Friday, January 28, 2011

Weekly Overseas Health IT Links - 28 January, 2011.

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.


Mobile, Analytics Lead Health IT Trends

Researchers say healthcare providers and insurers will invest heavily in business intelligence tools, wireless technologies, and cloud computing in 2011.

By Nicole Lewis, InformationWeek

Jan. 18, 2011


Insurance companies and physicians face many challenges in 2011 as new models of care emerge, machine-to-machine transmission of health data increases, more business intelligence tools to analyze health data are used, and the adoption rates for mobile health devices grows.

Published last month, the IDC Health Insights report, "U.S. Connected Health IT 2011 Top 10 Predictions: The Evolving IT Landscape for Payers and Providers," identifies several major trends that will impact the payer and provider IT landscape this year. Among the trends noted in the report are the emergence of new care and reimbursement models and the expanded use of wireless networks to transmit health information from personal monitoring devices.


Survey: Docs Skeptical of EHRs, Hate Reform

HDM Breaking News, January 20, 2011

A recent survey of nearly 3,000 physicians shows high levels of displeasure with the Affordable Care Act--and a lot of them don't like electronic health records either.

Of the 2,958 physicians surveyed in September, only 39 percent believe EHRs will have a positive effect on the quality of patient care. Twenty-four percent believe EHRs will have a negative effect on quality, and 37 percent forecast a neutral factor.

HCPlexus, publisher of the The Little Blue Book reference guide for physicians, developed and conducted the survey with content vendor Thomson Reuters. The survey sample came from physicians in HCPlexus' database. The fax-based survey was done in September 2010, with additional information directly gathered via phone or e-mail from hundreds of the surveyed physicians in December and January.


Top 10 external factors for EHR success in hospitals

January 18, 2011 | Molly Merrill, Associate Editor

FALLS CHURCH, VA – Meaningful use, improved patient care and competition among providers are a few of the reasons electronic health records are succeeding at hospitals, according to one expert.

David Lewis, principal at CSC Consulting, shared with Healthcare IT News his top 10 list of why EHRs are gaining more positive traction, based on what he's seeing from his hospital clients.

In November, Healthcare IT News also interviewed Karen Fuller, a principal with CSC's Health Delivery Group, who weighed in on her top 10 list of why EHRs are succeeding today. The difference between the two lists is that Fuller focused on internal factors that had an impact on EHR implementation, such as leadership and governance, whereas Lewis's list focuses on external factors, such as the government's meaningful use incentives.


EMR not boosting productivity? It could be a mismatch between system and specialty

A study highlights how technology doesn't guarantee results if the system isn't right for the practice.

By Pamela Lewis Dolan, amednews staff. Posted Jan. 17, 2011.

If it's been many months since you bought your electronic medical records system and you're still seeing fewer patients as you did before you got it, the problem might not be you -- it might be your EMR.

Specifically, it might be that the EMR you bought isn't designed or customized to work with your specialty -- a problem technology industry experts say could become more common and acute as practices rush to buy systems to gain federal financial incentives.

Researchers at the University of California at Davis studied how an EMR implementation at six primary care offices affiliated with the same academic medical center affected physician productivity levels. They found that after an initial dip in productivity during the training period -- which is normal -- internists were able to increase productivity above pre-EMR rates, while pediatricians and family physicians were never able to regain their pre-EMR productivity. Why? Because the EMR system more closely matched the work flow of the internists.


Accenture contract will examine EMR real-world use

January 20, 2011 — 1:45pm ET | By Janice Simmons - Contributing Editor

Under a new contract, Accenture will be working with the Office of the National Coordinator for Health Information Technology to develop and manage real-world "use cases" that ONC will use to help in the exchange of data across the healthcare system.

The use cases will focus on patient‑related information--ensuring that care providers' certified EMR systems can handle patient requests for clinical summaries, according to the Reston, Va.-based consulting and technology services company.


What can we expect for Stage 2 of Meaningful Use?

January 20, 2011 — 9:24am ET | By Janice Simmons - Contributing Editor

Survey data released this month by the Office of the National Coordinator for Health Information Technology (ONC) showed promising figures in terms of adoption of electronic health records during the first stage to achieve meaningful use.

In survey data prepared by the American Hospital Association, 81 percent of hospitals said they plan to achieve meaningful use of EHRs and take advantage of incentive payments. About two-thirds of those hospitals (65 percent) responded that they will enroll during Stage 1 of the incentive programs during 2011-12.


