Quote Of The Year

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

Wednesday, July 31, 2013

Minister Plibersek Requests Comments On The Concept Of The Medical Home - Smart Move I Reckon.

The following appeared a little while ago.

Govt seeks GP advice on ‘medical homes’

19 July, 2013 Paul Smith
The Federal Health Minister wants “expert input” on patients registering with individual GP practices as part of a drive to tie patients closer to a “medical home”.
Marking the conclusion of last week’s Family Doctor Week, Tanya Plibersek lavished praise on GPs, describing them as the “backbone of Australia’s world-class universal health system”.
“It is their genuine, enduring, and intimate relationship with patients that helps make their clinical impact so powerful. That relationship allows family doctors to truly understand their patients, plan their care carefully, and even pre-empt their health needs.”
She said the government was seeking expert input on the “medical home” concept where patients receive much of their ongoing care through a single GP practice.
“That clinic then becomes responsible for the patient, providing access to a greater range of services aimed at keeping them healthy and out of hospital,” she said.
The minister said she wanted expert feedback — including from GPs — on whether the plan would improve patient care.
There have been various models proposed with the aim of strengthening cradle-to-grave care. The RACGP this year unveiled a blueprint in its budget submission calling for cash payments of $165 to practices for every patient who voluntarily enrols.  
More here:
There are discussions of this area on the blog going back to 2007.
Here are some recent links.
and here:
(This is an especially useful link). The article cited is found here:
and here:
and here:
These links all seem to suggest the Patient Centred Medical Home (PCMH) approach - especially if enabled by quality Health IT to assist with care co-ordination and a patient portal to assist with patient access can be a pretty good way to go.
It is a way better idea for investment than the PCEHR, which, if you think about it is not really the tool to make a PCMH work optimally as the practitioner does not have guaranteed access to all relevant information.
The point that it is important to make is that the PCMH concept is not just about patient registration but also about all the other infrastructure that is needed to make it work well.
As a last point if the Minister wants to know more this looks like a great place to start:
with all of 70 references!
David.

AusHealthIT Poll Number 177 – Results – 31st July, 2013.

The question was:

Will The Connection Of GP Computer Systems To The NEHRS / PCEHR Result In Unexpected Security Breaches As The System Is More Widely Used?

For Sure 53% (31)
Probably 24% (14)
Probably Not 8% (5)
No Way 7% (4)
I Have No Idea 8% (5)
Total votes: 59
This is a pretty clear outcome. 77% think there are real risks that information will leak from the PCEHR.
Again, many thanks to those that voted!
David.

Tuesday, July 30, 2013

The Light Is Starting To Dawn That The NEHRS PCEHR Is Based On A Fundamentally Flawed Concept. Pity It Has Taken So Long.

In the last few months there have been a couple of very interesting contributions to the PCEHR debate.
We have had articles like the following appear from people who should really know.

'It's not a push of a button', says PCEHR lead

The Federal Government's much critcised patient controlled electronic health records scheme is still a long way off benefitting GPs, according to the clinical lead of National E-health Transition Authority.
In an exclusive video interview with 6minutes Dr Mukesh Haikerwal, a Melbourne GP, reveals the extensive amount of work involved in uploading shared patient health summaries and event summaries which are the backbone of the $1 billion scheme.
…..
Check out the full video below to hear more of what he has to say:
The full article is found here - the video is short and worth a watch:
and articles like this:

PCEHR still too difficult: GP

23rd Jul 2013
A SPIKE in personally controlled e-health record (PCEHR) registrations almost brought the federal government to its target of 500,000 sign-ups by the end of June, but GPs insist the system is still not useful or accessible enough to lure them.
Dr Peter Hopkins, a GP in NSW’s Hunter region, said using the PCEHR was still too complex and the benefits not apparent enough.
“To actually get a patient enrolled and hooked up in the system, it’s a difficulty which I haven’t even attempted.
“We are all waiting for the better understanding and leverage of this,” he said.
“But the time and effort it takes and explaining it to the patient and justifying it, it adds to the workload so much that it’s just not being done.”
The health department confirmed it passed the half million milestone last Wednesday, just over two weeks after the target date.
The same day, Health Minister Tanya Plibersek upped the incentive for patients to sign up by saying pathology and diagnostic imaging results could be uploaded to e-health records following an $8 million federal government investment.
Much more of the perceived problems are found here:
Of course we have the defence leap out as well, from those on the inside and presumably of the payroll, such as this article on the ABC site.

A second opinion on the progress of e-health

Wide criticism of the government's e-health system is premature, but more needs to be done in "meeting the gap" faced by regional and rural areas.
Dr Chris Mitchell, Head of Adoption, Benefits and Change at the National E-Health Transition Authority, says it is "really important that we prioritise rural Australia" for the roll out of ehealth initiatives and infrastructure such as the National Broadband Network which drives it.
"I think rural Australia misses out in a whole lot of areas - in terms of a whole lot of infrastructure - and I think Australia should do more to be meeting that gap for our rural communities," Dr Mitchell explained.
"I think it is really important that we prioritise rural Australia for the roll out of these sorts of technologies if we are going to be taking advantage of them and meet the health needs of our rural communities.
"I think all of us want to work in a better connected health system," Dr Mitchell added.
The National E-Health Transition Authority (NEHTA) has been the subject of rasping criticism, particularly from doctors.
Lots more here:

http://www.abc.net.au/local/stories/2013/07/26/3811854.htm

Additionally, in recent times a new blog has appeared which makes many cogent criticisms of the PCEHR program and how engagement with GPs has, and is, being handled.
See here:
There is a lot of very interesting material to be found on this blog.
So what is the problem. If pushed I would suggest there are three principle problems that lie at the root of the concerns.
The first is that the PCEHR does not know what it is and who is its intended user / customer. As presently architected the PCEHR is neither ideally suited for use by either a technically and clinically aware professional or their patient. It is a compromise that is neither fish nor fowl and so is in any way ideal for anyone. It simply addresses no one’s needs properly.
The second is that the present system really does not provide the things - such as easy access to your doctor, repeat prescription requests, appointment making and so on surveys all over the world say patients value. The PCEHR simply does not facilitate this sort of interaction.
The third is that separates the patient record the clinician uses in their day-to-day work and the record the patient holds with an imposition of issues on both parties such as currency, timeliness, completeness and so on.
All this, of course, ignores the issues of workflow impact, system slowness and clumsiness, security and liability issues that many have raised.
It is clear what needs to be done. First, with real consultation with a broad range of working clinicians there need to be major changes to the PCEHR’s architecture to restore clinician centrality and to ensure the system works optimally for them.
Second with broad consultation approaches to patient access and use need to be developed and implemented.
Third the leadership and governance of the whole e-Health effort needs to be drastically overhauled and made accountable and realistic regarding what can be achieved and what will make a difference - preferably based on real evidence and not hunch.
These three steps would save the salvageable from what presently could reasonably be argued to be an unsatisfactory system for both patients and their doctors.
David.

