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.
May 14, 2010 | Molly Merrill, Associate Editor
DENVER – Kaiser Permanente is crediting healthcare information technology and care coordination as helping more than 40 percent of very high-risk patients reach national cholesterol guidelines – a feat that past studies indicate is difficult to achieve.
In 2004 the National Cholesterol Education Program issued revised cholesterol goals recommending people at very high-risk for heart disease move their target LDL or "bad" cholesterol from 100 mg/dL to 70 mg/dL to reduce the risk for another heart attack.
Many health experts have questioned the legitimacy of such an aggressive goal. Previous research has found only between 15 and 30 percent of patients were able to get their cholesterol to the recommended goal.
The study, which is the largest to date demonstrating how many patients can get to the lower goal, found that of the 7,247 Kaiser Permanente patients studied, 43.4 percent lowered their bad cholesterol to less than 70 mg/dL. The majority of patients who attained an LDL less than 70 mg/dL in the study were receiving a statin or a combination of statin and other cholesterol-lowering therapies.
May 24, 2010 — 12:03pm ET | By Neil Versel
Think the tug-of-war between vendors, health systems and privacy advocates over data mining and de-identification of patient records is subsiding? Think again.
The outspoken Dr. Deborah Peel has a memorable line that she often repeats: "Once your information is released, it's like a sex tape that lives in perpetuity in cyberspace," she says in a Dallas Morning News story. "You can never get it back." The Morning News last week took a look at the contentious struggle for control of data that must be resolved before the healthcare industry is to fulfill President Obama's vision of a nationwide, interoperable system of EMRs and health information for all Americans.
Posted: May 24, 2010 - 12:01 am ET
The American Recovery and Reinvestment Act of 2009, commonly known as the stimulus law, has a host of tight deadlines for its myriad health information technology subsidy and IT network development initiatives.
Nearly all of them are timed to help fulfill the ambitious goal set by former President George W. Bush in 2004 and adopted by President Barack Obama last year to make electronic health records available to most Americans by 2014.
Not surprisingly, a federally funded health IT workforce training effort is both part of the overall program and caught up in its mad rush.
“We are moving fast,” said Patricia Dombrowski, director of the Life Science Informatics Center at Bellevue (Wash.) College, which is leading a consortium of community colleges that applied for and won $3.4 million in workforce training grants funded by the stimulus law—covering career paths from information management to IT hardware installation.
Posted: May 25, 2010 - 12:01 am ET
Part two of a two-part series (Access part one):
Along with the push to ramp up the use of health information technology in hospitals and doctors' offices comes the need for a highly skilled labor force to get the job done.
Claire Dixon-Lee is executive director of the Commission on Accreditation for Health Informatics and Information Management Education; the CAHIIM is a division of the American Health Information Management Association that accredits 281 health information management certificate and baccalaureate degree programs at schools across the country. In the past, health information management workers dealt with managing paper records, but their jobs have changed with the times.
Dixon-Lee said that today many AHIMA members are doing the work of IT specialists at their hospitals and physician offices while others can be retrained for these new positions. CAHIIM-accredited programs graduate between 3,000 and 3,500 students a year, of which 600 receive bachelor's degrees and the rest associate's degrees, she said.
Tuesday May 25th, 2010
Training for a New Health Care Information Era:
Kirkwood receives major Federal grant, part of regional and nationwide program
Kirkwood Community College will soon launch a training program to boost skills and advance careers in health information technology. A grant from the U.S. Department of Health and Human Services will put more than a half million dollars toward training programs for IT professionals in hospital, clinical and other health care settings.
Kirkwood is one of 17 community colleges across the Midwest putting the training program into action. The grant provides $512,000 in Kirkwood support for two years of training sessions. The educational program will focus on non-credit, short-term training.
Cuyahoga Community College of Cleveland, Ohio is the lead institution in the Midwest portion health care information training project. The total grant award to the 17 Midwest community colleges totals $36 million, with an overall goal of more than 50,000 new health IT professionals in the workforce by mid-2012. The larger scope of this grant includes 70 community colleges across the U.S.
