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."

Saturday, December 11, 2010

Weekly Overseas Health IT Links - 11 December, 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 subscription payment.



Study Finds Medical Device Registries Enhance Patient Safety & Quality of Care

Research Based on Nation's Largest Implant Registry

OAKLAND, Calif., Dec. 1, 2010 /PRNewswire/ -- A detailed and standardized national registry of commonly used joint replacement devices would improve patient outcomes and create clinical and financial efficiencies, according to a Kaiser Permanente research study of 85,000 joint surgeries published in the November issue of the Journal of Bone and Joint Surgery.

Information on the more than 600,000 total knee and hip replacements performed annually in the United States could enhance patient safety and quality of care and provide a foundation for more in-depth research projects that will contribute to better outcomes as increasing numbers of replacements are performed in the future, researchers found.

This prospective study of 80,000 total joint replacement and 5,000 anterior cruciate ligament reconstruction procedures within Kaiser Permanente's national implant registries – the nation's largest registry of implants -- looked at patient demographics, implants and surgical techniques in relationship to outcomes for these procedures. This is the largest community-based research study of outcomes with total knees and hips and ACL reconstruction procedures, and one of few studies conducted with a registry that includes a level of detail to assess outcomes in the United States.



Medical Errors Stubbornly Common, Studies Find

John Commins, for HealthLeaders Media , December 2, 2010

It's been 11 years since the Institute of Medicine reported in December 1999 that medical errors caused more than 98,000 deaths and injured more than 1 million people each year. Unfortunately, the results from two recent studies indicate that—despite a lot of focus and effort—the nation's hospitals have not significantly reduced medical errors, which still lead to tens of thousands of deaths each year.

Hospital advocates don't dispute the findings, but they also don't believe the last 10 years were a lost decade. They believe that progress has been made, even if it is not immediately apparent.

"It was discouraging not to see more evidence that the hard work that has gone on in the past decade has had as substantial an impact as we believe it has. But the studies are what the studies are," says Nancy Foster, vice president for quality at the American Hospital Association.



OCR: Data Breaches Double Since July

Dom Nicastro, for HealthLeaders Media , December 2, 2010

The number of entities reporting breaches of unsecured protected health information (PHI) affecting 500 or more individuals is close to reaching the 200 mark.

As of Tuesday, November 30, the number of entities reporting breaches to the government's HIPAA privacy and security enforcer hit 197. The number of entities—listed on the Office for Civil Rights (OCR) breach notification website--has almost doubled since July, when the number hit 107.

In the past five months, 90 new reports have surfaced, or an average of 18 per month, a higher pace than the 15-per-month the first five months after OCR launched the website.



Security isn’t always a technical problem

By Jeff Rowe, Editor

We’ve commented more than once about the government’s responsibility to help providers with HIT security measures.

But as reported security breaches continue to pile up, it’s clear that policymakers’ first order of business should be to determine how much of the healthcare sector’s overall security problem is due to the push to transition providers to new HIT, and how much is the result of avoidable human error.

According to this report, “As of Tuesday, November 30, the number of entities reporting breaches to the government's HIPAA privacy and security enforcer hit 197. The number of entities—listed on the Office for Civil Rights (OCR) breach notification website--has almost doubled since July, when the number hit 107.”



HHS looking for a few good apps

By Christine LaFave Grace

Posted: December 2, 2010 - 11:45 am ET

In support of its new 10-year public health and illness prevention plan announced Thursday, HHS is calling on tech developers to create data-rich applications designed to promote community health.

The myHealthyPeople Application Developer challenge seeks "engaging and empowering" applications that pertain to the topics and objectives detailed in Healthy People 2020, the department's fourth 10-year health agenda. Submitted applications should target the professionals, advocates, funders and decisionmakers "who will be using Healthy People to improve the health of the nation," according to the Challenge.gov website.



'Exceptionally complex' CPOE a key part of 'meaningful use'

December 2, 2010 — 12:59pm ET | By Neil Versel

Think EMR implementation is tough? Wait until you try computerized physician order entry--which just happens to be one of of the required measures of Stage 1 "meaningful use."

"Given the importance of provider order entry, it is not surprising that the federal government's promotion of health information technology--via the HITECH provision of the American Recovery & Reinvestment Act and related meaningful use rules for implementation of an electronic health record--places so much emphasis on using computerized physician order entry. However, considering the complexity of adopting CPOE and the challenges any organization faces when changing a core process, it's also not surprising that so few hospitals have taken on CPOE," write John Glaser and Dr. M. Kent Locklear in a Hospitals & Health Networks online exclusive.

"HITECH effectively has put CPOE in a prom dress, requiring those who wish to pursue stimulus dollars to get ready for the big dance."



