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, July 16, 2011

Weekly Overseas Health IT Links - 16 July, 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.



US e-health Market Analysis

NEW YORK, July 5, 2011 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

The US represents one of the most developed healthcare markets globally. The annual healthcare spending of the country reached around US$ 2.6 Trillion in 2010, which is expected to soar to US$ 3.4 Trillion by 2015. This growth was attributed to the increasing usage of patent drugs, high administrative costs, and expensive hospital care. The enormous healthcare costs, which are expected to increase in future will pressurize the government to cut budget funding from other important segments. To gradually reduce this massive economic burden and to revitalize the prompt healthcare services, a flurry of regulatory acts has been passed. e-Health being the most prominent source of cost containment is being targeted by both public as well as private sector entities which help industry to grow manifold in last few years.

According to our research, "US e-health Market Analysis", e-Health market has evolved as one of the fastest growing industries in the US and remained almost immune even in the tough post recessionary scenarios. Number of federal policies and acts worked as catalysts for the market growth and are expected to drive the future market developments also. The e-Health adoption and its holistic application in healthcare system will open widespread market opportunities for the sector, which is poised to grow at a CAGR of around 13% during 2010-2015.



Latest HIE toolkit is primer for building information exchanges

June 27, 2011 — 4:01pm ET | By Ken Terry

The 10-year-old eHealth Initiative has released Phase II of its 2011 HIE Toolkit. Like the first two iterations of the toolkit, which were issued in 2006 and 2008, the latest version incorporates lessons learned by operational health information exchanges.

Phase I of the toolkit, which came out in April, addressed the components of planning an HIE, including governance, legal and information sharing agreements, and patient privacy issues. Phase II is a primer for building an HIE. Among the areas it covers:

  • Creating a sustainable model.
  • Technical aspects of connectivity.
  • Marketing and promoting of HIEs.
  • Enhancing services.
  • Tracking progress.



Small Doc Groups Question Advantages of Health IT

By Bara Vaida

June 30th, 2011, 4:07 PM

The government is offering as much as $27 billion in incentives to doctors and hospitals to adopt electronic health records, but the question is whether those incentives will be enough.

A new study published by the Center for Studying Health System Change and the National Institute for Health Care Reform illustrates the difficulty of getting everyone in the health care system to adopt electronic records.

The two organizations found that some physician practices with 25 or fewer doctors who were early adapters of electronic health records are unsure that their investment of time and money has been worth it.



The Future of Tele-ICUs: An Insider’s Perspective

Posted By Mary Jo Gorman On June 30, 2011 @ 12:09 am

Mary Jo Gorman, M.D., MBA, is the CEO of Advanced ICU Care, a medical service company headquartered in St. Louis, Mo., which provides high-quality care to patients in the intensive care unit. For more information, visit: www.icumedicine.com [1].

America’s ICUs are in crisis. Consider these staggering statistics: Today’s ICUs Serve 4 million patients annually, with roughly 20 percent mortality rates among those treated. On average, every patient admitted to the ICU suffers 1.7 potentially life threatening errors every day and estimates show that patients only receive half of the therapies that they should. And 50,000 patients annually die in the ICU from preventable deaths.

But research [2] indicates that ICU patients have lower risks of death and shorter ICU and hospital stays when an intensivist is on duty in the ICU and oversees patient care. The mortality reduction has ranged from 15 to 60 percent lower than in ICUs where there are no intensivists. However, the Committee for Manpower for Pulmonary and Critical Care Services predicts [3] a shortage of 10,000 ICU physicians, called intensivists, who have extra training to specialize in the care of the ICU patient. This national shortage of intensivists makes it extremely difficult to find intensivists that can provide 24/7 care for today’s ICU patients.



VA will allow more mobile devices Oct. 1

June 30, 2011 | Mary Mosquera

The Veterans Affairs Department expects on Oct. 1 to let clinicians in its hospitals and other employees use mobile devices, likely Apple’s iPhone among others, once they are verified as secure and that any personal information stored on them is encrypted.

VA did not disclose which devices would get the go-ahead but will focus on a “particular set of very popular devices,” said Roger Baker, VA CIO. The sole approved mobile device currently is the BlackBerry smartphone, which VA acquired for its employees.