Why is it difficult to implement e-health initiatives? A qualitative study

Elizabeth Murray, Joanne Burns, Carl May, Tracy Finch, Catherine O'Donnell, Paul Wallace and Frances Mair

Implementation Science 2011, 6:6doi:10.1186/1748-5908-6-6

Published: 19 January 2011

Abstract (provisional)


The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers - the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives.


KLAS Looks at Clinical Decision Support

HDM Breaking News, January 20, 2011

A new report from vendor research firm KLAS Enterprises examines provider use of clinical decision support software.

Many providers, according to the Orem, Utah-based firm, primarily are focusing on decision support requirements under Stage 1 of the electronic health records meaningful use program.

The report covers order sets, multi-parameter alerting, nursing care plans, reference content and drug information databases, along with non-EHR vendors providing such tools and content.


Lessons from EHR Pros

HDM Breaking News, January 20, 2011

Consultancy firm Accenture estimates nearly 90 percent of U.S. hospitals will have to install or upgrade electronic health records systems during the next three years to become meaningful users.

Consequently, Accenture recently conducted comprehensive interviews of 15 CIOs from delivery systems that have reached at least Stage 4 on the HIMSS Analytics' scale of EHR achievement to learn their lessons.


For the full report on survey results, click here.


Security and identification

One baseline requirement to protect security in a health information exchange is to make sure the record being accessed belongs to the patient in question.

The Privacy & Security Tiger Team, a work group of the federally chartered Health Information Technology Policy Committee, spent a couple of hours Tuesday wrestling with some of the thornier issues of medical records matching.

Absent a national patient identifier, most health information exchanges in the U.S. use some form of probabilistic matching of a handful of data elements to link patients to their records across multiple repositories. Commonly, those data fields include first and last names, date of birth, ZIP code, street address and gender. Cell phone numbers are becoming increasingly useful; Social Security numbers are waning in importance.


CCHIT launches custom-EHR certification

By Maureen McKinney

Posted: January 19, 2011 - 11:30 am ET

The Certification Commission for Health Information Technology has launched an alternative electronic health-record certification program crafted specifically for hospitals that have uncertified legacy software, customized systems or EHR systems developed in-house.

The EHR Alternative Certification for Hospitals, or EACH, will offer specialized assessment tools, online learning and preparation programs and support, according to a CCHIT news release.


New technology can be the best medicine

By Mike Snider, USA TODAY

We all know that smartphones, tablet computers and big-screen TVs are transforming the workplace and home. But the newest gadgets could also be a tonic for medicine and health care.

Cellphones have already proven to be a potent medical instrument in improving patient outcomes. Diabetes patients who are sent videos on their cellphones and actually view them are more likely to check blood sugar levels and comply with their care regimens, said U.S. Army Col. Ron Poropatich, who spoke at the International Consumer Electronics Show in Las Vegas last week.


Cancer survivor aims to raze treatment, research barriers with an app to enable collaboration

SAN FRANCISCO — In the late 1990s, Marty Tenenbaum was a hotshot e-commerce entrepreneur riding high on the dot-com boom when he noticed a lump on his body.

His doctor told him it was nothing, but when he finally had it removed, he learned he had melanoma, the deadliest form of skin cancer.

He beat the disease, but he never got over the sense of frustration he felt as he clawed his way through the maze of treatment options, clinical trials and research in search of a way to survive.

Now 67, Tenenbaum still believes he would not have made it if he hadn't had personal connections at the National Cancer Institute who guided him toward cutting-edge experimental treatments that saved his life.


ONC will simplify guides for establishing exchange standards

By Mary Mosquera

Tuesday, January 18, 2011

The Office of the National Coordinator for Health IT plans to develop a clearer set of technical descriptions for establishing the standard clinical document formats for exchanging summary information as patients move across settings of care.

ONC will also consolidate into a consistent template-based guide the advice offered by multiple organizations for implementing the standard document formats used to share data about patients’ medications and problems.

These are among the first projects that ONC has launched for its Standards & Interoperability Framework, which will tackle persistent challenges that healthcare providers face in successfully exchanging information in order to meet meaningful use requirements of electronic health records (EHRs), according to Dr. Doug Fridsma, director of ONC’s Office of Standards and Interoperability.


