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, January 18, 2014

Weekly Overseas Health IT Links - 19th January, 2014.

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.

Kaiser eyes outcomes with new network

Posted on Jan 10, 2014
By Mike Miliard, Managing Editor
Kaiser Permanente will put its longtime IT expertise to work in building a clinical data network aimed at improving patient outcomes in cancer, heart disease and obesity.
Funded with a $7 million grant from the Patient-Centered Outcomes Research Institute, the network is one of 29 projects approved for a total of $93.5 million to form PCORnet: the National Patient-Centered Clinical Research Network, which seeks to improve the efficiency of health research.
This network – called Kaiser Permanente & Strategic Partners Patient Outcomes Research To Advance Learning, or PORTAL – will convene four healthcare delivery systems: Kaiser Permanente, Group Health Cooperative, HealthPartners and Denver Health. It will also include the 11 research centers affiliated with those systems, and the patients, clinicians and operational leaders to develop the infrastructure necessary to conduct comparative effectiveness research.

Expensive EHR implementations threaten hospital credit ratings

January 7, 2014 | By Julie Bird
Huge capital outlays for  electronic health record (EHR) implementations are threatening the credit ratings of some large medical systems by tying up large amounts of cash and temporarily reducing profits, Becker's Hospital Review reported.
The financial challenges are not insurmountable and most hospitals should recover fairly quickly, according to the article. The biggest problems occur when EHR implementations cost more than expected, driving up accounts receivable, or if costs strangle a hospital's cash flow, Jim LeBuhn, director of the nonprofit hospital group for Fitch Ratings, told the publication.

Why "Google Health" failed.

In his Second Opinion column, Dr Constantine Constantinides from healthCare cybernetics looks at why “Google Health” failed…the Electronic Health Record “Death Trap” and its implications for Medical Tourism
If you were wondering what ever happened to the Google Health initiative … Let me provide some background to the death of Google Health.
What Google announced was this:
"Google Health has been permanently discontinued. All data remaining in Google Health user accounts as of January 2, 2013 has been systematically destroyed, and Google is no longer able to recover any Google Health data for any user. To learn more about this announcement, see our blog post, or answers to frequently-asked questions below"

The Promise, Peril of HIX

JAN 1, 2014
The Affordable Care Act's health insurance exchanges in late 2013 certainly got off to a rocky start, particularly at the federal level but also in multiple states that are running their own exchanges.
At some point the technology should start humming along and the exchanges, along with the millions of newly insured patients, will change how hospitals operate. But how ready are hospitals for new ways of doing business?
Health Data Management approached numerous provider executives for interviews on how they are getting ready for HIX, and they seemed to be as far behind as the exchanges are. Most did not respond to the request and those that did indicated they aren't yet sure enough to talk.
"Thank you for your inquiry," replied one hospital CIO. "We appreciate the opportunity to respond, however, due to the significant amount of uncertainty within the industry, we would be merely speculating at this time. As with all health care institutions, we are carefully monitoring the reactions from consumers, payers and providers to determine how to best deliver high quality, cost-effective care to the patients that we serve."

Wireless EHR market to hit $23.5 billion by 2018

January 8, 2014 | By Marla Durben Hirsch
The global market for wireless electronic health records is robust and expected to evolve in the next few years, according to the latest report from BBC Research.
The report, Wireless Electronic Health Records: Technologies and Global Markets predicts that the global market for wireless EHRs to grow to nearly $23.5 billion by 2018, with a five year compounded annual growth rate (CAGR) of 16.1 percent from 2013 through 2018. The report notes that wireless EHRs can streamline data and data storage options as well as provide "critical analytical data" inside and outside the traditional hospital setting.
While government initiatives are spurring the adoption of EHRs, they're also motivating efforts in related areas such as medical device connectivity, according to the report's authors.

