Quote Of The Year

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


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

Saturday, February 08, 2014

Weekly Overseas Health IT Links - 8th February, 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.

'Soft' ROI holds sway in health IT

Posted on Jan 31, 2014
By John Andrews, Contributing Writer
Hard numbers for return on investment in health IT aren’t always measurable, at least in a direct way. Instead, healthcare organizations need to look at both “hard” and “soft” savings when considering a system’s ROI.
“There are many areas where it is difficult to assign a hard dollar figure for savings,” said Dean Wiech, managing director for Lynbrook, N.Y.-based Tools4ever. “A lot of times quantifying savings is more about looking at cost avoidance.”
Tools4ever produces identity management and security software along with professional consulting services for healthcare organizations. Its objective is to provide customers with safe, secure and simplified procedures for accessing IT systems, Wiech said, which can pay dividends in myriad ways.

Patients May Have to Compete With Computers for Doctors' Attention

Study of office visits found a third of physicians' time was spent with their eyes on the screen

January 30, 2014
THURSDAY, Jan. 30, 2014 (HealthDay News) -- Is "The doctor will see you now" turning into "The doctor will watch the screen?" A new study suggests that physicians may spend too much time looking at their computer screens when seeing patients.
The study found that those who use electronic health records in the examination room spend about one-third of patient visits looking at the computer screen, which interferes with their ability to interact with patients.
"When doctors spend that much time looking at the computer, it can be difficult for patients to get their attention," study first author Enid Montague, an assistant professor in medicine, general internal medicine and geriatrics at the Northwestern University Feinberg School of Medicine, said in a university news release.

Privacy fears over NHS database in aid of medical research

January 30, 2014 5:44 pm
By Andrew Ward, Pharmaceuticals Correspondent
To advocates, it is a treasure trove of data that promises to advance medical science and improve the National Health Service. To critics, it is a Big Brother-style threat to civil liberties.
What everyone agrees, is that a new NHS database expected to be launched this spring is one of the most ambitious efforts yet to harness health data in aid of medical research and policy making.
Patient records from across England will be shared with academics, medical charities and drug companies in an initiative that the prime minister, David Cameron, said would “make the UK the best place in the world to carry out cutting edge research”.

Identifying Ireland’s eHealth Needs

Friday, 31 January 2014 13:13 Paul Mulholland
PAUL MULHOLLAND examines the Government’s new eHealth strategy and Health Identifiers Bill
Given the increasing importance of information technology within the health sector, the lack of a national IT health strategy has been seen as a fundamental gap that has prevented the Department of Health and the HSE from running a fully modernised service.

Survey: eHealth Exchange participants will serve 100 million patients

January 30, 2014 | By Ashley Gold
A new Healtheway eHealth Exchange survey reveals a dramatic increase in participation and online transactions in the national health information exchange.
The eHealth exchange, a public-private partnership formerly known as the National Health Information Exchange, currently represents 800 hospitals, 6,000 mid-to-large medical groups, 800 dialysis centers and 850 retail pharmacies throughout the nation, according to an announcement from Healtheway.
"It's particularly gratifying to witness the increase in transactions throughout the community," Michael Matthews, president and chair of Healtheway, said in the announcement. "Each transaction represents another process simplified, a patient better served or a doctor better informed. And this is just the beginning."

New to-do lists loom for 'post-EHR era'

Posted on Jan 30, 2014
By Mike Miliard, Managing Editor
As the electronic health record becomes "just another app," more and more providers are setting their sights on an array of complex future needs. IDC Health Insights' latest report sees big changes coming for care delivery in 2014 and beyond.
The "U.S. Healthcare Provider Predictions for 2014" report, authored by IDC Research Director Judy Hanover, spotlights the technologies and strategies that will be top-of-mind in the coming year, and shows how new realities will be shaping investment priorities in an era of regulatory burden and increased risk.
Chief among those big changes will be a reshaped role for EHRs, Hanover tells Healthcare IT News.

