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Denmark’s leading eHealth system still faces challenges
Posted Wed, 13/11/2013 - 06:07 by Fran Molloy
Denmark’s eHealth
system is a world-leader, with all GPs and all hospitals having electronic
medical records (EMRs), and communication and standards managed through a
central network, MedCom, with ownership shared between national, regional and
local government authorities.
In a case study
published in last month’s issue of the International Journal of Medical
Systems, Danish researcher Patrick Kierkegaard outlined the country’s key
eHealth challenges – which revolve around the fragmentation of EMRs and
difficulties of interoperability.
Denmark has a
population of just 5.6 million and one of the highest per-capita incomes
worldwide, with a tax-funded universal health care system and strong
primary-care and hospital infrastructure.
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Status Check on Medical ID Theft: Going Up
…
Security research firm Ponemon Institute estimates that 1.84 million
adult-aged Americans have experienced medical identity theft, with 313,000
becoming victims during the past year. That's a 19 percent increase compared
with a 2012 Ponemon estimate of 1.52 million who have in recent years been
victimized by medical identity theft, based on an annual survey conducted each
March and April.
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Homeland Security has tip for healthcare
Posted on Nov 15, 2013
By Erin McCann, Associate Editor
Data breaches and
cybersecurity threats in healthcare are going to happen. It's virtually
unavoidable. What can be avoidable, however, are the messy consequences of
substandard risk assessment strategies and inadequate threat response.
Department of
Homeland Security's Jason Gates, an analyst in the industry, engagement and
resilience branch within the Office of Cybersecurity and Communications, spoke
at a virtual event Thursday about how healthcare organizations can work to
mitigate the effects of a cybersecurity attack and lessen the risk of actually
having one.
The take-home
message? "Risk management never ends," he said. "New cyber
threats, vulnerabilities and consequences require the constant modification of
risk management strategy."
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CMS Eases Sharing Data with Researchers
NOV 14, 2013 2:45pm ET
The Centers for
Medicare and Medicaid Services has announced a streamlined process for
researchers to access and analyze the agency’s health care data. CMS is
transitioning from preparing and shipping encrypted data files that have been
requested, and now enables access from researchers’ own workstations with less
cost to them and the agency. Here is the CMS announcement:
“In a move that
advances the Obama administration’s work to make the health care system more
transparent and accountable—and to help meet the pressing challenge of health
care delivery system reform—the Centers for Medicare & Medicaid Services
(CMS) today announced the launch of the CMS Virtual Research Data Center (VRDC)
at the White House event Data
to Knowledge to Action: Building New Partnerships. Part of
the President’s Big Data Research and Development Initiative, which aims to
improve researchers’ ability to extract knowledge and insights from large and
complex collections of digital data, the VRDC is a secure and efficient means
for researchers to virtually access and analyze CMS’s vast store of health care
data.
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EHR copy and paste? Better think twice
Posted on Oct 08, 2013
By Erin McCann, Associate Editor
Who would
have thought that something so simple as copy and paste could have such serious
consequences?
Speaking at the October MGMA annual conference in San
Diego, Diana Warner, director at AHIMA, confirmed the seriousness of
inappropriately using copy and paste functions in electronic health records.
And the government agrees -- it's no laughing matter.
Seventy-four to 90 percent of physicians use the copy/paste function
in their EHRs, and between 20 to 78 percent of physician notes are copied text,
according to a September AHIMA report.
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US and UK share health data via cloud
Posted on Nov 15, 2013
By Anthony Brino, Editor, HIEWatch
About half a
century after epidemiology studies in Massachusetts and the United Kingdom
helped build the world’s understanding of cardiovascular disease and health
risks, public health and population data is being opened up by the U.S. and
joining international datasets.
As part of the Obama Administration’s Big Data Research and
Development Initiative, federal health agencies are contributing five-years
worth of public datasets to a cloud-based research platform being used by life
sciences researchers at universities and pharmaceutical companies to share
population data along with other medical and biological data.
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Charging for data: What is too much?
Posted on Nov 13, 2013
By Mike Miliard, Managing Editor
As patient
engagement gains momentum, and technology enables
easier access to personal health information, many providers still charge money
for copies of records. That's allowed under HIPAA and HITECH. But is it wise?
