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Is It Happening? Electronic Health Record Vendors Take Steps Toward Interoperability
In a move that signals a shift in the health care industry, Epic Systems and Cerner are quietly working with Greenway Medical Technologies to link together their electronic health records for the purpose of exchanging patient information. Epic Systems, which has maintained a closed legacy EHR, sells to hospitals, as well as larger medical groups. Cerner dominates in hospitals, but with Greenway it can now offer another option to smaller practices, where it has less of a presence. (In another milestone, Epic will connect its own network of EHRs with Surescripts, the electronic prescription company).
Preoccupied with market share, vendors have largely resisted making their electronic health records interoperable, but the government is pushing to break down information exchange barriers for the benefit of patients. Medical information is now locked in silos, where it cannot be truly useful.
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Medication Alert Fatigue Is Curable
Medication alerts are supposed to ensure patient safety, but clinicians ignore them when bombarded with too many. This dilemma needs to be solved.
By Paul Cerrato, InformationWeek
September 06, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/medication-alert-fatigue-is-curable/240006861
September 06, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/medication-alert-fatigue-is-curable/240006861
Medication alerts within EHRs can save lives, but as many clinicians are quick to point out, these alerts can also prove to be a major headache. The alerts sometimes note potential adverse effects that even first year medical students would know. While there's no perfect system, we can do better.
Given that between 33% and 96% of medical alerts are ignored, there's little doubt that providers need help in this regard. A good place to start is with a core set of critically important drug/drug interactions (DDIs) that everyone in your healthcare system needs to watch. 
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http://www.fiercehealthit.com/story/real-time-prescription-database-curbs-doctor-shopping/2012-09-07
Real-time prescription database curbs 'doctor shopping'
September 7, 2012 | By Susan D. Hall
A central, real-time database helped reduce the number of inappropriate prescriptions filled in British Columbia, according to an article published this week in the Canadian Medical Association Journal.
A real-time processing system called PharmaNet was installed in 1995, linking all pharmacies and hospitals in the province to a central database. To determine its effect on "doctor shopping" for inappropriate prescriptions, the researchers compared records before and after. They looked at prescription records between Jan. 1, 1993, and Dec. 31, 1997, for residents who either were on social assistance or were ages 65 and older. They labeled prescriptions for opioids or benzodiazepines inappropriate if they were written for at least 30 tablets of the same drug by a different doctor and taken to a different pharmacy within seven days, according to MedPage Today.
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ONC tables regulation of Nationwide Health Information Network
September 7, 2012 | By Dan Bowman
The Office of the National Coordinator for Health IT will not pursue governance of the Nationwide Health Information Network, it revealed at yesterday's meeting of the Healthcare IT Policy Committee. National Coordinator for Health IT Farzad Mostashari, M.D., in a post to the Health IT Buzz blog today, said the decision was made so as "not to hobble" exchange activities already in motion across the industry and the nation.
In May, ONC issued a request for information on such governance. Its goals at the time included improving efficiency for health information exchange among different entities, avoiding potential conflicts between disparate governance structures of state HIEs and guiding the evolution of interoperability standards in the HIE marketplace.
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EHRs May Shortchange Depression Patients
Electronic health records may focus a doctor's attention on certain medical conditions, leading to undertreatment for depression, researchers suggest.
By Nicole Lewis, InformationWeek
September 06, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-may-shortchange-depression-patients/240006895
September 06, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-may-shortchange-depression-patients/240006895
Patients with three or more chronic conditions are half as likely to receive treatment for their depression during a visit to a doctor's office that uses electronic health records (EHRs) when compared with patients who visited paper-based practices. At least that's the conclusion of an investigation recently published in the Journal of General Internal Medicine.
The study, conducted by researchers at the University of Florida and the University of South Florida, analyzed the odds of receiving treatment for depression during a doctor's visit by examining data from the National Ambulatory Medical Care Surveys (NAMCS) of 3,467 physician office visits by patients from 2006 to 2008. Researchers focused on visits to primary care providers by patients ages 18 and older with physician-identified depression. The 3,467 visits were divided into two groups: 2,584 visits to practices without EHRs, and 883 visits to practices with EHRs.
