Saturday, March 10, 2012
Weekly Overseas Health IT Links - 10th March, 2012.
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.
24 February 2012 Rebecca Todd
More than 300 GP practices have switched on access to the Individual Health Record in Wales, making about 2m summary patient records available to emergency care providers.
Approximately 3m people live in Wales. But the IHR is now available in every health board area, following the go-live of the Abertawe Bro Morgannwg University Health Board at the start of the year.
The IHR is the Welsh version of the Summary Care Record in England. It allows secure access to a summary GP record for doctors and nurses working in an out-of-hours services or medical assessment units.
28 February 2012 Rebecca Todd
More than 55,000 primary care records have been accessed by community, secondary and tertiary care providers in North Mersey over the past year as part of a local clinical pathways project.
North Mersey Health Informatics Service is supporting nine clinical pathways as part of a quality innovation, productivity and prevention programme.
These are: heart failure, urgent care, COPD, children’s services, cancer, diabetes, mental health, dementia and clinical support services.
Posted: February 27, 2012 - 12:15 pm ET
While most of the attention in the health information technology industry last week was focused on the newly proposed Stage 2 standards that providers would have to meet to achieve meaningful use of electronic health-record systems, a companion proposed rule affecting EHR vendors and the organizations that test and certify them also was made public.
The 184-page proposed rule, officially titled "Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology," was released Friday by HHS and the Office of the National Coordinator for Health Information Technology.
While many provider organizations are looking for ways to electronically connect home-bound patients to clinicians, a new effort combines chip technology with a decidedly low-tech feature—a paper card.
The program, designed to regularly monitor the health status of patients, uses a card with buttons that have an embedded chip in them. Patients press a button to start and then press other buttons to answer pre-selected questions about how they feel, medication adherence, pain levels and other appropriate indicators.
Information from the pressed chips is wirelessly transmitted to a cell phone, USB reader on a computer, or a home monitoring station. The information then is transmitted to personal health records vendor NoMoreClipboard and put into a PHR for a patient or family member, and in a Web portal for appropriate clinicians and case managers to access.
Healthcare IT is expensive. Just for starters, consider that the per-bed cost to implement EHRs and CPOE runs between $14,000 and $65,000 in the US, according to the federal Office of Management and Budget. Even at the low end of the estimate, that's an astonishing amount of money, and it doesn't include higher-order IT systems such as clinical decision support.
The high cost of IT creates a catch-22 for healthcare leaders already strapped for cash and forecasting declining revenues in years to come. IT systems offer a way—perhaps the only way—to lower healthcare system cost in a sustainable manner. But where do you find the money to invest in IT?
February 28, 2012 -- The iPhone is a fine platform for interpreting knee MRI images, and for most injuries it's equivalent to a workstation, according to a new study by Canadian researchers that was presented earlier this month at the American Academy of Orthopaedic Surgeons (AAOS) meeting in San Francisco.
Compared to arthroscopy, expert interpretation of iPhone images showed high sensitivity and specificity for medial meniscus and cruciate ligament injuries, though accuracy was reduced for lateral meniscus tears and cartilage injuries, said Dr. John Theodoropoulos, an orthopedic surgeon from the University of Toronto.
28 February 2012 Hal Hodson
An NHS Trust in Southampton is trialling a new analytics service that could open the door for pharmaceutical companies to analyse patient data.
The pilot is the first of its kind since prime minister David Cameron announced a plan to encourage data sharing between the NHS and the biomedical industry in December last year. "We're going to consult on actually changing the NHS constitution so that the default setting is for patient's data to be used for research, unless of course, they want to opt out," Cameron said at the time.
Created Feb 29 2012 - 1:49pm
For mobile health--specifically mobile medical apps--to be successful in a patient care setting, six principles must be taken into consideration, according to PricewaterhouseCoopers Managing Director Christopher Wasden, who spoke at a HIT X.0 session  at last week's Healthcare Information and Management Systems Society's annual conference in Las Vegas.
Wasden said mobile health has matured beyond novelty and eventually will become core to the practice of medicine, he believes that there is still a way to go before it gets there.
