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, March 12, 2011

Weekly Overseas Health IT Links - 12 March, 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.



iPad 2 looks even better for docs

March 03, 2011 | Molly Merrill, Associate Editor

SAN FRANCISCO – Apple introduced the iPad 2 on Tuesday with a special event that included a video highlighting the technology's use in different fields, with an appearance by John Halamka, MD, chief information officer of Beth Israel Deaconess Medical Center.

"Sometimes doctors are overwhelmed with data," said Halamka on the video shown at Apple's launch event. "What we have tried to do on the iPad is give doctors at the point of care the tools they need at the exact moment the doctor can make a difference.

"We are finding with the iPad, is that doctors are spending more time with patients, in fact doctors are engaging patients by showing them images, showing them data on the screen," he added. "So it is empowering doctors to be more productive. But it has also brought doctors and patients together.

"So I think what is so exciting about the iPad is that it will change the way doctors practice medicine," Halamka concluded.



Carrots, Sticks and Digital Health Records


THE United States is embarking this year on a grand experiment in the government-driven adoption of technology — ambitious, costly and potentially far-reaching in impact. The goal is to improve health care and to reduce its long-term expense by moving the doctors and hospitals from ink and paper into the computer age — through a shift to digital patient records.

Step back from the details and what emerges is a huge challenge in innovation design. What role should government have? What is the right mix of top-down and bottom-up efforts? Driving change through the system will involve shifts in technology, economic incentives and the culture of health care.

“This is a big social project, not just a technical endeavor,” says Dr. David Blumenthal, the Obama administration’s national coordinator for health information technology.



Privacy and Security in Health Care: A Fresh Look

New Issue Brief updates industry challenges and preparedness measures

Privacy and security is a significant challenge for every health care organization and a concern for every U.S. citizen. The move toward an entirely automated health care system featuring electronic and personal health records, clinical data warehousing, and increased transparency means more data is at risk and suggests an urgent review of industry privacy and security safeguards.

The potential liability for data breaches is significant and increasing. Stakeholders must act now to prevent compromising sensitive patient data, preserve brand value, and avoid substantial financial penalties for violations.



Slow progress halts EPS R2 applications

4 March 2011 Fiona Barr

The Department of Health has stopped any more primary care trusts from applying to take part in Release 2 of the Electronic Prescription Service, blaming slow progress from system suppliers.

The roll-out of EPS R2 began in Leeds almost 20 months ago with one GP practice and one community pharmacy. But since then, only seven further GP practices and 30 pharmacy sites have begun using the system.

EPS R2 was originally due for roll-out in 2007. This week, Tim Donohoe, director of programmes and operations at NHS Connecting for Health, and Susan Grieve, DH principal pharmacist, wrote to PCTs to tell them the scheme will be closed to new PCTs with immediate effect.

Donohoe and Grieve said “system availability” was limiting the roll-out so the DH has decided to stop further PCTs from applying at the moment.



Proposed Stage 2 meaningful-use criteria unreasonable: CCHIT survey

By Joseph Conn

Posted: March 4, 2011 - 11:15 am ET

All nine of the proposed Stage 2 meaningful-use measures that were enhancements of the Stage 1 criteria for successful electronic health-record use are considered too aggressive by at least one-third of all participants in a survey conducted by the Certification Commission for Health Information Technology, a federally authorized health IT testing and certification body.

To be paid under the health IT incentive program of the American Recovery and Reinvestment Act, providers must demonstrate that they are meaningful users of an electronic health-record system measured against government-developed criteria. A work group of the federally chartered Health IT Policy Committee released for public comment its initial recommendations for Stage 2 meaningful-use criteria, scheduled to take effect in 2013, and preliminary directions toward Stage 3 criteria, set to take effect in 2015.



McKesson to Buy British HIT Firm

HDM Breaking News, March 3, 2011

McKesson Corp. will acquire British hospital software vendor System C Healthcare for about $141.5 million in U.S. dollars.

