Saturday, November 09, 2013

Weekly Overseas Health IT Links - 10th November, 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.

5 Scary Things About Healthcare Quality

Cheryl Clark, for HealthLeaders Media , October 31, 2013

Despite stringent hospital protocols and watchful government agencies, tragic preventable medical errors continue to severely harm or cause death to some 400,000 patients a year in this country.

Sometimes stories about medical harm are especially creepy and bizarre, especially when incidents that should by now have been made impossible happen anyway.
It gives me nightmares to think that despite the most diligent precautions by providers, wrong site surgeries, retained foreign objects and other tragic medical errors cause avoidable death to some 400,000 patients a year in this country. Still.

3 in 4 Patients Want E-mail Consultations with Doctors

Ryan Chiavetta , November 1, 2013

Patient demand for e-mail consultations with physicians is high, but willingness to pay is low. Physicians practices are finding they can accommodate the preference for e-mail by identifying suitable billing strategies.

Research reveals a large discrepancy between how parents say they would like to communicate with pediatricians and how they actually do communicate with doctors. Three quarters (77%) of parents said they would seek out email advice from their doctors, but only 6% said that they are actually able to communicate with their doctors this way, a study released by the C.S. Mott Children's Hospital National Poll on Children's Health has found.
How physicians practices are accommodating the growing patient demand for e-mail consultations involves settling on a reimbursement strategy that makes financial sense and resolving questions about patient privacy concerns.

Tapping the Telehealth Revolution for Advancing Health Care Reform

by Mario Gutierrez Friday, November 1, 2013
A fundamental goal of the Affordable Care Act is to achieve the greatest value for the health care resources spent while making lasting improvements in health. Telehealth can potentially make a valuable difference in achieving this goal, yet widespread adoption is greatly hindered by both policy and practice barriers. 
While telehealth is not new, dramatic improvements in the available communication technologies have made it more accessible than ever before. As such, we can no longer just talk about traditional "telemedicine" to describe the breadth of applications across the entire health care and public health spectrum. As health innovations advance, it will be essential for policymakers, private insurance payers and consumers to fully recognize telehealth's capacity to not only increase access to care, but also to make real improvements in both the quality and the efficiency of care. 

3 ways healthcare orgs use big data

November 1, 2013 | By Julie Bird
Big data isn't all talk and buzzwords--CIO magazine recently highlighted several real-life cases of healthcare organizations that are using big data analytics to improve outcomes and reduce costs in a slideshow. The cases bridge traditional analytics and big data pushes with "rapid, agile insight delivery" to the point of decision. 

Watson vs. Siri: A tale of David and Goliath?

November 1, 2013 | By Susan D. Hall
Will IBM's Watson or Apple's Siri do more to transform healthcare? Robert Pearl, M.D., in a post at Forbes, says it's important to consider the strengths and weaknesses of each, relating it to the theme of Malcolm Gladwell's new book, "David and Goliath."
It's easy to assume Watson would win, he says, but the biblical tale reminds us to consider all the conditions.

ICD-10 starts at clinical documentation

Posted on Nov 01, 2013
By Bernie Monegain, Editor
Physicians and other healthcare professionals will have to employ much more accurate and specific documentation of their care if ICD-10 coding is to work right, speakers asserted in an education sessions this week at the AHIMA Convention and Exhibit.
ICD-10, which takes effect Oct. 1, 2014, increases the number of diagnosis and procedure codes from about 13,000 to more than 141,000. The idea is to provide much more granular detail on patient care.
"Clinical documentation impacts both the quality of care and reimbursement and bringing physicians up-to-speed about the level of granularity included in ICD-10 is one of our most important jobs as health information management professionals," Theresa Jackson, director of health information management at the University of Kansas Hospital, said in a statement.

Report Segments 40,000+ Medical Apps and IDs Top 5

OCT 31, 2013 4:18pm ET
A new report from the IMS Institute for Healthcare Informatics offers a general assessment of nearly 43,700 health care mobile apps available to consumers today, including the top five that are downloaded.
IMS started with health care apps available through the English language U.S. iTunes store in June. Researchers then excluded more than 20,000 apps as not truly related to health care and essentially gimmicks with no real benefits. That left 23,682 “genuine health care apps” with 7,407 targeting health care professionals and 16,275 for consumer use.
Ninety percent of the apps score less than 40 on an IMS scale of up to 100 for functionality. Nearly 11,000 apps can provide and display information, but less than half of these give instructions and only one-fifth capture user-entered data.

