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, August 23, 2014

Weekly Overseas Health IT Links - 23rd August, 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.

Why sharing data is so hard

Posted on Aug 15, 2014
By Government Health IT Staff
Is the health information exchange landscape as bleak as it appears?
More than $26 billion has been invested, mostly in incentive payments to hospitals and eligible professionals who meaningfully use electronic health records. Yet just a small percentage of healthcare systems are electronically sharing data, according to a report in the latest issue of Health Affairs.
“While the sharing of information electronically -- or health information exchange -- plays a critical role in improving the cost, quality, and patient experience of health care, there is very little electronic information sharing among clinicians, hospitals, and other providers, despite considerable investments in health information technology over the past five years,” Janet Marchibroda, director of the Health Innovation Initiative and the executive director of the CEO Council on Health and Innovation at the Bipartisan Policy Center, wrote in the report.

Online portal availability a mystery to many patients

August 15, 2014 | By Katie Dvorak
More patient portals are available at healthcare facilities across the U.S., but many patients don't know about the systems, according to a survey by TechnologyAdvice.
In a random survey of 430 patients, the consulting firm found that about 40 percent of patients don't know whether their primary care physicians have patient portal systems. However, 49 percent reported being shown the tool either during a visit or outside the visit.
The study's authors said the numbers suggest that more physicians offer patient portals due to the high rate of electronic health record adoption under Meaningful Use Stage 2, but fail to effectively communicate to patients that such tools exist.

Reaching out with robots

August 12, 2014Eric Wicklund - Editor, mHealthNews
Healthcare providers have long wondered how they might be able to use robots or robot technology to deliver care to remote locations. One are starting to show its value: imaging evaluations. 
Two recent reports, in fact, demonstrate that potential. The studies were conducted by staff at the New York-based Mount Sinai Health System's Icahn School of Medicine, and "give us a glimpse of what to expect in the near future, a patient-friendly imaging technology at your doorstep," said Jagat Narula, MD, PhD, director of the Cardiovascular Imaging Center and Associate Dean of Global Research at the Icahn School at Mount Sinai, in a press release.
In one study, Partho Sengupta, MD, directed a small, lightweight robotic arm with built-in ultrasound technology to examine the carotid artery of a patient in Boston. Sengupta, who was using a personal computer with a low-bandwidth Internet connection in Munich, Germany, completed the examination in four minutes.

Why hospitals are investing in telemedicine technology

By: Jonah Comstock | Aug 14, 2014
Forty-six percent of healthcare providers answering a HIMSS survey used multiple telemedicine technologies in their practice, with the most popular technology by far being two-way video messaging.
HIMSS had 400 responses to an online survey, mostly from directors and managers at hospitals, but also from doctors and nurses in hospitals and private practices. The results paint a picture of telemedicine slowly being adopted to fill niches in a healthcare system still very much focused on Meaningful Use.
“Having different solutions integrated and the ability to seamlessly connect physicians to patients, physicians to other physicians and organizations to other organizations, the electronic health record [EHR] is seen as somewhat of the hub of being able to do that within an organization,” HIMSS Director of Research Brendan FitzGerald told MobiHealthNews. “Now as organizations move toward more value-based care and set up ACOs and even HIEs, telemedicine networks are becoming increasingly important in terms of being able to connect all that clinical data together. ”

HIE Requires Nationwide Patient Data Matching Strategy

AUG 13, 2014 9:13am ET
The Electronic Health Record Association has called for a nationwide patient data matching strategy to ensure the accurate, timely, and efficient matching of patients with their healthcare data across different systems and settings of care.
In an Aug. 12 letter to the Senate Finance Committee, EHRA argued that a nationwide patient data matching strategy remains “one of the most critical unresolved issues in the safe and secure electronic exchange of health information” in this country. According to the organization, which represents 40 EHR companies, the problem is that patients often have medical records in multiple locations including hospitals, physician practices, laboratories, pharmacies and other settings.
“To improve patient safety and data interoperability, a consistent nationwide patient data matching strategy should be a priority,” EHRA told Senate committee members in response to their query regarding the availability and utility of healthcare data. “Patient identification that ensures accurate patient record matching across provider sites is a primary concern when aggregating patient information from multiple organizations. Error rates in existing technologies that manage patient identification are sufficiently high to cause concern about medical errors, redundant testing, and inefficiency.”

