Thursday, April 21, 2011

Weekly Overseas Health IT Links - 21 April, 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.


Physician Engagement Vital to EMR Implementation

Joe Cantlupe, for HealthLeaders Media , April 14, 2011

If the move toward electronic medical records were a race, the Valley Baptist Health System was ready to lap competitors several years ago. The system began looking into electronic medical records in 2008. James E. Eastham, president and CEO of the 800-bed hospital system in Harlingen, TX, was pretty excited about it then, remembering how everyone in the system was getting involved, and he saw physicians as part of the solution.

Within a short period of time, however, plans came to a sudden and costly halt. Physician "resistance" was part of the problem, Eastham recalls.

"We were excited about going to the EMR and spent a lot of time and resources and a lot of money. We wanted to be early adopters," Eastham says, recalling what turned out to be a humbling EMR transition, which is always a good lesson to everyone, physicians included.


Brussels, 12 April 2011

Digital Agenda: Commission seeks views on improving healthcare by applying ICT (eHealth)

The European Commission is seeking citizens' and other interested parties' views on how the EU can help to deliver widespread benefits to the quality and efficiency of healthcare by applying information and communication technologies (ICT) (so-called 'eHealth'). ICT is already playing a central role in addressing the numerous challenges faced by healthcare systems across the EU including an ageing population, a rise in chronic diseases, budget cuts and a shortage of healthcare workers by for example allowing remote diagnosis, remote monitoring of patients' condition and secure sharing of patient records between healthcare professionals. However, there is considerable potential to develop eHealth much further in the future. eHealth can also make an important contribution to allowing people, especially older people, to enjoy more dignified and independent lives.


ONC Program Yields 2,000+ HIT Workers

HDM Breaking News, April 15, 2011

A federal program to boost the number of health I.T. workers will graduate 2,280 workers this month, a total the Office of the National Coordinator expects to rise to 3,000 by the end of summer.

The Community College Consortia to Educate Health IT Professionals program is part of an array of efforts by ONC to address the HIT workforce shortage. The government estimates 50,000 more workers are needed industrywide to keep up with increasing I.T. demands. The American Recovery and Reinvestment Act appropriated to ONC $2 billion in discretionary funds for health I.T. programs, including funding to address the worker shortfall.


ONC Employs Social Media For Input On Strategy

The Federal Health IT Strategic Plan proposed revisions are available for public comment on the Health IT Buzz blog maintained by the Office of the National Coordinator for Health Information Technology.

By Neil Versel, InformationWeek

April 12, 2011


The Office of the National Coordinator for Health Information Technology (ONC) last week said it's accepting comments on proposed revisions to the Federal Health IT Strategic Plan through April 22 via its "Health IT Buzz" blog. This experiment in social media means that all comments are publicly viewable right on the blog page.

The 80-page proposal is the first update to the strategic plan since 2008 and spells out ONC's strategy for meeting national health IT goals from 2011 through 2015.

The revision, required by the HITECH section of the American Recovery and Reinvestment Act, considers "the rapidly changing landscape of health IT and health IT policy that has been drastically altered over the past years by two major pieces of legislation that have established an agenda and committed significant resources to health IT-the HITECH Act and the Affordable Care Act," recently departed national health IT coordinator Dr. David Blumenthal wrote in a March 25 blog post at "Health IT Buzz."


  • April 13, 2011, 4:28 PM ET

Athenahealth’s Bush on the Electronic Medical Record ‘Burn Unit’

Plenty of medical practices spent a lot of time and money to put in place electronic-medical record systems only to find that physicians find them so cumbersome to use that they, well, don’t.

So many, in fact, that Athenahealth has created a group called a “burn unit” to handle these physician practices that have been “burned” by the old systems and are looking for a new solution, the company’s chairman and CEO, Jonathan Bush, told us on a visit to Health Blog HQ.

About 35% of Athenahealth’s new EMR business comes from medical groups that have already tried one of the traditional software systems and aren’t happy with it. In many cases they’re large, hospital-owned physician groups that have either bought the systems themselves, or are unsuccessfully trying to roll out the system used by the hospital.


