Quote Of The Year

Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Saturday, July 07, 2012

Weekly Overseas Health IT Links - 7th July, 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.
June 26, 2012

UK unveils patient-centred electronic health strategy

Completing a full retreat from an e-health strategy based on centralized national records, the government of the United Kingdom has unveiled a 10-year blueprint that aims to put the “power of information” in the hands of patients.
Among pledges is a plan to compel all general practices to offer patients electronic access to their health records, electronic appointment scheduling, electronic renewal of prescriptions and electronic “communication with the practice” by 2015.
It’s part of a focus on patient-centred innovations, UK Secretary of State for Health Andrew Lansley stated in the forward to The power of information: Putting all of us in control of the health and care information we need (www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_134205.pdf).

Supreme Court upholds Obama’s health-care law

By Robert Barnes, Published: June 28 | Updated: Friday, June 29, 10:44 AM

Chief Justice John G. Roberts Jr. on Thursday joined the Supreme Court’s liberals to save the heart of President Obama’s landmark health-care law, agreeing that the requirement for nearly all Americans to secure insurance is permissible under Congress’s taxing authority.
The court’s 5 to 4 ruling was a stunning legal conclusion to a battle that has consumed American politics for two years. Roberts’s compromise offered a dramatic victory for Obama and Democrats’ decades-long effort to enact a health-care law and a bitter defeat for Republicans and tea party activists, who had uniformly opposed the Patient Protection and Affordable Care Act.

New Wireless Sensors Tackle Old Problems Like Pneumonia

Wireless sensor technology developed by the University of Missouri can measure subtle changes in pulse, respiration, and bed restlessness, warning clinicians of the early onset of pneumonia or other life-threatening problems.
For the past seven years, wireless sensor technology developed at the University of Missouri (MU) has helped detect disease in its early stages among residents living at the TigerPlace assisted care facility in Columbia, Mo. Now, thanks to a grant from the National Science Foundation, that technology soon will be expanded to remotely monitor the elderly in another facility in Cedar Falls, Iowa.
Marilyn Rantz, RN, professor of nursing at the Sinclair School of Nursing at the University of Missouri, said that staffers and MU researchers will remotely monitor residents in Cedar Falls from the TigerPlace facility, which is about three miles from MU. High-speed video conferencing capabilities will allow communication between staff and residents at the two locations. AdTech Ad

Failed EHR project proves a cautionary tale for hospitals

June 28, 2012 | By Susan D. Hall - Contributing Writer
A failed electronic health record system implementation at Girard Medical Center, a 25-bed facility in the southeast corner of Kansas, represents another healthcare organization lost in the weeds. Girard had an IT staff of two, neither a specialist in EHRs, when it brought in Cerner Corp. in 2010.
Now it's out $1.2 million in fees, still has no EHR system and doesn't qualify for federal monies to pay for one, as the Wall Street Journal points out. It's also enmeshed in a lawsuit against its vendor.

Health reform ruling reinforces importance of health IT, CIOs say

June 28, 2012 | By Dan Bowman
As the nationwide health IT community reacts to the Supreme Court's decision this morning to uphold the Affordable Care Act, hospital CIOs tell FierceHealthIT that the future of health information technology just got a little bit brigher.
While the ruling doesn't directly impact some of the larger healthcare IT efforts underway, such as Meaningful Use, which is part of the American Recovery and Reinvestment Act of 2009 and not the ACA--it is likely to have residual effects, says Stephen Stewart, CIO of Pleasant, Iowa-based Henry County Health Center.
Tuesday, June 26, 2012

Patients Go Online for Health Data but Afraid To Share What They Know

by Lisa Zamosky, iHealthBeat Contributing Reporter
Access to online health care information is growing, as is patients' interest in taking an active role in their medical care. However, progress toward doctors and patients working together to plan treatment may not be moving quite as fast. Many patients, it seems, avoid asking questions or sharing information they have found online for fear of angering their physicians. 
"People are reluctant to do anything that might challenge their physician's authority. Part of that is they've had negative experiences when they've done that. Part of that may be ... that you don't challenge a person upon whose good will you're dependent," Jessie Gruman, president of the Center for Advancing Health, said.
A recent study published in Health Affairs found that despite people expressing a strong interest in discussing treatment options with their doctor, they frequently felt shut down by doctors who often acted in an authoritarian manner.