EHR Analysis Shows Blood Pressure Can Be Too Low

AUG 13, 2014 9:36am ET
An analysis of the electronic health records of nearly 400,000 people reveals that aggressive treatment of hypertension may create unintended kidney disease and even death.
Researchers examined the EHRs of Kaiser Permanente patients in southern California who were taking medications to treat high blood pressure from January 2006 through December 2010. They found that:
*Patients within the range between 130 and 139 systolic and between 60 and 79 diastolic blood pressure were at the lowest risk for kidney failure and death. Those who achieved a blood pressure outside of that range, either above or below, were more likely to have increased health risks.

Stakeholders to ONC: No one architecture perfect for EHRs, data sharing

August 12, 2014 | By Marla Durben Hirsch
Interoperability is a major part of Stage 3 of Meaningful Use, but the timeframes may be too short to transition from current Consolidated Clinical Document Architecture (C-CDA) used in Stage 2 to the application program interfaces (APIs) and proposed HL7 Fast Healthcare Interoperability Resources (FHIR) Standard for Stage 3, according to vendors and stakeholders speaking at a recent joint Health IT Policy and Standards Committee listening session.
At the session, which explored whether APIs should be considered for electronic health record interoperability, witnesses expressed concern with both types of architecture, noting that C-CDA was not perfect, but--as Anil Sethi, CEO of GLIIMPSE, testified--that FHIR "was not ready for prime time." The Health IT Standards Committee implementation workgroup acknowledged in its meeting July 28 that the C-CDA for document exchange was faulty. EHRs must produce C-CDA documents to meet Stage 2 of the Meaningful Use program.  

EHRs help predict, reduce mortality rates

August 13, 2014 | By Marla Durben Hirsch
Hospitals with greater electronic health record capabilities can better predict and decrease mortality rates, according to a new study published by HIMSS Analytics.
The researchers used data from more than 4,500 acute-care facilities on 32 different procedures and condition-based clinical groups. Mortality was evaluated as an outcome in 19 of them, such as stroke, pulmonary embolism and pneumonia.  
They then determined a predicted mortality rate and compared it to the actual mortality rate to see if a hospital performed better or worse than expected, and then compared it to each hospital's level of EHR adoption, using HIMSS' Electronic Medical Record Adoption Model (EMRAM).

CEO declares Allscripts is 'back'

Posted on Aug 14, 2014
By Neil Versel, Contributing Writer
The message that Allscripts Healthcare Solutions CEO and President Paul Black wants to share is simple. "We are back. We are doing well," Black said Wednesday in opening the annual Allscripts Client Experience – ACE – users' conference at the McCormick Place convention center.
Last week, Allscripts announced its financial results for the second quarter. While the company reported a net loss of nearly $17.8 million for the three months ended June 30, that is an improvement from $22.9 million in red ink in the same quarter of 2013.
Black, however, preferred to dwell on the positive, reiterating that the Chicago-based EHR vendor posted year-over-year gains in bookings, revenue and adjusted EBITDA for the first time in two years.

What's in store for Apple's HealthKit?

Posted on Aug 14, 2014
By Tom Sullivan, Editor, Government Health IT
To an industry waiting for more information on Apple’s healthcare intentions, even a few crumbs here and there are too tasty to pass up.
HealthKit has been described at various times as a platform or a service, either or both intended for bringing together health and fitness data. Apple’s deals with EHR maker Epic, the Mayo Clinic and Nike are expected to figure prominently into HealthKit when it becomes available — which industry observers are speculating may happen along with the iPhone 6 arrival next month.
No word from Apple on timing yet, but Reuters has reported that anonymous sources revealed Apple has held HealthKit discussions with Mount Sinai, the Cleveland Clinic and Johns Hopkins, as well as Epic rival Allscripts

