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."

Tuesday, September 30, 2014

It Looks Like National Standards Setting (Including E-Health) Is Getting More Messy.

This appeared late last week.

Standards Australia quick off mark in review of royalties on SAI Global contract

Simon Evans
The 74-member Standards Australia organisation that made a last-ditch effort to try and be part of a buyout process for SAI Global has revealed a review of royalties for a key contract with SAI has already begun, and that its chairman is stepping down.
SAI’s former parent Standards Australia has just released its 2014 annual review which is the last presided over by chairman Alan Morrison. In it the firm outlines that it expects larger amounts will be due to the organisation from a revised royalties deal with SAI, but it doesn’t specify how much.
SAI last week revealed that after a protracted sale process which began in May with an indicative $1.1 billion proposal, it ended up without any whole-of-company bids.
Uncertainty over the key contract with Standards Australia for the publishing and sale of 6900 standards was one of the main reasons.
Private equity firms Pacific Equity Partners, which later brought in Kohlberg Kravis Roberts as a partner, made an original indicative buyout proposal in May for SAI which valued the company at up to $1.1 billion.
Standards Australia wrote to SAI just before the deadline for bids expired, saying it was interested in submitting a bid, but required more time. SAI and its advisers spurned that request.
The Standards Australia annual review for 2014 outlines that it receives royalties primarily based on net revenue from publishing sales under the contract with SAI, known as the Publishing Licence Agreement (PLA).
“A review of the calculation of royalties is being undertaken and it is expected that an additional amount will be due to the company,’’ the annual review states.
But it warns that currently there is no reasonable basis for estimating the amount receivable.
More details are here:
What this means is that the price of printed Standards are very much likely to rise from their already hardly cheap levels and the chances of DoH continuing to fund e-Health Standards in the longer term would appear to be dropping.
Given this it would make sense to download all the documents you might need reasonably soon!
All that are presently available can be downloaded free from here (for now - sponsored by DoH):
I also thought I would see if I could find the NEHTA Standards Catalogue which we were told would soon be available in Feb 2013:
Here is the blog of the time:

Wednesday, February 27, 2013

Can This Be Seen As Acceptable In Any Way? Can’t See How.

Checked this link today.

Standards Catalogue

The National E-Health Standards Catalogue (Standards Catalogue) consists of a collection of standards and specifications that are essential guidance for those who develop, sell, support, buy and implement e-health software in Australia. The catalogue provides a list of the standards recommended by, and specifications sourced or developed by, NEHTA, and is updated regularly.
What does the Standards Catalogue provide?
  • advice on when and where the use of a standard is appropriate.
  • can be navigated via  content classifications
  • links to both de facto and de jure standards from national and international standards bodies including proprietary, business, and more openly developed standards.
Open Standards
We support the adoption of open standards where appropriate. These standards should require no royalty payments, be openly published, allow extension, promote reusability, and reduce the risk of technical lock-in and high switching costs. However, where open standards are not appropriate due to significant market or technical issues, we will adopt the standards deemed most fit-for-purpose, relevant and useful to the community.
Importance of Standards
Standards are relevant to all areas of our work, and provide rigour as well as a means of validation with external expert groups. The lack of clear standards makes it difficult for vendors to develop software applications that can support a broad range of communication within the health community. Vendors face developing their own solutions and accepting the risk of industry adopting a different approach. Where widely supported standards are available to vendors, the lack of agreement at a national level about their use can preclude their adoption.
Standards also benefit those who purchase and implement health software applications. Knowing which software products conform to agreed standards can greatly simplify the purchasing process, and increase purchaser confidence that the selected product will be fit-for-purpose. Standards also offer the potential to avoid vendor 'lock-in'.
The PCEHR Standards Catalogue currently being updated and will be available soon.
For any inquiries regarding Standards, please contact us at standards@nehta.gov.au
----- End extract.
The link above now goes below here and we still don’t have a catalogue of recommended Standards but we have a huge number of NEHTA Resources of unproven quality as far as I can tell in terms of clinical impact and value.
So bottom line grab what you need soon and wonder when we will ever see some better managed co-ordination and progress in E-Health Standards setting. I am sure not holding my breath.

Monday, September 29, 2014

Weekly Australian Health IT Links – 29th September, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

Another very quiet week with the biggest news being the new Health IT being implemented in the Defence domain and some movement from Apple in the Health IT Space.
Minister Dutton seems to have gone to ground on the PCEHR. Wonder when we will hear something?

Australian Medical Association to scrutinise Apple’s HealthKit app over privacy concerns

Chris Griffith

HARNESSING Apple’s new HealthKit system for patient care may have benefits but there are also big issues involving privacy and the accuracy of data, healthcare professionals said.
The Australian Medical Association said it would welcome the opportunity to meet with Apple to discuss how its HealthKit system and Health app could assist patients.
Apple’s new Health app can amass almost 70 types of health and fitness data on a phone, including blood glucose, blood pressure, body temperature, caffeine level, cycling distance, heart rate, potassium levels, sleep analysis and even falls.
The app can gather data such as steps walked from the phone’s sensors, let users add health information manually, and store data passed to it by devices such as wristband monitors and medical equipment.

Gearing up for the wearables revolution

The recent announcement of Apple’s watch defined the next must-have gadget for tech-hungry consumers.
But with smartwatches, fitness trackers, head-mounted displays and other wearable devices forming the latest craze in consumer electronics, some business leaders are already asking how they will manage and utilise them for their workforce and customers.
Australians have demonstrated a mania for personal technology. Australia ranks sixth globally for smartphone usage, according to Google, with 64.6 per cent penetration, just seven years after the release of the first iPhone.
The rapid uptake of smartphones caught many organisations by surprise, both in terms of the strong desire of employees to bring them to work, and customer demands to use them as a means of interaction.
There are signs the adoption of wearable technology could happen faster still. Deloitte has estimated the global market for wearables at $US3 billion, and according to the analyst firm Telsyte, there were already 380,000 smartwatches in Australia at the end of June this year.

Clinical communication, interruption and the design of e-health

September 23, 2014
The different ways clinicians interact does not just shape the success of the communication act. Our propensity to interrupt each other, and multitask as we handle communication tasks alongside other duties, has a direct effect on how well we carry out everything we do. Interruption for example has the capacity to distort human memory processes, and lead to memory lapses as well as memory distortions.
Earlier this year I was interviewed by Dr. Robert Wachter, the Editor of the Agency for Healthcare Research and Quality (AHRQ) WebM&M. In that interview we covered the roles that interruption and multitasking play in patient safety, discussing both their risks, as well as strategies for minimising their effects. The interview also looked at the implications these communication and task management styles have for the design of information technologies.

