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, August 20, 2011

Weekly Overseas Health IT Links - 20 August, 2011.

Here are a few I have come across last 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.



Diabetes: Computer security experts uncover vulnerability in insulin pumps

August 4, 2011 by MassDevice staff

Security experts uncover flaws in insulin pumps and other medical devices that could allow attackers to alter their functions and harm a patient.

MASSDEVICE ON CALL — Insulin pumps and other wireless medical devices may be vulnerable to software attacks, security experts noted at a computer security conference in Las Vegas today.

Security expert Jay Radcliffe, who is himself a diabetic, found that his insulin pump could be altered to respond to remote control operation that modified insulin flow.



UPMC, Nuance aim to take speech recognition to new level

August 10, 2011 | Bernie Monegain, Editor

PITTSBURGH – UPMC and Burlington, Mass.-based Nuance Communications have signed a 10-year agreement on a multi-million-dollar project to develop what they’ve dubbed Medical Intelligence solutions. The idea is to transform the way patient information is captured, understood and used by caregivers.

Under the agreement, the two organizations will develop speech and clinical language understanding (CLU)-enabled technologies. As the partners see it, Medical Intelligence solutions will transform clinical data into actionable information that can be used to drive smarter clinical, business and compliance decisions. Most medical data today is captured as unstructured free text and cannot be easily analyzed.



ONC plans consumer health IT campaign

August 10, 2011 | Mary Mosquera

WASHINGTON – The Office of the National Coordinator for Health IT will widen its efforts in mid-September to bring consumers into its orbit of tools and outreach with a campaign to get the public more involved in their health and health care.

ONC will develop activities to explain the value of health IT tools, such as electronic health records (EHRs), personal health records (PHRs) and mobile phone applications.

ONC plans to include a variety of organizations that touch consumers to participate in the effort and to seek their ideas for how to involve patients, according to Lygeia Ricciardi, ONC’s senior policy advisor for consumer e-health, at an Aug. 9 meeting of the Consumer Consortium on eHealth.



CSC ‘on target for new MoU’

11 August 2011 Jon Hoeksma

CSC says that it remains “on target” for signing a re-negotiated NHS IT contract, and will meet with the government in September.

On an earnings call about its first quarter results today, the company remained tight-lipped on its long-running negotiation for a new local service provider deal for the North, Midlands and East of England.

However, it said it was due to meet with the government next month and remained on track for signing a new memorandum of understanding.



Online patient records enhancing care for 2 million Ontarians

eHealth Ontario invests $5M in ClinicalConnect

Waterloo - More people across the Hamilton Niagara Haldimand Brant and Waterloo Wellington Local Health Integration Networks now have access to better quality and more efficient health care.

Thanks to a five million dollar investment from eHealth Ontario, ClinicalConnect is expanding to better serve more patients in the WW and HNHB LHINs. Now, more than 2,500 health care providers, such as doctors, nurses and pharmacists in both LHINs can exchange secure patient information much faster.



UK offers US chance to learn from failure

August 09, 2011 | Jeff Rowe, HITECH Watch

So far, it seems reasonable to believe that HITECH is working, but where could things go wrong?

Policymakers interested in pondering that question might want to look across the pond to a new report from Britain’s parliament that has apparently lead officials to pull the plug on a mult-year effort to create a nationwide health information network.

There is, of course, no shortage of differences between the two countries, but it’s hard to believe there aren’t enough similarities that US policymakers wouldn’t learn a thing or two. At the very least, policymakers might use the report’s criticisms to see if similar problems are occurring in this country’s HIT transition.



Overworked IT employees not likely to see EHRs as 'Meaningful' without some perks

August 11, 2011 — 2:29pm ET | By Dan Bowman

Hospitals and practices are pushing hard to meet the government's goals for technology use in healthcare--and so are their exhausted IT teams, as the results of two recent surveys seem to indicate.

The first survey, of 139 healthcare CIOs conducted by healthsystemCIO.com, found that more than 65 percent of those polled were "under excessive strain" because of Meaningful Use-related efforts. Nearly 54 percent of CIOs said they've been unable to fill open positions for at least three months.

The other poll, which we report on in this issue, found that EHR adoption is on the rise among physician practices throughout the U.S. Since October 2010, physician usage of EHR software at all facilities, both large and small, has increased nearly 2 percent, according to data from healthcare marketing solutions firm SK&A, which surveyed more than 237,000 physician sites.



Thursday, August 11, 2011

New Trend in Sustainable HIEs: Fair Share Financial Support

CMS recently solidified a new trend in electronic health information exchange sustainability: requiring all stakeholders who stand to benefit from electronic HIE to share in a portion of its costs. It seems like common sense, but a scan of HIE initiatives reveals that HIE traditionally has been funded by a precious few -- usually hospitals, philanthropies and the government. This traditional funding model is unsustainable, and, CMS suggests, unfair.

