This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
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.
Think of it as a health policy wonk’s dream: Football stadium after bigstockphoto One insurance company’s data could fill 60 million of these. football stadium packed to the brim with...health insurance claims data.
An odd dream, to be sure. But health insurance data is crucial to understand how health care dollars get spent. It shows how people use health care, what’s changing and, in some cases, why. Health insurers, however, have tended to keep that data private, as it could tip competitors off to how they handle business.
That all, however, changes today. This morning a new nonprofit called the Health Care Cost Institute will roll out a database of 5 billion health insurance claims (all stripped of the individual health plan’s identity, to address privacy concerns).
Health systems and policymakers mustn't lose sight of the big picture when discussing IT strategy and goals, believes the leader of the largest private healthcare delivery organization in the United States.
"The goal is the care," advised Kaiser Permanente president and CEO George Halvorson. "The technology is a tool."
"A lot of people put medical records in place but don't have a goal, don't have a particular strategy to use them, and if you just put the medical record in place and don't use it for anything, care doesn't get better," Halvorson told InformationWeek Healthcare in an exclusive interview. The Kaiser leader keynoted at the pan-European World of Health IT conference in Copenhagen, Denmark, this month, then spoke to InformationWeek Healthcare at the official residence of the U.S. ambassador to Denmark, Laurie Fulton.
NEW YORK – On the second and last day of the Connecting Healthcare + Social Media Conference in New York this past week, Jessie Gruman, president of the Center of Advancing Health, took the stage to present an honest and point-blank keynote on what she, and a majority of patients, ultimately want to see from an organization's social media efforts.
"I speak as someone who's been diagnosed four times with cancer," she said. "I'm a frequent user of healthcare, and I draw on my experiences to inform my own work … many of us personally know healthcare is a delicate balance between the cognitive and emotional, the subjective with objective and individuals with populations. Websites are an ever-changing puzzle, and as we become more familiar with looking for health things online … social media makes this puzzle less puzzling for us."
President Obama’s directive to made federal data more accessible and useful is a nice idea. But clearly, he doesn't have the slightest idea of what it takes to create digital interfaces to data that can work all the time across multiple platforms and without glitches.
Just as a simple example: a major bank for which I do contract work had paid a group of programmers to create an accounting program. After three years and having spent several million dollars, they fired the group because the software still didn't work. Creating digital tools, applications, and interfaces is not easy work. If it were, everyone would be doing it.
More importantly, doing something that presents a uniform face to the information-consuming public requires cooperation in the design and implementation of proposed solutions. This is something for which government is not known. Departments sequester information often for no other reason than simply to show that they have the power to do so. To expect the floodgates of Christian charity to open wide to usher in a new age of interdepartmental cooperation and goodwill is tantamount to believing in the tooth fairy.
The Continuity of Care Document (CCD), a standardized format for clinical summaries that can be exchanged between disparate electronic health record systems, could greatly advance public health initiatives, according to a new paper in the American Journal of Public Health.
Among the public health areas that the CCD could benefit, the paper said, are public health agencies' efforts to help reduce the burden of chronic diseases; the improvement of clinical detail in death certificates to identify dangerous trends; and the improvement of biosurveillance to detect disease outbreaks.
May 25, 2012 | By Susan D. Hall - Contributing Writer
The Federal Communications Commission yesterday voted to approve a channel to accommodate wearable electronic devices that will free patients now tethered to hospital beds.
New rules will allow healthcare providers to use wireless spectrum for "medical body area networks"--or MBANs--which can transmit information from, and between, mobile medical devices both in the hospital and at home. FCC Chairman Julius Genachowski predicted last week that the expansion will allow providers to monitor patients vital signs throughout the continuum of care, prevent adverse events and hospital readmissions, and ultimately lower healthcare costs.
A recent report from Englewood, Colo.-based research firm, IMS Research, is predicting that medical devices utilized by the consumer to self-monitor their health, rather than those used in managed telehealth systems, will be the biggest opportunity for wireless technologies in healthcare over the next five years. In the report, “Wireless Opportunities in Health and Wellness Monitoring – 2012 Edition,” IMS Research forecasts that more than 50 million wireless health monitoring devices will ship for consumer monitoring applications during the next five years, with a smaller number being used in managed telehealth systems.
