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, August 06, 2011

Weekly Overseas Health IT Links - 06 August, 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.



EMR data determines statin use doesn't lead to cancer

July 28, 2011 — 10:11am ET | By Janice Simmons

The use of statins, a popular drug class in the U.S. prescribed for such conditions as atherosclerosis and various cardiovascular events, did not appear to increase the risk of cancer among patients, according to a retrospective study appearing this week in the Journal of the American College of Cardiology that reviewed more than 11 million electronic medical records (EMRs).

To study any link between cancer and statin use, Claudio Marelli--of Cincinnati-based S2 Statistical Solutions--and colleagues conducted an analysis using records from January 1990 through February 2009, courtesy of GE Healthcare's Centricity EMR database. Clinical information for more than 30 million patients throughout the U.S. can be found in the database.



Expanding the registry universe--one EMR at a time

July 27, 2011 — 6:31pm ET | By Janice Simmons

A new report out this week from the Institute of Medicine on surveillance of chronic conditions notes that registries can be useful for obtaining information about individuals with particular diseases or conditions. However, there's a hitch: the registry data often just reflects a portion of the population--say, with lung or cardiovascular disease or even diabetes--who receive specific treatment and who are entered into the registry.

So, what about everybody else? How about those patients who had one abnormal lab result, or who failed to continue with a treatment? Recent research from the Massachusetts eHealth Collaborative shows that there might be a better way to expand the scope of registries--while improving quality of care--thanks to electronic medical records (EMRs).

The work of the collaborative, a four-year $50 million health information technology program--and how it installed EMRs and initiated workflow redesign--is profiled this month in Health Affairs. What was found was that its provider users of EMRs were far more likely to produce various registries than the less enthusiastic EMR users.



Disease surveillance needs to include EHRs, social media, IOM says

July 25, 2011 — 3:50pm ET | By Ken Terry

The Institute of Medicine (IOM) has proposed that the federal government take the lead in organizing a national surveillance system to track trends in chronic health conditions, focusing primarily on cardiovascular and lung diseases. The aim is to provide public health authorities and policymakers at the federal, state and local levels with a fuller understanding of the continuum of disease prevention, progression, treatment and outcomes.

A number of surveillance systems already exist for these health conditions. But the IOM report points out that the growth in the use of electronic health records and consumer trends provides new opportunities for strengthening disease surveillance.

"Expanding the use of EHRs in surveillance will have challenges, including the relatively low numbers of hospitals and practices now using the technology," an IOM report brief notes. "But use of EHRs is expected to expand as healthcare reforms advance, necessitating their inclusion when planning for a national surveillance system."


To learn more:

- read the IOM report brief (.pdf)
- see this
post on The Hill's Healthwatch blog

- read the AHA's press release


Hospitals Boost IT Spending Plans

The prospect of Meaningful Use dollars has spurred healthcare providers to spend more in tough economic times, according to a HIMSS Analytics report.

By Neil Versel, InformationWeek

July 28, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/231002861

The federal incentive program for Meaningful Use of electronic health records seems to be having its desired early effect by spurring healthcare organizations to adopt more than just basic EHRs, according to a new study. And many hospitals are making plans to spend more on other forms of IT in the next few years, suggesting that EHRs are becoming integral to the overall organizational strategy.

"In hindsight, 2010 proved to be the year organizations ramped up their approach to meet the first stage of the [Meaningful Use] criteria," reads the report, "Essentials of the U.S. Hospital IT Market, 6th Edition," a publication of HIMSS Analytics. In its survey of hospitals and integrated delivery networks nationwide, the research arm of the Healthcare Information and Management Systems Society (HIMSS) found that spending on revenue cycle management (RCM), enterprise data warehousing, and associated areas such as business intelligence will continue growing for at least the next five years.



AMA and 91 groups call on CMS to alter e-prescribing penalties

July 26, 2011 | Molly Merrill, Contributing Editor

The American Medical Association and 91 state and specialty medical societies have submitted formal comments to the Centers for Medicare & Medicaid Services (CMS) expressing concern over the proposed changes to the electronic prescribing penalty program.

