 2010

NHS Connecting for Health has announced that 20m referrals have now been made through Choose and Book.

The Department of Health’s IT agency said the achievement was a "key milestone" for the e-booking system, which was launched in 2004.

However, the figures also show that the system is currently used for around 50% of first outpatient appointments; well short of the 90% target originally set by the DH.



DEA Proposes Allowing Biometrics to Identify E-Prescribing User

Janice Simmons, for HealthLeaders Media, March 30, 2010

The Drug Enforcement Agency (DEA) is posting in the Federal Register on Wednesday an interim final rule that would permit hospitals, healthcare providers, and pharmacies to use electronic prescriptions in the dispensing of controlled drugs. Comments on the rule will be open for 60 days.

The rule is similar to a regulation proposed by DEA in June 2008 for e-prescribing. That provision ran into trouble when federal healthcare providers told DEA that the approach proposed for the private sector was inconsistent with their existing practices and did not meet the security requirements for federal systems.



Griffin Hospital Reports Breach Of 957 Patients' Records

By Matthew Sturdevant


March 30, 2010

Medical information for 957 patients at Griffin Hospital in Derby was breached by a radiologist who broke into a computer archive system over a period of several weeks after he was terminated in February.

The hospital announced the security breach Monday on its website.

The doctor worked for a radiology group contracted by Griffin Hospital. His job ended Feb. 3, although it's not clear if he was fired.

His archive password was revoked when he lost his job, but he continued to access the system using passwords of other employees without their knowledge between Feb. 4 and March 5, the hospital said.



NHIN won't funnel information to CIA: Blumenthal

By Joseph Conn / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

Part one of a two-part series:

David Blumenthal, head of HHS' Office of the National Coordinator for Health Information Technology, has denied allegations that a framework for selecting data transmission standards for the proposed national health information network would configure the system to afford federal control over patient data and funnel that information to federal agencies, including the CIA, Justice Department and National Security Agency.

Blumenthal's remarks came more than three hours into the March 25 meeting of the Health IT Standards Committee. The committee is a federal panel created under the American Recovery and Reinvestment Act of 2009, also known as the stimulus law, to advise the ONC on matters concerning health IT standards.

Just before Blumenthal spoke, ONC staffer Doug Fridsma completed two lengthy presentations, followed by group discussions. One talk was on NHIN Direct, an ONC open-development project that had its startup meeting the day before.

NHIN Direct aims to develop specifications for simple information exchange tasks to afford less technologically advanced healthcare practitioners the means to perform basic clinical information-sharing required under a federal electronic health-record subsidy program, part of the meaningful-use criteria of the stimulus law.



Health IT group stresses patient-safety reporting

By Maureen McKinney / HITS staff writer

Posted: March 30, 2010 - 11:00 am ET

In its latest set of draft recommendations, the Certification/Adoption Workgroup of HHS' Health IT Policy Committee stressed the need for a standardized, transparent system for reporting patient-safety issues. During a March 29 meeting, the group also discussed the creation of a national patient-safety organization, which would serve as a clearinghouse for safety concerns from providers, vendors and patients.

“We believe patient safety is going to be more and more of an issue with the increasing use of health IT,” said Marc Probst, chief information officer of Intermountain Healthcare, Salt Lake City, and co-chairman of the work group. “We also think it's very important to create a safe, nondisciplinary environment so people don't try to hide errors.”



Health Reform Brings Changes, More Work for HIM

Andrea Kraynak, for HealthLeaders Media, March 25, 2010

After an eventful week on Capitol Hill, HIM directors are likely wondering how health reform will affect them. Understanding what is in the bill is an important first step to figuring out what is on the horizon. Only then can HIM directors begin to figure out how to manage those changes.

"It will be awhile until all of this is flushed out and there is a clearer picture for the impact on HIM or other healthcare professionals," says Darice Grzybowski, MA, RHIA, FAHIMA, president of HIMentors, LLC, in Westchester, IL. After all, many of the provisions don't go into effect until several years in the future.