According to the IMS report, medical devices bought by the consumer to self-monitor their health will account for more than 80 percent of all wireless-enabled consumer medical devices in 2016. The researchers say the demand for consumers to self-monitor their health is growing much faster than the market for telehealth implementation. The report states consumers will want to be able to monitor and manage their own health at home, even if they don’t belong to a healthcare systems that is adapted for this. The researchers expect a proportion of wireless devices used in managed telehealth programs to increase from five percent in 2011, to 20 percent in 2016.
The NHS’ own health organiser, HealthSpace, has been confirmed as an unlikely casualty of the NHS information strategy, published earlier this week.
In a speech today, Dr Charles Gutteridge, the national clinical director for informatics at the Department of Health, confirmed that HealthSpace would cease to exist in the next 12 months.
Even though the strategy makes giving patients access to their records a key part of its vision for improving access to information, and HealthSpace was developed to give patients access to their Summary Care Record, Dr Gutteridge said he could not make the technology work.
COLORADO SPRINGS, CO – For the first time ever, the United States Olympic Committee will use electronic medical records rather than paper charts to manage care for more that 700 athletes at the summer games.
The USOC announced Thursday that it will deploy GE’s Centricity Practice Solution, which integrates EMR with practice management technology, to manage the care of more than 700 American athletes competing in the London 2012 Olympic and Paralympic Games, and for 3,000 additional records maintained by USOC staff.
The telemedicine market is expected to achieve "significant" growth in the next few years, from $736 million in 2011 to $2.5 billion in 2018, according to a new study by WinterGreen Research.
Telemedicine and home telehealth monitoring will increasingly be used to treat people with chronic conditions and reduce readmissions by using diagnosis support tools and treatment support tools, according to the study. It is being recognized as an effective way to keep patients healthy and thus cheaper for payers.
Facebook's recent IPO means that the company now has a lot more incentive to use the personal data it has collected on its 900 million-plus users, Congdon says. He writes that, were the company to get into the protected health information business, it could decide to offer that information to pharmaceutical companies looking to market specific drugs to specific patients.
A funny thing happened on the way to ICD-10: Suddenly, there's talk of using the Systemized Nomenclature of Medicine--Clinical Terms (SNOMED-CT) in place of or in conjunction with the controversial diagnostic coding set. The American College of Physicians (ACP) and the Texas Medical Association (TMA) have both taken this position, although in different ways.
In a May 17 letter, ACP told the Department of Health and Human Services that it supports the proposed implementation of ICD-10 by Oct. 1, 2014; a year later than the current deadline.
WASHINGTON – The departments of defense and veterans affairs plan to fully merge their health care records systems in the next five years, with the goal of giving troops and veterans a single, seamless system to track medical care throughout their lifetime.
President Barack Obama touted the idea of a lifelong electronic military medical record in April 2009, as part of dramatic improvements to veterans health care. But during a joint appearance in Illinois on Monday, Defense Secretary Leon Panetta and VA Secretary Eric Shinseki announced they hope to put the single system in place in 2017, creating what would be the world’s largest electronic health record system.
May 21, 2012 by The Editors of Healthcare Informatics
Largest vendors maintain their rankings from last year
Healthcare Informatics, a New York City-based magazine providing leadership and strategy for healthcare IT leaders, is proud to officially announce the 2012 version of its unique industry offering: the Healthcare Informatics 100, a compilation of the top health IT companies based on HIT revenues from the most recent fiscal year. For this year’s list, McKesson Technology Solutions (Alpharetta, Ga.) was the top ranked company, marking the fifth year in a row that the diversified healthcare IT software solutions vendor has sat atop the list.
The HCI 100 is a complete look at the top 100 revenue-earning companies in the industry, eligible to any company that can identify HIT-based revenues. On the list, along with the company’s revenue, is a look at detailed information including a brief description of each company’s activity, its past revenues, recent acquisition information, and more.
In the first quarter of 2012, two important reports on consumer privacy were issued in Washington: In February, the White House laid out a "Consumer Privacy Bill of Rights" and in March the Federal Trade Commission followed with its report, "Protecting Consumer Privacy in an Era of Rapid Change." Both documents acknowledge that most federal data privacy laws apply only to specific sectors of the economy, such as health care, education, communications and financial services. Both reports call on Congress to enact baseline consumer privacy legislation to fill the gaps and, in the interim, urge companies to voluntarily adopt best practices or model codes of conduct based on fair information practice principles.
Unfortunately, because most health care system entities -- chiefly health care providers and payers -- already are required to comply with baseline health privacy regulations enacted under HIPAA, these reports received little attention from the health care industry.