Telstra pays millions for stake in US electronic signatures firm DocuSign

Fran Foo

TELSTRA has expanded its investment tentacles in Silicon Valley, pumping millions of dollars for a stake in electronic signatures firm DocuSign, which counts blue chip brands Google, Visa and SAP as investors.
The telco joins the likes of Japan’s telecommunications provider NTT and Korean electronics giant Samsung in DocuSign’s latest funding round.
DocuSign, reportedly valued at $US1.6 billion ($1.8bn), offers an online service that allows people to electronically sign documents and return them without the need for printing or scanning.
The news comes weeks after Telstra splashed $US270 million on Ooyala, increasing its stake from 23 per cent to 98 per cent in the Valley-based online video service provider.

Telstra pays millions for stake in US electronic signatures firm DocuSign

Fran Foo

TELSTRA has expanded its investment tentacles in Silicon Valley, pumping millions of dollars for a stake in electronic signatures firm DocuSign, which counts blue chip brands Google, Visa and SAP as investors.
The telco joins the likes of Japan’s telecommunications provider NTT and Korean electronics giant Samsung in DocuSign’s latest funding round.
DocuSign, reportedly valued at $US1.6 billion ($1.8bn), offers an online service that allows people to electronically sign documents and return them without the need for printing or scanning.
The news comes weeks after Telstra splashed $US270 million on Ooyala, increasing its stake from 23 per cent to 98 per cent in the Valley-based online video service provider.

Telstra buys into US startup DocuSign

Telstra has made an undisclosed investment in DocuSign, a US technology startup that lets people use digital signatures in documents and financial transactions, as part of its push into Silicon Valley.
Telstra spent millions of dollars to buy the stake as part of a funding round, news reports suggested, but it refused to specify the exact amount. It will adopt the system as part of the move.
It comes as global technology giant Apple enters the game of authenticating payments and documents via the fingerprint recognition system on its hugely popular Apple iPhone 6 and iPhone 6 Plus devices in the US.

Telstra takes stake in DocuSign

Telco will roll out digital signature technology internally and then offer to customers later this year
Byron Connolly (CIO) on 23 September, 2014 12:28
Telstra has invested in US-based electronic signature and digital transaction management firm, DocuSign.
The online DocuSign platform lets users upload documents; add names and email addresses of the signers; places tags in the document where the signature, initial and dates are required; and hit send – within a secure, online environment. It is used by more than 40 million people in 188 countries.
Telstra will use the platform internally to speed up its paper-based processes before offering the technology to its customer base later this year.

In iOS 8, Medical ID could be a life-saver

The Medical ID record in the new Health app in Apple's iOS 8 hasn't gotten a lot of attention. But it should, says columnist Ryan Faas.
Ryan Faas (Computerworld (US)) on 22 September, 2014 20:32
Of all the new features in iOS 8, one hasn't gotten a lot of attention -- and it's the one feature that all iOS 8 users should at least consider.
I'm talking about the Medical ID record in the new Health app. Even if you aren't tracking fitness, diet or sleep -- and fortunate enough not to be managing or monitoring a chronic condition like diabetes, COPD or heart disease -- this is one aspect of the health app worth understanding. Although all other HealthKit-related functions are on hold for now, Medical ID is fully baked and ready to use.
The Medical ID pane of the Health app is a pretty generic medical information and history form. It contains much of the data that you'd see requested on a form when you visit a new doctor or an urgent care center -- birthdate, existing medical conditions, notes about those conditions or your medical history, allergies (to drugs, foods and environmental factors), medications you're taking, emergency contact (including relationship to you), blood type, whether you're an organ donor and your height and weight. The app automatically pulls your name and photo from the iOS Contacts app.

"I buy up to 500 pseudo tablets a day for drug cooks"

Date September 25, 2014 - 4:15PM

Nicole Cox


An anonymous talkback radio caller has confessed to "pseudo-shopping" around Perth pharmacies, buying up to 500 cold and flu tablets a day to on-sell to illicit drug cooks.
The man, known only as "Bob", told 6PR Radio on Thursday morning that he managed to avoid strict controls on the sale of pseudoephedrine-based drugs, including having his personal details recorded on a database set up by the Pharmacy Guild to stop such activity.
If he spent half a day shopping around chemists, he could sell the tablets to drug cooks for $1 each, he said.
"I live on the other side of the fence, mate. I buy them for illegal activity," Bob told 6PR's breakfast show hosts Steve Mills and Basil Zempilas.

openEHR 2014 Roadmap Meeting, Sep 16/17, Oslo

Last week saw the first major face-to-face international openEHR community meeting, which took place in Lilletstrom, near Oslo, at premises kindly organised by DIPS asa, openEHR Industry Partner and major EHR supplier in Norway.
We had 32 participants from vendors including DIPS asa, Cambio Healthcare Systems, Code24Marand, Ocean Informatics, Raysearch Labs, as well as Erik Sundvall (Linkoping University, Sweden), Gunnar Klein (Professor of eHealth, Informatics Section, Örebro University School of Business), attendees from Oslo University Hospital, Furst Medical Laboratories, Helse-Bergen (Bergen regional health org), as well as Shinji Kobayashi (Kyoto University), David Moner (Polytech University, Valencia), and Luis Marco-Ruiz, who organised the great Tromso openEHR conference earlier this year. I know Koray Atalag (University of Auckland) and some others were listening in.

Sale of SAI’s assurance unit most likely: CIMB

Edited by Sarah Thompson, Anthony Macdonald and Jake Mitchell
While an offer for the whole of SAI Global has failed to materialise, CIMB analyst Julian Guido thinks the sale of its assurance division should be the “easiest” to achieve.
“Our scenario analysis indicates a potential sale price of $372 million to $483 million,” Guido writes in a research note to clients on Tuesday. “Unfortunately, (SAI’s) valuation still doesn’t appeal to us … with our price target reverting to our passive valuation of $4.20 per share.”
Guido says the sale of the assurance division would be the most likely transaction to proceed given “cleaner operating performance relative to the other two divisions, and identifiable potential offshore buyers such as Intertek, SGS and Bureau Veritas.”
Guido also reckons a weaker Australian dollar does not hurt for offshore buyers.