Because CMS is poised to provide substantial Medicaid funding to support the development of HIE networks in states throughout the country, its ground rules are likely to be an important driver of HIE sustainability strategies in the near future.



NHS Scotland to sign with Imprivata

1 August 2011 Fiona Barr

NHS Scotland has bought a single sign-on solution from Imprivata to be deployed across the entire health service north of the border.

Imprivata’s OneSign solution is being delivered in a partnership with IT provider Northgate Managed Services after a successful pilot project. It will be deployed on a board by board basis.

The system has been almost fully rolled-out in NHS Fife. This development led the procurement on behalf of NHS Scotland.



DH quits predictive risk modelling

10 August 2011 Fiona Barr

The Department of Health is to stop funding its two risk prediction tools – Patients at Risk of Re-hospitalisation and the Combined Predictive Model.

Stephen Johnson, head of long term conditions at the DH, has told primary care trusts that the DH will not commission a national upgrade of either the PARR++ tool or CPM.

In a letter to PCT chief executives, Johnson said both tools were in need of an “urgent refresh”, but that it would be up to local NHS organisations to either fund an upgrade themselves or move to an alternative model. Until now the tools have been freely available to the NHS.



HIEs Deliver Savings to Rural Hospitals

Alexandra Wilson Pecci, for HealthLeaders Media , August 10, 2011

Although there are definite challenges to forming health information exchanges in rural areas—a lack of broadband access being chief among them—one advantage that rural stakeholders may have over their urban counterparts is a greater willingness to collaborate.

According to a report from the National eHealth Collaborative, "HIEs serving rural markets seem to have a natural advantage over urban HIEs in their ability to attract otherwise competing providers to participate in health information exchange."

The report also finds that rural communities' lack of health IT infrastructure is actually the reason that when rural HIEs do get up and running, they share information efficiently and are more likely to attract members based on the exchanges' real business value.



New KLAS Market Report Covers CPOE

Joseph Goedert

HDM Breaking News, August 9, 2011

The electronic health records meaningful use program has significantly increased adoption of computerized physician order entry systems, with Cerner Corp. and Epic Systems Corp. leading the way, according to a new market report from vendor research firm KLAS Enterprises.

Before MU, an average of 87 hospitals a year went live with CPOE but that average is now 233, according to KLAS. Cerner has more hospitals live on CPOE than any of the 10 other vendors in the study. Both Cerner and Epic have doubled their live CPOE sites since 2009 and both have an average of more than 80% of orders being entered via CPOE at their client sites.



Survey reveals docs' perceptions of EHRs as potential buyers, users

August 08, 2011 | Molly Merrill, Associate Editor

TAMPA, FL – Meaningful use remains the strongest driver to implement electronic health records for physicians, according to a new survey that finds both potential EHR buyers and current users valuing the technology, but with substantially different perceptions and expectations.

Sage Healthcare Division, a developer of electronic health records for medical practices across North America, worked with Forester to conduct a survey among physicians nationwide in an effort to examine perceptions and determine attitudes toward these systems. The sample included both physicians using EHR and those in the market for the technology.


California Clinic System Embraces Online Consultations

The nation's largest public health plan seeks to streamline patient referrals and reduce wait times for specialists.

By Neil Versel, InformationWeek

August 08, 2011

URL: http://www.informationweek.com/news/healthcare/interoperability/231300424

A major safety-net insurer in Los Angeles is adopting secure online communications to streamline referrals from primary care physicians to medical specialists, in hopes of preventing unnecessary visits and reducing wait times for those truly in need of specialty care.

L.A. Care Health Plan, which, with 900,000 mostly low-income enrollees in Los Angeles County, considers itself the largest public health plan in the country, is spending $1.5 million to implement eConsult, an physician-to-physician consultation and referral network, at 47 safety-net healthcare facilities.

That represents nearly a quarter of all safety-net clinics in the nation's most populous county, and officials eventually hope to expand it.



The 5 steps for improving patient care

August 08, 2011 | Mary Mosquera

Patient care that is coordinated and effective demands a series of steps that start with putting the technical tools and practice procedures to work to enable the components of meaningful use and other milestones that will improve health care, according to Dr. John Blair, president of Taconic IPA, a large physician group in New York’s Hudson Valley.

Blair spoke with Government Health IT recently about which steps come first and what works. Blair also is part of the leadership team of the Hudson Valley Initiative, which deploys electronic health records (EHRs), health information exchange and patient centered medical home among a number of provider participants to transform the healthcare system in New York and eventually nationwide. Blair is also CEO of MedAllies, a health information service provider (HISP).



