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Atul Gawande: Future of healthcare requires constant reinvention
Posted on Jun 14, 2013
By Erin McCann, Associate Editor
Atul Gawande, MD, professor of surgery at Harvard Medical School and staff writer at The New Yorker, offered a reflective presentation earlier this month at Health Datapalooza IV, taking the audience back through what the healthcare system used to look like, and showing and how data innovations have helped set the stage for big transformations.
"There was a period in time where there was no analytics, no effort to look at the data, no effort to understand what was happening," Gawande said. In his mind, healthcare is at least heading in the right direction.
Despite these innovations, all this progress and the potential power of big data, however, Gawande made sure to differentiate between technology and medicine – arguing that it was crucial to remember the human element.
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Kaiser’s Halvorson to Payers: Help Lead Change
JUN 14, 2013 2:26am ET
Opening AHIP 2013 in Las Vegas, George Halvorson, chair and CEO at Kaiser Permanente and its health plan, delivered a call to action for health insurers to take a leading role in transforming the American health care system.
“We are on the cusp of a golden age of health care delivery,” he asserted. “The toolkit that is available to health care is getting better every day.” That toolkit includes better policies, technologies and outreach programs to support an interactive and patient-focused delivery system.
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Editorial
Aging society our greatest challenge
No issue better defines our society -- both in terms of our capacity for compassion and for common sense -- than our treatment of the elderly.
The scary thing is that as our society ages -- particularly with the giant baby boomer generation heading into its twilight years -- we're not ready for it.
The problem isn't a lack of government spending -- spending on health care alone now eats up almost 50% of provincial budgets and continues to rise well above the rate of inflation.
The problem is that the money is often spent in the wrong places, or wasted, as in Ontario's notorious billion-dollar eHealth and Ornge air ambulance scandals.
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Beacon programs share patient engagement IT lessons learned
June 14, 2013 | By Ashley Gold
Four women gave honest insight into the lessons they've learned in their individual Beacon Community programs--in central Pennsylvania, southeast Minnesota and Western New York--at the Government Health IT Conference & Exhibition this week in Washington, D.C.
Ellen Makar, senior policy advisor for the office of consumer eHealth at the Office of the National Coordinator for Health IT, discussed the "three A's" approach to consumer engagement before the other speakers shared their stories.
"You can see there's a big theme coming--consumer and patient engagement," Makar said. "Access, action, attitude. Those things are moving together all the time in advancing the idea of shared decision making--with data."
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Technology can mitigate challenges of genomic data in EHRs
June 14, 2013 | By Susan D. Hall
Much work remains to be done before genetic content can effectively be incorporated into electronic health records, research from the University of Wisconsin concludes.
In a paper published online today in the Journal of the American Medical Informatics Association, the researchers explore the ethical, logistical and technological issues needing attention.
"The rapid pace of genetic research necessitates urgent focus on integration solutions that minimize risk while maximizing benefit," the authors write, also while stressing the need to allow patients to make their own decisions about the treatment of their information.
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FDA calls for increased health IT cybersecurity efforts
June 14, 2013 | By Dan Bowman
With hackers and cyberattacks increasing as threats to medical devices, the U.S. Food and Drug Administration this week published new guidance calling for developers and healthcare facilities to beef up security efforts while creating and using those devices.
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Survey Examines Physician Satisfaction With EHRs
About one-quarter of practices have no EHR; more than half of adopters report increased efficiency
About one-quarter of practices have no EHR; more than half of adopters report increased efficiency
THURSDAY, June 13 (HealthDay News) -- About three-quarters of physicians report that their practice either has a fully implemented electronic health record (EHR), uses a hospital or corporate EHR, or is in the process of implementing an EHR, according to a technology survey published by Physicians Practice.
Researchers from ZirMed surveyed 1,291 physicians, including 26.1 percent in solo practice and 34 percent in small practices (two to five physicians), 55.4 percent of which were independent, regarding their satisfaction with EHRs.
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MGMA finds practices in the dark about ICD-10
By Diana Manos, Healthcare IT News
The Medical Group Management Association published research Thursday that suggests overall readiness of the industry to meet the Oct. 1, 2014, ICD-10 compliance deadline continues to be a concern.
MGMA researchers found the greatest concern for physicians is the lack of communication and critical coordination between physician practices and their essential trading partners, including claims clearinghouses, electronic health record vendors and practice management system vendors regarding software updates and testing, which has not yet occurred.
Only 4.8 percent of practices reported that they have made significant progress when rating their overall readiness for ICD-10 implementation. The research includes responses from more than 1,200 medical groups where more than 55,000 physicians practice.