Electronic Health Record Deployment Techniques

SA Kushinka of Full Circle Projects

January 2011

Starting in 2006, the California Networks for Electronic Health Record Adoption (CNEA) initiative has worked to speed adoption and lower the cost of electronic health records (EHRs) in California's community clinics and health centers. In August 2008, seven grantees representing four models of EHR deployment were funded to accelerate the adoption of EHRs in the safety net. In 2010, CHCF began publishing a series of tactically oriented issue briefs that highlight lessons learned since the initiative began.

The first issue brief in the series, Chart Abstraction: EHR Deployment Techniques, examines the process of entering or "populating" the electronic chart with clinical data from the paper record. This process entails an inevitable decrease in productivity due to disruption in workflow, user training, and the need to maintain both paper and electronic records during the transition period. Through clinical committees or other consensus building forums, CNEA grantees developed strategies that defined what information would be entered, when, and by whom - weighing the value of the information versus the cost of entering it. The clinics' experiences with these techniques and a discussion of pros and cons are included.


JAMA: PHRs must be patient-centered to work

Written by Editorial Staff

January 18, 2011

Personal health records (PHRs) have great potential to help patients manage their health, but the technology must be designed with the patient in mind—which means doing more than helping patients merely access their health information, according to an editorial in the Jan.19 issue of the Journal of the American Medical Association.

In the editorial, Virginia Commonwealth University (VCU) family medicine physicians Alexander Krist, MD, associate professor in the department of family medicine in the VCU School of Medicine; and Steven Woolf, MD, professor in the department of family medicine and director of the VCU Center for Human Needs, describe a model to guide the creation of more patient-centered PHRs.

PHRs should include five key functions, according to the model:

  • Collect and store information from the patient;
  • Collect and store information from the patient’s doctor;
  • Translate clinical information into lay language;
  • Tell patients how to improve their health based on their personal information; and
  • Make the information actionable for patients.

Using principles from their model, Krist and Woolf’s research team has created a patient-centered PHR for prevention which shows patients their medical information and tells them what it means in a way they can understand. Further, it guides them to the next action steps.


CCDs help UPMC coordinate care across various settings

January 18, 2011 — 10:07am ET | By Ken Terry - Contributing Editor

The continuity of care document (CCD), a standardized care summary designed for information exchange among different kinds of electronic medical records, has not been widely used up until now. But the University of Pittsburgh Medical Center is relying on CCDs to coordinate care as patients move through the system--which will help the hospital and its physicians in meeting requirements for Stages 2 and 3 of meaningful use.

When primary-care physicians in the community refer patients to specialists employed by UPMC, they're encouraged to send CCDs from their EMRs. When the consultants send the patients back, they transmit CCDs to update the doctors on what has happened with the patient. And as patients move from one care setting to another--whether it be the oncology department, the transplant program, or the emergency department--their CCDs go with them online.


Colorado HIE efforts spotlight privacy issues

January 17, 2011 — 10:17pm ET | By Ken Terry - Contributing Editor

A recent Denver Post article about the Colorado health information exchange reveals the disconnect between the nationwide effort to connect health records online to improve patient care and safety and the continuing worries about the security of online medical records.

To those who follow this field, the most important fact in the piece is that the Colorado HIE--one of 56 state and territorial HIE initiatives that are in line to get federal grants--has already signed up 800 providers. But the major focus of the article was on the critics who say that HIEs will increase the already high risk of unauthorized individuals getting their hands on personal health information. Sure, that's a problem, and one that technology should be able to address. But at this point, what's critical is to get all the information silos connected.


More 'on-ramps' could accelerate provider connectivity to HIEs

January 18, 2011 — 10:34am ET | By Ken Terry - Contributing Editor

Considering that the federal government is pouring $563 million into the states to build health information exchanges, it's not surprising that some of the largest technology and telecommunications companies are moving into the business of electronic connectivity.

Hewlett Packard's just-announced foray into information exchange with the Texas Medicaid program is the latest in a barrage of announcements from tech giants within the past nine months.

Covisint, which provides the platform for the American Medical Association's physician portal, recently said that it's expanding its relationship with the Northeast Pennsylvania HIE. Covisint currently provides the exchange with secure clinical messaging. It now will deliver clinical and administrative data to providers at the point of care, as well.


E-Health Systems: For Love or Money?