Created Feb 29 2012 - 11:12am
No doubt that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) stole the show with their announcement of the proposed requirements for Stage 2 Meaningful Use and 2014 certification of electronic health records at the Healthcare Information and Management Systems Society's annual conference in Las Vegas.
Following a 60-day comment period, the final rule is scheduled for release this summer.
The proposed rules and standards largely reflect the recommendations made last year by the Health IT Policy Committee and the Health IT Standards Committee, National Coordinator for Health IT Farzad Mostashari, M.D., told an overflow crowd.
February 29, 2012 -- Is it easy to harness the power of a supercomputer to make it useful, practical, and affordable for healthcare applications? Not really, attendees surmised after a presentation at the Healthcare Information and Management Systems Society (HIMSS) annual meeting last week in Las Vegas.
Ever since Watson, IBM's massive artificial intelligence system equipped with natural language processing, became a contestant on the television game show "Jeopardy," healthcare professionals have been interested in its use. This was the talk of the 2011 HIMSS annual meeting, which took place one week after IBM and Nuance Communications announced that they'd entered into a five-year long joint development agreement.
Dr. Nick van Terheyden, chief medical information officer of clinical language understanding at Nuance Communications, discussed the objectives and challenges of the project to date.
Thursday, March 01, 2012
Facebook and clinical research may sound like strange bedfellows, but researchers from academic settings and the pharmaceutical industry have started to jump onto the social media bandwagon. Many researchers say social media can educate patients about the value of clinical research and encourage them to participate in studies.
The success of clinical research hinges, in large part, on the ability to recruit patients. Yet, targeting the right patients and retaining their participation is one of the greatest challenges researchers face. "The percentage of people getting involved in clinical trials is pretty low, and that's a huge problem for us in this country," said Naz Sykes, executive director of the Dr. Susan Love Research Foundation.
By Bernie Monegain, Healthcare IT News
Created 2012-02-29 11:04
When Secretary of Defense Leon Panetta and Veterans Affairs Secretary Eric K. Shinseki met at the Pentagon earlier this week, EHRs was one of the topics on the table.
The meeting on Monday was one in a series the two secretaries have held on issues of common interest to both Departments.
"The vision Secretary Panetta and I share is to provide an integrated, seamless experience to our people across their lifetimes – from when they raise their hands to take the oath, to when they leave active service and join the Veteran ranks, to when they are laid to rest with final honors," Secretary Shinseki said. "Over the past three years, VA and DoD have made significant progress, but more work remains."
February 29, 2012
New research from the research arm of the Chicago-based Healthcare Information Management and Systems Society, HIMSS Analyticsand the Washington D.C.-based The Advisory Boardshows that hospitals with advanced electronic medical records (EMR) systems report achieving a broad range of benefits from their implementations, including clinical quality, patient safety and operational efficiencies.
The data collected for the report, EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals, indicates that highly advanced EMR environments can produce substantial benefits for individual hospitals and the healthcare system as a whole. The survey is the first to report results from hospitals that have achieved Stages 6 or Stage 7 on the EMR Adoption Model (EMRAM). It collected information from 33 chief information officers (CIOs) at Stage 6 or Stage 7 EMRAM hospitals from throughout the country.
By Chris Anderson, Contributing Editor
DANVILLE, PA – A remote monitoring program implemented by Geisinger Health Plan using interactive voice response (IVR) and other telemonitoring technology to aid case managers has shown a 44 percent reduction in hospital readmissions.
The Geisinger Monitoring Program (GMP) uses a range of technologies from remote monitoring and telehealth company AMC Health designed to increase the number of interactions patients had with caregivers post-discharge.
“That first week or two post-discharge is when you really see readmissions happening,” said Joann Sciandra, director of case management and strategic planning with Geisinger Health Plan. “Having the ability to have a couple more touches or encounters with that patient makes this a very valuable tool. From a case management standpoint, it gives the case manager a little bit more time they may need with more complex patients.”