“The AMA has continually advocated for changes to the e-prescribing program to ensure it’s fair for all physicians and that as many physicians as possible are able to successfully participate,” said AMA immediate past president Cecil B. Wilson, MD. “While we appreciate the modifications CMS presented in the proposed rule, they don’t go far enough. More changes are needed, including establishing an additional reporting period in 2012 and not applying penalties until 2013.”



Incentives boost hospital IT budgets: HIMSS

By Joseph Conn

Posted: July 27, 2011 - 12:30 pm ET

Hospital budgets for information technology are on the rebound after a hard knock from the recession, according to a new health IT market report from HIMSS Analytics, the market-research arm of the Chicago-based Healthcare Information and Management Systems Society.

The report, the sixth edition of "Essentials of the U.S. Hospital IT Market," is based on HIMSS Analytics database information on 5,200 hospitals and 32,000 medical facilities in the U.S., including 24,000 ambulatory-care sites.



Panel advances standards for clinical quality, hospital discharge meds

July 21, 2011 | Mary Mosquera

The Health IT Standards Committee has been wrestling this summer with identifying standards for electronic prescribing of medications at hospital discharge, vocabulary for clinical quality coordination, and others to support stage 2 of meaningful use.

The challenge is to come up with technical approaches that are simple yet specific enough for healthcare providers to adopt and vendors to incorporate as part of certification of their electronic health records (EHRs), according to standards committee members at its meeting July 20.

Standards provide the common technical methods that can be installed in EHRs to support functions that improve care and help physicians and hospitals meet meaningful use.



  • JULY 28, 2011, 4:45 P.M. ET

Cerner 2Q Profit Leaps 30% As Bookings, Backlog Climb


Cerner Corp.'s (CERN) second-quarter profit jumped 30% on a double-digit pop on its top line and a surge in bookings.

The health care information-technology company again lifted its current-year forecast, calling for $1.80 to $1.83 a share on $2.09 billion to $2.12 billion in revenue. For the current quarter, Cerner sees earnings of 46 cents to 48 cents on $520 million to $540 million in revenue, bracketing the 47 cents and $528 million expected by analysts polled by Thomson Reuters.



Use of PHRs remains weak

July 26, 2011 | Jeff Rowe, Editor, HITECH Watch

While the HITECH incentives are intended to move the country toward comprehensive use of EHRs, many HIT proponents have been banking on patient demand for access to their records as the real key to pushing providers forward.

The problem, however, is that if the use of Personal Health Records (PHRs) is taken as a good indication of growing patient interest, that demand is still barely registering.

This observer points to a recent report from CSC that claims "despite the renewed buzz and some well-publicized initiatives, the reality is that we are still no closer to a true personal health record than we were five or 10 years ago.”



Top 5 worst EMR myths

July 26, 2011 | Molly Merrill, Associate Editor

SAN FRANCISCO – Rumors about electronic medical records continue to persist, but one vendor is trying to separate the myths from the facts.

Practice Fusion, a San Francisco-based EMR developer has identified the top five worst EMR myths:

  1. EMRs are bad for “bedside manner." Does a computer ruin the interaction between patients and doctors? The opposite is true, according to a 2010 Government Accountability Office report. The study found that EMRs help doctors have more information about the patient and contribute to better communication. A good EMR allows a doctor to spend more time with a patient and less with paperwork. Plus, patients can get real-time access to their own health records online through the doctor's EMR system.



Web startups aim to give consumers more control over their health

Mobile, social technology employed, bringing digital know-how to bear on age-old problems

By Peter Delevett, McClatchy/Tribune news

July 26, 2011

SAN JOSE, Calif.

— When new mom Leah Dillon needed advice for her son's first fever, she wondered where to turn. Recently arrived in Palo Alto, Calif., 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 Silicon Valley startup. 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."

The birth of a child also set Robert Auguste looking for technological help, but for spending, not symptoms.



Educated providers will be the public's best teachers

July 29, 2011 | Jeff Rowe, Editor, HITECH Watch

A recent survey from Xerox Corp. shows the general public is still very much in the dark when it comes to EHRs.

