Quote Of The Year

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

Saturday, June 19, 2010

Weekly Overseas Health IT Links - 18 June, 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.



June 7, 2010

Doctors and Hospitals Say Goals on Computerized Records Are Unrealistic


WASHINGTON — In February 2009, as part of legislation to revive the economy, Congress provided tens of billions of dollars to help doctors and hospitals buy equipment to computerize patients’ medical records.

But the eligibility criteria proposed by the Obama administration are so strict and so ambitious that hardly any doctors or hospitals can meet them, not even the most technologically advanced providers like Kaiser Permanente and Intermountain Healthcare.

Doctors and hospital executives, who have expressed their frustration in meetings with White House and Medicare officials, said the issue offered a cautionary tale of what could happen when good intentions meet the reality of America’s fragmented health care system.



Survey highlights need for docs to talk to patients about moving to an EHR

June 09, 2010 | Molly Merrill, Associate Editor

NORWALK, CT – Although nearly half of all Americans are ready to toss the paper and believe electronic health records will enable more efficient healthcare, they are largely in the dark about what it actually means for them as a patient, says a new survey.

The online survey, conducted for Norwalk, Conn.-based Xerox Corporation by Harris Interactive, polled 2,180 adults between Feb. 17-19, 2010.

Only 16 percent of U.S. adults who have a healthcare provider/institution have been approached by their healthcare provider/institution to discuss converting to digital records, according to a release about the survey.



IT's Return on Investment Is Tricky to Pin Down

By Douglas Page

Typical measures aren't enough to capture the real value. Quality care is good business, hospital leaders insist.

As the rush intensifies to meet mandates for more health care information technology, hospitals must ensure they are getting solid returns on IT investments. Calculating accurate ROI, however, can be difficult.

The problem is, hospitals typically measure ROI from a business perspective—cost, revenues or operating efficiencies—but many benefits of clinical applications fall into quality and safety realms that do not easily translate into dollars.

"If the project is strategic in nature or a government mandate, ROI calculations are limited," says Denver Health Chief Information Officer Gregg Veltri.

To reach a keener understanding of IT value, investment rationale should center on clinical benefits, says John Frownfelter, M.D., chief medical information officer, inpatient services, Henry Ford Health System in Detroit. But even then, measurement tools are lacking.

"We know electronic health records are the right thing to do, but we don't have the data to predict how this will improve clinical processes or outcomes," he says, adding that hospitals generally don't prove either the business or clinical case well for clinical applications, though both are inextricably linked.



Details lead to picture of success

By Jeff Rowe, Editor

As we recently noted, ONC is on the right track in highlighting HIT success stories on its new Stories from the Road blog.

But we also suggested that they needed to find stories that gave useful details of how other providers have approached the challenge of implementing new HIT.

Take this interview with a healthsystem CIO, for example. To our eyes, while it may not be a “how to” primer in HIT implementation, it’s a good look at a system that has had success with new HIT and that knows how to keep moving forward.

Here are just a couple of the details for this system of “five hospitals, 11 immediate care centers and more than 90 physician practice locations”:

For starters, it has “small desktop groups in each hospital to deal with routine tasks, a PAC (picture archiving and communicant) administrator and a clinical informatics manager in each hospital, who connects the hospital’s clinical practices and processes with the technology,” all of which helps “drive standardization at the hospital level.”



States roll out ONC-approved IT plans

By Jennifer Lubell / HITS staff writer

Posted: June 10, 2010 - 12:00 pm ET

Maryland, New Mexico and Utah have received the green light from HHS' Office of the National Coordinator for Health Information Technology to move forward with a plan to implement a functioning health information technology exchange.

The three states are working to streamline the transfer of electronic health data among hospitals, physicians and patients through these exchanges.

In Maryland, the state's healthcare commission has chosen a not-for-profit health IT organization, the Chesapeake Regional Information System for our Patients, to develop the statewide health information exchange. CRISP has been awarded nearly $10 million in state funds by the ONC to build the exchange in phases, beginning with the delivery of a range of clinical information, including lab results, radiology and other transcribed reports. CRISP will be using the network services of Axolotl Corp., a San Jose, Calif., health IT company, for the state's exchange technical infrastructure.



