Saturday, December 08, 2012

Weekly Overseas Health IT Links - 8th December, 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.

Health reform to spur waves of data

By Mary Mosquera, Senior Editor
Created 11/30/2012
The Centers for Medicare and Medicaid Services will have to manage and analyze double the volume of Medicare data and triple the terabytes of Medicaid data after health reform is fully in place. 
By 2015, the waves of Medicare claims data will explode from 370 terabytes to 700 terabytes. For Medicaid, 30 terabytes of data will multiply to 100 terabytes, according to a CMS official.
The Centers for Medicare and Medicaid Services will have to manage and analyze double the volume of Medicare data and triple the terabytes of Medicaid data after health reform is fully in place. 

Privacy law falls short in age of proliferating medical devices

November 30, 2012 | By Susan D. Hall
Who owns the data produced from cardiac monitoring devices? The devices are proliferating as vendors make them ever smaller, improving patient comfort and care for heart disorders.
But the devices apparently fall outside U.S. privacy law, according to a Wall Street Journal article detailing how a Tennessee defibrillator patient has been unable to get access to the data from vendor Medtronic. The vendor says its clients are physicians and hospitals, and giving information to patients would require regulatory approval. Yet Medtronic is among the companies trying to monetize the data from cardiac monitors. Medtronic executive Ken Riff, at a July industry event, called these kinds of data "the currency of the future," the Journal reports.

Federal EHR regs driving docs out of private practice, says new report

By Mike Miliard, Managing Editor
Created 11/30/2012
Independent physicians are a vanishing breed, due in large part to government regulations requiring the adoption of health IT and the meaningful use of electronic health records, according to a new report from Accenture.
The report finds that 61 percent of those surveyed will seek employment rather than open a private practice, with the majority citing the government regulations as the cause.
The number of doctors in private practice has dropped from 57 percent in 2000 to just 39 percent in 2012, according to Accenture, which forecasts a further 3 percent downtick by the end of 2013.

Using the body to power batteries

November 30, 2012 | By Susan D. Hall
Research demonstrating that energy produced in the inner ear could be used to power sensors is but one example of new study on using the body's own power sources to charge medical devices, according to a story published this week in the Wall Street Journal.
Researchers from the Massachusetts Institute of Technology and Harvard Medical School demonstrated in guinea pigs that they could power sensors for about five hours without inhibiting the animals' ability to hear.

KLAS shines light on MRI, imaging, PACS

By Bernie Monegain, Contributing Editor
With reports on MRI, PACS and CT released this week at the Radiological Society of North America’s annual meeting, research firm KLAS provides insight into three imaging markets.
The introduction of new technology into the MRI landscape has changed the face of the market segment over the last year, KLAS analysts say. Although MRI satisfaction scores tend to cluster together, the differences are in the details.
Philips, which was in last place in the 2011 KLAS MRI report with its Achieva 1.5T MR, takes first place this year with its newly ranked Ingenia 1.5T MR scanner, receiving an overall score of 92.2 (out of 100). Siemens' MAGNETOM Aera 1.5T also appears in the KLAS report for the first time and is ranked fourth out of the five vendors, earning an overall KLAS performance score of 87.

Monday, November 26, 2012

The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials


Probe finds U.S. e-health program lacks oversight

Inspector general says physician and hospital self-reporting rule is ineffective

Lucas Mearian
November 29, 2012 (Computerworld)
Federal investigators Thursday released a report charging that the Medicare electronic medical records (EMR) program lacks effective fiscal oversight.
The report, issued by the Inspector General's office of the Department of Health and Human Services (HHS), states that the Medicare EMR program may be paying incentives to health care providers and hospitals that do not fully meet the quality standards known as "meaningful use".
The report stated that the program's self-reporting format lacks audit oversight requirements so it's impossible to prove whether reports from physicians and hospitals are accurate.
The U.S. Centers for Medicare & Medicaid Services (CMS) oversees the federal EHR program, including the incentive payments. The "incentive money" CMS pays to healthcare professionals and hospitals that have deployed EMRs and have met meaningful use criteria is funded by the American Recovery and Reinvestment Act of 2009.

After all the time and money invested, will e-health ever deliver on its promise?

