Quote Of The Year

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

Thursday, January 31, 2013

I Think This Really Is The Thin End Of A Very Nasty Wedge. Think Carefully Before You Sign Up for A NEHRS / PCEHR.

This popped up a little while ago.

'Grave concerns' over new GP dataset

16 January 2013   Rebecca Todd
GPs and privacy experts have “grave concerns” about an extensive new dataset to be extracted from GP practices.
The NHS Commissioning Board published its first planning guidance for the NHS - ‘Everyone Counts: Planning for patients 2013-2014’ – last month.
It says a new GP dataset will be “requested” from GP practices for submission to the Health and Social Care Information Centre, described as a “statutory safe haven.”
“The patient identifiable components will not be released outside the safe haven except as permitted by the Data Protection Act,” it adds.
Practices will be requested to provide data on patient demographics, events, referrals, diagnosis, health status and exceptions.
This includes information on patients’ alcohol consumption and whether a GP has given exercise or dietary advice or completed a mental health review.
GP practices are expected to provide the data using the General Practice Extraction Service.
“The data will flow securely, via GPES, to the HSCIC, the statutory safe haven, which will store the data and link it only where approved and necessary, ensuring that patient confidentiality is protected,” the guidance explains.
Potential uses for this data are not detailed, however the NHS CB’s national director of patients and information, Tim Kelsey told a conference in December that a “standardised routine set of data” would be required from all GPs to help assess their quality.
Dr Paul Cundy, joint chairman of the BMA and RCGP's joint IT committee, said the committee had no prior warning of the new data set before it was published in December.
The committee has met with Kelsey to discuss the proposals and invited him to its next meeting for “further discussions.”
“It’s an interesting proposal, but as with many simple ideas it has got some complex issues behind it,” Dr Cundy said.
“If you compare this data set with the Summary Care Record data set and the time it took to agree the SCR it’s obvious that we will need to be having quite prolonged discussions.”
“I know that there will be a significant number of patients who will not want their identifiable data to leave the practice.”
“The issue for me is what should a GP do if a patient explicitly dissents from this sort of data set going on to the IC?”
Lots more concerns here:
Frankly this is just horrifying and is so open to abuse it is really worrying. Anyone who thinks the Government’s lust for data is any less than policy makers in the UK is delusional and there is one clear lesson here - do not give any sensitive information to Government agencies that you want to remain in charge of and retain control over.
I am sure the ‘nanny state’ wants to know how much we drink and smoke and eat - but my view is that it is our business and not theirs.
Be both alert and alarmed and keep your sensitive information to yourself. The only saving grace is that it will be a good while before the NEHRS contains enough data to be statistically useful and maybe annoyance on the public’s part and much better governance might just save us!
David.

It Would Be Nice If NEHTA Created A ‘Blue Button’ for The NEHRS And GP Vendors Also Adopted It.

There has been some renewed in the downloadable Blue Button in the last week.
See here:

ONC posts tech guide for Blue Button Plus

By Mary Mosquera
The Office of the National Coordinator for Health IT has made available technical descriptions and guidance for its more automated version of the Blue Button feature aimed at giving patients easier access and use of their health information.
ONC announced in a Jan. 16 webinar an initial draft implementation guide for Blue Button Plus (+), a rebranding of its Automated Blue Button Initiative, so vendors and others can begin to incorporate the feature in their health IT system updates.
Blue Button+ will help providers meet requirements for meaningful use stage 2 because it incorporates in their certified electronic health records (EHRs) the function for view, download and transmit information for patients, said Lygeia Ricciardi, acting director of ONC’s Office of Consumer Health.
“But it goes beyond that, most notably by automating the information update functions for them,” she said at the webinar sponsored by the National eHealth Collaborative.
Any provider, developer or others may access the technical guides to accelerate a growing ecosystem of tools to help patients participate in and manage their care, especially through easier, secure access to their health information, Ricciardi said. The health IT tools also enhance communications between patients and their physicians and improve care coordination.
Blue Button+ is being advanced through ONC’s Standards & Implementation Framework community. The full draft implementation guide will be launched by the end of this month, said Pierce Graham-Jones, Innovator in Residence at the Health and Human Services Department, and a member of the S&I community working on the project.
The draft implementation guidance includes how to transmit data to patients in structured format, how to transmit data to patients using Direct secure messaging protocol, and a privacy and security piece.
More here:
as well as here:

VA Blue Button adds patient summary document tool

By Mary Mosquera
The Veterans Affairs Department has added a new tool through its Blue Button feature so veterans may more easily download a summary of their essential health information. The enhancement is the VA Continuity of Care Document (VA CCD) in xml file format.
The VA CCD uses recognized standards that support the exchange of information between healthcare systems and providers for coordinated and continued care of the patient. VA started Blue Button as an unstructured ASCII text document, a simple download mechanism.
VA has expanded its Blue Button feature with other capabilities, including demographics, active problem list, discharge summaries, progress notes, expanded laboratory results, vitals and readings, pathology reports, radiology reports and electrocardiogram (EKG) list of studies.
“As of today, veterans can electronically download their entire medical record plus CCD summary,” said Peter Levin, VA chief technology officer, on his Twitter account Jan. 20.
Veterans must be authenticated in person at a local VA clinic or hospital or online to confirm their identity to obtain their health information through MyHealtheVet.
More here:
It is interesting to think what this all means. Perhaps the NEHRS is even just an idea which has passed its use by date before it even starts.
Think of it - press the Blue Button - collect your EHR record on your USB key and share it as needed. Ultimate privacy control, ultimate personal control and no centralised database to be cracked.
I also think it would be a good deal cheaper than what is presently planned and everyone who wants such a portable accessible EHR could have one for a few dollars.
Of course we would need Standards and so on and some vendor support to provide genuine interoperability at a record level. Hard to see any losers if such a plan was adopted.
What do you think?
David.

