Quote Of The Year

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


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

Saturday, September 28, 2013

Weekly Overseas Health IT Links - 28th September, 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.

Google starts new health company to tackle aging

Alistair Barr, USA TODAY 6:21 p.m. EDT September 18, 2013

Calico, a new company backed by Google, may use powerful data crunching to tackle age-related illness and disease.

Story Highlights

  • Calico counts Google and Apple Chairman Levinson as investors
  • Calico may use powerful data-crunching to tackle age-related diseases
  • Calico is the latest project that takes Google far from Internet roots
  • Google chief Page says tech can improve lives in many different ways
SAN FRANCISCO — Google is not happy just organizing the world's information. The Internet search giant wants to help you live longer now too.
Google unveiled Calico Wednesday, a new health technology business focused on aging and related diseases.
It will be run as a separate company and operated independently, however, Google is an investor alongside Arthur Levinson, the chairman of Apple and biotech company Genentech, who will be Calico's CEO.

EHRs Are Not A 'Digital Menace'

Healthcare IT can compromise patient safety, but studies show that lack of it may present an even greater risk.
"The lottery is a tax on people who don't understand mathematics."
It's one of my favorite truisms because it aptly describes the magical thinking that so many people buy into about their chances of winning that $100 million jackpot, despite the fact that a person is more likely to get hit by lightning on his birthday.
This truism also applies to misconceptions about lots of other probabilities -- like the risk of developing a serious reaction to the measles vaccine versus the benefits of averting a life-threatening measles epidemic. Or the risk of getting the wrong medication due to an EHR glitch versus the benefits that come from replacing paper with digital files. Those benefits include better care coordination, zero risk of misreading physicians' illegible handwriting, and monitoring of drug/drug and drug/food interactions.
Probability is not one of our strong suits as a nation, and unfortunately that weakness plays into the mass media's tendency to run scary headlines that talk about the "digital menace."
A recent Bloomberg article, "Digital Health Records' Risks Emerge as Deaths Blamed on Systems", illustrates my point. The piece starts out describing the case of an 84-year-old woman who was rushed to the hospital for a suspected stroke and eventually died because, says her physician son Scot Silverstein, one of the drugs she needed had inadvertently dropped off the medication list in the hospital's EHR system.

Do Physicians Spend Too Much Time With Computers?

SEP 17, 2013 9:35am ET
A recent study of work hours of medical interns in the new era of duty hour regulations produced an interesting side finding, which is that modern medical interns spend about 40% of their time at a computer [1]. To some, this prompted concern that computers were drawing medical trainees away from patients and their care.
A finding like this certainly warrants attention. However, I wonder whether many expressing concern are asking the wrong question. The proper question is not whether this is too much time at a computer, but rather if this amount of time compromises the interns' care of their patients or of their learning experience.
Implicit among those who raise the question of too much time with computers is the assumption that computers are taking physicians away from patients. It is instructive, however, to consider historic data of how much time physicians spend in direct vs. indirect care of patients. It turns out that physicians have historically spent most of their working time in activities other than in the presence of their patients.

ONC: HIE governance framework puts emphasis on trust

September 18, 2013 | By Marla Durben Hirsch
The different business models for health information exchange governance are taking shape, and make "trust" a priority, according to the Office of the National Coordinator for Health IT's latest update on its continuing efforts to support HIE.
The update by ONC officials and others, conducted via a webinar hosted by the National eHealth Collaborative (NeHC) on Sept. 17, noted that ONC heard "loud and clear" from responses to its request for information (RFI) on the subject that stakeholders wanted the government to wait before taking a regulatory approach to HIE governance. ONC instead focused on creating a National HIE Governance Forum where stakeholders could partner with one another and with ONC to identify and share emerging and promising approaches and challenges in a collaborative environment.
The forum is the "heart of our response" to the RFI, said Jodi Daniel, director of ONC's office of policy and planning.

