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 27, 2011

Weekly Overseas Health IT Links - 27 August, 2011.

Here are a few I have come across last week.

Note: Each link is followed by a title and few paragraphs. 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.



Single vocab standard for each EHR reporting domain seen as 'momentous'

August 18, 2011 | Mary Mosquera

The Health IT Standards Committee has endorsed a single set of vocabulary standards and a single guide for putting them in place for each area of quality reporting measures, an accomplishment that some individuals and groups have been working on for 10 years. The domains include medications, labs and allergies.

The committee will recommend to the Office of the National Coordinator for Health IT to incorporate the vocabulary standards and implementation guides in certification criteria for electronic health records (EHRs) for stage 2 of meaningful use.

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.


Cloud Storage A Good Match For Healthcare

Cloud storage can provide transparent access to near limitless volumes of patient data. But doctors also need fast data retrieval.

By George Crump, InformationWeek

August 19, 2011

URL: http://www.informationweek.com/news/storage/231500358

Cloud storage has a role to play in many organizations. It can be used as part of the backup and archive processes and in some cases even used for primary storage. There are specific enterprise vertical markets however where cloud storage can be especially beneficial. The markets share a common need to be able to not only retain information but also retrieve that information.

A good example of this is the healthcare industry, potentially the most regulated industry in the world. This is also an industry that has seen a massive conversion to digital records. It is now commonplace to see doctors walking into patient rooms with iPads that provide them with complete access to a patient's history at their finger tips. They can see more patients per day while providing better care than ever.



Privacy advocates want stricter rules for online, patient-controlled health records

For 15 years, the Health Insurance Portability and Accountability Act (HIPAA) has given patients a variety of privacy protections for personal health information obtained by medical providers. Unbeknownst to many, though, the same protections do not apply to records controlled by consumers. Privacy advocates say it’s time that stricter standards apply to those records — but efforts to do just that have gone nowhere in Washington, and Congressionally mandated recommendations on how to make it happen are already 18 months late.

The regulatory void amplifies the dangers that exist when people post their health information online — to social networking sites, discussion boards, mobile technologies and personal health record-keeping systems, privacy experts say.

HIPAA, the law that outlines how doctors, hospitals and insurance companies are supposed to handle patient health information, dates to 1996, but was amended most recently in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act portion of the president’s economic stimulus legislation. HITECH set aside $27 billion to encourage doctors and hospitals to convert paper records to digital form, and Congress amended HIPAA to provide additional protections, since so much more data was likely to be exchanged electronically.



VA, Defense developing patient data-sharing system

By Kathleen Miller, Published: August 15

Electronic health record vendors Epic Systems and Cerner may face competition from a joint patient information-sharing network being developed by the Defense and Veterans Affairs departments, analysts said.

Prompted by President Obama’s push for medical facilities to adopt electronic records, hospitals may pay companies to modify the open-source code likely to power the government-developed system, rather than buying commercial systems, said Ed Meagher, former Veterans Affairs deputy chief information officer.

Veterans Affairs plans to modernize its records system using open-source software, making it likely that the VA-Defense system also will use it, said Meagher, now vice president of health-care strategy for Computer Sciences Corp. in Falls Church. Open-source software is publicly available and can be shared with other organizations at no charge.



HIT outreach should be "news you can use"

August 18, 2011 | Jeff Rowe, HITECH Watch

It’s pretty much a given in HIT policy circles that the public needs to know more about the potential benefits of health IT.

But as policymakers and proponents make increasing use of a variety of media to explain the HIT transition, it seems safe to say, as we noted just recently, that the public would best be served by information that is at once specific and useful.

For an example of something that doesn’t quite fit into this category, here’s a recent piece by Peter Orszag, former director of the Office of Management and Budget in the Obama administration.



HIMSS: Top 9 trends to watch in health IT

August 18, 2011 | Jamie Thompson, Web Editor

Revenue cycle management, HIEs and Massachusetts are among the healthcare topics that every organization should have in mind for 2011 and beyond, according to HIMSS Analytics.