Pollen app will track hayfever in the ACT

Date September 26, 2014 - 9:01AM

Fleta Page

A mobile app tracking and forecasting pollen levels has been issued by the Australian National University, designed to help hayfever and asthma sufferers, who can  in turn contribute to national research. 
The free Canberra Pollen app  has been developed by the ANU's Department of Archaeology and Natural History, which has used its expertise in pre-historic pollen to  study pollen in the modern atmosphere.
Department head Simon Haberle said it had the "biggest pollen collection in the southern hemisphere pretty much".

Online CBT for an anxious FIFO worker

23 September, 2014 Dr Jan Orman
A FIFO worker is steered towards online CBT resources after admitting to feelings of panic and anxiety.
Gary, 38, has been a patient for many years. He experimented with drugs and alcohol during his younger years, but has since returned to the 'straight and narrow' to finish his apprenticeship, get married and start a family.
He is now a qualified electrician. Gary has recently struggled to find locally based employment. For the past nine months, he has been working in a fly-in fly-out role for a mining company.

HL7 Australia #FHIR Forum and Connectathon

Posted on September 23, 2014 by Grahame Grieve
On Thursday & Friday 6-7 November 2014 Hl7 Australia is holding a FHIR Forum and Connectathon in Melbourne.
Day 1 is focused on education:
Keynote: FHIR in context … a step forward for patients  Andrew Yap, Alfred Hospital Melbourne

Profile: Snioch takes global role at GS1

The use of GS1 standards in healthcare isn’t just about improving the efficiency of supply chains, and therefore organisations’ bottom lines. Instead, says Tania Snioch, industry manager for healthcare at GS1 Australia, it’s all about improving patient safety and healthcare outcomes.
“If a patient is in hospital, they have to be delivered the right healthcare product at the right time,” she says. “If the healthcare product has to be correctly identified in case there is a recall,  this demonstrates another clear example of how the GS1 standards come into play.
“The GS1 standards are the foundations that enable a product to be related to the patient. GS1 Barcodes can be scanned at the bedside or in the theatre, thereby reducing risk of the wrong product being provided to the patient, and creating records of what has been administered.”

The AMT v20140930 September release is now available for download

Created on Friday, 26 September 2014
The AMT v20140930 September release is now available for download from the NEHTA website.

eHealth Guide for General Practice

Getting Started with eHealth – A guide for General Practice is designed for practices or organisations using the eHealth record system through their clinical software.
Getting Started with eHealth – A guide for General Practice
This guide will show you how to:
  • How to link local patient records with their Individual Healthcare Identifier
  • Patient consent and patient privacy controls
  • Clinical documents
  • Assisting patients to register for an eHealth record
  • Becoming familiar with the system
  • Help and support contacts

E-health system for soldiers launched

19th Sep 2014
A $133 MILLION electronic record system for Australian military personnel launched today in Canberra will not actually follow Australian soldiers to war. But it is likely to be free of the troubles plaguing Australia’s civilian e-health system.
Launched today by the assistant minister for defence, Stuart Robert, the Defence eHealth System will reduce red tape and provide up-to-date health data on Australian Defence Force personnel to treating clinicians and healthcare providers, Mr Roberts said. 
“Importantly, it will also allow health information to be easily and accurately passed to the Department of Veterans’ Affairs as well as to civilian health providers,” the minister said.  

Return of JeHDI makes Defence Australia’s eHealth leader

The military’s long march to get its nascent eHealth system out of triage and into the hands of Australian Defence Force members and medical staff has managed to leap-frog similar civilian efforts.
The massive department said on Friday said the new ADF eHealth system has been “successfully rolled out in Defence health facilities in Queensland, the Northern Territory and Western Australia” with facilities across the rest of Australia to be up and running by “the end of 2014.”
It’s a feat likely to produce a concerned pang or two at the office of Health Minister Peter Dutton who is still contemplating the best way forward for the frequently troubled civilian eHealth counterpart, the Personally Controlled Electronic Health Record (PCEHR).

Why Australian defence invested in a US$118 million eHealth system

The Australian Defence Force has just bought a new A$133 million (US$118 million) eHealth system to provide health providers accurate, up-to-date health data on their personnel.
The eHealth System will be made available to all stakeholders responsible for providing health services and benefits to defence staff, including clinicians, the Department of Veterans’ Affairs, and civilian health providers.
The members’ health data, from recruitment to discharge, will be centrally stored and updated in the system. This will help simplify internal work processes and reduce duplication of data, said Stuart Robert, Assistant Minister for Defence.
“The demands of service life can at times lead to physical injury or mental illness. It is therefore essential that Defence’s health services are at the cutting edge to ensure the provision of the best possible health care for our people,” he added.

A better alternative to “Dr Google”

24 September, 2014
Over 80% of Australians are now searching for health information online, and the majority of these people are looking for information about medical conditions and symptoms*. 
With more and more patients turning to “Dr Google”, it’s important that credible health information is available online and by phone to support those who are making important health decisions at home.
Healthdirect Australia was established by the Australian Government to provide all Australians with access to trusted health information online and over the phone.
Orion Health has appointed Andrew Ferrier as its new Chairman, succeeding Andrew Clements who announced his leave at the company’s annual general meeting.
  • 22 September 2014 15:03

Ignia sharing industry insights at the 2014 Health Information and Technology WA conference

Ignia sharing industry insights at the 2014 Health Information and Technology WA conference
Western Australia’s only e-health conference, HITWA 2014 brings together a diverse range of industry professionals and academics to share their knowledge and stories. International, national and state-wide leaders and thinkers will use HITWA as a forum.
This year's conference theme, 'Leadership and education: Encouraging innovative technologies for improving healthcare' aims to inform attendees about leading, encouraging, educating and engaging with health workforce colleagues in collaboratively designing and building better healthcare services by incorporating innovative technologies into service delivery models.

