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Providers: Assess the risks in EHR vendor contracting
July 3, 2013 | By Marla Durben Hirsch
Providers need look beyond electronic health record vendor contracts themselves and take a risk management approach when evaluating an EHR purchase, since there are so many vendor-related risks that can adversely affect them, according to John Christiansen, a health attorney with Seattle-based Christiansen IT Law. Some of those risks, according to Christiansen, speaking on a recent webinar conducted by the American Bar Association's Health Law Section, include operational risk, risk to reputation and risks to patients.
"You need to know what the risks are and how to mitigate or deal with them. It could be a very negative hit," he said. "You need a meeting of the minds."
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Avoid EHR 'backlash' with better implementation processes
July 3, 2013 | By Marla Durben Hirsch
Electronic health record "backlash"--the opposition to EHR adoption and Meaningful Use by clinicians and other staff--can be avoided by better planning and implementation, according to a recently published article in EHR Intelligence.
Interviews with CIOs and other hospital IT executives revealed that much opposition stems from failures on the part of the healthcare organization during implementation.
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Chen Medical Prints Health Records From iPad, Android Tablets
By Brian T. Horowitz | Posted 2013-07-02
Despite the ongoing move to electronic health records (EHRs) in health care, many doctors still prefer to print out documents and make annotations on hard copy. Chen Medical, a Florida-based health system for seniors, has turned to PrintMe Mobile from Electronics for Imaging (EFI) to do just that.
Since many of its users are low-income seniors who lack a computer or the knowledge to go online to access health records, Chen Medical providers must print out records from EFI's PrintMe Mobile platform to allow the patients to access their medical information, according to EFI.
"A lot of doctors and patients are very paper-driven, and we want to cater to just about every way of input that we can," said Cas Mollien, vice president of infrastructure and interim security officer at Chen Medical, which equipped 150 physicians with tablets. Most of the tablets are iPads, but Chen Medical is also using some Android devices.
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Published: July 2, 2013
Medical App Developers Tell House Committee of Major Challenges
Mobile Medical App developers spoke before the House Subcommittee on Health and Technology about the challenges they face bringing their products to fruition.
Last week Representative Chris Collins (R-NY) convened a hearing of the House Committee on Small Business Subcommittee on Health and Technology, with the goal of learning more about the business landscape of mobile health app developers and the challenges they face. The testimony from entrepreneurs was clear – small business are prepared to innovate in the face of the changing healthcare landscape imposed by the Affordable Care Act (ACA), but there are a lot of obstacles in their path, particularly on the regulatory front.
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Computer-assisted coding adds speed without loss of accuracy
July 5, 2013 | By Susan D. Hall
Computer-assisted coding (CAC) can live up to its namesake when paired with a credentialed coder to speed up the process without losing accuracy, according to a study in the Journal of the American Health Information Management Association. It doesn't fare so well when used alone.
The study looked at the ICD-9 procedure and diagnostic codes on 25 Cleveland Clinic cases, all of which were complex with an average length of stay of 16 days. Six coders assigned codes with the assistance of (CAC) technology and six without. Those with the technological help reduced time per record by 22 percent, according to an announcement.
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Patient portals not quite ready for med adherence
July 5, 2013 | By Ashley Gold
Patients are enthusiastic about using online portals to manage their medications, but more features and functionality are necessary to maximize medication management and adherence, according to a study published this week in the Journal of Medical Internet Research.
The study's authors point out that no data exist about the potential and real uses of patient portals for medication adherence to improve outcomes.
Patients who used portals tend to be white, affluent, well-educated, and privately insured, according to the results. They also were more likely to attend focus groups.
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New acronym; new hope?
NHS England has published its guidance on the creation of integrated digital care records for the NHS. Lyn Whitfield has an initial look at whether it will do the job that EHI readers wanted it to do.
1 July 2013
One of the first and clearest messages to come out of The Big EPR Debate was that NHS England should define its terms before setting out the future of electronic patient records.
