This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Quotes Of The Year - 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."
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The New York eHealth Collaborative has announced the winners of its personal health record portal challenge, with the designs in turn expected to inform the PHR that NYeC will offer all New Yorkers in 2014.
A Brooklyn-based health data and design startup called Mana Health won first prize and $15,000 for it’s PHR, followed by the NYC software company Applied Informatics’ iHealthNY PHR (awarded $7,500) and the Clifton, N.J.-based public health software company RDE Systems’ MyHealthProfile (awarded $2,500).
Responding to criticisms that Epic's electronic health record systems are closed and, thus, difficult to integrate with third-party vendors, CEO Judy Faulkner, in a rare interview granted to Forbes, called such accusations "totally wrong."
In fact, Faulkner referred to Epic as "the most open system I know," saying it's designed as a database management system.
"Database management systems need to allow their users to mold it to what they need," Faulkner told Forbes. "We interface with speech recognition, imaging, medical devices, lab, patient education content, user authentication and hundreds of different vendor systems."
A glitch causing medication orders to be passed on to the wrong patients is just one of several problems with a new computerized physician order entry system being implemented at Marin General Hospital, according to nurses at the Greenbrae, Calif., facility. The nurses have called for the implementation to be put on hold until such issues can be worked out and providers can receive more training, according to the Marin Independent Journal.
The ability to listen first and take action second has been key to Marilyn Tavenner's success in leading the Centers for Medicare & Medicaid Services since 2010, according to several FierceHealthIT Editorial Advisory Board members. However, they say, how well she continues to practice such patience in the face of politics will be what ultimately defines her tenure at CMS.
"For now, she seems to really want to come in and listen first, and then build a plan," Roger Neal (right), vice CIO and vice president of Duncan (Okla.) Regional Medical Center, tells FierceHealthIT in an email. "We'll see how that goes."
Members of Congress are lauding a bipartisan bill that limits funding for an integrated electronic health record system between VA and DoD and requires aggressive progress updates from both agencies, which have, in recent months, come under fire for the dilatory pace at which they're moving forward with the iEHR.
At a subcommittee mark-up hearing Wednesday, John Culberson, R-Texas, chairman of the House Subcommittee on Military Construction, Veterans Affairs and Related Agencies, called the bill a bipartisan success. "Our bill this year has dealt with the failure of DoD and VA to develop a single unified medical record in a very straightforward, commonsense way," he said.
The bill, Culberson explained, will limit the funding toward the iEHR to 25 percent — of the $344 million requested. The agency will not receive the remaining dollars until they can prove to both agency subcommittees that they're actually implementing a plan to create and roll out a single, unified medical record.
On any given day inside Mercy San Juan Medical Center's neuro-intensive care unit, a 5-foot-6-inch-tall robot with a computer screen can be seen roaming the halls.
The robot, named RP-VITA (Remote Presence Virtual Independent Telemedicine Assistant), is equipped with videoconferencing capabilities so doctors can beam in when there is an emergency.
"Before, you couldn't see the patient when an important decision needed to be made," said Dr. Alan Shatzel, a neurologist at the Mercy Neurological Institute. "This has proven to be tremendously valuable."
Nearly $1 billion in new Health Care Innovation Awards from the Department of Health & Human Services will fund applicants that have a high likelihood of driving healthcare system transformation and delivering better outcomes. HHS Secretary Kathleen Sebelius announced this second round of funding May 15.
"These awards will continue our work to drive down healthcare costs while providing high quality care to all Americans, and I’m excited to see the innovative ideas these applicants will bring to the table," Sebelius said in a statement. "Organizations from the public and private sectors throughout the country are finding creative solutions to our healthcare system challenges and these awards will continue to stimulate these ideas."
The need for transatlantic co-operation on health IT has been described as "critical" by Dr Farzad Mostashari, national co-ordinator, health IT, at the US Department of Health and Human Services.
The EU and US have outlined plans to further strengthen transatlantic co-operation on e-health - focusing on interoperability, standards and workforce IT skills development - to accelerate the uptake of health IT and e-health.
Speaking at a press conference at eHealth Week in Dublin, key EU and US government officials gave further details of a draft memorandum of understanding that was first outlined in December.
EHI readers believe that the present government should not give up on the goal of getting electronic patient records in use in the NHS as it pursues its vision of ‘paperless’ working.
Health secretary Jeremy Hunt has said that he wants the health service to be paperless by 2018, and has clarified this by saying that he wants to see it using electronic records and communications by this date.
However, neither he nor NHS England, which is due to produce guidance on records this June, have defined what they mean by electronic records, or the technologies they expect to see deployed.
