Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, May 14, 2011

Weekly Overseas Health IT Links - 14 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.



The Benefits of Health Information Technology

A Review of the Recent Literature Shows Predominantly Positive Results

Published In: Health Affairs, v. 30, no. 3, Mar. 2011, p. 464-471

An unprecedented federal effort is under way to boost the adoption of electronic health records and spur innovation in health care delivery. We reviewed the recent literature on health information technology to determine its effect on outcomes, including quality, efficiency, and provider satisfaction. We found that 92 percent of the recent articles on health information technology reached conclusions that were positive overall.



Berwick Announces CMS Final Value-Based Purchasing Rules

Cheryl Clark, for HealthLeaders Media , April 29, 2011

Hospitals now have the final set of Value Based Purchasing rules governing how they will be paid based on quality performance, which will weight clinical measures at 70% and patient experience measures at 30%.

In a news briefing on the rules Friday, Centers for Medicare & Medicaid Services administrator Donald Berwick, MD, called the new rules "a historic change. For the first time, hospitals around the country are going be paid for inpatient acute services based on healthcare quality, not on just on the quantity of services they provide. "

Beginning in fiscal year 2013 hospitals will continue to receive payment from Medicare, but will receive an across-the-board cut in reimbursement of 1%. That amount, estimated at about $850 million, will be used to reward improvement and achievement under the program.


Guide Governs Transferring PHRs

HDM Breaking News, May 3, 2011

Standards development organization Health Level Seven International has released an implementation guide for transferring a personal health record between health plans. The transfer is necessary when a member with a health plan-sponsored PHR changes to another insurer.

The transfer is done using HL7's Continuity of Care Document and the ASC X12 275 patient information transaction standard. The exchanged documents are known as Plan to Plan Personal Health Record or P2PPHR documents, and can be transferred individually or in batches if an employer changes health plans.



Large Patient Information Breach List Climbs to 265

Dom Nicastro, for HealthLeaders Media , May 3, 2011

The number of entities reporting breaches of unsecured PHI affecting at least 500 individuals to the Office for Civil Rights, the enforcer of the HIPAA privacy and security rules, reached 265 as of Friday.

By the middle of March, 249 entities had reported breaches, meaning a spike of 16 in the last 45 days, behind the pace established since OCR began posting the breaches more than a year ago.

OCR, per a provision in the Health Informational Technology for Economic and Clinical Health (HITECH) Act, began posting the entities and information about their large breaches in February 2010. In 15 months, an average of about 18 reports per month – or a little more than one every other day -- has surfaced on the OCR website.


E-Health Records Produce Some Environmental Benefits

Digitized patient record and medical imaging systems consume more electricity, but reduce paper use, patient travel, reliance on plastics used in traditional X-ray films and other waste, said a Kaiser Permanente report.

By Marianne Kolbasuk McGee, InformationWeek

May 04, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/229402711

Enterprise wide use of e-health records has a neutral to slightly positive impact on the environment, according to a new report released by Kaiser Permanente, which recently studied the "environmental footprint" of its own KP HealthConnect electronic patient records and its KP HealthConnect picture archiving and communication systems.

The environmental study of KP HealthConnect, which contains records for 8.7 million patients and is used by thousands of clinicians in 454 KP medical offices and 36 hospitals in nine states and Wash. D.C., found that the digital records eliminated about 1,000 tons of paper records while KP's digital medical imaging saved about 68 tons of X-ray film.



AHRQ examines IT's impact on drug management

By Joseph Conn

Posted: May 4, 2011 - 12:00 pm ET

Authors of a report published online by the Agency for Healthcare Research and Quality and based on a review of professional literature from 428 articles have concluded that the role of health information technology in medication management is well-studied and “holds the promise of improved processes,” but “clinical and economics studies and the understanding of sustainability issues are lacking.”

For example, as many as 174 studies reviewed by researchers addressed the role of e-prescribing in medication management, particularly IT systems for clinical decision support and computerized physician order entry in hospitals and in ambulatory care. They indicate there is substantial evidence that “care processes such as medication errors, time for tasks, workflow and knowledge, skills, and attitudes can be improved” with the use of technology, according to the report.



Pediatricians call for EHRs to support medical home model

May 4, 2011 — 8:54pm ET | By Janice Simmons

The establishment of family-centered medical homes for children will need to be backed up by timely, secure, and comprehensive electronic health records (EHRs), the American Academy of Pediatrics' (AAP) Council on Clinical IT says in a newly released policy statement.

