Quote Of The Year

Timeless Quotes - Sadly The Late 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."

Saturday, May 08, 2010

Weekly Overseas Health IT Links 06-05-2010.

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.



Promoting Use of Health IT: Why Be a Meaningful User

Tuesday, April 27th, 2010 | Posted by: Dr. David Blumenthal | Category: ONC

As I write, physicians throughout the United States are deciding whether to become meaningful users of electronic health records by 2011 when Medicare and Medicaid start making extra payments to meaningful users. For some the decision may be pretty simple. Almost 200,000 doctors already have adopted EHRs and are using them at a basic or sophisticated level. For these physicians, the journey to meaningful use, and its financial and clinical rewards, may be comparatively short. Many other doctors, however, remain undecided.

I don’t want to minimize the obstacles. When I started using an EHR, I found it challenging. I often longed for a dose of my old prescription pad (confession – I cheated once in a while). I chafed at reconciling medication lists, updating problem lists, scanning through seemingly endless consultant notes. (In the past, many wouldn’t have been available – lost somewhere in the paper world.) It was much easier to use the triplicate x-ray requisition I had used for 30 years than the radiology order entry software required by my EHR. My visits were longer and more complicated. Every time I turned on the computer, it seemed, I had to learn something new.



Health IT funding to create 50,000 jobs

Sixty regional IT help centers will help health care facilities implement electronic medical records

Lucas Mearian

April 30, 2010 (Computerworld)

BOSTON -- Federal dollars being pumped into grant programs to spur students to enter IT careers in the health care industry should help to create between 45,000 and 50,000 jobs over the next five years, a top federal health official said on Thursday.

Speaking at the Health Information Technology (HIT) Conference here, Dr. David Blumenthal, National Coordinator for Health Information Technology, said a portion of $2 billion in discretionary spending under Office of the National Coordinator (ONC) is being targeted at education and training for electronic health record implementation.

A large part of the training is for people to staff 60 regional extension centers, which are public, private partnerships that will assist rural hospitals and physician practices with 10 or fewer doctors in rolling out electronic medical records (EMRs) and supporting technology.



Survey puts spotlight on healthcare paper jungle

April 28, 2010 | Bernie Monegain, Editor

SAN FRANCISCO – The average patient's health in the United States is dependent on at least 200 pieces of paper in about 19 different locations, according to a new study.

GfK Roper conducted the survey for Practice Fusion, a Web-based electronic health record company that offers free EHRs.



ONC Gets Vocabulary Recommendations

HDM Breaking News, April 29, 2010

The HIT Standards Committee, an advisory body to the Office of the National Coordinator for Health Information Technology, has sent two recommendations to ONC covering the relationship of medical vocabularies to meaningful use of electronic health records.

The first recommendation calls for a single federal office or agency to be responsible for ensuring the creation, maintenance, dissemination and accessibility of all vocabulary value sets and subsets related to meaningful use. The entity would coordinate with standards development organizations, federal agencies and other relevant stakeholders.



A Secure EMR Transition

Organizations need to replace their trust-based security methods with an approach based on processes and policies.

By Saurabh Bhatnagar

Over the last five years, about 30 million data breaches have involved medical organizations. Often, in such incidents, hundreds of thousands of records were lost in a moment and legal notification requirements put a price on each lost record.

By 2014, it's likely that every American will have an electronic medical record (EMR). Privacy advocates fear all this digital information will put consumer privacy at risk. At the same time, Washington fears that paper records are driving up health care costs. They're both right. And businesses fear that IT system modifications and security solutions will cost more than they save.



National Patient Safety Foundation Awards Grant to Research Safety of Computerized Ordering of Medications

Quantros MEDMARX medication error reporting system will be linchpin of new patient safety research project

April 26, 2010 - Boston, MA - Although federal lawmakers have committed tens of billions of dollars to incentivize health systems and providers to use electronic information systems to improve patient care, thousands of potentially serious medication errors have been tied to use of computerized ordering of medications.

