Saturday, April 14, 2012

Weekly Overseas Health IT Links - 14th April, 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.

NeHC Releases Health Information Exchange Roadmap: The Landscape and a Path Forward

Washington, DC (April 2, 2012)National eHealth Collaborative (NeHC) today released the Health Information Exchange Roadmap: The Landscape and a Path Forward. This Roadmap offers stakeholders a clear picture of efforts being undertaken by both the public and private sectors to create and implement the building blocks for widespread deployment of interoperable HIE. It also provides an understanding of how these diverse approaches fit together into a cohesive strategy for nationwide HIE and suggests a four phase roadmap to help HIE initiatives make progress and become sustainable.
“In this time of unprecedented investment, growth and innovation, achieving widespread HIE is a worthy goal because of its many benefits to patient care,” said NeHC CEO Kate Berry.  “A great deal of progress is being made today yet ongoing challenges remain. We hope this HIE Roadmap helps to clarify options, motivate action and accelerate success for those stakeholders who believe that HIE is a necessary foundation for healthcare transformation.”

NeHC charts course to HIE

By Tom Sullivan, Editor
Created 2012-04-02 14:41
The National eHealth Collaborative (NeHC) today released a roadmap for establishing and operating successful health information exchanges. The map addresses building, operating and sustaining the HIEs.
NeHC is a public-private partnership focused on accelerating progress toward widespread, secure and interoperable nationwide health information exchange.
The Health Information Exchange Roadmap: The Landscape and a Path Forward,” offers stakeholders a picture of efforts being undertaken by both the public and private sectors to create and implement the building blocks for widespread deployment of interoperable HIE, NeHC executives say. It also provides an understanding of how these diverse approaches fit together into a cohesive strategy for nationwide HIE and suggests a four-phase approach to help HIE initiatives make progress and become sustainable.

Data analytics driving medical breakthroughs

Using big data to save lives

Esther Shein
April 4, 2012 (Computerworld)
A hospital is usually a pretty busy place, but the neonatal intensive care unit at Toronto's Hospital for Sick Children has been buzzing with even more activity than is customary. Thanks to a new technology partnership, the hospital is working to use analytics to predict more accurately than ever before which premature babies are at most risk for disease and infection.
The hospital is in a study to monitor temperature, heart rate, blood saturation and blood pressure levels on preemies, collecting streaming data from electronic devices that monitor the premature babies.
Sick Kids, as the hospital is known, is in good company. Healthcare providers -- from insurance firms to hospitals to service suppliers -- are lining up to adopt advanced technologies to help them take better care of their patients, in many cases becoming more proactive and more personalized than ever before, with the hopes of saving money, too.
Monday, April 02, 2012

Becoming Accountable: Delivering Value-Based Care Through Optimal Use of IT and Data

As the leader of an organization that has been "accountable" for nearly three decades due to our long-standing ownership of a health plan and our strategic focus on value over volume, I'm often asked to reflect back on our journey and to highlight the tactics we've implemented to achieve success. The two most crucial drivers of our transformation at Dean Health System have been our willingness to embrace the use of technology and the effective use of data to drive decisions and motivate change.
While we've made great progress in becoming a technologically and information-enabled health system, I don't want to say that we're perfect by any means. We have much further to go. Based on lessons learned during our transformative experiences to date, here are four predictions for the future of accountable care.

Meaningful Use Stage 2 Brings Cheers, Fears

APR 1, 2012
When the proposed Stage 2 electronic health records meaningful use rules came out in February, providers, vendors, consultants and attorneys reading the hundreds of pages had many "Ah-Hah!" moments when they came across a surprising paragraph or a new objective immediately recognized as problematic.
The core proposed meaningful use rule was issued by the Centers for Medicare and Medicaid Services and specifies the criteria that eligible professionals and hospitals must meet to qualify for incentive payments. The Office of the National Coordinator issued a proposed rule laying out the EHR capabilities and standards that are necessary for EHRs to be certified as meeting Stage 2 MU requirements.
In both proposed rules, federal officials made concerted efforts to make some meaningful use criteria more flexible.