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Data Collaborative Taps Predictive Analytics to Coordinate Care
Philip Betbeze, for HealthLeaders Media , June 13, 2013
Four geographically disparate health systems are banding together to redesign clinical care based on data to solve population health challenges such as preventable readmissions.
Name the technology, and unless it's a da Vinci robot or some other clinical whiz-bang item, hospitals and health systems are constantly criticized for being behind the curve. That's partially because it's been true. Hospitals and health systems have historically resisted investment in technology that would help make coordinate care better.
They've never had to, because their reimbursement didn't depend on it. But that's changing. Rapidly.
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Practitioners vent EHR concerns in newspaper op-eds
June 12, 2013 | By Marla Durben Hirsch
Tired of suffering in silence, physician practices are turning to the editorial pages of their local newspapers to publicize their concerns with their electronic health records.
Cathy Poole, an internal medicine practitioner in High Point, N.C., penned an op-ed article in the News & Observer on June 6 that was highly critical of her practice's EHR. She suggested that the "E" stands for "enemy," and noted that after 10 months of use, her practice has yet to experience improved efficiency and safety. She called her practice "far more fortunate than most," and outlined problems others in North Carolina are having with implementation.
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Massive cancer database to focus on personalized medicine
June 13, 2013 | By Susan D. Hall
England is launching an extensive cancer database tracking all 350,000 new tumors detected each year as well as 11 million historical records going back as far as 30 years, in an attempt to advance personalized medicine.
Jem Rashbass, national director of disease registration at Public Health England, said it would be "the most comprehensive, detailed and rich clinical dataset on cancer patients anywhere in the world."
Breast cancer, for instance, is now believed to be at least 10 completely separate diseases, each with its own life expectancy and requiring its own treatment, explains BBC News.
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State-level data governance efforts 'shaky at best'
June 13, 2013 | By Dan Bowman
State level governance efforts for storing and exchanging citizen data--including health information--are "shaky at best," according to Chad Grant, a senior policy analyst with the National Association of State Chief Information Officers.
Grant (pictured), who spoke at the Government Health IT Conference & Exhibition in Washington, D.C., on Wednesday, was touting the results of a collaborative study published this week by NASCIO and HIMSS on the health IT landscape in the states. Overall, 80 percent of responding state CIOs said they had no data governance structure in place at all.
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Mostashari: Slow but steady interoperability progress
By Anthony Brino, Associate Editor
Achieving Farzad Mostashari’s vision for a U.S. healthcare system where “every encounter and every patient has access to all the world’s knowledge” will require a balancing of standards and innovation and a combination of IT and process change.
“We are so far from that today,” the national coordinator for health IT told the HIMSS 2013 Government Health IT Conference. “Today, my last visit doesn’t contribute to my next visit in healthcare. Most discharge summaries don’t get to the primary care provider; most referral summaries don’t get back to the provider who ordered them.”
Offering a progress report on the Office of the National Coordinator’s interoperability standards development, Mostashari said what some meaningful use skeptics see as a foot-dragging – “why can’t it be like an ATM, where we stick our card into any ATM and we get our money out?” – is moreso an industry, guided by the federal government, working out regulatory and market-based solutions to complex, deep-seeded problems.
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Thursday, June 13, 2013
Mobile Part of Exchange Outreach Plans, but Full Use Lagging
by Rebecca Vesely, iHealthBeat Contributing Reporter
With a little more than 100 days until open enrollment starts for the state-based insurance exchanges on Oct. 1, a swift race is afoot to launch the online marketplaces and get the word out to potential customers.
Community groups will be doing extensive outreach to inform upwards of 30 million uninsured Americans that they may now be eligible for -- and required to buy -- coverage through the exchanges. States are issuing sizable grants to local organizations to help spread the word.
And some groups are leveraging the widespread adoption of mobile devices and social media among key demographics to contact potential customers.
"In the field, people will be knocking on doors, and we are going to do the same thing online," Adam Stalker -- national digital director for Enroll America and Get Covered America, nonpartisan national groups focused on enrollment -- said.
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Fridsma: Build standards for the future
Posted on Jun 12, 2013
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
Doug Fridsma, MD, director of the ONC’s Office of Science and Technology, likes to tell his staff: “If we’re going to make mistakes, lets make new ones; let's not make old ones.” Fridsma, a former Mayo Clinic internist in Arizona, told attendees at the 2013 Government Health IT Conference that his office has several goals in fueling health IT innovation – not as a creator, but as a curator.
