Saturday, March 29, 2014

Weekly Overseas Health IT Links - 29th March, 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.

Open, free popHealth at work on quality

Posted on Mar 21, 2014
By Anthony Brino, Editor, HIEWatch
An open source software program created with the help of the Office of the National Coordinator is now federally certified and ready to be used as a population health tool.
First developed in 2010, the program, called popHealth, imports data, then calculates, displays, and exports it as electronic clinical quality measures using Cypress, the same open source engine the ONC uses to certify eCQM functionality in EHRS.
Developed and certified in partnership with Northwestern University, popHealth “is in some ways a simple piece of software,” as ONC public health analyst John Rancourt wrote in a blog announcing its certification for meaningful use. "However, it is highly sophisticated and versatile because it is standards driven and it leverages the same quality measure engine as Cypress." 

How hospitals can make big data pay big

Posted on Mar 21, 2014
By Donna S. Charles, principal consultant, Oron Healthcare Group
Hospital executives are faced with numerous challenges related to healthcare reform in general and the Affordable Care Act  in particular. Strategic decisions about how to address these challenges will significantly impact not only the financial and clinical performance of hospitals, but the perception of executive leadership itself.
Even though optimizing workflows and other processes are the main avenues available to executives to address these issues, it’s critical to understand the role that advanced information technology has in bringing these efforts to fruition.
Reduced payments to hospitals for avoidable readmissions began in 2012 under the ACA’s Hospital Readmissions Reductions Program, and the program is expanding in future years by increasing the level of payment reductions and expanding the scope of illnesses covered.

FDA issues recall of McKesson Anesthesia Care Record

Author Name Kyle Murphy, PhD   |   Date March 20, 2014   |
Nearly a year after McKesson notified its customers about flaw in one of its health IT systems, the Food and Drug Administration (FDA) has moved to applying a Class I recall. The product in question is McKesson’s Anesthesia Care Record (ACR), a clinical decision support system aimed at helping anesthesiologists identify potential adverse drug events.
“The system is generally indicated in the anesthetizing environment when the anesthesia provider decides to perform a patient assessment, to generate a paper and/or electronic record of the administration of anesthesia to a patient, and to document care,” the FDA notes.

ONC Launches Program to Foster Health IT Use by EMTs

Written by Helen Gregg (Twitter | Google+)  | March 20, 2014
The ONC has partnered with the Office of the Assistant Secretary for Preparedness and Response on a campaign to increase the use of heath IT by emergency medical technicians and other first responders.

FDA Again Issues Recall Notice for McKesson Anesthesia Care Software

MAR 19, 2014
The Food and Drug Administration on March 14 issued a Class 1 recall notice to healthcare professionals for the Anesthesia Care software of McKesson Corp. The software collects, processes, and records data both through manual entry and from monitors which are attached to patients, such as in an operating room environment. San Francisco-based McKesson had initiated a voluntary Class II recall of the product last year.
The Class I recall is in the FDA’s highest risk category which is reserved for defects where “there is a reasonable probability that the use of or exposure” to the product “will cause serious adverse health consequences or death.” It is not often that the regulatory agency issues this kind of recall notice for standalone software that does not play a role in operating a medical device. However, the software “provides clinical decision support by communicating potential adverse drug event alerts proactively during the pre-anesthesia evaluation and at the point-of-care,” the FDA said in the notice.

FDA Surveillance System Leverages Databases to Monitor Medical Products for Adverse Events

MAR 19, 2014
The Food and Drug Administration is actively searching more than 100 million health insurance records to uncover possible adverse events, rather than relying on doctors and patients to report them, according to Michael Nguyen, M.D., Acting Director of the Division of Epidemiology in FDA’s Center for Biologics Evaluation and Research.
The surveillance system, called Sentinel, is the result of a partnership between FDA and the Harvard Pilgrim Healthcare Institute, who are using the system to determine whether a certain type of immune therapy is associated with heart attacks or strokes, and to better define the true rate of acute lung injury after transfusions of certain blood components. 