System C serves about 40 hospitals in the National Health Service. Its Medway product line includes a core hospital and ambulatory clinical information system and multiple modules supporting emergency care, maternity, diabetic care, ambulance care, infection control, and data analytics, among other functions. The company also sells software to social services agencies.



Health data exchange, cloud computing among key HIMSS trends noticed by observers

February 28, 2011 — 1:18pm ET | By Ken Terry

HIMSS11 in Orlando, Fla., was notable as much for its timing as for its 31,000-plus participants--a new record--and the positive energy they radiated. The show occurred just as registration for the government "meaningful use" incentives was getting off the ground, and it arrived in the midst of a veritable explosion of health IT vendors drawn by the prospect of $27 billion in federal funds. That said, here are a few of the viewpoints that the HIMSS convention stimulated among industry observers.



Insurance companies' leap into HIE field will change health IT

March 2, 2011 — 1:02pm ET | By Ken Terry

Health plans are preparing for a change in their business models by investing in health IT firms that will get them more involved in the clinical workflow of providers, according to participants at the recent HIMSS11 conference in Orlando, Fla. This accounts for the recent purchases of leading health information exchange vendors Medicity and Axolotl by Aetna and Ingenix--the latter a subsidiary of UnitedHealth Group--respectively. It also explains why several health plans have sponsored the activities of Prematics, an e-prescribing vendor that recently was acquired by Navinet, which provides online connectivity between providers and health plans.

David Classen, MD, senior partner at consulting firm CSC, says that health plans are "looking at their future business model under healthcare reform." They view health information exchange (HIE) as an implementation tool for the value-based reimbursement methods that are coming, he says. Accountable care organizations (ACOs) also will be a big issue, and Classen expects hospitals to partner with health plans to create ACOs. Health plans have core competencies that most providers lack but will need for ACOs, such as the ability to analyze data and manage care, he notes.



DoD, VA closing ground on joint EHRs

March 3, 2011 — 2:52pm ET | By Janice Simmons - Contributing Editor

The Departments of Defense (DoD) and Veterans Affairs (VA) appear to be moving closer to agreeing on a common electronic health record (EHR) system--and could, perhaps, make an announcement by the end of March.

Both agencies have been under fire recently to reduce duplicative efforts in modernizing their EHR systems. This week, the Government Accountability Office (GAO) said in a new report--"Opportunities to Reduce Potential Duplication in Government Programs"--that both departments could "save system development and operation costs while supporting higher quality healthcare for service members and veterans" if duplication in the EHR area was eliminated.



Indiana's HIE now reaches 1,500 physicians

March 3, 2011 — 3:03pm ET | By Janice Simmons - Contributing Editor

The Indiana Health Information Exchange (IHIE) passed another milestone this week with its Quality Health First Program now enrolling more than 1,500 physicians in over 50 communities throughout Indiana. The HIE--developed to improve screenings rates and to support the management of medical conditions such as diabetes, heart disease, asthma, and breast cancer--now reaches nearly 1 million patients.

Patients needing these and other interventions are flagged in the reports to their primary-care physicians, which helps them make better healthcare decisions possible before, during and after patient visits. Participation in the HIE--a non-profit corporation formed in 2004 by the Regenstrief Institute--is open to all primary-care practices in Indiana, regardless of their size or number of physicians, and is not restrictive to practices not using EHRs.



What should Meaningful Use Stages 2 and 3 include?

March 3, 2011 — 3:15pm ET | By Janice Simmons - Contributing Editor

During two days in late April 2009, the National Committee on Vital and Health Statistics convened a meeting in Washington, D.C., to better define what "meaningful use" was--and who could be a "meaningful user." More than three dozen experts--representing physicians, hospitals, vendors, consumers, academia, and public health interests, to name a few--presented their comments and visions before the panel.