Joe’s view: of The Power of Information

Does the new NHS information strategy hold the answer to life, the universe and everything – or even the future of NHS IT? Joe McDonald doubts it, but has his own version ready and waiting.
26 June 2012
Last month, I talked about rating clinical systems and threw down a challenge to suppliers to submit themselves to the www.comparethesoftware.co.uk test.
I was encouraged by the number of people who went to the dummy website and attempted to rate the usability of software, and I’ve been invited to take part in some interesting conversations. Watch this space.
Everything I know about the usability of electronic patient records was taught to me by the Department of Health’s excellent user interface expert Stephen Corbett during my time at NHS Connecting for Health.

EHRs improve safety, reduce stress, when implemented correctly

June 25, 2012 | By Marla Durben Hirsch
Electronic health records can reduce the hectic pace of physician practices and the resulting patient safety problems, but not in a vacuum, according to a recent article in American Medical News.
The article, reporting on the results of a recent study by the Agency for Healthcare Research and Quality (AHRQ), noted that EHRs are a "critical first step" in improving safety, but only if practices make the most of their EHR systems and utilize standardized procedures, according to David L. Bronson, M.D., president of the American College of Physicians and president of Cleveland Clinic Regional Hospitals.

Patients Need More Options for Self-Managing Their Own Healthcare

Guest post by Kaveh Safavi, M.D., J.D., North America Managing Director for Accenture’s Health Industry
Before banks introduced automated systems, personal bankers helped their wealthier clients navigate the complex terrain of a massive paper-based financial system. With the introduction of online banking, however, the role of the personal banker was diminished. Customers assumed control of their day-to-day banking needs and were soon able to self-manage their accounts online from anywhere in the world.
Just as in banking, most industries have adopted technologies that personalize the customer experience   and optimize labor costs. But, this has not been the case in the healthcare industry, where there is a misconception that personalized care must be delivered in person. Yet, Accenture’s recent survey  of 1,100 U.S. patients  shows that most patients (90 percent) would prefer to use the Internet, mobile devices and e-mail to self-manage their own healthcare information and services, such as refilling prescriptions and booking appointments.

6 points with regard to regulatory threats and mobile health IT

By Michelle McNickle, New Media Producer
Created 06/26/2012
Not long ago, the American Enterprise Institute (AEI) hosted an event titled, "There's a medical app for that – or not: Regulatory threats to mobile health information technologies." It was an extension of a recent Wall Street Journal article, focusing on the FDA, medical apps and the future of mobile health IT.
"All eyes are on the Supreme Court – everyone's starting at the Supreme Court, but that's not the only healthcare news in town," said J.D. Kleinke, resident fellow at AEI and healthcare business strategist. "An attempt has been made by the FDA to expand its mission to one of the more dynamic and important issues happening in healthcare and that's health IT generally, but more specifically, mobile applications."

DH won't mandate information standards

22 June 2012   Jon Hoeksma
The Department of Health has said that it doesn’t expect to mandate information standards in any more than a ‘handful of cases’.
Instead, the DH says it expects to work with partners in a consensual fashion, says Giles Wilmore, the author of the new NHS information strategy who spoke at a joint Intellect/DH event last week.
Asked about standards and whether they would be mandated, Wilmore said that mandation didn’t fit with the consensual, collaborative ethos of the strategy.

Platforms for comparative effectiveness research still evolving

June 27, 2012 | By Susan D. Hall - Contributing Writer
With the government pushing comparative effectiveness research (CER), it also has funded a look at the informatics platforms developed so far, according to research recently published in the journal Medical Care.
The Patient-Centered Outcomes Research Institute (PCORI), a nonprofit established by the Affordable Care Act, this month awarded $30 million in grants for CER projects.

GAO slams HHS on e-prescribing privacy guidance

June 26, 2012 | By Ken Terry
A Government Accountability Office (GAO) report charges that the U.S. Department of Health & Human Services (HHS) has not properly safeguarded the privacy and security of personal health information when electronic prescribing data is used for secondary purposes. The report also slams HHS' Office for Civil Rights (OCR) for not fully carrying out its enforcement of privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA).
With regard to e-prescribing, the watchdog agency noted that, under the Health Information Technology for Economic and Clinical Health (HITECH) Act, HHS is supposed to provide guidance on how covered entities should de-identify data in electronic prescriptions when it is used for purposes other than direct patient care. Such secondary purposes include the use of data in research, healthcare operations, public health, and drug marketing.