RAND: EHRs 'significantly worsened' doc satisfaction

March 18, 2014 | By Marla Durben Hirsch
Physicians' views of electronic health records are still mixed despite widespread adoption, seen as good in concept but that they "significantly worsened" their professional satisfaction, according to a new RAND Health report.
Conducted at the request of the American Medical Association, the report focused on determining the factors that lead to physician fulfillment. Its authors found that EHRs were a source of both promise and frustration. While they enabled doctors to improve quality of care and remotely access medical records, EHRs also:
  • Required time-consuming data entry that could be better accomplished by clerks and scribes;
  • Were difficult to use;
  • Interfered with patient face to face interaction;
  • Lacked interoperability; and
  • Degraded clinical documentation

David Blumenthal: Benefits of HIT programs will surface with time

March 20, 2014 | By Dan Bowman
An "asymmetry of benefits" for providers has kept the healthcare industry from ubiquitous adoption of health IT--and electronic health records, in particular--and thus realizing its full potential, according to David Blumenthal, former national coordinator for health IT and current president of The Commonwealth Fund.
"From the patient's perspective, this is a no-brainer. The benefits are substantial," Blumenthal told The Atlantic in a recent interview. "But from the provider's perspective, there are substantial costs in setting up and using the systems. Until now, providers haven't recovered those costs, either in payment or in increased satisfaction, or in any other way."
While to that end, Blumenthal said, the medical marketplace is broken, he added that there is still some hope. He pointed to systems like the U.S. Department of Veterans Affairs and Kaiser Permanente as examples where technology has thrived due to "internalized" benefits that have led to better and faster adoption.

When technology is a barrier to care

March 21, 2014 | By Ashley Gold
Are doctors suffering at the hands of the Herzberg principle--which says that the best way to discourage workers is to subject them to policies and procedures that don't make sense? 
An article in the Atlantic explores how changes in the healthcare payment model, health IT and the doctor-patient relationship are discouraging docs.
"It is easy for many healthcare leaders to forget that doctors go into medicine not because they enjoy entering data into complex electronic health records and ensuring that their employer gets paid for everything they do, but because they want to make good diagnoses, prescribe appropriate treatments and help patients," the article states.

5 Steps to Preventing Security Breaches

Lena J. Weiner, for HealthLeaders Media , March 20, 2014

Medical records are a high-value commodity, fetching up to $50 each. Medical data breaches are being reported ever more frequently. Risk assessments and basic IT and social media policies can help protect your organization.

Eight computers were stolen from medical billing contractor Sutherland Healthcare Solutions in Torrance, CA, on February 5, 2014. A month later, the week of March 6, many patients received letters on Sutherland letterhead alerting them that their personal data, including first and last names, social security numbers, and billing information—and possibly their dates of birth, addresses and even their personal medical information and diagnoses—had potentially been compromised. As many as 173,900 patients may be affected.
Medical records are a high-value commodity. While social security numbers go for about one dollar each on black market websites, medical records can fetch as much as $50 each, according to the Medical Identity Fraud Alliance.

IBM’s Watson finds a new challenge: personalised cancer treatment

March 19, 2014 8:33 pm by Richard Waters
For its most promising new technology, IBM has been searching for problems to solve that are both deep and broad enough. Now, with a clinical trial in the US aimed at personalising the treatment of cancers, it might just have found one.
The Watson question-and-answer system has felt like a solution waiting for the right problem. Winning the Jeopardy TV quiz show three years ago was a spectacular way to show off the new technology’s advances in pattern recognition and natural language. But how to make inroads into real business or social problems?
The big push CEO Ginni Rometty has given Watson this year suggests she’s impatient for some results. That has meant trying to apply the technology to broad issues in a way that can scale up quickly.
The announcement on Tuesday of a clinical trial to deliver more personalised care to brain cancer patients looks like a case in point.

IBM's Watson Takes Aim At Cancer

3/19/2014 03:26 PM
Collaboration between IBM and the New York Genome Center will use Watson to match cancer mutations to potential treatments, compressing process from months to minutes.
IBM Research and the New York Genome Center want to prove that IBM's Watson can dramatically reduce the time required to identify the most effective cancer treatments based on an analysis of a specific patient's genetic mutations.
In partnership with regional hospitals, the NYGC plans to evaluate Watson's ability to help oncologists develop more personalized care for patients with glioblastoma, an aggressive and malignant brain cancer that kills more than 13,000 people in the US each year. The NYGC is a nonprofit consortium of the state's academic, medical, and university leaders working to advance the applications of genomics, the branch of genetics that studies complete DNA sequences rather than individual genes.