Monday, July 29, 2013

Weekly Australian Health IT Links – 29th July, 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

It seems the rumblings regarding the NEHRS / PCEHR are continuing with the usual suspects - NEHTA consultants - saying all is well. My contacts are suggesting there are many GPs with a wide range of concerns that really need to be addressed.
Other than that there are some interesting bits of news on medical devices, e-Health start up funding and a few other fun bits!
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PCEHR still too difficult: GP

23rd Jul 2013
A SPIKE in personally controlled e-health record (PCEHR) registrations almost brought the federal government to its target of 500,000 sign-ups by the end of June, but GPs insist the system is still not useful or accessible enough to lure them.
Dr Peter Hopkins, a GP in NSW’s Hunter region, said using the PCEHR was still too complex and the benefits not apparent enough.
“To actually get a patient enrolled and hooked up in the system, it’s a difficulty which I haven’t even attempted.
“We are all waiting for the better understanding and leverage of this,” he said.
“But the time and effort it takes and explaining it to the patient and justifying it, it adds to the workload so much that it’s just not being done.”
The health department confirmed it passed the half million milestone last Wednesday, just over two weeks after the target date.
-----

'It's not a push of a button', says PCEHR lead

The Federal Government's much critcised patient controlled electronic health records scheme is still along way off benefitting GPs, according to the clinical lead of National E-health Transition Authority.
In an exclusive video interview with 6minutes Dr Mukesh Haikerwal, a Melbourne GP, reveals the extensive amount of work involved in uploading shared patient health summaries and event summaries which are the backbone of the $1 billion scheme.
…..
Check out the full video below to hear more of what he has to say:
-----

A second opinion on the progress of e-health

Wide criticism of the government's e-health system is premature, but more needs to be done in "meeting the gap" faced by regional and rural areas.
Dr Chris Mitchell, Head of Adoption, Benefits and Change at the National E-Health Transition Authority, says it is "really important that we prioritise rural Australia" for the roll out of ehealth initiatives and infrastructure such as the National Broadband Network which drives it.
"I think rural Australia misses out in a whole lot of areas - in terms of a whole lot of infrastructure - and I think Australia should do more to be meeting that gap for our rural communities," Dr Mitchell explained.
"I think it is really important that we prioritise rural Australia for the roll out of these sorts of technologies if we are going to be taking advantage of them and meet the health needs of our rural communities.
-----

Megan Robertson & Nilmini Wickramasinghe: Caring technology

Megan Robertson and Nilmini Wickramasinghe
Monday, 22 July, 2013
THE debate about e-health has so far been short on details about the specific issues facing doctors in implementing information technology in health care.
While a recent article in MJA InSight about the lack of information technology (IT) progress deserves applause, it was disappointingly short on specific details that are directly relevant to practising doctors.
Unfortunately, motherhood statements that relate to solutions in the business sector or social media fail to consider the unique and personal nature of health care provision.
We need to clearly separate the business components of running a practice from the clinical components of providing medical care in the e-health debate.
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Telehealth leaves GPs cold

24 July, 2013 Kate Cowling
Most GPs would abruptly end a video consultation if the patient presented with signs of anxiety, acute cough or gall-bladder disease, research shows, casting doubt on the viability of telehealth.
A study of 46 doctors has revealed that even those who began a video session with an open mind became ambivalent when conditions were perceived to be complicated or warranted "hands-on" clinical assessment.
The research raises questions about the clinical effectiveness of teleconsultations as a replacement for face-to-face ones.
The GPs in the study were shown six video vignettes from a remote location, filmed by actors, and were asked to diagnose the patient's condition and nominate whether they would proceed with the consult.
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Logical Observation Identifiers Names and Codes (LOINC) and SNOMED Clinical Terms to align

Created on Thursday, 25 July 2013
Leading global health care terminologies Logical Observation Identifiers Names and Codes (LOINC) and SNOMED Clinical Terms to align.
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Data breach law essential to protect individuals

Date July 24, 2013 - 4:03PM

Teresa Corbin

OPINION
The backlash by industry groups against long-overdue data breach reporting laws would be worrying if it wasn’t so predictable, says consumer advocate Teresa Corbin.
If we are to believe industry lobby groups like the Association for Data-driven Marketing and Advertising (ADMA – formerly known as the Australian Direct Marketing Association), the government’s proposed laws to make organisations notify consumers of breaches of their personal privacy would be a jobs killer and an unnecessary burden on business.
This is an argument aimed at further delaying a bill already five years in the making that would do no more than see businesses held accountable for being careless with their customers’ personal information.
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Telehealthcare leader Feros Care connects clients to their personal electronic records and into the e-health revolution

WhaTech Channel: Medical Software
Published: Tuesday, 23 July 2013 19:09
Press Release from: Feros Care
Feros Care continues to lead the way to better aged care through technology, as one of the first in the sector to successfully connect its own electronic client records to Personally Controlled Electronic Health Records (PCEHR).
The tech-savvy provider of community and residential aged care has embraced e-health, which is particularly valuable for older people, and has committed to assist all staff and clients register for one of the online records, provided they wish to opt in to the new system.
To make signing up even easier for its clients, the organisation is using the Australian Government's Assisted Registration Tool, a piece of software which streamlines the process of aged care staff to assisting older people who want to get their own PCEHR.
Feros Care CEO Jennene Buckley describes the PCEHR as a “wonderful enabler” that can ensure seniors receive the best possible multi-disciplinary healthcare, whether in the residential or community setting.
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ATMs hacker Barnaby Jack dies on eve of pacemakers talk

  • From: AP
  • July 27, 2013 4:04PM
A PROMINENT hacker who made ATMs spit out cash and was set to deliver a talk about hacking pacemakers and other wireless implantable medical devices has died in San Francisco.
The cause of death of Barnaby Jack, who died at his home in San Francisco, was still under investigation, San Francisco Deputy Coroner Kris Barbrich said.
Jack, who was in his mid-30s, was scheduled to speak on August 1 at the Black Hat security conference in Las Vegas. The headline of his talk was, "Implantable Medical Devices: Hacking Humans," according to a synopsis on the Black Hat conference website.
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Govt seeks GP advice on ‘medical homes’

