Quote Of The Year

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

Saturday, July 23, 2011

Weekly Overseas Health IT Links - 23 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.



HL7 Deepens Ties to International Standards Group

Joseph Goedert

HDM Breaking News, July 8, 2011

Health Level Seven International has strengthened its ties with the Denmark-based International Health Terminology Standards Development Organisation.

IHTSDO has provided HL7 with a free "public good" license to the SNOMED CT terminology codes and descriptions. This will aid HL7 in producing SNOMED-enabled international products or specifications to advance interoperability across nations.



6 Google+ Positives for Healthcare

Gienna Shaw, for HealthLeaders Media , July 12, 2011

Still in beta, Google’s latest foray into social networking, Google+, is already generating better buzz than its previous attempt, Google Buzz, and although there are some skeptics, many early adopters are simply gushing about it.

I count myself amongst the skeptics—but then again I always count myself amongst the skeptics. Some years ago, I didn’t believe smartphones would be that big a deal, either. And in the early days of Facebook and Twitter, I was guilty of being somewhat dismissive of social media.

I may have finally learned my lesson; you can indeed find me posting about healthcare technology on Google+.



Framework for medics in e-health

12 July 2011 Fiona Barr

A competency framework for practising clinicians involved in e-health has been launched by the Academy of Medical Royal Colleges.

The framework, produced in partnership with the Scottish Government, aims to define the knowledge, skills and behaviour that are required by clinicians who have a role in e-health at a local, regional or national level.

The document is published as E-Health Insider runs its campaign for all NHS trusts to consider appointing a chief clinical information officer to lead on health IT and champion information projects.

The EHealth Competency Framework aims primarily to support those who continue to work as clinicians while also holding an e-health role.



GP outcomes data to be published

7 July 2011 Fiona Barr

Comparative clinical outcome data by GP practice and prescribing data by GP practice are to be published by December this year.

The move, unveiled this morning, comes as part of the government’s transparency agenda which will also open up data on NHS complaints and clinical audit, the Cabinet Office has announced.

The drive to put more data into the public sector will mean data on NHS staff satisfaction and the quality of postgraduate medical education will be placed in the public domain.

The government’s plans for much more extensive publication of data, which also cover information about schools, transport, the courts and the salaries of thousands of high-earning civil servants, have been set out in a letter from Prime Minister David Cameron to his Cabinet colleagues.



HIEs more than double since last year

July 08, 2011 | Mary Mosquera

The number of operational health information exchanges has more than doubled to 228 since last year, and of those, private exchanges have increased more rapidly than public organizations for sharing information, according to researcher KLAS.

Since last year, functioning public HIEs have expanded to 67 from 37, while private-sector HIEs have surged to 161 from 52.

The slower establishment of public health information exchanges (HIE) may be due in part to government oversight and ensuring long-term funding, according to a KLAS announcement July 7.

HIEs enable hospitals, physicians, and clinicians to share patient records in order to coordinate and improve the quality and efficiency of care.



Telemedicine improves stroke care at hospitals

Technology that allows remote treatment is seen as boon to rural patients

7:48 PM, Jul. 12, 2011

When a patient comes into the emergency room with symptoms of a stroke, access to a neurologist within minutes can make a big difference between whether they live, die or end up permanently disabled.

Technology that hospital chain HCA’s local TriStar Health System subsidiary plans to roll out next week at five of its Nashville-area hospitals aims to ensure there’s a neurologist on hand instantly — albeit virtually — to make the right life-saving choices.

TriStar’s system can be used to determine whether the patient had a severe stroke and needs clot-dissolving drugs to prevent more damage.

Using his laptop from any location, neurologist Dr. Adrian A. Jarquin-Valdivia of the TriStar Stroke Network can interact with the patient and ER medical staff through a video monitor and listen to the patient’s heart rhythm through a stethoscope connected to the telemedicine robot.



Web startups aim to give consumers more control over their health

By Peter Delevett

When new mom Leah Dillon needed advice for her son's first fever, she wondered where to turn. Recently arrived in Palo Alto, she couldn't ask neighbors for guidance and wasn't sure if she should page her son's pediatrician in the dead of night.

So Dillon went to a website called HealthTap, unveiled this spring by a startup in her neighborhood. An interactive Q & A database walked her through a set of recommendations -- from doctors, not just anybody with an opinion and a keyboard.

"The Internet is so vast, you don't know where you're getting your information from," she said. "It gives me more confidence if it's backed by pediatricians."



