Quote Of The Year

Quotes Of The Year - 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."

Wednesday, December 22, 2010

Weekly Overseas Health IT Links - 22 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 Shows Almost One-Third of Patients Visit Multiple Hospitals, Demonstrating Need for Information-Sharing

Written by Leigh Page | December 14, 2010

In a five-year retrospective analysis in Massachusetts, almost one-third of patients visited multiple hospitals, suggesting significant unnecessary services that could be reduced by health information sharing through IT systems, according to a study in the Archives of Internal Medicine.

Surveying adult patients visiting Massachusetts emergency departments, inpatient units and observation units from 2002-2007, the study found 31 percent visited two or more hospitals and accounted for 56.5 percent of all acute-care visits. Additionally, 1 percent visited five or more hospitals, making up about one-tenth of all acute-care visits.



December 13, 2010

Panel Set to Study Safety of Electronic Patient Data


Almost two years ago, President Obama pledged $19 billion in stimulus incentives to help convert the nation’s doctors and hospitals to using a paperless system of electronic health records intended to improve the quality of care and reduce costs. But the conversion is still a slow work in progress.

Only about one in four doctors, mostly in large group practices, is using the electronic record system. A vast majority of physicians in small offices, the doctors who serve most Americans, still track patients’ illnesses and other problems with pen and paper.

The thousands of sometimes deadly medical errors tallied by an Institute of Medicine study in 1999 are still all too common, according to a recent report on North Carolina hospitals in the New England Journal of Medicine. And the electronic record systems are themselves increasingly attracting concerns that computer errors, design flaws and breakdowns in communication sometimes endanger patients.



Survey: Top 5 reasons providers not ready for meaningful use

December 13, 2010 | Molly Merrill, Associate Editor

NEW YORK – About 90 percent of healthcare providers that purchased electronic medical records technology are off track to meet their meaningful use implementation goals, according to the 2011 Black Book Ranking's user survey.

Black Book Rankings is a division of the market research firm Brown-Wilson Group. Its user survey ranks the top EMR vendors for 2011 based on key performance indicators including meaningful use.


The Workforce Challenge

Finding the qualified people to build and deploy health information exchanges is one of the biggest problems the healthcare industry faces.

By Marianne Kolbasuk McGee, InformationWeek

Dec. 11, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228800049

Finding the qualified people to build and deploy health information exchanges is one of the biggest problems the healthcare industry faces. There are relatively few people around who've worked on clinical information systems and also have an understanding of the interfaces, governance, and other technology issues involved.

The U.S. Department of Health and Human Services and the Bureau of Labor Statistics estimate there will be a shortage of about 50,000 health IT workers over the next five years, including people to work on data exchanges. HHS has several efforts under way to develop the needed workforce, including giving community colleges and universities grants to launch and expand health IT training programs.



HIT Privacy, Security Guidelines for Feds Released

Dom Nicastro, for HealthLeaders Media , December 14, 2010

President Obama's Health Information Technology (HIT) advisors are calling upon federal regulators to create a "universal language exchange" where healthcare data can be exchanged efficiently and with enhanced privacy and security controls.

The advisors made their recommendations in a report released last week, "Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward."



Commerce Department report calls for expanded online privacy protections

By Joseph Conn

Posted: December 16, 2010 - 12:00 pm ET

The U.S. Commerce Department has released a report on privacy and the Internet that leans heavily on transparency but treads lightly on new regulation.

In a cover letter that is part of the 88-page report, Commercial Data Privacy and Innovation in the Internet Economy: A Dynamic Policy Framework, Commerce Secretary Gary Locke observes that "the Internet is becoming the central nervous system of our information economy and society."

But the technologies prompt new concerns because they "allow the collection and use of personal information in ways that, at times, can be contrary to many consumers' privacy expectations," Locke said.