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Wednesday, September 5, 2012
EHRs: Which Ones Doctors Like and How Their Lives Changed
From the survey: "EHRs have become a fact of life. Eighty-two percent of survey respondents either currently use EHRs or are in the process of implementing them, up from just 38% in Medscape's 2009 EHR survey. Even holdouts are reluctantly buying in: 12% of respondents said they'll purchase or begin using an EHR within the next year or two, and only 6% said they have no plans to buy an EHR.
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Surescripts to boost clinical interoperability for Epic
By Bernie Monegain, Editor
Created 09/06/2012
ARLINGTON, VA – Surescripts and health IT company Epic are working together to connect Epic’s Care Everywhere interoperability platform to the Surescripts Clinical Interoperability Network.
The connectivity will allow healthcare providers that use Epic’s EHR to securely send and receive clinical information, including referrals, discharge summaries and lab results, with peers locally, between practices and across health systems, Surecripts executives announced today.
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UPMC and IBM keep focus on big data for personalized medicine
By Mike Miliard, Managing Editor
Created 09/05/2012
PITTSBURGH – UPMC has renewed an agreement with IBM, investing $120 million over the next four years in technology that will help spur changes in the way treatments are designed for individual patients by more effectively analyzing massive volumes of patient and research data.
Under its initial agreement with IBM, signed in 2005, UPMC saved more than $191 million over six years, eliminating the need to create a new data center and supporting UPMC's growth, officials say.
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Study: Tailor clinical decision support, allow for flexibility
September 5, 2012 | By Marla Durben Hirsch
Determining problem areas in need of clinical decision support and the supports themselves varies by medical specialty and should be determined by "deliberative analysis," according to a new study provisionally published this week in BMC Medical Informatics & Decision Making.
The Meaningful Use incentive program requires providers to implement CDS interventions that can improve performance on clinical quality measures. However, "[n]o framework exists to systematically assess potential CDS objectives to ensure that 1) they address the most critical gaps in care, and 2) they are clinically meaningful to the broad range of specialties participating in the Medicare and Medicaid EHR Incentive Program," the authors noted.
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EMIS prescribes tablets for Web
7 September 2012 Lyn Whitfield
EMIS has unveiled a mobile version of EMIS Web at its national user group in Warwick.
The EMIS Mobile app is compatible with major tablet computer platforms, including iOS, Android and Windows 8, and can be used both on and offline, to cover areas in which there is no connectivity.
Functionality includes the ability to access a diary and appointment schedule, to view patient records and to add consultations.
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DH launches ITK ideas fund
31 August 2012 Lyn Whitfield
The Department of Health has launched an Information Sharing Challenge Fund to support information sharing projects that can be replicated across the NHS through the interoperability toolkit.
In a ‘dear colleagues’ letter sent out this morning, Ailsa Claire, transition director of the patients and information directorate at the NHS Commissioning Board, says the scheme is “designed to improve patient care by stimulating the creation of new and innovative digital services.”
She adds that these ideas must be “underpinned by robust and effective information sharing based on approaches that are re-usable across the NHS.”
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Data analytics key to leveraging ENCODE DNA project discoveries
September 6, 2012 | By Julie Bird
It turns out there's a purpose to the so-called "junk" DNA comprising most of the human genome--and health technology will play a major role in unlocking more of its secrets.
Much of the material contains more than 4 million "molecular switches" that regulate the genes in DNA, NPR reports in summarizing the findings published Wednesday in more than two dozen scholarly journals.
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IOM: Technology a must to fix 'complex, costly' healthcare
September 6, 2012 | By Dan Bowman
Better use of technology to capture and share health data is necessary for the healthcare industry to make systematic changes that will lead to better quality care and lower costs, according to a new report published today by the Institute of Medicine.
The IOM calls America's current healthcare system "far too complex and costly" to continue on its current path, pointing out the inefficiencies have led to billions of dollars wasted on unnecessary care and tens of thousands of deaths that might otherwise have been prevented.
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Study: HIEs Need Metrics to Address Quality of Care, ROI
September 05, 2012
Only 50 percent of health information exchanges use or plan to use metrics to measure their impact, according to a study published in American Health Information Management Association's Perspectives in Health Information Management.