Scanned patient records will keep paper around, even after MU

July 12, 2011 | Molly Merrill, Associate Editor

BOSTON – Wednesday marks the one year anniversary since CMS set the meaningful use criteria for electronic health records. And while that has helped drive adoption, a high percentage of hospitals report they expect to continue to treat patient using paper records for up to five more years.

The findings come from a recent survey from information management company Iron Mountain that asked 200 health information professionals how they’re scanning paper patient records and planning to use them moving forward.



ONC will create animated videos to explain health IT

July 12, 2011 | Mary Mosquera

The Office of the National Coordinator for Health IT (ONC) intends to develop animated videos to explain the value of health IT to consumers to improve the quality of care.

ONC will hire a vendor to design one or two animated videos of 10 minutes or less to be used along with other materials to help the average American understand the basic mechanics of health IT.



Disney Applies Technology to Improve Patient Experience

Gienna Shaw, for HealthLeaders Media , July 11, 2011

Radio frequency identification (RFID) is a practical tool--often used to keep track of supplies and equipment, for example, or to keep track of surgical instruments such as sponges in the operating room. But a new use for this time-tested technology is emerging: improving the patient experience.

The Roy and Patricia Disney Family Cancer Center in Burbank, CA, uses RFID tags to track the location of its patients as they move through the system. At their first visit, the patient gets a small card with an RFID chip in it that's loaded with his or her preferences for lighting, temperature, color, and music. The patient keeps the badge over the course of their treatment.



'Most Wired' hospitals for 2011 named

July 11, 2011 | Molly Merrill, Associate Editor

CHICAGO – The nation’s "Most Wired" hospitals are making progress towards greater health information technology adoption, especially in terms of computerized physician order entry, according to Hospitals & Health Networks’ 2011 Most Wired Survey results.

The 2011 Most Wired Survey was conducted in cooperation with McKesson Corporation, HIT Exchange, the College of Healthcare Information Management Executives (CHIME) and the American Hospital Association. The survey was conducted between Jan. 15 and March 15, and asked hospitals and health systems nationwide to answer questions regarding their IT initiatives. Respondents completed 530 surveys, representing 1,388 hospitals -- roughly 24 percent of all U.S. hospitals.



Personal mobile devices can pose unknown threat to hospitals

July 12, 2011 | Molly Merrill, Associate Editor

MCLEAN, VA – As more doctors begin using their personal mobile devices to aid patient care, hospitals must be prepared to manage them in order to ensure security and privacy, according to one expert.

It is imperative that the hospital manage not just the medical devices it issues, but also personal devices, like the iPad or iPhone, that the clinician may have brought from home, said Ilene Yarnoff, lead assurance and resilience principal for Booz Allen’s Healthcare clients.

The hospital has less risk when it has issued the devices, says Yarnoff, because they can be password protected, encrypted and, “with thoughtful planning,” the hospital can set up tools to track the devices throughout the building. Most importantly, the devices can be turned off if there is any suspicious activity.



Top 5 most common gaps in healthcare data security and privacy

February 01, 2011 | Molly Merrill, Associate Editor

OAK BROOK, Ill – There are five common gaps in healthcare data security and privacy, and for many healthcare providers they could be the cause of a major security breach, according to one expert.

Raj Chaudhary, partner and national leader of the Security and Privacy Practice in the Risk Consulting Business Unit at Crowe Horwath LLP, one of the largest public accounting and consulting firms in the U.S., says that even though HIPAA rules for security and privacy safeguards were extended by the HITECH Act, gaps in the security and privacy of healthcare data still exist.



Corepoint, InterSystems Lead Interface Engine Market

Posted by Anthony Guerra on July 12th, 2011

KLAS Report Breaks Down Interface Market

Corepoint Health tops a new KLAS report, Interface Engines: Beyond Interoperability, scoring 96.3 points out of 100.

As such, it’s not surprising that the company is experiencing “tremendous growth” in its client base, according to KLAS. Corepoint had the largest presence of any vendor in smaller healthcare facilities (fewer than 200 beds), but very few clients in facilities with more than 500 beds. The company received the highest scores for product development and new technology, its customers raved about the “extra-mile efforts” of Corepoint’s support staff, and liked the robust and flexible technology of the interface engine, KLAS stated. Most customers felt the system met all of their expectations, the organization added.



Changing the script

There is growing interest in e-prescribing; but trusts still find it hard to make the business case when evidence for the expected safety and efficiency benefits is hard to come by. Some suppliers are now trying to help. Daloni Carlisle reports.

It is now more than a decade since auditors first called for the NHS to take up e-prescribing to reduce errors and deliver efficiencies. Until recently, progress was slow. But the past two years have seen a slew of implementations, tenders and boards considering business cases.

