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Friday, July 23, 2010
With the rules finally set for health IT stimulus money, now comes the long march to implementation.
By David Talbot
Seventeen months after the U.S. stimulus law authorized billions to subsidize electronic health records (EHRs), 864 pages of rules for how physicians and hospitals must show "meaningful use" of the technology are finally set. Now comes the hard part: implementing the technology in a country where, by one estimate, only 17 percent of doctors use EHRs at all.
"This is a turning point for electronic health records in America, and for improved quality and effectiveness in health care," David Blumenthal, the national coördinator for health information technology, said in a statement after the rules came out last week.
SmartRoom systems, now deployed at two University of Pittsburgh Medical Center hospitals, identifies clinicians, providing real-time access to patient information and workflow tools based on role and location of caregiver.
By Marianne Kolbasuk McGee, InformationWeek
July 28, 2010
IBM and University of Pittsburgh Medical Center, which are in the midst of an 8-year relationship to transform UPMC's IT infrastructure, have unveiled a new joint effort to make hospital rooms nationwide "smarter."
The two companies have formed a new business relationship to offer to non-UPMC hospitals SmartRoom technology that was developed by UPMC.
Under the deal, both IBM and UPMC will invest in the new SmartRoom company through a $50 million co-development fund set up in 2005 when IBM and UPMC entered an 8-year relationship to "transform" UPMC's IT infrastructure, which includes ambitious projects such as consolidating and virtualizing UPMC's IT environment.
Payment reform, provider support, better products, and enhanced privacy and security will give adoption of electronic health records a needed boost.
By John Glaser, InformationWeek
July 24, 2010
Healthcare is one of the most information-intensive and technologically advanced industries in our society. Yet most physicians and hospitals still use information systems that are largely paper-based. Four major challenges contribute to this situation:
• Healthcare consists of lots of small organizations that have a difficult time funding IT investments and rarely have trained IT staff to assist in selecting and implementing products.
• Although many healthcare apps have the potential to improve care--think e-prescribing systems that reduce adverse drug events--insurers don't always reimburse healthcare providers for delivering quality care, so providers see no financial gain from investing in IT.
Date: 22 Jul 2010 - 13:54
Source: European Commission
The European Commission has published a detailed report assessing the "economic benefits of privacy-enhancing technologies", known as PETs.
The study, authored by consultancy London Economics, sets out a framework for understanding PETs and how they are deployed, and gives the results of an extensive survey into the use of PETs, their perceived costs and benefits, and the role played by public authorities in the deployment of PETs. PETs are defined as data security technologies that are used to enhance privacy, though the report notes that some technologies can be used either to enhance, or reduce privacy.
New Law Establishes Framework for Secure Exchange of Electronic Health Records in Illinois
CHICAGO – July 27, 2010. Governor Pat Quinn today signed a bill into law that will create a secure framework for the sharing of electronic health information in Illinois. The new law creates the Health Information Exchange and Technology Act and establishes a state authority to operate the Illinois Health Information Exchange (HIE).
“Creating a more effective, efficient and secure health care system is a top priority of my administration,” said Governor Quinn. “The sharing of electronic medical records through a Health Information Exchange will help ensure that everyone in Illinois receives the best health care possible.”
Janice Simmons, for HealthLeaders Media, July 29, 2010
Recent discussions about how electronic health records can improve healthcare delivery mainly have focused on the impact on hospitals, physicians, or nurses. Missing from this lineup: patients. A one-year pilot called OpenNotes, however, is aiming to get patients more involved in their care by letting them read their primary care physicians' visit notes online through secure Websites.
"Patients say that they're really interested in this by and large. But, one of the questions is if we open these records, will they look at them?" says Jan Walker, RN, MBA, a health services researcher at Beth Israel Deaconess Medical Center, Boston, and one of the study's lead investigators. "So thanks to computer systems, we can find out."
The study, outlined in the July 20 Annals of Internal Medicine, involves about 100 primary care physicians—who volunteered for the OpenNotes project—at three diverse organizations: Beth Israel Deaconess, an urban academic health center with community practices; Geisinger Health System, an integrated health system in rural Pennsylvania; and Harborview Medical Center, a county hospital in Seattle which serves many homeless and indigent patients.