Ninety-six HIEs completed a 21-question survey, but valid responses were only received from 18. Under eHealth Initiative criteria, all participating HIEs qualified as Stage 5 or higher, meaning they were a "fully operational health information organization; transmitting data that is being used by healthcare stakeholders," according to the study. Results from the survey showed that most of the HIE respondents operate as non-profit organizations, serve large patient populations and have annual budgets of more than $1 million.
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Thursday, September 06, 2012
How To Ensure the Success of Hospital IT Projects
by Fred Bazzoli
Getting clinicians to add one more routine to their day is usually painful. It can be excruciating if caregivers figure out they'll be repetitively doing that routine dozens of times a day.
And when you can't promise it will save anyone any time for the foreseeable future, you've got a tough sell ahead of you.
But Cook Children's Medical Center in Fort Worth, Texas, has been able to achieve wide and consistent adoption of a bar-code bedside medication verification system, reporting that more than 97% of medications and patients are scanned before drugs are delivered to patients.
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Genomics is Here, But is Health I.T. Ready to Support It?
SEP 4, 2012 4:28pm ET
The most hyped scientific achievement of our time-the complete sequencing of the human genome in 2003-has taken awhile to make its utility obvious in clinical care. But consider:
*Nicholas Volker of Monona, Wis., has made it past the age of 5 because a full sequencing of his genome at the Medical College of Wisconsin revealed the rare genetic variant underlying the disease that was making holes in his intestines-an answer that had eluded all standard genetic testing. The research team also confirmed that his particular genetic profile made a bone marrow transplant the right treatment choice. Nicholas hasn't had an intestinal surgery since then-after enduring 100 of them before the diagnosis-and can eat real food. The medical college now reviews a steady stream of requests to sequence the genomes of children with mysterious diseases.
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Stage 2 casts mHealth in small role, critical nonetheless
By Eric Wicklund, Contributing Editor
Created 09/05/2012
WASHINGTON – With close to 700 pages to peruse, the newly released guidelines for Stage 2 Meaningful Use and the 2014 Edition Standards & Certification Criteria (S&CC) present a challenge for almost anyone. And for those looking for references to mHealth, the reward is meager: Only seven mentions of the word "mobile" in the final rule and its accompanying final rule for EHR standards and certification.
Still, experts say mHealth will play a significant role in the latest stage of the Centers for Medicare and Medicaid's (CMS) electronic health record incentive program, which places the spotlight on coordination of care and paves the way for improved outcomes.
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CSC signs new deal with DH
4 September 2012 Chris Thorne
CSC and the Department of Health have agreed a new deal that the DH says will save the NHS more than £1 billion.
It will also remove CSC’s exclusive rights to be the only provider of clinical IT systems in the North, Midlands and East of England.
Today's announcement ends a long saga of negotiations about the future of CSC's local service provider contract, signed as part of the National Programme for IT in the NHS.
The term of the latest agreement extends through July 2016 and in some cases contracts will extend to 2021. Crucially, the new arrangement appears to quash the threat of legal action from either side.
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Delaware HIE wants to be 'another pillar' of health information
By Anthony Brino, Associate Editor
Delaware became the first U.S. state in 1787, and its health information exchange, the Delaware Health Information Network (DHIN), became the country’s first statewide HIE in 2007.
Today, DHIN is kind of pushing the bounds of HIE by creating business lines with insurers and the government, offering new data analysis services and apparently offering a guide to states with still-nascent HIE systems.
About 95 percent of Delaware providers are DHIN participants, as are all the state’s acute care hospitals. Of course it’s a tiny state, with three counties and 907,000 residents. But others are watching. Health IT policy makers and researchers from 25 states have sought DHIN’s advice on HIE policy and systems, said Michael Sims, DHIN CFO.
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EHRs Feed Clinical Research Machine
One-million-patient study provides further evidence that EHRs and analytics tools can advance clinical research.
By Nicole Lewis, InformationWeek
August 31, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-feed-clinical-research-machine/240006570
August 31, 2012
URL: http://www.informationweek.com/healthcare/electronic-medical-records/ehrs-feed-clinical-research-machine/240006570
A major medical study that used EHR data to comb through the clinical records of nearly one million patients shows that advanced technology can have a significant impact on clinical research.
