This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
Friday, June 25, 2010
Weekly Overseas Health IT Links - 23 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.
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.
by Helen Pfister and Karyn Bell, Manatt Health Solutions
Federal government agencies and departments are moving forward with implementing various health IT provisions of the American Recovery and Reinvestment Act of 2009. This update summarizes significant developments over the past few months.
Health IT Committees Move Forward
Both the Health IT Policy and Standards committees met several times in April and May with discussion and actions focused in several areas.
The first national medical home demonstration has come to a close, and the 36 practices who put two years into transforming toward the model deliver somewhat discouraging news. Despite their intense efforts to implement same-day appointments, optimized office design, electronic prescribing, electronic health records, practice websites and more, the participating family practices registered modest improvements in quality-of-care measures but backslid in terms of how patients rated them, according to a set of eight articles in a special supplement of the Annals of Family Medicine.
The major problem: Unlike other pilots, the practices in the National Demonstration Project did not receive extra compensation from payers for their "feverish" efforts to be a medical home, but continued to get paid on a fee-for-service basis from June 2006 to May 2008. "Given that primary-care doctors are already overwhelmed and underpaid, expecting them to transform their practices without additional funding is unrealistic," said Ann O'Malley, MD, of the Center for Studying Health System Change.
SCOTTSDALE, Ariz., June 16 /PRNewswire/ -- New research from Compass Intelligence (http://www.compassintelligence.com) shows that the Health Care IT market is primed for continued growth over the next five years. Compass Intelligence expects health care organizations including hospitals, doctors' offices, private practices, clinics and other health care organizations to spend an estimated $73.1 Billion this year on IT products, services and solutions. By 2014 expenditures are expected to climb to $85.0 Billion. Health care IT spending is being driven by the government's push for the market to adopt Electronic Health Records (EHR or EMR) backed by stimulus dollars, investments in systems and networks to support new applications, and the adoption of mobile applications, hardware, and other software to support patient care, patient records, and next generation medical diagnostics and imaging.
A study by the Medical College of Wisconsin finds that emergency room doctors who have electronic access to patient data via a health information exchange spend less time gathering information and make better-informed clinical decisions in treating patients.
The study surveyed 185 emergency room doctors in three sites involved with the initial launch of the Wisconsin Health Information Exchange, which has been in operation for about three years in Milwaukee County and is currently being used in 10 emergency departments and several outpatient care facilities.
NORWALK, CT – Less than one in 10 American adults use electronic medical records or e-mail their doctor, according to a new Harris Interactive/HealthDay poll.
Nearly half of respondents of the poll, which was conducted among 2,035 U.S. adults online from June 8-10, weren't even sure if their physician offered these technologies.
The majority of those polled said they would like their doctors to access their medical records online, but only about a third (30 percent) believe their insurer should have the same access.
Overall, "the general public only has a vague idea, only a very limited understanding, of what all this is about," reasoned Humphrey Taylor, chairman of the Harris Poll, a service of Harris Interactive.
The Office of the National Coordinator for Health Information Technology at HHS has issued a final rule outlining a temporary program by which it will select and designate not-for-profit organizations to test and certify electronic health-record systems under the stimulus law.
The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, empowered the ONC to either "keep or recognize" a program or programs for EHR certification. In a proposed rule released in March, ONC head David Blumenthal chose not to “keep” the existing, federally supported program operated by the Certification Commission for Health Information Technology, but allow CCHIT to apply along with other entities seeking to become certifications bodies under a newly created federal recognition process. The March proposed rule called for two EHR certification processes, one temporary and one permanent.
In recent months -- through formal comments to the proposed "meaningful use" (MU) regulation, in articles in online health IT newsletters and blogs, in the halls of various conferences -- there has been a continuous, anxious conversation as to whether the MU regulations, when finally promulgated, would be, simply, too much.
In the service of using the American Recovery and Reinvestment Act's health IT incentive funds for maximum benefit, how far will HHS seek to have providers stretch for the greatest degree of health IT functionality, connectivity and meaningful use? Will HHS, in the final MU regulation, find that its reach exceeds its grasp?