So the first, good piece of news to come out of the ‘Safer Hospitals, Safer Wards: Achieving an integrated digital care record’ guidance that was issued today is that the commissioning board has done just that.
The less good news is that in doing so it has introduced a new acronym to NHS IT – IDCR. Despite the first half of the guidance’s title (with its unfortunate focus on hospitals), this is meant to convey the idea of a record that can be used across health and social care and accessed by patients.
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Survey of Physicians Shows Many Behind on ICD-10
JUN 26, 2013 4:03pm ET
A survey of more than 500 physician practices finds one-third have not started ICD-10 compliance work with the October 2014 deadline looming.
Claims clearinghouse Navicure commissioned Porter Research to conduct the online survey, which included clients of the vendor and non-clients. Of the practices that have stared compliance work, one-fifth believe they already are behind. Only 12 percent believe they are on track for timely implementation.
Thirty-six percent of respondents who have not started ICD-10 preparations believe there is plenty of time to prepare, 26 percent don’t have the time, staff or training resources to start; and 22 percent don’t where to start planning. Only four percent say they don’t have funds to start.
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Open eyes to NHS open source
NHS England is thinking of committing millions of pounds to a UK version of a US open source electronic record system. But instead of looking to Washington, it should open its eyes to more promising NHS alternatives closer to home, says EHI editor Jon Hoeksma.
27 June 2013
Earlier this month, health secretary Jeremy Hunt and NHS England’s director of patients and information Tim Kelsey were in the US, talking up the NHS as a trailblazer in all things tech and all things open.
Along with a plethora of high-powered NHS managers, they were at the Datapolooza conference to say that open data in the NHS is set to be bigger than the internet. Heady stuff.
At the same time, NHS England has been funding visits to the US Veterans Health Administration, to look at its much-admired VistA open source electronic medical record system.
The aim of the visits is to see what the NHS can learn from the VA’s experience of open source and, potentially, to investigate whether the English NHS can re-write the system for its own use. Again, heady stuff.
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NHS England to fund NHS VistA projects
1 July 2013
NHS England will spend some of the £260m Technology Fund on further exploring the creation of an NHS version of the US Veterans Health Association’s open source electronic medical record, VistA.
EHI revealed last week that senior figures from NHS England have visited the US to see VistA in action.
The guidance that NHS England issued today on creating ‘integrated digital care records’ suggests they came back impressed.
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HHS signs off on IT patient-safety plan
Posted: July 2, 2013 - 3:45 pm ET
HHS has released its final plan to address patient safety issues arising from the use of health information technology. But putting in place a framework to monitor and then act on those issues remains a work in progress.
One significant change, however, compared to a draft plan released in December, was the addition of a role for the Joint Commission to assist HHS' Office of the National Coordinator for Health Information Technology in “detecting and proactively addressing potential health IT-related safety issues,” according to a five-page fact sheet (PDF) about the plan.
The Joint Commission will investigate and analyze health-IT related adverse events, develop follow-up and corrective action plans and create a database of sentinel events for research and develop a scheme to classify them. The one-year contract is for $524,017 through June 2014, with a one-year option for $248,245. The contract requires the Joint Commission to prepare a final report and a research paper on IT-linked sentinel events after the first year.
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ONC plan makes reporting IT hazards easy
Posted on Jul 02, 2013
By Erin McCann, Associate Editor
With sights set on utilizing health IT to curb the alarming number of medical errors that transpire each year, ONC officials unveiled Tuesday their final plan to bolster patient safety initiatives nationwide.
Officials say the Health IT Patient Safety Action & Surveillance Plan builds on recommendations from the 2011 Institute of Medicine report on Health IT and Patient Safety. ONC has created the Health IT Patient Safety Program, within the Office of the Chief Medical Officer, to coordinate this undertaking.
“When implemented and used properly, health IT is an important tool in finding and avoiding medical errors and protecting patients,” said National Coordinator for Health IT Farzad Mostashari, MD, in a July 2 press statement. “This plan will help us make sure that these new technologies are used to make health care safer.”