“We will be highly confident that anything that is storing information on the device has encryption, and in all of the cases we’ll be satisfied that the authenticated user is able to view information but not download it on to the device,” he said in a monthly briefing June 30.



Streamlined Processes in a Massachusetts HIE

SAFEHealth focuses on automating key process into EHR and workflow

By Jennifer Prestigiacomo As health information exchanges (HIEs) are coming to terms with creating viable roads to financial sustainability, SAFEHealth, a central Massachusetts HIE, is focusing on patient consent management, automatic data management, and low operating expenses to keep the lights on. SAFEHealth connects Fallon Clinic, a large multi-specialty medical group practice with more than 20 practices, and HealthAlliance Hospital in Leominster, Mass. SAFEHealth has been live since June 2009.

SAFEHealth got its start from a $1.5 million Agency for Healthcare Research and Quality (AHRQ) HIE Grant in 2004 and a $4 million donation from Fallon Clinic, Fallon Community Health Plan, HealthAlliance Hospital, and UMass Memorial Medical Center (Worchester).



Doctors using smartphones, tablets to access medical data

Posted Tuesday, Jul. 05, 2011

If a patient of Arlington physician Ignacio Nuñez shows up at the emergency room when the doctor is not at the hospital, he doesn't have to wait long to start investigating what might be wrong.

The obstetrician/gynecologist can call up an expectant mother's medical records on his iPhone, or even watch the fetus's heartbeat on the device once the woman is connected to a hospital monitor, wherever he might be at the time.

"Maybe I made my rounds in the morning, but at 2 p.m. a nurse calls and says, 'We don't like the way an EKG looks.' I can see it. I don't even have to leave my house," he said.



State HIE leaders face uphill journey to health data interoperability

Don Fluckinger, Features Writer

Published: 5 Jul 2011

The HITECH Act and meaningful use aim to promote -- and fund -- the building of a health IT infrastructure in which patient data fires across a national health information exchange (HIE). State IT leaders discussed the trials of building this national network at the 2011 State Healthcare IT Connect Summit in Washington, D.C. The main hurdle they must overcome? Health data interoperability.

"At its worst, meaningful use can appear a bureaucratic hodgepodge of hoops to jump through," said national health IT coordinator Dr. Farzad Mostashari in his keynote address, in which he confirmed that proposed Stage 2 meaningful use criteria are on schedule to be released later this year and finalized by mid-2012. "As hard as [achieving electronic health record] adoption is, exchange is that much harder because of technical reasons, because the services you need aren't there yet, because policies need to be articulated -- particularly around privacy and money."


Less Paper, Better ER? One Rural Hospital's Bid

Duncan Regional Hospital emergency department uses analytics and predictive modeling to manage higher volume, share patient records.

By Neil Versel, InformationWeek

July 05, 2011

URL: http://www.informationweek.com/news/healthcare/clinical-systems/231000969

Despite being rural and relatively small, Duncan (Okla.) Regional Hospital has been a leader in health IT for years, first installing Meditech financial and clinical systems for acute care nearly 20 years ago. The latest IT project for the 167-bed facility in southwestern Oklahoma is to improve workflow and quality in the emergency department (ED) and better coordinate emergency care with care delivered elsewhere.

This summer, Duncan Regional is deploying T SystemEV Stat, an upgrade to an earlier management system from Dallas-based health IT vendor T-System, because the hospital has had problems managing paper records that came from other providers. The hospital also has been experiencing a steep increase in ED volume, according to Roger Neal, Duncan Regional's VP and CIO.



Microsoft Wins the HealthVault Battle, Loses the Hospital War

July 6, 2011 | about: CERN, MCK, MSFT

There is a common assumption in computing that when the generalists enter a niche, the specialists must give way. So when Microsoft (MSFT) entered the Electronic Medical Record (EMR) market, I assumed that specialists such as McKesson (MCK) and Cerner (CERN) would soon look for the exits.

This was especially true because Microsoft did its homework. It did not release its Amalga hospital system until it was tested successfully in some top hospitals, under the name Azyxxi, so it could deliver integration with HL7 billing codes and other industry standards. Its Healthvault Personal Health Record (PHR) was designed to integrate with existing systems and business models.