Included in the recent HIMSS Analytics report, "Essentials of the U.S. Hospital IT Market - 6th Edition," is an outline of the top health IT issues that will have a significant impact on the industry in the next few years, including:

1. Competitive Environments. Healthcare organizations will face pressure to meet funded and unfunded mandates before their competitors. Local and regional competitors should be watched for aggressive acquisitions, and new entrants or global competitors may enter the scene.



Geisinger researchers create new PTSD tool

August 16, 2011 | Bernie Monegain, Editor

DANVILLE, PA – Geisinger Health System researchers have developed a new post-traumatic stress disorder (PTSD) prediction tool they say is simple to administer and appears to outperform other screening methods.

Geisinger is widely recognized for its innovative use of electronic health records and the development and implementation of innovative care models, such as an advanced medical home. The researchers published their PTSD findings online in the August issue of the journal General Hospital Psychiatry.

After collecting information from more than 2,300 adults following the Sept. 11, 2001, terrorist attacks, Joseph Boscarino, senior investigator II, Geisinger Health System, and his co-investigators, including Charles Figley of Tulane University, examined the clinical factors that could predict PTSD. These included stressor exposures, psychosocial resources, functional status, depression symptoms, suicidal thoughts, PTSD symptoms and demographics. This was done to identify the best PTSD prediction models.



ONC: Metadata Pilots Start This Fall

Joseph Goedert

HDM Breaking News, August 18, 2011

The Office of the National Coordinator for Health Information Technology this fall will launch two pilot projects covering the use of metadata to support the electronic exchange of health information.

The pilots follow ONC's publication of an advance notice of rulemaking on August 9 to lay out its initial thoughts and seek public comment prior to development of a proposed rule. 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.



SNOMED CT becomes NHS standard

17 August 2011 EHI staff

The Information Standards Board for Health and Social Care has officially approved the SNOMED Clinical Terms healthcare terminology as a ‘fundamental standard’.

SNOMED CT is an internationally recognised set of numerical, machine readable codes and human readable descriptions, which can be used to uniquely identify clinical concepts.

Health minister Simon Burns described it as a “common clinical language” and said that adopting it should mean “much clearer and more consistent communication between hospitals and GPs” and “help patients better understand their care records.”



Physician alignment, end-user support vital for EHR success, CMIO says

August 18, 2011 — 3:43pm ET | By Dan Bowman

Physician alignment, end-user support and solid leadership are critical navigation tools on the journey to Meaningful Use, according to Dr. Richard Ferrans, vice president and chief medical information officer at Memorial Hospital at Gulfport in Mississippi.

"You can't get around the support issue," Ferrans said. "You've got to give just a ton of end-user support. It's required for success."

FierceEMR recently chatted with Ferrans about the challenges associated with implementing electronic health records, as well as some of the surprises he's encountered.



Is Your EHR Implementation in Trouble? 10 Things to Check

Written by Bob Herman | August 17, 2011

Electronic health records — they are the wave of the future for all hospitals but a headache for some as well. The Health Information Technology for Economic and Clinical Health Act provides federal incentives to hospitals and physician organizations that are meaningful users of the technology systems, but in the rush to meet the meaningful use stages, providers might be encountering problems during their EHR implementation projects.

So what should providers be evaluating if their EHR projects are hitting snags and speed bumps? Dave Vreeland is a partner at Cumberland Consulting Group, a health IT project management firm that helps healthcare providers with EHR implementation projects. He gives a checklist of 10 things all hospitals should check as they undergo those EHR implementation projects, and he notes that if providers can't answer "yes" to the majority of the following questions, they should be concerned their implementation is in trouble.