IOM model helps hospitals evaluate return on investment of EHRs

January 7, 2014 | By Marla Durben Hirsch
The Institute of Medicine has released a proposed model to help hospitals and others assess the potential financial benefits of adopting electronic health records.  
The proposed framework and model, published Jan. 6, is intended to evaluate a provider's EHR investment by making inter-organizational comparisons, help identify "best-in-class" implementation approaches and prioritize process redesign endeavors.
"Although it may seem obvious that both the demands for higher reliability and higher-value health care require robust electronic health records, information exchange, and deep analytic capabilities, it remains difficult to measure the return on investment in information systems," authors of a discussion paper published on the model said. "The lack of a standard model for ascribing the costs of implementing or the benefits of using EHRs and related technology makes comparisons across different institutional experiences, different implementation approaches, and different technologies difficult.

Providers keep sluggish pace on ICD-10

Posted on Jan 09, 2014
By Tom Sullivan, Editor, Government Health IT
With the switchover to ICD-10 some nine months away, many healthcare groups are rushing to be ready for go-live. However, from many recent accounts, that rush is really more of a slow walk.   
At least according to findings KPMG published Jan. 8, which jibe with WEDI’s freshest ICD-10 impact.
What can be taken as a bit of good news is that 76 percent of respondents to a series of KPMG surveys indicated they have completed an impact assessment, widely considered the first key step en route to ICD-10. 

CMS called out for EHR fraud failings

Posted on Jan 09, 2014
By Erin McCann, Associate Editor
Electronic health records may be doing great things for patient care, but they have also made it easier to commit fraud, according to the findings of a new report from the Office of Inspector General.
The OIG report underscored the shortcomings of the Centers for Medicare and Medicaid Services when it came to identifying and investigating EHR fraud -- deficiencies which have helped contribute to the estimated $75 billion to $250 billion in healthcare fraud, officials say.
OIG highlighted the two most common EHR documentation practices used to commit fraud: copy and paste, by which a healthcare provider copies and pastes information from a patient's record multiple times, often failing to update the data or ensure accuracy, and over-documentation, which involves adding false or "irrelevant documentation to create the appearance of support for billing higher level services."

Care.data campaign leaflet slammed

7 January 2014   Lis Evenstad
A leading privacy campaigner has condemned NHS England’s £1m leaflet drop about care.data for not including an ‘opt-out’ form.
Phil Booth, co-founder of the medConfidential campaign, told EHI that the leaflet, which is supposed to inform patients about the programme and advise them that they can opt-out, said the failure to include an easy way for them to do this was “ridiculous”.
“There’s no opt-out form in the leaflet. This is ridiculous. If you’re going to send out this you have to include an opt-out form,” he said.

Self-care med devices market to hit $16.8 billion by 2019

January 9, 2014 | By Ashley Gold
The market for self-care medical devices is set to hit $16.8 billion by 2019, according to a new report from Transparency Market Research. According to Transparency's analysis, the market is estimated to grow at a CAGR of 7 percent from 2013 to 2019.
"Rising incidence of chronic diseases as well as lifestyle disorders [obesity, diabetes, hypertension and others] coupled with increasing healthcare awareness are driving the demand for self-care medical devices market globally," the analysis states.

Teen privacy poses a problem in patient portals

January 9, 2014 | By Susan D. Hall
The easy access to patient information that portals provide also comes with some sticky HIPAA privacy issues--including how much information teens' parents should be allowed to view.
"Some minors have their parents or guardians as their representative who have the right to access their information through HIPAA, but they may be able to consent to some services--sexual health services, substance abuse treatment--on their own. Then the parent or guardian does not have the right to see the information," privacy attorney Adam Greene, a partner at law firm Davis Wright Tremaine, says in an interview at HealthcareInfoSecurity.
In a state that allows a 17-year-old to obtain reproductive health services without parental consent, disclosing that information to a parent through the portal could be a HIPAA violation, he explains.

