Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, March 31, 2013

A Very Kind Soul Is Doing All The Work For Me. Great Stuff To Browse On A Long Weekend!

A colleague pointed out this blog post last week.

eHealth records: blessing or burden? (slideshow)

In this slide show I have tried to explain the complexity of the Australian eHealth record (or PCEHR) and why it is not necessarily an improvement for health professionals. Feel free to use, download and/or share this presentation.
The direct link to the blog post is here:

I have embedded a direct link as the blog indicates Dr Kruys is keen to have the presentation shared.

Reading through the 19 well considered slides all I can say is I wish I had put so clearly on the blog such a useful summary of all that is wrong and ill-considered with the PCEHR.
To me the advantages cited on Slide 3 are totally outweighed the cons on slide 4.
The presentation is available for review and download from the link above.
Many thanks Dr Kruys for a quality presentation that makes it clear just how far the Government has to go to make this PCEHR even slightly useful, safe, clinically acceptable, trustworthy and suitable for adoption.
There are not enough voices warning about all the issues covered here! I suspect Dr Kruys comes down pretty firmly on the burden side as far as the PCEHR is concerned.

Friday, March 29, 2013

Weekly Overseas Health IT Links - 30th March, 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.

The Top 5 Trends From HIMSS13

March 12, 2013
Follow Me On Twitter @KenOnHIT
More than 34,000 health IT enthusiasts converged on New Orleans last week to attend the 2013 HIMSS Conference & Exhibition. As anticipated, the event provided a stage for several industry announcements, technology developments, and educational sessions. The Healthcare Technology Online team was there in full force, and the following are my top takeaways from the show.
Interoperability Takes Center Stage
As expected, interoperability was a focal point of HIMSS13. Perhaps the event’s biggest announcement — the launch of the CommonWell Health Alliance — centered on this crucial topic. Cerner and McKesson publicized plans to make a historic announcement at HIMSS a few weeks prior to the event, and health IT pundits immediately began to speculate that the news would involve interoperability between the two vendor platforms. However, the announcement turned out to be much bigger than initially anticipated — with Allscripts, Athenahealth, RelayHealth, and Greenway Medical Technologies also included in the news.
According to the release, these six vendors will form an independent, not-for-profit organization (CommonWell) in a collaborative effort to achieve data liquidity between systems, in compliance with patient authorizations. The Alliance will define, promote, and certify a national infrastructure with common platforms and policies. It also will ensure that health IT products displaying the Alliance seal are certified to work on the national infrastructure.

Study: Telehealth not cost effective for chronic patients

March 22, 2013 | By Susan D. Hall
Telehealth failed to produce gains more cost effectively than standard care alone in a new study published at BMJ. That work comes on the heels of previous research in the journal that found telehealth produced  no significant improvements in reported quality of life or anxiety or depression symptoms.
Both studies were part of the British government's Whole System Demonstrator Evaluation of telehealth. The latest study tracked 534 patients with heart failure, chronic obstructive pulmonary disease or diabetes who received telehealth services for 12 months along with usual care, and 431 who received usual care alone.
In the telehealth program, patients received equipment that enabled them to take measurements like blood pressure and blood glucose level at home and transmit readings electronically to a healthcare professional, according to Reuters.

Remote Patient Monitor Sales on the Rise

March 21, 2013
According to a research report from the New York City-based Kalorama Information, sales of advanced remote patient monitoring devices have risen 20 percent from the year before. The market for the devices, which process patient data and link them to an electronic medical record (EMR), has constantly ticked up, going from $4 billion in 2007 to $10.6 billion in 2012.
"We expected growth and that growth was certainly seen between 2011 and 2012," Melissa Elder, analyst at Kalorama, said in a statement. "The market has benefited from the demand to move to a more wireless and streamlined operation both within major health facilities and in the home treatment markets. The demand to integrate data processing capabilities and EMR transfer options has also fueled the market."
March 21, 2013, 11:46 am

Doctors and Their Online Reputation

When a doctor I know recently signed up for a Twitter account, his colleagues began teasing him. “Are you going to tweet what you eat?” one joked.
Their questions, though, soon turned serious. How often was he going to tweet? What would he do if patients asked for medical advice on Twitter? Did he make up a name or use his real one?
“Doesn’t it make you nervous to put yourself ‘out there’?” asked one doctor, a respected clinician and researcher who prided herself on her facility with technology … but only at home. “I refuse to look myself up on Google,” she said. “Quite honestly, I’m not sure what I’d do with what I might find.”