Study: Half of CDS prescription alert overrides are inappropriate

October 31, 2013 | By Julie Bird
Providers override about half of the alerts they receive when using electronic prescribing systems, according to a new study that also finds only about half of those overrides are medically appropriate.
Researchers reviewed more than 150,000 clinical decision support (CDS) alerts on 2 million outpatient medication orders for the study, published online this week by the Journal of the American Medical Informatics Association (JAMIA).
The most common CDS alerts were duplicate drug (33 percent), patient allergy (17 percent) and drug interactions (16 percent.) Alerts most likely to be overridden, however, were formulary substitutions (85 percent), age-based recommendations (79 percent), renal recommendations (78 percent) and patient allergies (77 percent).

HSCIC plans a national tech strategy

25 October 2013   Rebecca Todd
The Health and Social Care Information Centre plans to publish a national technology and data strategy in summer 2015.
The strategy will focus on a number of areas including minimising barriers to the flow of data between care settings, making data available in appropriate care settings at the lowest cost possible and improving public access to the data.
An HSCIC draft strategy for 2013-15 was presented to an HSCIC board meeting on Wednesday.

Tips for Training Physicians on ICD-10

OCT 29, 2013 9:58am ET
Many provider organizations getting ready for the transition to ICD-10 understand that the time is drawing near to start training physicians on what they need to know about the new diagnosis and procedure code sets.
When it comes to doctors, less but more focused training will bring more benefits, says Gary Huff, M.D., president and CEO at consultancy HUFF DRG Review.
It is important to economize physician time and that means that training videos are the least effective method of educating them, Huff contends. “Doctors don’t want to watch videos on coding; they’ll do their charts while listening to it,” he said during a talk with Health Data Management at the American Health Information Management Association’s annual conference in Atlanta.

5 usability keys for

Posted on Oct 29, 2013
By Chip Means, Manager, Digital Operations, HIMSS Media
A guy who launches websites for a living says is, despite popular opinion, not the worst website of all time.
I work at the offices where Healthcare IT News is published. I’m a former associate editor of Healthcare Finance News. We’re a HIMSS-owned company. And I have no idea what to think about as a centerpiece of the Affordable Care Act.
In a way, I love that a website is so critical to the success of the program - a sure sign of progress that ostensibly enables what couldn’t be achieved with large-scale health insurance mandates in the past. We’re all on the web now. We all get it. In this regard, we quietly and deftly leapt a major hurdle in the last decade.

Patient portals pose new security issues

Posted on Oct 29, 2013
By Gus Venditto, VP, Content
As healthcare facilities launch their own patient portals, technology is only the first step. Administrators are learning that decisions need to be made on everything from patient login protocols to support for patient record revisions.
HIPAA regulations, always a primary concern when patient records are involved, are far from clear cut and that means administrators need to carefully consider the choices, says Adam Greene, a lawyer and consultant on HIPAA-related issues with his firm Davis Wright Tremaine LLP. He spoke at the AHIMA annual conference in Atlanta on October 28.
Even the question of how to provide account logins requires serious attention, Greene said. Patient records must secure, but complex password requirements may create the impression that a provider is in the position of denying a patient access to his records. Greene advised against requiring high-security protocols for passwords that require multiple character sets: “You need to have password security that is not so strong that users can’t get in.”

EHR workarounds, poor documentation cause deaths at Memphis VA

October 29, 2013 | By Marla Durben Hirsch
The inadequate use of the Memphis VA Medical Center's EHR led to the deaths of at least two patients in its emergency department (ED), according to a new report by the Department of Veteran's Affairs' Office of Inspector General (OIG).
The OIG, which conducted its inspection after receiving a complaint of three patient deaths, found that in one case a nurse had inputted into the EHR the fact that the patient had an allergy to aspirin, but that the physician bypassed the EHR and hand-wrote an order for an anti-inflammatory drug that is contraindicated for aspirin. Had the physician order been inputted into the EHR, pursuant to hospital policy, a drug alert would have automatically been generated.

CommonWell talks top 3 HIE challenges

By Tom Sullivan, Editor
As it nears the launch of its interoperability pilot project, officials from the CommonWell Health Alliance used AHIMA’s annual conference here to outline some of the toughest health information exchange challenges facing vendors and providers today.
“If you want to share information with 5 organizations, you need 10 contracts,” Dan Schipfer, senior vice president at Cerner said Monday morning, explaining that regional HIE is happening, but thus far it is limited to local exchange.
“We EHR vendors have not made it easy for you to interoperate,” within the nomenclature and the organization, he said. “It’s a big deal, it’s something you believe in, we believe in, but there are challenges.”