19 July, 2013 Paul Smith
The Federal Health Minister wants “expert input” on patients registering with individual GP practices as part of a drive to tie patients closer to a “medical home”.
Marking the conclusion of last week’s Family Doctor Week, Tanya Plibersek lavished praise on GPs, describing them as the “backbone of Australia’s world-class universal health system”.
“It is their genuine, enduring, and intimate relationship with patients that helps make their clinical impact so powerful. That relationship allows family doctors to truly understand their patients, plan their care carefully, and even pre-empt their health needs.”
-----

Take notice of MLs’ effect, it’s positive

16th Jul 2013
AS THE nation embraces the political spin and campaigning that dominate the media and water cooler conversations each election year, I have been reflecting on the health reform agenda and where Medicare Locals are now sitting within the broader primary healthcare setting.
I think it is evident that MLs are now establishing themselves as a key component of their local healthcare infrastructure — recognised and appreciated by their local communities. In looking forward, I think it is important that we take a moment to reflect on where we are and how it is we came to be here.
We undertook these healthcare reforms because our health system was failing people. It has been fragmented, siloed, inefficient, inequitable and economically unsustainable. People have been missing out on the services they desperately needed — often the most vulnerable people.
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Behind the news – Medicare Locals

23rd Jul 2013
EARLIER this month a national survey of 1400 Australians revealed that almost three-quarters of respondents had no idea what role or purpose Medicare Locals played in the primary healthcare system.
One in 20 surveyed believed the bodies helped process their MBS claims. 
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Health checks go mobile

SMARTPHONES, wireless sensors and cloud computing are being combined to allow a doctor to monitor a patient hundreds of kilometres away.
Researchers are developing the communication pathways to allow health information collected by a network of tiny wireless sensors to be transmitted using smartphones or tablets.
The service, being developed at Charles Sturt University in regional NSW, was initially aimed at Australia's ageing population.
The cloud-based healthcare monitoring system enables a doctor to monitor the heart rate or check the blood pressure of a patient hundreds of kilometres away using wireless sensors and mobile phone technology.
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Sufferers see tyranny of distance fade thanks to broadband focus

FOR the first time chronic pain sufferers around the country will have a virtual conference to access expert advice via high-definition videoconferencing thanks to the National Broadband Network.
Chronic pain affects one in three Australians and is estimated to cost more than $34 billion a year in healthcare, according to Access Economics.
Armidale, in the NSW northern tablelands, will act as the main NBN hub, connecting at least seven other centres nationally.
Using the super-fast NBN to provide smooth video and voice transmission would allow participants to communicate -- virtually -- face-to-face with each other and with the experts as if everyone were in the same room.
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Health checks via smartphones, tablets on the way

Summary: A new cloud-based system could deliver real-time health monitoring and alerts to healthcare professionals.
By Tim Lohman | July 25, 2013 -- 02:21 GMT (12:21 AEST)
A new cloud-based health care monitoring system in development by Charles Sturt University (CSU) could help deliver improved health services to regional and rural Australia, while helping reduce the ballooning cost of the country's health budget.
The system, being researched by staff at the university's School of Computing and Mathematics, combines wearable sensors, wireless sensor networks, body area wireless sensor networks (BAWSN), smart devices, cloud computing, and security technology to continuously monitor and manage the vital statistics of patients, such as heart rate and blood pressure levels.
According to the head of the system's research team, Dr Tanveer Zia, the placement of collected data on the cloud will enable medical practitioners to access patient health information anywhere, regardless of their proximity to the patients.
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3 reasons to avoid Skype for telehealth

Is Skype safe for a clinical consultation? In June last year, the Royal Australian College of General Practitioners said in their publication RACGP advice on Skype: “There is currently no clear evidence to suggest that Skype is unsuitable for clinical use”.
This year however, new information came to light suggesting that Skype, owned by Microsoft, may not be as safe as we thought. Here are three reasons why you should be careful to use Skype as a professional video conferencing tool:
  • Skype is not encrypted from end-to-end. Microsoft can intercept information transmitted via Skype.
  • Skype tells the world where users are by exposing IP addresses. This allows criminals to target cyber attacks.
  • The US National Security Agency (NSA) can listen in and watch Skype chats with their data collection program Prism.
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Saluda Medical receives $5m in e-health funding

Money will be used for the development of pain management technology
National ICT Australia (NICTA) startup Saluda Medical has been awarded $5 million by the New South Wales Government for the development of technology which will improve chronic pain management.
According to Saluda researchers, electrical stimulation of the patient’s spinal cord can offer pain relief. However, it can also cause uncomfortable side effects.
The researchers plan to develop technology which will measure nerve responses to electrical stimulation and use this information to automatically adjust the stimulation to a comfortable level. The stimulation is delivered via a spinal implant.
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NSW Medical Devices Fund gives AU$10m to health tech startups

Summary: The NSW Medical Devices Fund has given AU$10.3m over three years to help fund five health startups across New South Wales.
By Chris Duckett | July 22, 2013 -- 06:27 GMT (16:27 AEST)
The NSW Medical Devices Fund announced (PDF) its inaugural grant recipients on Friday, which will be split five ways over the coming three years.
NICTA startup Saluda Medical walked away with AU$5 million for its implantable device for the treatment of chronic pain. Saluda was spun out of NICTA earlier this year, after picking up an initial AU$5 million in private investment.
"Saluda's goal is to bring this research to commercial reality and see our technology used in every neuromodulation application in the future." said Dr John Parker, Saluda CEO.
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Doctors praise new surgical knife that diagnoses as it cuts

Date July 19, 2013
A new kind of surgical knife can tell cancerous from healthy tissue in seconds and may help improve tumour removal in the operating room, new research shows.
Known as the iKnife, the tool analyses the vapour given off as surgeons use electrical current to cut away tissue - and it reports in real time whether the tissue is cancerous.
Tests in 91 human patients have shown the tool's diagnoses were extremely accurate and may be reliable enough for widespread use in operating rooms, the study, published in the US journal Science Translational Medicine, revealed.
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Clever scalpel sniffs out cancer