While a few details are still being worked out regarding EHR-related legislation, Congress took care of most of that in ARRA's HITECH Act. However, new healthcare reform legislation does address the topic briefly.



Can Broadband Really Save Healthcare?

Gienna Shaw, for HealthLeaders Media, March 30, 2010

The government is super stoked about the potential of greater broadband access to improve the U.S. healthcare system. Part of the 376-page National Broadband Plan report released by the Federal Communications Commission (FCC) last week gushes about health IT, e-health, m-health, telehealth, and electronic medical records (EMRs).

Can broadband really save healthcare? Well, technology is part of the solution for some of the industry's problems, such as physician and specialist shortages and disparities in access to care. But it's only part of the solution. And it comes with problems of its own. (Read more about wireless health, telehealth, and more in the March HealthLeaders magazine cover story, Medical Breakthroughs That Will Change Healthcare.)



Tuesday, March 30, 2010

Blumenthal Discusses Federal Health IT Strategy, Timeline

In a recent interview with iHealthBeat, National Coordinator for Health IT David Blumenthal discussed the timeline for issuing final rules on "meaningful use," standards and certification criteria and the certification process, as well as "NHIN Direct," the health IT work force and the likelihood of the country meeting President Obama's goal of providing all Americans with an EHR by 2014.

Blumenthal said that CMS has received more than 2,000 comments on the notice of proposed rulemaking describing how health care providers can demonstrate meaningful use of certified electronic health records to qualify for incentive payments under the 2009 federal economic stimulus package and that the Office of the National Coordinator for Health IT has received more than 300 comments on the interim final rule describing required certification standards for EHR technology.



Reports: Berwick to Lead CMS

HDM Breaking News, March 29, 2010

President Obama will nominate Donald Berwick, M.D., president and CEO at the Institute for Healthcare Improvement, as administrator of the Centers for Medicare and Medicaid Services, according to numerous published reports over the weekend. Charlene Frizzera, COO of CMS and acting administrator since January 2009, will remain COO once Berwick becomes administrator, according to a spokesperson.

Based in Cambridge, Mass., the Institute for Healthcare Improvement is an independent, not-for-profit organization that brings together stakeholders to share lessons, and identify gaps in quality and best practices.


EMR Data Theft Booming

Fraud resulting from exposure of electronic medical records has risen from 3% in 2008 to 7% in 2009, a 112% increase, researcher says.

By Nicole Lewis, InformationWeek

March 26, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224200494

Acceleration in the use of electronic medical records may lead to an increase in personal health information theft, according to a new study that shows there were more than 275,000 cases of medical information theft in the U.S. last year.

Unlike stealing a driver's license or a credit card, data gleaned from personal health records provides a wealth of information that helps criminals commit multiple crimes, according to Javelin Strategy & Research, a Pleasanton, California-based market research firm.

Information such as social security numbers, addresses, medical insurance numbers, past illnesses, and sometimes credit card numbers, can help criminals commit several types of fraud. These may include: making payments from stolen credit card numbers and ordering and reselling medical equipment by using stolen medical insurance numbers.



Healthcare reform legislation awash in IT

By John Moore

Wednesday, March 24, 2010

The healthcare reform legislative package signed into law yesterday by President Obama hinges on information technology for some of its most far-reaching changes.

The President yesterday signed the Patient Protection and Affordable Health Care Act, which includes IT-dependent projects that run the gamut from proposals to build state-run insurance “exchanges” to modern long-term care facilities.

Health IT is likely to play a key role in all these efforts. For example, the new law tasks the Department of Health and Human Services with creating a Web portal through which a resident in any state will be able to locate “affordable health insurance coverage options.”



HHS panel considers central authority for health IT vocabulary

Advisers examine who will decide the vocabulary and resolve disputes

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.

Experts say free and standardized terminology is needed for interoperability between health record systems. Currently, there are vocabularies for clinicians who identify patient problems, for medication terms and for lab orders, among others. Issues that haven't been resolved include governance, such as who decides what goes into the vocabularies, and how disputes are resolved.



Job Demand for Health Care IT Expanding in 2010 and Beyond

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.




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