EHRs key to improving public health, CDC chief says

By Paul Barr

Posted: December 16, 2010 - 8:45 am ET

Electronic health records play an important role in promoting public health, said Thomas Frieden, director of the Centers for Disease Control and Prevention, at the Office of the National Coordinator for Health Information Technology's 2010 Update conference.

EHR systems can be key tools within the six key areas targeted by the CDC for seeking substantial improvements in the health status of Americans, he said. The targeted areas of improvement are food, healthcare-associated infections, HIV, motor vehicle injuries, teen health and tobacco control, Frieden said.



Fed tech officials laud IT innovators at ONC Update

By Joseph Conn

Posted: December 16, 2010 - 11:45 am ET

The Office of the National Coordinator for Health Information Technology ended its two-day update of federal health IT activities on Wednesday with cheerleading from three top government information technology officials.

Aneesh Chopra, the Obama administration's chief technology officer and associate director for technology, led the first round. Although his portfolio covers a broad scope of industries, Chopra also serves on the federally charted Health IT Standards Committee and the enrollment work group of its sister HHS advisory panel, the Health IT Policy Committee.



Thursday, December 16, 2010

"Good Managers" And Complex Technological Projects - Recipe for Poor Results?

Once more on the topic of CIO’s and other health IT leaders lacking in solid healthcare informatics and clinical credentials, there’s this letter in today’s WSJ that I think says it all about complex technological projects, including (perhaps especially) healthcare IT.


Friday, December 17, 2010

Emerging Technologies Could Help Transform Health Care System

by Kate Ackerman, iHealthBeat Senior Editor

A new report from Computer Sciences Corporation offers a positive outlook on how disruptive technologies will reform the health care delivery system. The report, titled "The Future of Health Care: It's Health, Then Care," predicts that new technologies will help curb costs and improve health through a greater focus on wellness and self-monitoring, increased and earlier disease detection, and more effective treatments.

Fran Turisco -- the study's lead researcher and an Emerging Practices research principal in CSC's Global Healthcare Services Group -- said the report represents a "180 degree" reversal from how such research is typically conducted. She explained that most studies of this nature identify new technologies and from there extract the emerging trends. For this study, researchers talked to a number of industry leaders to first identify the major trends necessary to address the health care system's current problems and then selected the emerging technologies that support these trends, Turisco explained.



Survey:Rapid iPad Adoption Thanks to Point-of-Care Apps


iPad deployments are accelerating in large part due to the mobile device’s compelling point-of-care applications and uses, according to a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members from the Columbia, Md.-based BoxTone, a Mobile Service Management (MSM) software company.



ONC panel approves steps for provider directories, NHIN rules

By Mary Mosquera
Wednesday, December 15, 2010

A panel that advises the Office of the National Coordinator for Health IT has endorsed steps to help healthcare providers identify and address hospitals, clinics, labs and other organizations electronically through directories.

The Health IT Policy Committee also approved broad recommendations for rules of the road for governing the nationwide health information network in order to draw more participants. The NHIN is a set of standards and services that enables mostly large providers to share patient data securely through the Internet.



Doctor-patient relationship compromised by Facebook

Doctors on Facebook risk compromising the doctor-patient relationship because many don't use tight enough privacy settings.

Researchers surveyed the Facebook activities of 405 postgraduate trainee doctors at Rouen University Hospital in France and found that almost three out of four had a Facebook profile. One in four logged on to the site several times a day, and half logged on several times a week.

Almost half believed that the doctor-patient relationship would be changed if patients discovered their doctor held a Facebook account, but three out of four said this would only happen if the patient was able to access their profile.



Goodbye, Mr. FIPPs?

Based on current advice, HHS rule-makers can have their pick of three possible paths to take on patient privacy and consent.

One path was laid out this month by the Federal Trade Commission in a report on privacy involving commercial personal health record systems. The FTC calls for a standard of protection that defines privacy as consent.