That anxious conversation reached a new level when the New York Times earlier this month ran the article, "Doctors and Hospitals Say Goals on Computerized Records are Unrealistic." While much of the article's content was familiar to those in the know, that it appeared in the Times under Robert Pear's byline is particularly significant. Pear is arguably the most highly respected and influential health care journalist in the nation. His articles are must reads for senior policymakers in every president's administration. That Pear chose to spotlight the MU concerns of physicians and hospitals brings credibility and visibility to their issues.
The University Hospitals Birmingham NHS Foundation Trust is preparing to provide patients with access to their medical information via a new personal health record.
The portal, which will be developed in-house and piloted towards the end of the year, will allow patients to access their appointments and details of medications and results. It will also enable them to interact with other patients via sites such as Facebook.
Daniel Ray, director of informatics and patient administration, told E-Health Insider: “The initiative came about after we followed a patient who had a liver transplant. She had a number of different addresses but every time information was sent to her it was only sent to one address.
“In an ideal world, she would be able to log onto the internet to access the information she needs and also put any queries she has to the consultant remotely.”
By Joseph Conn, David Burda, John Morrissey and Maureen McKinney
Posted: June 17, 2010 - 12:30 pm ET
Peter Fine, president and CEO of Banner Health in Phoenix, and David Bernd, CEO of Sentara Healthcare in Norfolk, Va., were presented with Modern Healthcare's CEO IT Achievement Awards for 2010 at the Government Health IT Conference and Exhibition this week in Washington.
At a panel session Tuesday before the awards ceremony, Fine said Banner's success in implementing a health IT system and process improvement program stems from “an unrelenting organizational focus” on completing the project and unwavering support for the project from the top.
Comment: Very good stories – shows how Health IT can really work in the real world.
The not-for-profit Certification Commission for Health Information Technology has announced the creation of two new work groups to develop certification criteria for electronic health-record systems to be used by practitioners specializing in oncology and in women's health.
Pawan Goyal, a physician and chief medical officer for Hewlett-Packard's federal healthcare division, and Peter Yu, a physician and director of cancer research at the Palo Alto (Calif.) Medical Foundation, were named co-chairs of the oncology work group.
A member of the Florida Board of Medicine is pushing the board to issue a statewide warning that EMRs could cause more errors than they prevent.
"I think the Department of Health needs to put out a warning to physicians that they need to look at their programs' default settings," West Palm Beach dermatologist Steven P. Rosenberg said a recent board meeting, reports the Palm Beach Post. "This year we have seen as many if not more medical records violations from electronic medical records as we saw from hand-written records violations."
The European Union has launched 27 e-health projects this year following a call under the EU Framework Programme 7 (FP7).
The Seventh Research Framework Programme, which runs until 2013 with a budget of €50 billion, has launched projects in three key areas; ICT for personal health systems, ICT for patient safety, and international cooperation on virtual physiological human.
The EU’s Research and Development Framework Programmes aim to bring together teams from different organisations and EU countries, to combine knowledge and experience to improve the standard of living for people in Europe.
CareStream Health has announced a new addition to its CareStream eHealth Managed Services portfolio of cloud-based, fee-for-use services.
The company's new eHealth PACS Service is said to provide all the functionality of PACS -image management, viewing, distribution and storage - while lowering users' total cost of ownership by reducing their investment in capital equipment, security technology and management personnel.
The new eHealth PACS Service is available in the United States and other selected countries across Europe, Asia and Latin America.
CSC has announced that it will provide its electronic prescription system across Europe, following successful implementation in Denmark.
EPrescription will provide clinicians, pharmacies with a single view of the patients’ medication profile, eliminating administration processes associated with dealing with prescriptions manually therefore improving operational efficiency and auditing processes.
When Aaron McKethan told potential applicants for awards under the Beacon Community Program that their proposals should demonstrate how health IT can "achieve Meaningful Use improvements in cost and quality in a three-year period and beyond," he could have been speaking to every health IT manager tasked with adopting modern health IT for a new age.
