Saturday, September 17, 2011

Weekly Overseas Health IT Links - 17 September, 2011.

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.

Data breaches cost organizations a staggering $156.7 billion over six years

06 September 2011

Data breaches cost organizations $156.7 billion over a six-year period, according to new data breach study by Digital Forensics Association.

The study presents data breach information collected from 2005 through 2010, including the disclosure of more than 800 million records over that period. The association said the overall data breach dollar figure did not include the costs that the organizations downstream or upstream incurred, or the losses sustained by the data breach victims. Further, the report, The Leaking Vault 2011, said the data breach cost estimate was low because 35% of the incidents did not name a figure for records lost.

S.F. experiment in improving patient health care

Monday, September 5, 2011
Researchers long ago established that certain medical procedures are performed at dramatically different rates from place to place, and that these disparities affect the quality and cost of health care.
Now, health insurers, hospitals and government agencies from the Bay Area to Washington, D.C., are getting more aggressive about tackling variation in medical care.
The issue will surface in San Francisco with a collaboration that started this summer among Blue Shield of California and some local hospitals and physicians, aimed at better coordination of patient care for about 26,000 public employees.
The partnership is modeled after a similar one in the Sacramento region whose early efforts to rein in variation resulted in training doctors in newer medical techniques and offering patients less-invasive treatment options.
In the case of weight-loss surgeries, procedures fell in one year by 13 percent.

Spurring the market for high-tech home health care

A daunting array of financial and operational barriers is holding back growth. What can be done?

September 2011 • Basel Kayyali, Zeb Kimmel, and Steve van Kuiken
On the surface, technology-enabled home health care should be thriving in the United States. The country’s aging population and the transformation of acute illnesses such as heart failure into chronic diseases mean that the number of patients is growing. In addition, new medical-technology devices could help keep patients at home rather than in costly institutions, such as assisted-living facilities or nursing homes—leading to potentially big savings for the health care system.
Instead, the full potential of the technology-enabled home health care market remains to be tapped. In the United States, home care accounts for about 3 percent ($68 billion a year) of national health spending. The market is increasing by about 9 percent annually,1 solid but hardly booming growth, especially since labor (mainly nurses and aides) accounts for about two-thirds2 of the expenditure and home-monitoring technology represents a small fraction of it. What’s holding the market back? We observe a daunting array of financial and operational barriers, including the misalignment of incentives between payers and providers, the need to demonstrate a strong clinical value proposition, and the problem of designing attractive, easy-to-use products that facilitate adoption by patients.

Telemonitoring Pilot Attacks Diabetes

Health information exchange's project aims to keep diabetic patients out of the ER; if it works, the technology could pay for itself.
By Ken Terry,  InformationWeek
September 08, 2011
As part of a larger project to reduce the burden of diabetes on patients in western New York, Buffalo-based health information exchange HealtheLink has launched a pilot to test the effect of telemonitoring on diabetics' health. A premise of the 18-month pilot is that telemonitoring will pay for itself by reducing the enrolled patients' emergency room and doctor visits.
While the evidence for that remains uncertain, the pilot is set up to measure clinical and claims data for the study group and compare it to data from a control group of similar patients, Todd Norris, western New York Beacon Project director for HealtheLink, told InformationWeek Healthcare. HealtheLink will make quarterly reports to the Office of the National Coordinator of Health IT (ONC), which is funding the study through its Beacon Communities program. The study will end March 31, 2013.

Virtual Lifetime Electronic Record pilot expands to include more veterans

September 08, 2011 | Molly Merrill, Associate Editor
WASHINGTON – The pilot for the Virtual Lifetime Electronic Record (VLER), which enables sharing of Veterans' health records will be expanded, the Department of Veterans Affairs announced Thursday.
"The expansion of the VLER pilot program will allow more Veterans and facilities to participate in this exciting new technology," said Secretary of Veterans Affairs Eric K. Shinseki. "I invite Veterans to sign up for the program. It will keep health care providers informed, improve continuity and timeliness of care, and eliminate gaps in healthcare information."
VLER is a multi-faceted business and technology initiative that includes a portfolio of health, benefits, personnel and administrative information sharing capabilities. 