athenahealth topples Epic on KLAS list

Posted on Jan 31, 2014
By Mike Miliard, Managing Editor
After a long tenure as "Best in KLAS Overall Software Vendor," Epic Systems has been replaced by athenahealth for the top spot in this year's ranking, which is tallied based on provider feedback.
That's the first time Epic has been edged out of that category since 2008, when KLAS first began ranking an overall software leader.
athenahealth was also ranked first in the Overall Physician Practice Vendor category, as well as in the Practice Management Service (1-10 and 11-75 physician categories) and Patient Portal brackets.

US-UK sign healthcare IT MoU

23 January 2014   Lis Evenstad
NHS England and the Health and Social Care Information Centre will sign a healthcare IT memorandum of understanding with the US Department for Health and Social Services today.
The MoU focuses on sharing common values around healthcare informatics and making it easier for small and medium-sized enterprises to get a foot in the door on both sides of the Atlantic.
At the Information Services Commissioning Group board meeting earlier this week, Tim Kelsey, NHS England’s director of patients and information, said the agreement would be signed today “to try and make access to both markets easier for SMEs.”

NCHS Data Brief

Number 143, January 2014

Use and Characteristics of Electronic Health Record Systems Among Office-based Physician Practices: United States, 2001–2013


Integrating patient-generated data into EMR: Which road to travel?

Posted on Jan 09, 2014
By Joseph C. Kvedar, Director, Center for Connected Health
Two roads diverged in a wood, and I—
I took the one less traveled by,
And that has made all the difference.
”   Robert Frost
I received two emails from organizational leadership in the past week that represent milestones to me.  One was about our efforts to better manage populations in the context of risk-bearing (pay-for-value) contracts with our payers: “[Partners] is undergoing a planning process to determine what we can do over the next 3 years (2015 to 2017) to better prepare for increased risk in payer contracts….there is a segment of our Hypertension and Diabetes population (and CHF) that would benefit from telemonitoring.”  The language here is not dramatic, but the recognition that patient-generated data can be a critical tool for population health management and improved efficiency of care delivery is something we have strived to demonstrate over the last 10 years or more.  It feels good to hear it come from others.

3 reasons for the demise of patient privacy

January 29, 2014 | By Dan Bowman
Several factors have contributed to the demise of patient privacy in recent years, according to software analyst and healthcare blogger Shahid Shah (a.k.a., The Health IT Guy).
For example, Shah said at a recent discussion hosted by the Patient Privacy Rights Foundation on the best privacy practices for electronic health records in the cloud, patients tend to not "demand" privacy as the cost of doing business with providers.
"It's rare for patients to choose physicians, health systems or other care providers based on their privacy views," Shah said in a blog post summarizing thoughts he shared at the event. "Even when privacy violations are found and punished, it's uncommon for patients to switch to other providers."

CCHIT ending testing and certification of EHRs

Posted: January 29, 2014 - 12:00 pm ET
The Certification Commission for Health Information Technology is getting out of the business of testing and certifying electronic health-record systems after nearly a decade as the first and still most-commonly used provider of those services in the U.S.
The organization also stopped taking applications for testing and certification services from vendors Tuesday and will finish work on about 70 of those systems it has in the pipeline and wind down that part of its operations by April or May, CCHIT Executive Director Alisa Ray said.
Today, roughly half of all health IT systems on the official Certified Health IT Product List kept by the Office of the National Coordinator for Health Information Technology at HHS have been tested and certified by CCHIT.