May 20, 2010 | Kyle Hardy, Community Editor
ANDOVER, MA – Interoperability is a major part of the HITECH Act, the healthcare IT portion of the American Recovery and Reinvestment Act, passed in February of 2009. And according to Dale Wiggins, chief technology officer of Philips Healthcare Patient Care and Clinical Informatics, it all starts with modalities.
"It's important to providers that modalities (PACS, MRI, CT scans) integrate with the other legacy systems at their facilities," said Wiggins. "Providers have orders that need to be filled and Philips is moving to make sure work flow is not interrupted."
Interoperability has been touted as having much potential in improving the quality of care for patients. Providers are looking at integrating new systems with their existing IT infrastructure to reduce waiting room times, provide clinical decision support for physicians and ultimately reduce costs.
May 21, 2010 | Mike Miliard, Managing Editor
DENVER – The use of at-home blood pressure monitors and Web-based reporting tools that connect patients and clinicians appears to significantly improve patients’ ability to manage their hypertension down to healthy levels, according to new research.
The study, which was led by Kaiser Permanente Colorado in collaboration with the American Heart Association and Microsoft, followed 348 patients, ages 18 to 85, with uncontrolled high blood pressure. The initial study data was presented today by Kaiser Permanente Colorado researchers at the American Heart Association’s 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
By monitoring system performance on the backend, an Alabama health system hopes to make its e-health record rollout go smoother for users.
By Marianne Kolbasuk McGee, InformationWeek
May 25, 2010
When rolling out a new e-health record system, the last thing a healthcare organization wants is for clinicians to complain about how slow the system is, or even worse, being unable to access digitized patient information.
As it is, making the switch from paper records -- and paper-based processes -- to computerized record keeping, prescription ordering, and a digitized workflow can be disruptive and challenging enough for a doctor practice or hospital department. Throw in systems performance problems on the backend and the frustration will only escalate.
Avoiding those kinds of problems from the get-go is the plan at Baptist Health System of Birmingham, Ala., which operates four hospitals in the state and about 35 doctor practices and health centers.
25 May 2010 – Health institutions and schools in developing countries continue to have limited access to information and communications technology (ICT), the United Nations telecommunication said in a report issued today, calling for greater efforts to improve access to high-speed Internet services.
“The health sector stands to benefit greatly from the use of ICTs and ICT applications, for example through the more efficient delivery of health-care services and the provision of health information to the general public,” the UN International Telecommunication Union (ITU) said in its 2010 report.
25 May 2010
The role of the Internet and specifically ehealth portals continue to expand at a significant pace. The various major functions of ehealth portals are identified, along with the results of an online survey conducted among employees of eight major U.S. employers. Demographic variables, job characteristics, reasons for use of the portal and selected behavioral outcomes are presented from a sample of more than 20,000 employees, with a response rate in relation to the entire employee population of 19%. Major implications from the survey findings are then identified, with an intention of enhancing the health improvement effectiveness of the ehealth portal.
Intel Health, which is struggling to find a winning business model in the U.S., is entering Europe with a carrier strategy.
The company announced marketing deals with Telefonica of Spain, BT of England, and Orange in France as part of its entry to the continent’s e-health market.
Other strategic partners listed in the release are GE Healthcare, which will work with it in England, and Asklepios Hospital Group of Germany, one of the region’s largest private hospital groups.
By Cristen Conger | Wed May 26, 2010 01:56 PM ET
But the information didn’t come from someone directly involved with the late actress’s caretaking. Instead, the person in question hacked into Fawcett’s electronic medical record in the hospital’s patient database.
As the national initiative to create electronic medical records for every American moves forward, the Fawcett incident exemplifies the worst-case scenario for putting people’s most personal and sensitive health records in a digital format.
Unless electronic medical records are safe, they could end up in the wrong hands, opening the door to medical identity theft, insurance fraud and other breaches of privacy.