HDM Breaking News, July 29, 2010
The federal government may be pouring $548 million of stimulus funding into state-level health information exchanges, but there are a growing number of private HIEs emerging, where an integrated delivery system may link its owned and affiliated providers, or, in some cases, local competitors, to cooperate on data exchange.
It's the private market that many information technology vendors see as their primary HIE focus, says John Moore, managing partner of Chilmark Research, a Cambridge, Mass.-based consultancy. There typically is a sound business reason for private HIEs: "driving referrals back to the mother ship," he says. That business reason why 21 HIE vendors surveyed by Moore report that nearly 70 percent of their business is in the private market.
Posted: July 30, 2010 - 12:00 pm ET
As 56 state-run and federally authorized entities develop their regional health information exchanges, state-level officials are responsible for ensuring that the clinical information contained within eventually meets the info-sharing requirements of the National Health Information Network.
That's a primary conclusion of the fourth Profiles of Progress report (PDF) from the National Association of State Chief Information Officers, released this week. The association, whose membership comprises state chief information officers, notes that sharing information among clinicians—and doing so using a standardized federal database—is the “primary purpose” of the state and regional health information exchanges.
The Office of the National Coordinator for Health Information Technology doled out $550 million in grants to the 56 public and private organizations to develop their own regional systems through which to share clinical information among providers while maintaining patient privacy and data security.
By Kirsten Stewart
The Salt Lake Tribune
Updated Jul 29, 2010 09:16PM
President Barack Obama’s point man for digitizing the nation’s health care system defended the administration’s new plans against critics who say the watered-down rules miss an opportunity to lower costs and improve patient care.
The recently released rules dictate what qualifies as “meaningful use” of electronic medical records, the standard providers must adopt to access the billions in grants available to help them go paperless.
The standards seek to strike a balance between encouraging the change without expecting too much from health providers, David Blumenthal, the national health information technology coordinator, told a gathering of Utah health officials on Thursday.
Posted: July 29, 2010 - 12:45 pm ET
As a federal policy battle looms over the extent to which patients will exercise control over the movement of their electronic health records, one outstanding question is: Will electronic health-record systems be able to give practitioners and patients the level of consent management they'll need or want?
A possible answer might come from the not-for-profit Certification Commission for Health Information Technology, which has developed a new set of criteria against which EHRs can be tested for the special needs of behavioral health professionals, who have long dealt with patient-consent choices, laws and rules that the rest of the medical profession may soon face.
"I've lived in behavioral health all my life, so I'm more familiar with that," said Sharon Hicks, chief operating officer of Community Care Behavioral Health, part of the University of Pittsburgh Medical Center. "Once you live in it, you feel fine. We've had these rules in place for a long time and they don't create a problem."
Posted: July 29, 2010 - 11:45 am ET
The prospect of billions of dollars of federal subsidy payments flowing into the healthcare industry for information technology has so piqued the interest of a foreign IT company that has acquired an American firm to gain instant entry into the U.S. market, according to a news release.
Cegedim, a global technology services company, said it has completed a deal to acquire electronic health-record system provider Pulse Systems. The acquisition's total cost, excluding a capital increase and including a portion contingent upon meeting growth targets over the next two years, will not exceed $58 million, according to Cegedim's news release.
July 29, 2010 — 11:21am ET | By Neil Versel
After a bit of a lull in the late 2000s, health information exchange--to no one's surprise--is picking up again. (Funny how a massive national incentive program that requires HIE can do that.)
According to the multi-stakeholder eHealth Initiative, there are 234 active HIEs nationwide, up from 193 a year ago. Of that total, 56 are state-designated entities that have been awarded nearly $548 million in federal stimulus money to help promote interoperability of EMRs.
Thursday, July 29, 2010
by Speranza Avram
The California Health Information Partnership and Services Organization (CalHIPSO) is the nation's largest Regional Extension Center. Our charge is to assist 6,187 primary care providers in successfully adopting electronic health records so they can qualify for the "meaningful use" incentives made available by the federal government through the 2009 federal stimulus package.
We serve the entire state of California with the exception of Los Angeles County, which has its own REC -- HI-TECH LA -- and Orange County, which has not yet been awarded a REC contract. Under our current $31.2 million agreement with the Office of the National Coordinator for Health IT, we have until February 2012 to complete our task.