Enough already? The rise of home internet data limits—and what we do with all those gigs

  • September 24 2014
  • Finding No. 5286
  • Topic: Press Release
Source: Roy Morgan Single Source, July 2013-June 2014, sample = 20,022 Australians 14+ with a home internet connection.
Are our bandwidths getting bigger than our eyes when it comes to gobbling gigabytes? With an increasing number of Australians signing up for over 300GB per month of internet data, Roy Morgan Research looks at whether people with higher (or no) limits are actually doing more with them.
In the year to June 2014, of the 15.7 million Australians (14+) with a home internet connection 9% downloaded TV programs by computer in an average four week period, 7% downloaded feature-length movies, 9% streamed TV and 4% streamed movies.

Beyond the internet: moves to set up a 'third network'

Date September 25, 2014

Stuart Corner

The public internet is ubiquitous, you can connect from anywhere to anywhere but it's a decentralised, best-effort service, with poor security.
Private data networks, on the other hand, provide guaranteed bandwidth and guaranteed quality and security, but must be preconfigured.
Now the communications industry has come up with a vision for a "third network" that will combine the flexibility of the internet with the quality and reliability of private, ethernet-based, networks.
It's the brainchild of the Metro Ethernet Forum, an industry body charged with progressing data networks based on the ethernet protocol.

Microsoft offers first look at new Windows - and gives it a name

Date September 27, 2014 - 4:48PM

Bill Rigby

Microsoft will unveil a new name for its best-known product early next week when it offers the first official glimpse of its latest Windows operating system.
The project, known for the past few years as "Threshold" inside the software company and "Windows 9" outside it, will likely get an entirely new brand, or just be called Windows, analysts said, ahead of its full release early next year.
The name change is symbolic of a new direction and style for Microsoft, which is veering away from an aggressive focus on Windows and PCs, the hallmark of previous chief executive officer Steve Ballmer. The new, quieter emphasis is on selling services across all devices and is championed by new boss Satya Nadella.

Sunday, September 28, 2014

NEHTA Produces A Guide For GPs Using The PCEHR - Very Interesting Indeed And Not Good.

This appeared just a few days ago - Document created 23/09/2014:

eHealth Guide for General Practice

Getting Started with eHealth – A guide for General Practice is designed for practices or organisations using the eHealth record system through their clinical software.
Getting Started with eHealth – A guide for General Practice
This guide will show you how to:
  • How to link local patient records with their Individual Healthcare Identifier
  • Patient consent and patient privacy controls
  • Clinical documents
  • Assisting patients to register for an eHealth record
  • Becoming familiar with the system
  • Help and support contacts
How to order brochures and factsheets
If you are interested in ordering printed brochures from us, please provide the following information within an email to ask@nehta.gov.au
  • Organisation
  • Name
  • Street Address
  • Email Address (if different from the email address you have used to request brochures)
  • Phone Number
  • Quantity (minimum is 50)
NOTE: Orders will be received within 5 working days.
Here is the direct link:
Looks like having a GP as the NEHTA new chair has reminded NEHTA that writing obscure 100+ page documents for GPs just guarantees no one will ever read then and makes sure they continue not to make a difference.
In January we had this wonderful document released - and it was Version 2.0:

eHealth Clinicians User Guide

This eHealth Clinicians User Guide includes material that is relevant to both general practices and private specialist practices, however other healthcare professionals, e.g. allied health and in aged and community care, may also find this guide useful.
The eHealth Clinicians User Guide supports medical practices in navigating the complexities of eHealth (including the national eHealth record system) from planning, preparation, registration and implementation through to meaningful use. It covers key eHealth topics of interest to medical practices (including quality improvement) and focuses on the foundation products (e.g. Healthcare Identifiers, NASH, Secure Message Delivery), the national eHealth record system and other functionality currently available and being released by software vendors. Importantly it includes practical step-by-step implementation advice.
Through use of this guide you should reasonably expect to understand the benefits to your practice associated with adopting eHealth as well as some of the Organisational and Governance changes required. It also outlines some of the prerequisites for implementation and use of the eHealth features. It includes practical quick reference checklists for practice staff and links to additional education and support resources.
The eHealth Clinicians User Guide is also available in a web version at: http://www.nehta.gov.au/for-providers/about-ehealth-guidance
This was a wonderfully brief 157 pages long and as I said at the time:
“My guess is that this fiasco will be the end of any GP co-operation with the NEHRS / PCEHR.
DoHA has always wanted to reduce the cost of PIP and this will certainly do it!”
The real gem in the new document is the 54 step roadmap found in the document from page 16 and for the next few.
The rest of the 157 page document is just non-clinical jargon laid on non-clinical jargon.
That pages 125 to 134 are a Glossary shows just how clinician friendly this is!
There a links galore that one presumes are meant to be followed and so it just goes on.
The author is - not unexpectedly - a consultant hired by NEHTA.”
Here is my link to the blog where I described it and made these and other comments.
The new guide is just 9 pages and clearly written. This actually results in a useful document that is readable and allows a reader to grasp just what is going on with the PCEHR and, very probably, why one should not be involved.
This quote make it clear to me:
Page 4:

Viewing an eHealth record

 Who can view an eHealth record?

·         Any person involved in an individual’s care, who is authorised by the healthcare organisation can access an eHealth record. For example, reception staff, registered nurses, doctors. Your organisation may choose to limit access to clinical staff. Check with your organisation’s eHealth champion
·         Access is not limited to healthcare providers with a Healthcare Provider Identifier-Individual (HPI-I). Your organisation may authorise other staff who need to access the eHealth record system as part of their role in healthcare delivery (for example, an Aboriginal health worker who does not have a HPI-I). However, only providers with an HPI-I can author and upload clinical documents.
·         Organisations can authorise their staff by writing their details in the organisation’s eHealth record system security policy. Sample policies can be found on NEHTA’s website.
To me having even the possibility of non-clinicians accessing my PCEHR (see first paragraph)  - where another provider may have uploaded any information over which I might not have control (e.g. the intern uploading a discharge summary) means I would advise any sensible person to just say away!
I also have to say this rather surprised me… (Page 7)
Who can create a Shared Health Summary?
  • a registered medical practitioner
  • a registered nurse
  • an Aboriginal and Torres Strait Islander health practitioner registered with AHPRA
I had thought that it was doctors who created Shared Health Summaries (And the Aboriginal care providers) rather than nurses. To me having nurse created shared summaries further invalidates the utility of the record. How long before receptionists are adding and updating shared summaries?
The document then goes on to say that a nurse uploading a Shared Summary becomes the patient’s Nominated Healthcare Provider! Just how does that work?
At the least all shared summaries need to be created by doctors if other doctors are to be expected to trust them which I understand was the intent of the PCEHR. Nurse shared summaries just invalidate the whole thing in my view. I must have just missed this point in older documents!
My advice is for everyone to share their clinical information with their doctor and not with the PCEHR! Even better still don’t create one of these records until the controls are such that you are totally comfortable with what information may wind up in it - now and in the future.
It just seems to be getting worse…

AusHealthIT Poll Number 237 – Results – 28th September, 2014.