ONC is 'not going to retreat,' post MU

Posted on Sep 19, 2013
By Anthony Brino, Editor, HIEWatch
You'd be justified in wondering whether the Office of the National Coordinator might soon see its influence wane, what with EHR adoption having reached critical mass and meaningful use incentive funding dwindling toward the halfway point. But you'd be wrong, says Farzad Mostashari, MD.
Mostashari, the outgoing national coordinator, is adamant the agency’s policy and technical services will continue to be in high demand and continue to work to address the IT challenges and opportunities in healthcare.
The need for the ONC’s work on policy development and coordination with other agencies "is only going to grow, as there’s more and more health information in digital format, and as the flow of that information becomes more important for quality measurement, privacy and security," Mostashari said during an interview this week.

A better approach to clinical decision support?

September 19, 2013 | By Susan D. Hall
Differential diagnostic decision support tools generally are built to identify a single correct diagnosis, while focusing instead on the value of information they provide might better achieve the goals of shared-decision making to improve care and cut costs, according to a BMC Medical Informatics & Decision Making article.
In a scenario in which a 64-year-old man comes to the emergency department with acute chest pain, a tool would be most useful in paring the potentially hundreds of diagnoses to a subgroup with clear paths of action. These actions would aim to decrease morbidity and mortality, while lack of action would increase these. Such clear-cut paths, however, might include diagnostic errors of omission, according to the article.

5 elements to achieving health IT interoperability

September 19, 2013 | By Julie Bird
The Office of the National Coordinator for Health IT (ONC) has released what it calls a path to achieving interoperability among different electronic health record (EHR) systems.
In a blog post Wednesday, David Muntz (pictured), principal deputy and Nora Super, public affairs director, outline five elements critical to achieving health IT interoperability. They are:
1.       Adoption and optimization of EHRs and health information exchange (HIE) services
2.       Standards to support implementation and certification
3.       Financial and clinical incentives
4.       Privacy and security
5.       Rules of engagement or governance

Most hospitals have tools to meet Meaningful Use Stage 2 now

September 19, 2013 | By Dan Bowman
More than two-thirds of U.S. hospitals have bought technology from a vendor certified to the 2014 Edition certification criteria, according to a newly published report from HIMSS Analytics, meaning that many hospitals already have the tools they need to meet Meaningful Use Stage 2 at their disposal.
The report, which used data from 418 hospitals collected through the first six months of 2013, also found that 70 percent of respondents are "actively moving toward meeting Meaningful Use Stage 2" mandates, while 60 percent have met the requirements for at least nine core metrics in Stage 2.
"Despite low current readiness rates to achieve metrics such as providing patient electronic access, providing summary of care records for all transitions/referrals and the use of clinical decision support technology to improve performance on high-priority health conditions, there is substantial activity planned for the future," the report's authors wrote. "These results suggest that the industry is moving forward toward Stage 2 Meaningful Use and hospitals will be ready to begin attesting in 2014."

Abandoned NHS IT system has cost £10bn so far

Bill for abortive plan, described as 'the biggest IT failure ever seen', was originally estimated to be £6.4bn
An abandoned NHS patient record system has so far cost the taxpayer nearly £10bn, with the final bill for what would have been the world's largest civilian computer system likely to be several hundreds of millions of pounds higher, according a highly critical report from parliament's public spending watchdog.
MPs on the public accounts committee said final costs are expected to increase beyond the existing £9.8bn because new regional IT systems for the NHS, introduced to replace the National Programme for IT, are also being poorly managed and are riven with their own contractual wrangles.
When the original plan was abandoned the total bill was expected to be £6.4bn.

Report Ranks EHR Vendors’ Patient Portals

SEP 17, 2013 3:30pm ET
A new report from vendor research firm KLAS Enterprises assesses the patient portal capabilities of multiple electronic health records vendors to adequately support Stage 2 meaningful use criteria for patient engagement.
Information in the report comes from KLAS interviews with more than 200 providers with patient portals and focuses on nine vendors: Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway, Intuit Health, NextGen and Vitera. In general, providers are finding portals from EHR vendors to be better equipped than those from third-party vendors.