Wednesday, January 30, 2013

Talk About A Sense Of Déjà Vu. Australia Has Certainly Seen This Before. It Ultimately Ended Badly For The Provider Involved In Australia.

The following appeared a few days ago:

Should cash-strapped small practices turn to ad-supported EHRs?

Author Name Jennifer Bresnick   |   Date January 22, 2013   |  
Advertising is everywhere.  From your smartphone apps to your radio station to this very article, ads pay the bills for your favorite news outlets, entertainment destinations, and websites.  Sometimes they’re annoying, and sometimes they alert you to a useful product or service you might not otherwise find.  But should they be integrated into your EHR?  With implementation costs soaring into the tens of thousands and no immediate return on such a massive investment, many physicians are saying yes.
The market for EHR advertising revolves around cloud-based services, since advertisers need an internet connection to push ads into their product.  With 41% of physicians using cloud services, the market is robust and growing.  “Advertising is a natural fit in the healthcare sector,” Bill Jennings, CEO of Good Health Media told Practice Fusion, one of the leading ad-based EHRs. “Doctors get it; they’re comfortable with discreet advertising inside their medical practice. The advertising programs give a small medical practice the chance to add a time-saving, life-saving technology solution – for free. It’s a benefit for the advertiser, the doctor and the patient.”
EHR advertising is desirable to large pharmaceutical companies because there’s a high likelihood that the person observing the ad will be a physician.  Physicians spend the most time with EHRs, and are also the decision-makers when it comes to writing prescriptions for brand-name products.  Zach Gursky, VP of sales for Practice Fusion, told American Medical News that 85% of major pharmaceutical companies are running ads with the free service as a result of an explosion of interest over the past year and a half.  Gursky asserts that physicians are finding value in the ads due to the fact that they are highly targeted to them and the types of patients that they treat.
They are also finding value in the fact that web-based EHR systems require little to no cash output in order to use.  Small practices without a large surplus budget for technology upgrades can use certain free EHRs to attest to meaningful use and receive financial incentives from CMS.  These providers don’t need to worry about ongoing maintenance, software upgrades, or an in-house IT staff, which becomes a very attractive prospect.
Lots more here:
For those who don’t remember we used to have Pharma ads in Medical Director (MD) and this reduced the price of the software and support. The net effect was a near monopoly.
It was then realised by the profession that the Pharma companies would only be paying if they were making money out of the ads and that this was probably distorting ethical prescribing in the direction of profit and commercial interests.
Gradually antipathy to the whole business grew and eventually MD was forced to give up the sponsorship funds. This levelled the GP system playing field and allowed some real innovation to commence. In the long term this meant MD lost significant market share.
The lesson is that things that are ‘free’ may not turn out to be in the longer run. Certainly GP computing in Australia was not helped by the artificially distorted market in my view.
The US would be wise to nip this trend in the bud.
David.

Tuesday, January 29, 2013

NEHTA Achieves A Personal Best In Fake Helpfulness.

Popped on to the NEHTA website a few days ago and found this page on ePIP.

ePIP Support

From 1 February 2013, the PIP eHealth Incentive eligibility requirements change.
To help practices meet these new eligibility requirements, guidance is available for both organisations providing support to General Practice as well as for General Practices registering independently for the ePIP and meeting each of the five requirements.
Practices are strongly encouraged to read the PIP eHealth Incentive Guidelines and use the ePIP Compliance Checklist contained in the General Practice Registration Workbook to help establish eligibility for the ePIP.

What is ePIP?

The Practice Incentives Program (PIP) eHealth Incentive aims to encourage General Practices to keep up-to-date with the latest developments in eHealth to assist in improving administration processes and enhancing the quality of patient care by, for example, supporting the capacity to share accurate electronic patient records. More Information

Registration Collateral

General Practice Applying Independently
  • Guidance and support materials to register and meet the five ePIP requirements are available here. This includes more detailed information for each requirement, exemptions, compliance dates and associated application forms.
  • More Information
Organisations Offering Registration Workshops for General Practice
  • General Practice Registration workshops - here you will find workshop guidance and support materials for organisations to provide General Practice Registration workshops. This includes webinars, an approach overview, checklists, and tips and tricks for a successful workshop.
  • More Information
NOTE: We will continue to update and make new guidance and support materials available so check this website frequently. You can also sign up for an RSS feed.
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See here:
This heading intrigued me:
Organisations Offering Registration Workshops for General Practice
So I clicked more information only to find this.

Organisations Offering Registration Workshops

Organisations providing workshop registration support to support General Practices registering for ePIP can use these materials to plan and deliver registration workshops.
The workshop has been designed specifically for General Practices registering for ePIP, however the forms and guides can be used by other providers to support them in registering for their NASH PKI certificates and the personally controlled electronic eHealth record (PCEHR).
Practices are responsible for ensuring that they have met each of the five ePIP requirements at the time their ePIP application is submitted.