EHR alerts don't improve abnormal test result follow up rates

April 14, 2011 — 2:24pm ET | By Janice Simmons

Alerting healthcare providers about abnormal test results through electronic health records (EHRs) may not always lead to timely follow-up of patients, researchers report in the latest issue of BMC Medical Informatics and Decision Making.

The researchers conducted a study consisting of six focus groups (with six to eight members) at two large Veterans Affairs facilities. Participants included full-time primary care providers, along with personnel representing diagnostic (radiology, laboratory) and information technology services.


Should EHRs be regulated like medical devices?

April 14, 2011 — 4:32pm ET | By Janice Simmons

Will the Food and Drug Administration (FDA) decide to regulate electronic health records (EHRs) as medical devices--or will it decline? That's an interesting question that came up this past week at the first annual PharmEHR Summit in Philadelphia.

Jeffrey Shuren, MD, JD, the director of the FDA's Center for Devices and Radiological Health, told the audience that the FDA may reconsider its earlier hands-off approach toward EHRs. Or again, maybe it won't, he said. But either way, the issue remains "a political hot potato."

The EHR concerns are not new. Last year, for instance, the FDA's voluntary notification system logged in over a two-year period a total of 260 related reports of "malfunctions with the potential for patient harm," which resulted in 44 injuries and six deaths. Among the problems encountered were mixing up patients, putting test results in the wrong person's file, or losing critical medical information.


CHIME: CIOs' Hopes Sag for EHR Early Funding

John Commins, for HealthLeaders Media , April 14, 2011

Healthcare CIOs remain optimistic about getting federal EHR stimulus funding, but a growing number acknowledge that federal reimbursement will come later than they'd originally predicted, a quarterly survey by the College of Health Information Management Executives shows.

One-third of the 200 CHIME members who responded to the March survey said they expect to qualify for stimulus funding under the HITECH portion of the American Recovery and Reinvestment Act within the first year of the program, which began on Sept. 30, 2010.

The survey, however, shows fewer CHIME members believe they will qualify for funding within the first six months of the federal program. Only 7.5% of respondents said they expected to qualify for funding by April 1, 2011, compared with 15% of respondents to the same question in November 2010, and 28% of CIOs who responded to the first CHIME survey in August 2010.


CIOs Expect to Make it Through Stage 1 MU, but it's Tough Going

HDM Breaking News, April 14, 2011

Just over 90 percent of 200 provider organization CIOs responding to a survey conducted in March expect their organization to qualify for Stage 1 meaningful use incentive payments, although many won't meet the goal until late in fiscal year 2012 and 2013. (The Stage 1 MU attestation process opens Monday, April 18. On April 20, HDM will host a Web seminar about the process. For more info, click here).

The 90 percent rate is consistent with previous quarterly surveys from the College of Healthcare Information Management Executives, although the new survey indicates that reaching meaningful use is tougher than many CIOs previously thought.


HHS too reliant on IT to fight Medicare fraud

April 14, 2011 — 11:48am ET | By Sara Jackson

HHS program integrity director Peter Budetti is a man excited about the possibilities of anti-fraud software, data mining/screening and analytics, according to a lengthy feature on healthcare fraud in Reuters yesterday. He says they'll not only catch con artists, but also prevent fraudulent payments from even being made.

"We will be able to run every (billing) claim through advanced technology screening by the middle of next year. Every claim will be subjected to a wide range of analytics all of the time and it will be a system that learns on top of itself," Budetti tells the news site. The department is working on risk-screening for new Medicare suppliers, the ability to automatically stop payments to suspected crooks and software to sniff for patterns of fraud.


Consumers Slow To Adopt Electronic Personal Health Records

Some patients are still concerned about online security, while healthy consumers seem indifferent to the benefits of PHRs, according to a study by IDC Health Insights.

By Nicole Lewis, InformationWeek

April 08, 2011


Consumers have been slow to adopt personal health records (PHR), a Web-based tool designed to encourage consumers to engage in their healthcare by tracking and aggregating their health information online, according to a study from IDC Health Insights. The findings come at a time when other technologies such as electronic health records, mobile health devices, e-prescriptions, and other technologies are seeing accelerated rates of adoption as healthcare delivery organizations implement systems to manage patient data.