VA Kicks Off Contracting for New Electronic Health Records System

By Bob Brewin January 28, 2014
The Veterans Affairs Department has released the first procurement for its next-generation electronic health record system, with a focus on support services for the Health Systems Informatics division of the Veterans Health Administration.
The “sources sought” notice for the new version of Veterans Health Information Systems and Technology Architecture EHR, dubbed VistA Evolution, makes it clear that the Health Systems Informatics division will drive development in cooperation with the VA Office of Information and Technology.
VHA plans to contract for VistA Evolution “workgroup coordinators” to help manage, among other things, development of new interfaces to replace the aging VistA Web and other EHR viewers. These coordinators will also work with the moribund Defense Department/VA Interagency Program Office, which is “is programmatically responsible for managing and delivering the seamless sharing of interoperable health data between the departments.”

What Patients Will Share To Improve Care

1/28/2014 01:45 PM
Surveys show chronically ill patients and the general population are both willing to share personal information to help improve quality of care.
A survey of patients with chronic conditions showed that most are willing to share their health information with physicians, other patients, researchers, and drug companies to improve the quality and safety of care. In this respect, a second survey revealed, their attitudes are not too different from those of the general population.
The two polls were conducted by PatientsLikeMe (PLM), a social network for patients with medical conditions, and Consumer Reports National Testing and Research Center. PLM surveyed its own members, and Consumer Reports polled a group of consumers that more closely represented the US population. The results of both surveys were reported in an Institute of Medicine (IOM) discussion paper.

The Case for Patient-Controlled Data Sharing

JAN 27, 2014 4:37pm ET
Patient Privacy Rights leader Deborah Peel, M.D., recently penned a commentary attacking “myths” that personal health data is being acquired legally and ethically. Brian Baum, CEO at vitaTrackr Inc., which offers a platform for businesses to exchange patient-approved health data, counters that there is real value to patient data and that patients can have control over who gets it. Here is his response to Dr. Peel:
“Dr. Peel,
“I believe the correct answer is consumer control of their health information. You say: ‘Just ask anyone you know if they ever agreed to the hidden use and sale of sensitive personal information about their minds and bodies by corporations or ‘research’ businesses for analytics, sales, research or any other use. The answer is ‘no.’
“You assume that the unilateral response of 310+ million people is an automatic ‘no.’ I would respectfully suggest that if you rephrased the question, the answer may change:

DeSalvo feels 'pain' of overregulation

Posted on Jan 28, 2014
By Diana Manos, Senior Editor
ACO, ICD-10, MU, PCMH, and PQRS are more than just an acronym soup.
Sean McPhillips, project manager for the Kentucky Regional Extension Center, wants to know whether or not the government has any plans to coordinate these pressure-packed initiatives.
McPhillips said he's concerned that there isn't enough alignment in the various federal programs, forcing providers, who are primarily trying to focus on practicing medicine, to "jump through all these hoops for all these programs that seem to be competing with one another."
And it's what he asked of the new national coordinator Karen DeSalvo, MD, during a recent ONC summit in Washington, DC.
"I have seen the pain," DeSalvo answered.

Healthcare needs a 'Henry Ford' moment for big data

January 28, 2014 | By Susan D. Hall
In the quest to transform unconnected and unwieldy masses of health data into smart data, researchers from the Health Care Cost Institute call for a "Henry Ford" moment to achieve economies of scale.
"Just as the Model-T revolutionized car production and, by extension, transit, the creation of smart health data enclaves will revolutionize care delivery, health policy and health care research," researchers write at Health Affairs.
They suggest taking a page from the entertainment industry--using a digital rights manager (DRM)--as a governance structure. These data enclaves would be secure from outsiders, with carefully controlled access, then providing only the data covered in users' licenses.

Is the future of HIE private?

By Tom Sullivan, Editor
Whether public health information exchanges (HIE) will survive after federal funding has been a lingering question.
And while any survey or research project is not enough to seal the fate of public HIEs, the results ought to raise a few eyebrows. 
Nearly three-quarters (72 percent) of the respondents to a study Black Book intends to publish on Tuesday anticipate that “as few as 10 of the currently functioning public exchanges will sustain operations” by 2017. Unless, that is, they make significant changes to their processes, revenue streams and general business models.
What’s more, 97 percent of health insurers indicated that public HIEs are “struggling to exchange trusted patient data sets” which helps explain why 94 percent “do not see the value proposition in public HIEs.” And more than 80 percent “of the nation’s 220 operating public HIEs are stalling as federal grants supporting half of the state and regional HIEs are dried up.”