1. Is the implementation a top organizational priority or one of many? With so many things grabbing a hospital's attention amidst healthcare reform, including accountable care organizations and health information exchanges, Mr. Vreeland says making EHR implementation the number one priority has to occur in order to avoid problems, especially considering EHRs are the building block for almost any health IT venture.



Researchers Show Gains in Finding Reusable Drugs


In a bit of high-tech recycling, researchers have developed an innovative way to identify already-approved drugs that may work against diseases they weren't designed to combat.

The scientists have also demonstrated how a couple of such repurposed drugs may have benefits in treating two conditions, inflammatory bowel disease and lung cancer.

Researchers at the Stanford University School of Medicine (from left to right) Marina Sirota, Joel Dudley, and Atul Butte, created a computer program that Mr. Butte likens to an online dating service.

The findings, published in two papers Wednesday in Science Translational Medicine, come as drug companies and the National Institutes of Health are putting greater emphasis on so-called drug repositioning as a way of lowering the costs of drug development and getting therapies to patients more quickly.


Hospitals Lag In Computerized Physician Order Entry

More hospitals are adopting CPOE, but the uptick should be higher, a KLAS analyst says.

By Nicole Lewis, InformationWeek

August 16, 2011

URL: http://www.informationweek.com/news/healthcare/CPOE/231500041

A study that has tracked computerized physician order entry (CPOE) adoption since 2003 shows that more hospitals are using the technology.

Before the passage of the American Recovery and Reinvestment Act of 2009, an average of 87 hospitals went live each year with CPOE. Since ARRA, that number has climbed to 233. The increase shows promise, a KLAS analyst said, but CPOE adoption rates should be further along by now.

"Just over 20% of hospitals in the U.S. were live on CPOE as of the end of 2010 and today it's probably between 20% to 25%," Colin Buckley, co-author of the report, told InformationWeek Healthcare. "That means you've got thousands of hospitals out there that aren't live on CPOE and the majority of those need to be. They don't want to be impacted by Meaningful Use penalties."



NaviNet, Aetna Connect Doctors to Health Alerts on iPhone, iPad, Android

Health insurance carrier Aetna will allow doctors in Florida to use NaviNet's mobile platform to send alerts to patients and e-prescriptions to pharmacies.

Health insurer Aetna has launched new mobile tools for the iPhone, iPad and Android using NaviNet's Mobile Connect platform to enable physicians in Florida to receive mobile alerts about a patient's status and e-prescribe medication.

The goal of the collaboration between Aetna and NaviNet is to provide better communication between doctors and patients and allow for easier access to Aetna health benefits.

Florida is the first state in which Aetna is rolling out the NaviNet mobile tools, but the companies will add other states in the future, according to David Kates, NaviNet's senior vice president of product management and clinical strategy.



ELINCS lab order specification completed

By Joseph Conn

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

A key communications specification for laboratory orders between office-based physicians and community health centers and hospital and commercial clinical laboratories has been completed, the Califorinia Healthcare Foundation has announced.

The release closes the loop on the Electronic Health Record-Lab Interoperability and Connectivity Specification, or ELINCS, a project of the foundation that dates back to 2005 to standardize communications out of an electronic cacophony of standards and channels between providers and the labs they routinely use in patient care.

ELINCS Orders, as its name implies, aims to facilitate standardized orders between providers and labs and is the product of about a year of work, according to Glen Moy, the Oakland, Calif.-based senior program officer for the foundation.



10 Mistakes Accountable Care Organizations Still Make

Successful ACOs require new health information exchanges, better EHR functionality, and the ability to measure true outcomes. Two experts say we're not there yet.

By Ken Terry InformationWeek

August 12, 2011 12:40 PM

When the Centers for Medicare and Medicaid Services (CMS) announced its proposed regulations for accountable care organizations (ACOs) last spring, CMS administrator Donald Berwick said "information management--making sure patients and all health care providers have the right information at the point of care--will be a core competency of ACOs."

