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, August 13, 2010

Weekly Overseas Health IT Links - 13 August, 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.



Uncle Sam Wants Usability!

By John Morrissey

Federal policymakers and the health IT community are converging rapidly around the need to agree on standard practices for clearly communicating information contained in electronic health records and making it much easier for clinicians to navigate their way around tasks in an EHR.

Healthcare researchers, technology experts and EHR user advocates, bolstered by a new government commitment, are championing the idea that the “usability” of EHR systems is critical to efforts to get the nation’s clinicians to effectively use the software in daily healthcare practice.

The conclusion that uneven or poor usability is a barrier to IT adoption and must be overcome is being advanced strongly by Dr. David Blumenthal, who heads up the Office of National Coordinator for Health Information Technology (ONC). The ONC boss has put his special assistant, Dr. Sachin Jain, in charge of an internal usability work group to light a fire under the issue.



Surescripts Teams with HealthVault

HDM Breaking News, August 3, 2010

A new service from electronic prescribing network operator Surescripts will enable consumers using the Microsoft HealthVault personal health records software to download records of their dispensed medications from community pharmacies that use the Surescripts network.



Maine law on prescriber privacy upheld

By Joseph Conn / HITS staff writer

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

A Maine law aimed at constraining state spending on prescription drugs by protecting physicians from having their prescription patterns data-mined for commercial use by drug marketers has been upheld by a federal appeals court in Boston, the Associated Press reported.

In an 87-page ruling, the appeals panel found that although empirical evidence was sparse that using prescription drug data for marketing influenced physician prescribing patterns, the court nonetheless gave the state initial latitude for a program aimed at controlling spiraling costs for its publicly funded healthcare programs.



Electronic exchange begins connecting health care providers

Published: Thursday, August 05, 2010, 11:54 AM Updated: Thursday, August 05, 2010, 11:55 AM

Mark Sanchez

Providing a platform for doctors to electronically access diagnostic test results is just the start for the newly formed Michigan Health Connect.

The regional health information exchange, based in Grand Rapids, in the future aims to offer clinical messaging that pushes data about a patient from a hospital to a doctor’s office, as well as add capabilities that would enable emergency room physicians, for instance, to access medical data about patients who are unable to relay that information on their own.



Flagship NHS IT programmes head for the rocks

Government review suggests CfH should go, and the NPfIT be vastly reduced

Written by Stuart Sumner

A report on web site E-Health Insider (EHI) states that the NHS National Programme for IT (NPfIT) will be dramatically scaled down, and Connecting for Health (CfH) will be rebranded, losing much of its remit to the Department of Health Informatics Directorate.

The government has been reviewing its major IT projects, and it appears that neither the NPfIT nor CfH emerged favourably from the analysis.



Health IT proficiency a priority for medical board

By Jennifer Lubell / HITS staff writer

Posted: August 5, 2010 - 12:00 pm ET

The American Board of Medical Specialties announced that it will incorporate tools to promote the meaningful use of health information technology into its maintenance-of-certification program.

More than 750,000 U.S. physicians are certified by an ABMS member board, and building health IT proficiency and use can "help to facilitate physicians' knowledge, skill and use of health IT and in turn can improve physician performance and patient outcomes,” ABMS President and CEO Kevin Weiss said in a written statement.



Decision day arrives for CfH and NPfIT

05 Aug 2010

The National Programme for IT in the NHS is set to end in its current guise, with plans tabled for further deep cuts, and the name NHS Connecting for Health to be dropped.

E-Health Insider understands that a far-reaching review of the National Programme and Connecting for Health was completed by the coalition government last week, as part of a wider review of all public sector IT major projects.

The recommendations of the review was due to be evaluated today by a panel chaired by government chief information officer John Suffolk. Assuming it is approved, a ministerial announcement expected to follow within the next two weeks.