The medical home "must centralize and support the primary care relationship between the patient/family and healthcare provider through well-designed and well-implemented health information management," AAP said in its statement, which appears both online and in the May issue of the journal Pediatrics. For pediatricians, the core of such systems will be a "lifelong EHR."



Personalized treatment protocols can be developed with EHR data

May 3, 2011 — 5:48pm ET | By Ken Terry

Individualized treatment guidelines can help doctors prevent more heart attacks and strokes than they can by using population-based protocols, according to a new study published in the Annals of Internal Medicine. Researchers found that doctors can develop these guidelines for their patients by using computerized risk calculators integrated with their electronic health records.

The study compared the effectiveness and the costs of the individualized guidelines vs. the national consensus protocols for treating hypertension. By applying their approach to data from a long-term study of 15,800 U.S. residents--of whom 2,700 were eligible for this study--the researchers estimated that individualized treatment could prevent 43 percent more heart attacks and strokes than the national recommendations at the same cost.



Panel weighs delaying stage 2 of meaningful use

May 04, 2011 | Mary Mosquera

An advisory panel that is shaping measures for the next stage of meaningful use has suggested delaying stage 2 by one year until 2014 as an option to allow vendors and healthcare providers more time to update and roll out more advanced technology.

It is one of the approaches for dealing with the compressed timeline for establishing stage 2 of meaningful use of certified electronic health records (EHRs), but it would come at the expense of early adopters.

The delay option would primarily affect healthcare providers that have met meaningful use in 2011, according to members of the meaningful use work group, a panel of the Health IT Policy Committee.

“This is a compromise,” said Dr. Paul Tang, the work group chair. It doesn’t delay the overall program.



Adoption of PHRs may be key to EHR transition

By Jeff Rowe, Editor

For the sake of discussion, let’s say the feds put the cart before the horse in focusing the HITECH program almost exclusively on the adoption of EHRs.

We’re not saying that’s necessarily the case, but a recent article on the state of Personal Health Records (PHRs) makes us think that somehow, policymakers need to figure out how to get the cart and the horse to, well, run alongside each other.

The fact is, as one analyst puts it, “PHRs are really all over the map.”

There are arguably too many different approaches to PHRs, and more needs to be done to make them more than simply digital data cabinets.



Electronic medical records sharing expected to aid patient care efficiency

DECATUR - With electronic health records systems being implemented and improved at hospitals, clinics and medical offices throughout the nation, improving the flow of information among organizations has become increasingly important.

The Office of the National Coordinator for Health Information Technology indicates that initiatives are under way to develop a nationwide infrastructure that establishes, regulates and protects the use and exchange of electronic health information.

States and regions also are creating and improving health information exchanges, or HIEs, for sharing information.



Telemedicine left out of meaningful use, experts say

May 04, 2011 | Mike Miliard, Managing Editor

TAMPA, FL – "Historically, telehealth hasn't received the attention that it's deserved from the federal government," says Neal Neuberger, executive director of the Institute for e-Health Policy and president of Health Tech Strategies. A case in point is the government's meaningful use program.

Neuberger spoke with Healthcare IT News after participating in a panel discussion at the American Telemedicine Association's annual conference earlier this week. The discussion, titled EHRs and Telemedicine, also included Yael Harris, director of the Office of Health IT and Quality at Health Resources and Services Administration (HRSA), and Christina Thielst, a hospital administrator and independent IT consultant from California.



Accurate Measures?

From: The Hospitalist, May 2011

Despite challenges, CMS focuses quality efforts on processes, outcomes

by Bryn Nelson, PhD

For SHM’s official position on issues like healthcare reform, value-based purchasing, and medical errors, visit www.hospitalmedicine.org/advocacy.

Everyone’s talking about quality. Encouraging high-value care is one of the stated objectives of the value-based purchasing program being rolled out by the Centers for Medicare & Medicaid Services (CMS). It’s also the subject of a new report to Congress from the Department of Health and Human Services (HHS), “National Strategy for Quality Improvement in Health Care” (www.healthcare.gov/center/reports/quality03212011a.html). For its part, SHM is placing added emphasis on a range of mentored quality-improvement (QI) initiatives for hospitalists.

Amid the flurry of activity, researchers are still attempting to address a central question that could determine the success or failure of many such efforts: How do you accurately measure what constitutes high-quality care?