February 29, 2012
After a period of wait-and-see in the health information exchange (HIE) market when the American Reinvestment and Recovery/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act initially passed in 2009, meaningful use has since been pushing providers to adopt the EHR technology necessary to move forward to launch HIEs. Hospitals and health systems, as well as payers, are fueling HIE growth, building information backbones necessary to support care coordination and accountable care organization (ACO) development.
With the multitude of health IT responsibilities on providers’ plates now, it’s a tough decision as to whether an organization should build their own private HIE or link to a nearby public exchange, says Mark Allphin, senior research director, KLAS Research (Orem, Utah). Allphin reports that in a recent survey his consulting firm conducted, providers were in a 50/50 split on the choice, and the deciding factors were the amount of organizational resources the organization had and the maturity of the region’s public HIE. Carladenise Edwards, Ph.D., president and CEO, The BAE Company (Miami, Fla.), says that some primary considerations for assessing the value of a public HIE are access to greater legal protections for data breaches and access to data points and public health reporting inaccessible otherwise.
Posted: February 29, 2012 - 1:00 pm ET
Health Level Seven, the Ann Arbor, Mich.-based standards development organization, announced that by April it will have a file conversion tool and user's guide to adapt its Continuity of Care Document message transport specification to the Blue Button format developed by the U.S. Veterans Affairs Department.
By Mike Miliard, Managing Editor
CHICAGO – HIMSS Analytics and The Advisory Board have published new research showing hospitals that have implemented advanced electronic medical record systems enjoy a broad range of benefits when it comes to clinical quality, patient safety and operational efficiencies.
The joint report, titled "EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals," indicates that highly advanced EMR environments can produce substantial benefits for individual hospitals and the healthcare system as a whole. The survey is the first to report results from hospitals that have achieved Stages 6 or Stage 7 on HIMSS Analytics' EMR Adoption Model (EMRAM), offering insight about the benefits that can accrue for hospitals further along the development track.
By Michelle McNickle, Web Content Producer
HIMSS12 was a record-breaking event, attracting more than 37,000 attendees and 1,100 exhibitors. Speeches were made, demos were given and our favorite policymakers and social media stars spoke about all things health IT. Presenters shined the spotlight on ACOs, patient engagement, HIEs, ICD-10 and meaningful use, with the main highlight being the ability for industry professionals to connect with one another.
Healthcare IT News was there every step of the way, offering everything from breaking news to Twitter recaps, videos, blogs, slideshows and more. Here is our roundup of the six hottest stories from HIMSS12.
Cloud computing offers a speed ramp into the electronic health record highway. But don't overlook critical questions about security, performance, say legal experts at HIMSS.
By Marisa Torrieri, Physicians Practice, InformationWeek
February 29, 2012
Cloud computing--that lofty-sounding term that conjures visions of pillow-like, white puffs in a baby-blue sky--is a great option for small practices moving to an electronic health record (EHR). Requiring only an Internet connection, a cloud-based EHR allows practices to access, store, and transmit data without worrying about shelling out big bucks for second servers or other heavy hardware parts.
But before practices take the leap into the skies, there are multiple considerations they need to take into account.
During a Thursday morning session at the HIMSS12 Conference in Las Vegas, Melissa Markey, a shareholder with law firm Hall, Render, Killian, Heath & Lyman, and Margaret Marchak, the associate VP and deputy general counsel for the University of Michigan, gave attendees an earful of these considerations.
By Bernie Monegain, Editor
CHICAGO – To help physician practices navigate health information exchange, HIMSS and the Medical Group Management Association and its standards-setting body, the American College of Medical Practice Executives, have introduced the Ambulatory Health Information Exchange Toolkit for physician practices.
In delivering the proposed rule for meaningful use Stage 2 this past week, ONC chief Farzad Mostashari said Stage 2 emphasizes interoperability and health information exchange.
By John Morrissey
Hospitals are replacing the often haphazard approach of choosing IT projects with a much more formal and disciplined process
The requests: endless.
The potential payoffs: countless.
The resources: depleted and finite.