Here are the results of the poll.

Do DoH and NEHTA Understand The Issues Of Clinical Safety That May Surround The Deployment And Use Of Health IT Systems?

For Sure 4% (6)

Probably 5% (7)

Neutral 15% (22)

Probably Not 33% (47)

No Way 41% (58)

I Have No Idea 1% (2)

Total votes: 142

This is a pretty clear and enthusiastic outcome. Seems most who read here don’t think DoH and NEHTA are across the safety issues around Health IT.

Again, many, many thanks to all those that voted!


Saturday, September 27, 2014

Weekly Overseas Health IT Links - 27th September, 2014.

Here are a few I have come across last week.
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.

When EHR design is a 'what not to do'

Posted on May 07, 2014
By Mike Miliard, Managing Editor
Among the healthcare developers workshopping better approaches to technology design at HxRefactored in Brooklyn next week will be Stephen Buck, who'll offer some "lessons learned" from looking closely at leading EHRs – specifically, how not to design a user interface.
HxRefactored, which represents a coming-together of Health 2.0’s Health:Refactored and Mad*Pow’s Healthcare Experience Design conferences, will take place May 13-14 at the New York Marriott at the Brooklyn Bridge. There, 500 or so designers and developers will gather to explore new and innovative ways to improve healthcare experience for patients and physicians alike.
Buck leads the mobile health product management team for Danbury, Conn.-based health IT firm IMS Health. This past December, IMS launched a SaaS-based app prescribing platform called AppScript, which corrals more than 40,000 downloadable iOS and Android apps, categorizing them and evaluating them -- based on functionality, peer and patient reviews, certifications and more -- to help physicians know which ones would do best for their patients.

How to use an EHR? Depends whom you ask

Posted on Sep 19, 2014
By Mike Miliard, Managing Editor
The data in electronic health records may be structured, but the usage patterns of the doctors who interact with them is anything but, according to research from Weill Cornell Medical College.
After getting acclimated to EHRs, physicians tend to fall into their own personalized usage patterns, according to the research – leading to a huge variability to how the systems are put to work.
The Weill Cornell study – performed in collaboration with the Institute for Family Health, a network of 18 New York City health centers – aims to better understand these unique dynamics between docs and health IT, offering perspective on which aspects of EHRs work well, and which need to be improved to standardize and optimize care.


Hospital CIO: HL7 messaging protocol key to data mining

September 19, 2014 | By Katie Dvorak
With the amount of data healthcare organizations are collecting constantly growing, the HL7 messaging protocol is key to the data mining process, Wes Wright, senior vice president and CIO at Seattle Children's Hospital, tells HealthITAnalytics.com.
HL7, a formatted messaging protocol, allows data to flow through it from virtually every piece of equipment or medical system hooked into a network.

Breaches show need for improved data governance in healthcare industry

September 19, 2014 | By Katie Dvorak
When it comes to data security in the healthcare industry, it is a matter of finding the balance between technology, personnel and good governance structure, according to two information security experts.
Ron Raether, partner at the law firm Faruki Ireland & Cox, and Andrea Hoy, CEO of the consulting firm A. Hoy & Associates, spoke with HealthcareInfoSecurity.com about the importance of improving data governance for healthcare organizations.
Currently, the industry is doing "a fairly decent job of embracing the policies and procedures to handle many of the very visible known exposures of privacy data," Hoy said in the interview. However, she also said there are constraints, such as the use of legacy applications and systems, which makes it difficult to upgrade security because organizations have to consider how the upgrade will impact those systems. 

RECs Support More Than 100,000 Providers to Achieve MU

SEP 18, 2014 8:41am ET
Regional Extension Centers--created under the HITECH Act to assist providers in adopting and becoming meaningful users of electronic health records--have surpassed their goal by supporting more than 100,000 providers to demonstrate Stage 1 Meaningful Use, according to the Office of the National Coordinator for Health IT.
“RECs are partnered with over 150,000 providers across the country--44 percent (139,000) of all primary care providers and more than 13,000 specialists--and helped 91 percent of those providers adopt an electronic health record system,” states a Sept. 17 blog co-authored by National Coordinator Karen DeSalvo, M.D. In addition, DeSalvo reveals that a recent study found providers working with an REC were nearly twice as likely to earn an EHR incentive payment.

EHR Success: 4 Change Management Process Tips

9/18/2014 09:06 AM
Implementing a successful EHR system depends on first developing an efficient change management plan. Here's how to do it.
"When did the software change?" You've no doubt heard that question once or twice.
In healthcare settings, it often comes up when documentation and information on use of electronic health records are not communicated effectively. One reason users pose this question so often is that organizations sometimes overlook the importance of a good change management process as it pertains to EHRs. This, in turn, hinders the success of new EHR configurations.
In the context of an EHR build, change management refers to "a project management process wherein changes to the scope of a project are formally introduced and approved," according to John Fillcetti's Project Management Dictionary.
  • September 19, 2014 1:00 PM

Telemedicine reduces ER visits and shortens hospital stays for patients with chronic diseases

TORONTO, Sept. 19, 2014 /CNW/ - The use of telemedicine to help manage chronic diseases yields clear benefits including fewer, shorter hospital stays, fewer emergency room visits, less severe illness and fewer deaths according to a new study published in Telemedicine and e-Health.
Telemedicine patients also proved to be more engaged in their health management.
Researchers analyzed telemedicine studies of congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and stroke to determine the impact of telemedicine on access to and quality of care as well as cost.

Apple-Epic collaboration hits snag

Posted on Sep 18, 2014
By Mike Miliard, Managing Editor
The newest iPhone operating system was released yesterday, but the hotly anticipated HealthKit technology wasn't part of it. Nonetheless, even tight-lipped Epic has begun to offer details about what the platform will look like when the kinks are finally ironed out.
A coding snafu discovered in Apple's new wellness platform has developers in Cupertino, Calif., rushing to fix it – but it could be some time before that much-discussed piece of iOS 8 is ready for prime time.
"We discovered a bug that prevents us from making HealthKit apps available on iOS 8 today," said Apple spokesperson Trudy Muller in a statement on Wednesday.