HIE Vendor Market Poised For Shakeup

Among dozens of vendors selling technology products and services to health information exchanges, no clear player dominates, study says.
By Marianne Kolbasuk McGee,  InformationWeek
September 07, 2011
The health information exchange (HIE) vendor market is still very fragmented, with more than three dozen companies identified as providing IT products and services to these data sharing initiatives, according to a new report.
Of the 35 vendors HIEs named as product and services providers, no vendor has a majority foothold yet, according to a new report released by the eHealth Initiative, which recently surveyed 196 of the 255 HIEs currently operating in the United States. The HIEs surveyed ranged from state-run initiatives to community-based organizations, including for-profit and non-profit efforts.
Leading the pack is Axolotl, which provides products and services to 22 of the 196 (about 11%) surveyed HIEs. Axolotl was recently renamed OptumInsight, and is part of UnitedHealth Group's health IT services business. The next most prevalent HIE vendor is Medicity, being used in 14 initiatives, followed by a tie between Cerner and Mirth, with each providing products and services to nine HIEs.

Making the Most of Meaningful Use

Health Data Management Magazine, 09/01/2011
On one level, the meaningful use electronic record incentive program is all about the money. Many providers, especially small practices, jumped head first into the program because the financial incentives made it possible to automate at little or no cost-if they got those incentive checks.
Take Springfield (Ohio) Center for Family Medicine, where all six physicians have attested to meaningful use, with four by mid-July having received $18,000 first-year checks from the Medicare incentive program, and the other two awaiting payment.
That money is already flowing downstream at the practice, which purchased a document management and imaging system along with workstations, all integrated with the electronic records and practice management systems of Horsham, Pa.-based NextGen Healthcare Information Systems, says Cindy Brewer, office manager. The EHR and the purchase of ancillary technology would not have been done without the incentive payments, she adds. "We've wanted to do it but didn't know when the finances were going to be there."

ONC debuts new

Posted: September 8, 2011 - 12:00 pm ET
The Office of the National Coordinator for Health Information Technology on Thursday announced the launch of its new website targeting consumers as well as healthcare providers.

SE Essex develops EPR for COPD patients

8 September 2011   Shanna Crispin
NHS South East Essex has created a shared electronic patient record across primary, secondary and community care for patients with COPD.
The primary care trust decided some years ago to develop an integrated primary care system strategy.
This involved moving the majority of its GP practices onto the hosted SystmOne GP, and deploying SystmOne systems into its community services and prison.  

EMRs go mobile: Not to be ignored

September 6, 2011 — 5:38pm ET | By Dan Bowman
Although accessibility of electronic medical records (EMR) on tablet devices is nothing new (we've been reporting on such capabilities as far back as April 2010), that doesn't make recent announcements from drchrono, Epocrates, GE, Greenway Medical Technologies and SAP about their mobile EMR offerings any less important. Rather, it reaffirms the notion that mobility in healthcare is king, something all current and future EMR vendors would be wise to take note of.
The users, doctors and other medical professionals, are flocking to the iPad and devices like it in droves. In May, Manhattan Research concluded that 75 percent of U.S. physicians owned an Apple mobile device in one form or another.
More recently, the medical schools at Ivy League heavyweights Harvard and Yale each announced its own mobility news. Harvard is creating a set of apps specifically for med students, and Yale has handed out 520 iPads to its students.

Cloud-based EMRs offer improved data security

September 6, 2011 — 5:33pm ET | By Marla Durben Hirsch - Contributing Editor
Cloud-based electronic medical record systems may not be as vulnerable to security breaches as once thought, as more vendors begin to offer these systems as an option and information is made available about how they operate.
There has been some industry concern, if a Physicians Practice blog post is any indication, that cloud-based EMR systems, which operate on the web rather than on site at a provider, were more vulnerable to cyber attacks and other security risks. But that's not necessarily true, according to Sheldon Needle, president of CTSGuides, a software screening and referral service. Needle recently posted on his own blog, comparing the two types of systems.
Thursday, September 8, 2011

Internet VCs Circle Health Care

Silicon Valley investors helped reinvent everything from sharing photos to buying books online. Now can they fix health care?
Some prominent venture capitalists are betting that the Internet strategies that created giants such as eBay and PayPal could reshape the ailing U.S. health-care system. That system currently devours 18 percent of the world's largest GDP while delivering mediocre health results.
In August, the online health marketplace ZocDoc, which lets patients look up doctors by specialty and zip code and make appointments over the Internet, raised $50 million from the investment fund of Russian billionaire Yuri Milner, who in the past has backed companies like Facebook, Twitter, and Groupon.
The idea behind ZocDoc and other startups getting funding is that our costly, paper-based health-care system is ripe for the same technological fixes—such as data visualization, cloud computing, and mass-market self-service concepts—that have transformed industries such as consumer banking and travel.