IT ready for UK's biggest hospital move

10 Jun 2010

The University Hospitals of Birmingham NHS Foundation Trust is implementing a live bed management system to help staff transfer patients from Selly Oak Hospital to the new Queen Elizabeth Hospital, which will open next week as the largest single-site hospital in the UK.

The system, which has been piloted on four wards at Selly Oak over the past three months, will show staff exactly which bed a patient is in, to make sure that all patients are in the correct place.

The system, which has been developed in house, will eventually enable staff to view ward layouts and information - such as how long a patient has been in hospital, whether they are waiting for test or a result and their dependency score - from any location, including their home.



New AHRQ Software Made Available to Build Hospital Quality Website

Janice Simmons, for HealthLeaders Media, June 9, 2010

After more than two years of development, the Agency for Healthcare Research and Quality has released its MONAHRQ (My Own Network powered by AHRQ) software that hospitals can use without charge to compile, analyze, and post data on the quality and cost of their healthcare.

The Windows-based software is designed to permit hospitals and other users to create customized Websites with data that can be used either for internal quality improvement or public reporting of quality information. Average approximate time to set up the software is about one to two days, according to Anne Elixhauser, Ph.D., a senior research scientist with AHRQ.



Open Records Pilot Project Looks To Reinvigorate Patient-Physician Dialogue

John Commins, for HealthLeaders Media, June 8, 2010

Allowing patients access to their personal medical records is a decades-old idea that predates electronic medical records. Yet, the idea has yet to catch on.

Susan Frampton, president of Planetree, says the association of patient-centered care healthcare providers has for the last 20 years asked its members to allow patients access to their medical records, but with limited results. Of the 150 acute care hospitals in Planetree, only about 25% have opened their records to patient scrutiny.

"It has probably been the one most challenging practices that we have asked our members to do," Frampton says. "There is a lot of fear on the part of medical and nursing staff and that translates into resistance, in part because they are afraid of the potential for litigation if the patient reads something in their chart that they don't like the sounds of."



iSoft share price falls to five-year low

By Tony Collins on June 9, 2010 10:30 AM

The share price of NHS software supplier iSoft has today slumped to a five-year low, despite the achievement of an NPfIT milestone go-live at University Hospitals of Morecambe Bay NHS Trust earlier this month.

iSoft supplies the "Lorenzo" Care Records Service to CSC, which is the local service provider to NHS trusts in most of England, outside of London and the south.

iSoft's share price earlier today was about 25 Australian cents, down from 32 cents at the start of this week. Last week iSoft shares fell by the most on record - 30%, to 39 cents.



HHS, VA will add download feature to patient portals

By Mary Mosquera
Tuesday, June 08, 2010

The Centers for Medicare and Medicaid Services and the Veterans Affairs Department plan to add a feature to their electronic patient portals to let beneficiaries download their personal health information into a patient health record or other electronic media of their choosing.

To date, veterans and seniors have been able only to review their data on CMS’s MyMedicare.gov and VA’s MyHealtheVet patient Web portals. The “blue button” initiative, named for a new electronic button on the portal sites, will let patients use their data in any way they choose, said Todd Park, HHS’s chief technology officer.



Web-Exclusive Report:

50 Percent of Hospitals Cut IT Investments in Difficult Economy

Beacon Partners CEO Ralph Fargnoli sheds light on study of IT investments

By Jennifer Prestigiacomo

A just-released economic study from healthcare management consulting firm Beacon Partners finds that 50 percent of the participating healthcare organizations have had to cut back on IT investments due to the difficult economic climate.

According to Ralph Fargnoli, Jr., CEO of the Weymouth, Mass.–based firm, 80 percent of these healthcare organizations surveyed had decreased their capital spending, while 40 percent had made staffing cuts. “We saw this trend start in September 2008 as we were in the process of projects that were completely stopped by the economy or that really delayed decision-making processes,” says Fargnoli.