But while one obvious and necessary response to the findings would be to ramp up public education efforts, policymakers should remember that providers, who are the main point of contact between patients and their records, still need to be educated, too.

Not surprisingly, the survey found that there’s still considerable anxiety among the public about the use of EHRs, with “nearly 80 percent . . . indicat(ing) stolen personal information by a computer hacker to be their number one worry, followed by the threat of lost, damaged or corrupted records at 64 percent and the misuse of information at 62 percent.”



MGMA to HHS: Pull the Disclosures Rule

Joseph Goedert

HDM Breaking News, July 27, 2011

Following a survey of about 1,340 members, the Medical Group Management Association is calling on the HHS Office for Civil Rights to withdraw its proposed rule governing the accounting of disclosures of protected health information.

The association contends the rule is overly burdensome and unworkable, and asks that HHS engage group practices and other stakeholders to develop a consensus-driven solution. "If enacted as proposed, the rule would require medical practices that maintain electronic patient information to have the capability to product a detailed report of every instance a patient's information was accessed by any staff member for any reason, including submitting claims for payment," according to an MGMA statement.



MPs blast government IT failures

28 July 2011 Lyn Whitfield

The Commons’ public administration committee has concluded that the government’s lack of IT skills and over-reliance on an “oligopoly” of large contractors is a “recipe for rip-offs.”

In a report that echoes the findings of successive spending watchdog investigations into government IT, the committee says that the “overall record of developing and implementing new IT systems is appalling” despite an “obscene” amount of public spending.

Although it did not take evidence from the Department of Health, the committee’s verdict that “IT procurement has too often resulted in late, over budget IT systems that are not fit for purpose” sounds very like the latest National Audit Office verdict on the National Programme for IT in the NHS.



Survey analysis: Telemedicine crucial part of health IT

July 25, 2011 | Jamie Thompson, Web Editor

Telemedicine solutions are widespread and varied – but how much of a presence do they have in hospitals’ health IT systems? Healthcare IT News recently surveyed its readers about the role of telemedicine at their organizations.

An overwhelming 79 percent of respondents said that telemedicine is an important part of their health IT infrastructure.



E-health records still scare most of us

Healthcare industry needs to put more time into consumer education, survey shows

By Lucas Mearian, Computerworld

July 26, 2011, 3:24 PMNearly 80% of consumers surveyed earlier this year said they're concerned about electronic health records (EHRs) because their personal information might be stolen by hackers or lost.

The online survey, conducted by Harris Interactive for Xerox Corp. in February and released last week, included 2,720 U.S. adults, the majority of whom felt that their personal information could be misused if kept in an EHR.



Six more systems join Wales' ETP project

27 July 2011 Fiona Barr

Six community pharmacy systems have been given roll-out approval for Wales’ electronic transfer of prescriptions project, which is due to be fully rolled-out by the end of the year.

Cegedim’s Pharmacy Manager system was the first to receive roll-out approval in April.

Last month, Cegedim’s Nexphase software, Rx Systems’ ProScript software and software from Positive Systems and AAH received their authority to deploy the 2DRx service.

The 2DRx functionality enables pharmacists to scan 2D barcoded prescriptions, and should be fully rolled-out by the end of the year, according to the NHS Wales Informatics Service.



ICD-10 Is Gonna Cost Me How Much?

Gienna Shaw, for HealthLeaders Media , July 26, 2011

Last February I asked every CIO I could corner at the annual Healthcare Information and Management Systems Society meeting what his or her organization was doing to prepare for ICD-10.

I got a lot of blank stares.

Sure, the deadline for the massive coding switch-over isn't until in October 2013. But I got the sense that even if folks weren't quite ready to brag about their progress preparing for ICD-10, they were at least starting to think about it with greater urgency.



CCHIT: Don't buy a new EHR just yet

July 25, 2011 | Diana Manos, Healthcare IT News

Healthcare systems running on legacy software, customized commercial products or homegrown EHR systems that would cost hundreds of millions to replace can breath a sigh of relief, according to CCHIT.