General Practice Registration Workbook Contents

NOTE: Release notes will be added once a new version is uploaded.
There followed a list of some 30 NEHTA documents dated 17/01/2013 follows.
See here:
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So, in summary, we are offered a course (actually just a few documents) but no listing of who is offering to explain and each it and when. I think a list of who is running workshops or who to call to have all this explained and taught must have got lost. Or does it not exist? I wonder who the target organisations are and have they been told all this stuff is available and been given a guide on how it is best used? I guess the top document on the list on how to seek help via the help desk is what is your best bet.

More than that it is all a bit circular with no apparent list of where workshops and so on are being offered and referring back to the same page.

I guess NEHTA have provided the documents so they have ‘delivered’ but not actually! Talk about not being able to manage a party in a brewery!

Again we really see just way too little and it being delivered way too late.

David.

AusHealthIT Poll Number 152 – Results – 29th January, 2013.

The question was:

Are NEHTA And DoHA Competent To Be Managing The Delivery Of The E-Health Program In Australia?

Yes - They Are Fabulous 5% (2)
Maybe - Doing An Average Job 5% (2)
Neutral 0% (0)
Probably Not - They Are Not Doing Well 20% (8)
No - It Is An Awful Travesty 63% (25)
I Have No Idea 8% (3)
Total votes: 40
Very interesting. A clear majority are by no means convinced the people in charge have a clue what they are doing.
Again, many thanks to those that voted! 
Please Note: I am always interested in ideas for Polls. Send your suggestions via comment or e-mail!
David.

Monday, January 28, 2013

Weekly Australian Health IT Links – 28th January, 2013.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

The countdown has begun and it looks like less than ½ of the practices who are receiving ePIP payments up until Feb 1, will not be ready by that date for the new regime. Not that, of course, we will have any statistics on all this for a year or two. That will result in some grumpy and frustrated GPs to say the least.
Otherwise it is interesting to see how ‘apps’ are now part of the routine health environment. This change seems to have happened over the last few years and is only apparently accelerating. You can gauge the importance of all this by fact we now have legislation being drafted in the US to regulate them! 
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PCEHR chaos - have your say on just4docs

21 Jan 2013
The PCEHR scheme is in chaos with thousands of practices due to miss out on PIP payments. The issue has generated heated debate on Australian Doctor’s new secure online network for doctors.
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GP practices invited to ‘seed’ PCEHR

24 January, 2013 Sam Lee
GP practices are now being invited to become ‘seed organisations’ for the PCEHR system, with the release of new guidance on how to sign up and participation agreements tailored for different practice structures.
A new registration guide, released by the Department of Health and Ageing, suggests that most independent GP practices will be suited to sign up to the PCEHR program as a single ‘seed organisation’.  The more complex category of network organisation will be more suited to such as pathology departments within major hospitals.
However, the guidance warns that patients with ‘seed organisations’
may not be able to use access flags to restrict access to other providers within the same organisation.
The guide says GP practices will have to nominate a “Responsible Officer” such as the practice manager, and at least one IT-savvy “Organisation Maintenance Officer’ who will deal with the day-to-day operations of the eHealth record system.
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Internet poses risk to GP reputations

24 January, 2013 Kate Cowling
Online forums and search engine autocompletes have the potential to “irreversibly sully” the reputation of Australian doctors, the AMA’s president says.
And any potential solution is not clear-cut, he said, with costly legal pursuits unlikely to “overturn untruths”.
His comment came after it was revealed a Port Macquarie doctor was suing Google for defamation after auto-correct correlated his name with “bankrupt”.
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Jane McCredie: Keeping family secrets

THE sequencing of the human genome promises unparalleled opportunities to fight disease, identifying the genetic variants that predispose us to various illnesses or protect us from them.
In support of that noble endeavour, thousands of people around the world have donated their de-identified genetic information to free, publicly accessible databases such as those held by the 1000 Genomes Project.
Such projects are an invaluable resource for researchers but, in an age when so much information is available online about all of us, can the donors be assured their genetic information will remain private?
The answer, according to researchers at the Whitehead Institute for Biomedical Research in the US, is definitely not.
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Second opinion

Katie Hafner
The man on stage had his audience of 600 mesmerised. For 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.
At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.
Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Gurpreet Dhaliwal, 39, a self-effacing associate professor of clinical medicine at the University of California, San Francisco, is considered one of the most skilful clinical diagnosticians in practice.
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App may solve photo legal risks

A NEW smartphone app aimed at making clinical photography legally safe for doctors, patients and practices is just weeks away from release, according to the surgeon involved in its development.
Dr David Hunter-Smith, a plastic and reconstructive surgeon with Peninsula Health in Victoria, said the app would address the legal and security issues inherent in the booming use of smartphones in clinical situations.
News of the app coincides with an article published in this week’s MJA warning clinicians of their legal obligations regarding consent and privacy with clinical photography. (1)
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Doctors cautioned on taking patient pics

21st Jan 2013
DOCTORS have been advised to be vigilant about their legal and ethical responsibilities to patient privacy and consent when taking digital images of physical conditions on smartphones or other devices.
Authors of an article in the recent MJA have warned that with the increase of the practice by clinicians, and the resulting possibilities for these visual records to be used for patient management, medical education or research, doctors should be fully aware of their legal obligations.
Lead author Dr Patrick Mahar, of Melbourne’s Skin & Cancer Foundation, wrote that indemnity providers in both Australia and the UK had identified the “use or misuse of clinical photographs as an emerging medico-legal risk for the medical profession”.
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UNSW project spotlights text mining, language analysis