CCIO network launches 12-point plan

20 January 2014   Rebecca Todd
The CCIO Leaders Network has released a Vision and 12-point plan for chief clinical information officers, to improve the quality of clinical information across the NHS.
The plan calls for the appointment of a senior responsible clinician for information in a wide range of organisations, and argues that this is a vital step for establishing a robust 'post-Francis' regulatory regime.
Robert Francis QC’s second report on the scandal at Mid Staffordshire NHS Foundation Trust, released last year, called for more transparency in the health service and the government response has made 'fiddling' health data a crime
The CCIO Leaders Network plan sets out the steps that the Secretary of State for Health, NHS England, the Care Quality Commission, National Institute for Health and Care Excellence and others need to take to avoid clinical data problems.

Care.data safeguards detailed

28 January 2014   Rebecca Todd
The care.data leaflet due to reach 22m households
Patient identifiable information extracted as part of care.data will not be available via Section 251 requests while NHS England establishes trust in the data sharing programme.
A privacy impact assessment published by NHS England reveals that the flow of ‘red’ or patient identifiable data collected as part of care.data will be restricted “in the first instance to exceptional circumstances, for example in the event of a civil emergency."
Its disclosure would be permitted where there is section 251 approval, which allows the Secretary of State for Health to set aside the common law duty of confidentiality in specific circumstances where anonymised information is not sufficient and where patient consent is not practicable.

GPs doing well on data protection - ICO

28 January 2014   Lis Evenstad
Most GP surgeries have good patient data protection schemes in place, a report by the Information Commissioner’s Office has concluded.
The report, published today, sums up 24 advisory visits by the ICO to GPs across England in the past year.
It says the majority of GPs had good data protection policies and awareness of data issues, including proper security and patient confidentiality.
Many surgeries incorporated information governance and confidentiality requirements into employment contracts and that staff “generally showed a good awareness of information governance and security issues.”

HIEs can reduce redundant imaging in emergency departments, study finds

28 January, 2013
Repeat emergency department orders for X-rays and other images can be lower when providers have access to a health information exchange, according to a study by a team of University of Michigan researchers.
Patients who visited EDs in two hospitals participating in HIEs within 30-day periods reduced repeat imaging for computed tomography (8.7%), ultrasound (9.1%) and chest X-rays (13%). The researchers studied 20,000 patient visits at 37 EDs in HIEs and compared them against a control group of 410 EDs that did not. The study report, “Does Health Information Exchange Reduce Redundant Imaging? Evidence from Emergency Departments,” was published in the online journal Medical Care.
No dollar amount of cost savings was calculated for the reduced visits, but that doesn't mean those savings were negligible, nor limited to the three image types under the study, according to the study authors.

Five Pieces Of Advice For Karen DeSalvo

01/27/2014 By John Halamka
John Halamka, MD, CIO, Beth Israel Deaconess Medical Center
Karen DeSalvo started as the new National Coordinator for Healthcare IT on January 13, 2014. After my brief discussion with her, I can already tell she’s a good listener, is aware of the issues, and is passionate about using healthcare IT as a tool to improve population health. She is a cheerleader for IT, not an informatics expert. She’ll rely on others to help with the IT details, and that’s appropriate.
What advice would I give her, given the current state of healthcare IT stakeholders?
1. Rethink the Certification Program. With a new National Coordinator, we have an opportunity to redesign certification. As I’ve written about previously, some of the 2014 Certification test procedures have negatively impacted the healthcare IT industry by being overly prescriptive and by requiring functionality/workflows that are unlikely to be used in the real world. One of the most negative aspects of 2014 certification is the concept of “certification only.” No actual clinical use or attestation is required, but software must be engineered to incorporate standards/processes which are not yet mature. An example is the “transmit” portion of the view/download/transmit patient/family engagement requirements. There is not yet an ecosystem for patients to “transmit” using CCDA and Direct, yet vendors are required to implement complex functionality that few can use. I completely support the idea of “transmit,” but it should have waited until the ecosystem was mature enough to make it an attestation requirement.