3 tips to avoid BYOD breaches

Posted on Mar 19, 2014
By Diana Manos, Senior Editor
Without question, BYOD, or “bring your own device,” offers benefits to both healthcare employees and employers. It also presents security issues.
The benefits of BYOD are luring. To name a few, users are familiar and comfortable with their own devices, which increases productivity. No training is required. And employees provide the latest devices, saving hospitals the expense.
Yet, despite these benefits, security issues keep many hospitals from allowing BYOD, and with valid reasons. BYOD raises numerous red flags on the security and HIPAA compliance fronts and the bottom line is: No matter who owns the device, hospitals are responsible for any data breaches that occur.

Patient monitoring technology market to reach $5.1B by 2020

March 19, 2014 | By Susan D. Hall
The U.S. market for patient monitoring technology--increasingly moving outside the hospital--is expected to grow to more than $5.1 billion by 2020, according to a new report by iData Research.
The report points to the growth of multi-parameter vital sign monitors, electroencephalograms (EEG), electromyograms (EMG), cerebral oximeters and pulse oximetry devices in particular for fueling that growth. The pulse oximetry-monitoring market alone is expected to exceed $1 billion by 2020, it according to an announcement.

Health Information Exchanges May Reduce Hospital Admissions, Study Finds

Written by Ayla Ellison (Twitter | Google+)  | March 18, 2014
Weill Cornell Medical College in New York City has released the findings of a study that indicates health information exchange allows emergency departmentphysicians to treat patients more efficiently and effectively and could reduce unnecessaryhospital admissions.
 Using claims information collected from seven EDs in Rochester, N.Y., the researchers found that physicians and healthcare professionals who had access to patient data from other providers through the region's health information organization were better able to avoid hospitalizing patients who didn't need inpatient care.

ICD-10 Deadline: Ready or Not, Here It Comes

MAR 17, 2014 11:20am ET
Today is St. Patrick's Day, a sobering reminder that there are less than 200 days left until the October 1 ICD-10 implementation deadline. Either way, if you are a provider that is concerned about being prepared to make the code switchover, no one could blame you for having a good, strong drink (or two).
With only the spring and summer months separating providers from the ICD-10 go-live date, many are asking themselves how far along they should be at this point in implementation activities. Well, the truth is that significant numbers of providers have not even begun to prepare for ICD-10, as terrifying and as stressful as that may sound. A recent poll of 1,200 practices with more than 55,000 physicians found that less than 10 percent reported significant progress in overall ICD-10 readiness.

EHRs may help save lives from sepsis

Posted on Mar 18, 2014
By Erin McCann, Associate Editor
Here's another reason why those multi-million dollar electronic health record systems might be finally paying off, in terms of lives potentially saved. 
According to new research, EHRs can be used to predict the early stages of sepsis, one of the leading causes of death in the U.S., responsible for killing some 210,000 people each year. 
Researchers at UC Davis have found that routine health data – blood pressure, respiratory rate, temperature and white blood cell count – from the EHRs of hospitalized patients can detect the illness earlier in its infancy and help pinpoint what patients are at high risk of developing the disease. 
After analyzing the EHRs of some 741 sepsis patients, researchers were also able to determine that just three measures – lactate level, blood pressure and respiratory rate – can pinpoint the likelihood a patient will die from the disease.

EHR data can predict sepsis

Beth Walsh
Mar 17, 2014
EHRs can be used effectively to predict the onset of sepsis, according to researchers from the University of California at Davis. 
Researchers used routine information of hospitalized patients, including blood pressure, respiratory rate, temperature and white blood cell count. Analysis of the data from the EHRs of 741 patients with sepsis revealed that vital signs combined with serum white blood cell count can accurately predict sepsis, which is associated with increased blood levels of lactate. They found that lactate level, blood pressure and respiratory rate could determine a patient’s risk of death from sepsis. 
Sepsis is a leading cause of death and hospitalization in the U.S., occurring in more than 750,000 patients annually and killing nearly one-third of all people who develop the immune system response to infection that can damage organs and cause permanent physical and mental disabilities. Sepsis-related deaths and serious consequences, however, are preventable for up to 30 percent of patients. 