Gathering IT developers and stakeholders at a sort of technical roundtable, the Office of Science and Technology has helped reduce the time it takes to develop and implement technical specifications from between three to five years to between six to 12 months, Fridsma said.
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NSF unveils 'next-generation' 911 app
Posted on Jun 12, 2013
By Mike Miliard, Managing Editor
The National Science Foundation on Tuesday showcased a potentially game-changing smartphone app that allows 911 operators critical insights into what's going on at the scene of an emergency call.
The app relays crucial biometric data to dispatchers, enabling them to gather vital signs and other information that helps them assist victims and empower first responders.
The software, which was developed by researchers at the University of North Texas, led by Professor of Computer Science and Engineering Ram Dantu, offers users a slate of features that could be life-saving in an emergency.
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GE Healthcare puts up $2B to invent
Posted on Jun 12, 2013
By Bernie Monegain, Editor
GE Healthcare plans to invest $2 billion over the next five years to accelerate the development of innovative software for healthcare systems and applications.
The investment is designed to advance current and future offerings in order to address new and pressing operational and productivity challenges faced by healthcare organizations around the world, executives announced June 11 in a news release. GE Healthcare will work closely with the GE Software Center of Excellence in San Ramon, Calif. – as well as at various research and development hubs around the world – to develop new software solutions.
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E-referrals service gets official launch
12 June 2013 Rebecca Todd
The new NHS e-referrals service has been officially launched by Beverly Bryant, NHS England’s director of strategic systems and technology.
Use of the service, which will replace Choose and Book, will not be made mandatory, Bryant told the Health+Care conference in London this morning.
However, she said she was confident that it could create a tipping point for e-referrals around the NHS.
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Common standards for US-UK tech services
10 June 2013 Rebecca Todd
The UK and US are working on common standards for technology services that will help UK health IT companies expand into the US market, NHS England’s director of patients and information has revealed.
Tim Kelsey told EHI the plan was to announce the new bilateral agreement at the G8 summit in Northern Ireland in November.
Kelsey travelled to the US with an NHS delegation last week where they attended the Health Datapalooza conference in Washington.
He said NHS England and its US counterpart held summit meetings where they quickly identified a series of common opportunities and issues to resolve.
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CPOE alerts help Stanford curb blood use
June 12, 2013 | By Dan Bowman
Electronic health record alerts have helped providers at Stanford Hospital & Clinic to significantly cut back on the use of blood products over the last four years, according to an article published this week by Stanford Medicine's Scope blog.
Between 2009 and 2012, Stanford Hospital examined use of a computerized physician order entry alert system within its EHR that required doctors to validate any requests for blood use. That led to a 24 percent drop in the use of red blood cells over that time period. What's more, transfusions of blood products across the board declined from more than 60,000 in 2009 to less than 49,000 in 2012.
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‘Jeopardy’-winning supercomputer helping Maine doctors in cancer research
Posted June 10, 2013, at 3:49 p.m.
Doctors in Maine are testing IBM's Watson supercomputer in an effort to improve care for cancer patients.
Doctors in Maine are testing IBM's Watson supercomputer in an effort to improve care for cancer patients.
Just over two years ago, IBM’s supercomputer Watson appeared on television to trounce expert quiz show contestants on “Jeopardy!” Now, doctors are looking to Watson for answers.
The Maine Center for Cancer Medicine is one of two medical groups chosen to test Watson’s lightning-quick computing power in an effort to improve care for cancer patients. Along with New York’s Westmed Medical Group, doctors in Maine are “teaching” the supercomputer how to interpret clinical information to diagnose lung cancer patients and recommend treatment.
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EHR Association offers Code of Conduct
Posted on Jun 11, 2013
By Bernie Monegain, Editor
Calling it a landmark move, the HIMSS EHR Association, a collaboration of more than 40 EHR companies, today released an EHR Developer Code of Conduct.
“Representing the majority of operational EHRs in physicians’ practices and hospitals in the U.S., today, we understand firsthand the transformative power of health IT, and we offer this Code of Conduct as a reflection of our industry’s ongoing commitment to collaborate as trusted partners with all stakeholders,” said EHR Association Chair Mickey McGlynn, senior director, strategy & operations at Siemens Healthcare, in making the announcement.
ONC chief Farzad Mostashari, MD, who has been critical of some vendor practices, today gave the EHRA kudos on its initiative, especially as it pertains to patient safety.
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Patient safety the focus of EHRA vendor code of conduct
June 11, 2013 | By Marla Durben Hirsch
After months of speculation, the HIMSS Electronic Health Record Association has released its EHR Developer Code of Conduct to promote a "transparent set of principles" governing the EHR vendor industry.
