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, July 16, 2010

Weekly Overseas Health IT Links - 15 July, 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.



Electronic pill bottles might help medication adherence

The bottles send audio and visual alerts when it's time to take medicine. A study showed nearly 100% patient compliance when the devices are used.

By Pamela Lewis Dolan, amednews staff. Posted July 7, 2010.

Pill bottles that electronically alert patients to take their medications show promise for increasing compliance, according to research from the Center for Connected Health, a division of Partners Healthcare in Boston.

A randomized controlled study of patients who used electronic pill bottles wirelessly connected to the Internet found a 27 percentage point higher rate of medication compliance compared with patients who didn't use the electronic bottles.

The bottles, called GlowCaps and produced by Cambridge, Mass.-based Vitality, alert patients with light and sound when it's time to take their medicine. The bottles also generate missed-dose reminder phone calls and refill reminders. Automated progress reports also are sent to the patients' physicians, family or caregivers.


Healthcare.gov Adds Hospital Comparison Data

The data from the Hospital Compare Tool includes information on how well hospitals care for patients with heart attacks, protect outpatients from surgical infections and use of imaging equipment.

By Nicole Lewis, InformationWeek
July 8, 2010

Barely a week after launching HealthCare.gov, the first website to provide a central database of health coverage options and other comparative healthcare statistics, the Department of Health and Human Services announced Wednesday that new information about the quality of care in America's outpatient and emergency departments has been posted to the new website.

The new data, which can be found at the Compare Care Quality link on the front page of HealthCare.gov, includes information on how well hospitals care for patients with heart attacks, compares how hospitals protect outpatients from surgical infections, and examines how efficiently facilities use certain types of imaging equipment among Medicare patients.



HHS proposes new privacy, security rules

July 08, 2010 | Diana Manos, Senior Editor

WASHINGTON – Department of Health and Human Services Secretary KathleenSebelius announced Thursday new proposed privacy and security rules and resources. She said they would strengthen the privacy of health information and help all Americans understand their rights and the resources available to safeguard their personal health data.

Sebelius said the rules are part of an effort led by the Office of the National Coordinator for Health Information Technology (ONC) and the HHS Office for Civil Rights (OCR) to ensure Americans trust personal health data exchange.



Health care providers say keeping electronic records will be good for your health

Daniel Jackson

2010-07-09 09:58:51

Forget all those paper forms you have to fill out every time you go to a new doctor.

One day, we’ll each have one medical file — electronic health records on a National Health Information Network accessible anywhere in the country by any medical provider with authorization to review those files. But just as sure as some readers of The Gazette are viewing this article on newsprint, the conversion to digital medical records has yet to be embraced by all physicians and patients.

North Carolina started an organized effort to create a statewide health care information exchange (HIE) 15 years ago, but doctors offices, hospitals and other providers have been slow to adopt electronic health records (EHR) that could be shared on the HIE for a variety reasons, including financial, technical and privacy concerns.

With the passage of the American Recovery and Reinvestment Act last year, the federal government allocated roughly $36 billion for health information technology, including incentives for medical providers that switch from paper to digital records. And by 2016, medical practices that fail to make the conversion ultimately face penalties that are sure to make health information technology — to use the correct acronym — a HIT.



APSC urges FDA to establish device-ID system

By Shawn Rhea / HITS staff writer

Posted: July 8, 2010 - 1:00 pm ET

The Advancing Patient Safety Coalition, a group of provider, healthcare-quality and patient-advocacy organizations, has sent a letter to Food and Drug Administration Commissioner Margaret Hamburg urging the agency to publish a rule establishing a unique device identification, or UDI, system.

In the letter, the group said the agency was taking "an unreasonable amount of time to publish a proposed rule" for a UDI system, which Congress mandated be developed in 2007 with the passage of that year's FDA Amendments Act. The system would be used to track movement of medical devices from the point of manufacture to their use in patients. Advocates for a UDI system say it would promote a broad range of healthcare system improvements, including patient safety, comparative effectiveness of medical devices and cost reduction through supply-chain efficiencies.



Excellence in IT: St. Luke's Health System

By Deborah Gash

Posted: July 8, 2010 - 1:30 pm ET

In 2007, St. Luke's Health System, Kansas City, Mo., had a physician alignment problem: Its affiliated physicians were unhappy about the amount of paper received from the health system.

Laboratory results, discharge summaries, reports and more were delivered in hard copy. Solving this business problem would strengthen the provider's relationships with its physicians. Also, information technology leadership correctly suspected that the solution would have significant benefits beyond the reduction of paper. St. Luke's launched a health information exchange initiative that allows sharing of clinical data at the community level and beyond.