For CIOs, this study should bring comfort that other hospitals have faced tough times and made drastic cutbacks over the last couple years. “Across the board CIOs weren’t very different in terms of what happened to them in late 2008 and 2009,” says Fargnoli. “So when they look back they can say ‘we’re not different from anyone else out there who had to cut capital spending and reprioritize their projects.’”



'Perfect example' of why medical home demo proved so important

June 07, 2010 | Molly Merrill, Associate Editor

LEAWOOD, KS – Web tools that were developed as a result of the National Demonstration Project on the patient-centered medical home, an initiative by the American Academy of Family Physicians (AAFP) and its subsidiary TransforMED, are featured in report published on Monday that include all of the findings of the two-year project.

The project, which was undertaken by TransforMED and funded by the AAFP, ran from June 2006 to May 2008. It was the first and largest "proof-of-concept" project to determine empirically whether the TransforMED Patient-Centered Medical Home (PCMH) model of care could be implemented successfully and sustained in today's healthcare environment.



Medical homes don't guarantee patient satisfaction

By Andis Robeznieks / HITS staff writer

Posted: June 9, 2010 - 12:15 pm ET

It is possible to transform an independent medical practice into a patient-centered medical home, but to do so “requires tremendous effort and motivation,” according to a report by researchers summarizing the lessons learned in a two-year, 36-practice medical home national demonstration project.

A special supplement to the American Academy of Family Physicians' Annals of Family Medicine includes eight reports on the demonstration project launched June 1, 2006, and concluded on May 31, 2008; the demonstration included 18 self-directed and 18 facilitated practices of various sizes, ranging from one-physician offices to practices with seven or more doctors. The reports said these practices were chosen from a pool of 337 applicants.



The Use Of Health IT Outside The U.S.

Posted by Marianne Kolbasuk McGee on June 9, 2010 05:08 PM

While the push is on for mass adoption of e-medical record systems in the U.S., clinicians in many other countries are already accustomed to using digital health records in the care of their patients. What can we learn from each other?

In general, the use of health IT tools are often most prevalent in countries with government-run healthcare systems and also in nations where there are large and growing populations of older people, said Blair Butterfield, VP of international development e-health solutions at GE Healthcare in an interview with InformationWeek.

"Many countries advanced in their use of health IT are nations that are already facing demographic challenges that we'll soon also be facing in the U.S." said Butterfield. And that's an aging population of Baby Boomers.



Training Strategies: EHR Deployment Techniques

SA Kushinka of Full Circle Projects

June 2010

In making the transition from traditional paper files to electronic health records (EHRs), some of California's community clinics and health centers have joined together in networks to collaborate on developing best practices. This issue brief on training strategies is part of a series of tactically oriented publications based on lessons learned through the California Networks for Electronic Health Record Adoption (CNEA) initiative. The extensive training that is required to teach staff and providers to use an EHR system is one of the larger costs of implementation and an important opportunity for realizing the transformation in care delivery that EHRs can bring.

Document Downloads

Training Strategies: EHR Deployment Techniques (522k)



Health-Care IT Providers to Merge in $1.3 Billion Deal


Health-care IT providers AllscriptsMisys Healthcare Solutions Inc. and Eclipsys Corp agreed to merge in an all-stock deal valued at about $1.3 billion, creating an entity whose combined technology will make it easier for hospitals, nursing homes and doctors' offices to share patients' health information electronically.

Under the terms of the deal, announced Wednesday, Eclipsys shareholders will receive 1.2 Allscripts shares for each Eclipsys share. That's a 19.4% premium to Eclipsys's Tuesday closing price of $18.51.



The Early Take on Allscripts-Eclipsys

HDM Breaking News, June 10, 2010

Allscripts' pending acquisition of Eclipsys makes sense but has perils, according to several consultants specializing in helping providers select information systems.

Ambulatory vendor Allscripts needed a hospital vendor partner to more successfully compete with Epic Systems, Cerner, Meditech and other companies that offer ambulatory systems to hospitals for their employed and/or affiliated physicians. Further, ambulatory rival NextGen Healthcare Information Systems entered the hospital market in the past year.