The National Patient Safety Foundation (NPSF) has awarded a highly competitive research grant to the Center for Patient Safety Research and Practice at the Brigham and Women's Hospital and Harvard Medical School to research errors reported as being associated with computerized prescriber order entry (CPOE). Quantros, Inc., the Silicon Valley-based software company that manages MEDMARX, will partner with the Center on the year-long project. MEDMARX, initially developed by US Pharmacopeia (USP), now owned and managed by Quantros, is a Web-based solution that collects anonymous reports of medication errors. MEDMARX contains more than 1.5 million reports and is now the largest adverse drug event database in the world.



Nurses weigh in on new HIT

By Jeff Rowe, Editor

A recent survey indicates that while nurses have mixed opinions about the effectiveness of new EHR technology, they largely agree when it comes to how best to incorporate HIT into existing practices.

The survey, conducted by AFT Healthcare and reportedly the first attempt to get the views of nurses on EHRs, found that 49 percent of nurses surveyed “said new computerized systems have had a positive effect on patient care . . . 23 percent . . . said new computerized systems have had a negative effect on patient care, and 24 percent said they have not had any effect.”



Committee shows hits, misses from stimulus law

By Joseph Conn / HITS staff writer

Posted: April 29, 2010 - 12:15 pm ET

Since passage of the American Recovery and Reinvestment Act early last year, the Office of the National Coordinator for Health Information Technology has had its hands full doing what its name implies—stage managing a massive national health IT promotional production.

A meeting on April 28 of the Health Information Technology Standards Committee provided examples of federal actors both hitting and missing their marks. The committee was created under the stimulus law to advise the ONC.


I.T. Tab for Reform: $5 Billion+

HDM Breaking News, April 29, 2010

Federal, state and local governments will need to invest more than $5 billion in health information technologies to comply with provisions of the health care reform law, according to a new report.

The report is from INPUT, a Reston, Va.-based consulting firm serving public sector firms and companies seeking business with governmental units. Co-authors Angie Petty, senior analyst; and Deniece Peterson, manager of industry analysis at INPUT, identify I.T. opportunities in four categories:

* Clinical I.T. such as electronic health records and clinical decision support;

* Medical technologies such as diagnostic equipment and imaging hardware and software;

* Business I.T. such as billing systems, case management and document management; and

* Reform management applications such as Web portals and I.T. infrastructures for new organizations.



UK Study: EMR mining for heart risk as effective as universal screening

April 29, 2010 — 12:47pm ET | By Neil Versel

Foes of big government rejoice--though this news does come from England's National Health Service.

Mining of primary care EMRs to find patients at high risk for cardiovascular disease is just as effective in preventing heart disease as an NHS plan to screen nearly all UK residents between the ages of 40 and 74, independent British researchers have concluded.



EMRs can't fulfill potential unless patients have access to their own data

April 29, 2010 — 12:29pm ET | By Neil Versel

Here's the $25 billion (give or take a few billion) question: "Is HITECH working?" That's the title of a multi-part series by Vince Kuraitis, Dr. David Kibbe and Dave deBronkart, a.k.a. "e-Patient Dave," on the e-Care Management blog.

Wednesday's post, part five, is about "the reason the whole system exists: patients." Or, as outspoken cancer survivor deBronkart has said in multiple presentations, "Gimme my damn data!" In other words, EMRs won't fulfill their potential unless patients can see their own records and fully participate in care decisions.


For more:

- check out this e-Care Management blog post



Thursday, April 29, 2010

Oregon Lessons: Preparing the Work Force for Health IT Transformation

by Jo Isgrigg

The tipping point for the health IT work force and a technology-savvy health care work force occurred with the passage of the HITECH Act. The legislation's ambitious goals set in motion a need to increase the health IT, informatics and information management work force at an accelerated rate.

Experts have said that the health IT funding included the 2009 federal economic stimulus package could exacerbate the U.S.' health IT work force shortage. According to estimates, the country will need tens of thousands more health IT workers to effectively meet the goals of the HITECH Act.

The Office of the National Coordinator for Health IT and the U.S. Department of Labor recently awarded millions of dollars to educational institutions aimed at training the health IT work force needed to implement standards-based health IT systems, a nationwide health information network and provide every U.S. resident with an electronic health record by 2014.



