Quote Of The Year

Timeless Quotes - Sadly The Late 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, October 26, 2013

Weekly Overseas Health IT Links - 27th October, 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.

CHOP Researchers Introduce Data Navigation Tool

October 17, 2013
A team of informatics experts and biomedical researchers at The Children's Hospital of Philadelphia (CHOP) have created a software toolkit that aims to help researchers navigate different forms of data.
The software toolkit, called Harvest, is an open-source, interactive framework that helps users navigate quickly among different types and levels of healthcare data from individual patient records to aggregated reports of all patients in a database. The software allows users to query data by different subjects, such as age or ethnicity, individual blood test results or MRIs, or including or excluding specific diagnoses.

Toolkit designed to make biomedical data exploration easier

October 18, 2013 | By Susan D. Hall
Researchers have developed an open-source platform for creating software applications that make complex data understandable and accessible to those without sophisticated informatics expertise.
Commercial analytics tools tend to require biomedical researchers to understand underlying data models before being able to effectively explore and use large data sets, according to an article at the Journal of the American Informatics Association.
Researchers at the Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania have validated the platform, called Harvest, on two test cases: pediatric cardiology diagnostic and procedure data, and infectious disease data published by the OpenMRS open-source electronic health record (EHR) project.

EHRs can integrate genomic information to improve patient care

October 14, 2013 | By Marla Durben Hirsch
Electronic health records can help accelerate and advance the use of genomic medicine, as demonstrated in several articles published in a special issue of Genetics in Medicine, the official journal of the American College of Medical Genetics and Genomics.
The publication, meant as a "getting started" guide for the integration of genomic information and EHRs, includes a series of articles written mostly by members of the National Human Genome Research Institute-sponsored Electronic Medical Records and Genomics (eMERGE) Network, a federally funded consortium of nine institutions that have pioneered the use of EHRs. The authors note that these advances cannot be accomplished without the use of EHRs.

Big opportunities, still, for IT vendors

Posted on Oct 17, 2013
By Mike Miliard, Managing Editor
The healthcare market, especially health IT, remains "highly fragmented," with lots of openings for entrepreneurs who can solve providers' "pain points," according to the latest trend report from Berkery Noyes.
The report analyzes merger and acquisition activity for the healthcare sector during the first three quarters of 2013 and compares it with data from 2012. This market includes information and technology companies servicing the pharmaceutical, healthcare payer, and healthcare provider spaces.
"The healthcare market remains highly fragmented, with lots of opportunities for entrepreneurs with unique ideas looking to start companies that solve important pain points along the healthcare continuum," said Tom O'Connor, managing director at Berkery Noyes, in a press statement. "Large strategic buyers are also looking to acquire unique content/software solutions that are solving challenges in the healthcare market and are growing rapidly, offering exit opportunities for entrepreneurs at very attractive prices."

£1m national leaflet drop on care.data

16 October 2013   Rebecca Todd
The government will spend £1m sending a patient information leaflet about the controversial care.data programme to every household in England.
As part of a joint £2m public awareness campaign being run by NHS England and the Health and Social Care Information Centre, 22m homes will receive the leaflet in January and extractions will begin in spring next year.
The total cost includes around £800,000 in funding for a helpline to answer people’s questions about the scheme, to help take the pressure off GP practices.
The A5 leaflet will not be addressed to anybody in the household, but will clearly indicate that it is from the NHS and explain how people can opt-out of their data being extracted.

Report: Feds must make security less burdensome for workers

October 17, 2013 | By Susan D. Hall
Though insiders say federal agencies such as the U.S. Department of Health & Human Services and the Department of Veterans Affairs are vulnerable to cybersecurity threats, federal employees report bypassing burdensome security measures when those measures interfere with their work.
Federal security pros often fail to take user experience into account when implementing security measures, according to a new report by public-private partnership MeriTalk and underwritten by Akamai Technologies. The report urges federal security pros to work together with federal employees to ease their particular pain points while tightening security, according to an announcement.