8 June 2010

eHealth Worldwide

:: Haiti - Mobile EHR pilot in Haiti aims to develop standard (2 June 2010 - MobiHealthNews)

Dr. Steven Lane is part of a volunteer group of medical workers that is helping to create an international standard for health IT in disaster situations — his team has piloted the iChart mobile EHR program on the iPhone. Ever since the earthquake in Haiti, his group has sent a teams of volunteers every three weeks — the most recent trip to Haiti began earlier this month. Dr. Lane is also a Family Medicine Physician at the Palo Alto Medical Foundation and the EHR Ambulatory Physician Director at Sutter Health.

Lots of other Articles at link.



A Q&A About Alert Fatigue

Greg Gillespie

Health Data Management Blogs, June 8, 2010

Computerized order entry has popped up in a lot of recent conversations I’ve had about HITECH incentives. Not surprisingly, hospitals ramping up order entry systems are having a devil of a time avoiding programming alert fatigue into their CPOEs.

Following is a Q&A session on the topic I had with Linda Peitzman, M.D., who heads the clinical solutions group at Wolters Kluwer Health. Linda previously was a practicing physician and medical director at HealthSystem Minnesota/Park Nicollet Clinic.



EHRs should be certified for usability, says AHRQ

By Mary Mosquera

Tuesday, June 01, 2010

Usability should become part of the certification test for electronic health records to ensure systems are designed so clinicians not only find them appealing to use but operate them safely and effectively.

That was one of the recommendations made by researchers in a report about assessing and improving the usability of electronic health record systems prepared for the Agency for Healthcare Research and Quality (AHRQ).

Usability, which implies both ease-of-use and designing for effective use, will be critical to driving broad adoption of electronic health records (EHRs), according to the report. Without serious attention being paid to these factors, healthcare providers sometimes find flaws once they have deployed a system, forcing them to make costly workarounds or returns.



iPhone 4: Pixel Boost a Boon for Healthcare Apps

Gienna Shaw, for HealthLeaders Media, June 8, 2010

Unveiled yesterday at Apple's annual conference for software developers, the iPhone 4 is thinner, prettier, and has a longer battery life than its predecessor. But for healthcare professionals, the big news is that it shoots hi-def video and is packed with four times the pixels. Good for Farmville fans; even better for those who use medical apps, many of which rely on high resolution and advanced sharing capabilities.



NHS IT minister says SCR ‘will continue’

04 Jun 2010

The government has said that uploading of Summary Care Records will continue to take place, in its first public statement on the future of the SCR since gaining office.

In a Parliamentary written answer published yesterday health minister Simon Burns told Conservative MP Michael Fallon that uploads would go-ahead. Fallon had filed a question asking the health secretary whether he would make it his policy to end uploading of data to the SCR.



Should Doctors Reject the Government's EHR Incentive Plan?

David C. Kibbe, MD, MBA

Posted: 06/07/2010; Family Practice Management. 2010;17(2):8 © 2010 American Academy of Family Physicians

Abstract and Introduction


It's a big hill to climb for a carrot that may not be there when you reach the top.


Is health information technology (IT) being set up to fail? Might we be facing a lost generation of health IT investment? Will Kaiser Permanente and Mayo Clinic get windfall profits while small practices receive nothing but hassles? It's beginning to seem that way.

I'm sure you already know the broad outlines of the government's plan to pay physicians roughly $44,000 each (a national investment of $20 billion or more), over a five-year period starting next year, for "meaningful use of certified electronic health record technologies." (If not, see "'Will the Feds Really Buy Me an EHR?' and Other Commonly Asked Questions About the HITECH Act," FPM, July/August 2009.) While we now have the U.S. Department of Health and Human Services (HHS) proposed rule for defining meaningful use and the "interim final rule" for EHR certification criteria, we won't know until later this year precisely what meaningful use means, how doctors can apply for the payments, what technologies will be certified, or when the payments will start. But it's not too early to begin asking some hard questions.



iSoft apologies over its CSC and NPfIT statements

By Tony Collins on June 7, 2010 7:05 AM

Today (June 7, 2010) iSoft issued a formal apology over a statement it made last week which suggested that a deferral of decisions in relation to the National Programme for IT (NPfIT) for its partner CSC was due to an uncertain political climate in the UK and ensuing election.

iSoft had further suggested that government change was a reason for delays in NPfIT procurements in the South of England.