Cerner 1Q Profit Up 23% On Higher Revenue, Bookings

Cerner Corp.'s (CERN) first-quarter profit grew 23%, topping the company's own estimate, as the health-care information-technology company saw improved revenue and bookings.

Despite the beat, shares slipped 2.8% to $87.70 in after-hours trading as the company merely reaffirmed its view for the year and issued a current-quarter forecast in line with Street estimates. The stock is up 9.5% so far this year.

Many health-care providers have adopted clinical information technology slowly, due to its considerable expense and resistance from doctors reluctant to abandon familiar paper records. Electronic-billing systems are common, but in hospitals--Cerner's bread-and-butter customers--big IT gaps remain, notably for computerized clinical-order entry and electronic medical records. This provides the company with growth prospects.



Policymakers explore patient consent trigger point

By Mary Mosquera
Tuesday, April 27, 2010

An group advising the Health & Human Services Department on privacy matters is wrestling with determining at what point in a health information exchange it becomes necessary for providers to obtain consumer consent to approve the transaction.

That line is not clear in situations where intermediary organizations help providers transport data in one-to-one exchanges with other providers, for instance, said Deven McGraw, co-chairman of the Health IT Policy Committee’s privacy and security work group at its meeting April 26.


Telehealth Links Doctors To Remote Patients In Need

Don't have health facilities nearby? Medical providers across the country are delivering healthcare virtually.

By Marianne Kolbasuk McGee, InformationWeek

April 27, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=224600596

New telehealth initiatives across the country are starting to address critical shortages of many medical specialists, helping provide care to patients who previously didn't have access.

Widespread adoption of e-health records is expected to boost telehealth adoption even further. That's because in addition to videoconferencing capabilities that let clinicians remotely communicate with each other and patients, digitized health records will provide remote specialists with more complete information about those patients.

Meanwhile, the use of digital medical images from picture-archiving systems and even digital cameras are making a wide range of information available to doctors about patients from afar.

Healthcare organizations are deploying telehealth to patients where there are shortages of specialists such as dermatologists, neurologists, radiologists, critical care doctors, and mental health specialists. Telehealth is also helping to close the care gap for patients who live in rural areas, as well as patients with debilitating illnesses for whom travel is difficult or impossible. In some instances, telehealth is helping to link patients with medical expertise even while the patient is in transit.



Personal health records most likely to be used when doctors recommend them

Technically Speaking. By Pamela Lewis Dolan, amednews staff. Posted April 26, 2010.

The number of people using personal health records has doubled in the past year. But those users still account for only 7% of the American patient population, according to one recent survey.

That survey also found that if patients are going to be pushed toward greater PHR adoption by anyone, it's going to be by the health care system representatives they trust the most -- their physicians.

The California HealthCare Foundation commissioned a study in which researchers talked to people who use PHRs as well as people who don't. Nonusers made up 89% of the 1,864 respondents (the rest didn't know or refused to answer). The report, "Consumers and Health Information Technology: A National Survey," found that the biggest barrier to PHR use is privacy concerns, cited by 75% of non-PHR users. Many respondents expressed fears that their medical information could be used against them by insurers or employers, both of which are pushing for PHR adoption.



Ex-researcher gets 4 months in UCLA records case

By Gregg Blesch / HITS staff writer

Posted: April 28, 2010 - 10:00 am ET

A former UCLA Health System researcher was sentenced to four months in prison for illegally perusing the medical records of co-workers and celebrities.

Huping Zhou will be the first person in the U.S. to go to prison for violating the medical privacy provision of the Health Insurance Portability and Accountability Act, according to the U.S. attorney's office in Los Angeles.



Telehealth in Newfoundland and Labrador exceeds expectations

April 27, 2010 (St. John’s, NL) – Efforts to connect patients from remote communities to specialists far away have resulted in 8,601 virtual consultations in the past five years, exceeding projections by 6,743 consultations, announced Jerome Kennedy, Newfoundland and Labrador’s Minister of Health and Community Services.