Q&A: HIT's Critical Role in Rural Hospital of the Future

Gienna Shaw, for HealthLeaders Media , August 9, 2011

In last week's column, I wrote about how small hospitals can prepare for future technology demands . This week I thought I'd share some comments about the future of rural organizations and health information technology from Tim Size, executive director of the Rural Wisconsin Health Cooperative (RWHC) in Sauk City, Wisconsin. RWHC has been pursuing its mission, to help keep quality care available, cost-effective, and accessible in rural communities through an array of shared services and advocacy agendas driven by a cooperative model, for 30 years. It has 35 member hospitals.

I interviewed Size for the HealthLeaders magazine cover story, The Hospital of the Future. As often happens with a source who's passionate about a particular topic, much of our long conversation didn't make it into the story. Here's some of what ended up on the cutting room floor:



Health features in govt data plans

8 August 2011 Fiona Barr

Wider online access to medical records is highlighted as one of the key elements of the government’s plans for greater data transparency in a newly-launched consultation on open data.

The consultation seeks views on how the government could set up an enhanced ‘right to data’, ensure the collection and publication of the most useful data, hold public sector providers to account for their data, and set standards to enforce the right to data.

The consultation says open data could transform the way government and society work for the better.

On health, it says the government’s policy on transparency and open data are about helping people to find the right doctor and get access to their medical records “so that they can manage their health better and make more informed decisions with their clinician.”



GP Extraction Service is go

9 August 2011 Fiona Barr

The General Practice Extraction Service is to launch next year after its apppintment business case was finally approved by the Department of Health.

The NHS Information Centre said approval from the DH for the primary care data extraction and analysis tool brought to an end “a long period of external review” and meant the service could move towards full implementation.

GPES will extract data from all NHS GP practices in England and provide the information for all nationally sponsored initiatives that require GP data.

It will provide access to practice level information on a national basis for the first time.



Evaluation of RxNorm in Ambulatory Electronic Prescribing

Drug prescriptions need to accurately identify the medications that prescribers intend for pharmacists to dispense. However, the set of computer-interpretable identifiers currently used in electronic prescribing (e-prescribing) does not support the specific needs of the prescribers and pharmacists who conduct e-prescribing transactions.

RxNorm, a drug nomenclature from the National Library of Medicine, assigns a rigorously derived, centrally maintained, and publicly available unique identifier to each clinically distinct drug. It therefore has the potential to greatly improve drug identification in e-prescribing transactions.


EHRs Give Docs Analytics Tools They May Ignore

Clinicians with access to electronic health records find it easier to construct the registries needed to pinpoint at-risk patents, but one expert questions whether they'll use these powerful tools.

By Ken Terry, InformationWeek

August 05, 2011

URL: http://www.informationweek.com/news/healthcare/EMR/231300320

When physicians have electronic health records, it's easier for them to create registries--lists of patients who need particular preventive and chronic care services--according to a new study. And in fact, research suggests these registries may improve quality of care. It's unclear, however, whether most docs will take advantage of these clinical analytics tools.

The study in the July issue of Health Affairs looked at the results of surveys given to 163 doctors in three Massachusetts communities. These physicians were among those who received free EHRs and access to health information exchanges in a $50 million pilot program funded by Blue Cross Blue Shield of Massachusetts. The Massachusetts eHealth Collaborative, which administered the pilot from 2006-2008, also provided the practices with technical assistance, which of course is not the case for most community physicians who adopt EHRs.



Opinion: Leverage HIT to Improve Care Management

By Jane Metzger and David Classen, for HealthLeaders Media , August 5, 2011

The ever-increasing number of publicly reported measures of some aspect of quality or patient safety is one of the most concrete signs of the rising expectations of the public, employers, and payers. These provide a large set of targets for improving care, and much of the same patient information is required to measure performance as to deliver safe, high-quality care consistently.

Luckily, the pace of progress on the electronic health record—long envisioned by the Institute of Medicine and others as key infrastructure for provider organizations in the journey toward safer, higher quality care—has picked up considerably thanks to the HITECH incentive program. More and more patient data is being captured electronically and providers are reaching the stage that electronic support can become part of the toolset for clinicians at the point of care.

But putting the EHR to work to improve clinical performance at the bedside requires breaking down some of the traditional silos in our approaches to using HIT in the hospital.



Still at ground level

Security concerns hinder move into cloud services

By Joseph Conn

Posted: August 8, 2011 - 12:01 am ET

Two years ago this month, Modern Healthcare first reported on the status of cloud computing in the healthcare information technology industry, noting there was little awareness of its potential and limited uptake of cloud services in the healthcare IT industry at that time.

Today, cloud's market share has grown, but only by a smidgen. What has increased much more is the wary acceptance that remote software applications, computing power and data storage systems “in the cloud” are likely to play a larger role in the healthcare industry in the future, according to industry IT experts contacted for this story.

While the novelty of cloud computing is no longer an issue, some IT professionals remain uncomfortable with data security in cloud-based systems, and their insecurity, real and imagined, remains a key barrier to further adoption, the experts say.