In a new article about ACOs in the Journal of the American Medical Association, two other health policy experts reaffirm the importance of health IT, including electronic health records (EHRs), in building these organizations. At the same time, they point out that the technology is not yet up to the task.



For Rural EDs, CPOE Funding Must Come With Guidance

Alexandra Wilson Pecci, for HealthLeaders Media , August 17, 2011

Rural EDs tend to lag behind their urban counterparts when it comes to computerized provider order entry, research finds. More financial help must be needed, right? That's probably true, but the cause may run deeper than simply a lack of funds.

Imagine this: I'm going to give you $500,000 to help you build a LEED-certified, environmentally friendly home. Although that offer might sound great, it might also be very overwhelming. What are the requirements? Who are the best environmentally certified contractors in the area? Are some solar panels better than others? What does LEED even mean, exactly? And what happens if this lack of knowledge leads to some poor investments?



OCR Unveils HIPAA Hotspots

Dom Nicastro, for HealthLeaders Media , August 16, 2011

The Office for Civil Rights has revealed the top areas of interest on its HIPAA privacy and security compliance radar.

Adam Greene, former senior health information technology and privacy advisor at OCR and now partner at the law firm Davis Wright Tremaine in Washington, D.C., recently discussed each hot topic with HealthLeaders Media.

Hotspot: Incident detection and response (OCR's top issue)

Greene: I recommend both a top-down and bottom-up approach. From the top, covered entities and business associates should evaluate whether they are reasonably logging system activities and reviewing those logs in a way that is reasonably likely to detect impermissible uses and disclosures.

From the bottom, covered entities and business associates should ensure that all staff who have access to PHI are reasonably trained to be able to spot an impermissible use or disclosure and report it to the appropriate person (since the HITECH Act makes clear that the entire organization is treated as knowing of a breach if anyone, other than the person who committed the impermissible use or disclosure, knows of the breach.



Improving patient care, part 2: The next 5 steps

August 12, 2011 | Mary Mosquera

Providers who have established health IT tools and changed clinical and business operations to accommodate electronic systems are prepared to take the next step toward transformation, often becoming patient-centered medical homes.

The medical home is team-based patient care, not just with physicians who are specialists in other practices but also within a primary care provider’s practice, 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 the stages of transformation and approaches that work.

Blair, 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 providers in New York. Blair is also CEO of MedAllies, a health information service provider (HISP).



Patient health care records ready to go viral

By Misty Williams

The Atlanta Journal-Constitution

4:56 a.m. Tuesday, August 16, 2011

Taking control of your health -- from organizing medical records and lab results following doctor visits to logging efforts for dropping those few extra pounds -- one day might be as easy and intuitive as online banking.

A groundbreaking project in northwest Georgia soon will encourage consumers to play a bigger role in their health care by creating electronic personal health records, uploading medical information and images into one easy-to-access location a button click away.

Earlier this year, the Georgia Cancer Coalition and state Department of Community Health received a $1.7 million federal grant – one of 10 awarded nationwide – to create a patient-focused health information exchange in the Rome area.

While states have developed ways for hospitals, doctors and other providers to electronically share information, the Georgia effort to create a more consumer-focused system could result in a national trend, said Farzad Mostashari, National Coordinator for Health Information Technology.



By Joseph Conn

Patient control of data seen as within reach

The Office of the National Coordinator for Health Information Technology is asking as many questions as it is giving directives in its unusual “advance notice” of proposed rule making (PDF) regarding some of the recommendations for health information exchange issued late last year by a White House advisory panel.

The President's Council of Advisors on Science and Technology, or PCAST, told HHS to come up with a scheme to attach metadata tags to clinical information to facilitate search, research and privacy protection.

Regarding privacy, the ONC rule makers noted that some industry commenters “supported the concept of giving patients granular consent as envisioned in the PCAST report.” What the presidential advisers had in mind was attaching a patient's privacy preferences for individual data elements, say a positive lab result for HIV, or entire encounter records, such as treatment for drug or alcohol dependency. But the ONC also noted there has been industry pushback as well.