Published Thursday, Nov. 29, 2012 05:25PM EST
After Helmut Braun’s wife died, he turned to the Internet to find someone else to play cards with. Before long, like so many Canadian seniors these days, he’d become something of a keyboard wizard. But when Braun had a heart attack last November, the 85-year-old former barber figured he’d played his last online ace. As he lay in frightening pain in an ambulance, the last thing he could have guessed was that he would soon become a cyber-pioneer.
But that’s what happened in the long-term palliative care ward at Baycrest Health Sciences Centre in north Toronto. One day early last summer, a nurse named Maria De Leon popped a computer tablet onto his lap and asked him if he’d mind tapping in answers to 10 basic questions, including the degree of pain that he was feeling, his appetite, his mood and his energy level. Braun still has a lot of zest despite his badly damaged heart, and he was only too happy to get back online, especially if it spared Baycrest staff from filling out the questionnaire on paper. “I’m always happy to save some trees,” he joked.

Patients want 'granular' privacy control of electronic health info

November 28, 2012 | By Marla Durben Hirsch
Patients want strict control over the health information contained in providers' electronic health records, according to a new study in the Journal of the American Medical Informatics Association.
The study, conducted by researchers at Clemson and Indiana Universities, interviewed 30 patients whose health information was stored in EHRs. They found that sharing preferences varied by the type of information to be shared and the recipient. Not surprisingly, patients were more willing to share less sensitive information with healthcare providers. However, no one wanted to share all of their records unconditionally.

4 reasons to go virtual

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 11/29/2012
First there was the migration to the cloud, now it's a push for virtualization. Gone (or soon to be gone) are the days where every nurse, doctor, and healthcare professional is chained to a desktop PC upon which they rely for access to their software and information.
Virtualization and the cloud are not necessarily the same thing. The latter is a remote data warehouse that stores information. The former entails running an application on one computer through a browser on another machine, which could be hundreds of miles away. Imagine accessing a bulky and power-intensive application that normally requires a PC on a tablet. This is just one of many elements of flexibility that virtualization can provide.

BYOT: The Lines Between Work and Personal Technology are Blurring

NOV 29, 2012 12:58pm ET
Bring-your-own-technology (BYOT) is no longer driven by do-it-yourselfers choosing their own devices for work — instead, a rapidly growing population of workers across industries and regions is embracing a wide spectrum of bring your own “fill-in-the-blank.” BYOT now spans hardware, platforms, and apps, plus cloud services like storage and collaboration.
Just how big is this trend? According to Forrester's Forrsights Workforce Employee Survey, Q4 2011, of nearly 10,000 workers worldwide, 53% bring their own technology for work. The rapid growth of mobile BYOT devices within business is reminiscent of Web adoption during the mid-1990s. After early handwringing and resistance, followed by rapid growth and innovation, the Web emerged as an indispensable tool. No one thinks twice now about using the Web for work. BYOT will follow a similar pattern.

Lancashire clinicians access GP data

28 November 2012   Rebecca Todd
Urgent care doctors and pharmacists at East Lancashire Hospitals NHS Trust are accessing key information from the patient records of 91 GP practices using EMIS Web.
A&E clinicians and hospital pharmacists can access a core set of information - including active problems, medications and health status - through a secure, read-only view of the patient’s GP record via EMIS Web access points at hospital terminals.
Users within the trust calculate that since going live in April, the service has saved them hundreds of phone calls and faxes a month to GP practices to check patients’ medical details.

3 steps to HIPAA security in the cloud

By David S. Linthicum, Founder and CTO, Blue Mountain Labs
The default response for those charged with HIPAA security is to say ‘no’ to cloud computing. Why? Clouds are not under direct control, they are not typically up on existing and emerging healthcare regulations, and, most importantly, they are new and scary.
There is a clear need, however, to rethink the role of cloud computing by those charged with HIPAA security. The efficiencies that can be gained by leveraging public, private, and hybrid clouds are just too compelling.   
The trick is to understand the existing requirements, and then understand how the emerging use of cloud computing could provide compliant and secure HIPAA solutions. In many cases, leveraging cloud computing will improve upon the best practices and technology that exist today.   

Report Finds E-Prescribing Among Physicians Increased 41%

Written by Kathleen Roney | November 28, 2012
E-prescribing among physicians increased approximately 41 percent across the United States between December 2008 and June 2012, according to a data brief from ONC.
In December 2008, 7 percent of physicians in the United States were e-prescribing using an electronic health record. By June 2012, 48 percent of physicians were e-prescribing using an EHR.