HIMSS Analytics: Most providers adopt telemedicine to close patient-care gaps

August 14, 2014 | By Dan Bowman
Provider adoption of telemedicine solutions is largely driven by the need to fill gaps in patient care, particularly among hospitals, according to HIMSS Analytics' 2014 Telemedicine Study, published on Wednesday.
Of 335 hospital or health system respondents to the Web-based survey--conducted from April 22 to May 2 of this year--42.5 percent said their primary motivation behind investing in telemedicine tools was filling in gaps. Close to 16 percent of such respondents cited the removal of barriers to patient care as their main reason for adoption.
More specifically, 44.3 percent of hospital respondents cited patient care gaps due to community remoteness.

Appian Medical raises $580K, plans to build mobile sleep apnea therapy programs

By: Aditi Pai | Aug 13, 2014
Severna Park, Maryland-based mobile sleep apnea-focused company Appian Medical has raised $580,000 from angel investors to conduct validation studies and apply for FDA 510(k) clearance for its app.
Appian CEO Michael Thomas told MobiHealthNews they are also starting talks with investors to raise their series A funding round. Thomas was formerly the CEO of asthma monitoring company iSonea.
Appian Medical’s app, called SnoreSounds, uses an algorithm that the company licensed from University of Queensland in Australia. According to Thomas, the algorithm listens to the sounds of snoring to diagnose whether a patient has sleep apnea. Thomas said the app will eventually replace the current “gold standard” in sleep apnea diagnosis, which is polysomnography – a sleep map study. He also adds that although Appian is developing an app with the technology, the algorithm could be used in several different form factors.

HIMSS Analytics: EMRs boost clinical outcomes

By AuntMinnie.com staff writers
August 13, 2014 -- A new study from HIMSS Analytics has concluded that electronic medical record (EMR) software can positively affect clinical outcomes.
The study, which included clinical data support from online resource Healthgrades, found a beneficial relationship between the adoption of EMRs and hospital performance as measured by patient mortality rates.
HIMSS Analytics used its Electronic Medical Record Adoption Model (EMRAM) and mortality rate measures collected by Healthgrades across 19 unique procedure and condition-based clinical cohorts to analyze 4,583 facility records from the HIMSS Analytics database. Hospitals with advanced EMR capabilities -- as reflected in high EMRAM scores -- had significantly improved actual mortality rates, most notably for heart attack, respiratory failure, and small intestine surgery.

HIEs Adding Data Analytics Capabilities

Christopher Cheney, for HealthLeaders Media , August 14, 2014

California and Mississippi are investing in health information technology projects that incorporate a broad range of longitudinal patient data and promise insight into population health.

Efforts to upgrade the quality of patient data on statewide health information exchanges are taking a leap forward in California and Mississippi.
In The Golden State, a pair of healthcare payers have announced ambitious plans to launch the California Integrated Data Exchange. Blue Shield of California and Anthem Blue Cross have committed $80 million to operate Cal INDEX for three years.
The HIE will feature longitudinal patient information, which will enable healthcare providers and payers to see a broad range of clinical information over time, such as hospitalizations, medications prescribed, lab results, and allergy histories. This type of data is more comprehensive than encounter-based health records and can be used to study and track population health.
AUGUST 11, 2014


To achieve electronic health records' full potential, providers must be able to exchange information easily, accurately, and securely.
What's the issue?

Little Return on $26B Investment in Health IT by Feds

AUG 13, 2014 7:41am ET
Despite more than $24 billion in incentive payments to hospitals and eligible professionals who "meaningfully use" electronic health records and another $2 billion spent on interoperability standards and EHR certification, there is very little electronic information sharing among providers.
That is the conclusion of a new health policy brief from the journal Health Affairs and the Robert Wood Johnson Foundation authored by Janet Marchibroda, director of the Health Innovation Initiative at the Bipartisan Policy Center.
“While considerable investments in health IT have been made, advancement of interoperability and electronic information sharing across systems has been slow,” Marchibroda writes. “Additional action is needed to provide the information foundation necessary for higher-quality, more cost-effective, patient-centered care in the United States.”