New Text Mining Collaboration project at the University of NSW aims to increase awareness of textual analytics tools
An interdisciplinary group of researchers at the University of NSW is seeking to promote a higher profile for text mining and automatic language analysis among academics.
The group has launched a UNSW-funded project, which went public late last year, that seeks to make it easier to use text mining tools for research and help prevent researchers from reinventing the wheel when it comes to extracting information from unstructured data.
The Web-based Text Mining Collaboration portal, which operates under the auspices of UNSW's Kirby Institute, offers access to online tools as well as bringing together related resources such as case studies and tutorials in an effort to make the technology easily available to the university's community of researchers.
"It's a mixture of our UNSW research outputs as well as commonly used text mining frameworks from around the world," says project lead Dr Stephen Anthony, Research Fellow at the Faculty of Medicine.
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Calvary takes the ehealth plunge

Published on Tue, 22/01/2013, 11:04:10
Little Company of Mary Health Care - officially Calvary Care - is seeking IT partners for its first three tiered ehealth initiative project in the Hunter region of NSW, just north of Sydney, according to a report in the Australian newspaper’s IT section today.
The article says the organisation, with a turnover in excess of $1 billion, is in discussions with both multi-national and local IT companies with a view to rolling out “a range of cutting edge tele-health services across its nationwide network.”
According to the article by Damon Kitney, Little Company of Mary CEO, Mark Doran said hospital groups would need to establish three-tier systems (home care, hospital care and aged care) to address the country's increasing ageing population, make available more hospital beds and tackle the growing public hospital waiting-list problems.
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Twitter more informative for health info than search engines

The research included analysis of more than 4700 tweets from 114 government health-related organisations.
University research has found that social networks like Twitter have a more powerful role in disseminating public health information than search engines.
The research was carried out by Professor Robert Steele and PhD candidate Dan Dumbrell at the University of Sydney.
“Using new communications technologies to allow people to directly receive relevant and up-to-the-minute public health information could benefit the health of millions and change the paradigm of public health information dissemination,” Steele, head of discipline and chair of health informatics at the university’s Faculty of Health Sciences, said in a statement.
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Practice 2000 Health Identifiers has been granted access in Production to the HI Service

January 9, 2013
We are pleased to inform that Practice 2000 has been certified by Medicare Australia to a Production access to HI Service. Currently, Practice 2000 has been listed on the PIP eHealth Register of Conformity. For more information, please refer to https://epipregister.nehta.gov.au/registers/healthcare-identifiers
A new version of Practice 2000 that is compatible with eHealth is available to download via http://abaki.com/portal/download/
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Twitch in time saves nine as speech solution expands Stephen Hawking'a universe

  • From: The Times
  • January 23, 2013 12:00AM
STEPHEN Hawking is to take a quantum leap in the world of communication thanks to new technology that will allow him to write faster.
For the past decade, the 71-year-old physicist has composed sentences one letter and word at a time by using a twitch of his cheek muscle to stop a cursor moving across text on a screen. His sentences are then read out by a speech device, producing his distinctive robotic voice.
But the degenerative motor neuron disease from which he suffers has made it harder to control the twitch, and one of science's quickest minds had been reduced to typing only one word a minute.
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DNA used as data storage device

24th Jan 2013
A GENETIC storage device has been used to ‘download’ all 154 of Shakespeare's sonnets onto strands of synthetic DNA.
British scientists were then able to decode the information and reproduce the words of the Bard with complete accuracy.
The same technique made it possible to store a 26-second excerpt from Martin Luther King's I Have A Dream speech and a photo of the Cambridgeshire laboratory where the work took place.
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PIP eHealth Incentive registration support available

18 January 2013.  The Practice Incentives Program (PIP) eHealth Incentive aims to encourage General Practices to keep up-to-date with the latest developments in eHealth to assist in improving administration processes and enhancing the quality of patient care by, for example, supporting the capacity to share accurate electronic patient records.  From 1 February 2013, the PIP eHealth Incentive eligibility requirements change. 
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Organisations Offering Registration Workshops

Organisations providing workshop registration support to support General Practices registering for ePIP can use these materials to plan and deliver registration workshops.
The workshop has been designed specifically for General Practices registering for ePIP, however the forms and guides can be used by other providers to support them in registering for their NASH PKI certificates and the personally controlled electronic eHealth record (PCEHR).
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Health apps win NSW awards

  • From: AAP
  • January 23, 2013 3:53PM
SMARTPHONE and tablet apps are set to take over outdated magazines in doctors' waiting rooms as health providers update the way they manage data.
Four developers have won the NSW government's apps4nsw competition, which this year focused on e-solutions for health.
"I love apps. I use apps to do everything," NSW Health Minister Jillian Skinner said at an awards ceremony at NSW parliament.
"These ideas have the potential to help the people of NSW make better choices about their health."
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Australian internet speeds fall to 40th place globally

Date January 25, 2013 - 12:27PM
Australian internet speeds have fallen again compared to the rest of the world, says a new survey.
Average Australian connection speeds fell 2.5 per cent in the third quarter of 2012 as the country sank to 40th in the world, according to Akamai Technologies' third quarter "State of the internet" report.
Australia dropped from 39th position globally in the second quarter of 2012, being beaten by five countries in the region. Australia came out on top of New Zealand, however, which ended up in 46th place.
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Google working on password alternatives

Date January 21, 2013

Samantha Murphy

The topic of passwords has made headlines in the past year — from high-profile hacks to web users repeatedly not picking the right ones — but Google has its sights set on making the login-process much more secure in the future.
How secure, you may ask? Consider logging into Gmail with a high-tech ring worn on your finger or a key card that plugs into your computer's USB port.
As detailed in a research paper in IEEE Security & Privacy Magazine and reported on by Wired, Google is already looking into password alternatives in the form of passdevices. The initiatives have also been confirmed by Mashable.
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Enjoy!
David.