Information Integrity: A High Risk, High Cost Vulnerability

APR 1, 2012
Accuracy and validity of data are persistent concerns for those who use it and are the subject of that data. And the concerns are well founded. Data error is a risk to patient safety.
Distrust of data can stop or delay action on a performance improvement agenda and it's very difficult to overcome that distrust. Tracing and correcting errors is costly and often imperfect. The amount of operational inefficiencies due to data quality issues, such as untangling an error in patient identification, is legend.
In short, problems in data accuracy and validity can impair the value of the information that health care is investing so much to digitize.
The Data Warehousing Institute estimates that poor data quality costs U.S. businesses $600 billion a year. There's no estimate of the cost of data quality problems in health care-but even the most conservative guesses for quality problems in the nation's largest industry would indicate there's real money at stake here.
Thursday, April 05, 2012

E-Health Record Adoption: A Look Under the Hood

Electronic health record adoption in small physician practices is increasing much faster than adoption in large physician groups, according to a recent SK&A survey. That fact, plus the overall growth in EHR usage shown by several recent polls, bodes well for the government achieving its goal of having EHRs in most practices by 2014.
But a closer look at the numbers indicates that EHR adoption still has a long way to go.
For example, in its survey of 240,000 practice sites, SK&A -- a subsidiary of the health care technology and services company Cegedim -- found that the percentage of one-doctor practices with EHRs zoomed to 37% from 31% a year earlier, while 47% of two-doctor practices reported having EHRs, up from 41% a year earlier. But 77% of groups with 25 or more doctors said they had EHRs -- more than twice the percentage of soloists who had them.

7 types of security features for your tablet

By Michelle McNickle, Web Content Producer
Created 04/06/2012
With the release of the "new" iPad, an increased focus has been placed on how to protect sensitive information. And although there are a myriad of basic ways to safeguard your device, certain security features have become necessary to take tablet protection one step further.
"Clearly, healthcare is a vertical that is more concerned, or needs to be more concerned, about security, more so than any other vertical because of the personal info they're dealing with," said John Bischof, executive director of sales operations for Lenovo Americas. 
And with tablets in particular, Bischof continued, there's a number of added security concerns users need to be aware of. "When you look at PCs, they've had years and years to see and react to security issues – mainly hackers and people who try to break into the operating systems. When you look at tablets, because of their mobility, the bigger concern isn't just that, but also the loss of the lack of control of data that the IT center has … as tablets explode across the world in terms of the volume, that's becoming a big place for hackers to break into." 

FDA seeks text-mining software vendor

Posted: April 5, 2012 - 11:45 am ET
The Food and Drug Administration has put out a call to vendors for text-mining software that relies on natural language processing. The software will be used by the agency's Center for Drug Evaluation and Research "to rapidly analyze documents to find therapeutically useful and possibly unknown associations between drugs, disease processes, adverse events and therapeutic agents," the FDA said in a request for proposals published on the Federal Business Opportunities website.

HIT policy panel wants to adjust some MU2 HIE plans

By Mary Mosquera
Created 2012-04-04 17:29
The Health IT Policy Committee began hashing over some information exchange requirements contained in the meaningful use stage 2 proposed rule that it might recommend refining or revising in comments that the advisory group is preparing for the May 7 deadline.
Meaningful use proposals that incorporate communications and sharing information include electronic prescribing, sending lab results and transitions across care providers and settings.
It is important to make the requirements very clear and balanced so providers will have a better chance at accomplishing them, according to Micky Tripathi, chair of the committee’s information exchange panel at the April 4 meeting. He is also president and CEO of the Massachusetts eHealth Collaborative.

CMS should rethink patient engagement requirement for Meaningful Use

By mdhirsch
Created Apr 4 2012 - 11:07pm
Editor’s Corner
One of the most controversial provisions of the proposed rule implementing Stage 2 of Meaningful Use [1] is the requirement that more than 50 percent of an eligible professional's (EP) patients have the ability to view, download and transmit data, and more than 10 percent of those patients actually have to do so. Not surprisingly, this has been met with fear and anger in the provider world, with some noting that providers can't control what their patients do [2], and can't force them to access their electronic records.
The agency acknowledges in the rule that the new measure, meant to encourage patient engagement, is a departure from the other requirements by obligating action by patients or their representatives in order for an EP to meet Meaningful Use.

4 tips for start-up health IT companies

By Michelle McNickle, Web Content Producer
Created 04/04/2012
Start-up health IT companies have made quite a splash this past year – with some even claiming they have the ability to change the healthcare industry as we know it. Programs have been launched to help fledgling companies grow, and now the focus has shifted onto how these organizations can increase innovation and improve health and wellness. 
Lisa Suennen, managing member at venture capital firm Psilos Group and author of the blog Venture Valkyrie, outlines four basic tips for start-up health IT companies.

Is the Industry Ready to Get Personal?