At the recent AHIMA convention in
Atlanta, Kim Murphy-Abdouch, clinical assistant professor at Texas State
University, said it might be time to rethink policies and procedures related to
patient access that may be holdovers from a paper-based way of thinking.
Even as
"patients are becoming much more aware of their own healthcare, and much
more savvy" about managing their health data, "cost could be a
barrier to patient access," said Murphy-Abdouch.
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Lessons from an HIE pioneer
November 15, 2013 | By Susan D. Hall
It has taken
multiple efforts, but the latest effort at health information exchange that Joe
Heyman, M.D., has been involved with is close to success, reports Medical Practice Insider.
Heyman, formerly an
Americal Medical Association (AMA) board chairman and president of the
Massachusetts Medical Society, runs a solo gynecology practice two days a week
in Amesbury, Mass. The rest of the time he focuses on the data exchange created
by Whittier Independent Practice Association in Newburyport, Mass. Earlier this
year it began combining data from disparate sources into a single record for
each patient.
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IEEE, Continua Collaborate on Standards
November 13, 2013 by Rajiv Leventhal
IEEE Standards
Association (IEEE-SA) and Continua Health Alliance have signed a strategic
agreement to help accelerate and broaden the adoption of globally relevant
standards-based technologies for the healthcare arena.
This collaboration
brings together Continua, a Beaverton, Ore.-based organization dedicated to
enabling end-to-end, plug-and-play interoperability for personal connected
health, and IEEE-SA, the global standards-setting organization and developer of
the IEEE 11073 family of standards designed for the entire healthcare continuum
for personal health device communications.
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3D printing is new face of medicine
By Sally Davies
Inside the
pistachio-coloured walls of a London hospital, 16 fake eyeballs sit gleaming on
a shelf next to a collection of noses. A man holds up a slice of green silicone
in the shape of an ear.
“It’s a very early
sample,” says Tom Fripp, managing director of Sheffield-based design
consultancy Fripp Design and Research. The company is the first to directly
print an object in medical grade silicone, a substance whose pliable texture is
well-suited to soft tissue prosthetics.
In the next room
London dentist and implant manufacturer Andrew
Dawood shows a 3D printed copy of the vascular
system of conjoined twins. They were separated in 2011 after doctors used Mr
Dawood’s model to practice the surgery beforehand, improving the odds of
success and reducing the risky time the patients spent under the knife.
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HIMSS EHRA: Health IT framework needs more 'predictability'
November 12, 2013 | By Marla Durben Hirsch
Electronic health
records, clinical decision support systems and health IT that focuses on
transmission or storage of data should not be subject to traditional device
regulation, but new risk-based oversight, according to the executive committee
of HIMSS Electronic Health Records Association (EHRA).
That's one of the
primary suggestions that EHRA made in a recent letter to U.S.
Department of Health &Human Services Secretary Kathleen Sebelius regarding
draft recommendations presented by the Food and Drug Administration Safety and
Innovation Act (FDASIA) workgroup and approved by ONC's Health IT Policy Committee
Sept. 4. EHRA also suggested that the new risk-based framework's criteria
should be applied to health IT currently regulated to identify opportunities
for more effective and appropriate oversight, and that health IT with lower or
low risk should not be subject to additional health IT-specific oversight or
regulation.
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Birmingham to offer PICS licence-free
11 November 2013 Lis Evenstad
University
Hospitals Birmingham NHS Foundation Trust will offer its Prescribing
Information and Communication System to the NHS on a licence-free basis instead
of “open-sourcing” it.
EHI reported last
week that NHS England is working with four different organisations, one of
which is Birmingham, to put their products on a new open source electronic
patient record systems framework.
The trust’s medical
director, Dr Dave Rosser, told EHI that Birmingham would not be offering its
PICS e-prescribing system open source because it is too risky.
“We think open
sourcing PICS would be dangerous. It’s too complicated a programme with very
complicated code,” said Dr Rosser.
“It would be risky
to say the least. It has 600,000 lines of code and it is all interactive. It’s
very easy to make a change in one part that changes something in another part
that not even the programmers can predict.”