Sunday, January 27, 2013

This Is Really Sad - Twitter Being Abused

I have been following #qldfloods and #bigwet on Twitter today.

Was great until 1 hour ago - now an epidemic of porno spam.

What a pity.  Sad a useful service is being abused big time. What jerks.

David.

They Simply Don’t Seem To Be Able To Keep It Up. Surely A Full, Properly Working System Is Not All That Hard?

Had my usual weekly visit to my NEHRS Record.
Findings were as follows.
First the response time is just awful. Even the News Ltd Home Page and The SMH are 10 times as quick. Comparisons with Google and Amazon and simply not worth making.
Second it now seems you can register for a NEHRS if you wish - so that has been fixed during the week.
Third we have:

Service availability

  • Home
  • Service availability
This page identifies scheduled outages to the eHealth record system.
The Personally Controlled Electronic Health Record System (PCEHR) is undertaking essential maintenance from 4am Wednesday 30 January to 7am Wednesday 30 January (AEDST).
The PCEHR System will not be available between 4am and 7am Wednesday 30 January .
We apologise for any inconvenience.
Contact the eHealth helpline on 1800 723 471 for assistance during this period.
See here:
It just seems that never a week goes by when it all works as it should.
David.

Saturday, January 26, 2013

Weekly Overseas Health IT Links - 26th January, 2013.

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.
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3 ways to keep communications secure

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 01/16/2013
In 2012, the Massachusetts Ear and Eye Infirmary was hit with a $1.5 million fine when they lost control of a mobile device containing sensitive medical records of its patients. By no means was the other side of the nation immune: Alaska's public health network was ordered to pay up for a similar data breach.
Instances of healthcare organizations being dinged for failing to keep a tight enough of a lid on patient records have been racking up over the past few years. Combine that with the increasing prevalence of mobile devices in healthcare and the large sector of the industry clamoring for BYOD, and many organizations are seemingly faced with a lose-lose situation where either staff are happy and enabled to work more efficiently, but prone to costly and dangerous data leaks. So it would seem, at least.
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Pediatric EHR redesign in the works

By Molly Merrill, Associate Editor
Created 01/18/2013
Meaningful use has unintentionally shifted the market's attention away from child health electronic health records (EHRs), according to Feliciano "Pele" Yu, Jr., MD, chief medical information officer at St. Louis Children's Hospital. However, this has not stopped advocates from working to get pediatric functionality into EHRs through innovative projects – some soon to be announced and others in the works – that could improve the technology for pediatricians and child heath.
“Meaningful use is by no means perfect for pediatrics, but the trajectory that we have seen is amazing. [CMS and ONC] have worked hard and well for the last few years,” said Christoph Lehmann, MD, medical director of the American Academy of Pediatrics (AAP) Child Health Informatics Center. “In Stage 1 we were very concerned because we were afraid that pediatricians would be left behind,” he added.
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Hospital leaders: New HIPAA rule will be a challenge

January 18, 2013 | By Dan Bowman
While the newly unveiled HIPAA omnibus rule, announced Thursday afternoon by the U.S. Department of Health & Human Services represents a win for patient privacy protection, executing the new rules will present a multitude of challenges, according to several FierceHealthIT Editorial Advisory Board members.
Todd Richardson (right), vice president and CIO of Wausau, Wis.-based non-profit health system Aspirus, Inc., told FierceHealthIT that providers and vendors that use and create electronic health record systems already walk a tight balance between complying with HIPAA and meeting the requirements of the HITECH Act and Meaningful Use regulations.
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HHS unveils final HIPAA omnibus rule

January 17, 2013 | By Dan Bowman
The long-awaited expansion of the Health Insurance Portability and Accountability Act of 1996, unveiled Thursday afternoon by the U.S. Department of Health & Human Services, comprises four final rules, according to HHS "which have been combined to reduce the impact and number of times certain compliance activities need to be undertaken by regulated entities."
The four rules that combine to create the omnibus final rule include:
  • Modifications to the HIPAA Privacy, Security, and Enforcement Rules mandated by the Health Information Technology for Economic and Clinical Health Act, and certain other modifications to improve the rules, which were issued as a proposed rule on July 14, 2010.
  • Changes to the HIPAA Enforcement Rule to incorporate the increased and tiered civil money penalty structure provided by the HITECH Act, originally published as an interim final rule on Oct. 30, 2009.
  • A final rule on Breach Notification for Unsecured Protected Health Information under the HITECH Act, which replaces the breach notification rule's "harm" threshold with a more objective standard and supplants an interim final rule published on Aug. 24, 2009.
  • A final rule modifying the HIPAA Privacy Rule as required by the Genetic Information Nondiscrimination Act (GINA) to prohibit most health plans from using or disclosing genetic information for underwriting purposes, which was published as a proposed rule on Oct. 7, 2009.
"Much has changed in healthcare since HIPAA was enacted over 15 years ago," HHS Secretary Kathleen Sebelius said in a statement. "The new rule will help protect patient privacy and safeguard patients' health information in an ever expanding digital age."
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Tuesday, January 15, 2013