22 July, 2013 Amanda Sheppeard
A revolutionary adaption of the electric scalpel is poised to change the way surgeons approach the removal of cancerous tumours.  
The iKnife analyses smoke from burned tissue as it is cut, providing immediate feedback on whether the tissue is cancerous, healthy or unidentified.
Developed by Dr Zoltan Takats, from Imperial College London, it's describes it as a potential game-changer for tumour resection.
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How big data can result in bad data

Date July 23, 2013 - 8:13AM

Drew Turney

Stacks of information is just yada yada yada until it's analysed properly.
A couple of years ago, ratings agency Standard & Poor's downgraded US debt. Not because of the state of the economy, but because of an error in its original calculations - a mere $US2.1 trillion.
Nate Silver, the poster child for analytic predictions, told a recent conference that the financial crisis was as much about bad modelling as greed. The ratings agencies, he said, based assumptions on past mortgages, not the number of people who would default.
Welcome to the world of bad data, something that's caught on in Australia, too. GS1, the agency responsible for barcoding and product identification systems, recently released a report that found bad data will cost Australian grocery retailers $675 million in lost sales over the next five years, and that 65 per cent of ''data misalignment'' problems led to lost sales.
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NBN costs set to soar past $60bn

  • by: Annabel Hepworth, National business correspondent
  • From: The Australian
  • July 24, 2013 12:00AM
CONSTRUCTION contractors on the National Broadband Network are pushing to be paid up to 40 per cent more to do further work, fuelling fears of a cost blowout on Labor's flagship infrastructure project.
The Australian has been told that industry suppliers are looking for increases in the value of contracts of between 20 per cent and 40 per cent for further work and that high-level evaluations are circulating suggesting that the ultimate cost of the project could spiral out to between $60 billion and $70bn.
A slew of NBN Co's current construction contracts are due to expire between this year and 2016 and will have to be renewed; NBN Co is also expected to take tenders for delivering fibre, fibre links and new developments this year. Some of NBN Co's main contractors appear to have hit financial strife and some of their sub-contractors have downed tools in Victoria and Tasmania, claiming they are not being paid enough. "There's a huge probability this thing will go completely through the ceiling," said a senior industry source.
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Hunt for alien spacecraft begins, as planet-spotting scientist Geoff Marcy gets funding

Date July 24, 2013

Peter Brannen

In the field of planet hunting, Geoff Marcy is a star. After all, the astronomer at the University of California at Berkeley found nearly three-quarters of the first 100 planets discovered outside our solar system. But with the hobbled planet-hunting Kepler telescope having just about reached the end of its useful life and reams of data from the mission still left uninvestigated, Marcy began looking in June for more than just new planets. He's sifting through the data to find alien spacecraft passing in front of distant stars.
He's not kidding - and now he has the funding to do it.
If intelligent life is common in the galaxy, "where is everybody?" 
Last fall, the Templeton Foundation, a philanthropic organisation dedicated to investigating what it calls the "big questions" - which, unsurprisingly, include "Are we alone?" - awarded Marcy $US200,000 to pursue his search for alien civilisations.
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Earth viewed from a billion miles away

Date July 26, 2013 - 2:01PM

Peter Spinks

Fairfax Science Columnist

From the remote vantage point of Saturn, planet Earth seems mighty small and insignificant. Yet the first interplanetary portrait to be taken in natural colour is a stark reminder of how alone and potentially vulnerable we are in the vastness of space.
The series of snaps was taken early last Saturday by NASA's Saturn-orbiting space probe, Cassini, from a distance of 1.44 billion kilometres.
The images – facilitated by a unique version of an outer solar system eclipse in which the sun's glowing dial hid safely behind Saturn – are short on detail. Earth, after all, shows up as a trifling 1.5 pixels wide, with the illuminated part less than a pixel across.
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Enjoy!
David.

Another Very Helpful PCEHR Presentation From Dr Edwin Kruys


This presentation makes it clear just what problems many of the proposed users of the PCEHR see with the system.



Looks like DoHA and NEHTA have a lot of work to do.

Mandatory viewing.

David.

Sunday, July 28, 2013

A Real Friend Of Australian E-Health Passed Away Yesterday.

Not much to say other than to say just how sad this is. Jon was one of the good guys in all this.

His blog is here and is worth a read to understand the decent and caring man he was.

http://ehr-the-grail.blogspot.com.au/

Vale Jon,

David.


I Am Not Sure DoHA And NEHTA Have Thought Through Pathology And Radiology Results In The NEHRS / PCEHR.

A week or so ago Tanya Plibersek announced the spending of some $8M on the following.

Pathology and Diagnostic Imaging Results to be Added to eHealth Records

17 July 2013
Patients will soon be able to have pathology and diagnostic imaging results uploaded to their eHealth records thanks to an $8 million Federal Government investment.
The Minister for Health, Tanya Plibersek, said it will mean things like a patient’s blood test and x-ray results could be stored securely online as part of their own personal eHealth record.
“This is a landmark next step in the evolution of the Government’s national eHealth records system,” Ms Plibersek said.
“We expect both doctors and patients will find the new functionality useful, as it will reduce the need for them to chase down results or duplicate tests.
“In an emergency, having this kind of information on a patient’s eHealth record could save lives.”
Both patients and healthcare professionals will be able to access results uploaded to a record.
“The $8 million investment includes funding for planning and design work associated with upgrading medical software used by doctors so results can be downloaded or uploaded at the click of a button,” Ms Plibersek said.
“This work will pave the way for x-ray and MRI images themselves to be stored on a patient’s eHealth record in the future.
…..
The new functionality is expected to roll out in the first half of 2014.
The full spin laden release is found here:
At present pathology and radiology results go to the doctor of the patient who requested the tests be done (often electronically - especially in pathology) where they are reviewed and then discussed with the patient on their next visit or by phone if some more urgent action is required.
Thus what cannot happen is that any results go via any path into the PCEHR other than after clinician review and discussion. If they do then we can all see what will happen. Patients will read results - see something that concerns them - whether it should or not - and be calling, e-mailing or whatever anxious and concerned.
We are also going to have the anxious types worrying when they don’t need to if it takes longer than a day or so to be able to see their results in their PCEHR.
What we get by offering this is anxious patients and harassed clinicians who will have their usual workflows interrupted and worse then have to spend time closely reviewing results to make sure there are no contents in the report the patient does not want on their PCEHR. This says nothing of the time needed to locate if each patient with some results has a PCEHR, wants the information sent and getting consent to do so!
Of course we also know the pathology and radiology providers are also aware that their results are a professional opinion - usually with some interpretation - and they are also going to be concerned about results being misunderstood etc. with possible liability issues etc. to say nothing about consent issues.
The most innocuous test can pin-point a diagnosis the patient may not want disclosed. Examples include measurements of Serum Lithium (points to serious mental illness) and various drug levels that point to Epilepsy or even a blood sugar that may reveal diabetes.
To me this is a feel good announcement made by a Minister at an e-Health Conference way before any careful discussion with clinician groups has been had. All them would have made it very clear that there are all sorts of traps for the unwary in making this initiative work properly. The technology is the very least of it!
David.