In an online connectivity solution named St. Luke CareLink, St. Luke's uses a combination of e-health technologies to enable two-way communication: secure messaging, e-prescribing, clinical results delivery and automated personal health records. This e-connectivity is accomplished using a software-as-a-service network platform and supplier-hosted rapid deployment methodology that allows flexibility and extensibility to connect outward. The exchange requires minimal staffing resources and eliminates the need for infrastructure beyond access to the Internet, eliminating large capital outlays.



HHS proposes changes to HIPAA privacy rule

By Joseph Conn / HITS staff writer

Posted: July 8, 2010 - 1:00 pm ET

HHS has proposed a new federal healthcare information privacy rule to amend the Health Insurance Portability and Accountability Act of 1996. Reflecting changes Congress sought last year in the stimulus law, the proposed rule would give patients the right to restrict certain disclosures and ban the sale of patient data without patient consent, according to HHS.

According to an HHS announcement made jointly by David Blumenthal, head of the Office of the National Coordinator for Health Information Technology, and Georgina Verdugo, director of the Office for Civil Rights, the proposed rule would:

-expand individuals' rights to access their information;

-restrict certain disclosures of protected health information to health plans;

-extend the applicability of certain of the HIPAA privacy and security rule requirements to the business associates of covered entities;

-establish new limitations on the use and disclosure of protected health information for marketing and fundraising purposes;

-strengthen and expand OCR's ability to enforce HIPAA's privacy and security provisions.



Use of Health Information Technology Leads to Improved Care Quality

Kaiser Permanente Study Finds Quality of Care Scores Increase as Patients and Physicians Communicate via Secure E-mail

OAKLAND, Calif., July 7 /PRNewswire/ -- Secure patient-physician e-mail messaging improves the effectiveness of care for patients with diabetes and hypertension, according to new research by Kaiser Permanente. The study, published in the July issue of Health Affairs, shows that health information technology improves quality of care scores.

The study observed 35,423 patients with diabetes, hypertension, or both, in Kaiser Permanente's Southern California region, finding that use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2.0 percentage-points to 6.5 percentage- points improvements in glycemic, cholesterol and blood pressure screening and control.



eHealth Initiative finds significant gains in EMR adoption since 2007

July 8, 2010 — 12:00pm ET | By Neil Versel

Health IT adoption is gaining steam, but many have been unable to articulate the value of EMRs within their organizations and, significantly, to the public, a new report suggests. Still, people are optimistic about the future, but worry that the transition to ICD-10 coding and HIPAA 5010 transactions could slow momentum.

The "National Progress Report on eHealth," supported by the Commonwealth Fund and released by the broad-based, nonprofit eHealth Initiative, is an update on a 2007 study meant to identify trends that have emerged since passage of the American Recovery and Reinvestment Act in February 2009. For the report, the eHealth Initiative surveyed more than 100 healthcare professionals in each of five focus areas: aligning incentives; engaging consumers; improving population health; managing privacy, security & confidentiality; and transforming care delivery.



Dell Puts Hope in Health-Services Unit

Computer Giant Aims for Higher Margin Areas Using Perot Systems' Technology; H-P, IBM Remain Fierce Competitors


Dell Inc. hopes customers like Methodist Hospital System will help cure what ails it.

Methodist has contracted with Dell's services since December 2009 to help it create and maintain an electronic medical records system. Dell's technicians are also customizing software for Houston-based Methodist's 2,600 doctors so those records can be accessed by staff at any of its four community hospitals.

Dell plans to use Perot to move up the technology food chain. Above: CEO Michael Dell shown in June.



Healthcare Mobile Devices Forecast To Gain 7%

The healthcare industry is among the fastest growing handheld device markets, and should hit $8.8 billion this year, says Kalorama Information.

By Nicole Lewis, InformationWeek

July 2, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=225702193

The total market for handheld devices in healthcare is expected to reach $8.8 billion for 2010, a 7% increase from last year when the global market posted $8.2 billion, a new report shows.

The report, titled "Handhelds in Healthcare: The World Market for PDAs, Tablet PCs, Handheld Monitors, & Scanners," was published this week by healthcare market research firm Kalorama Information. Noting that the healthcare industry is considered to be among the largest and fastest growing industry segments worldwide, the document said, "the industry can be classified on the basis of the roles that various entities perform. Hence, the healthcare value chain consists of producers, purchasers, providers, fiscal intermediaries, and payers."



