Saturday, November 26, 2011

Weekly Overseas Health IT Links - 26th November, 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.

Patients Have Security Concerns On Data Sharing

New report by PwC reveals what consumers think about data sharing, privacy and security, online consultations, social media in healthcare, and more.
By Marianne Kolbasuk McGee,  InformationWeek
November 17, 2011
Consumers are concerned about the privacy and security of their health data, but most are comfortable having their health information shared among healthcare providers if doing so would improve their care, according to a new report.
In a recent PwC Health Research Institute online survey of 1,000 consumers, when asked to select the purposes for which they would be comfortable having their health data shared among healthcare organizations, 60% said for improving coordination of their care; 54% said for supporting real-time decisions in their care; 36% said to support analysis of doctors' performance; and 29% said to provide data to identify groups or patients at risk for health issues.

4 keys to the cost of health IT

November 17, 2011 | Michelle McNickle, Web Content Producer
We know health IT saves money and streamlines workflow, and when used properly, its benefits are widespread and long lasting. But within the past decade or so, the revolution of health IT has also sparked some interesting talk about the cost. 
“First of all, investment firms that normally stayed on the sidelines are going all in," said Lisa Suennen, managing member at Psilos Group and author of the blog Venture Valkyrie. “Three years ago, if you told a roomful of venture capitalists that healthcare IT would boom like the Internet once did, they would have laughed you out of the room. Today they are trying to figure out how to get in on the action.” 

One-third of nation's primary care providers enrolled in health IT extension centers

November 17, 2011 | Mary Mosquera
Regional health IT extension centers have signed up more than 100,000 physicians, or one third of all primary care providers in the nation, to help them deploy electronic health records, reaching its goal slightly ahead of its yearend schedule.
And 70 percent of all primary care providers in small practices in rural areas around the country are working with the extension centers, and in some states, it’s practically 100 percent, said Dr. Farzad Mostashari, the national health IT coordinator.
Those are among the efforts through which the Office of the National Coordinator for Health IT’s toolbox has established a beachhead, he said at a Nov. 17 summit spotlighting the progress of the extension centers, health information exchange, and beacon or model health IT communities to help to transform health care.

Don't Regulate EHRs Like Cars

In the interest of patient safety, the Institute of Medicine recommends that health IT be more tightly regulated, much like the auto industry. But are the two industries comparable?
By Paul Cerrato,  InformationWeek
November 16, 2011
It's hard to argue against safety. And in our lawsuit-crazy society, not taking all reasonable measures to keep the public safe is an invitation to bankruptcy. But there are two complicating issues to keep in mind when considering whether to apply an auto industry regulatory approach to medical informatics.
One is the fact that IT systems are a lot like sex. And we all know there's no such thing a safe sex, only safer sex. My point is, there's no completely safe technology, so we have to decide how safe is safe enough, and are we willing to spend the millions of dollars required to reach that level of safety?

AHIMA, Forbes Sound Off on AMA's ICD-10 Stance

HDM Breaking News, November 17, 2011
Among reaction to the American Medical Association's vow to fight implementation of ICD-10, the American Health Information Management Association and Forbes magazine take decidedly different views.
AHIMA officials expressed disappointment in the AMA's position. CEO Lynne Thomas Gordon said the industry must move its disease classification system toward international standards and align it with the meaningful use program and value-based reimbursement, which requires a more contemporary and detailed coding system.

Birmingham Women's pauses Lorenzo

17 November 2011   Shanna Crispin
Birmingham Women’s NHS Foundation Trust has ‘paused’ implementation of Lorenzo as it re-assesses the system’s benefits.
The trust was the third ‘early adopter’ to take the iSoft electronic patient record software from CSC as part of the National Programme for IT in the NHS, and went live with the care management and clinical documents modules in 2010.
A trust spokesperson has now told eHealth Insider it is delaying implementation of the requests and results module. “We have taken a short pause on requests and results to re-evaluate the benefits of the product.”

EHR safety: IOM report a good start, but more can be done

November 17, 2011 — 9:44am ET | By Marla Durben Hirsch - Contributing Editor
There's been a lot of fanfare about the Institute of Medicine's (IOM) recent report calling for a new federal watchdog agency to oversee the safety of health information technology (HIT) and investigate adverse events related to HIT. While IOM acknowledges that some components of HIT have improved the quality of healthcare and reduced medical errors, patient safety overall has not improved to the extent that the organization had hoped for. Moreover, new patient safety issues are emerging that are directly attributable to HIT.
And while the report notes that the safety incidents involve a variety of HIT tools--such as personal health records, patient portals, and health information exchanges--there's no denying that the bulk of IOM's emphasis is on electronic health records.   