95M Americans used mobile for health in 2013

By: Jonah Comstock | Oct 29, 2013
As of 2013, 95 million Americans are using mobile phones as health tools or to find health information, according to Manhattan Research. That’s 27 percent more than 2012, when the number was 75 million.
These numbers come from Manhattan’s annual Cybercitizen Health US survey. The research firm surveyed 8,605 US adults online and on the phone between August and September.
The study found that 45 percent of online adults with a chronic condition reported that the internet is essential to managing that condition. Manhattan listed the top ten conditions for which patients use mobile devices. Cystic fibrosis was number one, followed by growth hormone deficiencies, acne, ADD and ADHD, hepatitis C, migraines, Crohn’s disease, chronic kidney disease, generalized anxiety disorder, and bipolar disorder.

Patients Wary of Secondary EHR Data Use, Study Finds

Written by Ellie Rizzo (Twitter | Google+)  | October 29, 2013
Patients care more about the purpose of secondary electronic health record data use than the user of the data or the sensitivity of the data, according to an article in JAMA Internal Medicine.
Researchers surveyed more than 3,300 adult patients, describing a scenario in which data from their personal health record was used either by a university hospital, commercial enterprise or public health department for research, quality improvement or commercial marketing. Researchers described the hypothetical data as either having genetic information about a particular patient's cancer risk or not.

You may know a drug cocktail is dangerous before FDA

By: Chris Morris, Special to | Tuesday, 29 Oct 2013 | 9:13 AM ET
Picture this: Your doctor prescribes a new medication, but once you start taking it, you begin to feel a little off. While the smart thing to do is call the doctor or pharmacist, the more common action today is to hop on the Web and see if you can figure out what's going on.
As it turns out, that self-diagnosing and hypochondriac-like behavior could help save people's lives.
Researchers at Microsoft Research Labs, in conjunction with Stanford University, have found that Web searches can help the FDA and pharmaceutical companies discover previously unknown dangerous drug interactions. And the FDA is welcoming the help.

Star Trek Telemedicine Tablet Wasn’t Real McCoy, U.S. Says

OCT 25, 2013 12:35pm ET
An Illinois man who persuaded a company to provide almost $1 million in financing for a telemedicine computer tablet named after the physician on the “Star Trek” TV show was arrested for fraud, according to federal prosecutors.
Howard Leventhal also allegedly presented an undercover U.S. agent posing as an investor with a fake contract to supply the Canadian government with a make-believe device.
“Leventhal claimed to have lucrative connections within the Canadian government and cutting edge technology that could help save lives,” U.S. Attorney Loretta E. Lynch in Brooklyn, New York, said in a statement today announcing Leventhal’s arrest on a wire fraud charge. “In reality, his scheme was pure science fiction, complete with phony documents and a fictional medical device.”

Registries playing catch up with Stage 3

Posted on Oct 29, 2013
By Anthony Brino, Editor, HIEWatch
Although meaningful use visionaries are hoping to advance the cause of robust public health registries as part of the program's Stage 3, widespread, seamless public health data exchange still has a ways to go.
Among several meaningful use Stage 3 issues discussed by stakeholders charged with advising the Health IT Policy Committee, advanced case reporting to both public health agencies and specialized disease registries is striking some as overly ambitious and potentially impractical.
The Meaningful Use Workgroup is trying to align Stage 1 and 2 objectives and Stage 3 requirement recommendations with Stage 3 goals, such as for case reporting -- "efficient and timely means of defining and reporting on patient populations to identify areas for improvement," and data sharing with public health agencies.

3D medical holograph shows early wins

Posted on Oct 29, 2013
By Erin McCann, Associate Editor
Three-dimensional holographic medical imaging may not be as far away in the future as one might think, one recently concluded hospital pilot study has confirmed. 
For certain structural heart disease procedures, the 3D holographic visualization technology has shown considerable promise, according to the results of a pilot conducted at Israel-based Schneider Children’s Medical Center in collaboration with Royal Philips and RealView Imaging.  
The pilot included eight patients who required minimally invasive structural heart procedures, and according to officials, doctors on the interventional team were able to view detailed, dynamic 3D holographic images of the heart essentially "floating in free space" during these specific procedures, without using special eyewear.