Patients, referring docs at MD Anderson making good use of Web portal

July 06, 2010 | Molly Merrill, Associate Editor

HOUSTON – Just one year after its launch, officials at the University of Texas MD Anderson Cancer Center report that 57 percent of patients and 40 percent of referring community physicians are using its Web-based portal for personal health information.

Patients are accessing their medical information an average of 3.3 times per week, while referring physicians are clicking on their patients' records 2.8 times per week, according to MD Anderson Clinical Information Services reports. Officials also noted that new-patient users are being added every week as they register at MD Anderson, return for checkups or hear about the portal.



Health Information Exchanges, Part 1: Follow That Patient

Successfully establishing the means to link healthcare providers through networks, as impressive as that may be, is just the beginning. "Laying pipe isn't enough," says Jason Hess, general manager of clinical research at KLAS. "You still need some ground rules related to data access, data safety, other legal issues and ease of use."

One of the goals of improved healthcare in the U.S. is to ensure that health insurance is portable. The idea is that people should be able to change jobs, move around the country, and still be enrolled in the same health insurance plan.

Still, when a person from Texas relocates to California and changes physicians, the new doctor may know a more about that person's health insurance than his or her physical condition. To obtain information about the new patient's health usually calls for the doctor to conduct a complete physical exam, perhaps order a few tests, and depend upon the patient's recollections to create a medical history.



Scottish practice goes live with iPlato

07 Jul 2010

iPlato Healthcare has implemented iPlato Patient Care Messaging in Scotland for the first time.

The Dunbar Medical Centre in East Lothian has launched the web-based system, which integrates with GP systems and enables fully automated appointment reminders and targeted group messaging.

Its two practices hope to reduce waiting times for GP appointments and to enable GP-led, personalised and timely public health promotion.



Secrecy of cloud computing providers raises IT security risks

Ellen Messmer, Network World

Tuesday, July 6, 2010

(07-06) 04:33 PDT -- Despite how attractive cloud computing can sound as an outsourcing option, there's widespread concern that it presents a security and legal minefield for businesses and government. Cloud service providers often cultivate an aura of secrecy about data centers and operations, claiming this stance improves their security even if it leaves everyone else in the dark.

Businesses and industry analysts are getting fed up with this cloud computing version of "don't ask, don't tell," where non-disclosure agreements (NDA) dominate, questions aren't answered, and data center locations and practices are treated like national security secrets. But public cloud service providers argue their penchant for secrecy is appropriate for the cloud model -- and at any rate, everyone's doing it. They often hold out their SAS-70 audit certifications to appease any worry (though some don't have even that)."The business data you store in Google's cloud is safe," said Google product marketing manager Adam Swidler at the recent Gartner security conference held in National Harbor, Md. He emphasized that Google's multi-tenant distributed model entails "splicing data across many hard drives" so that in this "hardened Linux stack" there's a "quick update of all fragments of all files in the hard drives," a process he called "obfuscated files."



HHS sends final meaningful-use rules to OMB for review

By Joseph Conn / HITS staff writer

Posted: July 6, 2010 - 4:15 pm ET

HHS has sent its final meaningful-use rules and certification criteria for electronic health-record system testing to the Office of Management and Budget—typically one of the last bureaucratic hurdles before rules are released. The criteria are called for under the EHR subsidy program established by the American Recovery and Reinvestment Act of 2009.

OMB received a copy of the final rule of the “meaningful use” criteria from the CMS Monday, according to the posting on the website of its Office of Information and Regulatory Affairs.



Excellence in IT: University of Pa. Health System

By Mike Restuccia

Posted: July 7, 2010 - 11:45 am ET

Following is one of the five winners of Modern Healthcare's 2010 IT Case Study Contest.

The University of Pennsylvania Health System includes three acute-care hospitals and two large ambulatory networks that serve Philadelphia, the surrounding five-county area and parts of southern New Jersey. Its physicians see more than 2 million outpatient visits in more than 220 practice locations each year.

The healthcare implementation project for this submission is a comprehensive outpatient electronic medical record. Its features include: clinical documentation, physician ordering, data reporting, outpatient pharmacy, a communications module, myPennMedicine and a referring physicians portal. More than half of Penn Medicine physicians are active users of the ambulatory EMR.



Medical records go online, but at what cost to privacy?

Allison Grisham learns how to navigate her medical records with help from Dr. David Seo, a cardiologist at University of Miami Miller School of Medicine.

You're a South Florida resident on vacation in Boise or Bogotá. You suffer stomach pains and visit a local doctor. You whip out your BlackBerry, punch in your access code and show the doctor a list of your medications, allergies, past illnesses, tests, surgeries and advice from your physician back home.