"Both these statements were iSoft's opinion and cannot be taken as fact. iSoft remains fully committed to delivering the NPfIT with its partner, CSC, and building on recent success and apologises for any unintended criticism of either the NHS or CSC," says iSoft today.



NHS supplier sorry for misleading comments

'Opinion not fact'

Posted in Enterprise, 7th June 2010 11:21 GMT

Key NHS software supplier iSOFT has apologised for a market update released last week which it now says was a matter of opinion, not fact.

Explaining shortfalls in revenue to the stock market last week iSOFT said "uncertainty associated with the change in UK government" and a weak European economy were reasons for "the deferral of decisions in relation to the NPfIT".



Oklahoma Blood Institute's fingerprint ID automates blood donation check-in

Oklahoma Blood Institute's new finger-touch program is designed to enhance convenience and security for blood donors.


Published: June 2, 2010

The Oklahoma Blood Institute has launched a fingerprint identification program designed to simply and safely establish donors' identities.

With a touch of the donor's finger, the new software searches the blood institute's database to find the identification, reducing check-in time and cutting down on human error during check-in, according to a news release.

The idea is to eliminate the need for donors to produce driver's licenses, Social Security numbers or other sensitive identification forms.



Issue Date: June 2010

Surfing the HIE

The Santa Cruz information exchange experience offers lessons on what works

by Chuck Appleby

“The computer is the network” goes the famous Sun Microsystems advertising tagline; some consider it one of the smartest marketing slogans ever conceived, because it actually has meaning. Put simply, the phrase implies that all of a network's resources are available on the user's computer to the point they appear to be part of the user's desktop. It's also a line that may outlive its company of origin-and not just because the Redwood City, Calif.-based Oracle Corporation completed its acquisition of the Santa Clara, Calif.-based Sun in January. In fact, the emergence of health information exchanges (HIEs) is making it more and more clear that the computer can be and possibly will be the network in healthcare.

Perhaps this is nowhere more evident than in Santa Cruz, Calif., which claims to have the longest-running successful HIE in the United States. Spearheaded in 1996 by Physicians Medical Group of Santa Cruz County (PMG), a large independent physician association (IPA), the Santa Cruz HIE uses a virtual clinical network to connect 80 percent of the region's physicians and staff as well as competing hospitals, labs, radiology centers, Safety Net Clinics, county health clinics and other healthcare entities.




By Joseph Conn / HITS staff writer

Posted: June 7, 2010 - 12:01 am ET

Part one of a two-part series:

Probably the quickest way to understand what HHS officials hope to accomplish with their recently announced Community Health Data Initiative is to turn to the latest weather forecast.

Go online or tap a smart phone and pull up the weather outlook in text, supported by maps, slick graphics and maybe even a forecast automatically customized to a specific geographical location. But whatever communications tool is used, 98% of the data on which that forecast was based originated—free of charge—from the federal government's National Oceanic and Atmospheric Administration, according to Todd Park, chief technology officer at HHS.

That's the model against which HHS hopes to pattern its new Community Health Data Initiative, Park told about 100 people gathered last week in the auditorium at the National Academy of Sciences in Washington.

“We thought that was inspiring,” Park said, addressing the half-day, official kickoff session June 2.

Park and other HHS officials outlined a plan to leverage federal-level boosterism and a more customer-friendly reorganization of the vast trove of government-controlled data to catalyze the creation of a new network of public and private software developers and healthcare data users.


Data-driven: HHS aims for info accessibility

By Joseph Conn / HITS staff writer

Posted: June 8, 2010 - 12:00 pm ET

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

HHS' new Community Health Data Initiative Web page aggregates not just popular and high-profile data catalogs—the Centers for Disease Control and Prevention's Healthy People 2010 database and the CMS/Hospital Quality Alliance Hospital Compare database among them—but also more-obscure info sets, such as Medicare data on disease prevalence and healthcare use, that were never before available publicly.

Initially, the files will be downloadable from the HHS website, but the CDC's National Center for Health Statistics, is developing a data "warehouse" and portal that should be up and running by the end of this year. It will make the data even more readily accessible via computerized Web services.