EHRA: Data should follow the patient

Posted on Aug 13, 2014
By Bernie Monegain, Editor
The HIMSS Electronic Health Record Association told U.S. senators that, in general, a patient's healthcare data should follow the patient, and it also called for a nationwide patient data matching strategy.
The EHRA, made up of nearly 40 EHR companies, was responding in its Aug. 12 letter to a Senate Finance Committee request regarding healthcare data sharing. The committee letter, dated June 12, asked the association to advise the panel on various EHR topics, such as standards and data use.
EHRA noted the recent rapid uptake of EHRs by physician practices and hospitals, and asked Congress to work with the industry to ensure the best use of technology.
Sunday Aug 10 2014

Sutter celebrates 10 years of eICU program

A medical innovation that brings a “second pair of eyes” to the Sutter Health network’s intensive care units is celebrating its 10-year anniversary.
Sutter’s eICU (electronic intensive care unit) “provides timely crisis intervention to some of the sickest patients in Northern California,” spokeswoman Stephanie Breitbart said in a press release. “Sophisticated alarm monitors allow intensivists (medical specialists in critical care medicine) real-time alerts to abnormal vital signs and lab results, leading to improved clinical quality.”
eICU intensivists and nurses monitor up to 431 ICU beds around the clock from two central hubs —- in Sacramento and San Francisco. The system relies on high-speed data transmission, in-room cameras and remote diagnostic tools, she said.
Sutter eICU Director John Winchell describes it as a partnership.

Complex Care Management Requires HIT, Analytics Improvements

AUG 12, 2014 8:47am ET
Health systems will need to improve upon the current state of analytics and health information technology infrastructure in order to fully realize the potential of complex care management, according to researchers from Massachusetts General Hospital and The Commonwealth Fund.
"The analytic approaches and HIT required for effective CCM remain underdeveloped," researchers write in a perspective paper published in The New England Journal of Medicine. "Better algorithms could be developed for identifying patients whose care offers the greatest opportunity for reducing expenditures, health information exchanges could be created to provide real-time data to CCM teams, and software for population management and care manager work flow could be improved."

Telestroke Hits the Mainstream, but Can Other Specialties Follow Suit?

by Rebecca Vesely, iHealthBeat Contributing Reporter Wednesday, August 13, 2014
Telestroke -- the delivery of expert neurology care via remote videoconferencing to patients who may have suffered a stroke -- is the fastest growing trend in stroke care and is one of the most widely adopted and accepted uses of telemedicine.
Indeed, telestroke is viewed by many as a "backbone" for acceptance by providers, payers and patients, but it's unclear if other specialties can replicate the successes of telestoke. And telestroke still faces similar hurdles to implementation and reimbursement as other telemedicine specialties.
Recent action in Congress and among influential regulatory bodies, as well as changes to payment reform, could help pave the way for further integration of telestroke and other telemedicine into hospital care nationwide, experts say.

Wearable Tech Can Extend Clinical Analytics

8/12/2014 01:00 PM
Wearable health devices and apps could help fill the gaps in electronic health records, if we can get past the challenges.
As healthcare costs increase, so does the need to implement clinical analytics further. But collecting data that reflects a person's well-being is a challenge, especially for chronically ill patients.
As of 2009, more than 75% of healthcare costs are linked to chronic conditions, and nearly half of all adults live with at least one chronic illness. Chronic illnesses evolve over time, but until recently, the only way to grasp the bigger picture has been through patient-reported outcomes and bits of data spaced over long periods of time.
  • August 12, 2014, 12:01 PM ET

Hospital CIO Says Health IT Needs Major Rehab

By Dick Escue
Standard hospital hardware and software solutions, especially electronic health records, can cost billions of dollars and place incredible demands on data centers and the people who oversee them. Despite the fact that the purpose of these systems is to advance information flow across health care, they too often are “closed,” a situation that few people appreciate. Meaning, data cannot be accessed and used by hospitals, providers, or patients as they see fit.
While other industries are flourishing as a result of advances in data access and information flow, and consumer and social technology, health care lags. While other industries use IT as a tool for revenue growth to attract and retain new and existing customers, health care IT can inhibit or prevent efforts to connect with customers in ways that create loyalty. Why? Because the market leaders in health-care technology are not delivering massive advancements to the systems they sell. In part, this is because tough regulations make it difficult for new entrants to come into the market with alternatives. Also, many hospitals are locked into contracts with closed, antiquated software vendors that fail to keep up, let alone set pace with industry quality and technology initiatives. And finally, it’s because hospitals in the market for a new IT system often follow suit of their peers; instead of exploring new technology models that are already proven standards in other industries.