10 Technologies Hospital Leaders Should be Watching

Ryan Chiavetta and Chelsea Rice , March 22, 2013

The ECRI Institute has released its third annual 10 C-Suite Watch List. The list was compiled by polling various technical colleges at ECRI, along with associated of the company who track hospital and health care operations to figure out which issues were of the most importance to them.
While some entries to the top ten list are repeats from last year, many of the entries are new, as various technologies in certain fields have made great strides over the last year.
1.Electronic Health Records
A big goal for many hospitals is to make sure they are able to certify their electronic health records for Stage 1 Meaningful Use. A concern that has arisen is whether the rush to achieve Stage 1 has affected patient safety.  While few errors involving health information technology have been reported, there have been  instances of patient harm associated with those errors, which included four fatalities. Errors involved data entry into the wrong file, inadequate data transfer between HIT systems, and failure for the systems to function as designed, which has called for hospitals to tighten up these errors in order to keep patients out of harm.

Study: No vendor has a lock on EHR usability

March 21, 2013 | By Marla Durben Hirsch
Electronic health record vendors need to improve the usability of their products and provide more guidance to their provider clients, according to a new study by Orem, Utah, research firm KLAS.
In its study of 128 physician leaders, KLAS found that no vendor scored above a four (on a scale from one to five) in clinical usability. Epic scored the highest at four, while Cerner and Siemens each came in at 3.7. Allscripts scored a 3.5, with McKesson Paragon at 3.4 and MEDITECH v. 6 at 3.

Docs cling to paper, EHR workarounds

March 21, 2013 | By Marla Durben Hirsch
Providers continue to use "workarounds" to deal with perceived inadequacies of their electronic health records, according to a new study in the Journal of the American Medical Informatics Association.
Current EHRs require clinicians to change the way they work and contain design flaws, such as difficulty in finding data and complex order entry processes. As a result, they often use workarounds, such as paper reminders or overriding alerts. However, these workarounds can pose a threat to patient safety, according to the study's authors.

A Prescription for Failure

MAR 21, 2013 9:23am ET
We spend a lot of time reporting around the elderly/chronically ill. Taking care of that burgeoning swath of society has become a big priority for health providers and payers with accountable care, hospital readmissions and population health management ruling the day.
The technology is bulking up—at-home medical monitoring devices, talking pill-boxes, analytics-driven care coordination and predictive modeling, and dozens of other software and hardware solutions trying to keep geriatric populations out of trouble. But they’re not moving the chains far enough or fast enough, and I think one reason is that none straight-on address the problem of polypharmacy and the prescription for failure that it’s written for so many costly and well-intentioned I.T. efforts.
Polypharmacy by abridged definition means “the use of multiple medications by a patient, especially when too many forms of medication are used by a patient, when more drugs are prescribed than is clinically warranted, or even when all prescribed medications are clinically indicated but there are too many pills to take (pill burden).”

House panel grills Mostashari on delay of widespread interoperability

By Diana Manos, Senior Editor
Created 03/21/2013
Today in the third of three hearings held by subcommittees of the House Energy and Commerce Committee, Farzad Mostashari, National Coordinator for Health Information Technology reassured a congressional panel that health IT interoperability will take some dramatic leaps forward within the next two years.
Michael Burgess, MD (R-TX) vice-chairman of the House Subcommittee on Oversight and Investigation, questioned the sluggishness of interoperability.
“We do hear about this a lot,” Burgess said. “Even anecdotally, hospital systems in the same city, that have the same operating system aren’t talking to each other.”
“You’re the head, why don’t you fix that?,” he asked Mostshari. “Why don’t you just make that happen?”