Sharp HealthCare Rises to the Challenges Posed by This Digital Age

by Fred Bazzoli Thursday, October 17, 2013
When Sharp HealthCare in San Diego flipped the switch to move to an electronic health record system about a dozen years ago, sorting out duplicate records and multiple patient identities was a big problem.
"When we first started the department in 2001, we were creating 18 duplicates a day across the whole system," said Tommy Egbert, supervisor of Sharp's master patient index department. "Now, we're doing about four duplications a month, so it's had a huge impact."
In addition to gaining experience over the years, Sharp has added patient identification technology, such as palm vein recognition biometrics, to avoid mix-ups with patient identities and records. Because of its efforts to keep duplications out of its records, it's been able to accurately share patient information within the system, increasing patient safety and reducing unnecessary services, thus saving money.

The Case for Computer-Based Health Care

By Darius Tahir
October 16, 2013
The victory of Watson, an artificial-intelligence system designed to dominate the quiz show Jeopardy!, over the country's best nerds in 2011 may not be the equal of John Henry struggling against a steam-powered drill in the annals of man versus machine. But the replacement of Jeopardy!'s human competitors with a computer algorithm may signal a trend that could soon spread through the health care sector as Obamacare is implemented.
That's the prophecy of venture capitalist Vinod Khosla. Khosla, a prominent Silicon Valley investor, has predicted that computers will replace 80 percent of what doctors do in a couple of decades. The shift could counter another health-sector trend: stagnant productivity, which the Affordable Care Act aims to address with financial incentives for effective, efficient care, and which could encourage a move toward digital doctoring.
Between 1990 and 2010, productivity in the health care sector declined by 0.6 percent annually as employment increased by 2.9 percent, according to Robert Kocher, now a venture capitalist at Venrock, in an October 2011 editorial in the New England Journal of Medicine. Increasing productivity might bridge this disconnect, and computers could be part of the solution.

Lack of encryption brings breach blunder

Posted on Oct 16, 2013
By Erin McCann, Associate Editor
Device encryption may seem like a fairly straight forward undertaking, but it's proven one which HIPAA-covered entities and business associates frequently forgo -- much to their chagrin down the road when they're notifying individuals of a privacy breach involving unencrypted personal data. 
Legal Aid Society of San Mateo, Calif. is now seeing this firsthand. The public interest law firm recently notified 3,200 clients that their protected health information was compromised after 10 unencrypted laptops containing clients' Social Security numbers, medical data, names and dates of birth were reported stolen. 
"We are sorry that this incident occurred and want to assure you we are carefully reviewing our procedures and practices to minimize the risk of recurrence," wrote LASSM Executive Director M. Stacey Hawver, in an Oct. 10 letter mailed out to affected clients. 

Two Watson-based tools offer docs real-time analysis

October 16, 2013 | By Susan D. Hall
Scientists have trained IBM's "Jeopardy!" champ Watson to interact more naturally with doctors in two new projects aimed at improving patient care.
The work is a collaboration between IBM Research and the Cleveland Clinic along with Lerner College of Medicine of Case Western Reserve University.
WatsonPaths aims to help doctors diagnose patients and solve medical problems. To do so, it can understand spoken language and can consult reams of medical research in an instant, reports Crain's Cleveland Business.

Cleveland Clinic, IBM Making Progress on Watson Supercomputer

OCT 15, 2013 3:14pm ET
A year after starting work with IBM to develop ways for the Watson supercomputer to support medical training and serve as a doctor’s assistant, the Cleveland Clinic has issued a progress report that includes two new technologies.
The clinic and IBM have developed WatsonPaths, a new process to train the supercomputer to interact with clinicians in a way that is more natural, enabling them to understand the data sources that Watson consulted and how it made recommendations.

Watson joins the fight against cancer

Posted on Oct 18, 2013
By Mike Miliard, Managing Editor
First he won on Jeopardy!, now he's going to try to beat leukemia. The University of Texas MD Anderson Cancer Center announced Friday that it will deploy Watson, IBM's famed cognitive computing system, to help eradicate cancer.
The two organizations will leverage Watson's computing power to help clinicians uncover insights from MD Anderson's vast patient and research databases, officials say. After a yearlong collaboration, the two will showcase a prototype of MD Anderson's Oncology Expert Advisor, powered by Watson.
That technology seeks to integrate the knowledge of MD Anderson's clinicians and researchers, and to advance the cancer center's goal of treating patients with the most effective, safe and evidence-based standard of care available, say officials. Starting with the fight against leukemia, the Oncology Expert Advisor aims to help clinicians develop and fine-tune treatment plans for patients, while helping them recognize adverse events that may occur throughout the care continuum.