Emis creates PHR with Apple HealthKit

18 September 2014   Lyn Whitfield
Emis is using the Apple HealthKit platform to create a personal health record that is integrated with its Emis Web GP and clinical system.
Patients from the area covered by NHS North West London Clinical Commissioning Group will be the first to have the chance to use the new record, with the CCG encouraging its GPs to use the data collected.
Emis chief executive Chris Spencer said the company had been working on the project for two to three months, with “increasing visibility” as Apple got ready to launch its Apple Watch product, which can be used with the Apple Health app and HealthKit.

Docs still unconvinced of EHRs' worth

Posted on Sep 17, 2014
By Mike Miliard, Managing Editor
Fewer than 25 percent of physicians say electronic health records have made them more efficient, and not even 33 percent of them say EHRs have improved care quality, according to a new survey.
The poll of 20,000 physicians was commissioned by The Physicians Foundation. It found that, while 85 percent of docs had implemented EMRs, nearly half of respondents (47 percent) complained that the systems detract from patient interaction.
Meanwhile, the report paints a picture of a medical practice industry in flux, with doctors stretched thin – and many planning to close-up shop thanks to the regulatory and technology changes unfolding all around them.

AMA presses for better EHRs

Posted on Sep 17, 2014
By Bernie Monegain, Editor
The American Medical Association, which represents more than 200,000 members, says its time to fix poorly designed EHRs so doctors can use them more effectively and better serve their patients.
The demand follows an AMA study with RAND Corp. confirming that physician frustration with EHRs is taking a significant toll not only on them, but also on their patients.
Calling the need for better EHR design "urgent," the AMA on Tuesday released a new framework outlining eight priorities for improving EHR usability to benefit caregivers and patients.

Healthcare takes cautious approach to new technology

September 17, 2014 | By Susan D. Hall
Early adopters of technology are more likely to lead in revenue growth and market position, according to a study conducted by Harvard Business Review Analytic Services and sponsored by Verizon, though healthcare tends to take a cautious approach.
The study found only 27 percent of healthcare organizations seek out that early advantage, compared with 36 percent that buy new technology after others have proven its benefits, and 35 percent that wait until something has become well established, according to the breakout of healthcare responses from the 672 total executives polled.

Coverage, reimbursement remain barriers to telehealth use, health industry leaders testify

September 17, 2014 | By Katie Dvorak
Coverage and reimbursement of telehealth, especially for Medicaid and Medicare, was the topic of choice during a roundtable discussion held by the U.S. Senate Special Commission on Aging on Tuesday.
During the discussion, government officials and healthcare leaders spoke about the issues facing telemedicine when it comes to the laws and regulations surrounding the technology.
Jack Resneck, M.D., a member of the American Medical Association's Board of Trustees, said the main roadblocks for telemedicine use have been geographic restrictions and dual eligibility for patients who are on Medicare and Medicaid yet fall under Medicare restrictions.

ONC Launches New Blue Button Toolkit

SEP 16, 2014 8:51am ET
The Office of the National Coordinator for Health IT has launched a new toolkit for organizations that want to use Blue Button technology to help consumers get access to their digital health information.
The Blue Button Toolkit includes technical guidelines for organizations such as labs, pharmacies, immunization registries, and health information exchanges, as well as a portfolio of national standards that “further the goal to empower all Americans with electronic access to their own health data.” In particular, ONC added alternative technical approaches to the toolkit that support consumer exchange of information and Direct protocols for the secure exchange of information.

Health IT Early Mover Advantage Examined

9/16/2014 02:00 PM
Early technology adopters have higher growth rates than healthcare organizations that hold back on health IT, says Harvard Business Review/Verizon study.
Although few healthcare organizations view first-adopter status as a business advantage, those that more quickly implement new technologies do reap valuable returns on these investments, a new study suggests.
Consumer behavior and expectations are the primary factors driving healthcare market changes, according to 61% of respondents in "The Digital Dividend: First Mover Advantage," a study conducted by Harvard Business Review Analytic Services and sponsored by Verizon.
Today's consumers expect their providers to use electronic health records; a year ago 41% of patients said they would be willing to switch doctors to get online access to their medical records, according to an Accenture study. Consumers use wearable devices and mobile apps, larger co-payments make them more cost-sensitive, and they want more insight into side effects such as cumulative radiation exposure doses.

EHR Systems 'Immature, Costly,' AMA Says

Cheryl Clark, for HealthLeaders Media , September 17, 2014

The president-elect of the American Medical Association says there is "a crying need" to make electronic health record systems "time-saving rather than efficiency-diminishing."

Electronic health record systems are so complicated and poorly designed that they are impacting the quality of doctors' clinical decisions and challenging the sustainability of their practices.
Those were messages Tuesday from the American Medical Association, which has published an eight-point wish list for technology vendors to improve EHR usability.

Primary Care Providers Crucial to Patient Portal Adoption

SEP 16, 2014 7:25am ET
Integrating promotion of online patient portals into primary care visits appears to be the most effective way to increase portal usage, according to a Virginia Commonwealth University-led study published in the Annals of Family Medicine.
Researchers also found that 1 out of 3 patients aged 60-69 utilized the portals--the highest rate of any age group studied.
“While patient portals can help to engage patients in their care and even lead to improved health outcomes, getting patients online has been difficult,” said Alex Krist, M.D., associate professor in the Department of Family Medicine and Population Health, VCU School of Medicine. “However, primary care practices can effectively encourage their patients to use a portal by making promotion of the portal part of routine care.”

Less than One-Third of Consumers Access Health Records Online

SEP 16, 2014 7:48am ET
Only three in 10 individuals had online access to their medical records last year, according to results of a national survey reported in a new data brief from the Office of the National Coordinator for Health IT.
“This is likely related to providers’ limited capabilities prior to implementation of Stage 2 Meaningful Use,” state ONC authors, who point out that fewer than half of all office-based physicians in 2013 had the computerized capability to provide patients the ability to view, download and transmit electronic health record data, and only about a quarter routinely used this capability. Among hospitals, ONC reports that last year fewer than half offered patients access to view health record data, with substantially fewer offering download or transmit capability.