Since 2005, Telehealth has helped increase access to specialized and critical health care services for residents across Newfoundland and Labrador. The technology allows patients to consult with specialists from across the province without leaving their communities - saving time, money and increasing access to much needed care.

“Telehealth has become an essential element for many physicians and health care providers throughout our province,” said Jerome Kennedy, Minister of Health and Community Services. “Considering the vast geography of our province, implementing technology such as Telehealth closes the gaps created by distance and offers sustainable access to health care for patients in rural areas of the province.”



Rotherham: NPfIT has put us back 10 yrs

28 Apr 2010

The chief executive of The Rotherham NHS Foundation Trust has said the National Programme for IT in the NHS has "put back the contribution of IT in the NHS by more than ten years."

In a controversial speech at the Health Informatics Congress 2010 in Birmingham, Brian James renamed the programme "NFFPIT - Not Fit for Purpose IT." He also said it had "not only impacted on systems within healthcare but also on the skills of the IT profession to scope and manage projects."

Last year, The Rotherham became one of the first NHS trusts to go outside the national programme for an electronic patient record programme. It rejected iSoft's Lorenzo system from CSC and instead decided to implement a £40m Meditech v6.0 system from FileTek.



FoI reveals plans for SCR Release 2

26 Apr 2010

Summary Care Records may be created outside general practice under NHS Connecting for Health plans for the development of the SCR programme.

Documents released under the Freedom of Information Act reveal that 'release 2' of the SCR would enable non-GP care settings - such as A&E and outpatient departments - to create a record and not just to add to one created in general practice.

The documents obtained by Hampshire GP Dr Neil Bhatia also indicate that 'release 2' would hold far more information, including hospital letters.

Public information programmes would not run for release 2 information. However, CfH said systems sending release 2 content to the SCR would first check the patient’s SCR consent preference on the Spine.



Lessons of the military’s global EHR

  • By Capt. Michael Weiner
  • Monday, April 26, 2010

As the nation moves toward standards for EHR and the Nationwide Health Information Network, the future of electronic health records has arrived.

Sometimes people ask why all of this is important, but there is really a simple answer. EHRs share healthcare data throughout the nation, and this data exchange can make a difference in saving lives, energy and pain. The Military Health System proves that concept every day by making faster and more comprehensive treatment decisions to its more than 9.6 million beneficiaries.

Even so, as of March 2009, as the New England Journal of Medicine has noted, less than 1.5 percent of U.S. hospitals have adopted a comprehensive electronic health records system.



To Reduce Spending, American College of Physicians Will Advise Doctors What's Too Costly and Useless

Cheryl Clark, for HealthLeaders Media, April 27, 2010

This summer, the organization representing 130,000 internists will publish of a series of papers that will tell America's doctors what they should and should not order in diagnostic tests and therapies, a guideline that strives to lower cost while it eliminates unnecessary care.

"We feel it's our responsibility to be developing some recommendations as to what our physicians should be doing to keep costs down," says Steven Weinberger, MD, deputy executive vice president of the American College of Physicians. While the organization will be looking at diagnostics as well as therapies, its first target will be the former.

First up, Weinberger says, will be a paper examining the needless yet expensive tests such as magnetic resonance and CT scans ordered for simple low back pain when simpler and much less expensive x-rays would suffice.



HHS data breach site grows to 64 organizations

By Joseph Conn / HITS staff writer

Posted: April 27, 2010 - 12:30 pm ET

In six months, HHS has posted information about 64 healthcare organizations that have suffered breaches of patient medical records extensive enough to warrant public posting under the requirements of the American Recovery and Reinvestment Act of 2009, also known as the stimulus act.

Posting dates range from September 2009 through March 2010.

Under the stimulus act, HHS is obliged to post a list of breaches of so-called “unsecured protected health information” if the breach involves the records of 500 or more individuals. Among the more common offenders, there are 23 hospitals on the list, 13 health plans, 13 physician offices and four clinics. The average physician office breach affected 4,496 individuals while the average hospital breach involved 6,251.