Hurdles to big data use in healthcare more social than technical

October 16, 2013 | By Ashley Gold
Are the real hurdles to using big data in healthcare social and not technical? A report authored by Gina Neff, a professor in the department of communication at the University of Washington in Seattle argues just that, saying that big data won't cure us because although data-intensive modeling has immense potential, figuring out how to use it is a bigger challenge.
"The ways in which health technology innovators have talked about the power of data neglects key aspects of the social interoperability or integration of data into health solutions," Neff's report says. "How will such data be integrated into care providers work practices; through the complex routines of clinics and hospitals; and into existing legal, social, political and economic frameworks?"

Big Ideas From The Forbes Healthcare Summit

Todd Hixon, Contributor
The Forbes Healthcare Summit in New York last week brought together very senior people across the U.S. healthcare spectrum: CEOs of big insurance companies, R&D heads of top pharma companies, CEOs of major medical centers, and CEOs of a few of the key upstarts: AthenaHeath, ASAP Urgent Care, Rothman Institute, MinuteClinic, etc. Here’s a summary of the big ideas that emerged.
No One Thinks Health Reform Is Going Away. Regardless of the drama in Washington, health reform is going ahead, and the major institutions are working to adapt to it. Beyond the ACA* the big driver for this is patient empowerment, which was the theme of the conference. Patients are being forced to pay more of the cost of their care, and because of this plus social change, they are taking more control and demanding more information and service.

Is ONC more essential than shutdown reflects?

By Tom Sullivan, Editor
There is little debating that when HHS drafted its contingency blueprints for a government shutdown, the architects of that strategy had to make some very difficult decisions — literally gutting ONC among those.
“The fact is ONC’s work is very important and it does disappoint that they aren’t able to continue doing that,” former deputy principal director of ONC David Muntz said in an interview with Government Health IT after leaving the office for a new job. “Because ONC is focused on deployment of HIT, anything that might slow that down, I think, is unfortunate.”
Muntz was not alone in expressing such disappointment. And with meaningful use Stage 2 commencing on the same day much of the government closed down, not to mention the health insurance exchanges opening, the timing was, at best, ill-fated.

Study: EHRs a Big Factor in Influencing Physician Satisfaction

OCT 14, 2013 4:10pm ET
Physicians believing they provide or facilitate high-quality care have higher professional satisfaction and how they feel about their electronic health records system plays a big role in that satisfaction.
Those are the key findings in a new study from RAND Corporation, which conducted in-depth surveys with 220 clinicians and administrators in 30 practices across six states. The American Medical Association sponsored the study.
“In the practices we studied, physicians approved of EHRs in concept, describing better ability to remotely access patient information and improvements in quality of care,” report authors note. “Physicians, practice leaders and other staff also noted the potential of EHRs to further improve both patient care and professional satisfaction in the future, as EHR technology--especially user interfaces and health information exchange--improves.

Provider workflow suffers after poor EHR implementation process

October 16, 2013 | By Dan Bowman
While one intention of electronic health record implementation is to improve provider workflow, that was hardly the case for pair of southern California hospitals, Medscape Medical News reported.
In fact, EHR implementation had the exact opposite effect for residents at both Riverside County Regional Medical Center in Moreno, Calif., and Pomona Valley Hospital Medical Center in Pomona, Calif.; it increased the average time of residents for seeing patients and charting the visits from 21 minutes to 37 minutes.
"Some of us were really excited. We thought it would improve patient care," Maisara Rahman, M.D., who helps to train family-medicine residents at Riverside County, said during a talk at the American Academy of Family Physicians' annual meeting in San Diego in September, according to Medscape. "But when implementation started, we saw inefficiencies."

Advice to the next National Coordinator

Posted on Oct 10, 2013
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Over the next few months, Jacob Reider will serve as the interim National Coordinator for Healthcare IT while the search continues for Farzad Mostashari's permanent replacement.
What advice would I give to the next national coordinator?
David Blumenthal led ONC during a period of remarkable regulatory change and expanding budgets. He was the right person for the "regulatory era."
Farzad Mostashari led ONC during a period of implementation when resources peaked, grants were spent, and the industry ran marathons every day to keep up with the pace of change. He was the right person for the "implementation era."
The next coordinator will preside over the "consolidate our gains" era. Grants largely run out in January 2014. Budgets are likely to shrink because of sequestration and the impact of fiscal pressures (when the Federal government starts operating again).