McKethan, program director for the Beacon Community Cooperative Agreement Program, held a conference call on June 1 to brief more than 200 potential applicants on what they should include in their proposals as they prepare their applications for the last two Beacon Community awards, which will be announced in August.
A strong argument can be made that the success of long-term health care reform and the promotion and meaningful use of health information technology are linked, according to a new report from consultancy Computer Sciences Corp.
Adoption and meaningful use of electronic health records, for instance, can improve health insurers' disease and case management programs by augmenting their traditional and limited use of claims data with clinical data.
To access the full free report, "Meaningful Use for Health Plans: Five Things to Consider," click here.
A consortium of academic medical centers, drugmakers and other healthcare-related organizations has created a joint initiative aimed at improving the clinical-trial-recruitment process through the use of electronic medical records.
Members of the collaborative, called Partnership to Advance Clinical electronic Research, will work to design clinical-trial-recruitment data sets that could be incorporated into electronic medical-record software. The information gleaned from the medical records could help researchers more quickly and accurately identify patients who would be appropriate candidates for experimental treatments, said PACeR participants.
The National Institutes of Health and the Food and Drug Administration are crafting coordinated initiatives aimed at increasing the availability of gene-therapy drugs, according to an article appearing online in the New England Journal of Medicine.
In the article “The Path to Personalized Medicine,” FDA Commissioner Margaret Hamburg and NIH Director Francis Collins write that the initiatives will support the advancement of personalized medicine through rapid development, review and approval of safe and effective genetics-based disease therapies. “Together, we have been focusing on the best ways to develop new therapies and optimize prescribing by steering patients to the right drug at the right dose at the right time,” they wrote.
When Congress passed the American Recovery and Reinvestment Act of 2009, it called on HHS to create from scratch a nationwide network of regional extension centers to promote the adoption and use of health information technology.
HHS won't have to reinvent the wheel in rolling out the program: The Smith-Lever Act of 1914 established the U.S. system of cooperative agriculture extension services anchored in the nation's land-grant colleges and universities.
Funded by the U.S. Department of Agriculture, today's cooperative extension service centers do more than send agriculture agents into the field to serve as links between farmers and researchers. There also are extension programs in economic development and conservation and a host of consumer science programs. It is that successful extension service program that Congress used as a model when drafting language for the health IT regional extension centers.
Support of incremental change and improvement is one of the guiding principles of the federal effort to promote the use of health information technology, a top federal IT official said at a tech conference in Washington on Tuesday.
But Farzad Mostashari, senior adviser for policy and programs with the Office of the National Coordinator for Health Information Technology at HHS, said during his keynote speech to open the Government Health IT 2010 Conference & Exhibition that he was looking for “bold incrementalism.”
Published: June 16 2010 01:02 | Last updated: June 16 2010 01:02
Huge stacks of paper-based medical reports from local health centres are being input into a computer at Nyamata Hospital, 24 miles south of Kigali, Rwanda’s capital. Dariya Mukamusoni, the hospital’s director, is supervising the process.
Data entry creates a lot of work, Dr Mukamusoni grumbles cheerfully. She and her team are obliged to meet strict weekly and monthly deadlines set by the Ministry of Health for its completion.
Data quality, meanwhile, is a constant challenge, requiring regular monthly meetings with staff at each of the district’s 11 health centres to ensure that high standards are enforced.
The future direction of the Summary Care Record is likely to be revealed in two weeks’ time following the publication of an independent evaluation of the controversial project by University College, London. Below is EHI Primary Care’s guide to the SCR in ten points.
1. What it set out to be
The origins of the Summary Care Record go back to 2002 when the previous government set out its vision for NHS informatics in the white paper ‘Delivering 21st Century IT’. With what now seems like wild optimism, the Department of Health hoped to deliver a National Health Record Service with core data and links to local electronic patient record systems by December 2007. In 2005, NHS Connecting for Health split the NHS Care Records Service into two parts; with a Summary Care Record and a Detailed Care Record. The aim of the SCR was to provide information for first contact care out-of-hours, in A&E and for temporary residents.