New warning on health records

Terence Corcoran, Financial Post

Auditor-General Sheila Fraser's report last week on Canada Health Infoway and the federal-provincial pan-Canadian Electronic Health Records initiative failed to generate much news. The report, "Electronic Health Records in Canada: An Overview of Federal and Provincial Audit Reports," is an alarming portrayal of a multi-billion fed-prov program that's at risk of running off the rails. Apparently, however, the AG's report didn't contain enough sweeping statements to satisfy media practitioners who prefer to have their boondoggles served up fully diagnosed and ready for surgery.

In summary, the report concluded that Canada's Electronic Health Record (EHR) program, as implemented so far by Infoway and the provinces, has no overall cost controls, no total cost estimate, no numbers on total costs to date, no way of measuring benefits, no way of determining whether budgets are being met, has lacked strategic planning, has a high risk of not achieving objectives, and there are questions about how the project will be funded through to the end.



The VA's many happy returns (on investment)

By Joseph Conn / HITS staff writer

Posted: April 27, 2010 - 12:30 pm ET

Arguably the rarest thing in all of U.S. healthcare is a robust analysis of the return on investment from a health information technology project.

The Veterans Affairs Department offers no exception.

The VA has spent massive sums over more than three decades to develop a clinical IT system that is one of the best electronic health records in the nation, and yet the VA could only estimate the actual cost of its system, much less determine the dollar value of its benefits. That's changed a bit.

Enter a team of six researchers from the Center for Information Technology Leadership, which is part of 10-hospital Partners HealthCare System, Boston, who undertook a forensic analysis of IT spending at the VA and attempted to calculate what benefits veterans and taxpayers have derived from it.

The write-up of their labors, “The Value From Investments in Health Information Technology at the U.S. Department of Veterans Affairs,” appeared in the April issue of Health Affairs, a healthcare policy journal.



VA's IT efforts helped boost quality: study

By Joseph Conn / HITS staff writer

Posted: April 28, 2010 - 10:00 am ET

Part two of a two-part series (Access part one):

The Veterans Affairs Department's VistA clinical information system is getting a second look here today because there are some issues arising in Congress and the healthcare community itself about the safety and efficacy of health information technology systems and whether the pending, massive federal subsidies of electronic health-record systems is really such a good idea.



Point-of-Care Tool Helps Clinicians Answer Questions, Make Decisions

Cynthia Johnson, April 22, 2010

There may be no better way for a clinician to problem-solve than by analyzing all of the information at hand and making an informed decision when it's most needed—at the point of care.

Fortunately, clinicians have more recent and relevant medical data at the ready with the availability of a clinical reference tool called DynaMed by Ipswich, MA-based EBSCO Publishing.

DynaMed is an evidence-based tool that can help healthcare professionals answer the clinical questions they encounter in hospitals, medical schools, residency programs, and in their own practices. It contains timely, clinically organized summaries for more than 3,000 topics. The tool, which is updated daily, monitors hundreds of journals and evidence-review databases.

"It really ought to be wherever the clinical question comes to mind," says Brian Yeaman, MD, chief medical information officer at Norman (OK) Regional Health System (NRHS). "Because if you wait even 30 seconds, the probability that you're going to look up a question goes down significantly as a provider. And if you wait until the end of the day, that probability is likely in the single digits at that point in time."



Not Enough Time on My Hands for an Online PHR

Gienna Shaw, for HealthLeaders Media, April 27, 2010

I had such a clever idea for this week's column: I would test a number of free online personal health record sites and write about the experience. About four and a half hours into my research—with only one prescription and a list of the vitamins I take daily entered into just one online PHR site—I realized that I would have to either abandon the project or abandon all hope of meeting my deadline.

My personal health record currently consists of a file in my home office stuffed with random papers—bills, test results, receipts for co-pays, old insurance cards, and notes scribbled on scraps of paper—from a number of different sources. My most comprehensive record is a little blue book with my childhood immunizations recorded in fading ink in my pediatrician's scrawling hand. I've moved and changed providers often enough that many of my records are likely lost forever.



ACP: Quality measures key to meaningful use

April 23, 2010 | Bernie Monegain, Editor

TORONTO – Increasing the use of quality measurement as part of electronic health records systems is critical to achieving meaningful use of health information technology, the American College of Physicians reported in a paper released Thursday at the 129,000-member organization's annual meeting in Toronto.