The report – "Vendor Assessment: When Will PHR Platforms Gain Consumer Acceptance?" -- was based on an online survey of 1,200 consumers between February 18 and February 23, to gauge their interest in PHRs and to compare the numbers with a similar report conducted in 2006.


Report from PharmEHR Summit: Will FDA Regulate EHRs?

Agency weighs device interoperability, safety issues as it updates software rules, exec says

By David Raths As the U.S. Food and Drug Administration updates its rules regarding software, will it choose to regulate electronic health records as medical devices?

Speaking at the first annual PharmEHR Summit in Philadelphia on April 7, Jeffrey Shuren, M.D., J.D., director of the Center for Devices and Radiological Health at the FDA, said his agency could change its traditional hands-off approach to EHRs, but he acknowledged that the potential of FDA regulation raises serious clinical issues and is a “political hot potato.” “As of right now we’re not regulating EHRs, and it may turn out that we won’t,” he said.

The FDA will issue new rules about software either later in 2011 or in 2012, Shuren said, adding that the agency already regulates certain types of software and is also developing rules for the development of medical mobile apps. FDA regulation could mean that EHR vendors would face review of their manufacturing processes and design controls, as well as FDA testing to show a system does what it claims to do.


Hospital IT cuts and job losses revealed

13 April 2011 Lyn Whitfield

The scale of cuts and job losses being demanded by acute trusts is revealed in an eHealth Insider survey, published today.

Just over a third of respondents said their trusts were looking to make savings of more than 20% of their total budget, with another four out of ten saying trusts were looking for cuts of more than 10%.

The survey shows that the cuts are feeding through into job losses, a preoccupation with balancing the books, and reduced investment in IT.


Cuts hit IT investment, EHI survey shows

14 April 2011 EHI staff

NHS trusts are looking to “sweat” their current IT systems instead of invest “in new toys” as they struggle with efficiency saving demands.

An exclusive eHealth Insider survey, more details of which are published today, shows that board level and senior IT managers are expecting to see their budgets cut significantly over the coming year, and to have to make significant job losses.

It also suggests that their focus is on “keeping existing systems up and running” or on delivering basic infrastructure upgrades, rather than on major investments.

However, a quarter of those who responded said their trusts were planning to deliver a major patient administration system or electronic patient record upgrade.


Watson Goes to Work in the Hospital

Technology developed for the Jeopardy champ is being used to identify when babies are acquiring an infection.

Designed to answer Jeopardy questions, IBM's Watson is of little use beyond the game show's set. But some of the techniques that helped the computer defeat two human Jeopardy champions in February are showing promise in a new context: the hospital. Researchers in Canada are using analytics like that which helped the computer decipher the language of clues to provide an early warning when babies in an intensive care unit acquire a hospital-borne infection.

As you would expect, babies in an ICU are surrounded by equipment that tracks their vital signs, but much of that data is wasted, says Carolyn McGregor, a researcher at the University of Ontario Institute of Technology. "They produce constant streams of data," she says, "but that information is often distilled down to a [nurse's] spot reading every 60 minutes, written on paper."


Mobile app for melanoma detection wins VA, WWHI tech challenge

By Joseph Conn

Posted: April 12, 2011 - 11:30 am ET

Programmer, Vietnam War veteran and information technology entrepreneur Steven Palmer is the winner of a $10,000 prize funded by the West Wireless Health Institute in conjunction with the Veterans Affairs Department for developing a mobile-phone application to help patients with the early detection of melanoma, the institute has announced.

Palmer, a melanoma survivor who has a doctoral degree in science from the Massachusetts Institute of Technology, worked to develop the application with Dr. Martin Weinstock, a professor of dermatology and community health at the Alpert Medical School, Brown University, and chief of dermatology for the VA Medical Center in Providence, R.I. Palmer founded Alternate Universe Technologies in Providence to market his smart-phone applications.


Goodbye Dr. Blumenthal, and Thank You

Joseph Goedert

Health Data Management Blogs, April 11, 2011

David Blumenthal, M.D., has left government service to return to Harvard, having spent a whirlwind two years as national coordinator for health information technology. I have mixed feelings about his performance, but that doesn't temper the respect I have for the overall job he did.