In drafting its recommendations, the FTC looked at the Fair Information Practices Principles, or FIPPs, developed by the Department of Health Education and Welfare in 1973. One of the five FIPPs says: “There must be a way for an individual to prevent information about him that was obtained for one purpose from being used or made available for other purposes without his consent.”



XML, New Design Mentality Raise Hope On The EHR Front

Rob Tholemeier

Health Data Management Blogs, December 16, 2010

Based on our frequent conversations with practicing physicians, and knowledge of how other industries automated and implemented information sharing, we have three primary knocks against the current stable of electronic health records systems:

1. Terrible user interfaces based on a Microsoft .NET paradigm, which focuses on building screens to capture data into an SQL database vs. building applications which automate and improve doctor’s workflows and time management.

2. EHRs utilize some data security techniques, but virtually none do anything to implement patient privacy and granular consent over what health information is shared with whom and when.

3. The is a complete lack of integration standards and capabilities built into most EHRs.



The Case for XML-based EHRs

HDM Breaking News, December 14, 2010

In a recent posting on Health Data Management's Discussion Board, a reader promotes the use of XML technology to create a standardized format for electronic health records, an idea that the President's Council of Advisors on Science and Technology recommended two days later (see story).



2010 Best in KLAS Vendors Named

HDM Breaking News, December 15, 2010

KLAS Enterprises LLC has issued its 2010 Best in KLAS Awards based on customer satisfaction with health information technology vendors and consultants.

The awards are based on data from more than 17,000 interviews the Orem, Utah-based vendor research firm has conducted during the past year from thousands of hospitals and physician practices.


EHR Adoption Crosses 50% Threshold

Government survey finds that a slim majority of physicians are now using electronic health records or electronic medical records systems.

By Nicole Lewis, InformationWeek

Dec. 13, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228800286

Results from the National Ambulatory Medical Care Survey (NAMCS) show that between 2009 and 2010, the percentage of physicians reporting having an electronic medical record/electronic health record (EMR/EHR) system that meets the criteria of a basic system increased by 14% and a fully functional system increased by 46%.

The survey, published earlier this month and conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS), found that preliminary 2010 estimates were that 51% of physicians reported using complete or partial EMR/EHR systems, versus 48% last year. About 25% reported having systems that met the criteria of a basic system, up from 22% last year, and 10% reported having systems that met the criteria of a fully functional system, an improvement from 2009 when 7% said they were using systems that met the requirements of a fully functional EHR/EMR system.



Will HL7 Create Payer/Provider Symbiosis?

Karen Minich-Pourshadi, for HealthLeaders Media , December 13, 2010

The American Medical Association estimates that nearly $210 billion annually is spent to process healthcare claims. Moreover, approximately one in five medical claims are processed inaccurately, according to the AMA 2010 National Health Insurer Report Card. These processing errors cost an estimated $15.5 billion to the healthcare industry, and the report notes that if insurers could improve that number by just 1%, they would save nearly $777.6 million.

The pressure for both payers and providers to operate more efficiently and cooperatively is becoming a necessity for all concerned—which is why many in healthcare are using their Six Sigma and Lean initiatives to make the interaction between payers and providers a collaborative effort to decrease claims adjudication woes. But there’s more afoot that will help morph this traditionally adversarial relationship.



Study Shows EHR Costs, Benefits Per Physician

HDM Breaking News, December 14, 2010

Costs for adopting an electronic health records system in an ambulatory practice could hit $120,000 per physician, with 84 percent of that cost ($101,250) being lost revenue from fewer patient encounters during the transition, according to a recent study.

However, EHRs once fully adopted could increase the number of patients seen by each physician by up to 15 percent, bringing in $151,000 in additional revenue per physician per year, the study projects.



Panel members say EHR consent is possible

The President's Council of Advisors on Science and Technology in its report on healthcare information technology last week came up with some interesting ideas about redirecting federal efforts to put more emphasis on health information exchange.