Electronic medical records, or EMRs, are quickly becoming a reality for doctors and hospitals in South Florida and beyond.



Large Patient Information Breaches Passes Century Mark

Dom Nicastro, for HealthLeaders Media, July 6, 2010

The number of entities reporting breaches of unsecured protected health information (PHI) affecting 500 or more individuals has hit the 100 mark and then some.

As of Friday, July 2, the number of entities reporting the egregious breaches to the government’s HIPAA privacy and security enforcer hit 107. The number of entities—listed on the Office for Civil Rights (OCR) breach notification website—has more than tripled since the enforcer first began posting them in February. The list has grown about 15 per month, or an entity every other day.



Missing a beat: Cardiovascular information systems lack functionality

June 30, 2010 — 11:41am ET | By Sandra Yin

Nearly one-third (30 percent) of cardiology IT users say they are considering replacing their cardiovascular information system software (CVIS), because their current vendors don't deliver the performance they expect.

"Client satisfaction continues to trend downward industry-wide as vendors fail to deliver on integration, functionality and service expectations," said Ben Brown, general manager of medical imaging and medical equipment research for KLAS and author of the new CVIS report, Cardiology IT: Has the industry missed a beat?



ACLU suit against Rhode Island HIE shows why privacy is so central to health IT

July 5, 2010 — 9:51pm ET | By Neil Versel

The other shoe has dropped.

Last week, the American Civil Liberties Union sued a state-sanctioned health information exchange in Rhode Island, saying that the pre-operational exchange doesn't have adequate protections for patient privacy. Rules developed by the Rhode Island Department of Health to govern the HIE, called Currentcare, require patients to opt in to the system and control who can access their medical records, but does not allow them to wall off certain data elements, including sensitive information about substance abuse, mental health or HIV status.

The lawsuit, filed June 29 in state court, alleges that the DOH violated the Rhode Island regulatory process by failing to spell out exactly how data sharing will work. "In light of the important privacy and confidentiality issues raised by an EHR system, the legislature clearly envisioned the adoption of detailed regulations through a transparent process of public input," ACLU volunteer attorney Frederic Marzilli told CMIO magazine. "This lawsuit simply seeks to carry out that intent."



Web's sports health information can be way off base

By Maureen McKinney / HITS staff writer

Posted: July 6, 2010 - 12:00 pm ET

The Internet is usually the first stop for people seeking information about common sports injuries such as tennis elbow or a torn rotator cuff. But according to a new study in the July issue of the Journal of Bone and Joint Surgery, the accuracy and quality of that data varies considerably based on the source.

Researchers did Internet searches for 10 of the most common sports medicine diagnoses using Google and Yahoo and then ranked the first 10 websites based on accountability, transparency and content.



Excellence in IT: North Texas Specialty Physicians

By Fowad Choudhry and Thomas Deas Jr.

Posted: July 6, 2010 - 12:00 pm ET

Relevant, quality patient care relies on comprehensive clinical information available at the point of care. To fully transform its paper-based healthcare delivery system into an electronic and integrated care model, North Texas Specialty Physicians, an independent physician association based in Fort Worth, invested more than $10 million into the development of an interoperable health information exchange.

NTSP wanted to gather and use real-time patient information that could be parsed from multiple sources to provide faster, better and safer patient care, enhance physician communication and provide fiscally responsible care within one single sign-on application.

NTSP's HIE collects, communicates and distributes medical data to physicians on disparate electronic health-record applications, providing healthcare providers with real-time parsed clinical data at the point of care. It communicates with certified EHR systems through clinical documents called Continuity of Care Records, or CCRs. The system processes either the ASTM International standard CCR or the Health Level 7-based Clinical Care Document, or CCD, which includes patient demographics, diagnoses, current and past medications, allergies, laboratory results, procedures and a list of patient providers. The interoperable EHR system automatically sends and receives clinical documents prior to the patient's scheduled visit.



Health IT panel scrutinizes 2013 quality measures

By Mary Mosquera

Friday, July 02, 2010

Even before healthcare providers begin to demonstrate the first set of meaningful use requirements next year, federal health IT policymakers are already working on how high to set the bar for providers to qualify for the next round of financial incentive payments in 2013.

One set of criteria – that providers show the use of health IT to healthcare quality outcomes – will appear in progressively more sophisticated stages. A tenet of meaningful use, quality measures are expected ultimately to help providers both hone their treatment protocols and lower healthcare costs.



Mental Health Data Breached in Maine

HDM Breaking News, July 6, 2010

The University of Maine is notifying 4,585 current and former students after two servers holding information from the school's mental health and support counseling center were breached.