APR 1, 2012
Six years ago, Women's Care Florida, a 13-physician group practice, thought it was leaping into the future when it implemented an ambulatory EHR. The software enables physicians to document their care, process labs and write prescriptions. "We had paper charts everywhere and it was a nightmare to find patient information," recalls practice member Matthew Mervis, M.D. "But we realized as we got further into the transition, we weren't doing the patient side. They were still calling us to get lab results, to ask follow-up questions, and to make their next appointment. Every telephone call represented another piece of paper. We got the office converted but we still had to figure out how to convert the patients."
Like a growing number of practices, Women's Care Florida turned to a patient portal, in this case one embedded in its ambulatory software package, from Greenway Medical Technologies. At first, the practice used the portal to publish care-related pamphlets. Then it added service-oriented transactions, which caused the popularity of the software to spike.
Now, patients can book appointments, ask routine follow-up questions, request medication refills, see their lab results and even pay bills online, all behind the firewall of a secure Web site, Mervis says. "Nearly all of our patients use it," he says. "It works out very well for the practice from an efficiency standpoint."

Patients want radiology results online--and fast

By sjackson
Created Apr 5 2012 - 1:45pm
Patients prefer to have instant--or near-instant--access to their radiology test reports, even when the findings may be difficult to understand, according to a new study [1] conducted by Wake Forest Baptist Medical Center, published this week in the Journal of the American College of Radiology.
The study is relatively small, covering only 53 respondents, but the findings were consistent and powerful: 80 percent said they would prefer to receive the test results via an online portal, even moreso than a phone call from a nurse or doctor, or even an in-person consultation.

HIE that really works

By Daniel Wayland, Director of Software at Ellumen Inc.
Created 03/29/2010
Just a few short decades ago, when the Internet was first forming, the community of people using this new network quickly settled on some standard ways to share documents, images, and other information over the web.
The Transmission Control Protocol / Internet Protocol (TCP/IP) was a reliable way to handle the lower level communications over packet switched networks.  Very quickly, some application layer protocol standards like FTP for exchanging files, HTTP for hypertext documents, and SMTP for e-mail became widely adopted standards allowing for the massive interoperability that exists over the Internet today.  Thanks in large part to these standards, it is now surprisingly easy to share all kinds of data over the Web.
So what about our health data like our allergies, the medications we’re currently taking, and the notes our healthcare providers wrote the last time we went to the doctor?  What about our X-rays, previous conditions, and lab results?  Medical data is special.  Our health data has additional requirements surrounding security, privacy, and consent to be met.  Many of these additional requirements are established as our right in laws like HIPAA and the Privacy Act.

New report addresses HIE sustainability

By Diana Manos, Senior Editor
Created 04/03/2012
FRAMINGHAM, MA – IDC Health Insights has released a new report on best practices for establishing enterprise or community health information exchanges (HIEs).
IDC Health Insights researchers claim the new report, “Best Practices: Establishing Sustainable Health Information Exchange,” provides a framework for establishing a new HIE based on keen insight from successful early adopters.
While many HIEs have attempted to become sustainable, financially viable entities, only some have succeeded, the researchers found.

How to harness big data for improving public health

By Roger Foster, Senior director, DRC’s high performance technologies group, and advisory board member of the technology management program at George Mason University
Created 2012-04-03 09:37
Today, healthcare in the U.S. is a $2.6 trillion market. According to recent reports, at least $600-850 billion of the healthcare spending goes to embedded inefficiencies that increase the cost and decrease the overall quality of public health.
These inefficiencies include the un-warranted use of healthcare services, criminal fraud and abuse, administrative inefficiencies, provider inefficiencies including medical errors, lack of overall coordinated care, and preventable conditions/avoidable care.
In an attempt to address these challenges, government agencies are flooded in a tidal wave of biomedical information. It is not unusual to see hospitals and hospital chains addressing petabyte (1015 bytes) scale data sets when they review all their electronic records.

CDI: Why clinical documentation improvement is so important to hospitals

No matter what the Centers for Medicare & Medicaid (CMS) decide to do with the ICD-10 implementation deadline, clinical documentation improvement (CDI) may become a survival tactic for hospitals.
CDI is a process typically used in hospitals that employs specialists who  review clinical documents and provide feedback to physicians, says Mark Morsch, vice president of technology at OptumInsight. The feedback is designed to fill gaps in documentation such as questions about coding, quality measures and overall care management of a patient. "This kind of  feedback loop back to the physician is intended essentially to make sure that documentation is high quality and corresponds to care delivered as well as the diagnoses that are being made."