Respondents to The Big EPR Survey, which EHI has just run as part of The Big EPR Debate, voiced concern about this.
Bed-management applications represent one of the hottest software markets in HIMSS Analytics' new report, "Essentials of the U.S. Hospital IT Market."
The report profiles 24 applications in five operational areas--general finance, financial decision support, human resources, supply chain management and revenue cycle management-- and rates their level of maturity in the market.
With a low rate of market penetration, bed-management software represents a hot opportunity for vendors, the report says.
A new predictive tool in the form of a risk algorithm--dubbed QStroke--can help to identify and treat patients at risk of having a stroke, according to research recently published in BMJ.
The algorithm uses a statistical model and established risk factors, based on variables that patients are likely to know, according to researchers from the University of Nottingham. They tested a large group--3.5 million patients between the ages of 25 and 84.
The results found that the QStroke algorithm explained 57 percent of the variation in women and 55 percent in men without a prior stroke.
Source: Fabienne Bourgeois, MD, Children's Hospital Boston Date: May 16, 2013
As more and more practices and hospitals are making patient portals available to their patients, providers of adolescent patients are encountering a major hurdle: how to handle confidential adolescent information.
While adult patients generally maintain full personal control of their personal health record (PHR), adolescent PHRs are anything but personal. Adolescents rarely have full control of their record, but instead rely on parents and guardians to share control. The details around this shared access changes over time, depending on developmental and age-appropriate considerations, as well as guardianship arrangements.
The biggest challenge then, becomes how to protect the adolescent’s legal right to privacy and confidentiality within this hybrid/proxy-control model. Many medical encounters with adolescents come with the verbal assurance that what they tell us will (under most circumstances) remain entirely confidential, meaning we will not discuss personal health information pertaining to reproductive health, sexually transmitted diseases, substance abuse and mental health with their parents or anyone else without their consent. As it turns out, this type of confidential information is pervasive through most EHRs.
Two years ago, the University of Utah Hospitals and Clinics embarked on a Herculean data analytics task: the five-hospital system wanted to know its true service line costs. Like care delivery organizations across the industry, the academic medical center had only a rough idea of how much any given procedure cost, says Charlton Park, finance director.
Its former cost-modeling effort was a bit of a crapshoot when it came to accuracy. “We had allocated cost to the patient level, but it was based on cost-charge ratios,” Park says, meaning that bottom line expenses were stacked up against aggregate charge levels, or the full list-price of procedures. “At the macro level, it makes sense, because you’re allocating costs somewhere, but when you drill down to what we actually did and take into account supplies, pharmacy expenses, and lab costs at the visit level, you’re not seeing what something actually cost.” (Park will speak at Health Data Management’s upcoming Healthcare Analytics Symposium & Expo, July 15-17 in Chicago.”
The majority of physicians nationwide believe health information technology can precipitate positive outcomes in the provider setting, but in many realms — such as mHealth — health IT continues to be underutilized by docs, according to the findings of a new Deloitte study.
According to the physician health IT adoption study, some two-thirds of physicians report that they have met meaningful use Stage 1 requirements thus far. When broken down by practice type and age, however, these numbers vary significantly.
For example, physicians aged 60 years or over have only a 50 percent attestation rate to Stage 1. Further, solo practitioners demonstrate an attestation rate of 31 percent, versus 62 percent of mid-size practices and 82 percent of large-sized practices.
EHI readers have backed payments for the ‘meaningful use’ of electronic patient records, as part of a ‘roadmap’ for their implementation in NHS trusts in England.
Respondents to The Big EPR Survey, which EHI has been running as the next stage of The Big EPR Debate, were overwhelmingly in favour of NHS England issuing a “road map or road maps for trusts at different stages of digital development.
They also indicated support for the roadmap to include incentives for trusts that reach key milestones, including payments for 'meaningful use' on the US model.
President Barack Obama's American Recovery and Reinvestment Act of 2009 triggered $30 billion for incentives for using clinical records to improve care. Although the meaningful use criteria are complex, it is credited with triggering a big uptake in EPRs in the US.
Looking to ensure funding for your healthcare organization's security efforts? You'd be wise to take a proactive approach, hospital IT personnel recently toldHealthcareInfoSecurity.
Chuck Christian, CIO at Columbus, Ga.-based St. Francis Hospital, compared the task to buying insurance. "Getting and maintaining funding is always a chore; that is, unless you have an 'issue' that you've recently had to deal with," Christian said. "Project-specific funding is an approach, but these may be tied to physical hardware acquisitions; other projects may be related to program or risk analysis."