EHI interview: Neil Jordan

Lyn Whitfield talks to the general manager of health for Microsoft worldwide public sector about the health service’s looming XP problem and the company’s evolving role in healthcare.
17 September 2013
It’s eight years since Neil Jordan left for the US after being promoted from UK head of healthcare to global head of healthcare by Microsoft. In that time, a lot has changed for both the healthcare IT market and the company.
Back in May 2005, in the week that Jordan’s promotion was announced, the National Programme for IT was able to reveal that it had met its target of establishing 6,000 live connections to the new national network, N3.
It still had all five of its local service providers in place, and had big plans for national programmes such as Choose and Book (which, it was suggesting, might be able to offer patients appointment reminders – by text!)
Microsoft had just extended is Enterprise-wide Agreement with the health service, covering server, desktop and Office software licences for around 900,000 staff.
And in return, NHS Connecting for Health had secured the company’s backing for projects such as the ‘common user interface’ that it hoped to see adopted by all clinical application vendors.

Eight in ten NHS desktops still on XP

18 September 2013   EHI staff
Microsoft’s decision to end support for Windows XP in April next year looks set to cause significant problems for the NHS, which still has 85% of its desktops running on the obsolete operating system.
The scale of the XP challenge is revealed today in a report from EHI’s research arm, EHI Intelligence, which calculates that there are 677,000 computers across the health service that work on the OS, which was launched in October 2001.
By contrast, just 14% of the computers covered by the research (or 110,000) are running the Windows 7 OS that Microsoft introduced in October 2009, and just 1% (10,600) are using the newer Windows 8.

5 ways to link health information technology, quality measurement

September 18, 2013 | By Susan D. Hall
A new report from the Agency for Healthcare Research and Quality (AHRQ) summarizes the comments it received on its July 2012 request for information and from focus groups on how to enhance quality measurement through health information technology.
The 111-page report breaks the input down into three types of findings: "Perspectives" notes that different stakeholders have different views, and their opinions might vary in different situations. The perspectives section focus on linking quality measurement with systemic improvement, maximizing the capabilities of health IT, and understanding the tradeoffs involved in incorporating measurement with workflow. "Pathways" outlines critical topic areas to be addressed. "Practical guidance" outlines more than 100 practical steps organizations can take.

Docs optimistic HIT can improve care, but doubt promised cost savings

September 18, 2013 | By Julie Bird
Most physicians think health IT will improve quality of care long-term, but just as many are skeptical that it will also reduce the cost of care, according to a new study by the Deloitte Center for Health Solutions.
Doctors who have practiced 10 years or fewer are more likely to think health IT will improve quality of care--81 percent, compared with 73 percent overall.
Optimism about improvements in quality of care also is higher among physicians in larger practices--80 percent for those in practices of 10 or more physicians, compared with 73 percent for those in smaller practices.
When it comes to cost reduction, 81 percent of solo practitioners think health IT will increase costs, compared with 71 percent among all physicians queried.

Under Pressure

SEP 1, 2013
For health care finance executives, the adage "no money, no mission," has never been more apropos, as they face both dwindling reimbursements and payments increasingly tied to outcomes.
But another adage, "If you've seen one hospital, you've seen one hospital," also applies.
Delivery organizations vary widely by payer mix, local demographics, physician relations and even local I.T. talent available.
What follows are snapshots of how CFOs and senior level finance executives are using I.T. to streamline their financial organizations-and the tools they're considering to meet their future needs.