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ONC initiative looks to curb prescription drug abuse
November 14, 2013 | By Dan Bowman
A new Standards
& Interoperability Framework initiative launched today by
the Office of the National Coordinator for Health IT aims to create a common
technical standard to allow prescription drug monitoring programs (PDMP) to
share data with health IT tools used by providers for clinical decision
support.
The initiative,
described in a post to the Health IT Buzz blog,
would be a boon to efforts to curb prescription drug abuse, writes Jennifer
Frazier, a behavior health subject matter expert with ONC.
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Docs blame EHRs for lost productivity
Posted on Nov 14, 2013
By Mike Miliard, Managing Editor
Nearly 60 percent
of ambulatory providers surveyed for a new IDC
Health Insights report say they're unsatisfied with their
electronic health records, citing frustrations with usability and workflow.
IDC's new study,
"Business Strategy: The Current State of Ambulatory EHR Buyer
Satisfaction," polled 212 ambulatory and hospital-based providers. It
found that while the adoption of EHRs is widespread, the experience of most who
use them "is one of dissatisfaction."
According to
results, 58 percent of ambulatory providers surveyed were dissatisfied, very
dissatisfied, or neutral about their experience with ambulatory EHRs.
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EHRs can't do everything
Posted on Nov 14, 2013
By Zack McCartney, Contributing Writer
Like many other
industries, healthcare is becoming more consumer-focused. As Eric Wicklund and
Mike Miliard have recently documented for Healthcare
IT News, patients and doctors alike have spoken out against EHR solutions for
interfering with rather than facilitating doctor-patient interactions. While
thorough data collection and analysis, where EHRs offer great value, feeds
research at the population level, it seems that the apparent failure of current
EHRs to accommodate patients as unique cases has sparked this shift in attitude
in the health IT industry.
The issue may not
be so much the failure of EHRs, as their falling short of unduly high
expectations -- expectations not only from the people who use them, but also
the vendors themselves.
“I think it’s a
myth that EHR vendors are going to be able to provide everything. Every
other industry has proven this wrong, says Joanne Rohde, CEO of Axial Exchange, in an interview
with Healthcare IT News.
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EMR Market to Grow 7.5% Annually Through 2016
The global market
for hospital-based electronic medical records is expected to grow at a compound
annual growth rate of 7.46 percent through 2016, according to a TechNavio report.
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Non-Profit Releases Education Material for Health IT-related Patient Safety
November 13, 2013 by Gabriel Perna
The National
Patient Safety Foundation, a Boston-based non-profit organization, has released
educational materials that aim to help healthcare professionals align their
health information technology goals with patient safety.
The educational
material, titled Health Information
Technology through the Lens of Patient Safety, is geared towards
physicians, pharmacists, nurses, and patient safety and health quality
professionals.
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CMS Launches New Data Sharing Tool
November 13, 2013 by Rajiv Leventhal
The Centers for
Medicare & Medicaid Services (CMS) has announced the launch of a new data
sharing tool to help researchers virtually access and analyze CMS’ store of
healthcare data.
The tool—the CMS
Virtual Research Data Center (VRDC)—was unveiled on November 12 at the White
House event “Data to Knowledge to Action: Building New Partnerships” as part of
President Obama's Big Data Research and Development Initiative.
Researchers using the
VRDC will access CMS data from their own workstations and will be able to
perform analyses and manipulate data within the VRDC. Historically, CMS
has filled researchers’ data requests by preparing and shipping encrypted data
files. However, given the rapidly-growing demand for timelier Medicare
and Medicaid data, the agency needs a less resource-intensive means of
responding to data requests from researchers. The VRDC will help CMS meet
these demands while also ensuring data privacy and security and reducing the
cost of data access for most users, according to CMS officials.
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What's Wrong With Healthcare Quality Measures? Part I
Cheryl Clark, for HealthLeaders Media , November 14, 2013
We need to measure the hell out of healthcare to help us compare one organization or system with others. I believe measuring quality helps healthcare systems improve. But I also believe that we can measure healthcare quality a lot better than we do.
If you really think
about it, the way we measure hospital quality of care is pretty darn primitive.
That's what I've concluded after a few days contemplating today's methods and
practice of measurement.