Evidence developed for IT investment

14 March 2014   Rebecca Todd
NHS England is working with McKinsey to develop an evidence base for the NHS to invest in technology.
The economic analysis will support the release of NHS England’s Transparency and Participation Call to Action, which is due out in the summer.
NHS England director of intelligence and strategy Christine Outram presented on the project with representatives from McKinsey at the Health and Care Innovation Expo in Manchester last week.
Outram said the Cabinet Office, Treasury and individual trusts “need persuading that it’s worth investing in empowering patients and the power of technology”.

3 ways to enhance patient engagement

March 18, 2014 | By Zack Budryk
Engaging patients in their own wellness and care--as well as their personal health data--is necessary to qualify for new payment models and incentives and to improve outcomes. 
Looking for some creative strategies to engage patients? Tech reporter Allison Diana compiled a whopping 16 of them in a slideshow for InformationWeek. Here are just three of the recommendations:
Electronic messages to patients: "Meaningful Use Stage 2 mandates that more than 5 percent of patients communicate with healthcare providers via secure electronic messages," Diana writes. "Increased messaging saves on phone costs and pleases patients with its convenience and immediacy." At Children's Medical Center in Dallas, for example, patients and families averaged 480 messages monthly over six months in 2013, a number that is expected to increase, according to the article. 

ICD-10 and EHR Fuel Clinical Documentation Improvements

Scott Mace, for HealthLeaders Media , March 18, 2014

The electronic health record is at the heart of efforts to improve clinical documentation. One effort strives to get disparate EHR software programs—and the physicians using them—to encode problem lists in a common way.

This article appears in the March 2014 issue of HealthLeaders magazine.
With the October 1 activation date for ICD-10-coded payments and the end-of-year move to meaningful use stage 2, this will be a watershed year for clinical documentation improvement.
Technology is playing a big role in both efforts. To an unprecedented degree, and with significant cost and effort, the electronic health record is becoming the heart of clinical documentation improvement—prompting doctors to enter more specific diagnoses, reducing the need for labor-intensive coding, and propagating a common vocabulary between disparate care coordinators to enhance decision support.

RECs Won't Finish Mission Without More Funding

Scott Mace, for HealthLeaders Media , March 18, 2014

For many small and rural providers, Regional Extension Centers have been a low-cost or no-cost lifeline through the process of acquiring EHR technology and participating in the meaningful use incentive payment program. What happens to the stragglers as the RECs wind down?

Consider the plight of the nation's Regional Extension Centers, which serve as serve as support and resource centers to assist providers in EHR implementation and Health IT needs around the country.
Until late last year, the RECs' funding was due to run out. Recently, unspent portions of that previously allocated funding was freed up through February 2015 through an ONC ruling known as a "no-cost extension."
For many small and rural providers, RECs have been a lifeline of low-cost or no-cost source of advice and support through the daunting process of acquiring EHR technology and participating in the meaningful use incentive payment program.

Online tool could be used to identify public figures' medical care, say critics

OmegaSolver's Patient Analyser tool has been taken offline after concerns over use of 'patient-level' data
An online tool that claimed to be able to use NHS patient hospital records to reveal treatment "right from initial diagnosis until the current day" has been pulled from the internet after privacy campaigners warned it could be used to identify the precise details of medical care for people in the public eye.
OmegaSolver, a company founded last year, had access to NHS hospital episode statistics and offered an "internal database [which] tracks actual patients within every hospital within England providing … up-to-date information for every disease area". The company said its clients included drugs firms.
However, the firm's website was closed down last week after press inquiries to the health authorities regarding the release of "patient-level" data to the company.
Satnews Daily
March 17th, 2014

ITU—Health Data Exchange Spec Enabled (Comms)

 [SatNews] Following calls for increased global coordination of standards enabling e-health, ITU has offered first stage approval to an important specification enabling an exchange of multimedia health data between a health provider, a controlling function and patient.
The new standard will enable different e-health systems to smoothly exchange patient health data in both low- and high-resource settings, making it ideal for applications in both developed and developing countries.
e-Health experts explain that a combination of a common data definition with connectivity across different systems—ranging from the personal health and point-of-care devices described in Recommendation ITU-T H.810 to a range of health management back-ends—will provide simple, secure and scalable interoperability.