Treating the Small Cell Cancer in Health Care's Big Data

by Jonathan Handler Thursday, January 9, 2014
A recent Wall Street Journal article focused on marketers who specialize in identifying an individual's health issues without ever accessing the medical records. They get the information by mining non-medical data sources, such as buying patterns, age, gender and cable TV subscriptions. It seems almost everyone has access to health care's Big Data except for medical researchers.
Medical studies depend on data, and Big Data might turbocharge lifesaving research. However, regulatory and financial systems functionally discourage the use of patient data for research. The penalties for data breaches are severe, and the incentives to share are almost non-existent. Patients needlessly suffer and die as a result. Instead, our health care system should more effectively encourage data sharing to support medical research.
A few years ago, I worked on a project with the government. We hoped officials could use our analytics platform to facilitate health care research. To protect patient privacy, identifiers such as name, phone number and account number were removed.

A medical practice guide to patient portals

Source: Madelyn Kearns, Medical Practice Insider Date: Jan 9, 2014 
Patient portal technology let patients use a web-based connection to communicate with their healthcare providers from laptops, tablets and their smart phones. Physicians also have a range of choices.
Forty percent of U.S. office-based physicians currently have a portal through their electronic health record or practice management system, according to research released by Frost and Sullivan in September 2013. Although portals can be used in a variety of ways, practices generally set up a portal to give patients schedule appointments, registration forms, secure email to providers, lab results, prescription refill requests, create and maintain a personal health record, and viewing educational materials.

Patient portals prove prowess at Kaiser

Posted on Jan 08, 2014
By Erin McCann, Associate Editor
Patient portals have proven to be far more than just a convenient tool for patients to access their health information. These Web-based portals are also doing big things for improving care.
For diabetic patients who accessed their online portal to refill medications, these care improvements translated to a significant increase in medication adherence in addition to an overall improvement in cholesterol levels, according to the findings of a new study.
Researchers at the University of California San Francisco, University of Washington and Kaiser Permanente followed nearly 18,000 Kaiser patients with diabetes for five years and found those who requested statin refills exclusively via the patient portal decreased medication non-adherence by 6 percent. Patients who used the Internet-based portal also decreased their risk of high cholesterol levels by 6 percent.

Ireland plans big e-health investment

6 January 2014   Lyn Whitfield
Ireland is planning to massively increase the amount of money that it spends on healthcare IT as part of a strategy to transform its health services and boost its economy over the next seven years.
An ‘eHealth Strategy for Ireland’, published in December, says national healthcare ICT spending will be “re-aligned” so that it reaches the “EU average of between 2-3%” from the current 0.85%.
The strategy and spending will be overseen by a new body, ‘eHealth Ireland’, which will be headed by a chief information officer to be appointed through open competition.

FDA wants to use EMRs to streamline adverse drug event reporting

January 8, 2014 | By Ashley Gold
The U.S. Food and Drug Administration wants to leverage electronic medical records to probe for adverse drug events, according to a recent article in Regulatory Focus. Big data has the power to help expose adverse events more quickly than ever, and the FDA wants to use that to assess drug side effects.
Late last month, the FDA posted on the Federal Business Opportunities website that it is looking for a partner to develop a database of EMR data that has been scrubbed of individual-identifying patient information. Such as system, the FDA said, would allow them to "estimate the contribution of various risk factors" among a minimum of 10 million patients in the database, including information like demographics, health history, diagnoses and procedures, laboratory test orders and results, use of drugs and biologics and health encounters like hospitalizations or visits to a physician.

The year ahead in health IT policy

By Anthony Brino, Associate Editor
In a new year with a new ONC chief, the federal health IT policy committee is taking comments from the public and its many expert workgroups, and then crafting recommendations for the third phase of the meaningful use program.
With an open public comment period ending January 14, the health IT policy committee and its subcommittees and workgroups covering meaningful use, privacy and security, standards, ACOs and more are scheduled to convene dozens of times now through the end of the year, brainstorming, discussing and then rehashing recommendations on key areas of EHR functions and information exchange.
The first and last health IT policy meetings on the ONC calendar for 2014 are both being held by the Meaningful Use Workgroup, chaired by Paul Tang, MD, chief innovation and technology officer at Sutter Health’s Palo Alto Medical Foundation.