CSC: Right people, processes lead to EHR success

December 2, 2010 — 11:57am ET | By Neil Versel

As a principal with the Health Delivery Group of Computer Sciences Corp., and a critical care nurse with more than 35 years of experience in healthcare and health IT, Karen Fuller has seen more than a few successful EHR implementations. Now, on the CSC Meaningful Use Community blog and in an interview with Healthcare IT News, Fuller shares her top 10 internal factors to EHR implementation success.

As Healthcare IT News reports, Fuller puts the 10 factors into four "buckets": the right people, right processes, right change management and right technology. Without all four components, it's tough to make an EHR investment pay off.

Organizational leadership must show a clear commitment to the EHR and make sure clinical and operational executives are fully accountable for their actions and visible to rank-and-file staff. "They have to understand that is it is an organizational priority," Fuller says, and that the implementation represents a "transition for the entire organization."



IMSS Analytics: Few medical devices connect with EMRs

December 2, 2010 — 2:17pm ET | By Neil Versel

If you read FierceMobileHealthcare regularly, you'd know that many, if not most, mobile devices used in healthcare don't connect to much other than the Internet. According to a new white paper from HIMSS Analytics and communications IT firm Lantronix, the problem seems to extend to EMRs and in-hospital medical devices.

The paper, released Wednesday, says that just a third of the 825 U.S. hospitals queried report having active interfaces between devices such as defibrillators, physiologic monitors, vitals monitors and electrocardiographs and their EMRs. The results may be skewed by the finding that 71.7 percent of those with hubs for "intelligent medical devices" are interfaced with EMRs because just 11 percent of respondents reported using such hubs.



Wednesday, December 01, 2010

What Are Top Barriers Keeping Doctors From Communicating With Patients Through E-Mail?

Sixty-four percent of health IT professionals surveyed said a lack of reimbursement is a key barrier keeping physicians from communicating with patients through e-mail, according to a Healthcare Information and Management Systems Society survey.

Fifty percent of respondents said they view an increase in workload as a key barrier, while 47% said data security and privacy issues were a barrier.


VA Pilots Digital Medical Record Retrieval

A contractor will collect, scan, and transmit private healthcare records with the goal of speeding Veterans Affairs' claims decisions.

By Nicole Lewis, InformationWeek

Nov. 30, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228400215

The Department of Veterans Affairs (VA) has announced that it will work with a private contractor to speed claims decisions and significantly reduce the average time needed to obtain medical records from private physicians.

The department updated veterans on the progress of the VA Claims Transformation Plan on Monday, noting that one of the pilot projects it's conducting can significantly improve the efficiency of the claims processing system as well as help the department to meet its goal of processing all claims within 125 days and with 98% accuracy by 2015.

According to Eric Shinseki, secretary of Veterans Affairs, innovations that will speed, simplify, or improve VA's services are being rigorously tested.



Top 10 Healthcare Technology Hazards for 2011

Cheryl Clark, for HealthLeaders Media , December 1, 2010

The ECRI Institute, an independent group that evaluates medical devices and procedures, has issued its latest list of the 10 most perilous technologies in healthcare health providers should keep an eye out for in 2011.

This year's list reflects the group's judgment based on:

  • A review of recent recalls
  • Analysis of information found in the literature and in the medical device problem reporting databases of ECRI Institute, and other organizations
  • ECRI experience in investigating and consulting on device-related incidents

The goal "is to increase awareness of these hazards and to stimulate action within healthcare facilities to formulate programs" to minimize dangers, authors say.

1. Radiation Overdose and Other Dose Errors During Radiation Therapy.
This underreported problem makes the number one spot on the list for two reasons.

First, the consequences of a radiation overdose rarely manifest right away, "meaning that certain errors—such as those resulting from improper device setup or an inappropriate treatment plan—could lead to a patient being repeatedly exposed to an inappropriate dose before the error is noticed in clinical review. And by that time, the damage has already been done, and can't be undone."

And second, radiation treatment plans are more complex, "leaving very narrow margin for error," the report states.

Administering the wrong dose, or treating the wrong site or patient are all caused by human error, software problems, and provider or operator inexperience with the fast pace of technological change.

For example, the report says, in one year from July 2009 to July 2010, there have been over 40 reports of software errors, manufacturing-required software modifications or dose calculation errors for radiotherapy systems, linear accelerators and radiation treatment planning systems.

The report advises hospitals to make sure personnel have up-to-date and appropriate certifications and training and that staffing levels are adequate. Maintain systems to ensure that patient treatment procedures are documented and followed, with attention to providing oversight of incident reporting and safety alerts management.