Healthcare creating IT jobs faster than other industries

August 4, 2011 — 12:04pm ET | By Ken Terry

Partially due to an infusion of federal funds, the healthcare industry is creating IT jobs faster than other industries, according to a new Bureau of Labor Statistics report. The number of IT positions in healthcare is expected to grow 20 percent annually through 2018, the report says.

Since 2009, the number of health IT jobs has increased 67 percent, according to an article in Computerworld. Online employment agency SimplyHired.com, lists 7,200 open positions in the field, the article points out.

Most in demand are CIOs and CTOs, but jobs in health IT administration also are growing rapidly, SimplyHired.com's database reveals. Since 2009, database administrator positions have grown 94 percent, and other administrative jobs in networking, systems and storage have also seen strong growth. In addition, the healthcare industry needs thousands of software developers and system analysts.



Ovum expects health tech growth

29 July 2011 Shanna Crispin

Investment in mobile health technology is expected to boom as the overall spend on healthcare IT in the UK hits £1.8 billion this year.

Independent technology analyst Ovum has predicted that overall investment will top £3 billion in 2016 – a cumulated annual growth rate of 13% since 2010.

Telehealth and interoperability - termed health information exchange in the report - are expected to see the strongest growth.

However, Ovum’s healthcare technology analyst Cornelia Wels-Maug, said electronic health records and picture archiving and communications systems would continue to be important, while new investment in mobile apps that allow patients to monitor their own condition come to the fore.



Health Care Is Becoming the Fastest-Growing Vertical in IT: In-Stat

By: Brian T. Horowitz


With cloud computing being adopted by hospitals at a fast pace and wireless spending growing, health care IT will experience the fastest growth among U.S. vertical industries, according to a report by In-Stat.

Health care is becoming the fastest-growing vertical for U.S. businesses, with (IAAS) (infrastructure as a service) leading the way, according to a new report by research firm In-Stat. IT spending in health care will grow 29 percent from 2010 to 2015, the company reports.

"The health care vertical segment, across all sizes of business, and across nearly all product groups, is fast becoming the most robust business vertical segment in U.S. business markets," Greg Potter, an In-Stat analyst, said in a statement. "Demand for cloud computing services in particular has exploded, and we see nothing that would indicate that the trend won't continue at least through 2015."



Evidence-Based Staffing Enhances Patient-Centered Care

Rebecca Hendren, for HealthLeaders Media , August 2, 2011

Patient-centered care is a healthcare buzzword, but what does it really mean? A bedside nurse would say that all her care is patient centered. It's the paperwork and bureaucracy that draws the nurse's focus from patients. All nurses want is time and appropriate staffing levels to focus on patients and their needs.

Patient acuity systems give hospitals flexibility to maximize staffing effectiveness. The systems demonstrate how hospitals can provide adequate staffing based on actual patient needs, rather than restrictive ratios.

Edwin Loftin, RN, MBA, FACHE, is the vice president of nursing at Parrish Medical Center in Titusville, FL. The hospital takes patient-centered care seriously. In the 1990s, when PMC realized it was time to build a brand new hospital, it was one of the early adopters of designing a healing environment. It designed a new space that used spirit-lifting architecture and decor, natural light, and intelligent patient-centered design to aid patient healing.



CMS unveils quality compare finder portal

August 05, 2011 | Mary Mosquera

The Centers for Medicare and Medicaid Services has launched a single online location for consumers to find quality information about hospitals, nursing homes and physician offices so they can make informed choices about their health care.

CMS unveiled a quality “compare” finder portal so consumers can easily link to and evaluate the quality of care and services of providers in various health service sectors and get their contact information.

The agency also updated its Hospital Compare website to include how well hospitals protect outpatients from surgical infections and whether hospitals use proven therapies that reduce the risk of death on outpatients treated for suspected heart attacks.



HHS Plans to Issue Rule on EHR Metadata Standards

Joseph Goedert

HDM Breaking News, August 5, 2011

The Department of Health and Human Services expects soon to issue an "advance notice of proposed rulemaking," on adoption of metadata standards to support the electronic exchange of health information.

The notice is a first step toward implementing certain recommendations from the President's Council of Advisors on Science and Technology, particularly focused on including some degree of metadata in Stages 2 and 3 of electronic health records meaningful use criteria.



Doctors disappointed in e-Health system

08.08.2011, 12:00

Estonian doctors say they are deeply unhappy with the digilugu or electronic medical record system, saying that entering data for a single patient takes at least fifty mouse clicks, requires opening multiple windows and takes ages to upload documents., writes Postimees.

According to doctors, the problem is that there are several various documents such as diagnosis, test results, etc. that they need to open and in some cases there are tens or even hundreds of such documents per patient.




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