On the negative side, he wasn't particularly media-friendly. When we talked it wasn't for long and he stuck to the script as much as possible. He never fixed the glaring lack of representation of physician practices and community hospitals on the HIT Policy and Standards advisory committees, which have considerable influence over the meaningful use rules and design of the emerging nationwide health information network.


Budget Deal Appears to Spare HITECH

HDM Breaking News, April 12, 2011

An extensive search of the 459-page Continuing Resolution that cuts more than $38 billion from the federal government's fiscal 2011 finds no reductions in health information technology programs funded under the HITECH Act.

However, officials of the House Appropriations Committee and the Office of the National Coordinator for Health Information Technology did not quickly return e-mails asking whether any HITECH funds were eliminated.


More Study Needed Prove Telehealth's Worth

Gienna Shaw, for HealthLeaders Media , April 12, 2011

The field of telehealth is still emerging, and while there's anecdotal evidence of its benefits to care, there haven't been a lot of long-term studies to quantify it. That hasn't stopped organizations from pursuing the model. In the 2011 HealthLeaders Media Industry Survey of technology leaders, 46% of respondents said they have one or more telemedicine programs in place. Another 41% say they'll have one in place in one to five years.

What's driving the technology? The shortage of intensivists, specialists, and physicians willing to take call, for starters. Remote access brings doctors to patients regardless of where they happen to be. Another factor is that the technology itself is advancing so fast.

Remote units have high-definition displays, the ability to zoom right in and take high-resolution photos and high-quality videos, and digital stethoscopes that let docs listen just as well as—or even better than—they can in person.


Expert view: Tim Benson

The director of Abies outlines the role of the XDS suite of standards in sharing patients data in the new NHS, ahead of giving an expert seminar at Primary Health Info 2011.

12 April 2011

Every patient has his or her own unique combination of conditions, treatments, needs and values. These need to be treated holistically throughout their complex, unpredictable and life-long journey between many health care providers and clinicians.

But care providers and clinicians all have their own specialist skills, knowledge, ways of working and IT systems. As a result, the patient’s medical record is fragmented, making and it hard for anyone to grasp the whole picture, leading to unnecessary errors, duplication and waste.

The vision of the white paper, ‘Equity and excellence: Liberating the NHS’ is of patient-centric electronic patient records (EPRs) to solve this problem. It wants to place the patient, not the care provider organisation, at the centre of the information system.

This is a radical departure because NHS IT systems were originally developed in a provider-centric context, to solve problems within each separate organisation. Tracking patient records across multiple organisational boundaries is the most difficult type of many-to-many interoperability problem.


ONC Names Mostashari National Coordinator for HIT

John Commins, for HealthLeaders Media , April 8, 2011

Farzad Mostashari, MD, has been named National Coordinator for Health Information Technology, effective immediately. He replaces David Blumenthal, MD, who is returning to Harvard University after leading Office for the past two years, the Department of Health and Human Services announced.

Mostashari joined the Office of the National Coordinator in July 2009, serving as deputy national coordinator for the office, which is within the Department of Health and Human Services, said ONC in a media release.


Mostashari recent comments offer snapshot of ONC leadership

April 08, 2011 | Mary Mosquera

Dr. Farzad Mostashari, the newly minted national health IT coordinator, recently offered a snapshot of the near-term direction for the Office of the National Coordinator for Health IT as he saw it, steady on the current path but aware that "nothing stays still, and certainly not in health IT."

As Mostashari takes leadership, ONC is preparing to develop three proposed rules by the end of the year for stage 2 of meaningful use and the accompanying standards and certification criteria for electronic health records (EHRs). ONC will also propose a governance rule to support the expansion of the nationwide health information network (NHIN) to promote sharing of patient data.

ONC is coordinating with the Centers for Medicare and Medicaid Services to develop the regulations for the meaningful use of certified EHRs that healthcare providers must fulfill to qualify for Medicare and Medicaid incentive payments.


Thursday, April 14, 2011

Pick for New Health IT Chief Lauded by Industry; Challenges Lie Ahead

When David Blumenthal announced plans to step down as national coordinator for health IT this spring, some health care stakeholders raised concerns that his departure could slow the momentum of key federal health IT initiatives.