GE's health care division today announced its first electronic medical record (EMR) product in a software-as-a-service (SaaS) platform aimed at small or remote physician practices with a lower-cost, monthly fee model.
GE Healthcare's Centricity Advance product offers a combination of EMR, physician administrative management and patient portals.
The SaaS offering differs from a traditional hosted or application service provider model in that after a start-up fee of $4,000 to $9,000, customers are charged a monthly subscription fee, said Chittaranjan Mallipeddi, vice president and general manager of GE Healthcare IT's newly launched SaaS business unit.
The U.S. Dept. of Health and Human Services this month is finalizing the much-anticipated requirements for what constitutes the "meaningful use" of electronic health records. Those requirements will let healthcare providers know what they must do to qualify for the more than $20 billion in incentive funds set aside as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act. It's expected that many healthcare providers who haven't deployed EHRs yet, will do so after the meaningful use requirements are released.
InformationWeek editor at large Marianne Kolbasuk McGee recently spoke to the nation's health IT coordinator, Dr. David Blumenthal, about what's at stake as healthcare providers, especially smaller ones, start deploying and using EHRs.
70% — Percentage of Colorado physicians not linked electronically and still sharing patient data and medical records by telephone, fax or printed documents (Getty Images)
Colorado is racing a five-year deadline to build a network of electronic medical records linking doctors' offices and hospitals across the state — a massive challenge given that about 70 percent of physicians still use the print-fax-phone method to share data.
In 2015, the federal government will begin penalizing doctors who aren't using electronic records by reducing their reimbursements for treating patients with Medicare or Medicaid.
David Blumenthal, M.D., national coordinator for health information technology, recently said federal officials have heard the concerns of the proposed meaningful use rule "loud and clear." But in a June 14 blog entry on ONC's Health IT Buzz page, Blumenthal's tone does not sound hopeful to those who advocate streamlined meaningful use criteria. Here's his argument:
"Introducing change in health care is never easy. Historically, adopting our most fundamental medical technologies, from the stethoscope to the x-ray, were met with significant doubt and opposition. So it comes as no surprise that in the face of change as transformational as the adoption of health IT - even though it carries the promise of vastly improving the nation's health care - some hospitals and providers push back. I resisted using EHRs while an internist in Boston, as I wrote in my blog, 'Why Be a Meaningful User.' Over time, however, I found that working with health IT made me a better and safer physician. Most importantly, my patients received better, safer care and improved outcomes.
Dom Nicastro, for HealthLeaders Media, June 11, 2010
The Office for Civil Rights' (OCR) list of entities reporting major patient information breaches began at 32 about four months ago.
It is now near 100.
The number of entities reporting breaches of unsecured PHI affecting 500 or more individuals has nearly tripled since the agency that enforces the HIPAA privacy and security rules first posted them on its website in February.
OCR posted a list of 32 entities that, since September 22, 2009, had reported the egregious breaches to OCR. On Friday, that number climbed to 93.
Gienna Shaw, for HealthLeaders Media, June 15, 2010
There are so many new, cool things happening in the world of healthcare technology that it's impossible to keep up—which is why my inbox is cluttered with e-mails from PR folks who are "just checking" to make sure I got their e-mail . . . for the fourth time. So, since today is National Clean Out Your Inbox Day (OK, there's no such day—but there should be), here are a few cool healthcare technologies that hospitals are using to reduce hospital-acquired infections (HAI) and help clinicians practice safer medicine.
The not-for-profit Electronic Healthcare Network Accreditation Commission, Farmington, Conn., has posted for public review and comment its draft Health Information Exchange Accreditation Program.
Copies of the proposed accreditation program are available on the organization's website. The public comment period opened Thursday, June 10, and will run through Aug. 13. A final set of criteria incorporating those comments is expected to be released by Sept. 23.
Allscripts-Misys Healthcare Solutions, Chicago, a developer of electronic health records systems for ambulatory-care physicians, will borrow most of the $577 million or more needed to extricate itself from the majority control of British IT developer Misys and then swap $1.3 billion in stock to buy all of Atlanta-based hospital and physician electronic health-record system developer Eclipsys.