5 'crazy ones' reshaping health IT

Posted on Aug 12, 2014
By Healthcare IT News Staff, New Gloucester, Maine

"Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes.

The ones who see things differently …While some see them as the crazy ones, we see genius. 
Because the people who  are crazy enough to think they can change the world, are the ones who do."
With a nod to Apple and its famous 1997 TV spot, which highlighted doers and dreamers in all fields of endeavor who colored outside the lines, we put the spotlight on just five of the many 'crazy ones' who are helping transform health IT in new and unique ways. 

Police chief calls for records access

11 August 2014   Sam Sachdeva
Police should be given greater access to medical records without patient consent, a senior police chief has argued in an interview in which he also called for a register of vulnerable people to be set up to facilitate this.
Sir Peter Fahy, the Greater Manchester chief constable, told the Guardian that Alzheimer’s patients and victims of domestic abuse are among those who could benefit from changes to how police can access their data.
He said people with dementia and Alzheimer’s, those with drug or alcohol problems, and those with mental health issues, now make up around 70% of police work.

Smart glasses offer vision of future

7 August 2014   Sam Sachdeva
The new glasses and the prototype headset on show at this morning's launch
A pair of smart glasses that can help improve the vision of people with sight loss has won a £500,000 award to go towards a large-scale test.
The glasses, developed by Oxford University and the Royal National Institute of Blind People, won the People’s Choice award in the Google Impact Challenge, for UK charities using technology to tackle significant problems.
Stephen Hicks, the Oxford University researcher who has led the project, said work on the glasses started in 2011 with funding from the NHS National Institute for Health Research.

Almost one in six doctor visits will be virtual this year

eVisits are expected to save $5B this year over the cost of traditional in-office physician visits

August 8, 2014 02:36 PM ET
Computerworld - With an aging Baby Boomer population and broadband bandwidth improved a hundredfold from a decade ago, telemedicine is exploding as a convenient and less costly alternative to the traditional visit to the doctors' office.
This year in the U.S. and Canada, 75 million of 600 million appointments with general practitioners will involve electronic visits, or eVisits, according to new research from Deloitte.
The overall cost of in-person primary physician visits worldwide is $175 billion, according to Deloitte. Globally, the number of eVisits will climb to 100 million this year, potentially saving over $5 billion when compared to the cost of in-person doctor visits. The eVisit projection represents growth of 400% from 2012 levels, Deloitte's study showed.
Last November, The University of Pittsburgh Medical Center (UPMC) revamped its patient portal, renaming it MyUPMC, and rolling out AnywhereCare, offering patients throughout Pennsylvania eVisits with doctors 24 hoirs a day, seven days a week either over the phone or through video conferencing.

Telemedicine could yield $6B per year in savings

Laura Pedulli
Aug 11, 2014
Telemedicine has the potential to deliver more than $6 billion in healthcare savings per year to U.S. companies, according to global analytics company Towers Watson.
Managing such savings would require all employees and their dependents to use the technology-enabled interactions in place of face-to-face visits to the doctor, urgent care center or emergency room for appropriate medical problems, according to the analysis.