FDA, Obama Digital Medical Records Team at Odds over Safety Oversight

By Fred Schulte and Emma Schwartz
Huffington Post Investigative Fund

Created 2010-08-03 17:07

Previously Undisclosed Hospital Mixup Underscores Challenges on Road to Reform

Computers at a major Midwest hospital chain went awry on June 29, posting some doctors’ orders to the wrong medical charts in a few cases and possibly putting patients in harm’s way.

The digital records system “would switch to another patient record without the user directing it to do so,” said Stephen Shivinsky, vice-president for corporate communications at Trinity Health System. Trinity operates 46 hospitals, most in Michigan, Iowa and Ohio.



Adoption and Meaningful Use of EHRs – The Journey Begins

Posted By David Blumenthal On August 5, 2010 @ 9:20 am

On July 13, with the issuance of two regulations defining and supporting “meaningful use” of electronic health records (EHRs), our nation began in earnest its journey toward ubiquitous and effective use of health information technology. In considering the significance of this moment, it is useful to remember the events and energies that have brought us to this starting point, and to understand the many different elements that will support this initiative.

The proximate event leading us to the July 13 announcement was the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act, in February 2009. This act makes available unprecedented resources to support the nation’s transition to EHRs. In the months since its enactment, extensive preparations have been made. These constitute the operational supports for a multiyear, multiphase campaign of EHR adoption and use. But behind these preparations lies a longer and deeper history that has prepared us to seize this moment.



FDA Approves Mobile Diabetes Tool

HDM Breaking News, August 3, 2010

The Food and Drug Administration has given 510 (k) clearance to the mobile phone-based DiabetesManager System of WellDoc Communications Inc.

The application enables Type 2 diabetic patients to enter their blood sugar readings into their mobile phone and receive real-time feedback on what they should eat and other ways they can help stabilize their blood sugar. The software also can alert patients when they need to test their levels.



iPhone apps that could save your life

Developers create mobile apps that help consumers make better medical decisions

By Carolyn Duffy Marsan, Network World

August 02, 2010 04:26 PM ET

Move over games and make room for medicine. A growing number of developers are tapping into a treasure trove of U.S. government healthcare data and coming up with innovative iPhone apps that help consumers make better medical decisions.

Here are three iPhone apps that point towards a future of patients having more medical data at their fingertips.

These smartphone applications were showcased at an event held this summer by the U.S. Department of Health and Human Services when it launched its Community Health Data Initiative. The initiative is releasing federal healthcare data with a standard application programming interface for developers.



'Cyberchondriacs' jump to almost one-third of all adults

Most users very satisfied with their ability to find reliable health information online

Lucas Mearian (Computerworld (US)) 05/08/2010 04:55:00

The number of adults using the Internet to find health-related information leaped from 154 million in 2009 to 175 million this year, according to a Harris Interactive poll released today. It's the largest year-over-year increase since the poll began in 1998.

The new poll shows that 32% of adults say they regularly look online for health-related information compared with 22% last year.



AMA will offer NextGen EHRs

By Joseph Conn / HITS staff writer

Posted: August 4, 2010 - 11:30 am ET

The American Medical Association will offer remote-hosted electronic health-record and practice management systems from NextGen Healthcare Information Systems through the AMA's information technology platform, according to a news release from NextGen.

The EHR and PMS will be provided using the software-as-a-service delivery model on a subscription basis, according to the release. The AMA announced in April 2009 that it was developing the platform with technical assistance from Covisint, a division of Detroit-based Compuware. The platform is being tested in Michigan. It is expected to debut nationwide next year, according to the news release.



NHS spends millions on websites that fail patients, says government report

Leaked review suggests many of NHS's 2873 sites do not cater for vulnerable members of public

Randeep Ramesh, social affairs editor

guardian.co.uk, Wednesday 4 August 2010 21.06 BST

The NHS spends up to £86m a year on thousands of websites that are difficult to find, badly designed and irrelevant to patient needs, according to a leaked government report.