Benchmarks: 10 years of momentum

Posted on Jan 07, 2014
By Mike Miliard, Managing Editor
HIMSS Analytics was founded back in 2004, and has been tracking data relating to IT purchasing, processes and products ever since – most notably with its Electronic Medical Record Adoption Models, which seeks to help hospitals and ambulatory providers track their progression toward a fully-paperless environment.
For the past two years, Healthcare IT News has been producing the "Benchmarks" column with the help of HIMSS Analytics, spotlighting different facets of the industry and taking stock of their growth. This month, we take a look at the past decade, which has been a period of remarkable growth and change – especially in the past five years or so.
The numbers are hard to ignore. Compare 2006 (the first year of EMRAM data) with 2013: Back in 2006, more than 20 percent of hospitals were entirely paper-based – zeros on the scale. By 2013, that number was down to 6.9 percent. Meanwhile, just 0.1 percent ranked Stage 6 and none were Stage 7. By 2013, 13.3 percent had achieved those milestones, combined.

CPOE far from the debacle it once was

Posted on Jan 07, 2014
By Neil Versel, Contributing Writer
Ten years ago, the Center for Information Technology Leadership at Partners HealthCare in Boston published a widely heralded report suggesting that nationwide adoption of ambulatory CPOE, tightly coupled with electronic health records and clinical decision support, could prevent 2 million adverse drug events, 130,000 life-threatening medication errors and 190,000 hospital admissions per year – all while saving $44 billion, largely from avoiding duplication.
"Those were the days when electronic medical records were kind of a gleam in some people's eyes," recalled Jan Walker, RN, who served as executive director of the now-defunct CITL at the time the report came out.
Those also were the days when the Leapfrog Group, a Washington-based coalition of large healthcare purchasers, was heavily promoting CPOE adoption as a way to boost patient safety.

IBM Struggles to Turn Watson Computer Into Big Business

Revenue Is Far From Company's Ambitious Targets

By Spencer E. Ante
Jan. 7, 2014 7:49 p.m. ET
Three years after International Business Machines Corp. began trying to turn its "Jeopardy"-winning computer into a big business, revenue from Watson is far from the company's ambitious targets.
IBM Chief Executive Virginia "Ginni" Rometty has told executives she hopes Watson will generate $10 billion in annual revenue within 10 years, according to an October 2013 conference-call transcript reviewed by The Wall Street Journal. She set that target after the executive in charge of Watson said its business plan would bring in $1 billion of revenue a year by 2018. That would make Watson the fastest IBM business unit to reach the $1 billion milestone.
But Watson had total revenue of less than $100 million as of late October, according to the transcript. One of its first big projects, with the University of Texas M.D. Anderson Cancer Center, was "in a ditch" in early 2013, said Manoj Saxena, the executive overseeing Watson.

Another view

GP Neil Paul is fed up of passwords. Every time he constructs a safe and memorable password, his computer wants him to change it. High time, suggests, for someone to create an NHS identity app to take over their job.
7 January 2014
My desktop computer at work has once again started warning me that my password is about to change.
I think it is set to change every 90 days. But the computer starts warning me from 15 days to go, which annoys me even more. If I change it now, I’ll be changing it every 75 days…
Passwords, passwords everywhere
I’d probably cope better with this irritation if I only had to deal with passwords at the surgery. But, of course, I don’t.
This weekend, I tried logging-in to several websites to catch up on the paperwork associated with some of the clinical trials I run.
Some don’t work on Safari and some don’t work on IE7, which means that some of the paperwork can’t be done at home, and some of it can’t be done at work. But putting that aside, I had a nightmare logging-on because of passwords.