Experienced, educated workers flock to health IT retraining programs

November 29, 2012 | By Julie Bird
One constant in various provisions of the Affordable Care Act being implemented over the next few years is that most will require expanding the nation's skilled health IT force, notes Bloomberg News.
The opportunities are attracting IT workers from other fields into healthcare-specific training programs, as well as experienced healthcare workers learning information-technology skills, according to the article. President Barack Obama's re-election is further fueling the retraining boom, Bloomberg says, by all-but guaranteeing the overhaul will become reality.

Health IT requires more federal innovation faster, DoD official says

November 29, 2012 | By Susan D. Hall
Federal agencies must pick up the pace of healthcare IT to respond to a rapidly evolving landscape, Dave Wennergren, assistant deputy chief management officer at the Department of Defense, told federal leaders this week at the "Digital Innovation in Healthcare" forum in McLean, Va.
While he cited innovation taking place in data security, mobility and sharing, he said the years-long process of putting big projects together takes too long to respond quickly to changing conditions, reports Federal Computer Week.

OCR: No fail-safe for de-identifying patient info

November 29, 2012 | By Dan Bowman
Neither the expert determination method nor the safe harbor method of de-identifying patient data are 100 percent effective, according to new guidance released this week by the U.S. Department of Health & Human Services' Office for Civil Rights. While both methods can lower the risk of re-identifying data to miniscule levels, neither are completely secure, OCR officials write.
"There is a possibility that de-identified data could be linked back to the identity of the patient to which it corresponds," the guidance says.
For the expert determination method, a person deemed an expert--a.k.a, someone "with appropriate knowledge of and experience with generally accepted statistical and scientific principles for rendering information not individually identifiable"--uses their expertise to measure the risk of re-identification for certain sets of data. In a blog post written this week by FierceHealthIT Advisory Board member David Harlow, Harlow says it's worth noting that OCR says that expert determinations should only be valid for a finite amount of time.
Thursday, November 29, 2012

Neurological Institute Expands Telehealth Network

by Alice Daniel, iHealthBeat Contributing Reporter
SACRAMENTO -- There are days when Medical Director of Neurology at Mercy Health Alan Shatzel needs only his laptop and his expertise to diagnose stroke patients. The robot does the rest. 
With access to the Mercy Telehealth Network, Shatzel can diagnose in real time stroke patients in emergency departments in the Central Valley and Northern California from Bakersfield to Redding. By connecting electronically with a robot in the ED, he can zoom in next to the patient, listen, ask questions and perform a sort of virtual examination. His face appears on the robot's computer screen.
"That's the beauty of telemedicine," Shatzel said. "It breaks down those barriers and allows specialists clustered in metropolitan areas to reach needs in rural areas." 

Electronic Medical Records Drive Physicians to Stay, Go

Joe Cantlupe, for HealthLeaders Media , November 29, 2012

After 25 years of using paper records, Winfield Young, MD, recently dove into electronic medical records for his Virginia Beach, VA, pediatric practice. "Today is the first day of training. I'm tickled pink," Young told me recently.
Young wants to maintain his freestanding practice and not be employed by a hospital. With an EMR, he envisions the possibility of increasing his income, and definitely more efficiency. "We see the importance of better documentation of diagnosis, and it's going to be easier to track," he says.
Independent primary care physicians often think they don't have the time, money, or resources to implement EMR, even with government subsidies. Still, they know they need to adapt to the changing environment. Patients are demanding more transparency and the government is incentivizing the shift. A growing number of physicians seem to figure they have no choice. To survive, they must opt for EMR, though they know the journey may not be easy.

Programs preview mainstreaming of personalized medicine

Researchers say a data-driven approach is less than a few years away for specialists and less than a decade away for primary care physicians.

By Pamela Lewis Dolan, amednews staff. Posted Nov. 26, 2012.
As health information technology adoption inches closer to a saturation point, it is expected to help accelerate the use of what is known as personalized medicine.
Some large health care organizations recently launched large, multimillion-dollar personalized medicine initiatives that will allow physicians and researchers to combine patient data — including genomic, claims and financial data as well as clinical data collected by physicians — with other sources of data and to apply intensive analytics to develop treatment plans tailored to each patient. The goal is to improve outcomes and control costs by reducing overdiagnosis and ineffective treatments.
Personalized medicine allows physicians to prescribe treatments based on a patient’s genetic makeup and disease profile and the effectiveness of therapies for other patients with similar characteristics. Projects are using this approach to better match patients with complex diseases to the best therapies, eliminating the trial-and-error process that often has resulted in ineffective treatments, particularly in the use of pharmaceuticals.