More than 5,000 health professionals are in attendance at the meeting, which runs to Saturday at the Metro Toronto Convention Centre.

The ACP paper, titled "EHR-Based Quality Measurement and Reporting – Critical for Meaningful Use and Health Care Improvement," asserts that using EHRs as the basis for quality measurement systems would allow for a more complete reflection of care processes and patient outcomes. Ultimately, this would result in a more clinically useful set of quality data.



New technology decreases risk of deadly medical mistakes

One in five Americans say themselves or a family member were victims of a medical mistake. Now, hospitals are taking steps to ensure patients stay safe.

Reporter: Maureen McFadden

Email Address: maureen.mcfadden@wndu.com

It's supposed to be a place you go to for help, but sometimes, a trip to the hospital can turn into a patient's worst nightmare.

One in five Americans say themselves or a family member were victims of a medical mistake. Now, hospitals are taking steps to ensure patients stay safe.

She looks like a typical young girl.

"Candace was the most beautiful, loving little girl," says Candace's mother Mathy Milling Downing. "She was everybody's friend."



McKesson commits to bring Paragon to NHS

27 Apr 2010

US healthcare IT company, McKesson, has committed to bring its Paragon hospital information system to the NHS market.

The system, which is aimed at the mid-sized community hospital market in the US, will be anglicised for use in the NHS, where it will be offered to acute trusts as a replacement to ageing McKesson TotalCare and Star systems.

McKesson has employed a UK-based team to work alongside the US Paragon team in order to adapt he product for the NHS and will use a “multi-staged deployment strategy” to implement the system across NHS trusts.



Website to collect patients' views on adverse events

By Maureen McKinney / HITS staff writer

Posted: April 26, 2010 - 12:00 pm ET

Patients who have been the victim of an adverse medical event will now have a new way to share the details of their experiences, according to the Empowered Patient Coalition. The San Francisco-based not-for-profit group, in collaboration with the Austin, Texas-based Consumers Union Safe Patient Project, has released a 40-question online survey that patients can use to report on their perspectives of incidents of medical harm.

The survey prompts respondents to provide the details of the incident including the state where it occurred, the type of provider involved, contributing factors, whether they considered litigation and providers' response following the event. Patients have the option of submitting the surveys anonymously.



Spotlight Shines on Health I.T. Safety

Joseph Goedert
Health Data Management Blogs, April 23, 2010

Some months ago, Sen. Charles Grassley (R-Iowa), who has been investigating the safety of health information technology, sent a letter to Health and Human Services Secretary Kathleen Sebelius asking for her views on whether the Food and Drug Administration should regulate health I.T. products.

Grassley wasn't coy. One of his questions was: "With over $20 billion in taxpayer money at stake and with increasing complexity in the technologies being used in our hospitals, do you believe it is time to revisit FDA's responsibilities in regulating HIT products being used in clinical care?"



HHS: Privacy Rule Changes Coming

HDM Breaking News, April 26, 2010

The Department of Health and Human Services is scheduled in May to issue a proposed rule making a series of modifications to the HIPAA privacy and security rules mandated under the HITECH Act.

Other expected regulations include a proposed rule in October to revise the electronic submission of clinical trials data covering human drugs and biologics, and a proposed rule in December to establish a unique identification system for medical devices.



Royal Devon and Exeter selects System C

26 Apr 2010

Royal Devon and Exeter NHS Foundation Trust has chosen System C as its supplier for order communications and electronic prescribing, as key elements of a new electronic patient record system.

System C will supply the trust with components of its updated Medway Clinical product.

Although no official confirmation has yet been made, and the trust says the procurement has yet to be completed, E-Health Insider understands System C has been selected following an OJEU procurement. The company was selected ahead of three other short-listed suppliers: iSoft, Cerner and Alert.

The trust told EHI that no procurement decision had yet been made “we are still in the procurement process and are unable to comment further”. System C declined to offer any comment.



NHS Scotland picks Ensemble to integrate

26 Apr 2010

NHS Scotland has awarded a contract to InterSystems for a national licence to use its Ensemble product for e-health integration across the Scottish health service.