Person@Center: ONC Driving Toward More Patient-Centered Care

by Helen R. Pfister and Susan R. Ingargiola, Manatt Health Solutions Monday, January 27, 2014
Thanks to the payment reform provisions of the Affordable Care Act and the emergence of new consumer-facing health technologies, the health care system is in the midst of a broad-scale effort to make health care more patient- or "person"-centered (i.e., to place the individual at the center of the system and to recognize her as key to achieving better health outcomes at lower cost). The importance of placing patients in the driver's seat has not been lost on the Office of the National Coordinator for Health IT, which has been working to bring the benefits of health IT to bear on the nation's efforts to empower individuals. ONC recently released a new Issue Brief, titled, "Using Health IT To Put the Person at the Center of Their Health and Care by 2020," and is seeking feedback on new goals and strategies for health IT-enabled, patient-centered care.

ED Physician Executive Slams EHRs

Scott Mace, for HealthLeaders Media , January 28, 2014

Electronic health records "are not effective communications tools—not effective at all," says a self-avowed technology optimist who holds a dim view of current EHR capabilities, but has hopes for better systems to come.

Prentice Tom, MD, doled out some bitter medicine to a room full of healthcare IT vendors—and, I think, government regulators at the Northern California HIMSS Innovation and Technology Summit this month.
Tom, the lead speaker at the Silicon Valley event and a self-avowed technology optimist, shared his unvarnished assessment of current electronic medical records. They "are not effective communications tools—not effective at all."

Opening Up About Medical Records: OpenNotes Gives Patients Access to Provider Notes

By Jennifer Thew, RN, MSJ on January 28, 2014
Seinfeld has been described as a show about nothing. So it may come as a surprise that one of its episodes tackled the issue of patient access to medical information.
In the episode Elaine goes to visit her doctor because of a rash and gets a look at her chart. She notices she’s described as “difficult” for refusing to put on a paper gown at an appointment three years before. She tries to talk to her physician about it and he pretends to erase the comment. She goes to a new physician who takes one look in the chart, does a halfhearted assessment of the rash and hurries out the door. Her only option left is to get Kramer to “steal” her chart so she can remove the offending page. Of course in typical Kramer-style, this ends in failure. He doesn’t get the chart and: “Now there’s a chart on me!”
This episode aired 18 years ago, but some of the sentiment expressed is still present in today’s world of healthcare.

Privacy Leader Takes Issue with ‘Myths’ about Big Data

JAN 24, 2014 4:47pm ET
Responding to a recently published story in Health Data Management, “The Biggest Big Data Myths of 2013,” as well as the news that drug database vendor IMS Health Holdings will go public, Deborah Peel, M.D., leader of the Patient Privacy Rights advocacy group, offers a different view of Big Data:
“The biggest myth about ‘Big Data’ users of the entire nation’s health information is that personal health data was acquired legally and ethically.
“Just ask anyone you know if they ever agreed to the hidden use and sale of sensitive personal information about their minds and bodies by corporations or ‘research’ businesses for analytics, sales, research or any other use. The answer is ‘no.’

EHRs to redefine the role of doctor

Posted on Jan 27, 2014
By Bernie Monegain, Editor
Researchers at the Johns Hopkins Bloomberg School of Public Health and The Commonwealth Fund have concluded that electronic health record systems and other digital tools are likely to curb the demand for physicians in the future.
Based on their analysis of recent trends in digital health care and a review of the scientific literature, the authors conclude that patients’ future use of physician services will change dramatically as electronic health records and consumer e-health “apps” proliferate. The findings appear in the issue of the journal Health Affairs.
 “The results of our study are important because they provide a forward looking snapshot of how health IT will profoundly impact the American health care workforce over the next decade or two,” said the study’s lead author Jonathan Weiner, professor of Health Policy and Management at the Johns Hopkins Bloomberg School and director of the Center for Population Health Information Technology.