Canada Health Infoway, Trillium Health Centre and collaborate to benefit seniors care

New project will improve safety and quality of care for residents of long-term and complex continuing care facilities in Ontario
November 16, 2011 (Mississauga/West Toronto, ON) - Patient care for seniors in long-term or complex continuing care facilities will benefit from a new library of evidence-based information and clinical protocols that will be created as part of a $1 million investment Canada Health Infoway is making with Trillium Health Centre, announced Trillium President and CEO Janet Davidson, O.C.
Trillium, supported by, will develop and provide the library to benefit those living in more than 500 long-term care and complex continuing care beds in the Mississauga-Halton region.

PwC predicts top 10 issues in 'seminal year' for healthcare

November 16, 2011 | Mike Miliard, Managing Editor
NEW YORK – PwC's Health Research Institute has predicted the top 10 issues facing healthcare in the coming year. Health informatics, privacy and security, new reporting requirements and social media, among others, promise to be at the fore.
All these will continue to evolve against a backdrop of political and economic uncertainty in the United States, according to PwC. In response, the firm predicts that diverse healthcare organizations will "join forces in new collaborative business arrangements," and gird themselves with contingency plans for "legislative wildcards."

NHS IT market set to defy NPfIT gloom

7 November 2011   Jon Hoeksma
In spite of negative comment about the abandoned National Programme for IT in the NHS and general gloom in the public sector, England’s hospitals are set to increase their spend on IT over the next three years.
The first Market Forecast Report, published by EHI Intelligence, calculates that local NHS trust spending on information technology is set to rise by 3.7% CAGR (compound annual growth rate) over the next three years.
This will take the total size of the locally-determined English NHS hospital and mental health trust IT market to £883m by 2014-15.

6 golden rules of EMR implementation

November 15, 2011 | Michelle McNickle, Web Content Producer
A few months ago, we chronicled the 7 most deadly sins of EMR implementation. From ignoring nurses to declining help, these offenses can be hard to make right. 
But, in an effort to help big and small practices alike avoid the most common EMR faux pas, we followed up with Rosemarie Nelson, principal of the MGMA Consulting Group, and asked for her opinion on the best practices for implementing an EMR system.
Here are Nelson’s six golden rules of EMR implementation:
1. Include nursing staff.  When we first asked Nelson about the sins associated with implementation, the most detrimental, according to her, was forgetting about your nurses. And now, Nelson stands by that mantra and believes the EMR isn’t all about the physician. “Physicians are the owners, or the leaders, or the key decision makers, but they are not the exclusive users of the EMR,” she said. She mentioned nurses account for almost 75 percent of the use of the chart, and physicians, 25 percent. “A successful EMR implementation focuses on how the nurses can assist the physician in the integration of the EMR into clinical workflow,” she said. “Too often, an EMR committee is created in a medical practice, and there’s no nursing representative. Bring in the nurses.”

OMB: 'Aggressive' use of IT cuts $17.6 billion in waste, fraud, and abuse

November 15, 2011 | Diana Manos, Healthcare IT News
The Office of Management and Budget (OMB) announced Tuesday that the Administration has cut wasteful improper payments by $17.6 billion dollars in 2011. The cuts included those paid for Medicare, Medicaid, Pell Grants, and Food Stamps.
The government-wide error rate for Medicare and Medicaid dropped to 4.7 percent, down from the 2010 error rate of 5.3 percent and the 2009 error rate of 5.42 percent, according to the OMB. Also, the Medicare fee-for-service error rate fell from 9.1 percent in 2010 to 8.6 percent in 2011.
OMB Director Jack Lew said the cuts are due to the effective and agressive use of technology. In 2010, the president announced that by the end of 2012, the Administration would avoid $50 billion in improper payments, cut Medicare fee-for-service errors in half, and recapture $2 billion in overpayments to contractors. The Administration is on track to meet or exceed those goals, the OMB said.

HHS Earmarks $1B for Healthcare Jobs, Innovation

Margaret Dick Tocknell, for HealthLeaders Media , November 15, 2011

The healthcare industry got a $1 billion shot in the arm Monday when the Department of Health and Human Services announced a competition to spark "innovative healthcare delivery models." Preference will be given "to projects that rapidly hire, train and deploy healthcare workers."
Most of the department heavyweights were on hand for the afternoon press conference: Secretary Kathleen Sebelius, Don Berwick, MD, administrator of the Centers for Medicare & Medicaid Services, and Richard Gilfillan, MD, acting director of the Center for Medicare & Medicaid Innovation.