CIOs push for patient ID progress

Posted on Oct 15, 2013
By Neil Versel, Contributing Writer
The patient identification issue refuses to go away, mainly because nobody has quite figured out how to assure proper patient identity when engaging in health information exchange. At the College of Healthcare Information Management Executives Fall CIO Forum in Phoenix last week, some leading hospital CIOs emphasized the operational, clinical and financial importance of accurate patient matching.
Joey Sudomir, senior vice president and CIO of Texas Health Partners – the healthcare management affiliate of Arlington, Texas-based Texas Health Resources – said it costs about $600 to $800 to remediate duplicate patient identities following hospital discharge.
The IT department at Sharp HealthCare in San Diego has 10 full-time-equivalent employees just to investigate and clean up duplicate records, at a cost of about $1 million a year, according to Senior VP and CIO Bill Spooner. Matching also goes on in other departments of the health system, so the overall price tag is probably significantly higher, Spooner said.

EHR, informatics, health IT jobs 2.5% of all healthcare hiring

Author Name Jennifer Bresnick   |   Date October 11, 2013  
It might not sound like much, but 2.5% of all healthcare jobs are directly related to EHR system implementations, informatics, and other health IT strategies, according to research published in Industrial Relations: A Journal of Economy and Society. Most of the 434,282 positions open between 2007 and 2011 are due to opportunities created by the HITECH Act, says Aaron Schwartz and colleagues, with 39% of job listings posted by healthcare providers themselves.
Implementation support was the most sought-after skill, with 43% of listings requiring system installation, purchasing, or workflow design responsibilities.  This is not in the least surprising when correlated with the first stage of the EHR Incentive Program and the mad rush for providers to switch from paper to electronic record keeping.  The HITECH Act was associated with an 86% increase in monthly job postings containing the phrases “electronic health record” or “clinical informatics,” Schwartz says.

Biometric Tools Edge Into Health Care

by John Moore, iHealthBeat Contributing Reporter Tuesday, October 15, 2013
The term "biometrics" refers to measuring human characteristics -- a central task of health care since the invention of the science.
Indeed, industry executives contend that biometrics aren't anything new in health care, noting that X-rays, computerized tomography scans and a host of other medical technologies all represent ways to measure the human body. What is new, however, is the use of biometric authentication in health care. This technology aims to use human traits such as fingerprints and iris patterns to validate identity. Biometric authentication is just beginning to play a role in health care, which some observers find surprising.
"Health care is a strange environment in the sense that on the clinical side of health care we probably have some of the ... world's best technology," said Paul Donfried, chief technology officer at LaserLock Technologies, a security technology vendor. "On the business side of health care, it is almost the opposite. We actually have some of the most antiquated IT systems and IT infrastructure you can find anywhere."

HIX, A Disaster Foretold, Needs Time

Scott Mace, for HealthLeaders Media , October 15, 2013

It would be easy to focus on the price of the federal government's health insurance marketplace and expect it to work better than some Web startup launched by a couple of heavily-caffeinated kids. But it wouldn't be fair.

No one ever said information technology was foolproof. Even the most advanced systems today have their glitches. Now we can add healthcare.gov to the list.
Last week, at the CHIME conference, my informal poll of healthcare CIOs found broad agreement that it's no surprise the federal health insurance exchange Web site, healthcare.gov, has been overwhelmed by the number of unexpected visitors and other basic flaws.
Here's one example of how bad it is: A New York Times researcher successfully registered, but despite "more than 40 attempts over the next 11 days," was reportedly unable to log into healthcare.gov.
"I know the government spends a lot of money on their contractors and Web sites, and I also know that it's very difficult for them to make changes because of the process the government may go through," said Pam McNutt, senior vice president and CIO of Methodist Health System in Dallas, TX.