Top 5 security threats to the HIX hub

By Yo Delmar, Vice president, GRC Solutions at MetricStream
The vast amount of consolidated sensitive information passing through health information exchanges is unprecedented, and will introduce privacy and technology risks that HIX stakeholders need to be vigilant in addressing.
Questions arise as to who will have access to this information, how secure will it be from cyberattacks, and what training and clearances will be required to access and protect the data from fraud and abuse.
In many ways, the HIX will form part of what we have come to consider “critical digital infrastructure.” Critical infrastructure, which houses and processes sensitive and potentially valuable information, attracts threat agents, and is vulnerable to a wide range of security threats. So, a sophisticated attack, which seriously disrupts the HIX for a prolonged period across a wide geographic area, could devastate the health services ecosystem.

EMIS buys Ascribe for £57.5m

13 September 2013   Jon Hoeksma
Primary care systems supplier EMIS has purchased clinical software supplier Ascribe for £57.5m.
The purchase of Ascribe, a pharmacy and e-prescribing software specialist, is by far the largest acquisition yet made by AIM–listed EMIS.
The deal will significantly strengthen the position of EMIS in the increasingly competitive NHS clinical software market for hospital, community and mental health systems.
Chris Spencer, chief executive officer of EMIS Group, said in a statement: “The acquisition of Ascribe represents a significant milestone in our stated strategy of providing clinically led, integrated cross-organisational healthcare systems.

HHS launches site to help providers engage patients

September 17, 2013 | By Dan Bowman
The U.S. Department of Health & Human Services this morning launched a new website aimed at aiding providers in their efforts to engage patients in determining the best way to share their electronic information.
The site, called the Meaningful Consent site, provides "strategies and tools" to providers, including background information and lessons learned by other providers. It is based on 2011 recommendations made by the Office of the National Coordinator for Health IT's HIT Policy Committee.
"As patients become more engaged in their healthcare, it's vitally important that they understand more about various aspects of their choices when it relates to sharing their health in the electronic health information exchange environment," Joy Pritts, chief privacy officer at ONC, said in a statement.

ONC launches eHealth resource site

Posted on Sep 18, 2013
By Erin McCann, Associate Editor
For healthcare providers and organizations looking to brush up on laws and policies surrounding electronic health information exchange, or wanting some tips on patient eConsent engagement, look no further.
The U.S. Department of Health and Human Services on Wednesday launched a meaningful consent online resource to help providers effectively engage patients in choosing how they want their electronic patient health information shared.  
The site addresses laws, policies and issues related to health information exchange, and includes strategies and tools that can be used to spur patient engagement and further educate patients, officials said. 
September 16, 2013, 9:45 p.m. ET

Patients Share DNA for Cures

Patients with rare and deadly diseases are getting a powerful new boost.
Cancer foundations and other nonprofit patient groups are investing tens of millions of dollars to build genetic databases in an effort to speed drug development and jumpstart clinical trials.
The databases are designed to collect DNA and other information from patients with hard-to-treat diseases. The material can be analyzed for certain genetic mutations and made available to scholars and pharmaceutical companies.
The databases could also help patients familiar with their own genetic mutations to find information about clinical trials.
On Tuesday, the Leukemia & Lymphoma Society is set to announce a three-year, $8.2 million project that combines the resources of the Oregon Health Sciences University, gene-sequencing company Illumina Inc., and Intel Corp. Funded by the society, the resulting database will contain DNA information and analysis gathered from 900 patients with acute myeloid leukemia.

Survey: 41% of Patients Would Switch Physicians to Gain Online Access to EMRs

Written by Helen Gregg (Twitter | Google+)  | September 16, 2013
More than 40 percent of Americans would be willing to switch physicians to be able to access their electronic medical records online, according to a recent survey by Accenture.
The survey, featuring the results of 1,000 respondents from across the country collected in July, also found 84 percent of consumers believe they should have full access to their medical records, though 63 percent currently have limited access.