Cerner/Siemens and the future of EHRs

Posted on Aug 11, 2014
By Mike Miliard, Managing Editor
As the dust settles from this past week's mammoth $1.3 billion merger, Siemens Health Services CEO John Glaser tells Healthcare IT News what led up to the Cerner deal, how his experience as a health system CIO could help smooth integration challenges and what to expect – from the two companies specifically and electronic health records in general – over the months and years to come.
Q: What were the factors -- both within your respective companies, and across the healthcare landscape -- that made this the right deal for Siemens and the right deal for Cerner?
A: The basic strategic rationale was that if you look at the pressures that providers are facing, both in the U.S. and also oversees -- reimbursement pressures, quality pressures, being asked to create systems of care and manage populations -- you look at all that stuff and you realize that if you really want to be a very effective enterprise health IT supplier to them, you've got to have substantial resources. Development resources, services resources with the capability to be doing cloud, technical resources to deal with personal devices, all kinds of stuff.

How El Camino reduced pressure sores

Posted on Aug 11, 2014
By Bernie Monegain, Editor
El Camino Hospital, known for its advanced use of health information technology, is using wireless technology to reduce the risk of pressure ulcers for patients. Pressure ulcers -- often called bedsores -- have been one of the most elusive problems hospitals across the nation are attempting to solve.
El Camino tapped Leaf Patient Monitoring system to help prevent hospital-acquired pressure ulcers by monitoring the position and movement of patients susceptible to bedsores.
El Camino started by conducting a six month-long, 138-patient study of the monitoring system. The study showed what El Camino executives view as "dramatic improvement in compliance with the hospital's patient turn protocols." Turning patients regularly is the one of the most effect ways to prevent pressure sores.

Can drones improve healthcare in remote regions?

August 8, 2014 | By Dan Bowman
While mobile health efforts are helping to boost care quality in rural and underdeveloped nations worldwide, hurdles remain for providers in such areas when it comes to access to supplies.
To that end, the World Health Organization and the government of Bhutan, a small South Asian nation in the Himalayas, are teaming up with a California technology startup to examine a new method for improving patient care efforts: Drones.
The technology, according to an article in Quartz, will connect three rural clinics with the Jigme Dorji Wangchuck National Referral Hospital in Bhutan's capital city of Thimphu. Each of four drones will be tasked with carrying roughly 4 pounds of supplies, such as medicines and blood samples, back and forth between specified landing stations.

Med management market to pass $1.6 billion by 2019

August 11, 2014 | By Dan Bowman
In addition to government initiatives driving more accountability in patient care, concerns around lowering medication errors and adverse drug events are steadily increasing the value of the global market for medication management, according to a new report.
Currently, the market is worth $845 million, according to the MarketsandMarkets.com report. By 2019, that number is expected to surpass $1.6 billion, thanks to compound growth of 14 percent annually. North America, predicted to be the largest market, will account for roughly 63 percent of that figure, the report notes.
The market, by "modes of delivery," is divided into three categories: on-premises, Web-based and cloud-based models. By software, it is divided into computerized physician order entry, clinical decision support systems, administrative tools, inventory management tools, automated dispensing and assurance systems tools. Leading health IT companies--including CareFusion, McKesson, Allscripts, Cerner and Siemens--last year accounted for more than 60 percent of the industry, although the report calls the overall market "fragmented."

The Role of Telehealth in the Triple Aim

by Mario Gutierrez Monday, August 11, 2014
In the February issue of Health Affairs dedicated to Connected Health, several of the best thinkers in the field -- Joe Kvedar, Molly Coye and Wendy Everett -- called for a partnership to be created among government agencies, academia, patient advocacy groups and private-sector organizations to capitalize on the exceptional opportunity offered by a "connected health model of care." This model would help improve access and quality of care while decreasing costs, more efficiently using the skills of highly trained health professionals and allowing greater patient participation. The knowledge to be gained from this partnership could lead to true innovations and efficiencies to advance the goals of national health reform.
In response to this call to action, the Center for Connected Health Policy (CCHP), which I direct, embarked upon a six-month intensive effort to critically assess the current and potential future role of telehealth in strengthening health care delivery within the dimensions of the Triple Aim objectives of national health reform: improved quality, improved health outcomes and reduced costs. This "Telehealth and the Triple Aim" project has given us a deeper understanding of the barriers inhibiting the full adoption of telehealth and has resulted in a series of action recommendations for how health care providers, public and private payers, and consumers working together in partnership can best advance the use of telehealth in support of better and more efficient health care delivery for the underserved.


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