Consumer-directed health care? Yes. Consumer-connected? Maybe.

Health Data Management Magazine, 06/01/2010

For an industry confronting a chronic disease crisis and runaway costs, putting consumers in charge of their health care-financially and clinically-may seem like a last gasp effort. But many stakeholders believe consumerism is the best response to those challenges, and that the very absence of consumer involvement has helped drive up costs and led people to ignore their health.

On the financial side, consumer-directed health plans are here to stay, many experts say, and indeed, insurance plans are scrambling to provide their members tools to understand and utilize CDHP benefit packages. On the clinical side, consumer connectivity efforts-most notably online access to providers-also are growing apace. Both plans and providers hope that their I.T. strategies will result in a far more engaged population that appreciates costs, follows their treatment plans, and minimizes risky health behaviors.

Yet, when it comes to involving consumers in an integrated fashion, the divide between payer and provider remains gaping. The industry has a long ways to go before it can realistically provide consumers with accurate information on how consumer-directed health plans work and how service quality and price data can be analyzed to guide health decisions.



The doctor's in-box

By Lisa Zamosky, Special to the Los Angeles Times

June 7, 2010

The doctor-patient relationship is moving online. With 68% of American adults now using the Internet to search for healthcare information, it's no surprise that many also want digital access to their doctor. Whether they have that option will depend heavily on doctors' ability to get paid for the service.

Online physician consultations, also called e-visits, are already being used to treat patients for non-emergency conditions and to answer questions about minor ailments, symptoms or medications. According to Meredith Ressi, vice president of research at the health information firm Manhattan Research, about 42% of U.S. physicians say they've discussed clinical symptoms online with patients, and more than 9 million consumers report having had e-mail communication with their physician.


Monday, June 07, 2010

Telehealth Beginning To Go Mainstream, But Long Road Lies Ahead

by Jane Sarasohn-Kahn

Telehealth has gone mainstream: an article on telehealth recently was published in the New York Times, CMS proposed new rules for telehealth credentialing and UnitedHealthcare hired a telemedicine veteran to head up a new unit.

Datamonitor estimates that the telehealth market in the U.S. and Europe will increase from $3 billion in 2009 to $7.7 billion in 2012 -- growing over 2.5 times in the next three years. Meanwhile, an Intel survey of health providers and experts found that 89% believe telehealth will transform health care in the next 10 years.

Within the health arena, telehealth is forecasted to grow faster than any other area. There's a confluence of factors driving this trajectory, including telecommunications innovations, a growing evidence base, consumers' growing embrace of technology, vendors in and outside of health care getting into the telehealth act, and an emerging regulatory framework.



Report: Global HIS spending to hit $18B in 2016

June 7, 2010 — 1:41pm ET | By Neil Versel

The worldwide market for hospital information systems will grow by a compound annual rate of 13 percent for the next six years, reaching $18 billion in 2016, up from $7.8 billion in 2009, research firm GlobalData says. Most of the growth will come from hospitals receiving government subsidies--like those in that start in the U.S. in October--as facilities look to boost efficiency and raise the quality of care through IT.

EMRs make up the largest segment of the market, accounting for $3.4 billion in 2009--more than double the next-largest category, the $1.2 billion market for practice management system--GlobalData reports. EMRs sales are expected to increase at a compound annual growth rate of 15.3 percent through 2016, faster than any other category in the study. GlobalData also looked at the markets for CPOE, pharmacy information systems and laboratory information systems.



Of course consumers don't understand evidence-based medicine

June 7, 2010 — 11:37am ET | By Neil Versel

The esteemed policy journal Health Affairs last week ran results of a new study from the Department of Obvious Results--er, I mean the California HealthCare Foundation. The study, entitled, "Evidence That Consumers Are Skeptical about Evidence-Based Health Care," found that consumers generally believe that new care and more care are almost always better.

"The idea that getting high-quality care or the 'right' care could mean getting less care was counterintuitive. As one interview participant said, 'I don't see how extra care can be harmful to your health. Care would only benefit you,'" the research team reports.




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