By Brian Robinson
Tuesday, July 27, 2010
Development of ways to link regional health IT systems, as well as an information plan that maps what data flows, security and standards are need to ensure real-time communications between health organizations and emergency services, are some of the key elements of a plan for achieving U.S. national health security.
A draft of the Biennial Implementation Plan (BIP), published July 19 by the Department of Health and Human Services, is the first-ever attempt to pull together a national strategy for minimizing the health impact of natural and man-made disasters, disease outbreaks, and biological and other terrorist attacks.
The draft adds the first programmatic details of the National Health Security Strategy (NHSS), following an initial announcement of the initiative by HHS Secretary Kathleen Sebelius earlier this year. The plan was opened for public comment July 26.
23 Jul 2010
The International Health Terminology Standards Development Organisation and the World Health Organisation have signed a collaborative agreement to utilise WHO classifications and SNOMED CT together.
The collaboration aims to create an integrated classifications and terminology system that will improve patient information for health policy, health services management and research across the world.
23 Jul 2010
Germany’s CompuGroup Medical has won the contract to provide an integrated electronic patient record system to primary and outpatient care centres in the Swedish region of Skåne.
The implementation, which will cover all primary care institutions and private GPs in the region, is expected to be completed by the end of the year.
The contract will see the company supply its Profdoc Medical Office electronic patient record system to more than 130 healthcare centres, 140 child health centres and around 130 rehabilitation centres in the region.
Posted: July 28, 2010 - 11:15 am ET
Illinois healthcare providers moved one step closer to interoperable electronic data sharing as Gov. Pat Quinn signed a bill creating the Health Information Exchange Authority.
Under the new law, the state authority will establish and oversee the Illinois Health Information Exchange and will work to promote adoption of electronic health-record systems and health information exchange participation.
Cerner Corp.'s (CERN) second-quarter profit climbed 27% as the health-care information-technology company recorded robust revenue and bookings.
It raised its 2010 earnings guidance to $2.85 to $2.92 a share from its prior outlook of $2.80 to $2.90 and tightened its revenue estimate. Cerner also forecast third-quarter earnings of 71 cents to 76 cents on revenue of $455 million to $470 million, bracketing analysts' forecasts.
27 July 2010
Despite significant investment in e-health, practical outcomes are yet to be realised.
In Ontario, the implementation of electronic records has relied on the goodwill and financial resources of individual practitioners, especially “early adopters” who adopt e-records without a solid infrastructure in place. Funding is sporadic and inadequate. Not surprisingly, uptake is low. Without a strong central structure, the branches cannot support the weight of their fruit.
Posted: July 27, 2010 - 11:15 am ET
Will the U.S. achieve its goal of providing most Americans access to an electronic health record by 2014?
Maybe not, if the experience of the country's neighbor to the north is any indication.
Seven of 13 Canadian provinces and territories offer subsidies to primary-care physicians for the purchase of EHR systems, according to a new report published in the Journal of Healthcare Information Management. But after nearly a decade of providing these subsidies, Canada still has not achieved majority adoption of EHR systems among its primary-care physicians, the report notes.
In 2004, President George W. Bush set the goal of making electronic medical records available to most Americans by 2014. Soon after taking office in 2009, President Barack Obama adopted the same goal for his administration.
Posted: July 27, 2010 - 12:00 pm ET
The Certification Commission for Health Information Technology has launched several new certification programs under its "CCHIT Certified" brand that aim to go beyond federal minimum requirements and meet longer-term goals for use of electronic health records with integrated functionality, interoperability and security.
Although CCHIT has applied to be an authorized testing and certification body as determined by the Office of the National Coordinator for Health Information Technology, vendors seeking to have their products designated as eligible for federal subsidies under the CMS meaningful-use requirements will have to apply via a separate testing process, according to CCHIT.
Gienna Shaw, for HealthLeaders Media, July 27, 2010
Quick: When you think about defensive medicine, what comes to mind? For me, it’s imaging technologies. Try going to your primary care physician’s office on a Friday afternoon and telling her you have a slight pain in your abdomen. You’ll be holding your nose and swigging a barium cocktail in no time as technicians warm up the CT scan machine. You—or, more accurately, your health insurer—will spend a lot of money to find out whether your appendix is about to burst or if that burrito with extra jalapeño peppers you ate last night is to blame.
In the July issue of HealthLeaders Magazine, I wrote about the cost-quality conundrum of healthcare imaging technologies.