That's because the Certification Commission for Health Information Technology claims that some healthcare organizations, particularly teaching hospitals, have discovered that certifying their own system through a special CCHIT program is the best alternative.

CCHIT announced last week that five new organizations joined Beth Israel Deaconess Medical Center in certifying complete or modular EHRs under its EHR Alternative Certification for Healthcare Providers, or EACH, an ONC-ATCB 2011/2012 certification program for already-installed EHR technology. They are: Health Management Associates, New York University Langone Medical Center, Northwestern University, Tenet Healthsystem Medical and the University of North Carolina Health Care.



FDA on verge of regulating medical apps

19 July 2011 Shanna Crispin

The American Food and Drug Administration has released guidelines on how it plans to regulate mobile medical apps.

The draft guidance outlines the small number of mobile apps the agency plans to oversee; saying they are “medical apps that could present a risk to patients if the apps don’t work as intended.”

It proposes that manufacturers should classify their applications, annually register with the FDA, and list the apps being produced.



Survey finds trepidation, uncertainty about EHRs

July 22, 2011 | Mike Miliard, Managing Edito

ROCHESTER, NY – A new survey from Xerox Corporation shows that more needs to be done to convince patients that their personal health information is secure in electronic health records.

Of the poll's 2,720 respondents, nearly 80 percent of those who have concerns about digital medical records indicated stolen personal information to be their chief concern, followed by the threat of lost, damaged or corrupted records (64 percent) and the misuse of information (62 percent).

“The survey results indicate an urgent need for better patient-provider communication,” said Paul Solverson, partner, strategic advisory services at ACS, a Xerox Company. “Providers need to start conveying the benefits of electronic records, particularly the security advantages over today’s paper-based system.”



CMS partners to move beyond 'pay and chase' anti-fraud efforts

July 21, 2011 | Mike Miliard, Contributing Editor

The Centers for Medicare and Medicaid Services revealed intentions to tap predictive modeling to root out Medicare fraud last month, and now has announced the technology and vendors that will make that happen.

Verizon, alongside Northrop Grumman and WellPoint subsidiary National Government Services, has helped develop a technology for the Centers for Medicare & Medicaid Services that improves detection and prevention of fraud and waste.

The new platform incorporates predictive modeling technology from Verizon to transform the way Medicare fraud is detected, and officials say it will provide CMS with a scalable and automated solution that scrutinizes incoming Medicare program claims, routing those that may be fraudulent to case managers for investigation.


How Health IT-Related Errors Hurt Patient Safety

New analysis explains how the occasional glitches with EHRs and related systems can get out of hand.

By Ken Terry, InformationWeek

July 26, 2011

URL: http://www.informationweek.com/news/healthcare/patient/231002617

As an Institute of Medicine (IOM) committee considers how medical errors related to health IT affect patient safety, a new analysis published in the Archives of Internal Medicine defines these errors, breaks down their "sociotechnical" sources, and suggests some fixes.

"These errors, or the decisions that result from them, significantly increase the risks of adverse events and patient harm," write Dean Sittig and Hardeep Singh in the Archives article. The reason, they explain, is that "there are often latent errors that occur at the 'blunt end' of the health care system, potentially affecting large numbers of patients if not corrected."

In an interview with InformationWeek Healthcare, Sittig, a professor at the University of Texas Health Sciences Center in Houston, explained that problems in a health information system are usually caught fairly soon. But, because they may affect an entire hospital or a multi-hospital system, they can cause a lot of harm in a short time, he said.



Public HIE proving unsustainable without federal funds

July 19, 2011 — 3:31pm ET | By Ken Terry

On the heels of our story last week about a lack of sustainable health information exchanges comes word that a Tennessee regional health information organization may have to close its doors due to (gasp!) a sub par business model.

CareSpark, the Kingsport, Tenn.-based RHIO, could shut down, primarily due to an inability to function on its own. After six years, the system--which holds records for 1.28 million patients--failed to come up with a viable plan to stay afloat, causing the Health Information Partnership of Tennessee (HIP TN) to pull federal funding this past March, reports Healthcare IT News. The tale is a cautionary one for publicly funded HIEs, which have been under much scrutiny of late, especially compared to their private brethren.