ONC Names Blue Button Plus Contest Winners

September 16, 2013
The Office for the National Coordinator (ONC) has announced the winners of its Blue Button Co-Design Challenge this week at the Consumer Health IT Summit, which is a daylong event held during the annual Health IT Week.
The contest asked developers to create apps that implement and use Blue Button Plus functionality to address one of several patient problems. The winning team was GenieMD, an app that provides users with a variety of patient services including symptom checking, finding providers and pharmacies, and alerts for drug interactions through what ONC calls is an “intuitive, easy-to-use interface.”
It also combined data from multiple providers through Blue Button +, including patient-entered data, data from smart devices, and content provided by Harvard Health Publications.

Patients Define Evolving Expectations for HIT

Scott Mace, for HealthLeaders Media , September 17, 2013

If providers keep up with the tools available to patients, and turn yesterday's one-page brochure on a disease into tomorrow's Web site or mobile app, they will continue to be at the center of patient care.

What's the value of health information technology?
That's the question being asked during this week, National Health IT Week, organized by the Healthcare Information and Management Systems Society (HIMSS).
Certainly health IT has been very good to the members of HIMSS. The billions in Medicare incentive money paid out to providers in the past several years have enriched participating health IT vendors in a way that few portions of the IT industry have been able to enjoy, even considering the dot-com boom and the Y2K scare.
In Verona, WI this week, attendees of Epic's annual user conference are marveling at the company's brand new conference center, which holds 13,000 people. That's one big corporate conference center.

The Building Blocks of an HIT Strategy

A comprehensive strategy can help providers promote adoption of health information technology and capture the benefits.
The adoption of health information technology (HIT) in its many forms—including electronic health records (EHRs), tools that assist in decision-making and patient interactions, and mobile technology—remains a work in progress. A recent Deloitte survey found that while many physicians recognize that HIT can improve the quality of care, they also remain unconvinced that it will reduce costs. Many smaller practices and older physicians in particular aren’t transitioning to EHRs. What’s more, many physicians have yet to fully utilize support tools and mobile devices that are intended to enhance patient service.
The stakes are high for providers that can lead the way in promoting HIT adoption. HIT has the potential to improve safety and outcomes, increase accuracy in diagnosing medical problems, and reduce administrative costs. HIT can also be critical to reaping the benefits of performance-based incentives used by Medicare and private plans to encourage effective care coordination and technology-enabled patient interaction and paperwork reduction.

Wireless health market poised for growth

Posted on Sep 16, 2013
By Erin McCann, Associate Editor
The global wireless health market has hit growth mode, according to new report findings, which project the market will expand more than 20 percent within a five-year period. 
The report, conducted by Research and Markets, pegs the wireless health market currently at $23.8 billion, expected to reach $59.7 billion by 2018, the growth being attributed to the uptick in remote patient monitoring applications and diagnostics, aging populations and growing hospital deficits. 
Wireless network technologies represent the largest market segment and will continue to be the largest contributor over the next five years, researchers say. 
The mobile devices and mobile apps segment, however, is also growing rapidly and will continue to grow at a similar pace over the next few years due to its wide applications and increased adoption by various healthcare professionals, pharmaceutical companies and research laboratories.

Consumers get serious about their EMRs

Posted on Sep 16, 2013
By Bernie Monegain, Editor
As patient engagement grows, a new survey indicates that a growing number of U.S. consumers (41 percent) would be willing to switch doctors to gain online access to their own electronic medical records. Doctors, though, are not as eager to make the change.
The survey, of more than 9,000 people in nine countries, shows that only about a third of U.S. consumers (36 percent) currently have full access to their EMR, but more than half (57 percent) have taken ownership of their record by self-tracking their personal health information, including their health history (37 percent), physical activity (34 percent) and health indicators (33 percent), such as blood pressure and weight.