Saturday, July 27, 2013

Weekly Overseas Health IT Links - 27th July, 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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KLAS Report Gives Early Lay of the Land in Health Analytics

JUL 16, 2013 12:24am ET
A study of provider perceptions of the business intelligence vendor field finds a lot of interest in the field but also confusion among health care providers.
Vendor research firm KLAS Enterprises interviewed executives at more than 70 hospitals or delivery systems with more than 200 beds. Asked which BI vendors will stand out in health care, 41 percent of respondents were unsure. Of the 59 percent responding, IBM, SAP, Microsoft and Oracle are perceived as the leaders in enterprise BI applications, with none getting more than 12 percent of the vote, explained Joe Van De Graaff, a KLAS research director, during Health Data Management’s Healthcare Analytics Symposium in Chicago.
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A Sober Look at the Need for Analytics

JUL 18, 2013 12:27pm ET
During a presentation at Health Data Management’s Healthcare Analytics Symposium, John McDaniel, national practice leader at data storage and management vendor NetApp, laid out the sobering reasons why data analytics are coming to the health care industry and must be embraced.
Start with a “unibyte.” That’s 10 to the 24th power, the amount of data the health care industry is rapidly reaching, with the amount growing more than 40 percent annually for the next decade, he said. The data comes from clinical documentation, genomics, personal monitors and sensors, medical images, electronic health records, health information exchanges, claims, and machine-to-machine transfers, which is the fast growing data source and partly fueled by telehealth/telemedicine.
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Health IT has hot half for M&A

Posted on Jul 19, 2013
By Mike Miliard, Managing Editor
During the first six months of 2013, health information technology was the "most active market segment" of the healthcare/pharma/IT industry for mergers and acquisitions, according to investment bank Berkery Noyes.
Industry-wide, deal volume decreased 16 percent since second half 2012, but the number of deals was close to the industry's historical average for 2011 when examined on a half year basis, according to the report.
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3 reasons most EHR vendors will be out of business by 2017

July 17, 2013 | By Susan D. Hall
The crowded field of electronic health record vendors likely will be slashed to less than half by 2017, or by the implementation of Meaningful Use Stage 3--whichever comes first--according to a new Black Book Market Research report. Most vendors are likely to go out of business, merge or be acquired, according to the survey of 880 EHR consultants, analysts, managers and support team members.
The report follows up on another report released in February that called 2013 the "year of the great EHR switch" due to user dissatisfaction.
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The Value of Lifestyle Questionnaires to Get Good Data

JUL 16, 2013 2:32pm ET
Attention physicians interested in accountable care organizations and data analytics to support population health management: Do you have your patients complete a comprehensive lifestyle questionnaire?
John McDaniel, national practice leader for the provider market at data storage and management vendor NetApp completed a questionnaire and his physician learned that McDaniel consumed six two-liter bottles of diet cola a day. The body metabolizes artificial sweeteners as sugar, and the result of all that soda was that McDaniel had active diabetes. His level of triglycerides—a fat in the blood—was 475 compared with a normal reading of 150. He went cold turkey and improved his diet, the reading dropped to 150 within three months and the diabetes now is inactive, McDaniel said at Health Data Management’s Healthcare Analytics Symposium in Chicago.
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VA makes mHealth pilots priority

Posted on Jul 18, 2013
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
The Department of Veterans Affairs is making strides with testing the viability and potential of mobile health technologies after launching several pilot projects. The agency's newest pilots include one for mobile scheduling and another distributing 1,000 loaner iPads to caregivers of post-9/11 veterans.
The Veteran Appointment Request Web App pilot is offering about 600 veterans the ability to request primary care and mental health care appointments using mobile devices and desktop computers. Currently limited to health services at the Washington-based VA Medical Center and the VA Palo Alto Health Care System, the pilot has the possibility of expanding in the future.
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Standards for EPRs launched

12 July 2013   Rebecca Todd
A new set of standards for the content and structure of electronic patient records has been launched at the Royal College of Physicians.
‘Standards for the clinical structure and content of patient records’ provides a set of generic standards for recording clinical information, allowing it to be easily shared with other parts of the health or social care system
The standards have been developed by healthcare professionals from multi-disciplinary backgrounds, patients, carers and health IT specialists in a programme of work led by the RCP and commissioned by Health and Social Care Information Centre.
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Tuesday, July 16, 2013

The Healthcare IT Applications of Google Glass

Last week I had the opportunity to test Google Glass.  
It's basically an Android smartphone (without the cellular transmitter) capable of running Android apps, built into a pair of glasses.  The small prism "screen" displays video at half HD resolution.  The sound features use bone conduction, so only the wearer can hear audio output.   It has a motion sensitive accelerometer for gestural commands.    It has a microphone to support voice commands.   The right temple is a touch pad.  It has WiFi and Bluetooth.   Battery power lasts about a day per charge.
Of course, there have been parodies of the user experience but I believe that clinicians can successfully use Google Glass to improve quality, safety, and efficiency in a manner that is less bothersome to the patients than a clinician staring at a keyboard.
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Most health care records now are electronic

David Jackson, USA TODAY 9:02 p.m. EDT July 16, 2013
An ever-expanding amount of the nation's medical records — millions of prescriptions, medical reports and appointment reminders — are now computerized and part of an ambitious electronic medical records program, the Obama administration reports.
Since the start of a 2011 program in which the government helps finance new health records systems, doctors or their assistants have filled more than 190 million prescriptions electronically, according to data provided by the Centers for Medicare & Medicaid Services.
Providers have also shared more than 4.3 million health care summaries with colleagues when patients change doctors, according to the data.
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Clarification With Major Impact: A Safety Net for Meaningful Use Attestation Success

by Naomi Levinthal and Anantachai (Tony) Panjamapirom Thursday, July 18, 2013
Eligible professionals (EPs) and eligible hospitals (EHs) participating in the CMS Electronic Health Record Incentive Programs must demonstrate meaningful use based on a number of metrics or measures. At its basic level, many of these measures are ratios: denominators are a number of patients seen over a given period of time (i.e., the reporting period), and numerators are information collected about those patients included in denominators. The quotient is the provider's performance, of which a specified threshold must be met in order to receive incentive payments.   
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Leah Binder Wants Your Hospital Data