The Code of Conduct, which is voluntary, is offered by EHRA "as a reflection of our industry's ongoing commitment to collaborate as trusted partners with all stakeholders," the association says on its website
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Why Putting Capital Into EMR is a Smart Move
Rene Letourneau, for HealthLeaders Media , June 11, 2013
Most healthcare providers believe enhancing their collection and use of patient data is the only way to move forward in the pursuit of better care delivery.
Despite concerns over the sluggish economy and changing payment models, hospitals and health systems are making big investments in electronic medical records, earmarking significant portions of their capital spending dollars to implement these expensive systems in the hope of improving their ability to manage population health.
The irony is not lost on providers, who are well aware that they are investing vast amounts of money in an IT project that will allow them to provide better coordinated care for which the government and commercial payers intend to pay less. Yet most believe enhancing their collection and use of patient data is the only way to move forward in the pursuit of better care delivery.
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Another view: Neil Paul
Our GP columnist held a BBQ while the sun was out, but his guests took a gloomy view of GP IT.
11 June 2013
As we have just had our one nice week of weather for the year we, like many others, had a BBQ for our friends.
Although my wife and I do know plenty of non-doctors, this BBQ ended up being one of those where at least one of each couple was a GP. As sad as it sounds, the conversation soon turned to work and, rather more unusually, to computers.
Normally, talk at these kinds of events revolves around weird patients or odd conditions that we have seen, or crazy rules or regulations that have come along.
However, as regular readers will know, all the GP practices in our area have recently upgraded to Emis Web. In general, this has gone well. There have been no major disasters, and certainly no data loss. However, I can’t say that many are in love with the new system.
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HIMSS, NASCIO study finds HIE filling regional needs
By Anthony Brino, Associate Editor
“If you’ve seen one Medicaid program, you’ve seen one Medicaid program,” as the old adage goes. Much of healthcare is regional and local, and nowadays the same is true for health information exchanges.
Even before the HITECH Act, there were regional health information organizations, some HIEs spanning regions and some efforts at statewide HIEs — a fairly successful one being the Indiana HIE, created in 2004. The HITECH Act’s state cooperative agreement then set that trend apace across the country.
The HIE landscape today among the 50 states shows the diversity of the country’s medical needs, governance approaches and healthcare markets, with a mix of public, private and public-private organizations managing HIEs on regional and statewide levels.
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5 Reasons You Need an HIE Now
Scott Mace, for HealthLeaders Media , June 11, 2013
Health information technology is full of promises—and ever-escalating costs. But there's one technology I would bet on right now. That's the technology to accurately, securely, and easily transfer health data information from one system to another.
In the switch from fee-for-service healthcare to accountable care, the old ways of developing healthcare systems aren't working. The escalating cost of care is due in no small part to overspending on hospital capacity, equipment that isn't always needed, over-engineered technology, short-sighted planning and bad hunches.
But there's one technology in particular I would bet on right now. That is the technology to accurately, securely, and easily transfer health data information from one system to another.
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Hello Doctor Helps Patients Navigate Complex Medical Conditions
A missing link in the personal management of health information
I’m confused.
That’s one of the most important insights around patients and caregivers who find themselves lost in the complexities of healthcare. Ths is espically true when the condition is complex or confounded by multiple issues or diseases. The cacophony of information has resulted in what some have called ‘information obesity’–a condition that very well have a morbidity all to itself. The new iPad application enables real-time usage and storage of medical records from multiple sources.
Launching its public beta on the App Store , Hello Doctor is designed for people in complex medical conditions, such as cancer and heart diseases.
A new ipad app from Hello Doc help patients undertand and track key health data
It enables you to intuitively organize all your medical records in “SmartLists” making sure you can easily navigate and access your records, no matter how many different doctors or clinics you visit.
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No paper, no trauma
EHI reporter Rebecca Todd visits the newly formed Barts Health NHS Trust, which has used its Cerner Millennium electronic patient record system to go paper-lite in A&E.
4 June 2013
In the A&E department of the Royal London Hospital, Dr Malik Ramadhan is searching for a piece of paper. Not a specific piece of paper, just any old piece of paper to show EHI what patient notes used to be written on.
Barts Health NHS Trust’s clinical director for emergency medicine returns from his second search empty-handed; and we agree that I can imagine what the notes would have looked like. We then crowd around one of the many computer screens to see what they look like now.