May 26, 2010 (St. John’s, NL) – Newfoundland and Labrador has officially begun connecting community pharmacies to the provincial Pharmacy Network, the Honourable Jerome Kennedy, Minister of Health and Community Services announced today. Minister Kennedy was joined by Mike Barron, CEO of the Centre for Health Information, Don Rowe, Newfoundland and Labrador Pharmacy Board, Don Sweete, Canada Health Infoway’s Executive Regional Director for the East, and Paul LePage, Vice President and General Manager of Healthcare Delivery Solutions, TELUS. The Pharmacy Network is a provincial drug information system that contains a record of patient medication information and comprehensive drug information which will assist pharmacists in identifying potential adverse drug interactions.
May 25, 2010 8:41 am by Elana Centor in Tech
There are fewer things in life more important than our health. And yet, most of us have never even peeked at those records. In the five -- make that nearly six decades -- that I've been seeing physicians, I have never once looked at a single page in my medical record. Not one page. Ever.
How bizarre is that? What if there is something in there that's inaccurate? What if there is something in there that I should know but have forgotten? Until recently, it never even occurred to me that I should review these records. It just wasn't on my radar.
My medical records probably are skinnier than most. I have no chronic diseases. Don't take medications on a regular basis. Have had a couple of surgeries. A concussion. A couple of pregnancies. The most significant medical event was a case of shingles on my facial nerve that created a rather thick file for my ophthalmologist. To the best of my knowledge, that file has never been shared with my regular physician. Maybe there is something in there in how I responded to treatment that would be important for future medical episodes.
By Mary Mosquera
Monday, May 24, 2010
Healthcare providers should encrypt patient information when they share it with another provider, even in a case of the direct exchange of personal health information or data that is not facilitated by a health information exchange or other third-party organization.
The recommendation for guarding patient information privacy in a simple health information exchange was made by the privacy and security workgroup of the Health IT Policy Committee at a May 19 policy committee meeting.
In recent weeks the workgroup has been wrestling with determining at what point in a health information exchange it becomes necessary for providers to obtain consumer consent to approve an exchange a transaction.
May 24, 2010 | Bernie Monegain, Editor
BOSTON – No issue is more important to healthcare providers than data management, according to a new global survey of healthcare executives, conducted by BridgeHead Software, which develops and markets healthcare storage virtualization solutions.
Forty-four percent of respondents to BridgeHead Software's Healthcheck 2010 Survey of hospitals and healthcare organizations worldwide indicate that data backup/business continuity/disaster recovery is their top IT investment priority throughout 2010 and likely beyond.
The Healthcheck 2010 survey gauged the opinions of 133 healthcare executives on their most pressing IT needs. Nearly 50 percent of respondents were from the IT executive or director/manager level, and approximately 10 percent were non-IT executives. The rest included technology and medical professional with a spattering of titles and responsibilities.
Web Alerts When Doctors Run Late
A new Web-based tool seeks to help patients spend less time in the waiting room before seeing their doctor. The application, called MedWaitTime, allows patients to check before their appointment whether their doctor is running late, akin to getting a flight-status update before going to the airport.
Patients can access the site, medwaittime.com, up to two hours ahead of their appointment. If the doctor is running late, patients can be instructed to arrive later than their scheduled appointment.
Patients can also enter their cellphone number into the system for alerts through text messaging.
The employer consortium is offering its e-health record software to other companies via the cloud and is also developing an EHR package for small and mid-size businesses.
By Marianne Kolbasuk McGee, InformationWeek
May 24, 2010
Dossia, the consortium founded several years ago by nearly a dozen large employers to develop and offer e-health records to their workers, is now making that software platform available to other companies.
Via a software-as-a-service, multi-year subscription-fee model, the Dossia Personal Health Platform is now being offered to a wider range of employers that want to provide EHRs to their workers, said Steve Munini, Dossia chief operating officer. Those customers will be offered the same bells and whistles that founding members are provided, he said. That includes an array of applications that have been developed for or are available via the Dossia platform by third parties, including Mayo Clinic, Allviant, and MediKeeper.
26 May 2010
The European Commission has set out its Digital Agenda, which includes measures to use technology to address rising healthcare costs and help member states to cope with their ageing populations.