Physicians' overall comfort with computers and communication skills determine whether technology is a positive or negative influence during patient visits, according to a new report from the American Medical Association board of trustees. The five-page paper, "Exam Room Computing & Patient- Physician Interactions" is being presented for approval to the AMA House of Delegates meeting this week in Chicago.
While computers in the exam room give physicians easy access to health information, in general, and the patient's electronic records, in particular, one study found that patients see doctors as less capable if they look up information during a consultation, rather than if they do so out of sight or consult a colleague.
Use of computers in an examination room clearly affects a clinical encounter, but it does not inevitably disrupt or undermine patient-physician communication, according to a new report from the American Medical Association.
For the most part, feared negative effects of an in-room electronic health record have not materialized, the report notes. “Technical improvements in EHRs that focus required computer tasks on activities that meaningfully influence patient outcomes, or that streamline data input and reduce the time needed to complete common tasks in clinical work and decrease the potential for distraction, will help minimize the possibility for disruption.”
Since its passage three years ago, some in Congress have sought every opportunity to reduce funding related to the Affordable Care Act. It's no surprise that the recent round of sequester cuts have targeted elements of health care technology infrastructure, including the health insurance marketplaces that are meant to be online later this year.
Congress needs to be sure to consider the positives of health IT when considering reductions in ACA-related spending, especially as it comes to widespread use of electronic health records. Change obviously has immediate costs, but investments in updated technology now will improve patient care in the long run.
By Benjamin Harris, New Media Producer, Healthcare IT News
HIMSS Media launched a global online community Monday dedicated to chronicling new and innovative models of care that improve individual and community well-being, while also reducing healthcare costs.
The Future Care community website is supported by IBM and its Smarter Care initiative.
"I believe that the future of care will call us to convene differently and will cause us to collaborate differently," says Dan Pelino, general manager of IBM's public sector business, regarding the mission of Future Care.
“It’s systems that let ordinary people do extraordinary things,” national coordinator for health IT Farzad Mostashari, MD said during a Health IT Policy Committee meeting talk that vice chair Paul Tang described immediately afterward as “inspiring and challenging.”
The challenge: Transform healthcare to harness the IT either in place today or currently being implemented. And the inspiration: demonstrable improvements in cost and care quality that make patients healthier, for instance, helping diabetics avoid heart attacks or strokes by better managing high blood pressure and LDL levels.
“We’re about halfway through the process of computerizing and digitizing America’s hospitals and doctor’s offices,” Mostashari said in the May 7 meeting, “and we’re about 5 percent of the way through changing workflows and redesigning care to take advantage of those technologies.
More than 21,000 patients have been impacted by a trio of recent healthcare data breaches throughout the U.S.
Indiana University Health Arnette in Lafayette, Ind., announced last week that an employee's password-protected laptop with patient information--including names, dates of birth, medical record numbers, diagnoses and dates of service--was stolen from a car in April. The organization indicated that it doesn't have reason to believe the information has been improperly accessed or used, but police were immediately notified, regardless. IU Health Arnett began mailing letters to affected patients--nearly 10,000, according to the Journal and Courier--informing them about the breach on May 10.
Meanwhile in Memphis, Tenn., the Regional Medical Center (MED) issued a public notice on May 9, stating three e-mails were sent from October 2012 to February 2013 that included personal information of outpatient physical therapy patients receiving services between May 1, 2012, and January 31, 2012. The personal information included name, account number, date of birth, social security number, home phone number and type of service received. According toWREG, roughly 1,200 patients were impacted.
Despite a feeling of inevitability regarding the use of integrated technology healthcare, the bulk of U.S. physicians remain hesitant in their adoption of such tools for direct patient care, according to a newly published analysis by consulting firm Deloitte.
More than 70 percent of 613 physicians responding to the Deloitte Center for Health Solutions 2013 Survey of U.S. Physicians indicated that they think use of health IT tools ultimately will cost more, not less, and that the promise of reduced costs due to increased use is "inflated." What's more, 60 percent of respondents said they think that hospital-physician relationships will become less stable as hospitals continue to comply with Meaningful Use.
The U.S. Department of Health & Human Services needs to find better ways to make its troves of health data useful for technology innovators, Bryan Sivak (right), HHS chief technology officer, told developers at the recent Health: Refactored conference in Mountain View, Calif. HHS is looking for ways to bring value to little-used assets, some which are locked away in bureaucratic silos, reportsComputerworld.
The HHS efforts are part of a larger "open data" project throughout the federal government to make information the government collects more available to the public. The Office of Management and Budget unveiled a new policy last week requiring all federal agencies "to collect or create information in a way that supports downstream information processing … including using machine-readable and open formats, data standards, and common core and extensible metadata for all new information creation and collection efforts."