Advanced imaging technologies add to the high cost of healthcare; the latest model of any given machine is always more costly but not always more effective than the previous version; and access to technology definitely plays a role in overutilization and defensive medicine. It may not be the only problem, but it is part of the picture.
27 Jul 2010
A former chair of the BMA’s GP IT committee is advising GPs to automatically opt-out all patients from the Summary Care Record.
Dr Paul Cundy, a Wimbledon GP, said he was issuing advice to GPs because trade union law was hindering the BMA and its General Practitioner Committee from doing so.
Dr Cundy’s advice is that GPs should enter the Read code 93C3 (refused consent for upload to national shared electronic record) to all patient records except those for which a patient has given explicit consent to have an SCR.
A cancer diagnosis can quickly rob individuals of normalcy. The news often also leaves people confused about how and where to get the information and support they need. To address these difficult issues, researchers at the University of Wisconsin-Madison have developed electronic communications tools to help provide this information and improve the quality of life of patients with cancer and others suffering from serious illnesses.
CHESS started out as a DOS-based system run from a local computer, and now it's on smartphones.
—Dr. David Gustafson
The work has been under way for more than 3 decades at the university’s Center for Health Systems Research and Analysis (CHSRA), an NCI Center of Excellence in Cancer Communication Research (CECCR). The CHRSA’s flagship communications program, called the Comprehensive Health Enhancement Support System (CHESS), has grown in parallel with the rise of the Internet and online advancements.
The choices Healthcare CIOs make between single vendor enterprise solutions and best-of-breed offerings are driven by budget constraints that often reveal the healthcare haves and have-nots.
By Anthony Guerra, InformationWeek
July 13, 2010
In what's become an epic battle for the heart and soul of sound CIO strategy, I continually hear the emergence of two camps -- the enterprise, one-vendor-for-all folks, and the cobble-it-together best-of-breed/suite folks.
In interviews with CIOs of each type, I hear different levels of derision directed at the other camp. None of this, mind you, is extremely overt, healthcare CIOs are too deferential for that. Most of it comes in the form of questions, such as, "I'm not sure that's the most responsible strategy." The funny thing is that this exact barb has been directed by each side towards the other.
July 23, 2010 | Bernie Monegain, Editor
MENLO PARK, CA – Physician adoption of smartphones is experiencing exponential growth, according to "Point of Care Communications for Physicians," a new study from Spyglass Consulting Group.
The study shows significant trends on how physicians across the United States are adopting mobile communications at point of care to improve communications and collaboration, streamline productivity, and enhance patient care and safety.
The report reveals 94 percent of physicians are using smartphones to communicate, manage personal and business workflows, and access medical information. This represents a 60 percent increase from Spyglass' findings in a similar study published in November 2006. At that time, 59 percent of physicians were using smartphones.
By Mary Mosquera
Wednesday, July 21, 2010
The Office of the National Coordinator for Health expects that there will likely be multiple organizations to test and verify electronic health record products for the temporary certification program, leading to a faster, more open and more competitive process.
So far, ONC has received six or seven completed applications out of the 30 it sent to organizations that have requested them since July 1, said Dr. David Blumenthal, the national health IT coordinator, at a meeting of the advisory Health IT Policy Committee.
ONC released in June its final rule for the temporary certification program, which lays out steps organizations must take to be authorized by ONC to both test and certify that EHRs can perform the functions required for meaningful use.
HDM Breaking News, July 23, 2010
The Health Solutions Group of Microsoft Corp. will discontinue marketing of its Amalga Hospital Information System, a clinical and financial application sold primarily in the Asian Pacific region. The company will continue to support existing users for at least five years.
Redmond, Wash.-based Microsoft will focus development and marketing efforts on the Amalga Unified Intelligence System, which is a data aggregation, analytics and reporting application.
HDM Breaking News, July 23, 2010
The Health Industry Group Purchasing Association and the Association for Healthcare Resource and Materials Management are asking federal officials to consider adoption of two identification standards used in the health care supply chain.
National adoption of the standards and their integration into electronic health records and supply chain management systems can increase patient safety while bringing efficiencies to the supply chain side, the associations wrote in a letter to David Blumenthal, M.D., national coordinator for health information technology. "Without data standards in this area, it is virtually impossible to efficiently recall devices and other supplies and that can lead to grave injury and even death."