2015 records access promise scaled back

29 October 2013   Rebecca Todd
The government’s pledge for patients to have online access to their GP record by March 2015 will only require access to the brief information held on their Summary Care Record.
NHS England’s Patient Online programme lead Kathy Mason told EHI that providing access to the same information as held in the SCR is the minimum that GPs must do by March 2015.
The SCR contains a core set of clinical data, including allergies, medications and adverse reactions, but there is work going on to enrich it.

Latest Wave of MU Audits Delivers a Fresh Scare

Scott Mace, for HealthLeaders Media , October 29, 2013

A slew of Meaningful Use audit notices have suddenly materialized, aimed not only at Medicare, but at Medicaid recipients as well. The deadlines are tight and the documentation requirements exacting, making a most unwelcome October surprise for healthcare CIOs.

As the CHIME conference wound down on the evening of October 10, CIOs were abuzz: A new wave of Meaningful Use audit notices was making its way into their email boxes with November 7 due dates for responses.
The government might have been shut down, but the federal contractor conducting the audits, Figliozzi & Company, was still on the job. The new fiscal year was unfolding before CIOs with a fright worthy of Halloween.

ECRI on health IT hazard trail

Posted on Oct 28, 2013
By Bernie Monegain, Editor
ECRI Institute Patient Safety Organization has unveiled a new health IT hazard reporting system that employs AHRQ common formats and a tested standardized taxonomy for health IT hazard information.
"Well designed, well implemented health IT has the potential to help healthcare organizations improve care and patient outcomes, but too often health IT is implemented without full understanding of the work environment, and results in risks," Karen P. Zimmer, medical director, ECRI Institute, said in a news release.
The Health IT Hazard Manager was developed and piloted in a federally funded project led by Abt Associates with ECRI Institute and Geisinger Health System’s Patient Safety Institute. The reporting system collects IT hazards via the Internet in a centralized and standardized way, which allows for the identification of specific types of hazards and the ability to trend data.

EHRs at risk of becoming irrelevant

Posted on Oct 28, 2013
By Eric Wicklund, Editor, mHealthNews
With mHealth becoming the norm instead of the exception, a panel at Partners HealthCare's 10th Annual Connected Health Symposium last week concluded that EHR vendors will have to find a way to modify their products to focus on data that the patient and his or her care team want, or they'll become obsolete.
Important information for a patient's care actually exists outside the electronic medical record, panelists said.
"In many ways the EHRs are on the outside," said Andrew Watson, MD, medical director for the Center for Connected Medicine at the University of Pittsburgh Medical Center and the panel's moderator. "This is on the inside. It's not the paranormal … any more – it's the normal."

Partners HealthCare Symposium: 'A new level of maturity' can boost health IT

October 28, 2013 | By Susan D. Hall
The basic infrastructure is largely in place to foster widespread low-cost innovation in health IT, Bill Geary of Northbridge Venture Partners said as part of a panel discussion last week at the Partners Connected Health Symposium.
"We're seeing the ability on relatively small dollars to build really compelling tools that providers absolutely need to run their businesses. It's so incredibly disruptive to legacy vendors, but in healthcare, we needed to see that cost curve collapse to really get innovative products," he's quoted as saying at Mobihealth News.
The event was part of Boston's Connected Health Week, which began with leading policymakers from the United States and European Union gathering at the EU-US eHealth Marketplace and Conference to discuss how technology innovation can improve patient care and provide economic benefits, according to a post at

Digital reform within the NHS is not a choice, but a necessity

One of Professor Bruce Keogh's ambitions for the NHS is to have the leadership using data competently
The NHS turned 65 this year but the world's second largest publicly funded organisation is experiencing the most challenging time since its creation in 1948.
The recent publication of the Keogh review looking into 14 hospital trusts has sent shockwaves at a national level to the quality of healthcare in the NHS. In many cases, the problems are also financial, with nearly a quarter of clinical commissioning groups struggling each financial year.
Why is this happening? Some of the NHS's pressures come from a governmental level with the target of £20bn worth of efficiency savings by 2014/2015 looming and the funding gaps in 2020 and 2025 threatening to have a significant impact on long-term budgeting. As there are challenges on both the provider and commissioner sides of the NHS, there is urgency to find an immediate and long term solution.