New Federal Guidance on De-Identifying Patient Information

NOV 27, 2012 12:00pm ET
The HHS Office for Civil Rights has issued lengthy and detailed guidance on two methods for de-identifying protected health information under the HIPAA privacy rule.
More than two dozen frequently asked questions explain the two methods--Expert Determination and Safe Harbor--that satisfy the privacy rule’s standards for de-identification. “This guidance is intended to assist covered entities to understand what is de-identification, the general process by which de-identified information is created, and the options available for performing de-identification,” according to OCR.

GPSoC to mandate open APIs

27 November 2012   Rebecca Todd
The new GP Systems of Choice contract could force all GP system suppliers to open their Application Programme Interfaces to third party suppliers.
The idea would coincide with the Government ICT strategy, which states: “The opening up of APIs is part of the government’s overall approach to open ICT and user centred digital services."
Intellect head of healthcare Jon Lindberg said he understands the idea is being discussed internally with the GPSoC team and board.
He hoped it would help open up the market and allow “quick and innovative solutions” to be developed and added on as demand and requirements develop.

Automated calls, letters boost med adherence

November 27, 2012 | By Susan D. Hall
Automated phone calls and letters to patients who did not fill prescriptions increased their rate of compliance, according to a study published in the Archives of Internal Medicine. But an accompanying commentary points out that the overall improvement was only marginal.
The researchers, from Kaiser Permanente Southern California, selected 2,606 patients to undergo the intervention and 2,610 for a control group who got no reminders. Patients were randomly assigned to the groups from a larger population of patients prescribed cholesterol-lowering statins who did not fill their prescriptions within two weeks.

Prediction model combines Google Flu Trends, weather forecasting techniques

November 27, 2012 | By Susan D. Hall
A model using data from Google Flu Trends and weather forecasting techniques could predict the peak of flu outbreaks in specific areas more than seven weeks in advance, according to researchers from Columbia University and the National Center for Atmospheric Research.
Their work was published Monday at Proceedings of the National Academy of Sciences.
Previously, researchers in Pakistan asserted that while Google Flu Trends serves as a good "baseline indicator" of epidemic trends, it could become an effective early warning system through application of "sophisticated statistical analysis."

Health information exchange: Significant market growth ahead

November 27, 2012 | By Julie Bird
U.S. healthcare providers will "significantly ratchet up their participation" in health information exchanges (HIE) over the next 18 to 24 months, consulting firm Frost & Sullivan finds in a new market analysis.
The Supreme Court's ruling upholding the constitutionality of the Affordable Care Act, as well as President Barack Obama's re-election, are fueling the growth, according to the report, "U.S. Health Information Exchange Market: A Comprehensive Guide to Market Dynamics, Technology Vendors and Future Trends."
Additional factors driving market growth include the Stage 2 Meaningful Use requirement for more HIE participation, and technical standards for interoperability, according to an announcement detailing the findings.

Cloud Technology Overturns IT Assumptions

Scott Mace, for HealthLeaders Media , November 27, 2012

I'm here to say that healthcare should be thankful it has come late to part of the technology party.
Why? Because healthcare doesn't have to play by the so-called rules that existed a few years ago. Healthcare can challenge the assumptions that drove decisions a short while ago and take advantage of cloud computing technology that overturns the conventional wisdom—and price structure—of IT services.
Want an example? Recently, I spoke to Qualsight, a healthcare provider you probably haven't heard of, even though it serves more than 75 million health plan members.
Chicago-based Qualsight launched eight years ago to connect independent ophthalmologists to healthcare plan sponsors to provide their members laser vision correction services. Today, the ophthalmologists operating out of 800 locations let Qualsight boast of being the nation's largest Lasik services manager.

From hackers to hurricanes: 6 crucial steps to securing your data

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 11/26/2012
From hurricanes to hackers, there's a lot that can go wrong with your data. If a major storm takes out power to a cloud provider's sole computer center, a hospital's entire cloud-based system could go offline, hamstringing doctors indefinitely. Should a hacker decide to hit a data warehouse, the integrity of an entire healthcare network's IT could be compromised.
With so much riding on unfettered and highly secure access to healthcare data of every kind – from prescription information to scheduling to payroll – keeping that data ironclad is more important than ever.
Kurt Hagerman, compliance director for Dallas-based cloud firm FireHost, talks about six key points that should be second nature to anybody concerned with securing their data from natural disasters or malicious cyber marauders.