The Department of Health's digital communications review, circulated internally in June, identified 4,121 NHS websites – but noted that more than 1,000 were no longer accessible. Almost a third of the 2,873 live NHS websites had "at least one notable deficit in standards" with confusing navigation or poor content.



Pathology, the present and the future

On July 8 2010, E-Health Insider convened a round table debate on clinical pathology, sponsored by iSOFT. The event gathered together some of the leading players in pathology in the UK, with industry, the NHS and academia represented.

The event was chaired by Ian Barnes, who is currently national clinical director for pathology for the Department of Health, on secondment from Leeds Teaching Hospital, although he was speaking in a personal capacity.

He started by setting out what he hoped the debate would cover, arguing that technology had moved faster than pathology had been able to respond.



Policymakers press for public health IT measures

By Mary Mosquera
Monday, August 02, 2010

Public health experts last week lobbied for including more public health goals into the “meaningful use” incentive plan, including ways to make it easier for public health minders to measure population health trends in chronic and virus-borne diseases.

One idea floated during the July 29 meeting of Health IT Policy Committee’s meaningful use work group was to have certified electronic health record systems carry a feature or “button” that would transmit data to state public health agencies to make case reporting easier for physicians and hospitals.



Physicians: Get Over Your Fear of Electronic Messaging

Gienna Shaw, for HealthLeaders Media, August 3, 2010

The more effectively patients and physicians can communicate the better healthcare will be. And that includes better electronic communications, such as by e-mail. Yes, I understand doctors’ concerns that it would take up too much of their time—uncompensated time at that—and expose them to liability and leave an electronic trail of typos. But I believe that deep down inside they also know it is the right thing to do.

Almost every non-healthcare business uses e-mail to communicate with its customers (and it’s probably safe to drop the modifier “almost” on that one). And we know that most patients would like the option to e-mail their doctor.



CPOE requires long-term perspective

By Leah Binder

Posted: August 3, 2010 - 12:01 am ET

Some time ago, I toured one of the nation's top hospitals—a Leapfrog survey participant—and had a chance to talk with them about Computerized Physician Order Entry. When it comes to health information technology, this hospital is one of the most advanced and experienced. I wanted to know how the system functioned at the bedside. “Does the nurse check the order and record that in the system somehow?” I asked. The awkward silence that followed suggested I inadvertently struck a nerve. And indeed I had. It turned out nurses at the hospital waged something of a mini-revolt when the CPOE system was first adopted, and their concerns surrounded exactly that issue. On the “go-live” date, nurses were expected to stop rechecking orders at the bedside and rely on the CPOE system protocols to verify each order. “No way,” said the nurses, and ultimately their role as the final safety check was restored.



Insurers and ratings groups post information to help patients choose doctors

By Michelle Andrews

Tuesday, August 3, 2010; HE04

For most people, picking a doctor is hardly a scientific process. They ask friends or family members to pass along names of doctors they like and trust, or rely on another doctor's referral.

Increasingly, health plans and independent groups are making physician information available online to help consumers make these choices more methodically. But experts caution that most doctor-rating systems are still rudimentary, and a four-star rating or other high-performance designation may not reliably reflect a doctor's abilities. While ratings can provide helpful information, consumers still need to dig a little to find the best doctors for their needs.



Accenture to help develop Singapore EHR system

By Joseph Conn / HITS staff writer

Posted: August 3, 2010 - 12:15 pm ET

U.S.-based consultancy Accenture and several other U.S. vendors have been awarded a contract by the Singapore Ministry of Health to implement a national electronic health-record system, Accenture has announced.

Under the proposed system, providers will be able to exchange patient demographics, allergy lists, diagnoses, medication histories, radiology and lab reports and discharge summaries, according to an Accenture news release. The system is expected to debut in April 2011.



ICO issues guidance on SCR opt-outs

30 Jul 2010

GPs must inform their patients before carrying out a blanket opt-out of all their patients from the Summary Care Record, the Information Commissioner’s Office has said.