Cheryl Clark, for HealthLeaders Media , July 18, 2013

The Leapfrog Group CEO wants public reporting of nine so-called "never events" to remain public. The AHA, she says, wants to suppress it. But that's not all. Binder wants "more data—a lot more data."
Leah Binder has a very tricky job.  
As president and CEO of the Leapfrog Group, she has to be nice to hospitals because she needs more of them to voluntarily report quality data to Leapfrog, even though they may suffer the ignominy of getting a poor safety grade, or appear shabby for not having implemented electronic systems for physician orders.  
If she isn't nice to them, they might get turned off, or drop out of Leapfrog's program, and the employer groups and others she represents—who want public reports on lots of measures to show them where to spend their healthcare dollars won't be happy.
But she also has to be critical of the hospital industry, be tough, and hold her ground. And that side came out this week in her Forbes blog, which was topped with the provocative headline: "Bone-Chilling Mistakes Hospitals Make and Why They Don't Want You to Know."
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Will CDA replace HL7 version 2 messaging?

July 18, 2013 -- CDA, or Clinical Document Architecture, is the document standard defined by HL7 as part of its version 3, which is used to exchange information between healthcare providers' electronic health records (EHRs). The new requirements mandate EHR implementation as part of qualifying for federal meaningful use payments.
CDA implementations are still in their infancy, even though at the recent Integrating the Healthcare Enterprise (IHE) Connectathon, there were literally hundreds of those documents exchanged and properly "consumed." Consuming a document means that the information is presented properly and added to the appropriate record in the database. For example, a list of medications in the physician electronic medical record (EMR) is properly updated based on a discharge document from an emergency room visit.
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Survey shows uncertain future for ICD-10

Posted on Jul 17, 2013
By Diana Manos, Senior Editor
Despite the one-year delay in ICD-10 compliance, many healthcare providers still do not understand the value of the new medical diagnostic codes that will be used beginning Oct. 1, 2014, according to a new survey from eHealth Initiative.
The survey, conducted in partnership with the American Health Information Management Association, reveals a lack of communication around the benefits and value of the new ICD-10 code set, which was expanded to improve the quality of care, research and surveillance with more accurate and specific data. 
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EHRs 'transforming' care, says Tavenner

Posted on Jul 17, 2013
By Mike Miliard, Managing Editor
Providers are increasingly using electronic health records, both to manage their patients' care and to provide more information to those patients, according to new data published Wednesday by the Centers for Medicare & Medicaid Services.
Already, approximately 80 percent of eligible hospitals and more than 50 percent of eligible professionals have adopted EHRs and received meaningful use incentive payments from Medicare or Medicaid, according to CMS.
By meaningfully using EHRs, physicians and care providers have shown increased efficiencies while safeguarding privacy and improving care for millions of patients nationwide, the data show.
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IT can fill £30 billion gap - Kelsey

11 July 2013   Rebecca Todd
Technology can fill a “large part” of the £30 billion funding gap facing the health service, NHS England’s director of patients and information has claimed.
Tim Kelsey told a group of health IT business people at an NHS England entrepreneurs day last Friday that they must get involved in the government’s “call to action” on the future of the NHS, and push for more investment in technology.
He said NHS England projects a £30 billion funding gap by 2020 as NHS funding remains flat, but the health service faces rising demand and costs.
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Mostashari: Emphasize training when adopting health IT

July 17, 2013 | By Dan Bowman
To successfully implement technology--such as electronic health record systems--into healthcare processes, providers need to spend ample time ensuring employees are trained to use such tools, according to National Coordinator for Health IT Farzad Mostashari.
In a recent interview with NPR, Mostashari (pictured) talked about the importance of not only embracing technology in the healthcare industry, but doing so in a responsible manner.
"The key thing is that you can't just plop in technology," he said. "You've got to really work with the people and the processes. You've got to work with the training, and you've got to look at the workflows that you're doing and not just repeat the same processes--broken processes that you were doing before."
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Field of EHR vendors could shrink significantly by 2017

July 17, 2013 | By Susan D. Hall
The crowded field of electronic health record vendors will be slashed to less than half by 2017, or by the implementation of Meaningful Use Stage 3--whichever comes first--according to a new Black Book Market Research report.
It follows up on a report released in February that called 2013 the "year of the great EHR switch" due to user dissatisfaction. To that poll of 17,000 users in physician practices, this new study adds in the opinions of 880 EHR consultants, analysts, managers and support team members.
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EHRs slow increase in outpatient costs

July 16, 2013 | By Marla Durben Hirsch
Electronic health records can stem the short-term growth in healthcare costs, according to a new study published this week in the Annals of Internal Medicine.
The researchers, from the University of Michigan and elsewhere, studied four years of healthcare cost data of 179,000 patients in nine Massachusetts communities. Three of the communities had adopted EHRs; the other six were used as control groups.
The study found that EHRs reduced the costs of outpatient care by 3 percent, which amounted to about $5.14 in savings per patient per month, according to an announcement. Most of the savings were realized in radiology. 
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VA launches caregiver pilot with 10 new apps

By: Jonah Comstock | Jul 16, 2013
The Department of Veterans Affairs has fully launched its pilot, announced last year, in which it’s distributing 1,000 iPads to family caregivers of veterans loaded with 10 specially-created apps.
“There are three things that we’re looking at in the pilot,” said Kathleen Frisbee, Director of Web and Mobile Solutions in the Veterans Health Administration. ”The first is the impact of the iPads on caregivers’ stress and burden. We’re looking at the historical stress and burden scores we collect through our home visits on those that have the iPad versus those that don’t. The second is looking at caregiver preparedness and trying to understand the impact iPads can have on that. And finally we’re looking at the characteristics of caregivers that predict use of the iPad. It’s trying to understand the audience, what made people use it versus why they didn’t use it.”
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CareCloud Upgrades EHR Platform With Faster Charting

By Brian T. Horowitz  |  Posted 2013-07-16

CareCloud has released a new generation of its cloud-based electronic health record platform to speed up the real-time workflows for doctors and enable "rapid charting."