The action plan says the smart use of technology and the exploitation of information will help to address these and other challenges facing society, including climate change.
The EC will set up wide-scale pilots to take forward the ideas in the Digital Agenda. One of these will aim to give Europeans secure, online access to their medical health data so they can share it with doctors. The action plan says the planned delivery date for this initiative is 2015-20.
21 May 2010
The head of Kaiser Permanente’s Innovation Centre has urged NHS professionals engaged in health IT implementations to ‘keep the faith’, as the benefits to patient care are worth the effort.
In an exclusive video interview broadcast today on EHI TV, Dr Yan Chow of leading US healthcare network Kaiser Permanente tells EHI editor Jon Hoeksma, how KP has just completed a seven year $4 billion implementation of electronic medical records that is already proving transformational.
Dr Chow, the director of innovation and advanced technology, Kaiser Permenente Information Technology, says that his organisation has completed the roll-out of EMRs in the last few weeks and already has hundreds of published studies showing the benefits to the quality of patient care, patient experience and delivery of services.
May 27, 2010 — 1:52pm ET | By Neil Versel
Sex sells. Apparently, that's even true when it comes to EMRs. How else to explain U.S. News & World Report picking up a HealthDay News report on the effect an EMR has on treatment? That's because the disease in question is chlamydia.
A study published online today in the journal Sexually Transmitted Infections finds that an EMR cut the average treatment start time to 3.5 days from 11.5 days following a chlamydia diagnosis at a sexual health clinic in the UK. The percentage of patients getting treatment within two weeks of their diagnosis rose to 94 percent with the EMR from 38 percent before the clinic installed the system.
May 27, 2010 — 11:29am ET | By Neil Versel
Anyone in the biz knows that you don't just put in an EMR and expect success. The federal subsidies, which require "meaningful use" of EMRs, up the ante. Still, implementations continue to fail, or at least not live up to expectations.
A new book, Beyond Implementation: A Prescription for Lasting EMR Adoption, examines the pitfalls of EMR projects and discusses why and how organizations should focus on user adoption, not just implementation. The authors, Heather Haugen and Dr. Jeffrey Woodside, spoke at length about the book with CMIO magazine.
May 27, 2010 — 12:07pm ET | By Neil Versel
It's likely a combination of reluctance to change and poorly designed systems that has held back wider EMR adoption, though opinions do differ greatly. Jack Callahan, executive VP at "hybrid" EMR vendor SRSsoft, Montvale, N.J., clearly believes that systems design is more at fault.
In response to a recent discussion of slow EMR uptake on the EMR and HIPAA blog, Callahan wrote what blog author John Lynn calls a "passionate" email, which Lynn published on his related EMR and EHR blog. "A major reason why the rate of EMR adoption is so slow is that, despite vendor claims, the actual needs and priorities of the busy, practicing provider are not built in," Callahan says. "I've worked closely with three EMR companies, and am aware of more than 300 EMR products, almost all of which, like lemmings, have decided to follow the old CCHIT design-and-development pathway over the cliff," adds Callahan, clearly no fan of the prevailing certification process.
28 May 2010
Kigali — The Rector of Kigali Institute of Science and Technology (KIST) has called on all stakeholders in the e-health sector become a global reality.
Addressing a workshop organised for e-Health Centre of Excellence stakeholders in Kigali yesterday, Prof. Abraham Atta Ogwu told participants that the centre is meant to help improve the health sector in the country.
"The main objective of this workshop is to bring together you as stakeholders in your respective capacities to create awareness that Rwanda has progressed and has become a part of the Global Health Informatics programs"
Posted: May 28, 2010 - 12:01 am ET
The federally chartered Health IT Policy Committee heard last week from its Strategic Plan Workgroup, which delivered advice to the Office of the National Coordinator for Health Information Technology for an annual update to the Federal Health IT Strategic Plan.
At a full-committee meeting May 19, the Health IT Policy Committee took under advisement the work group's recommendations to make several tweaks to the plan. ONC head David Blumenthal said a final vote on the recommendations could come at the policy committee's next meeting, scheduled for June 25. The Health IT Policy Committee was created under the American Recovery and Reinvestment Act of 2009 to advise the ONC on IT policy issues.