Prioritize workflow during HIT implementation

March 21, 2013 | By Dan Bowman
For providers asked to use new technologies like electronic health records and analytics tools, workflow impact, no doubt, is a top of mind issue. Transitioning away from familiar and comfortable practices and adopting new habits is one of the biggest obstacles an organization can face.
In a recent interview with the Institute for Heath Technology Transformation, Stephen Beck, chief medical informatics officer at Cincinnati-based Catholic Health Partners, said that's exactly how he approaches his organization's IT implementation processes. For instance, during Catholic's EHR implementation, Beck said he asked his employees to anticipate across-the-board changes--everything from physical movements to communications processes.
"Continual reinforcement of the new efficient workflows helps drive this change," he said. "A small change in habit, such as always using an admission order set, makes subsequent changes easier over time."

Govt plans law to stop "fiddled" figures

16 March 2013   Lyn Whitfield
The government is thinking of holding trusts criminally liable for manipulating figures on waiting times and death rates as part of its response to Robert Francis’ final report into the scandal at Mid Staffordshire NHS Foundation Trust.
According to a report in the Daily Telegraph, health secretary Jeremy Hunt is inclined to introduce new criminal sanctions to support Francis’ call for more transparency in the health service, and in response to a spate of newspaper stories claiming that trusts have “fiddled” their mortality figures.
The paper says that “a source close to” Hunt told it that “the manipulation of data has been happening, rarely but consistently, for many years. We feel strongly that if NHS trusts are caught acting fraudulently about their performance on areas such as death rates or waiting times they should be criminally liable.”

Fewer health IT contracts last year: report

Posted: March 20, 2013 - 1:45 pm ET
Healthcare companies inked 39% fewer information-technology contracts last year as the market for IT services saw a contraction across the board.
A report from Ovum, a technology research and consulting firm, found that the volume and value of IT services contracts last year fell to their lowest levels since 2002 as economic uncertainty prompted a cutback in spending in both private and public sectors.
The firm looked at a number of industries in both the U.S. and Europe and found that fourth-quarter IT deal value fell 34% to $20.8 billion, while the number of deals declined 17%.
Thursday, March 21, 2013

States Not Keeping Up With Telehealth Advances

State laws on telehealth are antiquated, contradictory and confusing, according to a recent comprehensive report on how all 50 states oversee the use of technology to deliver health care remotely.
No two states are alike in how telehealth is defined and regulated, according to the report by the Center for Connected Health Policy, an independent not-for-profit telehealth planning and technical assistance group based in Sacramento, Calif.
"Generally speaking, the policies and regulations that govern telehealth are not keeping up with where telehealth is today," said Mario Gutierrez, executive director of the CCHP, which is partially funded by the California HealthCare Foundation. CHCF publishes iHealthBeat.

EHRs Rush in Where Doctors Fear to Tread

Scott Mace, for HealthLeaders Media , March 21, 2013

This article appears in the March 2013 issue of HealthLeaders magazine.
Resistance to new technology may be futile, but it remains an issue for healthcare.
"Physicians do have to spend more time at computers now, which diminishes the amount of time we can spend at the bedside and interacting with patients and actually doing those things like surgical procedures and interventions that only we have the skill and the knowledge and the training to do," says Steven J. Stack, MD, chairman of the board of the American Medical Association.
Stack, who also heads the AMA's health information technology advisory group, says physicians flock to new technology when it helps them provide better diagnosis or treatment in a more timely fashion. "Just look at robotic surgery," Stack says.

EMIS and TPP share data

18 March 2013   Rebecca Todd
EMIS and TPP are working on a data-sharing agreement to allow clinicians to see information held in each other’s systems.
The GP IT companies plan to deliver one-to-one local health community data-sharing for clinical commissioning group areas using both EMIS and TPP systems.
The new agreement, described by the companies as “groundbreaking” and “momentous”, means clinicians using one system will be able to view patient records from the other system.
This will be subject to sharing agreements and patient consent at the point of care.
EMIS managing director Neil Laycock told EHI the two companies were working together to find pilot sites for the new data-sharing arrangement. Areas with high populations of TPP and EMIS users tended to be in the North East and South East of the country.