The ICO said that opting out all of a practice’s patients without first informing them could be considered as “unfair processing”. Earlier this week a former chair of the BMA’s GP IT Committee, Dr Paul Cundy, recommended that GPs should opt-out all their patients en masse.

The ICO’s stance on mass opt-outs has been revealed in response to a request for guidance from Dr Neil Bhatia, a Hampshire GP who has campaigned against the SCR and pledged only to upload SCRs for patients who have given explicit consent.



Birmingham SCR scare proves false

03 Aug 2010

The vast majority of the Summary Care Records identified as out-of-date are actually up-to-date, an investigation has discovered.

An NHS investigation has found that the problem was caused by EMIS GP systems incorrectly logging SCRs as out-of-date.

NHS South Birmingham launched an enquiry into out-of-date SCRs after it emerged that 8,800 of the 82,000 created were logged as “out of date SCR items” by GP practices using the EMIS computer system.


Hospital Building Community Health Information Exchange

Fremont Area Medical Center using Lawson software to develop a patient information exchange for Nebraska healthcare providers.

By Marianne Kolbasuk McGee, InformationWeek

Aug. 3, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226500195

While the HITECH Act allotted about $547 million to states and state entities to develop health information exchanges, some healthcare providers are taking matters into their own hands to create data exchanges that more immediately meet the information needs of regional clinicians.

Such is the case of Fremont Area Medical Center, located in northeast Nebraska, about 35 miles from Omaha. The 202-bed non-profit hospital, which is owned by Dodge County, just signed a contract to implement Lawson Enterprise Exchange to create a single source of patient data across all care settings, including hospital, clinics, primary care, and specialty physicians, that are affiliated with or employed by FAMC.

Like most states, Nebraska is building a statewide health information exchange, however to date, patient data that's part of the Nebraska Health Information Initiative, or NeHii, includes primarily lab and radiology reports and demographic info, said Richard Beran, FAMC director of hospital information systems.


Health IT Alone Won't Improve Primary Care

Federal report raises numerous questions about whether electronic health records and other technologies can advance the patient centered medical home model.

By Nicole Lewis, InformationWeek

July 29, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226300284

Health information technology can be a strong facilitator for the establishment of the patient centered medical home (PCMH), but health IT alone is not a panacea for building an efficient model, a government study reveals.

Published last month by the Department of Health and Human Services' Agency for Healthcare Research and Quality, the report, "Necessary but Not Sufficient: The HITECH Act and Health Information Technology's Potential to Build Medical Homes," said available evidence on the ability of health IT to support the medical home is mixed.

While some evidence suggests that health IT improves the cost effectiveness, efficiency, quality, and safety of medical care delivery, there is not broad evidence of success. "It may take 5 to 10 years to figure out the full unintended effects of health IT on transforming practices into medical homes," the report said.



Telehealth demo in Boston will involve patients with congestive heart failure

July 30, 2010 | Molly Merrill, Associate Editor

CAMBRIDGE, MA – Patients who have been hospitalized for congestive heart failure may benefit from a “Home Telehealth” demonstration project set to take place in the Greater Boston area that aims at testing the efficacy of home-based monitoring equipment for older adults with chronic illnesses.

The project is being funded by a 100,000 grant from the Center for Technology and Aging, which was awarded to the New England Healthcare Institute (NEHI), an independent, nonprofit organization that conducts evidence-based research.



Smartphones, Tablets Seen Boosting Mobile Health

Fred O'Connor Fred O'connor Thu Jul 29, 8:50 pm ET

Smartphones, tablet PCs and other wireless devices are poised to play a greater role in health care as doctors and patients embrace the mobile Internet, panelists at a mobile health technology conference in Boston said Thursday.

A study from Manhattan Research found that 71 percent of physicians consider a smartphone essential to their practice and 84 percent said that the Internet is critical to their jobs.