New House bill aims to slash FDA's mHealth oversight

October 25, 2013 by Arezu Sarvestani

A bipartisan group of House Reps introduces a new bill that would limit keep the FDA's mHealth oversight of out of software that is a component of a regulated medical device.
A new House bill co-sponsored by a bipartisan group of lawmakers aims to cut deep into the FDA's newly finalized oversight of mobile medical apps, keeping regulation only to programs that complement medical technologies or those that turn a mobile device into a medical one.
The bill would keep the FDA's tendrils out of apps deemed to be 'clinical' or 'health' software, reserving oversight for programs that directly changes the structure or function of any part of the body, makes clinical recommendations for consumers and includes the use of a drug or device without the involvement of a healthcare professional.

Physicians’ Exchange of Clinical Data Capabilities Vary, ONC Study Reveals

October 25, 2013
A new study, conducted by the Office of the National Coordinator for Health Information Technology (ONC) researchers, detailed the effectiveness with which office-based physicians are exchanging lab and medication data.
The research, which appeared in the American Journal of Managed Care, looked at how physicians were to electronically sharing clinical information with other providers and to describe variation in exchange capability across states and electronic health record (EHR) vendors. They used data from a 2011 survey of physicians for the study, with 4326 responding.
Of the findings, one of the more interesting pieces was the overall capability of all physicians (55 percent) to send prescriptions electronically. For those physicians with an EHR, the number was up to 78 percent.

Unsolicited Data in EHRs Posing Workflow, Legal Challenges for Some Providers

by Michelle Stuckey, iHealthBeat Staff Writer Monday, October 28, 2013
With the growing use of health information exchange technology and personal mobile health devices, patients' health records are being inundated with information that might not have been requested by their provider.
While such data can help make patient records more comprehensive, unsolicited information also can cause disruptions to providers' workflows and affect the usability of their EHR systems. Further, providers could be held liable if patient harm or misdiagnosis occurs that could have been prevented by more thoroughly reviewing such data, according to experts.
A recent practice brief released by the American Health Information Management Association outlines the challenges that unsolicited health information can pose for providers and offers recommendations for adopting protocols to handle such data. The problem was identified by AHIMA's Physician Practice Council -- which includes attorneys, health information management experts and consultants that work in the physician arena.

How Big Data is destroying the U.S. healthcare system

One thing I find ironic in the current controversy over problems with the insurance sign-up web site is that the people complaining don’t really mean what they are saying. Not only do they have have little to no context for their arguments, they don’t even want the improvements they are demanding. This is not to say nothing is wrong with the site, but few big web projects have perfectly smooth launches. From all the bitching and moaning in the press you’d think this experience is a rarity. But as those who regularly read this column know, more than half of big IT projects don’t work at all. So I’m not surprised that there’s another month of work to be done to meet a deadline 5.5 months in the future.
Yes, the Obama Administration was overly optimistic and didn’t provide enough oversight. Yes, they demanded fundamental changes long after the system design should have been frozen. But a year from now these issues will have been forgotten.

The seven deadly sins of

A data center failure is the latest in Obamacare site's litany of woes.

Everyone—even the CTO of President Obama's successful second presidential campaign—seems to have something to say about why experiences so much trouble. Today's news that the Affordable Care Act website and supporting IT infrastructure suffered from a data center outage piled more pain upon a project that members of the "tech surge" team now say will take at least another month to put in order.
The data center, operated by Verizon's Terremark unit, went down on Sunday when an equipment failure made it lose its Internet connection. Service was restored Monday morning, and services were brought gradually back online.
Data center outages happen to almost everyone in the cloud business, as Amazon and Google and Microsoft can testify to. But the structure of's deployment makes it particularly vulnerable to outages since it runs out of a single Verizon data center. That's just one more piece of a larger problem, however: rather than turning to private industry to look for best practices in running a high volume e-commerce website, the government's team embraced the opposite approach.

Responsibility for's IT problems lie with dot gov

This was a management not a technology failure. Obama's error was not to empower technologists to tell him the truth
The launch of has not gone well. This is the Obama administration's fault.
In the immediate aftermath of the 1 October launch, it looked as if the problems were caused by a surfeit of interest. As the days went on, however, the problems persisted. The site's most basic interactive operation was creating a new account. This was required for all subsequent uses of the insurance market, but something like nine out of ten attempts failed. By the middle of the month, Consumer Reports was telling its readers "Stay away from for at least another month if you can", because the site could not perform, even under the conditions its designers imagined.


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