New figures from Surescripts reveal that at the end of 2011, 58% (or 317,000) of office-based physicians were using e-prescribing tools to fill prescriptions, versus only 36% (190,000) in 2010.
"The National Progress Report on E-Prescribing and Interoperable Healthcare, Year 2011," which examined actual adoption and use of e-prescribing nationwide, also found that smaller practices led the way. Among practices with six to 10 physicians, 55% adopted the technology, as did 53% of practices with two to five physicians. The most significant growth in physician adoption of e-prescribing occurred among solo practitioners: from 31% in 2010 to 46% in 2011.
A test drive, a check against standard criteria, and lots of user reviews. Joe McDonald knows what a good test of EPR systems should look like. Now, he just needs a supplier to step forward...
23 May 2012
My first column compared services that allow patients to rate the healthcare they have received.
I allocated stars to the various services in what I admit was a fairly crude way of representing their relative merits (not least because they were awarded in a somewhat arbitrary way, with a large dollop of personal preference).
The column generated a fair amount of debate and that debate was generally good natured. Even better, the providers of feedback services covered themselves in glory by responding positively to criticism.
Patient Opinion, NHS Choices, and iwantgreatcare all offered to up their game in a variety of different ways. So could the same approach drive improvement in electronic patient record systems? Or would I merely generate a law suit from system providers?
May 23, 2012 | By Susan D. Hall - Contributing Writer
Much work remains on the joint integrated electronic health record system being created by the Departments of Defense and Veterans Affairs, Defense Secretary Leon Panetta and VA Secretary Eric Shinseki told reporters earlier this week at Chicago's James A. Lovell Federal Health Care Center, Nextgovreports. The full system, Shinseki said, is not due out until 2017, though a preliminary version will roll out at medical facilities in San Antonio and Hampton Roads, Va., in 2014.
"We'll go as fast as we can without accepting risk that's not tolerable," Shinseki said. "[Q]uality and safety are the standards we measure ourselves by."
Saint Vincent Health System in Erie, Pa., reports that using telemedicine technology has reduced readmissions in its 26 Pennsylvania facilities--and also netted a 100 percent return on investment in just two months.
St. Vincent's success story echoes the findings of Geisinger Health Plan's two-year study of home telemonitoring. That trial showed a 44 percent drop in readmissions among the monitored patients compared to a control group.
The Geisinger study looked at the use of an interactive voice response system for monitoring patients with congestive heart failure. The IVR system enabled the patients to report their weight and answer a series of questions about their symptoms.
According to a report by the Department of Homeland Security, the increased use of mobile health technology opens up a world of vulnerability to patients and medical facilities. The report, "Attack Surface: Healthcare and Public Health Sector" says since IT networks are remotely available through medical devices, there is a rising concern that these devices will fail toprotect against theft of medical information and malicious intrusion.
The report states, “These vulnerabilities may result in possible risks to patient safety and theft or loss of medical information due to the inadequate incorporation of IT products, patient management products and medical devices onto Medical IT Networks.”
It is no surprise that as the complexity of healthcare has increased, so too have the demands placed on today's clinicians.
With the widespread implementation of health information technology (HIT) rapidly proceeding and the reengineering of service delivery being initiated because of health reform, nurses are being asked to perform more critical tasks in an environment that is changing more rapidly than any time in the last several decades.
Because this amounts to "trying to build a plane while flying it," hospitals need to consider taking a step back and maximizing the efficiency of their current processes before tackling these enormous new undertakings.
By Roger Foster, Senior director, DRC’s high performance technologies group, and advisory board member of the technology management program at George Mason University
While it is true that organizations across all industries experience a certain degree of inefficient administrative processes, the size and the cost of the problem in the US healthcare industry is colossal.
Indeed, administrative system inefficiencies have been estimated in the range of $100-150 billion annually, and the actual costs could be even higher. According to a position paper by the Medical Group Management Association, “simplifying our healthcare system’s administration could reduce annual healthcare costs by almost $300 billion.”
Scott Mace, for HealthLeaders Media , May 22, 2012
If you've flown lately, you've seen them everywhere: e-books, running on Kindles, on iPads, on any number of tablet devices. Get ready to see them a lot in healthcare too.
Prompted by an announcement that yet another standard desk reference had been released in e-book form, I wonder if we've reached a tipping point yet where the standard nurse or doctor's desk reference on paper has gone the way of the telephone book. I normally recycle these phone company dinosaurs as soon as they land on my doorstep.