Flash forward two years now. The panel is now a memory. We're now familiar with the Stage 1 requirements of the Meaningful Use incentive program. But the funny thing is, the interest is still very much there about getting the MU concept and the use of electronic medical records (EMRs) right.



Thursday, March 03, 2011

Not So Fast -- Why It Pays To Wait Until FY 2012 on Meaningful Use

The registration process and reporting period for the meaningful use incentive program officially commenced on Jan. 3. More than 21,000 health care providers have registered to date and many more are ramping up efforts to meet meaningful use criteria and collect federal incentives in fiscal year 2011. However, rushing out the gates in FY 2011 is extremely risky and not advisable. In fact, the Advisory Board Company strongly recommends waiting until FY 2012 to first demonstrate meaningful use.



AMA to ONC: EHR program doesn't work for docs

By Rich Daly

Posted: March 2, 2011 - 11:00 am ET

Many physicians—specialists in particular—will not participate in the federal electronic health-record adoption incentive program because it requires them to include patient data that they do not otherwise collect, according to a Feb. 25 letter from 39 medical organizations (PDF) letter to the Office of the National Coordinator for Health Information Technology.

"From both a clinical and legal standpoint, physicians will be reluctant to take part in the Medicare or Medicaid EHR incentive program if they are being required to record data in their EHRs that they typically do not collect or that is not relevant to their scope of practice or the services that they provide to their patients," wrote the physician advocate groups, among them the American Medical Association.



GAO: Military, HHS could save millions on IT

By Joseph Conn

Posted: March 2, 2011 - 11:00 am ET

A government watchdog agency says the federal government could save as much as $460 million a year if the Military Health System would eliminate some top brass and consolidate its upper management operations.

The Defense Department and the Veterans Affairs Department probably also would save a good deal of money if they jointly modernized their disparate health IT systems, according to the Government Accountability Office.

The GAO cost-cutters called out HHS as well, saying the department would likely reduce its own health IT costs as well as those of state and local governments if it developed an overall strategy to better integrate a nationwide, electronic public health information system.



Patient Privacy Rights Comments on Stage 2

HDM Breaking News, March 1, 2011

Patient privacy safeguards are woefully missing from initial draft criteria for Stages 2 and 3 of meaningful use, according to Deborah Peel, M.D., founder of the Patient Privacy Rights organization.

"Like the criteria for Stage 1, the criteria for Meaningful Use Stage 2 and 3 are missing the key elements Americans expect from electronic systems: the ability to control who can see and use personal health information and the ability to segment information so they can selectively share information," Peel said in a comment letter to the Office of the National Coordinator. "Segmentation is essential to protect sensitive information, but also is absolutely critical for patient safety, so that erroneous health information can be kept from disclosure."



Privacy advocates slam MU stage 2 proposal

By Jeff Rowe, Editor

We recently noted the “applause” some consumer groups are giving HIT policymakers for the proposed criteria for Stages 2 and 3 of Meaningful Use, but another prominent group has a markedly different view.

According to the Patient Privacy Rights organization(PPR), privacy safeguards are “woefully missing” from the draft regulations.

In their comment letter, PPR claims “the criteria for Meaningful Use Stage 2 and 3 are missing the key elements Americans expect from electronic systems: the ability to control who can see and use personal health information and the ability to segment information so they can selectively share information.”



February 28, 2011

Do-It-Yourself Health Care With Smartphones


SINGAPORE — For more and more people, computers and software are becoming a critical part of their health care.

Thanks to an array of small devices and applications for smartphones that gather vital health information and store it electronically, consumers can take a more active role in managing their own care, often treating chronic illnesses — and preventing acute ones — without the direct aid of a physician.

“Both health care providers and consumers are embracing smartphones as a means to improving health care,” said Ralf-Gordon Jahns, head of research at research2guidance, which follows the mobile industry.

He added that the firm’s findings “indicate that the long-expected mobile revolution in health care is set to happen.”