ONC, HIMSS to help grads find IT work

May 05, 2011 | Government Health IT Staff

As health IT work ramps up across the country, the HIMSS Career Services Center aims to make it easier for new graduates of the Office of the National Coordinator's HIT Workforce Development programs to find jobs via HIMSS JobMine with new access from the ONC website and enhanced offerings.

HIMSS will also add a section dedicated to the ONC workforce program, where graduates can post resumes and find health IT positions posted by potential employers.

Educating health IT professionals to help providers implement electronic health records, the ONC HIT Workforce Development programs target mid-career healthcare or information technology professionals who have received specialized health IT training. They include: Community College Consortia; Curriculum Development Centers Program; and the Program of Assistance for University-Based Training.



FCC, FDA pave the way for wireless medical devices

May 02, 2011 | Mary Mosquera

The Food and Drug Administration and the Federal Communications Commission are working together and separately to bring forward innovative wireless technologies and devices for health care faster.

Both agencies aim to engage with innovators earlier and more often to streamline the process of licensing a product or bringing it to market.

One of the goals for both agencies is making sure that the proliferation of wireless devices that will be integrated in hospital work can operate together and with other equipment, such as an infusion pump next to the patient, and not interfere with each other’s activities and data transmissions.



Top 10 ways to engage patients with IT

May 03, 2011 | Healthcare IT News Staff

Top ten ways to engage patients with IT

1. Your patients are already getting and using health information online – shouldn't they be getting more from you? The report suggests providing patients with online health tools such as reminders, instructions and educational information about their diagnosis and treatments.

2. Patients are looking to connect with others about healthcare – isn't it time for you to enter this dialogue in a meaningful way? Social media is a key way to do this while building your brand, says the authors of the report. They recommend trying sites such as Facebook, Healthgrades, ICYou, Patientslikeme and Twitter.



New body will lead NHS IT

5 May 2011 Daloni Carlisle

Structures to support NHS and informatics nationally and regionally are beginning to emerge, with NHS London establishing an IT strategy group and the Department of Health sounding out the NHS IT community on its requirements.

In March, the London Programme for IT established a 2015 Strategy Group to work with London trusts as NHS London winds down.

The DH, meanwhile, has been holding meetings for some months with NHS IT staff in trusts, primary care trusts and health informatics services to gather views about the future support needed.



Kenya confident on e-health services

As Kenyan telecom operators attempt to move toward alternative revenue, health services have quickly taken top priority. Safaricom and Telkom Kenya announced they were embedding health services into their product offerings.

It is not an altruistic endeavor however, as both companies hope the move will see their profit margins increase, after prices wars have devastated the countries telecom sector in recent months.

This new battle has analysts worried that it could quickly become a heated struggle between companies if efforts are not made to ensure price wars on e-health services do not begin.



Thursday, May 05, 2011

Physician-Patient E-Mail: Why Aren't We Using a 'Low-Tech' Tool To Boost Quality?

Like many Americans, I take advantage of the conveniences that the Internet makes possible. This past month, for example, after filing my taxes electronically, I booked an airline ticket online, completed the teaching of an online course, purchased several items online and reserved a table at a local restaurant online. Despite these conveniences, I, like most Americans, do not have the regular option of communicating with my physician online -- which could potentially save me, my health insurer and my physician time and/or money. Incidentally, recent data suggest that I am in the majority of Americans who are interested in being able to e-mail their doctor.

Most physicians do not e-mail with their patients, and this situation is not surprising. Policymakers and health care leaders interested in improving our health care system have focused more attention on using health IT for boosting effectiveness (e.g. evidence-based decision support) and efficiency (e.g. reducing redundant tests, improving use of existing data through health information exchange) rather than for issues pertaining to patient centeredness (i.e. things patients want). We have spent comparatively little time thinking about ways to make physician-patient e-mails a common occurrence in our health care system.



An Open Letter to National HIT Coordinator Farzad Mostashari

Joseph Goedert

Health Data Management Blogs, April 29, 2011

Dear Dr. Mostashari: Welcome to your new post! You were a good pick and you'll do a good job. But here's some unsolicited advice on how to do even better.

You and your predecessors are all physicians, very familiar with the industry yet very unfamiliar at the same time. No ONC head has lengthy experience in a standalone community hospital or small practice independent of academia or government. It's a different world and most of the industry lives in this different world. Your advisors on the HIT Policy and Standards Committees also don't live in this different world. It's long past time to shake up the committees and give the vast majority of the industry more representation.