Federal IT Leaders Seek Support From Developers for EHR Adoption

The White House's Office of the National Coordinator for Health IT is looking to build a development community around the Blue Button electronic health record system.

CIO | Sep 17, 2014 4:49 AM PT
The White House is appealing to developers to join the open source community working to expand adoption of interoperable digital health records through its Blue Button initiative.
Blocking any useful cloud app doesn't work and ultimately does the business a disservice. This list
Blue Button, administered by the Office of the National Coordinator for Health IT (ONC) within the Department of Health and Human Services, allows consumers to obtain a digital copy of their health records through participating groups that administer patient data.

Apple's HealthKit is apparently ready for trials

September 15, 2014Eric Wicklund - Editor, mHealthNews
It may still be under production, but Apple's HealthKit is slated to star in two chronic disease management trials being launched in the near future.
As reported by Reuters, Stanford University Hospital will be using the mHealth platform to connect diabetic children with physicians tracking their blood sugar levels. Duke University, meanwhile, will be using the platform to enable physicians to track blood pressure, weight and other physiological data in patients who have been diagnosed with heart disease or cancer.
"This could eliminate the hassle of getting data from patients, who want to give it to us," Ricky Bloomfield, an internal medicine pediatrician and director of mobile strategy, told Reuters. "HealthKit removes some of the error from patients' manually entering their data."

Calls for Stage 2 changes grow louder

Posted on Sep 16, 2014
By Mike Miliard, Managing Editor
In a pointed letter sent to HHS Secretary Sylvia Matthews Burwell on Monday, a who's-who of industry stakeholders complained of "immediate concerns" about their members' ability to continue meaningful use participation.
The letter, co-signed by an array of groups – including CHIME, HIMSS, MGMA, AHA, AMA and others – was also sent to CMS Administrator Marilyn Tavenner and National Coordinator for Health IT Karen DeSalvo, MD.
In it, stakeholders reiterate what many of them have been shouting from the rooftops since CMS published its only-mildly-more-flexible Stage 2 final rule, which was announced in late August. The very existence of meaningful use "hinges on addressing the 2015 reporting period requirements," they state.

RAND: EHR usability a 'unique and vexing' challenge to doc satisfaction

September 16, 2014 | By Marla Durben Hirsch
The RAND Corporation has released a new study warning that electronic health records worsen physicians' satisfaction, which in turn may adversely affect patient care.
The study, sponsored by the American Medical Association, evaluated data from 30 physician practices in six states, 28 of which used EHRs. Fourteen different EHR products were represented. 
The authors evaluated physician satisfaction, and determined that the "most novel and important findings" involved how EHRs affected the physicians' personal satisfaction. While most physicians like the concept of EHRs and how they enhanced remote access and electronic communication, their inadequate design and usability provided a "unique and vexing challenge to physician professional satisfaction" in areas such as increased time on data entry, interference with face to face care, interfaces that don't match workflow, poor health information exchange and a mismatch between Meaningful Use and clinical practice.

AMA framework looks to improve EHR usability

September 16, 2014 | By Marla Durben Hirsch
The American Medical Association (AMA), concerned about current electronic health record design, has released a new framework outlining eight priorities to improve the usability of the systems.
"Today the design and implementation of EHRs do not align with the cognitive and workflow requirements of physicians within and across specialties and practice settings," Steven Stack, AMA president-elect and chair of AMA's Advisory Committee on Physician EHR Usability, said, speaking on a Sept. 16 webinar announcing the new framework.

Digital monitoring key to health future

16 September 2014   Sam Sachdeva
Personal digital health technologies could replace the traditional healthcare systems in the way that electricity made candles obsolete, health entrepreneur Ali Parsa has claimed.
Speaking at the King’s Fund International Digital Health and Care Congress in London last week, Parsa, founder of Circle Health, and now chief executive of the soon to be launched mobile health service start-up Babylon, said a rapid and continuing decrease in the cost of diagnostic testing is making it easier for wearable health devices and other monitoring technology to be more widely used.
Babylon aims to offer real-time video consultations, diagnostics, monitoring, prescription ordering and appointment booking, as well as cloud-based access to patient records in a smartphone app.

Nebraska Medical Center uses telemedicine to treat Ebola virus patient

September 15, 2014 1:39 pm by Stephanie Baum | 0 Comments
One of the most challenging things about highly contagious and dangerous diseases like the Ebola virus is figuring out how to deliver care without risking it spreading to others. A Nebraska medical center is using telemedicine to treat a patient with Ebola as a viable way to deliver care in an acute setting. It’s a move that reflects a broader trend of how hospitals are implementing telemedicine for acute care.
Vidyo’s video conferencing platform is being used in the 10-year old Biocontainment Patient Care Unit at The Nebraska Medical Center to help treat Dr. Richard Sacra. The unit is one of four in the country equipped to handle these cases. The Massachusetts physician contracted Ebola in Liberia where he worked in child delivery.

Two-thirds of NPs use mobile devices at work

Written by Shannon Barnet (Twitter | Google+)  | September 12, 2014
Increasingly, nurse practitioners use and rely on mobile devices, social media and online references for professional purposes, according to the results of a Wolters Kluwer Health survey analysis released earlier this week. Almost two-thirds, 65 percent of the nurses surveyed, said they use a mobile device for work.
Wolters Kluwer Health, a global provider of healthcare industry information and point-of care solutions, also found that, increasingly, healthcare institutions condone nurses using digital devices and consulting websites and online resources in the workplace. In fact, the study found 95 percent of healthcare organizations now permit nurses to use the Internet to find online resources for clinical information.
Clinician characteristics and work flow innovations affect usage
MONDAY, Sept. 15, 2014 (HealthDay News) -- A substantial proportion of primary care patients will use online personal health records that interact with the electronic health record, according to a study published in the September/October issue of the Annals of Family Medicine.
Alex H. Krist, M.D., M.P.H., from Virginia Commonwealth University in Richmond, and colleagues performed a mixed methods assessment of a proactive implementation strategy for a patient portal offered by eight primary care practices. The researchers performed prospective assessments of practice implementation strategies, portal use, and factors influencing use.