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Programming error leads to massive health breach
July 3, 2013 | By Greg Slabodkin
The Indiana Family and Social Services Administration (FSSA) is notifying its clients that some of their personal information may have been accidentally disclosed to other clients, according to an announcement. In compliance with federal and state privacy law, FSSA has sent written notices to 187,533 potentially impacted clients.
According to the announcement, the accidental disclosures may have occurred when RCR Technology Corporation (RCR), a contractor for FSSA, made a computer programming error to a document management system the company supports on behalf of FSSA. The programming error was made on April 6, and affected correspondence sent between April 6 and May 21.
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Proceed With Caution
JUL 1, 2013
Adam Kaplin, M.D., chief psychiatric consultant at Johns Hopkins Hospital in Baltimore, wants everyone to be aware that depression is the biggest killer of heart attack patients during the year after their surgery. Not smoking, not high cholesterol, but an insidious mental illness that, like other mental illnesses, has serious physical repercussions.
"Cardiologists should know that they need to pay extra attention to depressed patients because they're at much greater risk, since these diseases interact with each other," Kaplin says.
But how do they know which patients are depressed? Often they don't, unless the patients tell them.
Kaplin has struggled to share his patients' information with the other doctors who care for them, but has found institutional reluctance to facilitate that kind of sharing, even with an electronic health record system available.
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Docs to walk data tightrope
Posted on Jul 02, 2013
By Zack McCartney, Contributing Writer
Healthcare, which has always been based on the doctor-patient interaction, is nearing the end of Stage 1 meaningful use, and as the industry increases its reliance on electronic health records, it faces a new challenge.
That conundrum, says Nick van Terheyden, MD, and CMIO at Nuance Communications, is how to reconcile the need for standardized structured data capture with the importance of narrative in patient-doctor interactions.
“When a patient walks into the office…they want the attention of the clinician and unfortunately what the process of data entry and data capture has done is defocus that interaction,” van Terheyden told Healthcare IT News.
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HL7 takes certification exams digital
Posted on Jul 01, 2013
By Bernie Monegain, Editor
Standards organization Health Level Seven International is now offering computer-based testing for its certification exams. HL7 certification provides the health information technology industry with a means to qualify that individuals have achieved a high level of proficiency within the standard tested, HL7 officials say.
The move expands exam delivery from paper and pencil tests at HL7-sponsored events to electronic testing at testing centers throughout the world. HL7 has members in 55 countries. In addition, individuals will have the option to choose online proctored testing, which allows them to use their own computer from anywhere in the world, as long as they have Internet access and an external webcam that meets minimum requirements.
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The other side of the bridge
Wales has its own health minister, health budget, NHS organisation and IT programmes. EHI news editor Rebecca Todd visited Bridgend to hear about the country’s primary care IT strategy.
28 June 2013
Wales faces all of the health challenges that are facing larger countries; and some particular challenges linked to its industrial legacy and rapidly ageing population.
In response, it has made some decisive splits from health policy in England. There is no purchaser/provider split and no competition between Wales’ seven health boards. Instead, they are expected to cooperate and collaborate.
In other ways, its vision of the future is very similar. Welsh policy makers want a joined-up service in which any clinician involved in a patient’s treatment can see relevant information about them at the point of care. And they see the implementation of good IT as essential to retaining a quality service for the public.
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NHS Wales rolls out hosted GP IT
1 July 2013 Rebecca Todd
NHS Wales has started rolling out a centrally hosted IT service to its GPs.
A new national framework contract for GP IT was agreed in mid-2012, with Emis and INPS named as the two successful suppliers.
The service is centrally hosted and the country’s 473 practices can choose which system to use.
The split so far is relatively even, with 257 practices choosing to take INPS’ Vision 360 and 210 to take Emis Web.
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SCR to be expanded
1 July 2013 Rebecca Todd
Patients’ end-of-life care information, immunisations, and significant past problems and procedures will be added to the NHS Summary Care Record.