NYC Program Shows EHRs Can Boost Preventive Care

Program led by Farzad Mostashari, before he became national health IT coordinator, supports entering structured data into an EHR to monitor a population's health.
By Ken Terry,  InformationWeek
September 06, 2011
In a New York City program that subsidized doctors' electronic health records (EHRs) in return for sharing quality data with the city, physicians showed significant improvements on eight of 10 preventive care indicators, according to a new study in the Journal of the American Medical Informatics Association (JAMIA).
The findings provide some perspectives on the federal government's Meaningful Use program, which requires attestation-of-quality data this year and electronic reporting in 2012. Not coincidently, the national coordinator of health IT, Farzad Mostashari, MD, who has responsibility for implementing the federal incentive program, led the team that created the New York EHR program when he was assistant commissioner of the city's department of health and mental hygiene.

Hurricane Irene Sparks Talk Of HIT Disaster Strategy

Health IT managers are looking at the damage done and reassessing their disaster planning strategies.
By Nicole Lewis,  InformationWeek
September 06, 2011
Like other natural disasters before it, Hurricane Irene disrupted hospital services in the Northeast, causing hospital IT officials to once again mull their disaster preparedness strategies.
Several recent reports in the aftermath of Irene show how damaging hurricanes can be to hospital systems. At Johnson Memorial Medical Center in Stafford Springs, Conn., 43 patients were relocated to other medical facilities when the hospital lost power and utility workers were prevented from fixing the problem because of the approaching storm.

More than 30,000 health-records breaches since 2009: HHS

Posted: September 7, 2011 - 12:01 am ET
The medical records of about 7.9 million people have been exposed in more than 30,750 healthcare-related security breaches since breach notification requirements took effect two years ago, according to a report by the HHS secretary and the Office for Civil Rights at HHS.
The vast majority of the breaches—more than 30,500 of them—were relatively small-scale mishaps that involved fewer than 500 records each and collectively accounted for the unauthorized disclosure of the records of roughly 62,000 individuals, according to the report to Congress (PDF).

ONC Tackling Population Data Query Issues

HDM Breaking News, September 7, 2011
The Office of the National Coordinator for Health Information Technology has launched Query Health, an initiative to establish standards for querying widely distributed data sources such as electronic health records.
Three workgroups, with membership being solicited, will cover business, clinical, and technical implementation issues. The business work group will handle privacy, security, consent, sustainability, data use arrangements and best practices. The clinical work group will develop use cases, functional requirements, and standards for an information model, query syntax and results expression. The technical workgroup is responsible for implementation of Query Health and support of pilot projects.

ONC launches Query Health data-sharing program

Posted: September 8, 2011 - 12:00 pm ET
The Office of the National Coordinator for Health Information Technology formally introduced its Query Health data-sharing program. The program is part of its standards and interoperability framework—an initiative to promote health information exchange.

CONNECT issues latest iteration of open source HIE software

September 06, 2011 | Tom Sullivan, Editor
Health information exchanges running the CONNECT platform take note: The CONNECT team has issued a new version, 3.2.1, which fixes a number of bugs and known issues.
The open source software taps National Health Information Exchange (NwHIN) standards and protocols to enable the creation of an HIE and the exchanging of healthcare information, both regionally and on a national level.
Connect 3.2.1 corrects known problems, and the latest iteration can correlate multiple responses for patient discovery, defer patient discover requests and make policy checks inside the gateway and refactor deferred services implementation.

Health Care IT Departments Must Adopt Mobile Strategies: CSC

As physicians use mobile devices in large numbers, IT departments at health care organizations need a strategy to support them, according to a new CSC report.
CSC, an IT integrator and cloud-service provider, has released a new report suggesting that health care IT departments should act fast to support the mobile devices that physicians are using.
Doctors are adopting smartphones at more than twice the rate of the general population, according to CSC's report, called "Harnessing the Value of mHealth for Your Organization." More than 17,000 health care apps are available for smartphones, the company said.

KLAS Finds Enterprise Players Making Oncology Inroads

Posted by Anthony Guerra on September 6th, 2011
Looking for greater integration with other core clinical applications, providers have invited enterprise HIT vendors to enter the Oncology arena, according to a new KLAS report Oncology IS 2011: Integrating the Island.
The specialty is one fraught with information silos, due to physicians moving between hospitals and clinics, and patients moving between infusion suites and radiation oncology facilities.
Wednesday, September 7, 2011

E-Medicine's Perfect Storm

A look, in numbers, at the forces shaping electronic medicine.
A recent video that appeared on asked:  What if air travel worked like health care?
The hilarious answer (here) shows an imaginary traveler attempting to book a flight to Eugene, Oregon on Air Health Care.  Frustration mounts as he's instead offered a flight to Chicago for $17,885, but only if he first faxes in his "complete flight history."
There are plenty of reasons that health care isn't as automated as airline reservations or check processing. Each person's health situation is, if not unique, immensely personal. Would anyone want to book radiation treatment on a medical Orbitz?
Even so, automating the collection and processing of medical information is an huge opportunity for hospitals and software companies. The U.S. medical establishment has yet to universalize even simple look-ups, such as what drugs a patient is taking, and has only begun to harness such phenomena as cell-phone apps and Web 2.0 trends like crowd sourcing to improve health care.