That's the scenario facing nearly every hospital executive team as it considers which information technology projects to pursue. Chief information officers are under siege with requests to upgrade this and modify that; link these systems with those systems, and not forget to buy and install new state-of-the-art devices that would make Star Trek's Leonard "Bones" McCoy, M.D., jealous. And do it yesterday.
By Vince Kuraitis
Feb 08, 12 04:26PM
Brian Ahier sparked a feud with his Google+ post commenting on a recent JAMIA article entitled Shift in the Architecture of the Nationwide Health Information Network. We’re at 60+ comments and going strong. The discussion has also been picked up on in Modern Healthcare.
The JAMIA article was written by Leslie Lenert and colleagues, and Lenert joins in heartily in the Google+ discussion. From the abstract, here are 3 key points they make:
1) …a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internetlike architecture that encourages point to-point information exchange and private health information exchange networks.
2) The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success…
3) These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC’s proposed changes in its strategy for the NwHIN.
Embedding Privacy, by Design, Not by Chance
March 2, 2012 (Toronto, ON) Embedding and implementing Privacy by Design (PbD) into electronic health record (EHR) systems being built across Canada will enable us to benefit from the wealth of health information stored on these systems, while protecting patient privacy, according to a new paper released today at the Toronto Board of Trade.
“By incorporating the principles of Privacy by Design into the EHR environment, you can accommodate both individual privacy and access to health information for purposes that benefit society as a whole, such as research purposes — a win-win scenario,” said Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario.
Health and Human Services Secretary Kathleen Sebelius has made it official that her agency will "initiate a process" to "examine the pace" of ICD-10's implementation, with a new compliance date forthcoming. But many quality leaders and providers, not to mention vendors, who attended at HIMSS12 last week are imploring HHS to hang tough.
The pro-ICD-10 crowd insists ICD-10 should not be delayed. But if it must be, they want any postponement to be short-lived, limited in scope or perhaps phased in with a transition period. And they are mustering a fight to make their case.
"Our stance is, we're opposed to any kind of delay," says Sue Bowman, director of Coding Policy and Compliance for the 64,000-member American Health Information Management Association (AHIMA).
February 27, 2012
The Washington, D.C.-basedNational eHealth Collaborative (NeHC) released the results of the 2012 NeHC Stakeholder Survey, featuring responses related to health information exchange (HIE), consumer engagement, and other NeHC programs.
Coming on the heels of the release of the proposed rule for meaningful use Stage 2, survey results provide insights into stakeholder perceptions related to barriers to HIE and the importance of consumer engagement in transforming healthcare, which relate to some of the core measures that physicians and hospitals must meet in order to be eligible for Stage 2 meaningful use incentives.
By Government Health IT Staff
Created 2012-02-27 11:03
Health IT codathons, developer challenges, and programming contests are taking on increasing importance as small groups of developers are being encouraged to enter the innovation game. The hope is that ultimately winners and runners-up will gain venture funding to create systems that improve healthcare and reduce costs.
Also known as crowdsourcing, these challenges are being pushed by HHS, ONC, even the Surgeon General has held a developer contest, all aiming to spark innovation.
Indeed, such innovation historically has been difficult to reach in the healthcare realm, said Jim Hansen, vice president and executive director of Dossia Consortium, a nonprofit open-source personal health record service developed by a group of Fortune 500 employers.
Monday - 2/27/2012, 9:00am ET
The Department of Veterans Affairs has issued a stop-work order on a key component of the integrated electronic health record system it is developing with the Defense Department.
Virginia-based ASM Research was awarded the contract to build a central hub that would let the agencies incorporate private-sector products more easily into the combined system.
VA assistant secretary for information and technology and chief information officer Roger Baker called it the "heart" of the integrated electronic health record (iEHR) system.
By Bernie Monegain, Editor
WASHINGTON – A new study by the Deloitte Center for Health Solutions indicates physicians are not using IT broadly to engage patients. No more than 20 percent of doctors are providing online scheduling or test results for their patients and just 6 percent are using social media to communicate with them, according to Deloitte.