The PCAST laid to rest the canard that it is technologically infeasible to create electronic health-record systems that can restore to patients some semblance of privacy and control over the flow of their electronic health records. The council outlined a technological framework for not only recording patient consent directives for opting into or out of health information exchanges, but also even more granular controls over sensitive information such as diagnosis codes for psychiatric disorders.

I suspect the report will cause healthcare data-miners to increase their lobbying budgets while providing Maalox moments to providers who sell patient data.



Information fragmentation adds to costs: study

By Maureen McKinney

Posted: December 13, 2010 - 4:00 pm ET

Fragmentation of medical information persists in adult acute-care settings, resulting in higher medical costs and increased likelihood of adverse events, according to newly released research.

In a study published in the Dec. 13 issue of the Archives of Internal Medicine, researchers from Children's Hospital Boston found that of the nearly 3.7 million patients who sought treatment in acute-care settings in Massachusetts during a five-year period, more than 30% visited more than one hospital. And 1%—43,794 patients—visited five or more hospitals during the study period.



Report finds health data exchange lags

By Paul Barr

Posted: December 14, 2010 - 12:00 pm ET

The electronic exchange of health information is targeted as needing improvement in a new public health preparedness report from Trust for America's Health and funded by the Robert Wood Johnson Foundation.

In a state-by-state analysis looking at 10 indicators of emergency preparedness, seven states' health departments were identified as not being able to send and receive health information electronically to providers and community health centers. The 52-page report, "Ready or Not? Protecting the Public's Health from Diseases, Disasters and Bioterrorism," notes that as seen during the H1N1 influenza outbreak, "this type of communication is crucial to ensure public health departments have an accurate picture of the on-ground events and that healthcare practitioners are given the most up-to-date, accurate information.”



Great Ormond Street trials iPads

15 Dec 2010

Great Ormond Street Hospital for Children NHS Trust is piloting the use of iPads for e-prescribing.

The trust became the first paediatric hospital in the UK to complete the roll out of an electronic prescribing and medicines management system in October 2009.

It is now trialling the use of five iPads for e-prescribing on Victoria ward, which specialises in renal medicine, with a view to a wider roll out.



Online medical records system planned for N.Y.

Chris Swingle • Staff writer • December 13, 2010

The 10-county Rochester area is a leader in the state when it comes to sharing patients' medical records electronically across different places where care or testing is provided — such as hospitals, labs, imaging facilities and doctors' offices.

The record-sharing network has been created by the Rochester Regional Health Information Organization, or RHIO, granted nearly $24 million so far. The money has connected different medical computer record systems and paid for some private practices and clinics to switch from paper to digital patient records.


Big Exchange, Big Challenges

The CEO of the largest U.S. health information exchange discusses mounting tech pressures.

By Marianne Kolbasuk McGee, InformationWeek

Dec. 11, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228800084

The Indiana Health Information Exchange, the U.S.'s largest HIE and one of the longest running, serves more than 19,000 doctors and 70 hospitals. It has data on more than 7 million patients. Its CEO, Dr. Marc Overhage, recently talked with InformationWeek senior writer Marianne Kolbasuk McGee about the tech obstacles HIEs face.



Telemedicine in ICUs May Trim Critical Care Costs

HealthLeaders Media Staff , December 13, 2010

Tele-ICU technology could save 350 additional lives and more than $122 million annually if broadly and effectively implemented across Massachusetts, according to a study from the New England Healthcare Institute and the Massachusetts Technology Collaborative.

"Critical Care, Critical Choices: The Case for Tele-ICUs in Intensive Care" analyzed data collected from a demonstration project at UMass Memorial Medical Center and two community hospitals in Massachusetts. NEHI and MTC studied tele-ICU technology because of its potential to address the supply-and-demand problem plaguing critical care. It comes down to the "collision of two strong trends," according to the report.