8 lessons from a Beacon Community

November 14, 2011 | Michelle McNickle, Web Content Producer
BANGOR, ME – About a year and a half ago, the Bangor Beacon Community, in Bangor, Maine, was chosen as one of 17 national sites to receive a three-year federal grant. The Office of the National Coordinator awarded the organization $12.75 million with the hopes Bangor would use IT to improve the health of the population it serves.
Today, the Bangor Beacon Community, which comprises 12 partners throughout the state, has made noteworthy strides in improving quality and population health. So much so, in fact, that it’s easy to see where similar efforts can extend into non-Beacon Communities and improve the role of health IT nation wide.
Cathy Bruno, executive sponsor at Bangor Beacon Community, offers eight valuable lessons she and her team learned (and are still learning) while acting as a Beacon Community. 

Standards panel seeks advice on data exchange

November 14, 2011 | Mary Mosquera, Government Health IT
WASHINGTON – The federal advisory Health IT Standards Committee is asking for feedback from individuals and organizations experienced in deploying specifications developed for the nationwide health information network (NwHIN) Exchange.
The group also wants to learn about first-hand practice and observations of individuals involved in setting up the required infrastructure and operational use of the NwHIN Exchange specifications or technical descriptions of the requirements.
The NwHIN Exchange is composed of federal agencies and predominantly large organizations that have contracted with the federal government. ONC is seeking a foundation to expand participation in the exchange, which follows comprehensive standards and services to securely share health information through the Internet.

CHIME releases info exchange guide for CIOs

Posted: November 15, 2011 - 12:30 pm ET
The College of Healthcare Information Management Executives and the eHealth Initiative have jointly released The HIE Guide for CIOs to educate healthcare information technology leaders about technical requirements and other issues involving health information exchanges.

AMA opposes ICD-10

Posted: November 15, 2011 - 12:15 pm ET
UPDATED: 1:45 p.m.
The American Medical Association's House of Delegates voted today "to work vigorously to stop implementation" of the International Classification of Diseases 10th Revision family of diagnostic and procedural codes, citing the healthcare industry's already full plate for changes and reforms, including the federal push for physicians to adopt electronic health-record systems.
"The implementation of ICD-10 will create significant burdens on the practice of medicine with no direct benefit to individual patients' care," AMA President Dr. Peter W. Carmel said in a news release from the association's four-day policy meeting in New Orleans.
"At a time when we are working to get the best value possible for our healthcare dollar, this massive and expensive undertaking will add administrative expense and create unnecessary workflow disruptions," Carmel said. "The timing could not be worse as many physicians are working to implement electronic health records into their practices. We will continue working to help physicians keep their focus where it should be—on their patients."

Darlington first to finish SCR roll-out

10 November 2011   Rebecca Todd
More than 98% of patients in NHS Darlington now have a Summary Care Record, making it the first primary care trust to roll out the programme to its entire patient population.
All the GP practices in the area have created SCRs for patients who want them, with 1.66% of people having opted out of the scheme.
Clinical pharmacists on medical and acute admissions wards at County Durham’s two major hospitals have been viewing the records with patient consent since a pilot project was launched in July.
The hope is to extend SCR access to after-hours doctors within six months and ultimately to A&E physicians.

No Security for Health Information

Health Data Management Blogs, November 14, 2011
The daily stories of personal health information being stolen or lost cannot be a surprise to anyone by now.  And PHI in EHRs or health information exchanges will continue to be released unauthorized, or stolen, because there's no real enterprise-class information management architecture in any of the HIE or EHR products that we know of.
In fact, the health care I.T. industry is riddled with very poorly designed systems from an information management and security perspective compared with, say, the world of finance.  Relatively speaking, we read about almost no leakage of financial information compared with health information, especially if you compare the relative value of financial information vs. health information.
Tuesday, November 15, 2011

Health IT Saves a Life in Memphis

A medical data-sharing program saved at least $2 million and gave doctors crucial insight about a pregnant woman's complications.
A new study has found that a medical-information exchange system that is considered a model for health-care reform efforts saved significant amounts of money and led to better care for patients—including a woman who probably would have died without the system.
The woman was bleeding from her uterus when she came to the emergency room of Saint Francis Hospital in Memphis, Tennessee, in 2009. If her medical records had been unavailable, doctors probably would have ordered an ultrasound, incurring some delay in treatment. But because of the city's digital information-sharing program—a rarity among U.S. hospitals with different owners—the doctors learned that an ultrasound done days earlier at another facility had detected that the woman had an ectopic pregnancy, in which the embryo becomes implanted outside the uterus. (It's not clear whether the first institution had failed to follow up or whether the patient refused treatment there.)