Open Source Makes Debut in Health Care

Nov. 19 2010 - 4:22 pm


The high-tech industry is littered with once-thriving companies that chose to cling to closed, proprietary software or hardware. Slow-footed to respond to customer demands, they’re now gone.

It is taking a surprisingly long time for companies that sell electronic health records (EHRs)—a backbone of hospitals and soon of doctors’ offices, to learn that lesson. A “closed” mentality still permeates the health care IT business. Among the big companies, Allscripts is finally taking a step toward open source. Next month, the Chicago-based vendor of EHRs will allow outside developers to write programs for its digital medical records. It is setting up an “Application Store & Exchange,” where customers can shop for applications, and also share their own. “It’s an Apple store for health care,” says Dan Michelson, Allscripts chief marketing officer.



Survey finds high interest in home medical devices

November 30, 2010 | Molly Merrill, Associate Editor

SAN FRANCISCO – Three in five Americans with chronic disease say using a home medical device would improve their health, according to a new survey.

The poll was conducted by GfK Roper on behalf of San Francisco-based EHR provider, Practice Fusion.

Almost half of Americans currently live with at least one chronic condition, and more than ninety percent of Americans age 65 or older are living with some form of chronic illness, according to the CDC.



Black Book Rankings names top EMR vendors for 2011

November 29, 2010 | Molly Merrill, Associate Editor

NEW YORK – A survey by Black Book Rankings, a division of the market research firm Brown-Wilson Group, ranks the top EMR vendors for 2011 based on key performance indicators including meaningful use.

The rankings include the top 20 vendors in 10 categories including acute care/hospital, emergency and physician groups, which are broken down by size.

The rankings are a result of a four month poll, conducted by Black Book, that surveyed more than 30,000 healthcare records professionals, physician practice administrators and hospital leaders in the information technology arenas.



NAO launches NPfIT investigation

01 Dec 2010

The National Audit Office has confirmed that it will launch an investigation into the value of the National Programme for IT in the NHS, focusing specifically on the £546m contract that was awarded to BT last year.

The decision to run an investigation follows a request made in September by Conservative MP and member of the Public Accounts Committee, Richard Bacon.

Bacon, who has followed NPfIT since its inception in 2002, wrote to Amyas Morse, the head of the government spending watchdog, asking him to examine the BT contract.



Monday, November 29, 2010

Ultrasound Gets More Portable

A new handheld ultrasound device could be the first that can connect directly to cell-phone and Wi-Fi networks.

Two years ago, computer engineers at Washington University in St. Louis created a prototype that took ultrasound imaging to a new level of mobility and connectivity—they connected an ultrasound probe to a smart phone. Now a startup awaiting clearance from the U.S. Food and Drug Administration hopes to begin selling the device next year.

Such a device would be useful for emergency responders, who could scan an injured person to detect internal bleeding or other trauma, and then immediately send an image to the hospital so physicians could be better prepared for the patient's arrival. Or a nurse practitioner visiting a pregnant woman's home could ask a specialist stationed elsewhere to weigh in on anomalies in the scan.



eHealth Intelligence Report

November 30, 2010

Scientific Articles

:: A telemedicine service for HIV/AIDS physicians working in developing countries.

J Telemed Telecare. 2010 Nov 15. (Online ahead of print)

The user survey showed that telemedicine advice was valuable in the management of specific cases, and significantly influenced the way that clinicians managed other similar cases subsequently. Nonetheless, there was a declining trend in the rate of use of the service.

:: The empowerment and quality health value propositions of e-health.

Health Serv Manage Res. 2010 Nov;23(4):181-4.

In order to contribute towards an understanding and appreciation of e-health as a main stream concept, we propose the use of existing models, theories and principles in support of e-health. Specifically, the empowerment theory and the principles of quality health will be used to discuss the value proposition of e-health



Meaningful Use Spurs Leaders to Take Action

Gienna Shaw, for HealthLeaders Media , November 30, 2010

The headline for senior leadership editor Philip Betbeze's most recent column is dead on: Hoping for Repeal is Not a Strategy. As we gear up for our annual industry survey season here at HealthLeaders Media, he says he's noticing a disturbing trend: Some healthcare leaders are pinning their hopes for their organization's long-term well-being on repeal of the Patient Protection and Affordable Care Act.

In light of that news, healthcare CIOs and other leaders might want to give themselves a little pat on the back for their response to another federal program—the American Recovery and Reinvestment Act of 2009 and its meaningful use requirements.



VA provides tools to track hospital quality

By Mary Mosquera

Monday, November 29, 2010

The Veterans Affairs Department is “raising the bar” for its healthcare centers by providing online tools so veterans can compare how well the VA’s 153 hospitals perform, with the ultimate goal of spurring further improvements at those facilities.