CMS shows provider incentives improve clinical quality

By Mary Mosquera

Friday, December 10, 2010

The Centers for Medicare and Medicaid Services has shown that financial incentives offered to healthcare providers to improve patient care do enhance clinical quality and can slow the growth of Medicare costs.

CMS supplied results from three healthcare demonstrations, which included the use of electronic health records (EHRs), for small and solo physician practices, large physician practices and hospitals.

The pilots give CMS the opportunity to work closely with providers to improve quality and efficiency, and their lessons help shape Medicare policies, said Dr. Donald Berwick, CMS administrator.



ONC names two new certifying bodies

By Joseph Conn

Posted: December 13, 2010 - 11:30 am ET

The Office of the National Coordinator for Health Information Technology at HHS has named two more organizations as authorized testing and certification bodies.

They are ICSA Labs, Mechanicsburg, Pa., and SLI Global Solutions, Denver. Both organizations are now eligible to certify electronic health-record systems as well as modules of those systems as capable of letting a healthcare provider meet the meaningful-use criteria and qualify for IT incentive payments under the American Recovery and Reinvestment Act of 2009.



ONC wants PCAST report feedback

By Joseph Conn

Posted: December 13, 2010 - 11:30 am ET

The Office of the National Coordinator for Health Information Technology is seeking public comment on a report released last week by the President's Council of Advisors on Science and Technology.

The formal request for information was published in the Federal Register (PDF). The comment period will be open through the end of the business day Jan. 17.



Va. health info exchange links to veterans EHR

By Joseph Conn

Posted: December 13, 2010 - 11:30 am ET

MedVirginia, a Richmond, Va.-based health information exchange, is now linked to the virtual lifetime electronic record, a collaboration between the healthcare systems of the Defense and Veterans Affairs departments and civilian healthcare systems, the organization has announced.

To make the link, the information exchange used the Continuity of Care Document C32 format developed by the Health Level Seven International standards development organization and the federally supported Health Information Technology Standards Panel, as well as the Connect open-source gateway software developed by the federal government.



Remote users often lax with health data protection

December 13, 2010 — 2:16pm ET | By Neil Versel

Thanks to mobility, cloud-based storage and web access to office databases, about two-thirds of working professionals have accessed "some type of sensitive data" outside of their offices within the last year, according to a "visual data breach" survey conducted by People Security on behalf of 3M. A good number of those had viewed health data remotely, opening up the possibility of significant HIPAA violations (though the report doesn't specifically mention HIPAA).

"A significant number of respondents surveyed have accessed personally identifiable information and protected health information outside of the office, with 26 percent accessing credit card numbers, 24 percent accessing Social Security numbers and 15 percent accessing medical information," the report says.



Is Aetna, Medicity deal the beginning of the end for independent HIE vendors?

December 8, 2010 — 1:35pm ET | By Dan Bowman

While Aetna's $500 million acquisition of health information exchange vendor Medicity this week appears to be a direct reaction to UnitedHealth Group's deal for Axolotl earlier this year, the move is much bigger than one-upsmanship, and likely will start a ripple effect that will end with independent HIE vendors going the way of the dinosaur, writes Chilmark Research blogger John Moore.

Moore, an IT analyst with the health technology analyst firm, ultimately foresees more deals like these occurring--although probably not on such a grand scale--because of what he calls the "digitization of the sector" thanks to the Health Information Technology for Economic and Clinical Health (HITECH) Act.



Consultants: Medicity Positions Aetna for Future

HDM Breaking News, December 10, 2010

Aetna Inc.'s pending $500 million acquisition of health information exchange vendor Medicity Inc. is part of the insurer's preparation of its infrastructure to support accountable care organizations envisioned in the health care reform law.

That's the view of John Osberg, principal at Informed Partners LLC, a Marietta, Ga.-based consulting firm. Salt Lake City-based Medicity will help Aetna complete "last mile" connectivity to physician desktops, he says.




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