New guidance released today by NHS England says its has commissioned the Health and Social Care Information Centre to add immunisations, significant past problems and procedures, end-of-life care information, and other patient preferences to the SCR.
‘Safer Hospitals, Safer Wards: Achieving an integrated digital care record’ describes the SCR is a “key building block” towards achieving an IDCR.
The SCR was one of the key projects of the old National Programme for IT in the NHS.
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NHS England introduces IDCR
1 July 2013 Rebecca Todd
NHS England has released guidance for trusts to achieve fully integrated digital care records across all care settings by 2018.
'Safer Hospitals Safer Wards: Achieving an integrated digital care record' “sets out the benefits case for adopting safe digital record keeping as a precursor to achieving integrated digital care records across the health and care system."
It also gives full details on how trusts can get their hands on some of the new, £260m Safer Hospitals, Safer Wards Technology Fund and sets a deadline of 31 July for expressions of interest.
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CSC: Teleservices expand patient engagement on many platforms
July 2, 2013 | By Ashley Gold
A new whitepaper published this month by Falls Church, Va.-based consulting firm CSC outlines the new scope of teleservices in healthcare by supplying definitions for what its authors call the four main areas of teleservice: telecare, telehealth, telecoaching and telemedicine.
The report defines telecare as the use of remote monitoring and assisted living technologies; telehealth as the use of health tracking tools; telecoaching as tools designed to facilitate self-management and patient education; and telemedicine as the delivery of real-time consultations with a clinician.
"The new generation of teleservices, however, does not merely overcome geographic barriers; it also break down barriers in data capture, workflow and communication, and enables patients to become closer partners in their own care," the report's authors say.
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HHS finalizes health IT safety plan
July 2, 2013 | By Susan D. Hall
The U.S. Department of Health and Human Services has released a final health IT safety plan to eliminate medical errors related to technology and better protect patients.
The plan further builds on recommendations from a 2011 Institute of Medicine report and from public comments, based on proposals released in December, according to an announcement.
It calls for shared responsibility within HHS and for significant participation from the private sector.
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AMA meeting: Guidance offered on effective EHR use
■ Physicians respond to worries that technology may be interfering with patient communication and is a barrier to sharing information with other facilities.
Chicago The American Medical Association House of Delegates has approved a policy that’s designed to help physicians navigate patient interactions while using computers and electronic health records during exams.
The policy, approved during the Annual Meeting in June, encourages physicians to incorporate questions while using electronic devices and to ask patients in satisfaction surveys about how they felt regarding the use of these devices during exams.
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Doctors Need More Training on How To Use EHRs During Patient Encounters
Monday, July 1, 2013
The use of electronic health records in the exam room need not harm the doctor-patient relationship if physicians use EHRs properly, according to a recent report from the American Medical Association Board of Trustees. But observers raise some serious questions about how EHRs may be changing doctor-patient interaction and about whether physicians are trained well enough to know what they're doing.
William Ventres -- an Oregon family physician who coauthored a Family Practice Management piece on the subject -- said that many physicians are too absorbed in their computers to pay adequate attention to their patients during office visits. A major reason for this, he said, is insufficient training.
"Most people starting out with EHRs get very little training on how to use them in terms of the doctor-patient relationship," he noted. "The computer is put down in front of them and they're told to 'use it.' And there are many different ways of using it, but people don't get that education."
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Q&A: Analytics-as-a-Service from Deloitte and Intermountain Healthcare
Scott Mace, for HealthLeaders Media , July 2, 2013
OutcomesMiner, a software application codeveloped by Deloitte and Intermountain, leverages 40 years of clinical data to help analysts glean the "clinical nuances" of comorbidities and various treatment outcomes. How does it work and who will use it?
Can healthcare's Big Data become less of a mountain to be sifted through by experts, and more like a utility to hook up, like water, power or cable TV? We're about to start finding out. Analytics applied to Big Data offers tantalizing possibilities for improved healthcare, but the complexity is enormous.