By Joseph Conn

Mercury falling

The state of hyperfluidity in the deficit-reduction/debt-ceiling discussions in Washington last week could be likened to pouring mercury down a bobsled run—lots of high speed twists and turns, frequent scatterings and gatherings, and who knows what will wind up at the end.

On July 13, when Dave Roberts, vice president of government relations for the Healthcare Information and Management Systems Society, made his annual "Report from the Hill" presentation at the Physician-Commuter Connection symposium in Ojai, Calif., hosted by the Association of Medical Directors of Information Systems, he expressed confidence that the tens of billions of dollars authorized for the federal health information technology incentive payment programs were not really in play with the D.C. deficit hawks.



Halamka to leave Harvard Medical CIO post

By Joseph Conn

Posted: July 22, 2011 - 5:00 pm ET

Even for the peripatetic, prolific and almost always wakeful and black-clad Dr. John Halamka, there are limits to what one person can do.

Halamka, an emergency-medicine specialist who serves as chief information officer at both Harvard Medical School and Beth Israel Deaconess Medical Center, as well as a member of several federal health information technology advisory panels, has announced he will step down from the Harvard CIO post when a successor can be found.



Thursday, July 21, 2011

Preparing for the Future of IT at HMS

Every day I examine my life and think about the roles I serve. I consider all the unresolved issues in my professional and personal life, then ponder the processes needed to address them.

I think about the next week, the next month, and the next year. Hopefully, I'll be able to skate where the puck will be.

As I approach 50, I've become particularly introspective about the challenges in healthcare and medicine that lay ahead.

I believe that Accountable Care Organizations, Patient Centered Medical Homes, and the Partnership for Patients/CMS Center for Innovation will create exponential growth in healthcare IT requirements.



Monday, July 25, 2011

Google Health's Demise Shows Limitations of PHR Market

Since the early 2000s, personal health records have been touted as a way to improve care coordination and empower patients. Despite the buzz around PHRs, adoption rates have remained relatively low. A 2010 survey from the California HealthCare Foundation found that only 7% of U.S. residents are using a PHR. CHCF publishes iHealthBeat.

Google's announcement last month that it will discontinue its PHR platform, Google Health, on Jan. 1, 2012, has put a new spotlight on the PHR market. In a blog post explaining its decision, the company said that Google Health -- which it launched in 2008 -- "is not having the broad impact that we hoped it would."

The departure by such a major company from the PHR market has raised some concerns about the future of similar PHR platforms. However, experts in the field say that the demise of Google Health will not have much of an effect on the market.



Home health devices, mobile apps need to be connected to providers

July 24, 2011 — 9:27pm ET | By Ken Terry

Home healthcare, an essential ingredient of post-acute care, can help people recover from injury or illness faster, which ultimately can prevent relapses that leads to an emergency room visit or hospital readmissions. Increasingly, home devices are being used to monitor the health status and vital signs of patients; at the same time, there also has been an explosion of mobile apps that can work with such devices, smartphones, and/or tablets to aid consumers in managing their own health. Both of these developments hold promise for improving post-acute and chronic care.

Unfortunately, the guidance from the U.S. Food and Drug Administration on mobile apps and the report from the National Research Council on flaws in home health devices--both released last week--failed to address one of the main problems in health IT for home use: a general lack of connectedness between home and provider information systems. To really apply the new technologies in ways that will prevent readmissions, doctors must be online with their patients and their caregivers, and must receive relevant data from both in a way that's easy to use.



Women, Whites Most Likely to Seek Health Info Online: Survey

Education, job, income and insurance status also played role in Internet use for this purpose

THURSDAY, July 21 (HealthDay News) -- A new U.S. survey finds that women are more likely than men to use the Internet for medical information, and whites are more likely to do so than minorities.

According to the findings released Thursday by the U.S. National Center for Health Statistics, whites aged 18 to 64 were almost twice as likely as Hispanics to search for health information online.




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