Sarah Crowe, research fellow at the University of Nottingham’s school of community health sciences last year attempted to quantify what was going on. In what she describes as the first study of its kind, she and colleagues surveyed NHS trusts represented at a national e-prescribing forum about their intentions.

Their paper, published in the Journal of the Royal Society of Medicine in September last year, highlighted “considerable interest”. Specifically, researchers found that 46 (82%) of 56 trusts that responded to the survey were either currently implementing or thinking of implementing e-prescribing.



Partners HealthCare: HIT implementation boosts med reconciliation

July 14, 2011 — 1:38pm ET | By Karen M. Cheung

Health IT changes can help bring medication reconciliation adherence to 98 percent, according to Partners HealthCare, which includes Massachusetts General Hospital and Brigham and Women's Hospital in Boston.

With a program aimed at medication reconciliation, since 2005, Partners has instituted pre-admission and post-discharge medication lists to patients, all changes that required enterprise clinic, IT, and research collaboration, according to a CMIO article.



Data Increase of 48%, Participation of 70 Distinct Hospitals Mark Year of Expansion for Indiana Health Information Exchange

2010 report confirms position of organization as a health and medical information exchange leader

INDIANAPOLIS, July 12, 2011 /PRNewswire-USNewswire/ -- 2010 was a year of unprecedented growth for the Indiana Health Information Exchange (IHIE), according to a new report released today by the organization. At the end of 2010, IHIE counted 70 distinct hospitals, long-term health facilities and health centers as part of its robust, secure network. It also launched an impressive $16 million federally-funded collaboration to link the access of health information to better patient outcomes.



At Meaningful Use anniversary, clarity and usability issues still prevalent

July 14, 2011 — 9:33am ET | By Janice Simmons

Believe it or not, it's the one-year anniversary of defining criteria for Meaningful Use of electronic medical records (EMRs). On July 13, 2010, the Department of Health and Human Services and the Office of the National Coordinator for Health Information Technology released two long-awaited Meaningful Use final regulations specifying what physicians and hospitals had to do to receive up to $27 billion in bonus incentives for adoption of EMRs.



Mayo Clinc researchers close to securely mining info from all EMRs

July 13, 2011 — 3:53pm ET | By Janice Simmons

Investigators with the Mayo Clinic in Rochester, Minn., are close to completing a suite of computing tools that can be used to sort and identify digital health information from all types of electronic medical records (EMRs)--regardless of the file formats or types of data organizations.

The announcement was made following a two-day conference at the University of Minnesota highlighting milestones of the $60 million Strategic Health IT Advanced Research Projects (SHARP) initiative, funded by Office of the National Coordinator for Health IT. The SHARP project is seeking to safely convert stores of EMR data to support research--while maintaining privacy and security of that data.



Smaller practices not implementing all EHR features

July 14, 2011 — 11:00am ET | By Janice Simmons

In a new review of medical home processes by small to medium-size physician practices, the use of electronic medical record (EMR) systems by those practices appeared to be on the low side when compared with larger practices or those owned by hospitals or health plans, according to a new study in the current Health Affairs. The study surveyed 1,344 small and medium-sized physician practices with one to 19 physicians.

According to the study, about 17 percent of practices with one or two physicians had EMRs, compared with 38 percent of practices with three to seven physicians, 45 percent of practices with eight to 12 physicians, and 39 percent of practices with 13 to 19 physicians.



HIEs Increase But Sustainability Still Elusive

Joseph Goedert

HDM Breaking News, July 14, 2011

An annual survey of health information exchanges has identified 255 such initiatives in 2011, up 9 percent from 234 a year ago.

But only 24, or about 9.6 percent, of such initiatives report having sustainable business models, which is a slight improvement over the 7.6 percent reporting sustainability in 2010.

Further, many of the HIEs are concentrated with 110--or 43 percent--in just 10 states.



AMDIS president Bria discusses CMIO progress, IT barriers

By Joseph Conn

Posted: July 14, 2011 - 12:45 pm ET

Members of the Association of Medical Directors of Information Systems had a lot to talk about—and celebrate—as they kicked off their 20th annual Physician-Computer Connection Symposium on Wednesday in Ojai, Calif.

"This is a celebration of 20 years and of what we've got in front of us," said AMDIS President Dr. William Bria, a pulmonologist and the chief medical information officer at Shriners Hospitals for Children—Tampa (Fla). The conference, first attended by a small group of pioneers in what Bria calls applied medical informatics, drew a record-high 237 registered attendees this year.