Healthcare is IT's new frontier in Asia

o AvantiKumar
07.09.2011 kl 00:14 | MIS Asia
The adoption of information technology (IT) in the healthcare industry is speeding up, driven in part by cloud computing, according to Asia-based healthcare IT solutions provider iSOFT Health Asia.
The adoption of information technology (IT) in the healthcare industry is speeding up, driven in part by cloud computing, according to Asia-based healthcare IT solutions provider iSOFT Health Asia.
iSOFT Health Asia general manager Dr Timothy Nam said the healthcare industry has been slower than other sectors in adopting IT solutions. "Having to manage, as well as maintain, healthcare's legacy systems and upkeep its traditional best practices, many called the health sector extremely backward. In fact, quite a number of observers have declared it as being 20 years behind the banking sector."

Q&A: Between the lines of NEJM EHR report - 'Trust trumps technology' for EHR success, authors say

September 01, 2011 | Tom Sullivan, Editor
Distinguishing itself from previous efforts to prove the viability of EHRs and meaningful use, a study published Wednesday in the New England Journal of Medicine shed light on just what can be accomplished by using electronic medical records rather than paper records.
The finding: A survey of 27,000 adult diabetics spanning 500 primary care physicians across 46 practices in the Cleveland area found that those practices employing EHRs earned “annual improvements in healthcare that were 10 percent greater than their paper-based counterparts,” and their patients were “significantly more likely to have healthcare and outcomes that align with accepted standards than those where doctors rely on paper records.”
Government Health IT Editor Tom Sullivan interviewed two of the study’s authors – Randall Cebul, director of the Center for Healthcare Research and Policy at MetroHealth Medical Center and a professor of medicine, epidemiology and biostatistics at Case Western Reserve University; and Anil Jain, senior executive IT director at the Cleveland Clinic while the study was being conducted, and now CMIO at Cleveland Clinic spin-off Explorys – about the gap in care quality between patients attending practices using EHRs and those still in the paper- and filing-cabinet era, the competitive nature of providers sharing patient data, and bridging the chasm between EHRs and PHRs.

Mayo: Social media useful to recruit patients for clinical research

August 30, 2011 — 4:09pm ET | By Ken Terry
The use of social media and online networking promises to be important both in clinical trial recruitment and in clinical discovery. Down the line, it might even prove valuable in comparative effectiveness research.
A new Mayo Clinic study shows that social media can help researchers find patients with rare diseases who are candidates for clinical trials more quickly than conventional methods of recruitment. 
Using patient-run websites dedicated to heart conditions and women's heart health, a team of cardiologists led by Sharonne Hayes, MD, is reaching out to survivors of spontaneous coronary artery dissection (SCAD), a condition that affects only a few thousand people a year, but can be fatal if it leads to a heart attack. 

Cloud-based service streamlines quicker image sharing for hospital

September 1, 2011 — 7:48pm ET | By Ken Terry
Montefiore Medical Center in the Bronx, N.Y., has begun using a cloud-based service to share medical images among multiple physicians without entering them into the healthcare system's picture archiving and communication system (PACS), according to an article in InformationWeek.
These are images that the Montefiore specialists use in their review of referrals before they accept patients for treatment. The images, which may arrive on disc or film, have not been entered into the PACS. In case more than one physician has to view the images, the other doctors can pull them down from the cloud rather than waiting for the physical media to be delivered.

Verizon health ID management expands to cover EHRs, HIEs

September 1, 2011 — 5:54pm ET | By Ken Terry
Verizon is expanding its cloud-based identity-management services for healthcare providers. Verizon Universal Identify Services-Healthcare, founded in November 2010, now supports new identity standards for accessing electronic health records and health information exchanges. In addition, it offers new features for electronic prescribing, including the prescribing of controlled substances.
Verizon now provides legally binding digital signature capabilities for authenticating signatures on clinical documents. The company's new ID Message Center allows users to monitor their digital signature activities through a mobile application or optional Web-based portal. Providers can use their smartphones or other mobile devices to gain access to Verizon's identity management features.