Beth Israel aims for ICU harm reduction

Posted on Jan 27, 2014
By Mike Miliard, Managing Editor
With help from a $5.3 million grant from the Gordon and Betty Moore Foundation, Beth Israel Deaconess Medical Center will explore ways to put IT and patient engagement to work eliminating preventable harm in the ICU.
BIDMC officials say the grant will help them better define the burden of harm in the intensive care unit – including the loss of dignity and respect – as the hospital moves to a systems-based approach to eliminating preventable harm.
As it works to develop tools to support interventions that can eliminate preventable harm, BIDMC will focus on giving more timely and informative information to intensive care patients, families and providers. The hope is to develop new IT applications that can better involve people in the care process will reducing risk  in the ICU.

'Digital divide' persists in health IT adoption

January 26, 2014 | By Susan D. Hall
Adoption of electronic medical records by primary care physicians has grown substantially, but the "digital divide" between large and small physician practices persists, according to a new study from the Commonwealth Fund.
Between 2009 and 2012, adoption grew from 46 percent to 69 percent. A majority of physicians use core health IT functions such as e-prescribing, electronic ordering of lab tests and certain types of clinical decision support.
Practice size, however, is the major factor affecting adoption. Ninety percent in practices of 20 or more physicians use EMRs, compared to just half of those in solo practices.

GlassesOff aims to eliminate reading glasses with brain training

By: Jonah Comstock | Jan 23, 2014
Israeli neuroscience technology company GlassesOff has announced its first iPad app, just a month after the company launched its iOS app for iPhones and iPods.
The apps help users eliminate dependency on reading glasses by ”enhancing the image processing function in the visual cortex of the brain,” according to the company. Within the app, users can play intensive visual stimulation games comprised of the 12-minute game sessions and reading evaluations. GlassesOff suggests users participate in this routine for three months, but also that they come back to the app occasionally to maintain effects over a long period of time. The app monitors performance and progress and adjusts to the user’s results accordingly.
“Having an iPad specific application is extremely important for GlassesOff due to the prevalence of tablets devices in our target demographic – those aged in their forties and fifties are the highest among all age groups with 49 and 38 per cent respectively owning a tablet device,” Nimrod Madar, CEO of GlassesOff, said in a statement.

eHealth poses risks, says Kemri

Updated Sunday, January 26th 2014 at 20:58 GMT +3 By GATONYE GATHURA
 Your private medical information may not be safe anymore with the increasing use of eHealth programmes, a top research institution has warned.
Kenya Medical Research Institute ( Kemri) now wants Government to introduce safeguards that will guarantee privacy.
The requirement that all SIM cards be registered for the identification of phone users, Kemri says poses new challenges with regard to maintaining anonymity of research subjects.
 The law allows the police to track down SMSes, identify senders and subject matter. In the same way, they can intercept health messages between a patient and the doctor or a research participant and researchers.



Anonymous said...

Fascinating article - Identifying Ireland’s eHealth Needs.

One gets a distinct sense of de ja vue and so the wheel revolves one more time and we start all over again.

The story is about Ireland. So many similarities - the lack of a coherent National eHealth Strategy as a fundamental gap, with ePrescribing, Referrals and Telehealthcare getting top billings alongside the identifiers.

Anonymous said...

Re "Patients may have to compete with computers for doctors' attention". Too true - seems some have lost the art of personal attention. My elderly mother is hesitant to go to her GP these days because he does not look at her, engage with her, talk to her - he just sits and types into his computer which she finds 1) rude 2) uncomfortable 3) unnecessary.