Black Book poll names top 4 internal medicine EMR vendors

February 28, 2011 | Molly Merrill, Associate Editor

NEW YORK – A poll conducted by Black Book Rankings, a division of the market research firm Brown-Wilson Group, ranked four electronic medical record vendors as the top internal medicine EMRs based on physician satisfaction.

"CureMD, eClinicalWorks, Greenway Medical Solutions, Henry Schein MicroMD, and NextGen GBS consistently ranked among the top 10 highest ranked EMR firms including single and multi-physician Internal Medicine environments," said Doug Brown, managing partner of Black Book Rankings.



Best practices for physician directories will promote info exchange

By Mary Mosquera

Tuesday, March 01, 2011

An advisory panel has completed its recommendations for best practices and minimal requirements for individual level provider directories, or “white pages” listing physicians. The directories will, it believes, help to promote health information exchange by assuring that a message connects to the right physician at the correct address.

The information exchange work group plans to offer its proposals for endorsement by the Health IT Policy Committee on March 2. The committee will then relay them to the Office of the National Coordinator for Health IT.

States are already beginning to create their own provider directories so it’s important to come up with recommendations for best practices, such as data accuracy, and for those local policy levers that will drive participation in the directories, said Dr. Walter Suarez, co-chair of the provider directory task force on the work group. He is also director of health IT strategy and policy at Kaiser Permanente.


World Economic Forum Drives Health Data Initiative

The Global Health Data Charter calls for the use of technology to overcome worldwide gaps in health information collection, availability, privacy, and analysis.

By Nicole Lewis, InformationWeek

Feb. 28, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229219488

The World Economic Forum has launched the Global Health Data Charter, an initiative to advance global health through the management and collection of data. The charter aims to enable individuals and patients, health professionals, and policymakers to make more informed decisions through secure access to comprehensive health data.

Officials at the World Economic Forum in Geneva said at the charter's unveiling last week that accurate health data is not available across health systems operating in developed and developing countries, and that gaps in data can be overcome through the use of technology, which will be a main driver in the collection, analysis, and application of health information.



Doc looks to apply AI to healthcare

By Joseph Conn

Posted: March 1, 2011 - 11:45 am ET

A Philadelphia-based developer of clinical decision-support technology plans to add new meaning to the concept of defensive medicine.

Clinical Performance Solutions is a new company formed as a partnership between Amity Health of Philadelphia and SoarTech of Ann Arbor, Mich. Amity was founded by Dr. Steven Merahn to "identify intelligence and best practices from outside of healthcare that can contribute to and enhance new approaches to healthcare systems and operations," according to an Amity news release.

SoarTech is a military information technology contractor working in the field of artificial intelligence that develops systems that "enhance human performance by modeling human reasoning in complex situations such as tactical air support, special forces operations, global intelligence analysis and command and control scenarios," according to the release.



HIMSS 2011: 4 Long Days; 5 Short Stories

Gienna Shaw, for HealthLeaders Media , March 1, 2011

Last week my pedometer called to alert me to suspicious activity on my count—I'd logged so many steps over the course of four days at the CHIME and HIMSS conferences in Orlando that the device assumed someone else was using it. If you don't get the joke, you've never been to HIMSS. The number two topic of conversation there (second only to healthcare technology) is whether or not you wore the right shoes. As a friend said, at HIMSS there's no such thing as the "right shoe."

By the way, although the steps on my pedometer were all me, I assure you I had nothing to do with the emails that someone in Turkey sent to everyone in my address book after I used the hotel's free wireless Internet access.

Here are a few other notes and observations from the show (mostly of a more serious nature than shoes and Turkish malware).



Report: EHR Growth is Spiking

HDM Breaking News, March 1, 2011

A new report from Kalorama Information, a New York-based research firm, estimates the U.S. electronic health records market at nearly $15.8 billion and predicts it will rise to $31.9 billion in 2015.