I spoke last week with Brett Davis, general manager of Deloitte Health Informatics (DHI), following the release of OutcomesMiner, a service that leverages 40 years of clinical data from Salt Lake City–based Intermountain Healthcare to help analysts throughout healthcare glean insights about the relationship between combinations of comorbidities and various treatment outcomes.
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ONC reports on EHR progress, pitfalls
Posted on Jun 28, 2013
By Anthony Brino, Associate Editor, Healthcare Payer News and Government Health IT
In its annual report to Congress, the Office of the National Coordinator for Health IT outlined some of its milestones and how it's trying to fix some barriers to main goals of the HITECH Act, chief among them nationwide digital exchange through interoperable EHRs.
Amid the health IT challenges ONC acknowledged in its report — costs, workflow and usability concerns for some physicians, and exchange limitations for some hospitals — the past year also saw some criticism of meaningful use, with six Republican Senators calling for a “reboot” of the program.
Notwithstanding those and other challenges (which might be dissected in depth during possible Congressional hearings this summer), ONC told Congress members that the stage is set for long-term progress.
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Hospitals annoyed by bad search info
Posted on Jul 01, 2013
By Mike Miliard, Managing Editor
Here's a question you may be surprised to hear many healthcare providers often find themselves asking: "Why can't people look up my hospital's name?"
That's Ed Bennett, director of Web and communications technology at The University of Maryland Medical System and all-around healthcare social media guru. He's voicing a common frustration for many of his colleagues across the industry: Google often offers incorrect contact information for hospitals. Its wrong search results can lead to inconvenience and – at least potentially – adverse health effects.
Worse, correcting the problem is a major challenge – for some large and complicated health networks, it's an expensive, ongoing, nearly full-time job.
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Digital health investment on the rise
Posted on Jul 01, 2013
By Bernie Monegain, Editor
Investment in mobile health technology grew by 12 percent over last year, according to a midyear report from startup accelerator Rock Health. Nearly $850 million has been invested in 90 different companies so far this year, and 25 percent more deals were made in 2013 compared with midyear 2012.
“While not growing as fast as software (which is up 38 percent in Q1 2013 versus the prior year quarter), digital health has been outpacing traditional healthcare, where investments have dropped precipitously. Medical device funding is down 29 percent, and biotech is down 2 percent in the first quarter,” Rock Health cofounder and CEO Halle Tecco reports.
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NHS urged to use IT safety standards
19 June 2013 Kim Thomas
Trusts should adhere to patient safety standards when implementing new IT systems, a patient safety expert has argued.
Maureen Baker, clinical director of patient safety at the Health and Social Care Information Centre, told last week's UKRC that although the last 20 years had seen an increasing awareness of the importance of patient safety, there was still much to be done.
In the US, for example, an estimated 98,000 people a year die from medical errors occurring in hospital.
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Torrid rate of investment in digital health cools
July 1, 2013 | By Susan D. Hall
Investment in digital health startups is growing, but not at the same torrid pace as a year ago, according to a mid-year report from startup accelerator Rock Health.
Digital health startups attracted $849 million in the first half of the year, up 12 percent over the same period a year ago. However, the growth rate during the first six months of last year was 73 percent.
Nearly half the funding focused on remote patient monitoring, analytics and big data, hospital administration and electronic health records.
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Study: Patients' Internet use a predictor for participation in their own care
July 1, 2013 | By Dan Bowman
Patients who use the Internet more frequently are more likely to embrace patient-centered healthcare efforts and participate in their own care, according to a study published this week in the Journal of Medical Internet Research.
For the study, researchers from the University of Texas at Austin, the University of Florida and the University of Maryland examined Internet use patterns of 438 people.
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EHR Adoption in Ambulatory Settings Uneven Across US
June 28, 2013
Adoption rates for electronic health records at ambulatory healthcare sites vary significantly across different regions of the United States, according to a study in Health Services Research.
Researchers extrapolated the average adoption rates for ambulatory centers in local areas from targeted site studies and examined the association between EHR adoption and community characteristics, including population and average income.
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Enjoy!
David.
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