9 tips for getting started with big data

By Mike Miliard, Managing Editor
Created 03/20/2013
With big data promising enormous clinical and financial rewards for healthcare, but posing just as many technical and strategic challenges, the Institute for Health Technology Transformation (iHT2) has published a study mapping the way forward for providers at the starting line.
"Health care providers face significant obstacles in implementing analytics, business intelligence tools and data warehousing," writes iHT2 CEO Waco Hoover in the report. "Health data is diverse, comprising structured and unstructured information in a range of formats and distributed in hard-to-penetrate silos owned by a multitude of stakeholders.
Moreover, he writes, "each stakeholder has different interests and business incentives while still being closely intertwined."

Android gene test presages future of data privacy

By: Jonah Comstock | Mar 19, 2013     
A team led by University of California-Irvine researchers has developed what’s been called an Android-based smartphone paternity test. The app would allow two people, if they had access to their digitized genomes, to run a paternity test comparing their genomes, determine how closely related they are, and even scan their genome for predictors of different diseases. The team also includes researchers from the Xerox Palo Alto Research Center (PARC) and the New York Institute of Technology.
According to researchers, though, the real innovation of the platform, called GenoDroid, is that it allows people to run tests using their digitized genomic data, while maintaining data privacy — not sharing their genome with anyone, even the other subject of the test.

55% of Providers Don't Know When Their Organizations Will Have Formal Clinical Informatics Programs

Written by Anuja Vaidya  | March 18, 2013
More than half of healthcare providers don't know when their organization will have a formal clinical informatics program, according to "Needles in a Haystack: Seeking Knowledge with Clinical Informatics," a report by PwC's Health Research Institute.
For the report, researchers conducted 30 in-depth interviews with IT, clinical and strategy professionals involved with informatics within their healthcare organizations. They also conducted online surveys, in 2011, of more than 400 providers, 90 health insurers and 100 pharmaceutical and life sciences executives on their approaches and strategies for analyzing clinical data.

US hospitals making progress on EMRs

5 March 2013   Jon Hoeksma at HIMSS 2013 in New Orleans
US hospital IT leaders report strong progress towards electronic medical records, with two thirds saying they have achieved the first milestone in the Federal ‘meaningful use’ programme.
A further three quarters say they anticipate meeting the next - stage 2 - meaningful use milestone that falls in September 2014. The findings came as part of the annual HIMSS leadership survey.
But the continued momentum on EMR, fuelled by President Barak Obama’s American Recovery and Investment Act of 2009, which triggered $30 billion of incentives for using electronic records to improve and demonstrate quality of care, is creating intense competition for skilled and experience health IT professionals.

Chinese hackers targeting the healthcare industry

March 20, 2013 | By Susan D. Hall
Gangs of Chinese hackers are targeting the U.S. healthcare industry, going after intellectual property associated with new drugs and devices as well as business processes that improve efficiency, according to an article at Dark Reading.
Generally, hackers are looking for financial information they can use for identity theft and other financial fraud, but cyber espionage from Chinese gangs is growing, according to security firm CyberSquared. It released a white paper outlining some of the recent attacks.
"Many of these victims have technology or drugs that are a monopoly," Rich Barger, chief intelligence officer with CyberSquared, told Dark Reading. "If you are the first to market with some great new technology breakthrough or drug, and you get a profit from that research ... it would definitely be an issue for the Chinese to target some of these [firms]."

The Doctor Is In (Well, Logged In)

Published: March 19, 2013
Surfing the Web in his all-white Dumbo loft, Dr. Jay Parkinson, 37, looks like any other young tech visionary. He has a trim beard and thick-framed glasses. He wears slim-fitting black outfits and jaunty scarves. He speaks with a measured, “This American Life”-like cadence. And he’s a firm believer in the utopian promise of the Internet.
But Dr. Parkinson’s start-up isn’t a new app or social network. He is a founder of Sherpaa, a Web site that operates like a virtual doctor’s office, examining patients by e-mail and text message.
“We’re using the Internet to reinvent health care,” Dr. Parkinson said proudly, seated next to a Ping-Pong table and a shaggy goldendoodle.