Electronic health data security among HHS top management challenges

November 26, 2012 | By Susan D. Hall
The Department of Health and Human Services should play a more active role in educating physicians about protecting patient data in electronic health records, according to a report from the HHS Office of Inspector General.
That recommendation was just one of those contained in the OIG's annual report of the top management challenges facing the agency. Addressing the importance of protecting the security of health information systems, it noted that electronic records allow for a centralized repository of patient data, but such systems "can also be used to fabricate information, generating improper payments and corrupting patients' records with inaccurate and potentially dangerous information."

Genetics-based personalized medicine gets big data boost

November 26, 2012 | By Julie Bird
With the help of big data that shows the effectiveness of various treatment regimens on different kinds of patients, personalized medicine can "better match patients with complex diseases to the best therapies, eliminating the trial-and-error process that often has resulted in ineffective treatments, particularly in the use of pharmaceuticals," according to an article in
The power to conduct that level of analysis now rests with many healthcare systems, Jon Duke, M.D., investigator and innovation officer for the Regenstrief Institute in Indianapolis, told the publication. The University of Pittsburgh Medical Center, for example, recently announced a five-year, $100 million project launching a data warehouse for personalized medicine.

Surveillance shows potential in detecting HIT system failures

November 26, 2012 | By Susan D. Hall
An Australian study finds potential value in applying a syndromic surveillance system to health IT systems to detect early system failures.
Such surveillance typically is used in public health to monitor the spread of infectious diseases. The system was used in research at the University of New South Wales in Sydney to monitor four factors in a tertiary hospital laboratory: total number of records being created, the number of records with missing results, average serum potassium results, and total duplicated tests on a patient.
The researchers, led by Dr. Mei-Sing Ong, wanted to detect HIT system failures causing: data loss at the record level, data loss at the field level, erroneous data, and unintended duplication of data, according to a paper published at the Journal of the American Medical Informatics Association. Statistical models were used to detect system failures using simulated outages lasting 24 hours, with error rates from 1 percent to 35 percent.

'You too can YouTube' says London GP

13 November 2012   Rebecca Todd
A London practice is using YouTube to share health messages with patients including a video about ear wax removal that has had more than 100,000 hits.
Dr Shanker Vijayadeva presented a session at EHI Live 2012 entitled ‘You too can YouTube.’
He is a GP at the Hillview Surgery in Greenford where he first started YouTubing in 2010.

Revolutionary road

The government has promised a telehealth revolution; but there has been little sign of one at the events that Lis Evenstad has attended recently.
20 November 2012
“I’d like to remind people this isn’t about a minority sport; this is about how we use most of the money in the NHS,” Stephen Johnson, deputy director and head of long term conditions at the Department of Health told the Telehealth 2012 conference.
Johnson is, of course, right that most of the NHS budget goes on dealing with long term conditions, and that some of that money might be saved if people could be kept out of expensive hospitals and dealt with in the community or their own homes.
But in the absence of real evidence that telehealth can deliver on its promises, the ‘telehealth revolution’ that the industry and government have promised feels as far off as ever.

Study: Belief in Health IT ROI Comes from Organizational Support

November 21, 2012
Deloitte and the American Medical Informatics Association (AMIA) recently conducted a study and found that for providers, life sciences companies, and payers there is clear correlation between return on investment (ROI) from clinical IT systems and high organizational support from health informatics. The organizations where respondents didn’t buy into the idea that health IT leads to significant ROI didn’t have as strong organizational support, alignment, and executive sponsorship as those that did.
Monday, November 26, 2012

Health Care System To Benefit From Recent HIE Progress

by Brian Ahier
The stars seem to be aligned for rapid progress in health information exchange. We are fast approaching a point in the development of the Health Internet where ubiquitous exchange of health data to improve care coordination and health care quality and ultimately lower costs might be possible. We still face some problems, and standards and policies must be aligned, but there is some great synergy in play that will help drive this vision forward. There are a variety of different initiatives which are coalescing, but there is also a great deal of work still left to do.
HIE Efforts Under Way
The Nationwide Health Information Network Exchange (now called the eHealth Exchange) has successfully transitioned to an independently sustainable public-private partnership. This new organization, called HealtheWay, includes four federal agencies -- CMS, the Department of Defense, the Social Security Administration and the Department of Veterans Affairs -- as well as at least 21 non-federal entities that all share patient records for episodes of care. The ability to provide a platform for national exchange is critical to the success of efforts to reach the triple aim of improving the experience of care, boosting the health of populations and reducing per capita costs of health care. By ensuring that clinicians have the right information at the right place at the right time, we can finally begin to make progress in achieving these goals.


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