Denmark tests new health IT systems

Posted on Feb 25, 2014
By Dillan Yogendra, Managing Editor, HIMSS Europe
Sixteen new hospitals are being constructed, including eight new super hospitals with a state-of-the-art health IT structure. US$7 billion will be spent over the next ten years. This means fewer, but more specialized hospitals and an expanded use of health IT, which will ultimately decrease the number of beds required by 20% and reduce the average duration of hospitalization from five to three days.
Keeping healthcare expenditure down with a growing aging population and an increase in chronic diseases is a challenge, but Denmark has managed just this. While US healthcare averages 17.9% of GDP, Denmark has kept its costs to 10.5% of GDP. This is in a large part due to expansion of health IT solutions throughout the sector.
The Danish Government Growth Plan leading up to 2020 has made available 12 billion DKK for core welfare services and is expected to bring substantial changes to the classical idea of healthcare provided primarily through hospitalization. Telehealth is seen as a tool to increase the quality of care for its populations while lowering public spending costs.

Identity crisis looms for US healthcare

Posted on Mar 17, 2014
By Anthony Brino, Editor, HIEWatch
While the U.S. continues digitizing its healthcare industry, a huge challenge is arising: not only securing those systems but verifying identities.
With a steady stream of HIPAA-covered data breaches continuing over the past few years, not to mention the debacle of Target’s recent customer financial information loss, some argue that current identity security approaches just aren’t adequate -- especially considering that criminal attacks on hospitals are increasing substantially.
“Protecting sensitive personal information with passwords is akin to building a massive stone fortress and then securing the front door with the kind of lock I use to keep my two-year-old out of my bathroom,” said Jeremy Grant, a senior advisor on identity management at the National Institute of Standards and Technology, heading up the National Strategy for Trusted Identities in Cyberspace.

Gamification comes to clinicians

Posted on Mar 17, 2014
By Mike Miliard, Managing Editor
There's been a lot of talk in the past few years – some would say too much, and way too excited – about gamification.
Using computer game design and mechanics to teach people, or encourage them to change their behavioral patterns, certainly seems to make some sense. Harnessing digital stimuli and score-keeping to make the most of a person's natural inclination toward fun and competition has some exciting potential benefits.
But it all depends on the game, and how it's put to use. As Gartner put it in a 2012 report on the phenomenon – which predicted that, by this year, as many as 80 percent of gamified apps would be doomed by poor design – "gamification is currently being driven by novelty and hype."

Docs, nurses learn to get along in simulation game

March 17, 2014 | By Ashley Gold
A new simulation game aims to teach doctors and nurses how to work more collaboratively and avoid conflicts in order to prevent dangerous or sometimes fatal miscommunications.
Researchers at the University of Texas at Arlington College of Nursing, Baylor Scott & White Health and University of Texas at Dallas have developed a video-game simulation that can teach doctors and nurses to work together--helping them avert tense situations in the real world by playing them out in the game.
"Our hope is that this project will enhance patient safety and, ultimately, improve patient outcomes," Beth Mancini, a UT Arlington nursing professor, said in an announcement.

Computer virus at Glenwood hospital may have jeopardized patient info

By Drew Munro
The Post Independent
Posted:   03/14/2014 12:39:00 PM MDT | Updated:   4 days ago
GLENWOOD SPRINGS —Personal information of more than 5,000 people who have been patients at Valley View Hospital may have been compromised by a computer virus that infected the hospital's computer system, according to officials there.
Hospital information technology (IT) officials discovered the virus in January, said Stacey Gavrell, Valley View Community Relations director, and steps were taken immediately to quarantine the virus and begin the process of determining what happened.
A forensic IT team was brought in to conduct the investigation, she said.


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