For Allscripts, “It's a great deal,” said Vinson Hudson, founder of Jewson Enterprises, Austin, Texas, a healthcare IT consultancy specializing in systems for physician offices. “I think for Allscripts, they want to be the largest and they want to remove McKesson as being the largest, in terms of revenue from the physician end.”
Although American Medical Association members last year asked the AMA's board to push for regulation of personal health records and a basic common interface for electronic health records, the board reported back that—for right now—it might be best to stay out of the way.
These and other information technology subjects were debated in a reference committee meeting June 13 during the second day of the AMA's annual House of Delegates meeting in Chicago. Committee members will draw up their recommendations, and the full House will vote on suggestions later this week.
Dom Nicastro, for HealthLeaders Media, June 11, 2010
HIPAA compliance experts call the recommendation to mandate encryption on exchanges of electronic protected health information (ePHI) "overdue," "inevitable," and a necessary step toward ensuring a successful transition to electronic health records (EHR).
A privacy/security workgroup for the Office of the National Coordinator for Health Information Technology (ONC) reported last month that encryption should be mandatory for one-on-one exchanges between providers regarding treatments.
Until founding my own company earlier this year, I had no interest in the sales side of the publishing business. I really didn't have to think about sales because there was a whole group of people dedicated to bringing in cash so we could all get paid.
When I launched healthsystemCIO.com, I carried that semi-contempt for sales into my first 90-day business plan -- there was no time slotted for selling.
As the nation stands on the threshold of one of the most important eras in health information technology (IT) history, we are witnessing a “perfect storm” of health IT advancements, innovations and drastic overhauls.
Three waves of change in health IT over the past two years bear this out:
First, on Feb. 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act (ARRA), which includes billions of dollars in Medicare and Medicaid incentive payments to eligible professionals and hospitals for the "meaningful use" of certified health IT products. The legislation also included the Health Information Technology for Economic and Clinical Health (HITECH) Act, which allocates about $36 billion in funding to help healthcare providers obtain meaningful use of health IT, including electronic health records (EHRs) and care coordination through health information exchange (HIE).
Second, on Jan. 16, 2009, the Obama administration accepted the final rules for 5010 and ICD-10, intended to improve patient care quality, enhance claims processing, improve reporting and promote interoperability.
Third, on March 23, 2010, the President signed the Patient Protection and Affordable Care Act (PPACA), which includes provisions that address many of the challenges facing electronic health information exchange, as well as innovative new methods to reimburse expenses for quality care.
The “tiger team” created to resolve thorny privacy and security issues associated with sharing patients’ health records wasted no time before tackling a difficult issue Thursday at the team’s first public meeting.
Should health information services providers (HISPs), such as regional networks, be allowed to look at the records the HISPs are transferring from one health care provider to another?
If so, can HISP employees look at the records, or should this access be limited to computerized reviews to ensure the necessary routing and other minimum data are present?
"[P]ublic discourse on health reform is almost entirely focused on the whole [the unsustainable costs and inadequate health outcomes] at the expense of a focus on the parts [improving the health outcomes of individual patients]. As a result, the debate has centered on the provider side [facilities and physicians] while essentially ignoring the accelerating role of technology and the expanding role of individual patients in the healthcare delivery system," Dr. Charles J. Shanley, associate CMO for Beaumont Hospitals in Michigan, and David Ellis, corporate director of planning and future studies at the Detroit Medical Center, write in the online version of Hospitals & Health Networks.
Faster treatment of patients, less time wasted, faster accessibility to information and happier employees and patients. This is some of the feedback from the Faroe Islands after the implementation in 2007 of a very extensive system for electronic health records (EHR), which includes medical practitioners and hospitals as well as many other relevant hospital functions.
(Media-Newswire.com) - Faster treatment of patients, less time wasted, faster accessibility to information and happier employees and patients. This is some of the feedback from the Faroe Islands after the implementation in 2007 of a very extensive system for electronic health records ( EHR ), which includes medical practitioners and hospitals as well as many other relevant hospital functions.