Electronic health record vendor CareCloud has unveiled the next generation of its Web-based CareCloud Charts software to allow doctors to speed up documentation of patient visits.
Introduced on July 16, the new version of Charts is built around what the company calls "rapid charting," which involves opening a note for a patient visit, documenting findings with just a few mouse clicks and ordering lab tests and medications. Many other EHR systems can slow down documentation by requiring multiple screens, mouse clicks and page reloads to document patient visits, according to CareCloud.
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July 15, 2013

10 Things that Every HIT Company Needs to Know to Prepare for the September 23 HIPAA Final Rule Compliance Date

By Reece Hirsch
On January 25, the Office for Civil Rights (OCR) of the Department of Health and Human Services published new regulations that dramatically extend the reach of federal healthcare privacy and security law to a vast array of companies that do business with the healthcare industry, including many HIT companies. The long-awaited final omnibus regulations (the “Final Rule”) amend the privacy, security, enforcement, and breach notification rules under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act. The Final Rule represents the most significant development in health care privacy and security law since the original HIPAA regulations were published a decade ago.
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Cerner Builds Recession-Proof ‘Bunker’ For Health Data

By Elana Gordon and KCUR | Kaiser Health News,

This is a story about data. Lots and lots of data.
And not just any data. Extremely sensitive data.
The U.S. health system is undergoing a major technological shift right now. Some equate it to finally catching up to where the banking and airline industries have been for years: Doctors and hospitals are moving to electronic health records systems, and it’s not easyCerner, based in Kansas City, Mo., has grown into one of the nation’s biggest players in the field of health information technology.
Cerner’s main headquarters seems like a college campus, peppered with trees and walking paths, along with some Star Trek-like architecture.
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Finding the Right Consultant

JUL 1, 2013
Hiring an information technology consultant almost always comes down to one of three needs for a health care organization, according to Ted Reynolds, vice president at consultancy CTG Health Solutions. An organization needs expertise it doesn't have in-house; or somebody to drive an independent decision through the organization; or short-term labor to finish a project.
Sometimes the reason to hire a consultant is a combination of all three needs. In a large electronic health records implementation, the vendor often will teach users about one-third of what they really need to know, Reynolds says. A consultant who already helped with strategy can fill in the training blanks to shorten the learning curve, and do so with a smaller force than the vendor, he asserts. "The hardest thing to make up on a project is time."
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Commentary: Why healthcare must operationalize data breach response

By Rick Kam
Over the last decade, the scope of identity theft has widened from credit card and financial fraud to include widespread medical identity theft with potentially life-threatening consequences. 
In that time, organizations have grown in awareness and readiness to combat identity theft. According to Larry Ponemon, chairman and founder of the Ponemon Institute, recent research shows that companies are doing a better job of detecting, containing, and responding to breach incidents than they were ten years ago.
“C-level executives and boards now realize the costly consequences of material data loss and appear to be more willing to approve investments in data protection technologies and expert personnel,” Ponemon explained. “That’s a hopeful sign.”
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3 things to know about geomedicine

Posted on Jul 16, 2013
By Jeff Rowe, Contributing Writer
"Location, location, location" is a phrase that's long been associated with real estate, but in recent years it's also played a role in attempts by healthcare professionals to track disease. Now, some are putting health IT to work in adding location information – where patients have lived – into their EHRs.
"There's a huge body of health information that's been generated at high levels, particularly at the state and county levels, but it's had little effect in doctors' offices," said Bill Davenhall, senior health adviser for ESRI, a California-based provider of geographic information systems (GIS) services to a variety of industries.
If Davenhall has anything to say about it, that's going to change soon. In his eyes, the healthcare sector has done a great job of incorporating genetics and lifestyle into the factors considered when patients are treated, but "The third leg of the stool should be locational history."
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HIMSS launches Health IT Value Suite

Posted on Jul 16, 2013
By Diana Manos, Senior Editor
The Healthcare Information and Management Systems Society today announced the release of a new online collection of data – both quantitative and qualitative – designed to help care providers, lawmakers and other stakeholders research the value of health information technology.
As the health sector strives to improve health and healthcare through the optimal use of IT, measuring technology’s impact and value to patients and caregivers becomes critical. Recognizing the need for a consistent way to understand, evaluate and communicate the real-world impact of health IT, HIMSS introduced the Health IT Value Suite, which it bills as a comprehensive knowledge repository that classifies, quantifies and articulates the clinical, financial and business impact of health IT investments.
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AHA: Hospitals will be ready for ICD-10

July 16, 2013 | By Dan Bowman
Despite a multitude of reports that many providers are struggling with the transition from ICD-9 to ICD-10, the American Hospital Association and the Blue Cross Blue Shield Association recently assured Congress that its members are on track for implementation.
In letters to both House and Senate members, AHA Executive Vice President Rick Pollack and Blue Cross and Blue Shield Association Senior Vice President Alissa Fox offered support for the move to ICD-10, saying that "any delay in implementation threatens to increase cost."
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No Silver Bullet for Medication Adherence

Margaret Dick Tocknell, for HealthLeaders Media , July 3, 2013

Cost and forgetfulness play a large role in non-adherence, but even when medications are supplied at no cost, adherence hovers around only 50%. Forging personal connections with pharmacy staff can help, one insurer says.
A "spoonful of sugar helps the medicine go down," Mary Poppins, the quintessentially perky nanny,explains in song and dance to her young charges.
If only it were that simple to get patient to follow prescription orders.
A report card [PDF] released last week by the National Community Pharmacists Association places medication adherence for individuals with chronic conditions at the C+ level, with one in seven receiving a failing report card grade.
Skipping medicine doses and failing to get prescription refills are among the patient behaviors that threaten patient health, especially among individuals with chronic conditions. The NCPA report estimates that medication non-adherence adds about $290 billion to healthcare costs each year.
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Tech Tools Tackle Medication Problems

Scott Mace, for HealthLeaders Media , July 16, 2013

Medication adherence is a multifaceted challenge that's getting a shot in the arm from technology developers. Glowing pill bottle caps connected to the Internet and a digital library of pill images with detailed data on drug interactions are just the beginning.
If a picture is worth a thousand words, how much could a picture of a patient's medications be worth?
A lot.
It could be worth $290 billion in healthcare costs, and 125,000 lives a year – the cost of medication non-adherence and medication errors, according to the New England Healthcare Institute.
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EHRs Have Mixed Effect on Health Costs