Health Online 2013

From the report: "81% of U.S. adults use the internet and 59% say they have looked online for health information in the past year. 35% of U.S. adults say they have gone online specifically to try to figure out what medical condition they or someone else might have. 
Online resources join the stream of information flowing in from people's interactions with clinicians, family, and fellow patients.
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A Road Runs Through These Order Sets

Scott Mace, for HealthLeaders Media , January 17, 2013

This article appears in the December 2012 issue of HealthLeaders magazine.
Can a wiki share and standardize order sets? R. Dirk Stanley, MD, MPH, aims to find out.
"The fact that they're not standardized across the country leads to enormous costs and inefficiencies in healthcare," says Stanley, chief medical informatics officer at Cooley Dickinson Hospital in Northampton, Mass. "For example, if you have a doctor who's moonlighting, you know if you have a doctor from hospital A that you need to fill a shift in hospital B, if the doctor doesn't know what order set, kind of how the clinical functions operate, then it means you basically have to retrain the doctor on your clinical functions, but that's a lot of time and a lot of money."
Informally, order sets are finding their way from provider to provider through several routes today. Incoming residents are a source. Another is occasional informal exchange of order sets on the online forum run by the Association of Medical Directors of Information Systems.
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Hunt wants paperless NHS in five years

16 January 2013   Lyn Whitfield
Health secretary Jeremy Hunt has set out a tight timetable for making all records and communications in the NHS paperless.
In a speech to the right-wing think-tank Policy Exchange on Wednesday, he said that all records and communications in health and social care would be electronic by 2018.
There is no central funding for the plans, but a report commissioned from consultants PriceWaterHouseCoopers has estimated that more ambitious use of IT would save the NHS £4 billion.
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M-health: 2.8 million patients remotely monitored worldwide in 2012

About 2.8 million patients were remotely monitored worldwide at the end of 2012, using a home monitoring service based on equipment with integrated connectivity, according to a new research report from the analyst firm Berg Insight. The number of monitored patients is higher than nearly 2.2 million monitored patients at the end of 2011.
Some of the most common conditions currently being monitored are chronic diseases including cardiac arrhythmia, hypertension, ischemic diseases, sleep apnea, diabetes, hyperlipidemia, asthma and chronic obstructive pulmonary disease (COPD).
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Survey gauges consensus on docs' online behavior

Posted: January 15, 2013 - 12:30 pm ET
While the Federation of State Medical Boards and the American Medical Association have developed policies for physicians and social media professionalism, the consequences for violating these standards are still undefined, according to a report in the Annals of Internal Medicine.
A team of researchers, including FSMB President and CEO Dr. Humayun Chaudhry, distributed a set of 10 hypothetical vignettes depicting various violations of online professionalism to the executive directors of the 70 medical and osteopathic boards for the 50 states, Washington and the U.S. territories, and they were asked in a survey whether the violations warranted further investigation. (Two states have the same director for their medical and osteopathic boards, so 68 surveys were sent. Though invited, directors of the four territories with medical boards did not participate.)
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Thursday, January 17, 2013

What the 2013 Consumer Electronics Show Means for Health Care IT

Digital health was the fastest growing industry segment at the 2013 Consumer Electronics Show, which featured more than 200 exhibitors hawking the newest wristband activity trackers, digital weight scales, mobile phones for seniors and personal emergency response systems to help us when we've fallen and can't get up.
But the biggest health story at the CES was that United Healthcare had the largest single piece of real estate on the floor of the digital health area of the exhibit hall, about the same size as Whirlpool's space in the connected home area.
What does it mean that the nation's largest health insurance plan made such a big bet at a convention that features the latest in smartphones, flat screen TVs and self-driving automobiles?
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ONC names EHR design contest winners

By Mary Mosquera, Senior Editor
Created 01/16/2013
The Office of the National Coordinator for Health IT has selected the winning designs of printed health records to help patients better understand and use their electronic health records (EHRs).
The designs and formats were a response to an ONC challenge contest to make EHRs valuable to patients and their families. Patients who are engaged in their healthcare treatments have better outcomes, according to Farzad Mostashari, MD, the national health IT coordinator.
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ONC Finds Ways to Make EHRs More Readable

JAN 15, 2013 5:19pm ET
The Office of the National Coordinator for HIT has announced winners of a contest to convert printed text-based electronic health records into far more consumer-friendly versions. The goal is to make it easier for consumers to find and understand information in a printed record, whether downloaded via the government-funded Blue Button technology or through proprietary vendor technology.
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UnitedHealth, Mayo combine data to research medical treatments

January 16, 2013 | By Dina Overland
UnitedHealth and Mayo Clinic have agreed under a new partnership to combine their data for more than 110 million patients to help research methods to improve healthcare while lowering costs.
Under the new initiative, called Optum Labs, researchers will mine UnitedHealth's insurance claims for more than 109 million people, as well as Mayo Clinic's five million patient records, to determine best treatments and procedures for various health conditions, according to MedCity News.
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Hull and East Yorkshire takes Lorenzo

15 January 2013   Lis Evenstad
Hull and East Yorkshire Hospitals NHS Trust is the second trust to commit to take CSC’s Lorenzo electronic patient record system under a new agreement between the company and the Department of Health.
The trust, which currently uses the iSoft PatientCentre system, hopes Lorenzo will help eliminate paper records, facilitate agile working, support collaborative working and share information more effectively between clinical staff.
Martyn Smith, director of IT and innovation at Hull and East Yorkshire, said: “The Lorenzo deployment model allows us to be bold and to deploy a full like-for-like service at the earliest opportunity, including electronic ordering, electronic reporting and emergency care”.
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From the frontline