EHR vendor cooperation vital to interoperability workgroup

November 11, 2011 — 5:17pm ET | By Ken Terry
The agreement by seven states, eight electronic health record vendors, and three health information exchange vendors on an initial set of standards for exchanging health data is a major step toward the interoperability that has so long defied the best efforts of technologists and policymakers.
The achievement of the EHR/HIE Interoperability Workgroup is important for several reasons. First, standardization will decrease the cost and accelerate the process of connecting EHRs to HIEs, be they statewide or local. Second, insofar as the workgroup hews to national standards, it will lay the groundwork for connecting HIEs to the Nationwide Health Information Network (NwHIN). And third, this initiative has the potential to break down the barriers between disparate EHRs.

Epic to add 900 new jobs

November 14, 2011 | Bernie Monegain, Editor
VERONA, WI – Epic Systems plans to add 900 new jobs to its campus in Verona, Wis., according to the newspaper of the University of Wisconsin-Madison, The Badger Herald.
The newspaper reported that Epic also planned to add three new office buildings to house the new employees.

ECRI names top 10 healthcare tech dangers

November 14, 2011 | Bernie Monegain, Editor
PLYMOUTH MEETING, PA – Hazards from clinical alarms top the list of 10 technology hazards for 2012, according to the ECRI Institute, an independent nonprofit that researches the best approaches to improving patient care.
Now in its fifth year of publication, ECRI Institute bills its annual Top 10 hazard list as a comprehensive report designed to raise awareness of the potential dangers associated with the use of medical devices and systems. Most significantly, the report includes action-oriented recommendations on addressing these risks.

ECRI Unveils Top 10 Health Technology Hazards

John Commins, for HealthLeaders Media , November 14, 2011

The incessant beeping, chirping, whirring, flashing and whooping of any number of patient monitors continues to be a top hazard in hospitals, as bedside providers either struggle to prioritize the noisy demands of the machines, or tune them out completely.
That's according to a study, Top 10 Health Technology Hazards for 2012, from the nonprofit ECRI Institute.  The organization is designated an Evidence-Based Practice Center by the U.S. Agency for Healthcare Research and Quality.
The report notes that bedside providers increasingly are showing signs of "alarm fatigue" as they deal with the constant demands of ventilators, infusion pumps, physiologic monitors, dialysis units, and other technology.

HL7 and Regenstrief Institute connect on standards

November 14, 2011 | Diana Manos, Senior Editor
ANN ARBOR, MI – Health Level Seven (HL7) International and the Regenstrief Institute, Inc. announced on Monday an agreement to create a complementary process to develop and extend comprehensive standards in the healthcare industry.
“This agreement further solidifies and extends the wonderful relationship HL7 has enjoyed with Regenstrief for many years,” said Bob Dolin, chair of HL7 Board of Directors.“HL7 is committed to working with Regenstrief and other standards bodies to advance the delivery of safe and effective patient care.”
Logical Observation Identifiers Names and Codes (LOINC) is a universal code system developed by the Regenstrief Institute for identifying laboratory and clinical observations. When used in conjunction with the data exchange standards developed by HL7, LOINC’s universal observation identifiers make it possible to combine test results, measurements, and other observations from many independent sources. Together, they facilitate exchange and pooling of health data for clinical care, research, outcomes management, and other purposes.

DH pilot finds mixed mobile benefits

8 November 2011   Shanna Crispin
The Department of Health’s clinical lead on mobile solutions has warned NHS trusts not to expect immediate results from mobile working.
Kathy Drayton presented the results of a DH project focussed on assessing the benefits of mobile working in community settings at EHI Live 2011.
The National Mobile Health Worker project trialled mobile working at 11 sites across the country for a period of eight weeks.
Drayton said the results had led to overall efficiencies within trusts, but their experience was mixed to start with.
The City and Hackney Primary Care Trust, for example, saw a decrease in the number of patients being visited when it first introduced a mobile system, and Drayton said this was not uncommon.
“What we do know is that before you get a significant increase, there’s usually a decrease in productivity as people get used to the technology.
Monday, November 14, 2011

Data Could Be King in Reformed Health Care System

Laura Landry can tell you exactly why health information matters.
Landry, the interim CEO of Cal eConnect, California's newly created entity to oversee health information exchange, had a story to tell during the organization's annual stakeholder summit last week in Sacramento.
"It's not my government background that qualifies me for this job," Landry said. "It's not my tech background. And it's not my policy background." What qualifies her for the job, she said, is much simpler.
"I went blind in my left eye," Landry said.
About 10 years ago, Landry had vision problems during a weekend. "All of my health information was all locked up," she said. So Landry went through a battery of tests she'd already had, she said.