Health IT Can Learn From Past Screw-Ups

U.S. healthcare system will remain broken unless we redesign our tools and rethink our mindset.
If you're a fan of the musician Sting, you're probably familiar with the line, "History will teach us nothing," from the song of the same name. You might at first think the song suggests that we can't learn anything from the past. But a closer listen suggests Sting's point is that history will teach us nothing if we don't pay attention to it.
That's where health IT is right now: Poised at a historical crossroad where it can either ignore past mistakes made by other technology-driven industries or profit from them. AdTech Ad

Why Don't More Hospitals Use Electronic Health Records?

By Devin Leonard and John Tozzi on June 21, 2012
When the patient arrived, he started twitching uncontrollably. The elderly gentleman had been brought by worried family members to see a specialist at the Kaiser Permanente Santa Clara Medical Center in California late last year. The doctor there thought the man might be having an epileptic seizure—only he soon stopped twitching and, a minute later, seemed fine. Unsure of what to do next, the outpatient doctor called James Lin, chief of the hospital’s emergency department. Should he send the man to neurology, as he would an epileptic patient, or to emergency?
Lin, a fast-talking 38-year-old with brush-cut hair and freckles, had his colleague wait while he looked up the patient’s records on the hospital’s electronic health record (EHR) system. In an instant, he saw that the man had a history of twitching episodes from which he recovered quickly; usually people suffering epileptic seizures tend to remain confused and disoriented afterward. “Send him over to me right away,” Lin said. Minutes later, Lin put the patient on a cardiac monitor and confirmed that the man’s brain wasn’t the source of his medical issues. He watched as the patient’s heart rate slowed. There was a long pause between beats, during which the man started twitching again. He was at risk of cardiac arrest. Lin transferred him to the intensive care unit, where he was outfitted with a pacemaker in a matter of hours. Lin says the man might have died if he had gone to the neurology clinic. The doctors there don’t have cardiac monitors and might not have diagnosed his condition in time.

Online Program Lets Docs 'Prescribe' mHealth Apps

Happtique mRx program lets physicians send apps directly to patients' smartphones and tablets, or refer them to Apple store.
Happtique, a mobile health application store aimed primarily at healthcare providers, plans to launch an mRx program that will give hospitals and physicians a mechanism for prescribing mHealth apps to patients. Following a two-month pilot this summer, Happtique expects to launch its patent-pending mRx technology in the marketplace.

Telemedicine market to reach $2.5B by 2018

By Erin McCann, Associate Editor
Created 06/26/2012
LONDON – The thriving telemedicine market hasn't shown signs of abating any time soon, according to a new report by Companies & Markets. The report shows that in 2011, the global telemedicine monitoring market reached a value of $736 million and, according to officials, is poised to increase to $2.5 billion by 2018.
This significant growth in the global market can be attributed to numerous factors as telemedicine monitoring provides ways to improve clinical care delivery to patients while also reducing the need for hospitalizations and visits to the emergency room.

Can a Doctor's Smartphone App Thwart Lawsuits?

Joe Cantlupe, for HealthLeaders Media , June 21, 2012

Patient: You never told me.
Physician: Yes, I did.
Patient: No, you didn't.
Physician: Yes, I did.
These are the basic elements of patient-physician miscommunication. What was said, what wasn't, and by whom? The upshot could have little impact on the medical outcome, or it could be a matter of life and death. Legally, the rudiments of this conversation could determine whether a physician becomes a defendant in a malpractice suit.
Last month, a classic case of such miscommunication emerged in a Colorado courtroom, when a woman who apparently had a seizure while driving her SUV entered an intersection, went airborne, smashed into two other cars, and killed five. Prosecutors claimed the driver ignored medical advice to not operate a vehicle. She claims she never got such advice. The woman was eventually cleared of negligent homicide. It is uncertain if she will file civil claims.