The revenue figures cover software systems, consulting, installation fees and training, but not hardware. Kalorama estimates the EHR market grew 10.5 percent in 2009 and 13.6 percent in 2010, down from its previous estimates of 15 percent for both years. The firm attributes the lower growth to initial confusion over meaningful use requirements, and some market uncertainty around certification of EHR products.



Tuesday, March 01, 2011

Questions Linger on Social Media Regulations for Pharma

Consumers increasingly are tapping the Internet and social media sites for health-related information. A recent survey conducted by the Pew Internet Project and the California HealthCare Foundation, which publishes iHealthBeat, found that 80% of Internet users look up medical-related information online. According to the survey, online searches for specific diseases or medical problems are among the most popular health-related inquiries.

While online, consumers are likely to view promotions for health care products, but there currently are no federally imposed rules of the road governing pharmaceutical marketing activities.



Patient Check-In Technologies Cut Cost, Wait Times

Anna Webster, for HealthLeaders Media , February 28, 2011

Kiosks and automated check-in processes are making their way from the airport lobby to the doctor's office.

Eighty-nine percent of physicians polled in the 2011 HealthLeaders Industry Survey say they have or will have electronic health records in place within two years, what many consider the first step in streamlining the check-in process.

Physician practices are adopting touchscreen tablets, kiosks, or patient portals that automate the check-in process, resulting in shorter wait times, reduced errors, and lower labor costs.



HIMSS Analytics survey shows uptick in hospital readiness for meaningful use

February 24, 2011 — 1:49pm ET | By Ken Terry

More and more hospitals are developing the capability to show meaningful use of electronic health records. HIMSS Analytics defines 44 percent of respondents to its continuing survey as "likely" or "most likely" to meet Stage 1 Meaningful Use criteria. Of the 999 hospitals that have responded to the survey since May 2010, 25 percent already can meet 10 of the 14 core measures and at least five of the menu items required for meaningful use.



IT companies have vested interest in success of healthcare reform

February 24, 2011 — 5:47pm ET | By Ken Terry

Health IT has been one of the few areas of bipartisan agreement in recent years, observed Health and Human Services Secretary Kathleen Sebelius in her keynote address Wednesday at the HIMSS conference in Orlando. She's right about the history. For example, former President George W. Bush launched the federal government's campaign to increase EHR adoption in 2004, and both former HHS chief Mike Leavitt and ex-Senator Majority Leader Bill Frist have been strong supporters of the technology.

But the hyper-partisan warfare over the budget deficit has produced some dissonant notes in that picture of harmony. For example, the recently introduced bill to take back some of the money allocated for meaningful use incentives is not likely to pass, but it shows that some Republicans don't give a hoot about health IT. The GOP catcalling over President Obama's proposed "investments" in the economy also calls into question the future of federal efforts to promote information technology.



Consumers ‘Don’t Have a Clue’ About HIEs

HDM Breaking News, February 23, 2011

By many measures, the Keystone HIE has made steady progress toward the goal of widespread community health data exchange. Formed in 2005, the HIE, which serves 14 hospitals in Pennsylvania, has a database of 2.9 million records with seven hospitals and five emergency departments publishing to it. A number of labs and clinics are also members.

About 450,000 patients have given consent to have their information available via the exchange, but more are needed, said James Younkin, director of the HIE, during a HIMSS11 presentation. Younkin, who also serves as I.T. director for Geisinger Health System, a Danville-based provider organization participating in the exchange, noted that only a small minority actually decline to participate in the effort. “Our decline rate is about 5 percent,” he said. “Our ‘not asked’ rate is much higher.”


Microsoft, Dell To Deliver SaaS Analytics For Community Hospitals

Duo teams on analytics, informatics, business intelligence and performance improvement technology.

By Robert N. Mitchell, InformationWeek

Feb. 23, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229219183

Dell and Microsoft announced that they will deliver analytics, informatics, business intelligence and performance improvement technology for community hospitals.