Survey: Most U.S. community hospitals embrace EMRs

Written by Luke Gale
November 14, 2011
According to the results of a survey of community hospitals, a considerable majority of community hospitals, those with fewer than 300 beds, have already implemented or are in the process of implementing an EMR system.
The survey’s results were based on questionnaires completed by representatives from 74 community hospitals and returned to Anthelio Healthcare Solutions, a Texas-based health IT services company.
Of the 74 respondents, 23 percent are operating full-functioning EMRs, 69 percent have begun implementing EMRs and only 8 percent have yet to begin implementing or don’t plan to implement EMRs.

After EHR Frenzy: Health IT's Next Priorities

Healthcare providers are looking beyond electronic health records to find tools to tackle ICD-10 and accountable care organizations, says Allscripts CEO.
By Nicole Lewis,  InformationWeek
November 10, 2011
Although most healthcare organizations are now focused on getting their electronic health records (EHR) systems running properly, many are also setting their sights on the technology needed to meet ICD-10 compliance, support accountable care organizations (ACOs), and maintain systems that will reduce hospital readmissions, according to Glen Tullman, CEO of Allscripts.
Giving his assessment of the healthcare IT market during Allscripts' Nov. 3 third-quarter financials conference call, Tullman said technology has taken center stage as an important tool that can address challenges facing the healthcare sector.
"While Meaningful Use is on everyone's mind today, attention is beginning to shift to the required adoption of ICD-10 in 2013," Tullman said. "Another influential factor is the significant revision to reimbursement underway at the federal level fostering the move to a value-based system of care."

Federal panel begins work on Stage 3 meaningful use

November 10, 2011 | Diana Manos, Senior Editor
WASHINGTON – Some members of the Health IT Policy Committee on Wednesday cautioned against making the measures required under Stage 3 meaningful use too burdensome. The panel also began to focus on medical specialties.
Committee member Gayle Harrell, a Florida state legislator said, “We’re learning things every single day. We have an opportunity now to get Stage 3 right.”
Harrell said the committee is on an evolutionary path, learning from Stages 1 and 2. “We really want to get our bang for the buck,” she said.
She also cautioned that specialists be taken into account when developing Stage 3. “We want to use this opportunity wisely and make sure we move forward on a specialist level,” she said. “Seventy-five percent of the cost of care is provided by specialists. We need to make sure we’re not going to go down a track that would not allow every specialty the ability to qualify.”

Meaningful Use of Electronic Prescribing in 5 Exemplar Primary Care Practices

Published In: Annals of family medicine, v. 9, no. 5, Sept./Oct. 2011, p. 392-397
PURPOSE: Successful use of electronic prescribing (e-prescribing) is a key requirement for demonstrating meaningful use of electronic health records to qualify for federal incentives. Currently, many physicians who implement e-prescribing fail to make substantial use of these systems, and little is known about factors contributing to successful e-prescribing use. The objective of this study was to identify successful implementation and use techniques.
Monday, November 14, 2011

Aetna Hopes Games Will Make People Healthier

The health-care industry is using games to encourage better choices.
By this January, some people who are insured by Aetna will have a new tool to help them keep New Year's resolutions: the Life Game, an interactive platform that helps users formulate health goals and stay motivated to achieve them.
About 70 to 80 percent of health-care costs in the United States stem from chronic conditions that are largely preventable or manageable, such as hypertension, diabetes, and heart disease. Those three conditions alone cost U.S. employers nearly $500 billion in lost productivity, according to the Milken Institute, a nonprofit economic think tank. But effective prevention strategies have proved elusive; simply educating people about the benefits of eating better and exercising has had little effect.
Aetna and other health-care companies, such as Humana, hope the features that have made games so addictive will motivate people to adopt healthier lives. A crop of startups are integrating social networking and behavioral economics with games toward that end. Although Aetna declined to provide estimates, even a modest change for the better could have a big impact on an insurer's bottom line if the results were sufficiently widespread.


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