Computer modeling helps docs determine need for genetic testing

By Joseph Conn

Posted: August 16, 2011 - 12:30 pm ET

A customized computer model is part of a lower-cost, prescreening method designed to help determine whether individuals have Lynch syndrome, a genetic defect that increases the likelihood an individual will develop colon, uterine, pancreatic and urological cancers, according to researchers at the Intermountain Healthcare Clinical Genetics Institute at LDS Hospital, Salt Lake City.

Lynch syndrome occurs in people who have an inherited genetic mutation of mismatch repair genes, which normally assist in everyday repair of an individual's damaged DNA, according to a news release e-mailed from Intermountain.



Hospitals' slow adoption of CPOE impedes Meaningful Use

August 14, 2011 — 12:07pm ET | By Ken Terry

While many hospitals are expected to attest to Meaningful Use of their electronic health records in 2012, it's doubtful that the majority of facilities will. There are a number of reasons for that, starting with the cost. But, for providers that have the necessary resources, the biggest barrier to Meaningful Use is the requirement that hospitals use computerized physician order entry (CPOE) to order medications for at least 30 percent of patients for whom drugs are prescribed.

Hospitals are accelerating their CPOE efforts in response to the challenge. According to a recent KLAS survey, 21.7 percent of hospitals had CPOE systems in 2010--a big increase from the 15.7 percent that had them in 2009. But that means that nearly four in five hospitals did not yet have CPOE last year. Considering that it can take a few years to implement these systems and get buy-in from physicians, the prospects for most hospitals doing this by the end of 2012 are not bright.



OCR Data Breach Tally Passes a Milestone

Dom Nicastro for HealthLeaders Media , August 12, 2011

Covered entities have reported breaches of unsecured protected health information affecting 500 or more individuals to the Office for Civil Rights (OCR) nearly once every other day since the HIPAA privacy and security enforcer began posting the information 18 months ago.

The list, posted on the OCR breach notification website, hit the 300 mark this week. OCR went live with the site in February 2010, recording breaches that date back to September of 2009.

That's about 13 breaches per month dating back to the fall of 2009.



Congresswoman queries Sebelius about health IT errors

August 11, 2011 | Mike Miliard, Managing Editor

WASHINGTON – Rep. Renee Ellmers sent a letter Thursday to Health and Human Services Secretary Kathleen Sebelius, in which she requested that HHS consider a study of health IT's benefits and cost effectiveness, with a focus on gauging medical error rates.

Ellmers (R NC-2), the chairwoman of the Small Business Subcommittee on Healthcare and Technology, told Sebelius that her subcommittee held a hearing in June, during which "physicians testified that the cost to purchase and maintain a health IT system, in addition to staff training and downtime during the transition to health IT, are significant burdens for small practices.”

In addition, Ellmers – a former nurse who also served as clinical director of Trinity Wound Care Center in Dunn, N.C. – expressed concern about "recent news reports" spotlighting health IT errors.



Monday, August 15, 2011

Inland Empire Health Information Exchange Near Launch

by Lauren McSherry, iHealthBeat Correspondent

After two years of planning and negotiation, an information-sharing network linking health care providers throughout Riverside and San Bernardino counties in California is almost ready to go live.

Health officials say the Inland Empire Health Information Exchange will be one of the largest in the nation, covering a geographic region nearly the size of Maine with a population of 4.2 million. About 15 hospitals and 2,000 doctors are expected to participate in the health information exchange. California has a strategic plan for the mobilization of health care information electronically across organizations within regions, communities and ultimately the state.

"Our challenge in the Inland Empire is that our counties have some of the lowest health outcomes when it comes to some of the more chronic diseases," said Christina Bivona-Tellez, regional vice president of Riverside and San Bernardino counties for the Hospital Association of Southern California. "This is a tool we can use to more expeditiously intervene and make a difference," she said.




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