Andrew Carr is the clinical lead for IT at the emergency department of Cambridge University Hospitals NHS Trust, where a major IT project is underway. He wonders why so few of his fellow nurses are involved in something as critical as healthcare IT.
14 January 2013
The procurement of electronic health records by a variety of large trusts was a feature of news articles in eHealth Insider last year.
For the past 18 months, I have taken part in such procurement – eHospital - for Cambridge University Hospitals and Papworth Hospital NHS foundation trusts.
I believe that eHospital will bring about significant, positive, change in the way that healthcare staff provide care and the way that our patients and their families are cared for.
As a nurse working as an emergency nurse practitioner, and as IT lead for the emergency department, I want to make sure that the system we choose not only places patients and clinicians at the centre of all that we do, but also recognises the unique role that nurses contribute to patient care.
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Incentives spur high-level IT adoption, HIMSS Analytics finds

Posted: January 15, 2013 - 1:30 pm ET
Federal electronic health-record incentive payment programs appear to be accelerating the adoption and use of higher-level health information technology functions at U.S. hospitals, according to the latest data from HIMSS Analytics, the market-analysis arm of the Chicago-based Healthcare Information and Management Systems Society.
HIMSS Analytics measures the sophistication of hospital EHR systems in use through surveys, applying reported data against its own, eight-stage—Stage 0 through Stage 7—Electronic Medical Record Adoption Model.
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Incentives help boost hospitals' EHR sophistication

January 16, 2013 | By Susan D. Hall
Fueled by federal incentives, U.S. hospitals are growing more sophisticated in their use of electronic health record technology, according to HIMSS Analytics, the market-analysis arm of the Healthcare Information and Management Systems Society.
Its report looks at five quarters, beginning with the third quarter of 2011--when the first incentive payments from the Medicare and Medicaid Incentive Programs were paid out--through the third quarter of 2012.
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Are providers ripe for a massive medical records heist?

By Tom Sullivan, Editor
Every lost laptop, stolen smartphone and missing thumb drive containing health information confirms the dark reality of an industry disconcertingly tone deaf when it comes to data encryption and protection.
Many healthcare organizations have yet to institute security practices that financial services companies, for instance, put in place two decades ago — a fact that leaves them increasingly vulnerable to the large-scale data thievery that organized crime has perpetrated in other realms.
Take TJX, for instance. Criminals in South Florida drove around to the retail subsidiaries in 2005, located and cracked into poorly-protected Wi-Fi networks, burrowed deeper into the corporate IT systems to vacuum out some 46 million credit and debit card records and then, ultimately, sold those to Ukrainian organized criminals.
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EHR adoption could exceed 80 percent by end of 2013, new study finds

By Erin McCann, Associate Editor
Created 01/15/2013
Family physicians are adopting electronic health records (EHRs) at a much faster rate than previous data suggested, reaching a nearly 70 percent adoption rate nationwide, new study findings reveal. 
The study, published in the January/February issue of the Annals of Family Medicine, shows EHR adoption by family physicians has doubled since 2005, with researchers estimating that the adoption rate will exceed 80 percent by the end of 2013.
Findings also reveal a higher percentage of EHR adoption among physicians in comparison to a July 2012 study conducted by the CDC's Center for National Health Statistics, which reported that 55 percent of office-based physicians had adopted EHRs.
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Violating patient privacy: A social media 'never event'

January 15, 2013 | By Ashley Gold
What professionals should post on social media is always tricky, and physicians should be especially careful with what they tweet and post to Facebook, according to a survey of state medical boards--not only for their reputations, but also because it can violate patient privacy.
The biggest problem with physicians using social media was misrepresenting credentials or treatment outcomes, with 81 percent of those surveyed saying they believe that type of behavior would be cause for an investigation, MedPage Today reported. Seventy-nine percent were concerned about physicians inappropriately contacting patients or using their photos, a group at the University of California-San Francisco found.
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Most 'online diagnosers' also want doctor advice

January 15, 2013 | By Dan Bowman
Out of roughly 81 percent of U.S. adults who say they use the Internet, 72 percent claim they have looked up health information online in the past year, according to new research published this week by the Pew Research Center's Internet & American Life Project. Of those, 59 percent say they have looked online specifically to figure out a medical condition for themselves or someone else; to that end, Pew labeled those patients--who make up 35 percent of all U.S. adults--"online diagnosers."
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CHIME: Proposed Meaningful Use Stage 3 thresholds 'unrealistic'

January 14, 2013 | By Marla Durben Hirsch
Industry stakeholders submitting comments on proposed measures for Stage 3 of the Meaningful Use program from ONC's Health IT Policy Committee have expressed concern that the program is moving too quickly and needs additional evaluation before proceeding.
Both the American Medical Association and the American Hospital Association, in comments submitted to ONC Jan. 14, called for a thorough evaluation of the program, especially considering many providers have yet to even achieve Stage 1 of the program. They also recommended that regulators resolve current problems with the program, such as the usability of certified EHRs.
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CES Makes a Healthcare Splash