Mental-health help goes online

Mystrength.com is there to help those who can’t wait to see a therapist

Sep 13, 2013, 4:00am MDT
Reporter- Denver Business Journal
The digital revolution let people with physical ailments visit websites such as WebMD and diagnose their own conditions for the past 10 years. But Scott Cousino saw what it couldn’t do — help Americans with mental-health ailments aid themselves without a therapist.
In 2010, Cousino — an online-education professional who had overcome a bout of severe depression in his 20s — began working on myStrength.com. The website provides mental-health checks, affirmations and other supplemental help to people whose therapists aren’t available.
Three years later, eight community behavioral-health networks in Colorado use the website, it’s expanded to six other states and officials from the National Council for Community Behavioral Healthcare have created an exclusive relationship with the Denver company to advance the use of technology as a mental-health treatment extender.

Mostashari launches National Health IT Week with a question: Is the time now?

Posted on Sep 17, 2013
By Diana Manos, Senior Editor
Farzad Mostashari, National Coordinator for Health Information Technology, kicked off this year’s National Health IT Week at a meeting Monday focused on the patient’s role in health IT.
In a meeting that brought together a host of federal officials and stakeholders, Mostashari asked: “Is the time now?”
“There’s a glorious band of misfits here today who saw the world of health and healthcare and said, `we don’t fit. We need to change what’s happening here,’” said Mostashari. “Is it time for this movement to move beyond us misfits to the broader world of health? Do we have new tools and approaches? Do we have the oxygen for those new tools and information and data that will be available? Will providers be supportive, will patients even know to ask or to care?”
Dave deBronkart, often called “e-patient Dave,” co–founder and board member for the Society for Participatory Medicine -- what he called “a rag-tag band of activists” -- argued that the largest yet the most neglected resource in the world is the patient.

Mostashari Reflects on Tenure at ONC

by Kate Ackerman, iHealthBeat Editor in Chief
Monday, September 16, 2013
After four years at the Office of the National Coordinator for IT and two years serving as the country's health IT czar, Farzad Mostashari announced last month that he would step down from his post this fall.
As the country's fourth national coordinator for health IT, Mostashari became well known for his trademark bow tie and contagious enthusiasm for all things health IT.
Among other things, his legacy includes helping to spearhead the meaningful use incentive program, promoting the use of data to improve health care and stepping up federal efforts to boost patient engagement.
As his last day at ONC quickly approaches, iHealthBeat caught up with Mostashari to ask him to reflect on his work at ONC, discuss what qualities his successor should have and comment on his future plans.

Mostashari on Why He’s Leaving, What He’ll Remember

SEP 19, 2013 4:45pm ET
Being honored at a dinner that ended the 12th Annual HIMSS Policy Summit in Washington on Sept. 18, Dr. Farzad Mostashari finally explained why he is leaving as national coordinator for health information technology on October 5. Looking toward his wife, he said, “I listened to my heart and there she is standing in the front row.”
He’s also worried that his daughter, 11 years old now, will be 14 when the Obama Administration ends and won’t want to hang around her father. Asked what his next career step is, Mostashari said, “I honest-to-goodness do not know what I’m going to be doing in my career.” He figures taking a day or two off after Oct. 5 and then start beating the bushes and finding out what opportunities are available.

Has the cloud found its moment?

Posted on Sep 20, 2013
By Mike Miliard, Managing Editor
Long looked upon warily by healthcare security experts, cloud technology could soon find more favor as new rules bring clarity and assign responsibility for privacy protections.
That's one of the conclusions from a recent study conducted by Porter Research and sponsored by Covisint. The report, "Healthcare Industry Reaches Tipping Point: CIOs Now Demand the Cloud for Shared Savings and Interoperability," finds increasing confidence in the cloud among healthcare decision-makers, due in large part to the new specifications of the HIPAA Omnibus rule.
"For a long time, the cloud was untrusted on multiple levels -- people weren’t familiar with it, they were afraid of the security aspect and, simply stated, it just wasn’t the safe career choice -- in other words, nobody got fired for not choosing the cloud in the past," says Covisint's Chief Medical Information Officer John Haughton, MD.


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