Deep EHR use lags abroad: report

Posted: April 4, 2012 - 10:45 am ET
Asia, the Middle East and the United Kingdom are still emerging markets for health information technology, according to a new report by KLAS Enterprises, the Orem, Utah-based health IT market researcher.
The report, like other KLAS research, is not available to the public free of charge. It is one of several planned early ventures by the veteran researcher into reporting on overseas HIT markets.

Isabel Healthcare launches diagnostic decision support app

By: Neil Versel | Apr 3, 2012
In building its first-ever native iPhone app, diagnostic decision support content provider Isabel Healthcare also seized the opportunity to improve its flagship Web-based product.
“When you design something for an iPhone specifically, it forces you to simplify things,” CEO and co-founder Jason Maude explains. Most notably, the app has to support input on a touchscreen rather than with a mouse and keyboard. “I’m a great believer in simplification,” Maude adds.
The company, which is based outside of London and has a U.S. headquarters in Ann Arbor, Mich., on Monday released both its inaugural iPhone app and a new version of its desktop software. The main point of [building a native app] that was to make Isabel more accessible,” Maude tells MobiHealthNews.

EMR Pop-Ups Can Lead to 'Alert Fatigue'

By Michael Smith, North American Correspondent, MedPage Today
Published: April 03, 2012
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, Nurse Planner

Action Points

  • A VA point-of-care study found that medication alerts generated by the electronic medical record system were frequently frustrating to prescribers because they were numerous, contained extra information, and did not apply to the patient.
  • Note that the single center study highlighted the likelihood of "alert fatigue" given the high number of alerts during the prescribing process.
Medication alerts in electronic medical record systems (EMR) need improvement to avoid what has been called "alert fatigue," researchers suggested.
Some alerts don't give enough information and others contradict common clinical practice, according to Alissa Russ, PhD, of the Richard L. Roudebush VA Medical Center in Indianapolis, and colleagues.

As Smartphones Become Health Aids, Ads May Follow

Published: April 1, 2012
With smartphones changing the culture in so many ways, more and more young people are using their mobile devices to keep track of their health, and the trend is not going unnoticed by advertisers.
Young adults are much more likely than older people to have a smartphone and to use it to look for health information, according to the Pew Internet and American Life Project, which surveys technology trends. And their health concerns differ markedly from those of older people.
Nearly 100 million Americans own a smartphone, but “younger people use them very differently,” said John Mangano, a vice president of comScore, an online research firm. Three of the top five symptoms searched for on Yahoo Mobile in January were early pregnancy, herpes and H.I.V. None of these symptoms showed up among the top searches on desktop computers, which are more likely to be used by older people.

Integrated care pilots show few benefits

3 April 2012   Lyn Whitfield and Rebecca Todd
An independent evaluation of the Department of Health’s integrated care pilots has shown they are delivering few of the benefits hoped for them.
The DH established the pilots in 2009 to promote “personalised” and “seamless” care, and to show that linking up health and social care could deliver a range of benefits, including fewer expensive admissions to hospital.
IT has been recognised as essential for integrated care, with think-tanks calling for new integrated care records and services to be created to support it, and a number of suppliers promoting their systems as a way to achieve it.
However, an evaluation of the ICP by Ernst and Young has found that while staff identified a number of benefits, most of these were process related and not obvious to patients.

Cornell Targets Medical Informatics

APR 2, 2012 12:04pm ET
Weill Cornell Medical College has established the Center for Healthcare Informatics and Policy to conduct research on how information technology can improve the quality, safety and efficiency of care.
Rainu Kaushal, M.D., professor of medical informatics and chief of the college’s division of quality and medical informatics, is executive director of the new center. It will draw on expertise from personnel in multiple departments including pediatrics, public health, medicine, radiology, pathology and urology.

VA, DoD to make imminent open 3M Health Data Dictionary part of iEHR

By Tom Sullivan, Editor
Created 2012-04-02 10:56
A softly-whispered rumor may soon be coming true: Evidence is mounting that the VA and DoD are gearing up to use 3M’s Health Data Dictionary as a cornerstone of the joint iEHR and, in turn, make it freely available to the industry.
Such a contribution, likened to Kaiser Permanente opening its Convergent Medical Terminology (CMT) in September 2010, is viewed by those interviewed for this story as potentially creating a de facto industry standard set of medical terminology with the potential to ultimately bolster interoperability in the U.S. and worldwide.
“We have agreed that we will use a common data definition between the VA and DoD and that’s just a critical piece in the data layer for us,” said VA CIO Roger Baker, during his monthly call with reporters on March 28. “So watch for that to play a pretty key role in what we’re doing.”