The report, “Physician Perspectives on Health Information Technology,” shows that measured against the IT goals and deadlines prescribed by the Patient Protection and Affordable Care Act, only 25 percent of physicians are “on target” to meet the meaningful use incentives.
This article appears in the February 2012 issue of HealthLeaders magazine.
Millions of dollars continue to flow from Washington, DC, to communities across the country in the form of grants to so-called Beacon Communities, intended to serve as pilots and role models for how health information technology can be used to improve quality and care coordination. The federal government announced recently the award of $220 million to another 15 communities, and earlier recipients are reporting that the money can make a difference.
The Beacon grants can provide the necessary capital for improvements that many healthcare providers have on their wish list, the recipients say, but the money doesn't necessarily make the job easy.
Encryption would have stopped many of the patient data breaches caused by lost smartphones, laptops, and tablets, said Stage 2 Meaningful Use proposal.
By Nicole Lewis, InformationWeek
February 24, 2012
In an attempt to eliminate the potential for patient data breaches on mobile devices, the Notice of Proposed Rulemaking (NPRM) for Stage 2 Meaningful Use has proposed that mobile devices, such as laptops, smartphones, and tablets, that retain patient data after a clinical encounter should have default encryption enabled.
Published by the Department of Health and Human Services (HHS) Thursday, the proposed rule for Stage 2 Meaningful Use for the Electronic Health Record (EHR) Incentive Programs noted the increasing number of reported breaches which involve lost or stolen devices.
"We agree that this is an area of security that appears to need specific focus. Recent HHS analysis of reported breaches indicates that almost 40% of large breaches involve lost or stolen devices. Had these devices been encrypted, their data would have been secured," the NPRM for Stage 2 Meaningful Use states.
By Mike Miliard, Contributing Editor
Created 2012-02-24 09:00
LAS VEGAS – At HIMSS12 this week, Health Level Seven International (HL7) announced a pilot program that will offer some of its intellectual property, free of charge, in an effort to spur further EHR implementations.
“HL7 is keeping its promise to lower the barriers to adoption of electronic health records by making portions of our valuable intellectual property freely available to our stakeholders,” said Charles Jaffe, MD, CEO of HL7.
“We believe that caregivers, academic centers and vendors will greatly benefit from this significant enhancement for access to valuable HL7 material,” he added.
Created Feb 25 2012 - 4:36pm
Enthusiasm went viral this year at the annual conference of the Healthcare Information and Management Systems Society (HIMSS). About 37,000 people attended the conference--up from 31,500 last year--and their mood was upbeat in the educational sessions and on the exhibit floor.
One reason for the buoyant atmosphere was new evidence that the federal government's incentive program for the meaningful use of electronic health records is working. The U.S. Department of Health & Human services announced  it has distributed more than $3.1 billion in incentives and that hospital use of EHRs has doubled in the past two years, and it seems entirely possible that the Office of the National Coordinator for Health IT will meet its goal of getting 100,000 providers  to attest to Meaningful Use by the end of 2012.
Also, new technology continues to amaze. Mobile health apps are proliferating to take advantage of ubiquitous smartphones; workable native EHRs for iPads may be just around the corner; and some EHR vendors at HIMSS were demonstrating the use of natural language processing to improve the usability of their products.
Monday, February 27, 2012
Las Vegas was an appropriate metaphor for the Healthcare Information and Management Systems Society's annual conference, as bets are being placed on several health IT issues affecting providers: Will health care providers be able to meet Stage 2 of the meaningful use program? What will the timing be for ICD-10? Can health information exchanges survive? And of critical concern, how will slow-to-adopt physicians and community hospitals fare in this environment?
Ultimately, what shaped the sales pitches, product demos and migration paths at the HIMSS conference was not about technology at all: It was the market driver of health care payments moving from volume to value. Accountable care, whether it takes the form of an ACO writ large or in lower case, will compel health providers to undertake greater financial risk for managing population health. While the pace of this change can be debated, the trajectory is inevitable.
Posted by Dr David More MB PhD FACHI at Saturday, March 10, 2012