Research fills in Map of Medicine

21 June 2012   Rebecca Todd
About half of GPs and a quarter of community staff are using the care pathways tool Map of Medicine, new research suggests.
Map of Medicine is a collection of evidence-based practice-informed care maps, rolled out to GPs and community users as part of the National Programme for IT in the NHS.
Stockport NHS Foundation Trust IT Services manager Colin Cohen has been studying the Map of Medicine project as part of a thesis for his doctorate.

Health-care apps for smartphones pit FDA against tech industry

By Dina ElBoghdady, Published: June 23

Three tries. More than two years. And roughly $150,000.
That’s what it took for MIM Software to get the Food and Drug Administration’s clearance for a smartphone application that physicians can use to view MRIs and other medical images.
“It was 2008 when we first tried,” said Mark Cain, the Ohio firm’s chief technology officer. “They didn’t know what questions to ask and neither did we. . . . But at some point, they had to be thinking, ‘How many more people will be lined up behind these guys?’ ”
His was, in fact, among the first apps cleared by the FDA. And since then, medical applications have flooded onto millions of smartphones, offering consumers the chance to check their heart rate, identify a pill in their medicine cabinet or even scan moles for skin cancer. Soon, if a firm called AliveCor gets its way, they may even be able to get an EKG by pressing iPhone to chest.

Fewer malpractice claims when docs use EHRs: study

Posted: June 25, 2012 - 5:00 pm ET
A group of Massachusetts physicians saw a dramatic drop in malpractice claims after implementing electronic health-record systems, according to a research letter published by the Archives of Internal Medicine.
Researchers from Harvard-affiliated organizations—including the Harvard Pilgrim health plan and Harvard Vanguard Medical Associates—merged closed claims data from a Massachusetts malpractice insurer for the years 1995 to 2007 with data from a random sample of physicians surveyed in 2005 and 2007. Researchers said 275 doctors were surveyed in 2005 and 189 were surveyed in both years. Among the latter group, just over 14% reported having been sued at least once.

In a Medical Crisis, Service Helps Others to Help You


What if you were found unconscious or unable to clearly communicate, suffering from an injury or other medical crisis? It could take an emergency responder or a doctor precious time to figure out two key things: your medical profile and how to get in touch with a family member or friend.
Now, a small start-up company called EmergencyLink is trying to improve this situation with a free service that combines digital and physical aids. If you enroll, you can create a detailed profile, including your medical conditions, allergies, medications, insurance information and a list of emergency contacts who can provide more information. This profile is stored online and can be accessed, and updated, via a password-protected website and a companion smartphone app.

Digital Evolution of Journal Articles

By Todd Neale,
Published: June 25, 2012
Here at MedPage Today, we read a lot of papers in medical journals. Some are written better than others, but they're all pretty much the same -- abstract, introduction, methods, results, discussion. Occasionally, when reading a paper about a surgical technique or new device, I find myself wanting more illustrations or even a video showing me how it works.
Those aren't found in the vast majority of cases, but perhaps a new initiative by the American Society for Reproductive Medicine and Elsevier -- the publisher of the society's journal, Fertility and Sterility -- can take publications in that direction. The idea is to allow peer-reviewed video reports to be cited in the same way as a written article and indexed on PubMed. An abstract of the video report is included in the print version of the journal, allowing readers to find non-written reports through traditional means.

Time to Cut Out the Health Care Chauffeur?

JUN 22, 2012 12:55pm ET
During a June 22 general session at AHIP 2012, author Malcolm Gladwell espoused that the health care industry, unlike virtually every other industry, has not been able to eliminate the “chauffeur” in the care system, to the financial and clinical detriment of the country.
Gladwell, who penned Blink and The Tipping Point, among other books, opened with the trajectory of chauffeurs during the advent of the automobile. When cars first came to market, chauffeurs were critical for the rich because chauffeurs, unlike coachmen, understood and were responsible for the operation of a  complex new technology that was a mystery to others. They used that leverage to earn much higher wages than coachmen, as well as higher status in the social hierarchy. But as cars became commoditized, more reliable and less complex to operate, chauffeurs quickly lost that status as the wealthy began to drive their own cars—that is, the customer assumed control.