Gienna Shaw, for HealthLeaders Media , January 18, 2011

Healthcare providers are marching toward certification and meaningful use of their electronic health systems and thinking about how they'll spend the financial rewards for doing so. But are they doing it for the love of e-health technology? Or are they doing it because the government is all but forcing them to?

A recent survey conducted by the HealthLeaders Media Intelligence Unit, E-Health Systems: Opportunities and Obstacles, suggests healthcare leaders are feeling positive that they'll meet meaningful use requirements. In fact, 91% said they will be ready by 2016 at the latest. And 41% said their systems are already certified by an approved ONC certifying body.


HDM, University to Test EHRs

HDM Breaking News, January 18, 2011

The Polytechnic Institute of New York University and Health Data Management magazine have launched a new health care software testing facility.

Health Data Tech Labs ( will provide physicians and hospitals with expert, independent reviews of electronic health records software. Reports evaluate installation and maintenance, system configuration, user training and "test drive" use-case scenarios. They also incorporate a unique self-evaluation process that enables professionals to match systems to their own specific requirements. The Tech Labs service will not certify EHRs as meeting meaningful use requirements. It is intended to help providers during the vendor selection process.


Medical records technology helps with drug recall

January 17, 2011 8:56 AM

Jared Janes

The Monitor

McALLEN — When the U.S. Food and Drug Administration issued a recall on the prescription painkiller Darvocet due to heart-related side effects, the use of medical technology saved Dr. Juan Salazar’s nurses countless hours trying to identify his patients on the drug.

Salazar implemented electronic medical records in his clinic on East Nolana Avenue some 14 months ago in advance of federal government guidelines that aim to put the nation’s health care providers on computerized records by 2015. So when the Darvocet recall was issued in late November, Salazar’s staff could use his clinic’s computerized database to quickly identify more than 50 patients on the prescription.

“We got on the computer, pulled data that showed all the patients we prescribed the Darvocet, and it gave us all their phone numbers” to notify them of the recall, Salazar said. “Without (electronic medical records), we would have to go manually through all of my paper charts, which would have been impossible. It would have taken several people and lots of manpower hours to do so.”


Will Digital Technology Reduce Gap in Health Between Rich and Poor?

Experts Worry Low-Income Clinics Cannot Afford Electronic Health Records

By Emma Schwartz | January 11, 2011

Two years ago, the Ethio American Health Center opened its doors in the nation’s capital, promising the country’s largest community of Ethiopian immigrants a place where doctors spoke their language and understood their culture.

Many of the community’s poorest quickly flocked to the center. But for all the specialized services the center offers patients, there’s one area where it’s fallen short: moving from paper files to electronic health records. They don’t even have a website.

“It would be great, but we can’t afford it,” said Dawit Gizaw, the center’s administrator.

The center is not alone. Although the federal government is directing billions of dollars in economic stimulus money to get electronic health record technology into hospitals and clinics nationwide, some doctors and small clinics indicate they’re unlikely to meet the Obama administration’s goal of going digital in the next five years.


ONC will focus on interoperability in 2011

By Mary Mosquera

Thursday, January 13, 2011

The Office of the National Coordinator for Health IT will focus in 2011 on activities that will enable healthcare providers to perform complex exchanges of information and on the technical foundation to support secure sharing.

ONC is considering a set of tasks it needs to undertake “in short order” to make it possible for stage 2 of meaningful use to have a more robust exchange of information, said Dr. David Blumenthal, national health IT coordinator, at the Jan. 12 meeting of the advisory Health IT Standards Committee.

Those activities are centered around standards and certification criteria, privacy and security protections, governance of exchange, and the assurance that the public will need that organizations involved in exchanging information have accomplished the conditions that foster trust and interoperability, he said.


MP warns Health CIO: don't sign NHS IT deals with CSC or BT for now

A 2.7bn NHS deal with CSC is imminent – but an MP on the Public Accounts Committee says that signing a deal now could breach civil service responsibilities.

Richard Bacon MP, a long-standing member of the Public Accounts Committee, says in his letter, dated 13 January 2011, to Christine Connelly, the CIO at the Department of Health,

“As you know, the National Audit Office is now beginning a further urgent inquiry into developments in the NPfIT, and in particular of the awarding of former Fujitsu sites to BT.

"I would suggest that this inquiry will review a great deal of evidence that is relevant to the question of whether proposed contract renegotiations with BT and CSC really do represent good value to the NHS and taxpayers.




No comments: