Saturday, May 07, 2011

Weekly Overseas Health IT Links - 07 May, 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.


Electronic health records: the main patient record providers

In an updated guide to EHR software used to manage patient records, we look at market leaders CSC, iSoft and Emis

If all goes well over the next few years, most NHS trusts and boards across the UK will be implementing electronic health records (EHRs) as a replacement for the medical records paper chase that has been in place at most health organisations for decades.

In England at least, however, bringing in EHRs will have been a tough job. The National Programme for IT (NPfIT) Care Records Service, which was meant to provide a centrally-bought system for many NHS trusts, has not delivered this for more than a handful, owing to continuing delays on several fronts.

Those suppliers already involved with the CRS could lose guaranteed customers, but would arguably be left in a strong position to compete, given the years of work they have already undertaken with the NHS, and the (few) reference sites this has generated.

Cerner and iSoft are the chosen CRS providers to London and the north, Midlands and east regions of England respectively, although they also sell to trusts outside these areas.

Emis is in a slightly different position, but also has a very strong NHS presence: it is best known for supplying the majority of GP surgeries, and is aiming to add larger NHS organisations to its customer list.

Note: This is Part 1 of 2 parts covering a range of vendors (link to Part 2 at bottom) - well worth a browse.


Thursday, April 28, 2011

The Rise of Social Media & Participatory Medicine

Many have documented the shift from a paternalistic approach to medicine to a patient-centered approach, with greater participation by patients in their care decisions. The Internet has encouraged participation in health care for almost two decades. The Association of Cancer Online Resources in 1995 became one of the earliest groups to use listservs specific to different cancer types.

Now we are witnessing the rise of the e-patient, online advocates helping others to join participatory medicine. The joining of social media and participatory medicine can be observed throughout the stages of an illness, including:

  • Diagnosis and information gathering;
  • Finding a provider or second opinion;
  • Accepting a diagnosis and entering a community;
  • Participation in research; and
  • Being an advocate.


Can the usability barrier be overcome?

April 28, 2011 — 1:28pm ET | By Janice Simmons

At the workgroup meeting of the Health IT Policy Committee on Adoption/Certification last week, the hot topic was usability--or rather the lack of usability at times found among current electronic health record (EHR) systems.

One point of agreement among the panelists is that usability is not a one-size-fits-all topic. In her testimony, Chantal Worzala, director of policy at the American Hospital Association (AHA), best described EHR usability as the way in which EHR products "help clinicians and others complete care delivery tasks well, efficiently and in a way that is satisfactory."

As others have noted, she said, usability is an important factor in the pace of EHR adoption and has been identified as a barrier to increased adoption. "Put simply, if a system is not easy to use, it is less likely to be used."

For EHR products that are used in hospitals, Worzala said, two levels of usability should be considered: usability of the individual product and usability of the system as a whole.


Mostashari wants minimum govt. role in health IT

April 28, 2011 — 10:24am ET | By Janice Simmons

Farzad Mostashari, MD, in his first official public presentation as national coordinator of health IT outside of chairing internal committee meetings, acknowledged that the country--in terms of healthcare IT--is moving into an "intense phase of implementation" as initiatives supporting EHR adoption and Meaningful Use move into action.

"To some, it's a daunting place to be, but I'm thrilled. I feel we've made some great progress," he said in a speech before the Bipartisan Policy Center in Washington on Tuesday. "We're hitting our mile markers, but it's a marathon," he said.


Hospital labs consider sharing reportable electronic data

April 28, 2011 — 10:38am ET | By Janice Simmons

At least 500 hospital labs--including labs from about 100 critical access or rural hospitals--could become part of a new initiative funded by the Centers for Disease Control and Prevention (CDC) that would electronically connect their reportable data to public health agencies.

The goal of the initiative, called the Lab Interoperability Cooperative (LIC), is to provide services to hospital labs that would help them submit their results to public health agencies--while meeting Stage 1 of the Meaningful Use final rules.


Physician Groups Update E-Prescribing Guidelines

John Commins, for HealthLeaders Media , April 28, 2011

Five national healthcare organizations this week issued an updated "how-to" guide for healthcare professionals transitioning from paper to e-prescribing systems.

The 2011 edition of A Clinician's Guide to Electronic Prescribing is a collaborative by the American Medical Association, the American Academy of Family Physicians, the American College of Physicians, the Medical Group Management Association, e-Health Initiative, and The Center for Improving Medication Management, the healthcare organizations said in a joint media release.

"Whether a physician practice is just beginning to e-prescribe or is already using the technology, this guide is an important resource for all physicians," AMA Board Secretary Steven J. Stack, MD, said in the statement. "This updated guide includes information about the federal e-prescribing incentive program and can help physicians understand the requirements so they can receive incentives and avoid penalties."


Perceptions are nice, but are they real?

By Jeff Rowe, Editor

In our perfect world, every survey would open with two questions.

Question #1: What do you think about Issue X?

Question #2: What do you actually know about it?

This desired “rule” came to mind again as we read through a list of responses to a survey recently conducted by Sage Healthcare Division. The study aimed “to understand how the perceptions of physicians who use EHR systems differ or are similar to the perceptions of the patients who recall seeing their physician use the system.”

On one level, the study’s findings might at least help policymakers and HIT stakeholders develop an awareness of how EHRs are fitting into the doctor-patient relationship. For example, in response to survey questions, “62 percent of physicians and 81 percent of patients have a positive perception of documenting patient care electronically,” while 45 “percent of patients had a ‘very positive’ perception of their physician or clinician documenting patient care with a computer or other electronic device.”


10.8 Million Affected by Major Breaches

Federal Tally Includes 265 Health Breaches Since September 2009

April 25, 2011 - Howard Anderson, Executive Editor,

The federal list of major healthcare information breaches that have occurred since September 2009 now includes 265 cases affecting a total of more than 10.8 million individuals.

In the past month, 16 incidents that occurred in 2010 or 2011 were added to the tally, which the Department of Health and Human Services' Office for Civil Rights regularly updates. These include the largest breach on the list so far - the Health Net incident, which affected 1.9 million - and a breach at Eisenhower Medical Center, which affected more than 500,000.

Although only 11 incidents that occurred this year have made it to the federal list so far, those cases - because of the big numbers for Health Net and Eisenhower - affected a combined total of 2.5 million.


Electronic Patient Consent System Planned

Given the public's concerns about online privacy and ID theft, ONC is launching a pilot project that will build trust in data exchange.

By Nicole Lewis, InformationWeek

April 28, 2011


An e-patient consent system will soon become reality if the Office of the National Coordinator for Health Information Technology (ONC) has its way.

According to a listing on the Federal Business Opportunities website, ONC is currently seeking a vendor to conduct market research that will identify patient concerns as they design an e-consent pilot that will foster patient trust.

To achieve this, the vendor is asked to partner with medical facilities that are exchanging health information electronically, develop a way to obtain patient participation, identify key pieces of information relating to the exchange of health information and patient choice, and evaluate consumer understanding regarding patient consent to share their health information.


Court Hears Arguments In Data Mining Case

April 26, 2011

The U.S. Supreme Court appeared split on Tuesday as it considered a case testing state limits on data mining. At issue is whether states can bar the buying, selling and profiling of a doctor's prescription records without the physician's consent.

Government regulations require pharmacies to keep records of all doctors' prescriptions. In most states, pharmacies can and do sell these records to data mining companies -— companies that in turn sell the information to drugmakers for use in targeted sales pitches to doctors.

When doctors in Vermont found out their prescription records were being sold this way, they went to the state Legislature, and the state enacted a law barring the practice.

The data miners and the pharmaceutical industry challenged the law in court. They contend it is unconstitutional because it makes it more difficult for drugmakers to identify doctors who would be good prospects for sales.

But Vermont contends the law constitutionally allows doctors to decide for themselves whether information about their prescription habits can be sold to data miners.


Survey: Concerns linger, but iPad primed for healthcare

April 26, 2011 | Jamie Thompson, Web Editor

iPad use in hospitals is still a contentious topic in the healthcare IT realm. Healthcare IT News asked its readers if they think the iPad is ready for healthcare, and found that for many, the time for the iPad has arrived.

Nearly half of respondents think that the iPad is ready for healthcare. Many hospitals have shown initiative in providing their doctors with iPads, and the recent launch of the iPad2 garnered praise from many healthcare IT leaders, such as John Halamka, MD.


Hospital recruitment has begun for lab interoperability project

April 25, 2011 | Healthcare IT News Staf

ARLINGTON, VA – The American Hospital Association, the College of American Pathologists and Surescripts is seeking hospital participation for a program that will electronically connect hospital laboratories with public health agencies.

AHA, CAP and Surescripts are participating in what is called the Lab Interoperability Cooperative, a project funded by a grant funded by a grant from the Centers for Disease Control and Prevention. The project is intended to help hospital labs meet criteria established by the Office of the National Coordinator for Health Information Technology for meaningful use of electronic health records. This criteria includes submission of electronic data on reportable laboratory results to public health agencies. During the two-year grant period, the LIC will recruit, educate and connect to the appropriate public health agencies a minimum of 500 hospital labs – at least 100 will be critical access or rural hospitals.

----- SnapSurvey Shows CIOs Stressed About Work/Life Balance

Posted by Anthony Guerra on April 26th, 2011

Some CIOs Feel Caught in Deep Workload

Citing massive Meaningful Use and ICD-10-generated workloads, along with an inability to escape the wireless tentacles that bind them to the office, the majority of CIOs (53 percent) are not content with their current work/life balance, according to the April SnapSurvey.

Conversely, in either a show of support for work they know is important or resignation to a lifestyle they know will not change, 51 percent of CIOs said they families were, in fact, content with the same work/life balance.

Probing CIO discontent further, contributing factors may be that only 16 percent work what might be considered a normal workweek (40-49 hours), with the remainder working far longer – more than a quarter putting in between 60-69 hours per week. And work isn’t just confined to a Monday-through-Friday schedule. In fact, the vast majority (65 percent) said they put in a full week, plus at least another half day on the weekend.


Healthcare groups release e-prescribing guide

By Andis Robeznieks

Posted: April 26, 2011 - 2:45 pm ET

Six healthcare organizations have teamed up to develop a 56-page how-to guide on electronic prescribing. The guide includes information on meeting the federal criteria for meaningful use of electronic health-record systems—a necessary precursor to receiving federal health IT subsidies—as well as details on new Medicare e-prescribing requirements and frequently asked questions about adopting health information technology.


Mostashari: Efficient market is biggest driver of innovation

By Jessica Zigmond

Posted: April 27, 2011 - 12:00 pm ET

After nearly three weeks at the helm of HHS' Office of the National Coordinator for Health Information Technology, Dr. Farzad Mostashari further described his vision for the ONC as the healthcare community works through what he called "an intense phase of implementation" of health IT.

"We're approaching the virtuous cycle where what providers need to do to succeed in the new era of healthcare financing requires better information," Mostashari said Tuesday at the Bipartisan Partisan Policy Center in Washington. "And those better information systems can then help create alternatives for healthcare financing—better payment for quality, not quantity, that didn't exist before."


Giant HIE Planned for Chicagoland

HDM Breaking News, April 25, 2011

The Metropolitan Chicago Healthcare Council, a consortium of more than 150 hospitals and other organizations, has contracted with three vendors to build and operate a massive health information exchange serving a population of 9.4 million.

The MetroChicago Health Information Exchange will use the HIE platform and master patient index software of HealthUnity Corp., Bellevue, Wash. It also has contracted for the Amalga data aggregation and analytics software of Microsoft Corp., Redmond, Wash.


Researchers: EHR data valuable in genetics studies

By Joseph Conn

Posted: April 25, 2011 - 4:45 pm ET

Electronic health records can be a valuable source of relevant clinical data for genomic studies, according to researchers from a consortium of U.S. healthcare organizations.

An eight-page report on the research, "Electronic medical records for genetic research: Results of the eMERGE Consortium," was published last week at

The goal of the research, according to the report's 15 authors, was to determine whether data from EHRs could do a good enough job in identifying the phenotypes—outward manifestations—of certain diseases that it could then be used in genomic studies that look for links between health conditions and genetic markers.

All very SUSpicious

A new European directive and the UK government’s Health and Social Care Bill have reopened questions about consent for the use of data for medical research. Daloni Carlisle reports.

21 April 2011

Academics have warned - not for the first time - that the NHS is at risk of falling foul of privacy laws when it comes to using patients’ data for medical research.

A recent seminar organised by the Westminster Health Forum, which exists to debate public policy and inform politicians, discussed some of the ongoing problems in this thorny debate – and identified some new ones coming over the horizon in the form of the Health and Social Care Bill and the ongoing revision of the EU Data Directive.

Basic differences

Douwe Korff, professor of international law at the London Metropolitan University, has written extensively on the challenges for data protection posed by the internet, globalisation and ubiquitous computing – including the challenges for NHS research. And he makes the following case.

At the heart of the debate about privacy lies a simple disagreement. Family doctors and privacy campaigners have tended to argue that the confidentiality of patient data and patients’ explicit consent to its use trump all other arguments. Epidemiologists, on the other hand, have argued that using full population registers for research offers many potential benefits.


Trusts miss pseudonymisation target

26 April 2011 Daloni Carlisle

Fewer than half of NHS trusts have successfully “pseudonymised” their patient records, missing a government target aimed at making patient data more secure.

Figures from the Department of Health show that by 31 March, 186 out of 396 acute, mental health, ambulance and primary care trusts had reported successfully pseudonymising their patient records.

Under the DH’s Pseudonymisation Implementation Project, all NHS trusts are expected to encrypt patient identifiers in their data so it can be used safely, legally and securely for non-patient care, including commissioning, performance monitoring, analysing clinical trends and business requirements.


SCRs for nine in ten in Darlington

20 April 2011 Fiona Barr

More than 90% of patients in NHS Darlington have a Summary Care Record, making it the primary care trust with the highest uptake to date in England.

Figures for every PCT in the country have been published by NHS Connecting for Health, showing the progress of Patient Information Programmes and the percentage of patients with an SCR.

NHS Darlington - which has a much smaller than average PCT population size of about 100,000 - tops the list of SCR uploads.

It is followed by two PCTs that were early adopters for the SCR - NHS Bury with 74% and NHS South West Essex with 68%.

Mike Brierley, head of IM&T at County Durham and Darlington Primary Care Trusts, said: “Open discussion and constructive engagement with GP practices, combined with a strong public information campaign, have been instrumental in the success to date of our summary care record projects.


Patient portal use becoming an inevitability

April 23, 2011 — 2:24pm ET | By Ken Terry

Members of the Health IT Policy Committee, a government advisory body, recently debated whether Stage 2 of meaningful use should require the use of web portals to provide patients with online summaries of hospital visits. Most of the participants leaned against doing so for technical and security reasons. But, because of certain Stage 1 criteria, the whole discussion might become moot by 2013, when the second-stage requirements are due to go into effect.

On the ambulatory-care side, more and more physicians are purchasing patient portals linked to their EHRs in order to meet two current measures of meaningful use: providing visit summaries to at least half of their patients and giving electronic copies of health information to 50 percent of patients upon request.

According to consultants and vendors, the Continuity of Care Document (CCD) that the leading EHRs generate can meet both criteria, and can be automatically sent to a patient portal after each patient visit. Alternatively, a practice could store the CCD on a thumb drive or a CD and give that to the patient. But it's much easier to meet the criteria with a portal--and the portal offers many other advantages for both operational efficiency and the quality of care, physicians say.


Lab Connectivity Effort Gains Steam

HDM Breaking News, April 25, 2011

The Lab Interoperability Cooperative, a federally funded initiative to link hospital laboratories to public health agencies, is seeking hospital participants.

Organizations must register and complete a "Phase 1 Checklist" by April 29, at The American Hospital Association, College of American Pathologists and networking vendor Surescripts lead the cooperative. Its mission is to help hospital labs use the Surescripts network to meet electronic health records meaningful use requirements to submit electronic data on reportable lab results to public health agencies.


Advice on consent

Joseph Conn’s Blog

Either HHS or Congress must restore the rights of patients to control the flow of their healthcare information. This is a right that HHS, to a large measure, trampled when in 2002 it revised the Health Insurance Portability and Accountability Act privacy rule to allow the electronic movement of patient records for "other healthcare operations."

In the seven years since, I've heard every argument against consent—how hard and complicated it would be to restore it, what restoration would do to work flow, public health, and research. I take these points at face value, even though some who argue against consent have a direct financial benefit in maintaining the current consent-free environment. Still, I concede that it won't be easy to walk back consent. It will require technology, thought, public debate and money to protect privacy and preserve the promise of health IT. It, like democracy, will be an altogether messy process.


Microsoft to Power Data Exchange Network for Physicians in Hawaii

By: Brian T. Horowitz


Microsoft's Amalga health care data-aggregation platform will provide the foundation for TeamPraxis' physician data network in Hawaii.

Microsoft has announced that its Amalga data-aggregation application will provide the infrastructure for application service provider TeamPraxis' leading physician data network in Hawaii.

Founded in 1992, TeamPraxis offers Web-based ConnxMD practice-management software as well as EHR and workflow applications. Hospitals, insurance companies, pharmacies and laboratories also use the SAAS (software-as-a-service) products.


Healthcare Providers Prize PACS-RIS Integration

Clinicians want seamless integration between picture archiving and communication systems and radiology information systems and will sacrifice some functionality to achieve it, according to a KLAS survey.

By Nicole Lewis, InformationWeek

April 22, 2011


Providers that are considering making investments in radiology information systems (RIS) and picture archiving and communication systems (PACS), say they are looking for vendors that offer not only functionality, but also smooth integration between both systems, a KLAS survey has revealed. The poll also showed that providers are willing to sacrifice functionality to achieve integration, but would prefer both.

Released Tuesday, the report--"Ambulatory RIS/PACS: Integrating Provider Needs"--relied on interviews with more than 500 provider facilities about their RIS and PACS vendors. In addition to integration, providers say other considerations weighing heavily on their decision to purchase RIS or PACS systems are cost, technology, functionality, and service.


Electronic medical records systems create need for scribes to input data

April 21, 2011|By Stacey Burling, Inquirer Staff Writer

The rise in electronic medical records has given Brittany Fera, a premed student at Temple University, an "awesome" job that she had no idea existed before she saw an ad last year.

It's not the geeky programming kind of job you might guess.

The new record-keeping systems, which are touted as a way to improve efficiency and quality, slow down emergency medicine physicians so much that the doctors are hiring young people like Fera to input data for them. They call this growing group of employees "medical scribes."

The pay isn't great - around $8 to $12 an hour - but the experience for students with an interest in medical professions is hard to beat.


Study: Patients believe EMRs bring accuracy to their records

April 21, 2011 | Healthcare IT News Staff

TAMPA, FL – The majority of patients and physicians have a positive perception of electronic documentation, according to a survey conducted by Sage Healthcare Division, a unit of Sage North America.

“The adoption of electronic health records has grown in recent years as the U.S. government’s incentive plans and the benefits of these systems are realized by more and more office-based physicians,” said Betty Otter-Nickerson, president of Sage Healthcare Division. “The CDC’s National Center for Health Statistics estimates that more than half of office-based physicians have adopted a basic EHR, while more than 10 percent have adopted a fully functional system, such as Sage Intergy EHR. The results of the study will help Sage Healthcare design solutions that maximize the benefit to physicians and their patients.”

The Sage Healthcare Insights study examines the effect of implementing an electronic health record system on both physicians and their patients. The purpose is to understand how the perceptions of physicians who use EHR systems differ or are similar to the perceptions of the patients who recall seeing their physician use the system. According to the study, patients felt more comfortable with physicians that used an EHR system, and more importantly, felt that the information contained in the medical record was more accurate when they physically saw information being entered electronically.


ONC plans efforts to develop patient consent for exchange

April 22, 2011 | Mary Mosquera

WASHINGTON – The Office of the National Coordinator for Health IT intends to conduct a consumer electronic consent pilot as part of advancing health information exchange.

The ability for patients to decide whether they should provide e-consent in situations that would trigger it is a step that can build trust in sharing their health data and accelerate exchange.

ONC is gauging vendor interest and experience in managing such a pilot, according to an announcement in Federal Business Opportunities.

A potential vendor would develop and evaluate how to obtain feedback on patient choice in health information exchange and create innovative ways to educate consumers about options they have in providing consent in a clinical setting, whether it is automated or determined through a decision process with their primary physician in which the patient is a knowledgeable participant. The potential vendor would partner with healthcare providers that exchange health information.


Monday, April 25, 2011

Health IT Chief Mostashari Details What's Next for ONC

In an exclusive interview with iHealthBeat, Farzad Mostashari -- the country's new national coordinator for health IT -- discussed his top priorities, why some health care organizations might delay attestation of meaningful use, the importance of engaging patients in health IT efforts and the balancing act required to ensure that Stage 2 of the meaningful use program is ambitious yet achievable.

Earlier this month, Mostashari -- who previously served as the deputy national coordinator for programs and policy at the Office of the National Coordinator IT -- was selected by HHS Secretary Kathleen Sebelius to become the country's fourth national coordinator for health IT. Mostashari replaced David Blumenthal, who returned to academia after holding the post for about two years.

Mostashari said, "I learned a lot from David over the past two years. He really has been a great leader for ONC." He noted that his selection to replace Blumenthal helps ensure that ONC can provide continuity. Mostashari said that "the administration is completely committed to the health IT agenda, to our health IT strategies, to our health IT policies, and we're going to continue moving ahead. I think that continuity is a key point."




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