AMA Online Tutorials Cover I.T. Adoption

HDM Breaking News, May 3, 2011

The American Medical Association has introduced a series of six online tutorials to help physicians adopting health information technologies.

The tutorials, which can be credited for continuing medical education, last about eight minutes each. They cover adoption strategy, needs assessment, workflow analysis, product selection, training and implementation.



CMS finalizes new rule on telemedicine

By Jessica Zigmond

Posted: May 3, 2011 - 12:00 pm ET

A final rule (PDF) from the CMS will change the process hospitals use to credential and grant privileges to physicians and other practitioners who provide care through telemedicine.

According to the CMS, the agency's regulations before the final rule had required hospitals—including critical-access hospitals—to grant practice privileges to remote-site physicians and other practitioners who were already credentialed in distant-site facilities after they considered qualifications on a practitioner-by-practitioner basis. As a result, those practitioners could not provide care through telemedicine services unless they had been granted privileges by their home hospital and the remote hospital or critical access hospital where the telemedicine services were delivered.



Syracuse hospital network will let health care providers share medical records

Published: Tuesday, May 03, 2011, 5:00 AM
By James T. Mulder / The Post-Standard

Syracuse, NY -- The first stretch of an information highway that lets Syracuse hospitals swap electronic patient records is open for business after more than five years of planning.

HealtheConnections, the group operating the health information exchange, announced Monday that Community General, Crouse, St. Joseph’s and Upstate University hospitals as well as the Laboratory Alliance of Central New York LLC are connected to the new digital network.

The group said the exchange allows authorized participating health care providers to securely access patients’ consolidated medical histories for better care. HealtheConnections said it provides security protections with a sophisticated encrypted system. The group is working to connect 15 other community hospitals across Central and Northern New York.



Supreme Court hearings stir NEJM reaction

By Joseph Conn

Posted: May 3, 2011 - 12:00 pm ET

Three top editors of the New England Journal of Medicine have weighed-in on the controversial prescription drug data-mining debate in an April 27 online editorial, coming out foursquare in support of laws in three states seeking to control the use of physician-identified prescription data used in marketing drugs to those physicians.

On April 26, the Supreme Court heard oral arguments in Sorrell vs. IMS Health, et al, pitting the attorney general and the Vermont Legislature against the pharmaceutical data-gathering and data analysis industry. The fate of the Vermont statute and similar laws on the books in Maine and New Hampshire likely hang in the balance of what is shaping up to be a landmark decision by the high court in a case pitting states' rights to regulate the commercial use of patient information and what the data-mining industry purports to be the constitutionally protected free speech rights of corporations.



ONC seeks vendor to develop, test electronic consent

April 29, 2011 — 4:27pm ET | By Ken Terry

The Office of the National Coordinator for Health IT (ONC) is seeking a vendor to develop and test methods of obtaining electronic patient consent for the use of personal data in health information exchanges (HIE).

The vendor who wins the contract will have to find a way to involve patients in the development, use and evaluation of the "e-consent" system. The winner also must develop a method to inform patients of their privacy choices in clinical settings. To pilot its approach, the vendor would partner with providers engaged in health information exchange.



Patients show positive response to EHRs

April 28, 2011 — 10:15am ET | By Janice Simmons

Patients felt even more comfortable than physicians when it came to using an electronic health record (EHR) system--and also felt that the information contained in the record was more accurate when they physically saw it being entered electronically, according to a survey by Tampa-based Sage Healthcare Division.

Overall, the study found that more than 81 percent of patients and 62 percent of physicians had a positive perception of electronic documentation. About 45 percent of patients interviewed said they had a "very positive" perception of their physician or clinician documenting patient care with a computer or other electronic device.



New Public-Private community aims to help build NHIN

May 2, 2011 — 9:11am ET | By Ken Terry

Two years after the Office of the National Coordinator of Health IT (ONC) released an open-source version of its CONNECT software for linking to the National Health Information Network (NHIN), a new nonprofit organization--the Alembic Foundation--is assembling a private-public community to start building a critical mass of CONNECT users. This week, Alembic's Aurion Project will release the latest version of the CONNECT application, Aurion 4.0, and participants in the Aurion community will finalize a charter and a governance structure.