Why Halamka's health IT predictions might overestimate the future

September 5, 2011 — 4:46pm ET | By Ken Terry
John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston and a professor of medicine at Harvard Medical School, is one of the most respected opinion leaders in health IT. He's also one of the smartest people I know. Yet his new piece in the MIT Technology Review, predicting where health IT will take us in the next five years, is too optimistic by half.
I don't dispute Halamka's contention that the pace of electronic health record adoption will accelerate dramatically, partly because of the federal government's incentive program. Nor do I disagree with his argument that health IT will be essential to transforming the provider payment system in ways that can control cost growth.

EMIS: 'lessons learned' from crash

1 September 2011   Fiona Barr
The outage at the EMIS data centre was “a very rare occurrence” caused by a number of complex, interacting factors that are unlikely to be repeated, the company has said.
In a statement issued first to EHI Primary Care, Sean Riddell, the chief executive of EMIS, said the investigation into the outage on 18 August - which affected almost 800 GP practices - has now been concluded.
He added: “This shows that the outage was the result of a number of complex, interacting factors- it was, in effect, a very rare occurrence that could not have been predicted.
“At its core was a series of multiple, consecutive component failures in one of our storage devices – combined with a previously unknown bug in the hard disk firmware – that culminated in an unexpected shutdown of the entire device.”

Tech That Powers Quality Standards

Gienna Shaw, for HealthLeaders Media , September 6, 2011

A study published in the New England Journal of Medicine is among the first to put hard numbers on the benefits of electronic health records.
Researchers looked at four national quality standards, including:
  1. eye exams,
  2. pneumonia vaccinations,
  3. outcome measures such as blood sugar, blood pressure, and cholesterol control,
  4. patient-driven issues such as obesity and smoking
Nearly 51% of patients in EHR practices received care that met all four quality standards, compared to just 7% of patients at paper-based practices. Nearly 44% of patients in EHR practices met at least four of five outcome standards, compared to about 16% of patients at paper-based practices.
Tuesday, September 06, 2011

Jury Still Out on Health IT Workforce Training Programs

With health care providers working to implement electronic health records to qualify for meaningful use incentive payments and vendors seeing big spikes in business, it is not surprising that there is a huge demand for health IT professionals. What is surprising, though, are reports from recent graduates of federal health IT training programs who say they can't find a job.
It's been estimated that the country will need up to 50,000 health IT professionals to help doctors and hospitals meet meaningful use criteria.
With the U.S. unemployment rate hovering around 9%, health IT is seen as an area ripe for job creation. The federal government has invested millions of dollars in developing a skilled health IT workforce, and interest in federal health IT training programs has been high.
Tuesday, September 6, 2011

A Federal Jump-start for Health IT

White House aide leads push to improve health-care IT with billions in stimulus funds.
In a landmark government effort to drive American health care into the information age, the February 2009 stimulus bill earmarked about $30 billion in incentives for doctors and hospitals who install electronic medical records—paying up to $63,750 to individual physician and millions to hospitals.
Now comes the tough part: implementing "EMRs" and proving they really can reduce medical errors or get doctors to keep better track of chronically ill people. As National Coordinator for Health IT, Farzad Mostashari coordinates federal efforts to promote adoption of EMRs and to prod reluctant hospitals to share patient data.
Mostashari was recruited to take over the federal effort in February, after leading a patient-records initiative as an assistant health commissioner in New York City. He spoke with Technology Review's chief correspondent, David Talbot, about when we'll start seeing evidence that the technology is working.

Mobile staff 'save £3k each per year'

1 September 2011   Fiona Barr
Mobile working by community staff could save £3,000 per clinician per year, the Department of Health’s National Mobile Health Worker project has concluded.
A 254-page report says clinicians working across the 11 sites in the project estimated that mobile devices loaded with office and clinical software allowed them to make nearly 9% fewer referrals and avoid 21% of admissions.
Using standardised costs developed by Kent University, the project estimated this would equate to a saving of £3,002 per clinician per year.
  • Martin Regg Cohn
  • Fri Sep 02 2011

eHealth fiasco has a deep and wasteful history

The provincial election is about to begin, but the campaign against eHealth Ontario is already two years old — and still going strong.
EHealth is the gift that keeps on giving, the kiss of death in a field that is supposed to save lives. Brace yourself, in the weeks leading up to the Oct. 6 vote, for yet more reruns of the “billion-dollar-boondoggle” attack line.
Toronto Mayor Rob Ford used that catchphrase to devastating effect against his opponent in the city’s mayoral election — former provincial health minister George Smitherman, who carried much of the baggage for the eHealth fiasco. But like that other Ford slogan — “ending the gravy train at city hall” — the billion-dollar-boondoggle allegation doesn’t quite add up.


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