Docs believe EHRs safer than paper, but patients still ambivalent

By Mike Miliard, Managing Editor
Created 11/02/2011
SAN FRANCISCO – A new survey finds a majority of physicians believing that electronic health records are safer than their paper counterparts, citing accessibility of data as the top safety benefit.  But patient perception remains mixed with nearly half of respondents believing paper records are safer.
Conducted by GfK Roper on behalf of Practice Fusion, the survey polled patients about their views on the safety of EHR versus paper charts; a separate survey posed the same questions to medical professionals.
More than half of physicians (54 percent) agreed that EHRs are safer, with just 18 percent of respondents selecting paper as the safer option.

Docs adopt and adapt, yet still cling to old ways

By Erin McCann, Associate Editor
Created 06/25/2012
ATLANTA – The technology takeover has begun, and physicians nationwide are acclimating one step at a time, a new physician survey reveals. Laptop, smartphone and iPad usage is increasingly common among U.S. physicians, but the report finds old-fashioned methods of communication continuing to stand their ground.
The second annual National Physicians Survey, conducted by the little blue book and Sharecare, polled 1,190 U.S. practitioners representing more than 75 medical specialties. It reveals physicians' perceptions about the ongoing changes in the healthcare system and how those changes are impacting their daily practices as well as their ability to provide optimal patient care. 

NICE launches BNF smartphone app

14 June 2012   Chris Thorne
The National Institute for Health and Clinical Excellence has launched a free version of the British National Formulary smartphone app for health and social professionals employed by NHS England.
The NICE BNF app has been developed to provide easy access to the latest up-to-date prescribing information from the BNF, the most widely-used medicines information reference guide used within the NHS.
The app is available to download for free via the Apple App Store and Google Play Store. Users will need their NHS Athens user name and password to activate the app and download the content.

Docs increasingly think EMRs will hurt care quality

June 25, 2012 | By Dan Bowman
Physicians' use of mobile devices appears to be on the rise, while confidence that electronic medical records can improve patient care is slightly down, according to the results of a new survey conducted by health practice reference company The Little Blue Book and Sharecare.
Two-thirds of the nearly 1,200 physicians surveyed said EMR integration is a top challenge, according to the report. At the same time, 34 percent said they believe that the quality of patient care will deteriorate due to EMRs, up from 24 percent in 2011. Still, 66 percent said that care either will improve (35 percent) or stay the same (31 percent).

Better data standards, registries key to value-based healthcare

June 25, 2012 | By Susan D. Hall - Contributing Writer
The complex and highly fragmented healthcare system in the United States makes it difficult to develop a nationwide approach to value-based healthcare, according to a new report published by the Boston Consulting Group that called for better data standards and patient registries.
The report looked at efforts to improve health outcomes--while also maintaining or lowering costs--in the health systems of 12 countries: Australia, Austria, Canada, Germany, Hungary, Japan, the Netherlands, New Zealand, Singapore, Sweden, the U.K., and the United States.

Physician 'face time' is not optional, regardless of technology

June 25, 2012 | By Ken Terry
In a new Accenture consumer survey, 90 percent of respondents said they wanted to have online access to their medical information. The results also show that most consumers would like to be able to book appointments, request prescription refills and receive e-mail reminders when it's time for follow-up care.
None of that's surprising. What is surprising is that so many practices still don't provide these tools to patients, more than a decade after the technology became available.

AMA Approves of HHS’ Prescription Drug Use Data Pilot

June 22, 2012
The American Medical Association has announced its approval of the Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC) pilot programs aimed at making existing prescription drug use data available to providers and pharmacists when treating patients in ambulatory and emergency departments.

No evidence for 3millionlives roll-out

22 June 2012   Rebecca Todd
The 3millionlives campaign is not justified by the results of the whole systems demonstrator trials, experts say.
The first paper on the WSD trial, looking at the effect of telehealth on use of secondary care and mortality, has been published by the British Medical Journal.
The trial showed patients using telehealth had lower mortality and fewer hospital admissions, but failed to identify any cost savings.

Telehealth Provides Benefits, But Cost Savings Are Modest

Emma Hitt, PhD
June 22, 2012 — For patients with long-term conditions, telehealth can reduce 12-month mortality by nearly half, but the cost savings may be modest, according to a the results of a new randomized controlled trial.
Adam Steventon, MA, senior research analyst with the Nuffield Trust in London, United Kingdom, and colleagues reported their findings online June 22 in the British Medical Journal.
According to the researchers, telehealth, which involves the remote exchange of data between the patient and the clinician as part of healthcare management, may help improve patient outcomes.


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