Google (GOOG), by contrast, ignored the industry with its Google Health PHR. It drew a large crowd to the 2008 HIMSS show, but there seemed to be little follow through. Its eventual demise was easy to predict.



Thursday, July 07, 2011

Tale of Two Exchanges Shifting Gears in California

California, like most states, is in the process of creating two new health exchanges -- one for insurance and one for information. The two are closely related, somewhat dependent on each other and will have to work well together from birth for either to be successful.

On one hand, California finds itself in familiar territory as the front-runner in these two new, uncharted efforts. As an early believer in the value of health IT and the ability to share information, California formed Cal eConnect more than a year ago to oversee the sharing of electronic health information. Last fall, California was the first state to pass reform-driven legislation to create a health insurance exchange.

But as impetus and initial bursts fade into the background, California is shifting from sprint mode to a long-distance strategy. Where the state traditionally has been the trendsetter with innovative new ideas, state officials now are keeping a keen eye out to see what develops in other parts of the country. California's deep budget deficit is also a factor in the shifting of gears.



By Joseph Conn

A meaningful hurdle the VA still hasn't crossed

Question: What has a small band of open-source programmers and a handful of health information technology vendors accomplished that the massive U.S. Veterans Affairs Department has not?

Answer: Attained certification for their versions of the VA's VistA electronic health-record system as capable of meeting the meaningful-use requirements under the health IT incentive payment program of the American Recovery and Reinvestment Act of 2009.

The latest VistA version to be certified as a complete, meaningful-use-compliant inpatient system is WorldVistA EHR 2.0, developed by the not-for-profit World VistA organization. Hat tip to Denise LeFevre, the chief information officer at 153-bed Oroville (Calif.) Hospital; to Dr. Matt King; and to programmer George Lilly for helping make it happen.



Engage nurses as informatics leaders: HIMSS

By Christine LaFave Grace

Posted: July 7, 2011 - 12:30 pm ET

In the information technology-driven evolution of healthcare, nurses must be made key stakeholders, according to a new position statement (PDF) from the Healthcare Information and Management Systems Society.

The statement calls for academic organizations, government agencies, healthcare providers and IT vendors to take a variety of steps to "ensure that nurses are well-positioned to lead and advance healthcare." Specific recommendations include creating informatics departments within provider organizations and employing nurse informaticists in leadership roles such as chief nursing informatics officer or chief clinical information officer. In addition, according to the statement, nursing informatics leaders should be engaged in health IT public policy development, and academic institutions should incorporate informatics competencies into their undergraduate and graduate curricula.



Mass. project promotes patient registries

By Andis Robeznieks

Posted: July 7, 2011 - 12:30 pm ET

Physicians participating in the Massachusetts eHealth Collaborative increased their ability to generate patient registries for laboratory results and medication use, according to a report abstract in Health Affairs.

A collaborative-sponsored program, which ran from 2006-08 and was funded by a $50 million grant from Blue Cross and Blue Shield of Massachusetts, helped implement electronic health-record systems at ambulatory-care facilities and established a health information exchange, according to the report. In 2009, researchers from Harvard Medical School and its affiliates surveyed 163 doctors from 134 practices that had participated in a pre-intervention survey conducted in 2005.



Research and Markets: Hospital Information Systems (HIS) - Global Opportunity Assessment, Competitive Landscape and Market Forecasts to 2017

DUBLIN --(Business Wire)--

Hospital Information Systems (HIS) - Global Opportunity Assessment, Competitive Landscape and Market Forecasts to 2017 provides key data, information and analysis on the global hospital information systems market. The report provides market landscape, competitive landscape and market trends information on the hospital information systems market. The report provides comprehensive information on the key trends affecting the market, and key analytical content on the market dynamics. The report also reviews the competitive landscape and technology offerings.