Acute care, patient safety and intensive care are the principal areas targeted by the tools, which veterans and their families can access through the Linking Information Knowledge and Systems (Links) dashboard at VA’s Hospital Compare Web site (http://www.hospitalcompare.va.gov).



Direct Project completes first models of simple NHIN

By Mary Mosquera

Tuesday, November 30, 2010

The first version of the software that will allow simple information exchange between providers, a crucial enabler for the first stage of meaningful use of electronic health records, was announced by the Office of the National Coordinator for Health IT.

The open source reference model of the standards and services that enable connectivity, which will be available as both Java and .Net formats, will be deployed first in a series of pilots to test it for real-world use, according to Arien Malec, coordinator of the Direct Project, the new name for the old NHIN Direct, a project of the ONC.

The Direct Project is a streamlined version of the more robust nationwide health information network standards set (NHIN), and will offer physicians and small practices the ability to conduct basic health record exchanges. For example, a primary care physician who is referring a patient to a specialist can use the Direct Project to send a clinical summary of that patient to the specialist, and to receive a summary of the consultation.

“As we test out the specifications and learn more from the demonstrations, we’ll have more vendor support,” he said.



Funding delay slows e-health records project

Last Updated: Tuesday, November 30, 2010 | 1:15 PM ET

CBC News

The agency set up to digitize Canada's health-care system will fall just short of its target to see half of Canadians with electronic health records by the end of 2010, after the government delayed giving $500 million to the agency by one year.

Soon after the government announced the funding in the 2009 federal budget, officials wanted more information from Canada Health Infoway about where the money would be spent. Infoway complied and agreed to an audit that came back with no problems.

Then last September, finance officials emailed Health Canada to say the Prime Minister's Office had decided the money would be held back until 2010.



Top 10 factors for successful EHR implementation

November 23, 2010 | Molly Merrill, Associate Editor

FALLS CHURCH, VA – Right people, right processes, right change management and right technology – these are the "four buckets" that one expert says her list of top 10 internal factors for implementing an EHR fall into. Without all the components, she says, it is very difficult for organizations to succeed.

Karen Fuller is a principal with Falls Church, Va.-based CSC's Health Delivery Group and is a critical care nurse with more than 35 years of experience in healthcare and information technology. She shared with Healthcare IT News her top 10 list, which she says has been generated from her own experiences and those of her clients:

1. Right Leadership

  • Top-level leadership unwaveringly committed to make this an organization priority.
  • Clinical and operational executives accountable for success are visible and present to demonstrate solid commitment.

Fuller says when an organization is considering a technology change, it should take a top-down approach. It should, for example, start with the hospital's board, but should include all the members of an organization. "They have to understand that is it is an organizational priority," she said, and that it is a "transition for the entire organization."



Health IT still far from its potential

November 29, 2010 — 2:48pm ET | By Neil Versel

A couple of weeks ago, we referenced both the 1991 Institute of Medicine report, "The Computer-Based Patient Record: An Essential Technology for Health Care" and President George W. Bush's 2004 call for interoperable EMRs. Last week, Computerworld brought up these two pieces of history in benchmarking the slow progress in health IT.

"While there are many success stories, progress in using IT to improve patient care and cut costs has been slow. Research suggests that healthcare IT has a long way to go to match the hype," the magazine notes. "Not all healthcare providers have electronic records, many organizations can't share their records with other facilities unless they're affiliated with one another, and even those that can share with others outside their networks often have translation problems because there's no single data standard to facilitate the smooth transfer of information."



Royal Liverpool signs CSC portal deal

29 Nov 2010

The Royal Liverpool and Broadgreen University Hospitals NHS Trust has confirmed that it has become the first trust to sign a deal for CSC’s clinical information portal.

The CSC clinical portal is an interoperability product, providing a single view of data from different systems, and forms part of the company’s new portfolio of NHS products launched earlier this year.

Following the signing of the contract last week, the trust told E-Health Insider that it is now defining the project scope and plans to begin rolling the system out in March in two separate phases.



Monday, November 29, 2010

Physician Community Divided Over Social Media

From Twitter to Facebook to blogs, millions of U.S. residents are tapping social media tools to communicate. Physicians are no exception. Many doctors see social media as a way to strengthen the patient-physician relationship, interact with their peers and publicize their opinions on key issues.

However, others argue that as physicians' use of social media increases, the line between personal and professional is beginning to blur. They also say that the growing trend raises new privacy and liability issues. Despite the concerns, experts say the number of physicians who are active social media users is growing.

Why Doctors Are Taking the Social Media Plunge

For a new report, titled "The Social Physician," Bunny Ellerin -- co-founder of NYC Health Business Leaders and president of Ellerin Health Media -- spoke with 10 active social media users.




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