The way we think we know how good
we are at providing high value care is really flawed.
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5 overrated, overpriced healthcare technologies
November 13, 2013 | By Ashley Gold
By Ashley Gold
There's never a
shortage of companies and healthcare providers claiming to have invented the
next big thing that will transform patient treatment and care as we know it.
From new types of surgery, to multi-million dollar cancers centers and
implantable heart devices, healthcare technology has the power to transform
patient care.
But how does a
consumer, hospital executive or physician clear the hype--and be able to tell
what's really worth the money, and what's better off being left to traditional
means? With that in mind, FierceHealthIT
examined five overrated and overpriced healthcare technologies.
From surgery to heart monitoring, we explore what brings value for its price
tag.
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First National Physician-Owned HIE Launches
OnePartner HIE, the
first nationwide, physician-owned health information exchange, has opened to
physicians.
The HIE aims to
connect providers with various electronic medical record systems and help
physicians achieve the meaningful use stage 2 requirements for data exchange.
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IPhone App Wipes Out Population to Show Contagion Risks
November 11, 2013
The
idea of Plague Inc. is to build a bug and exploit countries’ vulnerabilities --
climate, population density, poverty -- to help it spread. Source: Ndemic
Creations via Bloomberg
The plague started in Indonesia. A viral infection, it spread
quietly at first, making its way from person to person with coughing and
sneezing its only symptoms. Then someone infected with the virus got on a
plane.
As the disease
spread around the globe, fever gave way to sweating, nausea, vomiting. Hundreds
infected turned to thousands. The virus developed drug resistance. Thousands
became millions.
It was all part of
Ian Lipkin’s plan.
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The Wild West Becomes Less Wild: States Fill Privacy Gap Left by Congress
Wednesday, November 13, 2013
Every day,
consumers introduce more and more personal health data into the commercial
space -- through mobile applications, social networking sites and personal
health records. Yet the U.S. does not have a comprehensive, baseline privacy
law that protects such data. As a result, states are increasingly taking
matters into their own hands, passing laws that both provide important
protections for consumers and exacerbate the problematic patchwork of sometimes
conflicting state laws that hamper easy, secure data sharing on a nationwide
basis.
Although HIPAA is
the nation's central, federal health privacy law, it applies only to covered
entities (physicians, hospitals and health plans, for example) and entities providing
services on their behalf. HIPAA's regulations were designed to protect patient
privacy while still meeting the data collection and disclosure needs of health
care providers and health plans. They do not address the unique privacy risks
facing consumers and patients using health tools offered by commercial vendors.
The vast majority of the digital health data zipping around the Internet are
not protected by U.S. law, beyond the policies of individual companies and a
handful of state laws.
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MU payments sail by $16 billion
By Diana Manos, Senior Editor
As of the end of
September, the federal government now reports that a significant number of
hospitals and eligible providers are now actively participating in the
electronic health record incentive program, with 425,000 registered for the
program and 325,00 unique providers having received some kind of incentive
payment so far.
At the Nov. 6
meeting of the HIT Policy Committee, Rob Anthony, deputy director at the CMS
Office of E-Health Standards and Service, said registration in September
represents a slight decrease from other months, but this is expected. “This is
the calm before the storm,” Anthony said. “We will continue to see an upward
trend of these numbers as we move into January and February.”
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4 innovation trends shaping healthcare's future
November 12, 2013 | By Susan D. Hall
Meaningful Use, the
switch to ICD-10, security and interoperability issues are consuming many
healthcare IT leaders' attention, but they mustn't overlook trends that will
shape healthcare in the future, according to an article at CIO.com.
The article
examines four trends that will shape future advances in healthcare, based on
discussion from last month's Center for Connected Health Symposium in Boston.
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Groups throw support behind MU legislation
Laura Pedulli
Nov 11, 2013
Nine specialty
societies are expressing their support for legislation that would allow
participation in clinical data registries to meet the quality reporting
component of the Meaningful Use (MU) program.
In a letter to EHR
Improvements Act (HR 1331) sponsor Rep. Diane Black (R-Tenn.), the Northern
American Spine Society and eight other groups lauded the bill but suggested an
expansion to allow all physicians who utilize certified EHR systems to
participate in registries as having met the MU criteria.