Harvard University

Physicians with electronic health records are better able to sort patients by care needs

July 13, 2011 12:15 PM

One of the perks of electronic health records is that they make patient information sortable. All the bits of the information entered into separate boxes on a patient chart can be categorized and filtered.

That gives physicians the power to easily and quickly create lists of patients who, for example, had an abnormal lab test or have complained of nausea after starting on a new prescription.



CMIOs in higher demand: researchers

By Joseph Conn

Posted: July 15, 2011 - 12:00 pm ET

It's no stampede just yet, but chief medical information officers are starting to move, according to Vi Shaffer, an analyst at Gartner, a technology research organization.

Shaffer based her conclusion on the results of a recent Web-based survey of 73 CMIOs or clinicians performing similar duties under different titles. Among respondents were members of the Association of Medical Directors of Information Systems, a professional association for physicians working in applied clinical informatics. Shaffer, vice president and global industry services director for healthcare providers at Gartner, presented her findings at the annual AMDIS Physician-Computer Connection Symposium Thursday in Ojai, Calif.



  • July 14, 2011, 9:29 AM ET

BMA to Doctors: It’s Not Complicated — Don’t Be Facebook Friends with Patients

Accepting Facebook friend requests from current or former patients is a lousy idea, the British Medical Association is telling physicians.

The group’s new social media guidance notes that “because of the power imbalance that can exist in any doctor-patient relationship,” it’s important to establish a professional boundary. And that can be tough to do given all the personal information a Facebook status-update stream can deliver.

The BMA writes:

Given the greater accessibility of personal information, entering into informal relationships with patients on sites like Facebook can increase the likelihood of inappropriate boundary transgressions, particularly where previously there existed only a professional relationship between a doctor and patient. Difficult ethical issues can arise if, for example, doctors become party to information about their patients that is not disclosed as part of a clinical consultation. The BMA recommends that doctors and medical students who receive friend requests from current or former patients should politely refuse and explain to the patient the reasons why it would be inappropriate for them to accept the request.



Vodafone launches mHealth package

6 July 2011 Shanna Crispin

Vodafone has launched mHealth Professional, a healthcare package dedicated to mobile working.

The package is born out of a partnership with Advanced Health and Care, for its iNurse mobile patient management application, Ubisys for its digital pens, and SitexOrbis for lone worker protection.

Enterprise director of Vodafone UK, Peter Kelly, said national demands for efficiency savings across the NHS have put a new emphasis on the need for mobile working.



EHI Interview: Nikki Thomas

Vodafone has become the first big telecoms company to launch an m-health package. Shanna Crispin talks to its head of health about its plans.

Last week, Vodafone UK became the first big telecoms company to launch a complete mobile health package – the mHealth Professional suite.

The company has been providing most of the systems offered in the package for some time. However, the new release is focussed on making it easier for trusts to implement mobile technology.

Similarly, pilots and small-scale implementations of mobile working are underway in the health sector, but they operate in a fragmented and inconsistent way. Head of health Nikki Thomas says Vodafone’s new way of offering systems is an attempt to address that.

Trusts can choose the components they want to integrate into their work-flows, and are provided with training and support from Vodafone to deploy them and make sure they are used.


How To Redesign The EMR User Experience

Seattle Children's Hospital enlists product design firm to engineer prototype patient information viewer for better communication.

By Neil Versel, InformationWeek

July 11, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/231001309

Seattle Children's Hospital is testing a new kind of data aggregator that focuses more on the front-end user experience rather than the underlying technology to provide a more complete, accessible snapshot of a patient's condition and status. The technology is intended to foster patient-centric communication and ultimately allow clinicians to provide better, more coordinated care.

"It's an incredible, new way to provide us with new ways of looking at information," Dr. Ari Pollack, an informatics leader at the hospital, said of the Seattle Children's Patient Information System, a custom-built, Web-based program that pulls data from electronic medical records and other information systems, then presents a variety of user-friendly snapshots of patients.

"EMRs are becoming increasingly more complex in terms of information going in," Pollack explained to InformationWeek Healthcare. "I was looking at them as an increasingly larger black box," Pollack said. He also had some difficulty coordinating data across the hospital's Cerner inpatient EMR and registration, billing, and scheduling technology from rival vendor Epic Systems.

The complexity "makes it hard to tell the patient's story," Pollack said.



Joint Commission safety goals should be part of EHR certification

July 08, 2011 | Molly Merrill, Associate Editor

CHICAGO – The Joint Commission’s 2011 National Patient Safety Goals (NPSG) for hospitals should be included in electronic health record certification and criteria for meaningful use, say authors of a commentary that appeared in the Journal of the American Medical Association.