In the long run, this project may have a considerable impact on the development of the NHIN. And, if it does, it will be in large measure because of its emphasis on collaboration between the public and private sectors.

Fifteen private-sector organizations and a consortium representing 26 federal agencies helped create CONNECT in 2007 and 2008. David Riley, chair of the Alembic Foundation, was one of the outside consultants who worked on this project; Vanessa Manchester, Alembic's chief operating officer, was another.



Researchers analyze social media as a disease-monitoring tool

By Melanie Evans

Posted: May 2, 2011 - 11:45 am ET

A project coordinated by Children's Hospital Boston researchers found that social-networking tools, in conjunction with the use of personal health records, could be valuable in the monitoring of a chronic disease.

Dr. Kenneth Mandl, an associate professor of medicine at Harvard Medical School and director of the Children's Hospital Informatics Program's Intelligent Health Laboratory, and Elissa Weitzman, an assistant professor of pediatrics at Harvard Medical School and of adolescent medicine at the hospital, were co-principal investigators for the project.



Balloting Open on HIE Standards

HDM Breaking News, April 29, 2011

Industry stakeholders are invited to vote between now and May 9 on proposed health information exchange specifications.

The specifications result from the HL7/IHE Health Story Implementation Guide Consolidation Project. The Office of the National Coordinated in January launched the initiative to consolidate and harmonize required health information exchange specifications that support meaningful use of electronic health record systems.



April 26, 2011

Mhealth is Pushing Patients Toward Perfecting Own Practice of Healthcare

By Deborah Hirsch, TMCnet Contributor

Mobile healthcare technologies are helping consumers manage their own wellness, chronic diseases and possibly even saving their lives.

At a time when 17 percent of the U.S. gross domestic product (GDP) is spent on healthcare and healthcare itself is actually growing 2 percent faster than the GDP, mobile healthcare companies believe they have the answers for making it more affordable and convenient to stay and get well

Coupled with an aging population and soaring levels of chronic diseases, mobile healthcare now provides potential for managing healthcare costs, as well as allowing the patient himself to keep track of blood sugar, heart rate and other vital signs critical to staying well.



VA, DOD to use open source in EHR

April 28, 2011 | Mary Mosquera

The secretaries of the Veterans Affairs and Defense Departments will meet May 2 to determine their next steps toward developing a single electronic health record for the two agencies, according a senior VA official.

VA Secretary Eric Shinseki and DOD Secretary Robert Gates agreed in March on a common technical architecture, data and services and exchange standards for the joint system.

But the two departments will move incrementally to a joint electronic health record (EHR) system to avoid disrupting clinicians treating patients at their medical centers, said Roger Baker, VA CIO.

A single electronic health record system has been advocated for years, but its development is finally gaining traction.



Monday, May 02, 2011

Stakeholders Calculate the Possibility of a Health Care Digital Divide

by Michael Pogachar, iHealthBeat Associate Editor

In the March issue of Health Affairs, researchers from the Office of the National Coordinator for Health IT presented results of a health IT meta-analysis. Their research looked at previous studies on health IT's effect on access to care, patient satisfaction and other factors.

The researchers reported that 92% of the 154 studies they reviewed reached overall positive conclusions on the effect of health IT.

One of the outlier studies looked at health IT implementation at a rural hospital. According to the study, "The hospital was hindered by a lack of clinical leadership, staff skepticism, turnover in the executive team, an overly aggressive schedule and a vendor whose products were not ready on time."




1 comment:

Peter Jones said...

Hi David,
Great blog and series of links. Noting your focus the following conceptual model introduced through a website and blog Welcome to the QUAD:


- may be of interest to you and your readers? Useful in health care this model also has socio-technical qualities.

Originally created in the UK by Brian E Hodges (Ret.) at Manchester Metropolitan University - Hodges' Health Career - Care Domains - Model [h2cm]


- can help map health, social care and OTHER issues, problems and solutions. The model takes a situated and multi-contextual view across four knowledge domains:

* Interpersonal;
* Sociological;
* Empirical;
* Political.

Our links pages cover each care (knowledge) domain e.g. POLITICAL:




Thanks for all these pointers David - look f/w to more!

Peter Jones
RMN, RGN, CPN(Cert), PGCE, PG(Dip) COPE, BA (Hons.).
Community Mental Health Nurse for Older Adults,
Independent Scholar and Informatics Specialist
Lancashire, UK
h2cm: help 2C more - help 2 listen - help 2 care