The study, which was recently published in the online edition of the Journal of the American Medical Informatics Association, involved a team of data experts at MetroHealth Medical Center and Explorys Inc., a Cleveland Clinic spinoff company that provides a health data analytics platform.
The study tried to find out whether height and/or weight can make a person more susceptible to blood clots in the lung or leg.
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The problems with BYOD
By Eric Wicklund, Contributing Editor
A recent survey should raise some alarms among healthcare providers who have adopted or are considering a bring-your-own-device (BYOD) strategy.
The survey, conducted by Coalfire, indicates that security isn't high on the list of priorities – for both the employer and employee. And as a result, officials warned, many healthcare organizations may be violating HIPAA guidelines for protecting sensitive patient data.
"They're not keeping pace with the changes in technology," said Rick Dakin, CEO and chief security strategist for the Louisville, Colo.-based IT governance, risk and compliance firm. "And this isn't just a minor shift – it's the tectonic plates of IT shifting."
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The cloud as a health data nexus for ACO
By Gary Palgon, Vice president of healthcare solutions, Liaison Technologies
The imminence of accountable care already is beginning to transform the way healthcare is organized. It logically follows that the information technology (IT) necessary to support Accountable Care Organizations (ACOs) is also changing under our feet. The massive shift of patients to the ambulatory sector to achieve lower-cost care, the need for coordinated care among diverse providers and the analytics required to manage population health are all moving the IT dial to a new frequency. That new frequency is likely to be the cloud.
Although the federal government originated the concept of ACOs as a value-based reimbursement model for Medicare and Medicaid, commercial insurers have also seized upon it as a viable answer to higher quality, more cost-effective care. The goal is to connect hospitals, physician offices, laboratories and other parts of the healthcare continuum to offer preventive, evidence-based medicine that achieves the best clinical outcomes possible. However, connectivity within and among a wide variety of stakeholders is essential before that goal can be reached.
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HL7 to Offer Free License for Standards, Other Properties
SEP 4, 2012 12:12pm ET
Standards development organization Health Level Seven International will make much of its intellectual property available via a free license, an initiative expected to start during the first quarter of 2013.
The free property includes all standards, domain analysis models, profiles, implementation guides and some tools. The intellectual property will not be licensed on the open source market, under which other developers may make enhancements. The freely available property means the content must be licensed for use but the license is free. HL7 will continue to control the content, which will continue to be developed and balloted following the organization’s internal rules and standard development requirements under the American National Standards Institute.
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HL7 standards to be free of charge
Posted: September 4, 2012 - 2:45 pm ET
The healthcare standards development organization Health Level Seven will make much of its intellectual property, including its key Clinical Document Architecture standard, available without charge to healthcare organizations and without the previously required HL7 membership.
"It's been a year in the planning," said Dr. Charles Jaffe, CEO of the Ann Arbor, Mich.-based organization. The HL7 board took a final vote Aug. 1 to go forward with the plan. "I can tell you that the board was unanimous in this and as hard as it is to believe, they firmly will position this as, 'This was the right thing to do.' "
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Lansley out, Hunt in
4 September 2012 EHI staff
Andrew Lansley has lost his job as health secretary in a government reshuffle and will become the leader of the House of Commons.
Lansley, who has led the Department of Health since 2010 and has overseen the controversial ‘Liberating the NHS’ reforms, will be replaced by Jeremy Hunt.
Hunt has also come under scrutiny in recent months in his role as secretary of state for culture, olympics, media and sport, because of the role played by one of his special advisors in News Corporation’s bid for BSkyB.
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CDC will use Direct protocol for health safety network
By Mary Mosquera
The Centers for Disease Control and Prevention (CDC) needs a health information service provider to deploy the Direct secure messaging protocol to make it easier and more automated for providers to send data to the National Healthcare Safety Network.
The secure transport standard will assist providers in transmitting data from electronic health records (EHRs) and other healthcare information systems using the Health Level 7 Clinical Document Architecture (CDA) standard for automated entry into the agency’s safety surveillance system, according to an Aug. 28 announcement in Federal Business Opportunities.