5 steps to managing data security risks in the cloud

By Rick Kam, President and co-founder ID Experts and Doug Pollack, CIPP, Chief strategy officer, ID Experts
Cloud computing. It’s like having a butler for your data — managing them, securing them, and making them available when and where they’re needed. No wonder the cloud is attractive to organizations burdened with time and budget constraints.
But the cloud is not without its risks. The Cloud Security Alliance (CSA) recently released its “Notorious nine,” a list of the top threats associated with cloud computing.  At the top of the charts for 2013: data breaches. With this threat at the forefront, healthcare organizations should determine when, if ever, is an optimal time for placing protected health information (PHI) and personally identifiable information (PII) in the cloud.

Are cloud-based record banks superior to HIEs for data sharing?

March 19, 2013 | By Dan Bowman
Health information exchanges, as currently constructed, are an "inefficient" means of sharing healthcare data due to interoperability issues, according to a commentary published recently in the Journal of the American Medical Association. A better solution--according to authors Edward Shortliffe of Arizona State University, Latanya Sweeney of Harvard University and William Yasnoff of consulting firm National Health Information Infrastructure Advisors--would be to use cloud-based health record banks that could allow patients more control over their information.
The authors called current systems "institution-centric," adding that such an approach to sharing data is "complex," "expensive" and "prone to errors."
"The problem is that health IT is on the wrong path," the authors said. "The current approach involves trying to use HIT to replicate existing manual process for contacting other clinicians or healthcare organizations to get patient records instead of creating a single, unified record for each patient, as has been done for years with paper records within single hospitals and clinics."

Evidence-supported decisions key to big data success

March 19, 2013 | By Susan D. Hall
With big data among the biggest buzz words in healthcare, a new report from the Institute for Health Technology Transformation (iHT2) offers guidance for leaders trying to harness all that information and gain insight from it.
The report highlights some success stories, including a partnership between the University of Ontario and IBM to develop a monitoring platform for newborns that allowed the hospital to predict the onset of nosocomial infections 24 hours before symptoms appeared.

HIMSS Recap: Intermountain Shares Tech Goodies, Big Data Plans

Scott Mace, for HealthLeaders Media , March 19, 2013

In the scramble that is today's healthcare industry, expect to see the unusual. At the HIMSS conference in New Orleans this month, Exhibit A was tech goodies on display at Intermountain Healthcare's booth and its announcement of a strategic alliance with Deloitte.
At the HIMSS booth, Intermountain chief technology officer Fred Holston was demonstrating new technologies developed internally, and looking for technology partners to help mass produce them.
The first invention was fiendishly simple: A wristwatch that can sense when the wearer has washed his or her hands. If they're washed, a light on the face of the watch glows green. If they aren't washed, or if the caregiver has left the room, the watch face displays a red light.

Telestroke programs significantly boost care access for rural patients

March 18, 2013 | By Ashley Gold
Researchers from the University of Pennsylvania School of Medicine have found that a telestroke program based in Oregon was able to increase access to stroke care by 40 percent in regions of the Beaver State. Their findings are being presented this week at the American Academy of Neurology's 65th annual meeting in San Diego.
According to an announcement touting the presentation, telemedicine programs in rural parts of Oregon upped the percentage of residents with access to stroke care within one hour from 54.5 percent to 80 percent. The researchers noted that in-person stoke care was crowded in urban areas, and while telestroke care was available in urban centers, it didn't reach less populated, uninsured areas quite as well.

Sensors promising for diagnosis, treatment of cancer

March 18, 2013 | By Dan Bowman
While new sensor technology developed by Chilean researchers holds promise for improving cancer diagnosis efforts, European researchers hope sensors also can eventually aid in treating the disease.
For the former, researchers at Chile's Centro de Estudios CientĂ­ficos created a molecular sensor with the ability to detect lactate levels in individual cells in real time. Lactate, according to the researchers, can be used to determine metabolism processes in such cells, and the researchers found that tumor cells produced lactate three to five times faster than non-tumor cells.
Their research was published recently in PLOS ONE.