Knowing what is going on
Barts’ A&E is not paperless, but is certainly paper-lite. Using the Cerner Millennium FirstNet module, the A&E went paper-lite in paediatrics in January 2012 and in the adult department in September.
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mHealth seen as boon to EU economy
Posted on Jun 10, 2013
By Bernie Monegain, Editor
New research by GSMA concludes that mHealth could save almost €100 billion in healthcare costs in the EU by 2017 as well as add €93 billion in GDP.
The GSMA РGroupe Sp̩ciale Mobile Association Рis composed of 800 of the world's mobile operators with more than 230 companies in the broader mobile market, including handset makers, software companies, equipment providers and Internet companies, as well as organizations in industry sectors such as financial services, healthcare, media, transport and utilities.
Another report published in January 2013 by market research firm Transparency Market Research showed the global mHealth market would grow at a compound annual rate of 41.5 percent in the next five years to reach $10.2 billion by 2018, up from $1.3 billion in 2012.
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Tuesday, June 11, 2013
Hand-Washing: How a 150-Year Process Change Offers Insight for Health IT
by Jonathan Handler
More than 150 years ago, Dr. Ignaz Semmelweis demonstrated that hand-washing prior to treating patients dramatically reduced fatal infections. His contemporaries could not accept his results, and they did not adopt hand-washing as a standard of care. One in four women continued to die after childbirth from overwhelming infection. Semmelweis sunk into a depression, was committed to an asylum and then was beaten to death by the asylum guards just two weeks later.
Today, hand-washing is a known prerequisite for safe clinical care. Yet, recent reports demonstrated that clinicians still failed to wash their hands more than one-third of the time, and patients suffered as a result. With Medicare funds at stake, health care organizations are even going so far as to enact video monitoring programs to ensure clinicians are washing their hands with soap or properly sanitizing with alcohol-based sanitizers. Standard hand-washing for clinical care literally takes just 15 seconds, it saves lives, and everyone knows they should do it. So what's the problem?
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More Mobile EHRs Add Speech Recognition
Third-party interfaces to iPad native applications allow more EHR vendors to voice-enable their products.
By Ken Terry, InformationWeek
June 10, 2013
URL: http://www.informationweek.com/healthcare/mobile-wireless/more-mobile-ehrs-add-speech-recognition/240156350
June 10, 2013
URL: http://www.informationweek.com/healthcare/mobile-wireless/more-mobile-ehrs-add-speech-recognition/240156350
While some companies still lag behind, EHR vendors are moving rapidly to enable their mobile products with speech recognition, either directly or through third-party interface vendors.
In the first category is Cerner, which just last month integrated Nuance Communications' speech recognition product with its ambulatory mobile EHR for iPads, according to Jon Dreyer, director of mobile solutions marketing for Nuance. In an interview with InformationWeek Healthcare, Dreyer added that in January, Epic embedded Nuance in its latest mobile EHRs for the iPhone and iPad. 
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Panel: Cloud's role in healthcare still up in the air
June 11, 2013 | By Dan Bowman
As hospitals and healthcare facilities continue to adopt electronic tools to store and share patient data, some are turning to cloud-based tools to meet their needs. What that means for privacy and protection still is up for debate, as evidenced in the tone of a discussion panel at last week's Health Privacy Summit in Washington, D.C.
"When data is managed or stored in-house [by a provider], there's a very clear responsibility of one company" to protect that data, Adrian Gropper, chief technology officer for Patient Privacy Rights, the non-porofit organization that hoted the event, said. "The cloud blurs that distinction--sometimes intentionally."
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55% of Physicians Think Patients Rarely Use Online Ratings
June 07, 2013
Most physician leaders think online physician ratings are inaccurate, unreliable and not widely used by patients, according to a survey from the American College of Physician Executives.
The physicians surveyed preferred internal organizational performance ratings to consumer websites, and most were frustrated with consumer online ratings.
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Kaiser Permanente research method has potential to transform U.S. health care system
By Sandy Kleffman, Bay Area News Group
Posted: 06/10/2013 08:14:30 AM PDT
Related Stories
It was a nuisance and David Gassman put it off for three weeks, but he finally put a little stool sample into a tube and mailed it to a Kaiser Permanente lab.
It's a good thing he did. The test indicated he had colon cancer.
The 68-year-old Oakland resident, who is recovering from surgery, can thank an emerging field known as "comparative effectiveness research." It's an idea that sounds so obvious it's hard to believe it isn't already routine: Rather than simply analyzing whether a drug or treatment method works, researchers compare options to determine which ones do the best job for patients.
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Enjoy!
David.
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