Electronic health records mean fewer tests: study

Thu, Mar 29 2012
By Andrew M. Seaman
NEW YORK (Reuters Health) - Doctors order fewer lab tests when they have access to a patient's electronic medical records, according to a new study, but the efficiency may be confined to state-of-the-art records exchanges for now.
The new study is based on the experience of two hospitals -- Brigham and Women's and Massachusetts General -- that form Partners HealthCare, a not-for-profit healthcare system in Boston. The findings are at odds with another recent study.
In the year 2000, the two hospitals established a health information exchange to access each others' electronic medical records.

FDA's Medical Device ID System Still Inactive

Scott Mace, for HealthLeaders Media , April 3, 2012

You would think that a 2007 federal law related to patient safety would be implemented five years later.
You'd be wrong.
The law in question will give hospitals unique identifiers for every medical device that's in their inventory or in use with patients. It's the kind of identifier you can find today on just about any appliance you buy at Wal-Mart.
Such IDs are commonplace at the retailing behemoth, in everything from bread makers to rice cookers, because of the enormous clout the retail giant wields. The Wal-Mart effect also ensures that much other retail merchandise is similarly labeled.

EMR sales up 14 percent in 2011

By Rene Letourneau, Editor, Healthcare Finance News
Created 03/23/2012
NEW YORK – Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of electronic medical records reached $17.9 billion in 2011, up 14.2 percent from the previous year, according to market research publisher Kalorama Information.
In its recent report, “EMR 2012: the Market for Electronic Medical Records,” Kalorama found the uptick in sales is being aided by increasing physician and hospital acceptance, robust competition and growth in EMR budgets.
Although there is no one leader in the current EMR market, “Allscript and Epic have made considerable gains," noted the report. "However, due to the fragmented industry, there seems to be room for additional mergers and acquisitions and new players.”

Feds should integrate primary care and public health, IOM report says

By Diana Manos, Senior Editor
Created 04/02/2012
WASHINGTON – The traditional separation between primary healthcare providers and public health professionals isn’t helping to ensure population health, says a new report from the Institute of Medicine
Integration of these fields will require national leadership as well as substantial adaptation at the local level, said authors of the report.
The report recommends ways that the Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) could foster integration between primary care and public health through funding, policy levers, and other means. 

Here's a really NICE app

21 March 2012   Chris Thorne
The National Institute for Health and Clinical Excellence has created an app to give healthcare professionals “quick and easy” access to its recommendations and guidance.
The free app, called NICE Guidance, is available to download now for users of Android and iPhone smartphones, and features more than 760 guidelines, including information on hypertension and stroke.
Jane Gizbert, communications director at NICE said: “For the first time, doctors, nurses and other users of NICE guidance will be able to access recommendations wherever they are.

DH launches £2m health tech prizes

30 March 2012   Chris Thorne
The Department of Health has announced two competitions, each worth up to £2m, to develop innovative ideas for addressing some of the biggest health problems of our time.
The DH is looking for proposals that will “improve the number of patients taking their medicine as prescribed”, and “change people’s behaviour and attitudes in order to reduce the impact of obesity and alcohol related diseases.”
Health minister Lord Howe said: “Technology and innovation have an important role to play in helping to address the healthcare challenges facing the NHS.

Haphazard IT implementation increases potential for patient risk

By danb
Created Apr 2 2012 - 1:09pm
There's a greater potential for patient harm when hospitals do not plan technology implementation, according to research published [1] in the March issue of the American Journal of Managed Care.
Researchers analyzing 118 interviews at seven Veterans Affairs hospitals from June 2006 through September 2007 said that universal support from staff and executives is necessary during such rollouts, as is flexibility to work around potential setbacks.

NHS chief’s plea on e-health records

Published on Monday 2 April 2012 10:31
THOUSANDS of South Tynesiders are being offered new electronic health records to ensure they get the best treatment in emergencies.
More than 127,000 patients across the borough have the chance to get their own Summary Care Records (SCR).
The records are designed to offer people faster and safer care when they are treated in emergencies, out of hours or in urgent care facilities.
Bosses at NHS South of Tyne & Wear, working on behalf of South Tyneside PCT, are sending an information pack to each patient to explain the service.


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