“Ideally, addressing the NPSGs should be incorporated into the EHR certification process, requiring each vendor to specifically engineer targeted solutions and each organization to carefully implement and use these systems to improve safety,” wrote Ryan P. Radecki, MD, and Dean D. Sittig, PhD, authors of a commentary that was published in JAMA on July 6.



KLAS: 'Private' HIEs leaving 'public' HIEs in the dust

July 8, 2011 — 5:21pm ET | By Ken Terry

KLAS, the Orem, Utah-based research firm that ranks everything under the sun, has just released its latest findings on health information exchanges (HIEs). It found that the number of operational HIEs has roughly doubled in the past year. "Private" HIEs, though--those associated with particular healthcare systems--are growing much faster than "public" HIEs that include unrelated healthcare providers.

"The number of live public HIEs rose from 37 to just 67 this year, while the number of live private HIEs mushroomed from 52 last year to 161 this year," KLAS says in an announcement.



Nurse informaticists are 'critical' for health IT revolution, HIMSS says

July 7, 2011 — 1:18pm ET | By Ken Terry

Nurse informaticists should have a greater role in health IT, HIMSS asserts in a new position statement. HIMSS also calls for improved informatics education for nurses. The statement reflects the recommendations of theInstitute of Medicine report, "The Future of Nursing: Leading Change, Advancing Health."

Since nurses play a key role in patient-centered care and have extensive contact with patients, HIMSS argues, they need to be involved in informatics-related decisions that will have a major impact on patient care. "Nurses integrating informatics solutions into clinical encounters are critical for the transition to an automated healthcare environment that promotes the continuum of care across time and place."



VA awards $12 billion for infotech work, including health IT

July 6, 2011 — 4:08pm ET | By Ken Terry

The Department of Veterans Affairs (VA) is hoping to upgrade and "transform" its information systems through a series of 14 recently awarded contracts worth $12 billion. Among the recipients are Hewlett Packard, Booz Allen Hamilton, and Harris Corp.

Under the Transformation Twenty-One Total Technology program, known as T4, the VA will modernize all of its systems. The upgrade will encompass program management and strategy planning; systems and software engineering; enterprise network, test and evaluation; independent verification and validation; cyber security; operations and maintenance; and training and IT facility support.



Surescripts' reaction to e-prescribing study doesn't erase the need for improvement

July 11, 2011 — 6:01am ET | By Ken Terry

A recent paper published in the Journal of the American Medical Informatics Association (JAMIA) found that about one in 10 computer-generated prescriptions contained errors, and that two-thirds of those were errors of omission.

In a joint statement released shortly after the study's publication, Surescripts, the company that connects physicians' offices and pharmacies online, and the authors of the study--who hail from Harvard Medical School, Massachusetts General Hospital, CVS and Partners Healthcare--point out that the data used in the study came from computer-generated prescriptions that were printed out or faxed to pharmacies. Although this wasn't made clear in the study, none of the prescriptions in the study were transmitted online. The statement observes that this does not reflect the current usage of the term "electronic prescribing," which now refers only to prescriptions that are sent online to pharmacies.



Monday, July 11, 2011

Lack of Genuine Privacy Interest Doomed Vermont Drug Marketing Law

On June 23, the Supreme Court issued its much anticipated decision in Sorrell v. IMS Health, striking down as unconstitutional a Vermont statute that prohibited the use of drug prescribing information for marketing purposes. In a 6-3 decision, the court found that the Vermont law violated the free speech rights of drug marketers.

A number of privacy advocates had weighed in on the case, seeing it as a showdown between privacy and corporate claims of free speech rights. The Center for Democracy & Technology was skeptical of the privacy arguments made in defense of the law, but we too were worried about its potential impact on a range of health privacy and health IT issues.

After thorough review of the opinion, it is clear that the case should not be read as a threat to well-crafted privacy laws. As interpreted by the Supreme Court, the Vermont statute was an explicit effort to control specific speech by specific speakers -- a double no-no in First Amendment jurisprudence. And, as a privacy law, it was ineffective because it allowed pharmacies to share the covered information with anyone for any reason save one: marketing by drugmakers.



Can Health Care Information Technology Save Babies?

Published In: The Journal of Political Economy, v. 119, no. 2, Apr. 2011, p. 289-324

Electronic medical records (EMRs) facilitate fast and accurate access to patient records, which could improve diagnosis and patient monitoring. Using a 12-year county-level panel, we find that a 10 percent increase in births that occur in hospitals with EMRs reduces neonatal mortality by 16 deaths per 100,000 live births.




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