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'Late Adopters'—How Small Hospitals Can Navigate Meaningful Use
Scott Mace, for HealthLeaders Media , November 12, 2013
Hospitals and health systems just now getting around to meaningful use have clearer guidance from CMS, a better selection of off-the-shelf EHR software, and the cautionary lessons learned from HMA.
Judging by last
week's readership on HealthLeadersMedia.com, more than a few of you were keenly
interested in HMA's $31 million
giveback to the Centers for Medicare & Medicaid
Services last week for failing to tell the truth about its meaningful use
attestation.
While we ponder the
fallout at HMA, how can you avoid being next?
The good news is,
CMS now has a
web page to help you navigate your way around (or
through) a meaningful use audit.
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Health IT Could Reduce Demand For Physicians
Comprehensive use
of IT in 30% of physician offices would have major impact, but that is not
expected to occur for 5 to 15 years, says study.
By Ken Terry, InformationWeek
November 11, 2013
URL: http://www.informationweek.com/healthcare/electronic-medical-records/health-it-could-reduce-demand-for-physic/240163754
November 11, 2013
URL: http://www.informationweek.com/healthcare/electronic-medical-records/health-it-could-reduce-demand-for-physic/240163754
If health IT were fully implemented in 30% of community-based
physicians' offices, the gains in efficiency would reduce demand for physicians
by 4% to 9%, according to a new study
in Health Affairs.
Using health IT to
support the delegation of work from physicians to midlevel practitioners and
from specialists to primary care doctors could reduce demand for physicians by
6% to 12%. And increasing the amount of IT-enabled remote care and asynchronous
care could cut the percentage of overall care that physicians provide by 2% to
5% and 4% to 7%, respectively, the study found.
If 70% of
office-based physicians adopted comprehensive health IT -- including
interoperable EHRs, clinical decision support, provider order entry and patient
Web portals with secure messaging -- the impact on physician workforce
requirements would be twice as large, the study said.
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One big HIE hurdle still stands
Posted on Nov 11, 2013
By Anthony Brino, Editor, HIEWatch
Interoperability among disparate systems continues to be one of the
biggest challenges facing health information exchanges today, according to
the findings of a new industry survey.
"Despite the incorporation of new meaningful
use policies, it is clear that interoperability issues are still stifling
organizations' ability to connect," the Washington-based eHealth
Initiative wrote in its 10th annual HIE survey. "The survey
results reveal that interoperability remains a great hurdle with little relief
in sight."
The of 199 health information exchanges around the country also
revealed that HIEs do have large opportunities to support health reform, and
many already are, but to do that they have to support patient
portals and self-service -- an area
HIEs and hospitals too are lagging in.
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Look at app
Ten years ago, Shawn Larson, then an agency radiographer at St
Thomas’s Hospital, had the idea of creating a software application to allow
medical professionals to practise using x-ray equipment in a 3D environment.
28 October 2013
“I saw a need for something to address the
basic psychomotor skill of moving the table and moving the equipment,” he says.
“I thought: ‘There
has to be a better way of doing this than learning on the job, on real
patients, using radiation, when there are so many simulators around. When you
think of games like Tomb Raider, they provide a learning element, so why not
transfer that to something real?’”
After developing a
version for PC in 2003, Larson returned to the idea a few years later, and
Virtual Cath Lab was launched as a mobile app in 2011. It has now been
downloaded 10,000 times from Apple’s app store, in countries as far away as
Vietnam and Mexico, as well as the UK.
Feedback has been
positive, says Larson. “It delivers the basics. It gets you to the stage where
you can operate the real equipment, and look at the anatomy with some intelligence,
and hit the ground running.”
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Blue Button Plus, other identifiers can reverse 'information asymmetry'
November 11, 2013 | By Susan D. Hall
Providing patients
with access to their own information and reasserting the primacy of the
physician-patient relationship can reverse the "information
asymmetry" that favors big healthcare corporations at the expense of
patients and individual physicians, according to a post at The Health Care Blog.
Adrian Gropper,
M.D., chief technical officer of the nonprofit Patient Privacy Rights writes
that information asymmetry drives $3,000 in annual waste per citizen amid a
health IT "certification" process that seems designed to drive small
vendors and open-source software out of the market.