The Global Hospital Information Systems Market is Forecast to Grow at a CAGR of 10% from 2010-2017

The global Hospital Information Systems (HIS) market was valued at $7.4 billion in 2010, and is forecast to grow at a Compound Annual Growth Rate (CAGR) of 10% to reach about $14.7 billion by 2017. The high growth forecast for the period 2010-2017 is significantly influenced by accelerated efforts from the public and private sectors around the world to contain rising healthcare costs and enhance quality of care. The inflow of key Information Technology (IT) technologies such as Software-as-a-Service (SaaS (News - Alert)), dictation and speech recognition solutions, and mobile healthcare solutions into the healthcare market space will also contribute substantially to growth prospects in this market. These technological advancements attempt to offset major deterrents to IT adoption in healthcare settings, such as significant upfront investmens and ineptitude of medical professionals, with large electronic data entry and handling. Rapid adoption in emerging economies due to enhanced focus of key healthcare IT players will also accelerate growth of the HIS market. With the concept of interconnected healthcare systems seeming to materialize, starting with the US healthcare IT market, vendors have accelerated their efforts in assimilating necessary capabilities to tap the significant market potential. Intense market consolidation activity has resurfaced in the last two years.



Nicholson pushed on £22m cost of Cerner

7 July 2011 Jon Hoeksma and Daloni Carlisle

The chief executive of the NHS in England has been challenged to defend the deal that will see BT paid £22m for implementing Cerner Millennium at North Bristol NHS Trust.

As the senior responsible officer for the National Programme for IT in the NHS Sir David Nicholson has been asked to discrepancy between the £22m cost of Cerner Millennium at North Bristol and £8.2m cost of System C's Medway at neighbouring.

The cost for North Bristol is still £6.3m less than the average of £28.3m bill for a BT Cerner implementation in the South.

The figures are quoted in a letter to Sir David from Conservative MP Richard Bacon, member of the Commons Public Accounts Committee.



How to Recover Health Data After Disaster

Gienna Shaw, for HealthLeaders Media , July 7, 2011

Despite the progress many organizations are making toward implementing electronic health records systems, there's still an awful lot of paper in the healthcare world. So when disaster strikes--such as the Midwest floods this April or the tornado that hit Joplin, MO, in May--virtually every organization is at risk of losing some kind of data.

A new fund set up by the charitable arm of the American Health Information Management Association, the AHIMA Foundation, aims to help association members return to work to help their organizations recover that data after a fire, flood, hurricane, tornado, or other disaster.

When computers or other equipment used to store health data suffer flood, fire, or storm damage, an electronic data restoration company can often save the day. But to ensure they do so in a way that's compliant with privacy laws, the American Health Information Management Association says contracts should ensure the company takes measures not to use or disclose recovered information and uses safeguards to prevent the use or disclosure of the information.


Delays Force Feds To Propose EHR Reporting Changes

Centers for Medicare and Medicaid Services isn't ready yet to accept data online from providers regarding clinical quality measures.

By Ken Terry, InformationWeek

July 06, 2011

URL: http://www.informationweek.com/news/healthcare/policy/231001080

The Centers for Medicare and Medicaid Services (CMS) said it plans to allow eligible professionals to attest in 2012 that they have used their electronic health records to collect data on clinical quality measures as part of the CMS criteria for "Meaningful Use" of EHRs.

The 2010 Meaningful Use regulations required attestation only in 2011; after that, providers were to report the quality data by uploading it from their EHRs to a CMS-designated Web portal. In its new proposed rule on changes in physician reimbursement, CMS explained that it would allow attestation in 2012 because it's not yet ready to accept the data online.



Doctors struggling to cross HIT frontier

By Jeff Rowe, Editor

Scratch beneath the surface of any policymaker, and you’re likely to find a person who fancies him- or herself a problem solver.

For those HIT policymakers who eagerly step up to that description, we present this article, which takes a long and in-depth look at the issues facing doctors trying to work their way across the HIT frontier.

To start with the good news for policymakers and HIT proponents alike, if the doctors quoted in the article can be considered anywhere near a representative sample of healthcare providers across the country, it seems safe to say there aren’t many doctors who don’t “get” the benefits of new HIT.



Hospital association predicts regulatory “perfect storm” ahead

By Jeff Rowe, Editor

The American Hospital Association (AHA) recently took advantage of the Obama Administration’s regulatory review process to urge HHS to simplify, among other things, the myriad regulations surrounding the implementation and use of new HIT.