Think of the upside. E-books are fully indexed. Any occurrence of a word is searchable with a touch. Paper-based indexing systems just can't compete.
Publishers can update e-books as often as necessary. Paper-based desk reference books are still updated at least (and often, at most) once a year.
Therefore, I thought I would share a story about how data cleansing saves lives, which I read about in the highly recommended book “Space Chronicles: Facing the Ultimate Frontier” by Neil deGrasse Tyson. “Soon after the Hubble Space Telescope was launched in April 1990, NASA engineers realized that the telescope’s primary mirror – which gathers and reflects the light from celestial objects into its cameras and spectrographs – had been ground to an incorrect shape. In other words, the two-billion dollar telescope was producing fuzzy images. That was bad. As if to make lemonade out of lemons, though, computer algorithms came to the rescue. Investigators at the Space Telescope Science Institute in Baltimore, Maryland, developed a range of clever and innovative image-processing techniques to compensate for some of Hubble’s shortcomings.”
The strategy puts a particular emphasis on the creation of portals for patients, health professionals, commissioners and researchers, in a series of moves that health secretary Andrew Lansley says will free up the "power" of information.
A national ‘portal’ will be created as the definitive source of trusted information on health and social care by 2013. The NHS portal will inform patients’ decisions on selecting treatments and providers.
Telemonitoring had a sustained positive impact on outcomes for diabetes patients, even as the intensity of the monitoring decreased, according to a Journal of the American Medical Informatics Association study.
The study examined veterans who participated in The Diabetes Telemonitoring (DiaTel) Study, which compared active care management that included home telemonitoring to monthly care coordination efforts via telephone calls. The initial study ran from January 2005 to November 2007.
By Andrea Falciani, Research Analyst, Suss Consulting
President Obama's IT budget for the Department of Health and Human Services (HHS) totals $7.1 billion for fiscal year 2013, marking a 3 percent increase from FY12.
The IT budget request covers a variety of business functions and plays a pivotal role in supporting the Department’s overall mission to protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves.
SALEM, OR – The state of Oregon is joining the burgeoning number of health information exchanges across the country, with the implementation of CareAccord, a statwide HIE officials say will promote improved communication between care providers, reduce duplicate orders and facilitate implementation of meaningful use requirements.
The Oregon Health Authority (OHA), which will administer CareAccord, has selected Harris Corporation – the international IT company whose HIE projects include implementations for the State of Florida and the Department of Veteran Affairs – for Direct Secure Messaging, a point-to-point communications system that enables registered providers to exchange information, including attachments containing patient data, using any device with Internet access.
The Agency for Healthcare Research and Quality reminds ambulatory practices of the availability of its free Workflow Assessment for Health IT Toolkit and is working to make it more useful to small- and mid-size physician practices.
I recently took my four-year-old son into the dentist for a teeth cleaning, and the first thing that happened, per usual, is that a technician came into the room and said it was time for X-rays. That’s just a given during a trip to the dentist; has been since I was a kid and had to be dragged to the dentist in chains (just hated getting my teethed cleaned, almost as much as I disliked brushing them, or so I’m told).
This time I was a little leery of doing business as usual. It was the fourth time in the past year my son was going to get a full set of X-rays. A while back he managed to shatter a tooth, which had to be yanked out old school with a pair of pliers and a dental hygienist and me sitting on top of him. That triggered a couple extra trips, and a couple more sets of X-rays to check for complications.
Ten years ago, most patients wouldn't have even considered bringing a camera into their doctor's office. The advent of smartphones, however, has changed that. So much so, in fact, that an article published this week in American Medical News asks if doctors should ban patients from taking cellphone pictures in their offices.
Sixty-two percent of physicians--nearly double the number a year ago--now use computer tablets, according to FierceMobileHealthcare reports. That report makes it appear as if iPads and other tablets will inevitably take over medicine. In fact, Monique Levy, director of research for Manhattan Research, told eWeek that all physicians will eventually adopt these gadgets.
That would certainly affect healthcare, but perhaps not as much as one might expect.
For one thing, only half of the current tablet owners have ever used them at the point of care. That's still a lot of physicians, but they're mostly using their iPads to read medical news, access drug information and e-prescribe. In other words, they're doing the same stuff they used to do on PDAs and smartphones, only on a larger screen.