By Nancy Ferris
Wednesday, May 26, 2010
By early July, the Office of the National Coordinator will announce the winners of 11 contracts for developing a health information exchange framework based on a model originated by federal homeland security agencies for sharing sensitive information over the Internet.
The National Information Exchange Model, or NIEM, is a technical approach to information sharing that federal agencies developed during the last decade, prompted by the need to share homeland security information quickly and securely. It is based on XML standards.
HDM Breaking News, May 27, 2010
Medical information content vendor WebMD has introduced a free mobile application to access its content on the Apple iPad.
The WebMD for iPad application is in addition to the New York-based vendor's previous offering for iPhone users, called WebMD Mobile. Both services feature the company's Symptom Checker, content on more than 1,000 conditions, drug information including side effects and interactions, and first aid information.
May 25, 2010 | Diana Manos, Senior Editor
FRAMINGHAM, MA – A recent study of health information exchange solution vendors shows enterprise HIEs serving integrated delivery networks, health, or hospital systems will be the fastest-growing market segment of HIE organizations in the coming two years.
The study, "Vendor Assessment: Industry Short List for Health Information Exchange Technologies," was conducted by IDC Health Insights, a Framingham, Mass.-based market research firm.
IDC researchers said enterprise HIEs are unlike regional health information organizations (RHIOs) and statewide or national HIEs, because they can establish a sustainable business model and are not as encumbered by organizational and data governance issues.
Issue Date: June 2010
Results of an important new study dispel some major assumptions about clinical IT implementations
by Mark Hagland
The logic in the argument would appear to be unassailable: given that there is inevitably a range in the experienced functional quality of various electronic health record (EHR), computerized physician order entry (CPOE), and other clinical IT products on the market, the better the quality of particular clinical IT products, the more fully those individual products should help hospital organizations to achieve better patient safety and care quality, correct? Indeed, such assumptions would seem to be supported by the results of such important industry resources as the regular reports coming out of the Orem, Ut.-based KLAS Research, for example.
Yet the results of a new study by researchers at the Falls Church, Va.-based CSC Healthcare seem to portray a far more complex picture of what actually happens once hospitals implement clinical information systems. Despite the strong value of knowing the quality rankings of various products, some CSC researchers recently found that, when it comes to the end results around reductions in physician order entry-related medical errors, researchers found only a slight correlation between buying a “quality” EHR/CPOE product and error reduction. In other words, the bulk of the difference in actual error reduction relates to a complex knot of processes and issues separate from the brand name of a particular system an organization is implementing or has implemented. But very bluntly, a hospital can buy a very “high-quality” EHR product and customize it very poorly; or take a “mediocre” product and achieve considerable success with it.
David Blumenthal Guides Billions Of Stimulus Dollars To Help Doctors And Hospitals Adopt Electronic Medical Records
May 24, 2010
Dr. David Blumenthal was not happy to find a new computer installed on his desk when he showed up for work one morning eight years ago at Massachusetts General Hospital in Boston. He knew the hospital had been hard at work on developing an electronic medical record (EMR) system, but Blumenthal wasn't keen on changing practices that had served him and his patients just fine over the years.
Quickly, though, he found himself to be odd man out at staff meetings where younger colleagues eagerly exchanged tips on how to retrieve patient histories, test results and consults with other physicians.
"I realized I was going to have to get on board," Blumenthal recalled in an interview. Still, he approached the task of converting paper-based notes and patient records to the electronic system as more obligatory than clinically useful. The "aha" moment, which Blumenthal frequently mentions in speeches, came on the day he entered orders for a CT scan and his computer screen flashed a reminder that the patient had already had one.
Trying to follow the ins and outs of healthcare information technology — a complicated morass of electronic health records, patient and medical-management systems, federal subsidies and mandates and a whole lot more — has been like assembling a giant jigsaw puzzle whose pieces are delivered in random order. It’s some comfort, though not much, to realize that this mess baffles the experts, too.