That's the purpose of Simon, a computer managed mannequin used by Altru Health System in Grand Forks to train a dozen regional health care facilities.
"North Dakota nurses need 12 hours of contact training every two years for licensure, 24 in Minnesota," said Sue Tharalson, nursing manager at Altru. "Simon provides four contact hours in one visit."
Posted: July 26, 2010 - 12:30 pm ET
Plenty of multicampus hospitals have a beef with the latest CMS rule on the federal electronic health-record system subsidy program, but theirs is a problem only an act of Congress can solve.
The consensus among industry leaders for the aggrieved hospitals is that CMS rulemakers had a solid legal peg on which to hang their disappointing interpretation—that multicampus hospitals using one Medicare provider number are ineligible for the same level of federal EHR subsidy payments as similar organizations in which each hospital has its own Medicare provider number.
July 26, 2010 — 12:04pm ET | By Neil Versel
An HHS "tiger team" tasked with finding ways to ensure privacy and security of protected health information in the context of government-funded health information exchange has recommended several models, depending on whether or not a patient must give consent.
The team presented the Health IT Policy Committee last week with a list of factors that trigger the need to obtain express consent to exchange patient-specific data. HIE, according to the tiger team's co chair Paul Eggerman, is "a voluntary process where there are opportunities for patients to say if they don't want to participate in exchange and opportunities for providers to not participate," Government Health IT reports.
By Mary Mosquera
Thursday, July 22, 2010
An HHS advisory committee has approved several models for strengthening the privacy and security of health information exchange that will allow patients to either opt-in or opt-out of taking part in the exchange of the data.
A privacy and security 'tiger team' developed a list of factors that will activate the need to obtain patient consent, including when the individual’s health information is no longer under control of the patient or the patient’s provider and when a third party retains the patient’s information for future use, said Paul Egerman, software entrepreneur and co-chair of the tiger team.
The tiger team's mission is to come up with solutions to thorny privacy and security challenges in health information exchange in programs funded by the Office of the National Coordinator for Health IT.
Posted by Marianne Kolbasuk McGee on July 26, 2010 11:43 AM
Hospital executives aren't just worried about having their own organizations meet the federal government's meaningful use requirements; they're also concerned about their affiliated and owned doctor practices achieving the goals. In fact, many hospitals are assisting (or plan to help) doctors to get on board with e-health records even as those hospitals struggle with their own projects.
A recent CSC survey of 60 hospital executives found that having their organizations help community doctors achieve meaningful use of an ambulatory e-health record was among the top three priorities of 86% of the respondents in the near term.
The 60 healthcare executives responding to the survey included about half CIOs and other IT leaders, and half operational executives, including CEOs, CFOs and COOs. The executives were from a mix of large multi-hospital health systems, single academic medical centers, and stand alone non-academic hospitals.
Online consultations between doctors and patients will become essential as more people access doctors under health reform, says Forrester Research.
By Nicole Lewis, InformationWeek
July 26, 2010
While there is widespread use of the Internet among Americans -- 74% of Americans 18 and older go online, according to the Pew Research Center -- a recent survey from Forrester Research shows that communication between physicians and patients via the Internet is still struggling to gain traction. Forrester's numbers reveal that of those patients whose doctors offer e-mails, less than a quarter have used it, while only 16% have taken advantage of their doctors' online forms for medical visits.
Published last month, the survey interviewed 5,264 people between August and September 2009, and found that, among e-Visit users, 46% have a college degree or higher and 54% don't. Among non-users, 25% have a college degree and 75% don't. eVisit users also have higher household incomes, averaging $88,000, while the average income for those not using the service is $70,000.
Monday, July 26, 2010
by Kate Ackerman, iHealthBeat Senior Editor
With the final rules on "meaningful use," standards and certification criteria and the temporary electronic health record certification program all released, many health care providers are starting to scramble to ensure that they can qualify for Medicare and Medicaid incentive payments beginning in 2011. But there's one sector of the health care industry that you won't find reading up on the recent rules or comparing EHR products from different vendors.
The 2009 federal economic stimulus package excludes clinical psychologists, clinical social workers, psychiatric hospitals, mental health treatment facilities and substance abuse treatment facilities from receiving incentive payments for the meaningful use of EHRs.