Big data, intelligent pills top hospital leaders' tech watch list

January 7, 2014 | By Ashley Gold
It's difficult for hospital leaders to make the right decisions about technology when there is so much available and the reimbursement climate is so weak. But a new ECRI Institute report, "Top 10 Hospital C-Suite Watch List," offers guidance on the latest evidence so leaders can make informed decisions.
"This is not a list of 'must-haves,' but rather a 'must think carefully about' list," states Diane Robertson, director, health technology assessment information service, ECRI Institute, in an announcement. "We don't profess to have all the answers, but the unbiased evidence that we present about these 10 technologies and infrastructure issues will get healthcare leaders off to a steady start on their often rocky journey of acquiring new technologies or making system-wide changes in 2014 and beyond."

Jacob Reider: Health IT usability still a challenge

January 7, 2014 | By Dan Bowman
Many of the health IT usability challenges "tolerated" by early adopter providers more than 10 years ago remain unresolved, according to Acting National Coordinator for Health IT Jacob Reider. To that end, Reider (pictured), in a new post to the Health IT Buzz blog, says that one of ONC's top priorities going forward will continue to be the optimal design and use of such tools, in particular electronic health records.
"These systems--if well designed--guide users toward more efficient, safer, better care," Reider says. "If poorly designed, the user may be frustrated or confused, and could make errors that result in patient harm."
While Reider says that typically, IT with poor usability fails to succeed because of "traditional market forces," he calls the health IT market a different animal for several reasons. For instance, he says, users of health IT aren't always the ones who actually buy such tools. Additionally, he says, contracts associated with EHRs tend to lock users in, meaning they can't just abandon ship at the first sign of trouble.

Diabetics Benefit from Online Patient Portal

January 6, 2014
Patients who have diabetes and use a patient portal online to refill medications increased medication adherence and improved their cholesterol levels, according to new research.
Researchers at the Oakland, Calif.-based Kaiser Permanente and the University of California, San Francisco Medical School looked at follow 17,760 patients with diabetes who received care from Kaiser Permanente in Northern California between January 2006 and December 2010. The patients were registered users of Kaiser’s personal health record (PHR), My Health Manager and had been prescribed cholesterol-lowering medications.

Study: Patient Access to Unedited Physicians' EMR Notes Improves Engagement

Written by Helen Gregg (Twitter | Google+)  | January 06, 2014
Reading physicians' notes directly from the electronic medical record system through an online patient portal left patients with a greater understanding of their health and feeling more in control of their care, according to a study in the New England Journal of Medicine.
Starting in 2010, more than 100 primary care physicians affiliated with Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Danville, Pa., and Harborville Medical Center in Seattle volunteered to allow a combined 200,000 patients to read their EMR notes through a secure online portal.

Health IT Growing Rapidly Through 2017

1/6/2014 09:13 AM
Meaningful Use regulations among the factors that will drive 7.4% annual growth rate in North America, says new research report.
The North American health IT market will grow at a compound annual growth rate of 7.4% to reach a total value of $31.3 billion in 2017, compared to $21.9 billion in 2012, the research firm Markets and Markets predicted in a new report.
The value of the US market, which accounts for nearly three quarters of North American HIT revenue, will rise to $22.6 billion in 2017 from $15.9 billion in 2012, according to the report.
Included in this market forecast are clinical information systems, provider financial systems, and payer systems, including hardware, software, and services. In 2012, the clinical information system with the biggest market value was electronic health records, followed by picture archive communications systems (PACS), computerized physician order entry (CPOE) systems, radiology information systems (RIS), and clinical decision support systems (CDSS).

Survey: Doctors mixed on electronic medical records

Jonathan Ellis and Jon Walker, USA TODAY 4:24 p.m. EST January 7, 2014

The federal government's push to get doctors and medical providers to use electronic health records rather than paper is not getting universal approval from physicians.