Data on the servers, covering students who sought counseling services between Aug. 8, 2002, and June 21, 2010, includes names, Social Security numbers and clinical information. "Any student or former student who visited the counseling center as a UMaine student since Aug. 8, 2002, should assume that he or she is in the affected database," according to a statement the university has issued.



NPS wants Vision 360 to be GP system

06 Jul 2010

INPS is to seek NHS Connecting for Health accreditation for its Vision 360 data hub as a GP system.

The GP systems supplier has been developing Vision 360 for some years and it is already in use as a data repository. It is used or will be used for information sharing in Scotland, Wales and several English health communities.

Max Brighton, INPS managing director, told EHI Primary Care that the eventual aim was to seek CfH accreditation for Vision 360 as a GP system.



EHI PC Interview: INPS

06 Jul 2010

EHI Primary Care editor Fiona Barr talks to Max Brighton, managing director of INPS, Russell Blackmore, the company’s product director, and Simon Fanthorpe, its IT director, about the future of the GP system supplier and its Vision 360 data hub.

Add up the column inches devoted to GP system suppliers on EHI Primary Care and elsewhere and you would probably find that they were dominated by two names - EMIS and TPP.

One of these companies is the biggest GP system supplier in the UK and the other has had a high profile entry to the market over the last decade.

Yet over that same period, another company, INPS, has not only maintained its position as the second biggest GP IT supplier in the UK but has also seen its customer base grow every year.



Health Guide gets first English trial

06 Jul 2010

NHS Central Lancashire is using Intel’s Health Guide with COPD patients in Preston so they can monitor their condition from home.

The Health Guide is being used by 40 patients as part of a 12 month pilot in what is the first implementation of the device in England.

The technology, which is provided by GE Healthcare, allows patients to measure their vital signs and respond to questions about their conditions on a regular basis, with all the data being reviewed by a community matron.



Tuesday, July 06, 2010

California's New Health Information Exchange Hires CEO

Cal eConnect, the new organization overseeing California's metamorphosis from paper-based to electronic health care, has hired a CEO -- Carladenise Edwards.

Edwards, former health IT coordinator for the state of Georgia and health IT adviser to former Florida Gov. Jeb Bush (R), will oversee the $38.8 million federal grant for health information exchange that California received under the American Recovery and Reinvestment Act of 2009.

"I am delighted to have the opportunity to be part of the largest health information exchange effort in the country," Edwards said. After moving from Atlanta to California, Edwards began managing the start-up organization's business in earnest last month.



July 06, 2010

What Does "Health 2.0" Mean?

The terms "Health 2.0" and "Medicine 2.0" get thrown around quite a bit in e-health circles, but is there any consensus about what they actually mean? The short answer appears to be: no. At least not according to a literature review recently published in the Journal of Medical Internet Research.

To search for unique definitions of Health 2.0 or Medicine 2.0, the authors examined electronic databases such as PubMed, Scopus, and CINAHL, and also searched "gray literature" on the Internet, using Google (News - Alert), Bing, and Yahoo. They found 1937 articles, and common to many definitions were the following themes: Web 2.0/technology; patients; professionals; social networking; health information/content; collaboration and change of health care.



Infoway Certification Services expands to include Diagnostic Imaging, Drug Information Systems

'Infoway Certified' assures products meet pan-Canadian standards

July 5, 2010 (Toronto, ON) – Canada Health Infoway (Infoway) has added diagnostic imaging and drug information systems to its pre-implementation Certification Services. Health information technology vendors can now receive certification for seven classes of technology.

Receiving the 'Infoway Certified' mark gives vendors of health information technology products an advantage in the marketplace by signalling to potential healthcare customers their commitment to pan-Canadian standards and industry best practices, and their leadership in contributing to interoperable health information for Canadians.



Medicine in the Age of Twitter

Some doctors are embracing the digital revolution and tweeting and using Facebook to give their patients a better understanding of their own health care.

By Ayako Mie | Email the author | 3:13am

When Rahul Parikh arrived at his office on Tuesday morning, the first thing he did was to tweet that the hospital finished construction of the front entrance.

"I thought it was useful information for the community," said the 38-year old Parikh.

Parikh is a pediatrician at Kaiser Permanente Medical Center in Walnut Creek. What makes Parikh different from some other doctors is that he fully embraces Web. 2.0. He tweets about heath care news, in addition to writing medical-related blogs on Salon.com and contributing to the New York Times, the Los Angeles Times, and the San Francisco Chronicle. You can follow the doctor at @parikhmd.




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