SnapSurvey: CIOs OK With MU, But Concerned About Peers

Posted by Anthony Guerra on July 25th, 2010

Many CIOs Feel Good About Meeting MU

An overwhelming majority of CIOs are both pleased with how public comments impacted the final Meaningful Use regulation and optimistic about their ability to meet it, according to the July healthsystemCIO.com SnapSurvey; however a majority of those same CIOs thought it far less likely that the “average” hospital will make the grade.

And the apparent bullishness — at least at their own institutions — further dissipates when analyzing the comments CIOs left after confirming they would meet the measure. That copy (see text below) is peppered with phrases like “we should qualify … we hope to meet the measures … we are fairly certain of reaching the goals.”

In an attempt to identify the reasons for any concern, CIOs volunteered the specific core measure that most distressed them, with “Report clinical quality measures to CMS or states. For 2011, provide aggregate numerator and denominator through attestation; for 2012, electronically submit measures,” taking the top spot at 24 percent.



ONC finds exchange standards hard to nail

By Mary Mosquera
Friday, July 30, 2010

When the Veterans Affairs and Defense departments began testing health information sharing for their joint virtual lifetime electronic record (VLER) project, they could not initially exchange patient data successfully using the very standards specified by the Office of the National Coordinator for health record formatting.

The popular C32 standard format for sharing information about a patient’s health status allows some flexibility in how organizations use it to accommodate their different needs. Ironically, that same feature limited the exchange of patient information between VA and DOD.

Dr. Doug Fridsma, acting director of ONC’s standards and interoperability office, used the experience of VA and DOD as an example of the trickiness of getting standards right so healthcare providers can exchange health information properly. C32 is among the requirements of ONC’s recent final rule on standards and certification of electronic health records (EHRs).



Privacy--Get Over It?

Rob Tholemeier

Health Data Management Blogs, July 23, 2010

You have zero privacy anyway. Get over it.” I'm not defending this quip by the master quipster, founder and former CEO of Sun Microsystem, Scott McNealy, but is this the de facto consequence of the mad dash to implement EHRs and HIEs?

Lately, my e-mail inbox is full of stories about hospitals fined for what looks like minor breaches of patient privacy. In one case, a California hospital was dinged $25,000 for two employees accessing three patients’ health information. Fines for more “egregious” breaches have been higher.

Really, how in the world can a medical facility ensure that there will be no unauthorized viewing of health information given the state of EHR’s internal data privacy, and given the fact that much of this information is now being more widely distributed via HIEs? Clearly, busting employers on a HIPAA beef is not working to prevent employees from accessing or leaking out personal health information.



E-prescription use grows, but some hurdles remain

August 2, 2010


By 2012, physicians who do not electronically prescribe medications -- instead of hand-writing them -- will be penalized financially by the federal government.

The Centers for Medicare and Medicaid Services, or CMS, has employed this carrot and stick approach to encourage complete adoption of e-prescribing to improve healthcare quality and cut costs.

While e-prescribing has grown dramatically in recent years, local doctors said there continue to be barriers to widespread acceptance of a technology that could save thousands of lives.

In a study released last week the Washington-based health policy think tank the Center for Studying Health System Change found that fewer than one-third of the nation's office-based physicians were e-prescribing.



Monday, August 02, 2010

HHS Moves Forward With HITECH Privacy, Security Provisions

One of the guiding principles behind the federal government's efforts to improve health care through health IT is that the benefits of health IT can be fully realized only if patients and health care providers are confident that electronic health information is kept private and secure.

The Health Information Technology for Economic and Clinical Health Act -- enacted on Feb. 17, 2009, and designed to promote widespread adoption of electronic health records and electronic health information exchange -- included a number of provisions to strengthen the privacy and security protections established under the Health Insurance Portability and Accountability Act. Amid a flurry of other regulations, including the final rule defining "meaningful use" of EHRs under HITECH's Medicare and Medicaid incentive programs, HHS last month released a Notice of Proposed Rulemaking that both implements many of the HITECH provisions and modifies other HIPAA requirements.