The new contract win follows InterSystems being picked in January to provide its TrakCare product, for the Scottish Patient Management System (PMS) to provide a common patient record system across Scotland.

InterSystems Ensemble product will be used in conjunction with the firm's TrakCare electronic record product for healthcare integration and the development of connected applications.

The use of a common integration platform should significantly enhance the secure flow of clinical and non-clinical information to improve patient safety and clinical outcomes.



California hospital says it's first to self-implement VistA

April 26, 2010 — 12:27pm ET | By Neil Versel

Hard to believe--and we'd like to see some more proof ourselves--but a California hospital claims that it is the first in the country to download the VA's VistA EMR software and tailor the open-source system for its own use. Whether it's truly the first, Oroville Medical Center is implementing VistA not through a third party such as Medsphere Systems, WorldVista or a major consulting firm, but by doing all the modifications in-house, the Oroville Mercury Register reports.



Is cutting and pasting a 'modern medical illness' or an attempt to fix an old malady?

April 26, 2010 — 1:51pm ET | By Neil Versel

A letter to the editor in the May issue of the American Journal of Medicine calls the copy-and-paste function of EHRs a "modern medical illness."

"Medical diagnosis in previous admissions that have no relevance for the present hospitalization are repeated and copied from one summary to the other. Previous medications are copied and printed as if they were the patient's current treatment even if the patient is no longer taking them. Data presented in a previous hospitalization are repeated without changing the details or actualizing the date; subsequently the reader may not be able to understand or may misinterpret the data. Much information from past reports, for example, in admitted patients with coronary heart disease, is copied from previous charts and presented in the history of the present illness as a never-ending paragraph that is repeated to exhaustion with each hospitalization, whereas the actual and relevant history of the present illness is briefly presented in one small single line," writes Israeli physician Dr. Arie Markel.

(Wouldn't you know, I just copied and pasted that long paragraph?)



Doc calls EHR copy and paste function a "modern medical illness"

April 23, 2010 | Molly Merrill, Associate Editor

NEW YORK – The copy and paste function of an electronic health record is "one of the most egregious dangers of electronic charting," according to a recent editorial in the American Journal of Medicine.

Arie Markel, MD, director of one of the departments of internal medicine at a hospital in Israel, found out first hand the ill effects of copying and pasting in patients' charts.

Markel wrote a letter entitled "Copy and Paste of EHRs: A Modern Medical Illness" in response to the AJM editorial in which he said he "identified strongly" with the subject of the editorial written by Ronald Adelman, MD, medical director of the Irving Wright Center of Aging and co-chief of the Division of Geriatrics Medicine and Gerontology at The New York-Presbyterian Hospital, and Eugenia L. Siegler, MD, medical director of the Geriatrics Inpatient Service at the Weill Cornell Campus of New York Presbyterian Hospital.



Monday, April 26, 2010

Government Making Progress on Federal Stimulus Provisions

The federal government continues to move ahead with implementing various provisions of the American Recovery and Reinvestment Act of 2009. This update summarizes certain significant developments since early March.

Health IT

On April 6, HHS announced more than $267 million in awards to 28 additional not-for-profit organizations to establish Health Information Technology Regional Extension Centers. This latest round of awards brings the total number of REC’s to sixty. Additionally, all REC awardees now have an opportunity to apply for a $25 million two-year supplemental expansion award to provide health IT support services to more than 2,000 critical access hospitals and rural hospitals having 50 beds or fewer. RECs are eligible for $12,000 for each critical access and rural hospital that they assist.

On April 2, ONC announced $60 million in awards for four institutions under the Strategic Health IT Advanced Research Projects program. The SHARP program funds institutional research on barriers to health IT adoption to inform solutions to achieving nationwide "meaningful use" of health IT, with a focus on:

  • Health IT security;
  • Patient-centered cognitive support;
  • Health care application and network platform architectures; and
  • Secondary use of electronic health record data.

Also on April 2, HHS announced awards totaling $84 million to 16 universities and junior colleges to support training and development of more than 50,000 new health IT professionals.




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