Story Highlights

  • Some doctors say electronic record keeping distracts from patient care
  • Congress created the Meaningful Use program in 2009 when it passed the federal stimulus bill
  • Proponents say electronic records improve patient care and will lower costs
A study by the Rand Corp., a non-profit worldwide research group, found that electronic health records, or EHRs, are a mixed bag for doctors. Though doctors in the survey said they believe that EHRs are improving some aspects of quality care for patients, the conversion has increased workloads, been more costly than originally thought and has limited face time with patients.
The study, conducted last summer and released in the fall, was sponsored by the American Medical Association, which has lobbied the federal government for more flexibility with EHR mandates.
"It just takes a lot more time and is much more cumbersome," said Steven Stack, an emergency physician in Lexington, Ky., and a member of the AMA's Board of Trustees. Doctors, he added, are not trying to halt the transition from paper to electronic, but they do want to make that transition less painful by being more reasonable with what Stack said is a "one size fits all" program.

IT's Key Role in Lean Healthcare

Scott Mace, for HealthLeaders Media , January 7, 2014

Our guest columnist recounts the IT-clinical partnership at Sarah Bush Lincoln Health System that reduced ED patient walkouts by 1.2% and increased co-pay collections by 26%.

Guest column by Maggie Ratliff, Vice President & CIO, Sarah Bush Lincoln Health System, with Brian Murphy, IT Technical Director
Sarah Bush Lincoln Health System is going Lean. Our organization, a regional health system in central Illinois, has implemented a very aggressive process improvement strategy based on Lean Six Sigma practices. While the effort necessarily involves many functions within the organization, IT has a particularly important role to play.

Consumers wild about wearables

Posted on Jan 06, 2014
By Bernie Monegain, Editor
More than half of consumers are interested in buying wearable technologies such as fitness monitors for tracking physical activity and managing their personal health, according to the Accenture Digital Consumer Tech Survey 2014.
Accenture, a global management consulting, technology services and outsourcing company, conducted the online survey last October and November.
The survey of more than 6,000 people in six countries -- Australia, Canada, India, South Africa, the U.K. and the U.S. -- showed that many are also interested in buying smart watches (46 percent) and Internet-connected eyeglasses (42 percent).
Wearable technologies deliver a wide range of capabilities: fitness monitors track a person's heart rate and calories burned, while Internet-connected eyeglass displays enable consumers to browse the Internet, take digital photos and receive hands-free notifications.

New tool effective in evaluating quality of clinical notes

January 6, 2014 | By Susan D. Hall
A tool called QNOTE was found effective in evaluating the quality of clinical notes, according to a study from the Maryland-based Uniformed Services University of the Health Sciences.
Quality clinical notes are key to improving patient care, the authors write in an article at the Journal of the American Medical Informatics Association. The point to three key functions the notes serve:
  1. They document the clinician's information collection, problem assessment and plan for the patient;
  2. They create a complete and accurate record that can be used by other clinicians to care for the patient;
  3. They provide substantiation for what was done for legal reasons and reimbursement.

Survey Finds Clinical Value in EHR Use

Written by Akanksha Jayanthi (Twitter | Google+)  | January 03, 2014
e-mail to a friendData from the 2011 Physician Workflow Study from the Centers for Disease Control and Prevention show the majority of physicians, 78 percent, who use an electronic health record said it enhances overall patient care, according to a study published in Health Services Research. Researchers looked at the 3,180 physician responses to the Physician Workflow Survey questionnaire, focusing on physicians' perceptions of clinical benefits of the EHR.
Here are four more key findings from the study.
  • Eighty-one percent of physicians said the EHR helped them remotely access a patient's chart.
  • Sixty-five percent of physicians said the EHR alerted them to a potential medical error.
  • Sixty-two percent said it alerted them to critical lab values.
  • Between 30 percent and 50 percent of physicians associated clinical benefits with EHR use, including providing recommended care, ordering appropriate tests and increasing patient communication.


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