HHS quietly withdraws HIPAA breach-notification rule

August 2, 2010 — 11:51am ET | By Neil Versel

Following a firestorm of criticism from privacy advocates who say federal officials gave too much leeway to healthcare organizations that inadvertently disclose protected health information, HHS has without fanfare withdrawn its controversial HIPAA "breach notification" interim final rule.

The move was "to allow for further consideration, given the department's experience to date in administering the regulations," the HHS Office for Civil Rights posted on its website late Wednesday. "This is a complex issue and the administration is committed to ensuring that individuals' health information is secured to the extent possible to avoid unauthorized uses and disclosures, and that individuals are appropriately notified when incidents do occur," OCR explained.



HHS to Rework Final Breach Rule

HDM Breaking News, July 30, 2010

The Department of Health and Human Services' Office for Civil Rights has temporarily pulled a final breach notification rule it has developed but not yet published, according to an HHS notice. The rule had been submitted to the Office of Management and Budget for review before publication. It now is being withdrawn for further consideration based on OCR's experience thus far in administering the notification rule under an interim final rule.

OCR will not comment on factors that compelled the withdrawal. "These are routine, formal regulatory processes," according to a statement from the agency.



AHA, group purchasers ask Blumenthal to include supply-chain management in EHR standards

August 2, 2010 — 12:11pm ET | By Neil Versel

We're finding more and more that electronic health records, as defined by the standards for "meaningful use," are far less than comprehensive. Mental health providers, with the exception of psychiatrists, aren't eligible for federal subsidies. Dental records aren't required. And now, two organizations say federal officials should consider integrating two standards from the healthcare supply chain into EHRs and supply-chain management systems as an additional safeguard against medical errors.

Specifically, the Health Industry Group Purchasing Association and the American Hospital Association's Association for Healthcare Resource and Materials Management say that standards known as the Global Location Number to pinpoint the location of a product or service and the Global Trade Item Number, which identifies specific products and services, can help take harmful devices and supplies out of care settings in case of a recall.



FierceHealthIT gets some insight from HIStalk--just not the identities of the principals

August 2, 2010 — 1:44pm ET | By Neil Versel

The most mysterious force in health IT is getting a little more Fierce. No, I'm not talking about the secret cabal of physicians united against ditching their paper records, I'm referring to HIStalk, the anonymously written blog that's often been referred to as the National Enquirer of health IT.

For the next several weeks, FierceHealthIT and HIStalk will be cross-posting links on each other's sites. That means you'll get the fierce insight of anonymous bloggers Mr. HIStalk and his crafty assistant, Inga, alongside the Fierce insight of this not-so-anonymous veteran health IT reporter and commentator. (I bet Mr. H and Inga still get more email than I do, and you know exactly how to find me.)



Mayo Clinic aims to accelerate online presence with new social media center

August 2, 2010 — 11:17am ET | By Dan Bowman

As readers of FierceHealthcare and its related publications well know, despite a notion by some that combining social media and healthcare is a dangerous mix, more and more health professionals appear to be taking the leap into the online world. From Facebook fan pages for practices to social networks like Ozmosis for physicians, the future is definitely now.

So it should come as no surprise that Mayo Clinic--with its 60,000 followers on Twitter, its medical provider channel on YouTube and its several successful blogs--is launching a Center for Social Media to "accelerate effective application of social media tools" within its own facilities, as well as to help other facilities in their efforts to connect patients and doctors online.



GE, Intel Form Health-Care Joint Venture


General Electric Co. and Intel Corp. announced plans to create a health-care joint venture focused on chronic disease and age-related conditions.

The corporate giants entered into a health-care alliance in April 2009, and the companies said Monday they will combine assets of GE Healthcare's home-health division and Intel's digital-health group. Terms of the venture weren't disclosed.

The effort will focus on developing products, services and technologies aimed at both at-home and assisted-living settings. Primary aspects will be chronic-disease management, independent living and technologies that assist the ill.




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