Blumenthal -- who became the country's health IT chief in March 2009 -- had always planned to leave the Office of the National Coordinator for Health IT to return to an academic post at Harvard University. So while his announcement was not unexpected, it came at a critical time in federal health IT efforts. Stage 1 of the meaningful use incentive program now is under way, and policymakers are hard at work finalizing criteria for Stage 2 of the program.


Despite information exchange plans, healthcare ultimately is local

April 10, 2011 — 5:44pm ET | By Ken Terry

The truism "all healthcare is local" seems to have been forgotten in the ambitious plans to hook up far-flung healthcare providers and create a national health data exchange. That was one of the thoughts I had back in 2004, when the Bush Administration called for the creation of a National Health Information Network (NHIN) before most doctors and hospitals even had electronic health records. The same thought occurred to me again last week, when five big healthcare providers established a Care Connectivity Consortium to allow the interchange of patient data.

The five CCC founders--Geisinger Health System, Group Health Cooperative (GHC), Intermountain Healthcare, Kaiser Permanente, and the Mayo Clinic--all reside in different parts of the country. (The only area of overlap is in Washington State, where Kaiser and GHC operate in different markets.) The chance that any of their patients will need care in one of the other systems is fairly small, so the interoperability they're going to demonstrate doesn't seem to serve a purpose, other than to accelerate the formation of the NHIN.


Medical privacy, access to records often at odds

Steps to prevent breaches can make it harder for doctors, hospitals to share data

In a world of paper records, consumers have long been vulnerable to someone's snooping around an unattended file drawer. Such thefts were rare but could be pulled off without detection.

In an electronic world, someone pulling a similar trick likely would get caught. Systems log who gains access to a record.

But such thefts could happen more easily on a grand scale. Instead of walking away with a backpack of records, it becomes possible to take off with virtual truckloads.


ONC community-college program sees first graduating class

By Maureen McKinney

Posted: April 11, 2011 - 11:00 am ET

More than 3,000 health information technology professionals will graduate this month from 82 community-college programs funded by HHS' Office of the National Coordinator for Health Information Technology.

This first wave of graduates, composed mainly of mid-career professionals, will be "equipped to facilitate the implementation of electronic health records, ideally in rural healthcare settings, where implementing EHRs is particularly problematic, largely due to a lack of expertise and a limited pool of HIT trained professionals," according to an ONC announcement.


Cisco survey finds global support for telehealth

April 07, 2011 | Eric Wicklund, Contributing Editor

WASHINGTON – At a time when patient-centered healthcare seems all the rage, a survey of top healthcare leaders around the world indicates they’re most concerned with implementing technology that allows doctors to communicate with each other.

Cisco’s Internet Business Solutions Group received responses from 96 leaders in 16 countries for its Global Health Leaders Survey. The results were released Wednesday in Washington, D.C., as part of the World Health Congress keynote presentation and a panel discussion titled Ministerial Forum on Global Health Innovation: A Perspective on National Health Opportunities.


Scientists Use Computer to 'Read' Human Thoughts

Technology could help disabled patients relate to world around them, findings suggest

By Amanda Gardner

HealthDay Reporter

THURSDAY, April 7 (HealthDay News) -- After hooking up a computer to human brains, scientists were able to program the computer to "read" the thoughts of disabled patients, thereby enabling them to control the cursor on the screen.

The researchers are hoping the breakthrough will one day lead to ways to help disabled patients connect better with the world around them.

"We have been fundamentally interested in creating a brain-computer interface that could help people with severe disabilities interact with the world," said Dr. Eric C. Leuthardt, lead author of a paper describing the findings in the April 7 issue of the Journal of Neural Engineering.


Liberals quietly push hospital secrecy bill

Last Updated: April 11, 2011 8:42am

After its $1-billion e-health scandal, Ontario vowed to allow greater access to hospital records to improve public transparency.

But the ruling Liberals are now backing off that pledge before legislation that was to take effect in 2012.

Midway through the province’s recent 328-page budget, a single line pointed to a change that nurses and a patient advocate say would cripple any move toward greater accountability.




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