Scott Mace, for HealthLeaders Media , January 15, 2013

The data is out there. We only have to decide to use it.
Everywhere we go, we leave "data exhaust." It starts when you wake up and check your phone. Now there's a record that this guy's no longer asleep. Like little bread crumbs, we are our own life recorders. Our phones know where we go and how long it takes to get there.
On the Internet, our intentions are exquisitely captured by a series of privacy-bending technologies that watch our surfing and searching history and tailor ads personally to us. I can't tell you how ads for vendor-neutral archives find me even when I'm checking ESPN, but given what I do for a living, I can hazard a guess.
There is one and only one place each year where the tech-minded assemble to swap stories and gawk at the latest manifestations of the digital fishbowl that is our total lives today. So I too found my way to Las Vegas for last week's Consumer Electronics Show, which also featured conferences-within-conferences on digital health, fitness technology, and technologies for seniors.
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NIH makes big deal of big data

By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Created 01/14/2013
The National Institutes of Health (NIH) is putting a fresh emphasis on health informatics, with Director Francis Collins, MD, creating a new advisory position and recruiting an associate director for Data Science.
Collins, a physician and geneticist, said there’s recently been an “exponential growth of biomedical research data” from genomics, imaging and electronic health records, with the new position being focused on building the NIH’s related research projects.
"There is an urgent need and increased opportunities for advanced collaboration and coordination of access to, and analysis of, the rapidly expanding collections of biomedical data," Collins said. "NIH aims to play a catalytic lead role in addressing these complex issues — not only internally, but also with stakeholders in the research community, other government agencies, and private organizations involved in scientific data generation, management and analysis."
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Study: mHealth productivity gains to reap $305 billion in savings over 10 years

January 11, 2013 | By Greg Slabodkin
Mobile technology will transform the healthcare industry with increased productivity gains saving $305 billion over the next 10 years, according to a new report by the Deloitte Center for Health Solutions. The savings will come from reduced travel time, better logistics, faster decision-making and improved communications, among other improvements, says Deloitte.
The report cites a 2012 Brookings Institution study predicting that remote monitoring technologies will save nearly $200 billion by managing chronic diseases in the U.S. over the next 25 years. Deloitte points out other estimates that suggest remote monitoring can reduce the costs for caring for the elderly in rural areas by allowing seniors to live independently and spend more time at home, while reducing the need for face to-face medical consultations, by 25 percent.
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Healthcare IT M&A deals increased in 2012

January 14, 2013 | By Ashley Gold
Over the past year, mergers and acquisitions have increased considerably in the healthcare IT sector, with smaller deals yielding big returns on investment, according to report from New York-based investment bank Berkery Noyes released Jan. 11.
The report, which analyzes M&A activity in 2012--comparing the data since 2010--shows that healthcare IT M&A transaction volume increased 21 percent annually, with private equity firms accounting for four of the industry's top-value deals last year.
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Proposal says IT could trim $2 trillion from national health spending

January 14, 2013 | By Ashley Gold
The Commonwealth Fund's Commission on a High Performance Health System last week proposed reform that could trim $2 trillion from national health spending over the next 10 years. The proposal, according to an article in InformationWeek Healthcare, has a central focus on the Meaningful Use of healthcare IT by healthcare organizations.
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Monday, January 14, 2013

Technology-Enabled Medication Tracking: A Tough Nut To Crack

A patient who comes into the hospital for a complex cardiovascular procedure, at one end of the spectrum, or a straightforward pneumonia case, at the other, both face a safety risk in what may appear relatively simple to do: Getting, and maintaining, an accurate medication list.
Even with health IT advances and the march toward computerized provider order entry, health care facilities still struggle with the process of medication reconciliation, which is woven throughout the care continuum.
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January 14, 2013

Mining Electronic Records for Revealing Health Data

By PETER JARET
Over the past decade, nudged by new federal regulations, hospitals and medical offices around the country have been converting scribbled doctors’ notes to electronic records. Although the chief goal has been to improve efficiency and cut costs, a disappointing report published last week by the RAND Corp. found that electronic health records actually may be raising the nation’s medical bills.
But the report neglected one powerful incentive for the switch to electronic records: the resulting databases of clinical information are gold mines for medical research. The monitoring and analysis of electronic medical records, some scientists say, have the potential to make every patient a participant in a vast, ongoing clinical trial, pinpointing treatments and side effects that would be hard to discern from anecdotal case reports or expensive clinical trials.
“Medical discoveries have always been based on hunches,” said Dr. Russ B. Altman, a physician and professor of bioengineering and genetics at Stanford. “Unfortunately, we have been missing discoveries all along because we didn’t have the ability to see if a hunch has statistical merit. This infrastructure makes it possible to follow up those hunches.”
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January 10, 2013

In Second Look, Few Savings From Digital Health Records

By REED ABELSON and JULIE CRESWELL
The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.
Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.
“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.
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RAND Walks Back HIT Savings Estimates

John Commins, for HealthLeaders Media , January 14, 2013

RAND researchers are walking back a report that the nonprofit public policy think tank issued in 2005 estimating that the widespread adoption of healthcare information technology could trim more than $81 billion each year from the nation's healthcare tab through improved efficiencies.

Instead, a new RAND analysis by a new team of researchers, published this month in
Health Affairs, notes that seven years later, expectations about the safety and efficiency of HIT mostly have not been met, and annual healthcare spending has increased by $800 billion. 

"The failure of health information technology to quickly deliver on its promise is not caused by its lack of potential, but rather because of the shortcomings in the design of the IT systems that are currently in place," said
Dr. Art Kellermann, the study's senior author said in a media release.
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Enjoy!
David.