A recent Microsoft (MSFT) press conference that included David Brailer, the first national health IT czar, put the current state of this jigsaw puzzle in a high-level perspective. But it was only slightly less confusing after Brailer and Peter Neupert, vice president of Microsoft Health Solutions, expounded on their views.
Let’s start with electronic health records, or EHRs. Last year’s stimulus bill included incentives for physicians and hospitals to acquire EHRs — but healthcare providers first have to show they’ll be using the information systems in “meaningful” ways. The draft “meaningful use” regulations, published in January, drew negative comments from many medical societies and other healthcare organizations. Providers believe it will be too difficult for them to meet the criteria within the specified time frame, and they feel it’s unfair that they have to satisfy every requirement to get the government funds.
Philip Betbeze, for HealthLeaders Media, May 21, 2010
Let's stipulate, before I go on, that I don't know much about technology or how computers work. I can run routine maintenance on my computer, but that's about it. In fact, a good (and patient) friend of mine is coming over tonight to help me hook up my wireless internet router, which really isn't all that difficult for him, but gives me hives just thinking about it. Give me a lawnmower engine to rebuild or a set of brakes to change, and I'm your man. Give me a computer to work on, and you'll get a blank stare in return.
I'm guessing many of the readers of this column fit the same mold, minus perhaps, the car repair abilities, and plus the overwhelming responsibility of being in charge of a health plan, a hospital, a physician practice or health system. No, you're not likely a computer security guru, but given the almost weekly news item about embarrassing and costly patient health information breaches in healthcare, it's appropriate to remind those of you who are in charge of your hospital, health system or physician practice: protecting this data is YOUR responsibility. I know you depend on delegates to get these jobs done, and you pay them well. You can't micromanage this stuff.
Gienna Shaw, for HealthLeaders Media, May 25, 2010
The patient of the future—also known as the e-Patient—is technologically savvy, information hungry, and has a sense of entitlement about the level of service and the types of services they want. They'll demand up-to-date, easy-to-understand, and easy-to-access information about the cost of care and billing, online appointment scheduling, the ability to e-mail their physicians, and hospital Web sites that have more information than can be found on Google maps. The patient of the future will put plenty of demands on healthcare organizations in general and healthcare IT departments in particular.
Donna Cryer is one such patient. A liver transplant recipient who's had to deal with multiple and complex health issues starting when she was just 13, she wants to be cared for in ways that can only be delivered with data-sharing and expedited communication.
HDM Breaking News, May 25, 2010
The Secretary of Health and Human Services should consider creating information technology certification programs beyond those being adopted for complete electronic health records systems and EHR modules, according to the Electronic Health Network Accreditation Commission.
Farmington, Conn.-based EHNAC, which certifies transactions processors for meeting specific performance criteria, in a comment letter makes the case for certification of other I.T. services. These could include claims clearinghouses and value-added networks, financial services, electronic prescribing, and health information exchanges, among others.
The organization understands the reasoning for the proposed certification rule's definition of an accredited certification body that is limited to certifying EHRs and EHR modules. EHNAC, however, is concerned that a "minimum" definition in a final rule will eliminate itself and other entities from consideration if HHS designates organizations to certify HIEs.
Monday, May 24, 2010
A growing number of health care providers say that telemedicine is the key to health reform, arguing that the technology can enhance record keeping, reduce waiting times, cut unnecessary hospitalizations and reduce costs.
There also are those who view telemedicine as an expensive, intrusive technology, ostensibly a gimmick promoting exotic health care reform.
U.S. Health Care Spending
As background, the U.S. devotes 16% of its gross domestic product to medical care --- more per capita than any other nation. The total U.S. health care spending in 2009 was $2.5 trillion --- some $650 billion above expected levels. Two-thirds of the "excess" health care spending went toward outpatient care -- the fastest-growing categories being same-day hospital care and physician office visits.
Looking at the issue from another dollar perspective, reportedly 20% of all ailments represent 80% of the health costs. Typically, health care for the elderly and treatment for chronic diseases account for 75% of health care spending. The high costs are attributed to multiple readmissions caused by a fragmented health system focused on acute care.