In a discussion of the HITECH incentive programs, the letter called for “simplified regulations that recognize how health information technology (IT) is actually acquired, used and implemented . . . In particular, the requirements for meaningful use should be clear, but not over-specified. In addition, it must be easier for hospitals and physicians to use a combination of vendor products, but still meet the requirement to use certified EHR technology and receive EHR
incentive payments.”



VA’s VistA open source agent to launch in August

July 01, 2011 | Mary Mosquera

The Veterans Affairs Department expects that the organization that will manage the open source community to modernize its VistA electronic health record will launch as the custodial agent in August.

The Informatics Applications Group Inc. (TIAG), a management and technology services company that was awarded a $5 million VA contract, and its partners will start operations of the community in the fall, VA said in an announcement June 30.

VA has also established a website for the custodial agent organization, which sets the ground rules and manages the open source community, its processes and resulting software products.



Electronic prescriptions have as many errors as written prescriptions

June 30, 2011 — 5:24pm ET | By Ken Terry

Electronic prescriptions contain about as many errors as handwritten prescriptions, according to a new study published in the Journal of the American Medical Informatics Association. The study's conclusion: "Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors."

The researchers examined 3,850 electronic prescriptions received by a commercial pharmacy chain in three states over a month's time. Of these prescriptions, 452 (11.7 percent) contained 466 total errors, of which 163 (35 percent) were considered potential adverse drug events.



Internal issues are a bigger health IT security threat than hackers

June 29, 2011 — 2:51pm ET | By Ken Terry

A security consultant tells Healthcare IT News in an interview that security threats to the information systems of healthcare organizations are proliferating with the growth of mobile devices, embedded devices, virtualization software, social media and IT consumerization. But a recent study on health data losses cast doubts on some of his assertions.

Frank Andrus, chief technology officer of Bradford Networks, a security firm in Concord, N.H., says that the operating systems of mobile devices are targets for virus attacks. The use of "network access control" (NAC) solutions could help organizations fend these off, he adds.

Tablets, other mobile devices, medication scanners, patient-monitoring systems and imaging devices all have embedded connectivity that is vulnerable to viruses, Andrus continues. And many healthcare systems are using "virtualization" strategies that allow them to run multiple applications on the same server. Hosted virtualized desktops, Andrus says, have the same security issues that real PCs do, so organizations should deploy programs to protect them against attack, as well.



Health IT has become an obsession for group practice administrators

July 5, 2011 — 11:16am ET | By Ken Terry

Four of the five top issues this year for members of the Medical Group Management Association (MGMA) revolve around health IT. And even the fifth issue--rising costs--has some bearing on technology, whether you look at it as a glass half full (using health IT to increase efficiency) and or half empty (the cost of installing an EHR and learning how to use it).

In order, here are the key concerns of practice managers, according to an MGMA survey:

  • Preparing for reimbursement models that place a greater share of financial risk on the practice
  • Participating in the Centers for Medicare & Medicaid Services (CMS)' EHR Meaningful Use incentive program
  • Dealing with rising operating costs
  • Selecting and implementing a new EHR system
  • Implementing and/or optimizing an accountable care organization.



BMA still worried about benefits of SCR

1 July 2011 Fiona Barr

Doctors have expressed concern about the benefits of the Summary Care Record programme but stepped back from calling for the roll-out to be halted.

The BMA’s Annual Representative Meeting said it was concerned about evidence questioning the benefits of the English summary record.

However, it did not give its wholehearted backing to calls for the roll-out of the SCR to be stopped. It agreed instead that such a move should be given further consideration by the BMA.



Tuesday, July 05, 2011

Recent Change Means More Medicaid Money for Eligible Providers

Under the meaningful use incentive program, the maximum Medicaid incentive payment for eligible professionals (EPs) is significantly more than the maximum Medicare incentive payment. The difference in incentive payments rewards Medicaid providers for treating a less favorable patient mix.

Until recently, the Medicaid incentives were based on the EP's costs of acquiring an electronic health record, resulting in a significant barrier to collecting the maximum allowable Medicaid incentive for a majority of Medicaid EPs who may have received EHR subsidies.

However, a recent amendment to the Medicaid incentive calculation for EPs makes every Medicaid EP eligible for the maximum Medicaid incentive payment.




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