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Therapeutic at-home 3D video game for stroke patients developed
By ANI
| ANI – 19 hours ago
Washington,
Nov 11 (ANI): Researchers have developed a
therapeutic at-home gaming program for stroke patients
who experience motor weakness affecting 80 percent of survivors.
Constraint-induced
movement therapy
(CI therapy) is an intense treatment recommended for stroke
survivors, and improves motor function, as
well as the use of impaired upper extremities. However, less than 1 percent of
those affected by hemiparesis receives the beneficial therapy.
"Lack of
access, transportation and cost are contributing barriers to receiving CI
therapy. To address this disparity, our team developed a 3D gaming system to
deliver CI therapy to patients in their homes," said Lynne Gauthier, assistant professor of physical
medicine and rehabilitation in Ohio State's College of Medicine.
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EHR group weighs in on FDA work
Posted on Nov 08, 2013
By Bernie Monegain, Editor
The Electronic
Health Record Association, which represents 40 EHR
developer companies whose products are in use at a majority of hospitals and
physician practices today, applauds an FDA workgroup
recommendation that healthcare technology, such as EHR systems, should not be
treated as medical devices and should remain unregulated.
However, the group,
in a Nov. 6 letter to HHS Secretary Kathleen
Sebelius, asked for clarification on a number of topics, including clinical
decision support, medical device accessories, reporting of
safety event and post-market surveillance and "Class 0."
"We are not
convinced that most HIT not regulated as a medical device should receive a new
'Class 0' device classification by the FDA. Such a classification and
application for a formal regulatory approach to HIT is not warranted in our
view," stated the letter signed by the EHR Association Executive Committee
members, whose chair is Michele McGlynn, senior director, strategy and
operations at Siemens.
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EHR group weighs in on FDA work
Posted on Nov 08, 2013
By Bernie Monegain, Editor
The Electronic
Health Record Association, which represents 40 EHR
developer companies whose products are in use at a majority of hospitals and
physician practices today, applauds an FDA workgroup
recommendation that healthcare technology, such as EHR systems, should not be
treated as medical devices and should remain unregulated.
However, the group,
in a Nov. 6 letter to HHS Secretary Kathleen
Sebelius, asked for clarification on a number of topics, including clinical
decision support, medical device accessories, reporting of
safety event and post-market surveillance and "Class 0."
"We are not
convinced that most HIT not regulated as a medical device should receive a new
'Class 0' device classification by the FDA. Such a classification and
application for a formal regulatory approach to HIT is not warranted in our
view," stated the letter signed by the EHR Association Executive Committee
members, whose chair is Michele McGlynn, senior director, strategy and
operations at Siemens.
-----
Overrides of Clinical Decision Support Alerts Persist, Groups Try To Address Issue
Monday, November 11, 2013
Efforts are
underway to streamline electronic prescribing clinical decision support (CDS)
systems to avoid over-alerting physicians, as alert fatigue results in
clinicians overriding warnings. However, a
recent study by Boston-based Partners HealthCare shows
that the problem persists.
The researchers
analyzed more than 157,000 CDS alerts involving more than two million
medication orders and 1,718 outpatient providers and found that 52.6% of the
alerts were overridden. Further, they found that 53% of those overridden alerts
were clinically appropriate -- meaning that the particular drug combinations or
patient factors, if overlooked, had the potential to cause patient harm.
The study's lead
author Karen Nanji, an anesthesiologist and quality and safety researcher, said
that the study's results confirm that the problem of alert overrides -- whether
driven by alert fatigue or other factors -- persists and needs more attention.
-----
Enjoy!
David.
2 comments:
Clay Shirky's Healthcare.gov and the Gulf Between Planning and Reality is attracting lots of interest. Reading the third comment, from "Fran" on Nov19, I wonder how Ms Halton's execution of the "efficiency dividend" will cut into resources for NEHR.
At the Nov 20 Senate estimates Ms Halton - claims being ripped off by big vendors. When she adds in the efficiency dividend she will have the perfect excuse to blame everyone and everything bar herself won't she? Yes Minister.
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