3 lessons learned by eHealth Ontario chief

By:  Nestor E. Arellano  On: 18 Mar 2013 
For: ComputerWorld Canada 

Some electronic health records projects are better suited for the private sector, government should focus on setting standards, says eHealth Ontario CEO Greg Reed

Three years into his job as the steward of Ontario’s electronic health records program the head of eHealth Ontario said the organization has learned three valuable lessons about technology deployment that would help them deliver on a promise to have the health records of every Ontarian in digital form by 2015.
Topmost among these lessons, according to Greg Reed, CEO of eHealth Ontario, was accepting that the organization can’t go it alone.

HealthVault launches Windows 8 app

By: Jonah Comstock | Mar 15, 2013
Microsoft has just launched a new HealthVault app for its Windows 8 operating system, designed to run on tablets, W8 phones, and computers. The upgrade doesn’t functionally allow users to do anything they couldn’t do before, but it aims to make it easier for users to track and review their own health data by leveraging Windows 8’s multitasking features.
HealthVault Distinguished Engineer Sean Nolan told MobiHealthNews that Windows 8 is ideally suited to interacting with HealthVault. It’s also a mobile-focused operating system, and Nolan sees HealthVault as an increasingly mobile-focused platform.
“It became incredibly clear that mobile was a game changer for consumer health,” Nolan said. “The fact is that the behavior [of mobile users] is really fundamentally different. It’s particularly acute in health: [Managing health] doesn’t happen at 8 p.m. up in your den after the kids go to bed. The daily health stuff — ‘Hey my coach needs me to fill out this med form’, or I’m traveling, all these kinds of things help bring health into the world of everyday people.”

93% believe EHR-connected mHealth apps benefit patient care

Author Name Jennifer Bresnick   |   Date March 15, 2013   |  
Physicians want patients to use mHealth apps as much as patients themselves do, a new survey by EHR vendor eClinicalWorks says.  From scheduling appointments and emailing nurses to receiving follow-up reminders and accessing their own EHR data, mobile smartphone apps have numerous uses before, during, and after a clinical visit, and an overwhelming majority of physicians are eager to embrace the technology.
More than ninety percent of the 650 physicians polled believe that mHealth apps have the potential to improve patient outcomes, and an equal amount would like to see apps give patients the ability to upload data into their personal EHR file. Eighty-nine percent would recommend an app to a patient in the future.

Canada's TELUS Health expands big time

By Erin McCann, Associate Editor
Created 02/26/2013
A recent business acquisition by Longueuil, QuĂ©bec-based healthcare IT company TELUS Health will make the company the largest electronic medical record provider in Canada, officials announced Tuesday. 
TELUS Health announced it will acquire Ontario's largest electronic medical record provider MD Practice Software LP, a member of the MD Physician Services Group and subsidiary of the Canadian Medical Association. Financial terms of the agreement were not disclosed. Closing of the transaction is slated for March 4.
With the new acquisition, TELUS Health will further expand its reach in the first line of care, now providing EMR solutions to some 9,000 Canadian physicians nationwide, and impacting more than 25 million patient interactions each year, officials say. TELUS Health provides solutions to all major stakeholders in the health system, including hospitals, pharmacies and extended healthcare providers, such as physiotherapists and chiropractors.
Monday, March 18, 2013

How Stage 2 Changes the Stage 1 Rules for Meaningful Use

Buried within CMS' Stage 2 Final Rule are changes that will affect health care providers currently in Stage 1 of the Electronic Health Record Incentive Program. These changes range in severity and some require immediate attention. Providers should make plans now to comply with the new requirements.   
Providers must ensure that their Stage 1 work plan aligns with some potentially high impact changes. Two of note that Stage 1 program participants in fiscal year/calendar year 2014 must meet are a Stage 2 patient engagement measure and reporting an increased number of clinical quality measures.

Technology Alone Isn't Healthcare's Savior

Anyone who deploys tech "solutions" without reconsidering workflows and policies -- and doing other heavy lifting -- is in for a rude awakening.
If you believe everything you read and hear, technology is the Holy Grail of our industry. It will "fix" just about everything that's broken in healthcare. That's a presumption fueled by human nature: Gravitate toward simplicity and immediate gratification. Technology is tangible, something we can install, turn on and it works.
But what exactly should we expect from this working technology? Have we done a thorough job of defining what we want to accomplish and then addressed all of the components that go into ensuring we succeed?