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Transitioning to EMRs
Proactive planning is essential to a successful conversion.
Five years seems like a lot of time to make a transition to electronic medical records (EMRs), but as time continues to tick away the deadline is looming closer every day. The federal government promised funding to hospitals and other health systems to help defray the astronomical conversion costs with the goals of providing greater safety for patients. Failure to comply by 2015 will result in catastrophic financial loss to healthcare providers from Medicare.
This plan is currently under way, and both medical professionals and IT experts are scrambling to find ways to adhere to the timeline and ensure federal incentives. Prudent healthcare IT leaders realize that proactive planning is essential to ensure seamless, cost-effective transitions that both improve efficiency and maintain customer satisfaction. To successfully transfer to EMRs by the 2015 deadline, hospitals must start making preparation for the conversion now.
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Blue Button reaches 1 million users
Posted: August 31, 2012 - 6:00 pm ET
What's big and blue and not IBM?
The basic Blue Button technology developed by the healthcare arm of the U.S. Veterans Affairs Department. On Friday, the VA announced that Blue Button had recorded its 1 millionth registered user in less than two years.
Blue Button, named for the Web icon that triggers its use, allows veterans to access and download copies of their medical records and has proven immensely popular among veterans since it was rolled out in fall 2010 after being introduced in a speech by President Barack Obama in August of that year.
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Damage from Healthcare Data Breaches Spreading
Margaret Dick Tocknell, for HealthLeaders Media , August 30, 2012
Almost twice as many people were affected by healthcare data breaches in 2011 as in 2010, according to a report released on Wednesday. The total number of breaches dropped by 32% to 145 but the number of people affected by those breaches doubled to 10.8 million.
The drop in occurrences reflects increased security controls and investigation procedures put in place to uncover data breaches, explains Tyler Quinn, a CPA who co-authored the report for Kaufman, Rossin, and Co., a Miami-based accounting and business consulting firm.
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10 Healthcare IT Predictions for the Next Year
Scott Mace, for HealthLeaders Media , September 4, 2012
In honor of National Health IT Week next week, here are my top 10 predictions for healthcare IT for the next 12 months—none of them involving Meaningful Use or ICD-10!
1. Patients ask, where's my data? Patients will organize a single-day national event called Where's My Medical Data, in which providers and payers will be besieged by emails and phone calls from patients wanting their medical records. Patients will complain loudly at the slowness of the responses, the outright refusal by some providers, and the complexity of the records received.
While the scenario might not play out exactly in this form, I heard this proposal floated at the recent Healthcare Unbound conference in San Francisco, where it received the encouragement of Farzad Mostashari, the National Coordinator for Health Information Technology within the federal Office of the National Coordinator for Health Information Technology. It hasn't yet become an ONC initiative (they are a little busy right now), but patients might lead the way.
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Tuesday, September 04, 2012
Tracking Rx Misuse: State Programs Making Gains
by Bonnie Darves, iHealthBeat Contributing Reporter
Prescription monitoring programs (PMPs) that track when and where prescriptions for controlled substances are filled and who receives the medications are beginning to show results. The programs, now operational in 41 states and "on the books" legislatively in 49, neither purport nor promise to eradicate the country's narcotic-abuse epidemic -- deaths related to opioid use more than tripled between 1999 and 2008. But monitoring appears to be making a dent.
States with well-established PMPs are reporting reductions in doctor shopping and diversion of controlled substances and are finding that their programs are helping health care professionals make better informed clinical prescribing decisions, according to a recent report from the PMP Center of Excellence at Brandeis University in Massachusetts.
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Find the NEWS on an app
31 August 2012 Chris Thorne
An app has been launched in Wales to help hospital staff use the National Early Warning Score to identify patients who are developing serious illnesses, such as sepsis.
The app, which can be downloaded from Apple’s App Store for free, has been developed by 1000 Lives Plus in conjunction with Cardiff Medical Apps.
1000 Lives Plus is Wales’ national improvement programme, supporting organisations and individuals to deliver the highest quality and safest healthcare for patients.
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Enjoy!
David.
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