Delivered by Dell as a hosted online service, the technology combines Microsoft Amalga, a health intelligence platform, with Dell's cloud computing infrastructure and informatics, analytics and consulting services, the companies said at the Healthcare Information and Management Systems Society (HIMSS) conference on Tuesday.



Bar code system helps Salinas Valley Memorial prevent drug errors


Herald Staff Writer

Posted: 02/24/2011 01:33:40 AM PST

Updated: 02/24/2011 08:19:37 AM PST

Hundreds of thousands of hospital patients in the U.S. experience adverse reactions to preventable medication errors every year, but at the Salinas Valley Memorial Healthcare System, a new high-tech pharmacy aims to significantly reduce errors.

The pharmacy, which opened in October, uses bar codes to track drugs at every step of the medication process. The system issues an alert if a medicine, dosage, or time of day does not match the prescription in a patient's medical record.



EHRs, health IT will play expanding role in national vaccine plan

By Kathryn Foxhall

Thursday, February 24, 2011

Electronic health records and other health information technology will play a growing and significant role in vaccine safety surveillance and reporting to registries as part of the recently released National Vaccine Plan, according to senior Health and Human Services Department officials.

One of the top priorities of the vaccine plan is to expand and improve the use of health IT and electronic health records that can exchange health information. The plan lays out strategies and goals over the next 10 years to develop vaccines, increase their safety and assure access to a stable supply.



GE Healthcare moves Centricity to iPad

February 25, 2011 | Mike Miliard, Managing Editor

ORLANDO – GE Healthcare showcased the extension of its healthcare IT portfolio to mobile devices and tablet computing at HIMSS11 earlier this week. Its portfolio of EMRs for physician practices, including Centricity Advance and Centricity Practice Solution, is now available for use on the iPad and iPhone.

Officials say GE Healthcare is focused on shifting the architecture of its proven software solutions to web technologies, which lighten the application footprint and bring clinicians the benefits of anytime, anywhere access to critical patient data.



KLAS: Docs Look to Established Vendors in Tumultuous EMR Market

Posted by Anthony Guerra on February 23rd, 2011

Many Docs Switching Out EMRs

AllScripts is the most considered ambulatory EMR in a market rife with turnover, according to a new KLAS report, Ambulatory EMR: Win Rates, Replacements, and Provider Loyalty.

That turnover is represented by the fact that 35 percent of all providers interviewed for the report are replacing their existing EMRs. This includes nearly a third of the smallest practices, as well as 43 percent of groups with 100-plus physicians, according to KLAS.



AHIMA Comments on Stage 2

HDM Breaking News, February 25, 2011

Providers choosing not to adhere to clinical decision support information during treatment should document the reason why under Stage 2 meaningful use criteria, according to comments from the American Health Information Management Association on initial draft criteria. "When the treatment of care deviates from the direction guided by the CDS, this should be captured and included in the reporting for meaningful use," the association recommends.

AHIMA also urges policymakers to consider the current regulatory environment, which includes ICD-10 compliance and health reform initiatives among others, as 2013 draws near. "There are a number of other regulatory initiatives developing with a compliance timeframe of 2013 and we suggest aligning these programs to allow for a coordinated approach to implementation and production."



Consumer groups laud measures in Stage 2

Written by Editorial Staff

February 28, 2011

“Robust advancement of meaningful use criteria is essential both to ensure a return on investment for taxpayers who are funding the incentives and to lay a firm foundation for meeting the broad goals of healthcare reform,” wrote 25 consumer groups in a collective comment filed last week that that commend many components of the proposed meaningful use Stage 2 criteria included in the Health IT (HIT) Policy Committee’s Request for Comments.

In a letter sent to the Office of the National Coordinator (ONC) for Health IT, the groups laud the proposed Stage 2 meaningful use criteria for the steps they take toward a “seamless integration of health information, coordination of care…and the ability to monitor improvements in outcomes and functional status.”




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