Robot Surgery Damaging Patients Rises With Misleading Marketing

OCT 10, 2013 1:26pm ET
Porter Adventist Hospital in Denver announced last year that Warren Kortz, a general surgeon on the medical staff, was the first in the Rocky Mountain region to use a technique known as robotic surgery to remove gall bladders through one incision in the belly button.
The operation, performed while the doctor sits at a video- game-like console, was “taking advantage of another breakthrough in robotic surgery” and is “easier on the patient,” the hospital said in a press release.
“It’s Star Wars stuff,” Kortz was quoted as saying in another article put out by the hospital touting another operation, robot-assisted parathyroid surgery, in 2010. “My prediction is it will eventually replace everything else.”
What the hospital and Kortz didn’t reveal was the risk. Even as Kortz promoted robotic surgery, 10 patients he treated suffered injuries or complications between 2008 and 2011, according to an April complaint by the Colorado Medical Board. Five had arteries punctured or torn. Objects were temporarily left inside two, and others had nerve damage. One died and another needed cardiopulmonary resuscitation. The complaint charges Kortz with 14 counts of unprofessional conduct, including sometimes not advising patients on alternatives to the robot.

HIE shows cost savings in emergencies

Posted on Oct 14, 2013
By Mike Miliard, Managing Editor
Beyond improving the quality of emergency care, giving physicians access to data from a health information exchange saved nearly $2,000 per patient during a study unveiled Monday by the American College of Emergency Physicians.
The research tracked patient care over a 12-month period, starting February 2012, during which there were 325,740 patient encounters and 7,525 log-ons to the HIE by 231 eligible clinicians at 11 emergency departments in South Carolina, according to ACEP. The study was based on a sample of 532 patients from this population who had information available in the HIE and for whom the clinicians caring for the patients completed a survey.
"Nearly 90 percent of participants [89 percent] said that quality of patient care was improved, and 82 percent of participants said that valuable time was saved, reporting a mean time savings of 105 minutes per patient," according to study author Christine Carr, MD, of the Medical University of South Carolina, in a news release.

Empathy essential for patient engagement success

October 14, 2013 | By Susan D. Hall
Though technology can go a long way to help engage patients in their own health care, a little empathy can be an essential ingredient, according to an article published at CIO.com.
Wearable tech and medical devices, patient portals, personal health records and mobile apps hold the potential to improve care, but to do so, patients and physicians must use them and organizations must integrate them into traditional efforts to engage patients, the article says.

Health Insurance Exchanges Plagued By Data Errors

Health insurance exchanges, especially the one run by Uncle Sam, are having problems sending files that can be opened and that have complete information.
The unexpected volume of visitors that overwhelmed the federally operated health insurance exchange last week is only one of many problems confronting this entity and the state-based exchanges.
For starters, some insurance companies have received faulty enrollment data from the U.S.-run insurance exchange, according to insurance industry consultants interviewed by Bloomberg News. Either the plans have been unable to open files forwarded to them from the exchange or have found that the information on the enrollees is incomplete.
According to consultant Bob Laszewski, the plans are trying to fix the errors manually. Another consultant, Dan Schuyler, told Bloomberg that unless these problems are rectified in the next few weeks, some enrollees might not have coverage on Jan. 1, 2014.


1 comment:

Trevor3130 said...

It's too early to know if problems at launch of healthcare.gov will impede progress of HealthIT, but Clay Shirky is good.
"... a deputy CIO at Health and Human Services and one of the only people with a clear-eyed view of the problems, had understood what was happening, and not happening, by March this year; yet, his superiors are said to have downplayed his concerns."
People working on our NEHR need to understand how that (Shirky's observation) works if they have voiced concerns that have been downplayed, AND they wish to continue their careers AND they do not want the guilty to escape unpunished at a higher pay-grade.
It's no good saying "I told you so" well after the event, with nothing to back up the assertion. A notarised document attesting to the expressed but ignored warning, or a similarly verified recording will help to stand up your case in the public glare. Do not rely rely on recall. When events change, minds change, and it's a known fact that it may be impossible to reconstruct our own states of mind regarding an opinion held in the past. A hand-written note in a diary is better than nothing.
Many of the managers who have helped send a deeply flawed PCEHR on its way will have moved on to more rewarding positions. It'll be a pity if at least one of them can't be exposed to independent scrutiny.