Author Name Kyle Murphy, PhD | Date May 13, 2013 |
The people of New York are getting one step closer toward user-friendly access to their personal health information. The New York eHealth Collaborative has announced the winners of its Design Challenge for the Patient Portal for New Yorkers. Taking home the top prize is Mana Health, which also takes home $15,000 in prize money. Second and third place were taken by iHealthNY and MyHealthProfile, which earned themselves $7,500 and $2,500, respectively.
The announcement follows two demo days held in New York City and Buffalo after which time expert judges comprising healthcare providers, hospital leaders, consumer advocates, and public officials (to name a few) chose the winners.
Scott Mace, for HealthLeaders Media , May 14, 2013
The former Wall Street technology analyst turned key Silicon Valley investor believes city-wide ecosystems of health incentives and disincentives for unhealthy habits could have a significant positive effect on the nation's health.
Perhaps Esther Dyson has spent a bit too much time traveling, investing, and cosmonaut training in the former Soviet Union, becuase her latest pet project, for how healthcare and technology might start to fix America's health problems, can sound like a new spin on central planning, albeit with a twist.
Dyson, a former Wall Street technology analyst turned key Silicon Valley investor, helped jumpstart the current venture capital craze for healthcare technology startups. Her own investments include Medscape, PatientsLikeMe, HealthTap, PatientsKnowBest, and numerous others.
Scott Mace, for HealthLeaders Media , May 14, 2013
In a pilot, a system which permits patients to view all the notes in their electronic health records was such a hit with hospital patients and physicians that Beth Israel Deaconess Medical Center and Geisinger Health System are dramatically expanding their OpenNotes programs.
Possibly the most famous consumer of electronic health records is Dave deBronkart, better known as e-Patient Dave.
Several years ago, deBronkart participated in a trial of a new program that permitted patients to view all the notes in their EHR.
"I experienced a direct benefit," deBronkart recalls. "Weeks after a visit, I thought, 'Wasn't I supposed to have something followed up?' Heaven knows where my printed visit notes were … it was late in the evening, so ordinarily I'd have waited till morning and maybe remembered to call in and have someone look it up—very inefficient and vulnerable to 'I forgot.'
Headed to the doctor's office in Texas? Soon, you may be able to bring only your driver's license. A bill proposed in the Texas state Senate calls for providers to be able to swipe licenses electronically to obtain patient information.
This kind of data collection, taking shape in Senate Bill 166, is one of several initiatives that the Texas Medical Association is pushing for, in an attempt to modernize medical practices in the Lone Star State. They're also backing bills that would standardize preauthorization forms for prescription drugs and healthcare services--Senate Bills 644 and 1216--according to an article in the Texas Tribune.
All signs point to telemedicine entering the mainstream healthcare industry. Maybe it's fresh on my mind because the American Telemedicine Association's annual conference--which took place in Austin, Texas this year--just ended, but there's more to it than that.
Since the beginning of the year, telemedicine has been a hot topic. More and more states are pushing for coverage; according to ATA President-Elect Ed Brown, 18 states currently have laws requiring private insurers to pay for such coverage, while another 30 are developing similar legislation.
Almost 800 million prescriptions were routed electronically in 2012, 44 percent of prescriptions and up from 570 million in 2011, according to Surescripts' annual National Progress Report and Safe-Rx Rankings.
More than 38,000 physicians (69 percent) used e-prescribing in 2012 and nearly half of all office visits (48 percent) resulted in electronically generated medication history requests, up from 31 percent in 2011.
by Lisa Zamosky, iHealthBeat Contributing Reporter
We share many aspects of our lives online, and illness is no exception.
According to a 2011 report by the Pew Research Center's Internet & American Life Project, of the 74% of American adults using the Internet, 34% have read someone else's commentary or experience about health or medical issues on an online news group, website or blog. Meanwhile, about 13% of patients blog about their diagnosis or experience.
Many Options for Blogging
Blogging, while hardly a new idea, is one making its way further into mainstream medicine. Increasingly, health care systems recognize the power of blogging to help patients -- and their caregivers -- reduce feelings of isolation and anxiety, share treatment updates with friends and loved ones and engage more actively in their own care.
Many top-tier medical institutions, including University of California-Los Angeles, Johns Hopkins and Massachusetts General Hospital, are encouraging patients to blog about their experience with illness by partnering with companies such as CarePages and Caring Bridge, services that provide private websites on which patients and caregivers can share health updates with friends and families.