Published: Jul 15, 2013
By David Pittman, Washington Correspondent, MedPage Today
Using electronic health records (EHRs) saved a little more than 3% in ambulatory health costs 18 months after adoption but didn't reduce overall inpatient costs, a large comparative study of EHR use found.
With that rate of savings, it would take 7 years to recoup the projected 5-year adoption costs for an EHR, according to the study, which was published in July 16 issue of Annals of Internal Medicine.
"Reducing health spending by the magnitude that we observed would result in substantial savings if sustained over several years," Julia Adler-Milstein, PhD, of the University of Michigan in Ann Arbor, and colleagues wrote. "Larger savings are possible if providers have incentives to deliver more efficient care."
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EHRs May Slow Growth in Ambulatory Health Care Costs
Among projected savings are significant decreases in ambulatory radiology costs
MONDAY, July 15 (HealthDay News) -- Adoption of electronic health records (EHRs) modestly slows growth in ambulatory health care costs, according to research published in the July 16 issue of the Annals of Internal Medicine.
Julia Adler-Milstein, Ph.D., from the University of Michigan in Ann Arbor, and colleagues analyzed data from a natural experiment that included 806 ambulatory clinicians across three Massachusetts communities which adopted subsidized EHRs and six matched control communities that applied but were not selected to participate in the EHR program. Commercial claims data (January 2005 to June 2009) were used to assess health care costs.
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  • January 23, 2012

Should Every Patient Have a Unique ID Number for All Medical Records?

The WSJ Debate

As the U.S. invests billions of dollars to convert from paper-based medical records to electronic ones, has the time come to offer everyone a unique health-care identification number?
Proponents say universal patient identifiers, or UPIs, deserve a serious look because they are the most efficient way to connect patients to their medical data. They say UPIs not only facilitate information sharing among doctors and guard against needless medical errors, but may also offer a safety advantage in that health records would never again need to be stored alongside financial data like Social Security numbers. UPIs, they say, would both improve care and lower costs.
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State HIEs prep for disaster recovery

Posted on Jul 15, 2013
By Mike Miliard, Managing Editor
Working to ensure the availability and portability of health records in the wake of hurricanes or tornadoes, four Gulf Coast states and six states in the East and Midwest have set up infrastructure to safeguard access to critical health information.
Health information exchange programs in Alabama, Georgia, Louisiana, Florida, South Carolina, North Carolina, Virginia, Michigan, Wisconsin and West Virginia are working with the Department of Health and Human Services and the Office of the National Coordinator for Health IT to enable exchange of health information among providers caring for patients who are displaced from their homes.
All of the state HIE programs participating in the initiative currently have established at least one operational interstate connection and are working with other states including Arkansas and Mississippi, officials say.
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Study: Telehealth Safe, Cost-Effective Alternative to Follow-Up Visits for Ambulatory Surgery Patients

Written by Helen Gregg | July 12, 2013
Telehealth can safely be used as an alternative to in-person follow-up visits for patients who have undergone low-risk ambulatory surgical procedures, according to a study in JAMA: Surgery.
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Telemedicine helps hospitals double revenue

July 15, 2013 | By Dan Bowman
Hospitals that used telemedicine technology and referred patients to children's facilities saw their revenue increase significantly, according to research published this month in the journal Telemedicine and e-Health.
For the study, researchers retrospectively examined billing information for patients transferred from 16 hospitals that used telemedicine. They compared information before and after implementation of telemedicine tools from July 2003 to December 2010.
The researchers, from the University of California Davis Children's Hospital in Sacramento, found that the average number of patients transferred annually by 16 hospitals using telemedicine to children's facilities nearly doubled following deployment of such services, from 143 transfers before deployment to 285 after deployment. In that same vein, the researchers determined that average annual hospital revenue for the facilities examined jumped from $2.4 million before telemedicine deployment to $4 million afterward.
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Hospital workers fired after allegedly snooping into Kim Kardashian's medical records

July 15, 2013 | By Ashley Gold
Some hospital employees in Los Angeles may have gone too far in their quest to "Keep Up with the Kardashians" and now have to face the consequences.
Five workers and a student research assistant at Cedars-Sinai Medical Center (Calif.) have been fired over privacy breaches involving patient medical records--and there is speculation that the patient was Kardashian, who gave birth to her daughter with rapper Kanye West in a birthing suite at the hospital on June 15, the Los Angeles Times reports.
Accessing the records violates the Health Insurance Portability and Accountability Act (HIPAA), which limits what information can be accessed without a patient's permission.
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Update on Q2 Federal Health IT Activity

by Helen R. Pfister, Susan R. Ingargiola, and Erica L. Cali, Manatt Health Solutions Monday, July 15, 2013
The federal government continued to implement the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act (ARRA), during the second quarter of 2013. Below is a summary of key developments and milestones achieved between April 1, 2013, and June 30, 2013.

Highlights

The second quarter of 2013 saw a number of important developments:
  • ONC Releases Governance Framework. On May 6, the Office of the National Coordinator for Health IT released a Governance Framework for Trusted Electronic Health Information Exchange, which presents ONC's guiding principles on HIE governance and provides a common conceptual foundation applicable to all types of HIE governance models. Its intended audience includes any entities that set HIE policy (e.g., state governments, public-private partnerships, HIE organizations and private companies). The Framework consists of four principle categories focusing on: organizational processes, patient trust, business management and technical standards. 
  • EHR Association Releases Voluntary EHR Developer Code of Conduct. On June 11, the Electronic Health Record Association (EHRA), a trade association of electronic EHR vendors, released a voluntary code of conduct. The code is designed to "reflect the EHRA's commitment to support safe health care delivery, recognize the value and impact that EHRs have for patients and families, foster continued innovation and operate with high integrity in the market." Companies that adopt the code will be responsible for determining their own specific application of the code's principles.
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Sutter’s New Electronic System Causes Serious Disruptions to Safe Patient Care at E. Bay Hospitals

California Nurses Association Press Release, 7/11/13
Introduction of a new electronic medical records system at Sutter corporation East Bay hospitals has produced multiple problems with safe care delivery that has put patients at risk, charged the California Nurses Association today.
Problems with technology are not unique to health care – pilots of the ill fated Asiana airline that tragically crashed at San Francisco International Airport July 6 told federal investigators that an automatic throttle failed to keep the jetliner at the proper speed for landing, the Los Angeles Times reported July 9.
In over 100 reports submitted by RNs at Alta Bates Summit Medical Center facilities in Berkeley and Oakland, nurses cited a variety of serious problems with the new system, known as Epic. The reports are in union forms RNs submit to management documenting assignments they believe to be unsafe.
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Enjoy!
David.