15 states with the largest data breaches

Written by Shannon Barnet (Twitter | Google+)  | September 15, 2014
Breaches of unsecured protected health information come in a variety of forms including hacking, improper disposal, theft, unauthorized access and loss, to name a few. Desktop computers, laptops, email, network servers, EMRs and portable electronic devices are all potential sources of breaches.
Listed below are the top 15 states with data breaches affecting the largest number of individuals so far this year, according to HHS.
  1. Tennessee — 4.5 million individuals
  2. California — 338,700

HIT Interoperability Still Maddeningly Elusive

Scott Mace, for HealthLeaders Media , September 16, 2014

On the issue of interoperability, there is considerable evidence that technology vendors, federal regulators, and healthcare providers are persistently speaking past each other, resulting in the same kind of gridlock we see elsewhere in politics.

Apple last week introduced a glorified fitness trainer for your wrist that fell far short of being a medical device, and with good reason. Washington, of course, is known not as a hotbed of innovation, but as a hotbed of regulation. Medical devices, being but one part of healthcare under regulation's watchful eye, are no exception.
Nothing epitomizes the last few decades of regulatory culture like the usual process for public input into a new regulation, whether from the Food and Drug Administration or the Office of the National Coordinator for Health Information Technology.

AMA Urges Overhaul of Electronic Medical Records

Group Says Current System Detracts From Patient Care

Melinda Beck
Updated Sept. 16, 2014 12:23 p.m. ET
It's no secret that many physicians hate the electronic-medical-records systems they use, saying they are cumbersome, poorly designed and detract from patient care.
Amplifying those concerns, the American Medical Association on Tuesday is calling for a major overhaul of EMR systems to make usability and high-quality patient care a higher priority.
"The health system desperately needs working information technology to help support quality care," said AMA President-elect Steven J. Stack. "The current generation of EMRs and the way they are deployed is not supporting the quality of care we need it to."

10 technologies changing the future of healthcare

By Lyndsey Gilpin September 4, 2014, 4:00 AM PST // lyndseygilpin
From digital networks to wearables, the health care industry is undergoing massive technological changes. Here are 10 types of innovations changing its future.
The health care industry will see a 21% increase in IT jobs by 2020, according to research by the University of Chicago. Across all health care sectors, there is a demand for creative, thoughtful uses of health informatics, mobile technology, cloud systems, and digital diagnostics.
Many of these new inventions have yet to be approved by the FDA, a process that can take up to 10 years. But that's not stopping the research and development of new technologies. Here are 10 types of tech that are changing the course of health care.

Getting Fitness Data into Clinical Records

SEP 15, 2014 7:07am ET
For several decades, conventional wisdom about the amount of exercise the typical person needs to reach optimal health has stayed relatively constant at 30 minutes a day, five days a week. But a recent study in the Journal of the American College of Cardiology, covering more than 55,000 people over a mean 15-year period, discovered those who ran or jogged as little as five to 10 minutes a day also achieved substantial benefits--including 30 percent less risk of all-cause mortality and 45 percent less risk of cardiovascular-cause mortality.
The study's authors also concluded that running was as vital a prognostic indicator as smoking, obesity, and hypertension. The findings could revolutionize exercise science. Health Data Management spoke with one of the study's co-authors, Carl "Chip" Lavie, M.D., medical director of cardiac rehabilitation and prevention at the New Orleans-based Ochsner Health System, about the importance of the new data and how best to include activity data in clinical records.

DeSalvo touts interoperability, Blue Button at Consumer Health IT Summit

September 15, 2014 | By Katie Dvorak
The Office of the National Coordinator for Health IT jumped into National Health IT Week in the District of Columbia by placing the focus on the consumers' role in their own healthcare.
National Coordinator for Health IT Karen DeSalvo (pictured) kicked off the 2014 Consumer Health IT Summit by speaking about the advancements in the industry, such as Blue Button, which allows patients to secure online access to their electronic records, and the commitment to interoperability.
Interoperability is ONC's top priority, according to DeSalvo. "[Interoperability is] a way that individuals' health information is easily accessible to them when and where they need it," she said.

ONC survey: Nearly half of patients given online access to records use it

September 15, 2014 | By Susan D. Hall
For providers fretting over the patient engagement requirements of Meaningful Use Stage 2 (MU2), a new data brief from the Office of the National Coordinator for Health IT should offer some encouragement.
Its survey found that 46 percent of patients who were offered access to their health records online viewed their records at least once--a level nine times higher than the required MU2 threshold.
The survey of 2,100 people, conducted in 2013, however, found that only about three in 10 were offered access to an online medical record.

William Hersh: HIT education has undergone a 'huge change'

September 15, 2014 | By Dan Bowman
While William Hersh, professor and chair of the department of medical informatics and clinical epidemiology at Oregon Health & Science University in Portland, believes that technology is crucial to health IT education, he doesn't think it's necessarily the most important aspect of the industry for students to master.
"Informatics is not just about the technology, it's understanding how IT is used in healthcare," Hersh (pictured), tells FierceHealthIT. "Our curriculum does not just have courses on technology. No matter what field you're in these days, you don't learn everything you use at your job in your education; the education hopefully gives you a foundation. As you finish your formal studies, hopefully you're still always learning."

CDS could reduce inappropriate antibiotics for critically ill patients

Written by Akanksha Jayanthi (Twitter | Google+)  | September 11, 2014
Implementing a clinical decision support system may help identify patients who have been prescribed inappropriate antibiotic therapy for healthcare-associated infections, according to a study in Critical Care Medicine.
Researchers at Barnes-Jewish Hospital in St. Louis implemented a CDS that identified if an antibiotic order entry was placed for a patient who had exposure to the same class of antibiotics currently being prescribed or had a positive culture with resistance to the prescribed antibiotic within the previous six months. The ordering system reviewed all the antibiotic and microbiologic history for each patient across all BJC HealthCare hospitals upon antibiotic order to retrieve this information.

ChartSpan unveils mobile app for patient medical records

September 12, 2014 6:00 am by Dan Verel | 1 Comments
Chartspan said it has developed a patient-based, interoperable consumer technology that can automate paper health records into electronic patient records.
ChartSpan, based in South Carolina, developed an iPhone app that it says converts paper health records into digital form simply through taking a picture of a physical health record, or importing it from an email or fax, with no manual entry. An Android version is coming next month. Then, ChartSpan extracts the data and populates each user’s electronic, personal database.

EHRs are “a source of stress” for physicians, AMA says

Author Name Jennifer Bresnick   |   Date September 12, 2014   |  
Physicians who feel like they can’t deliver quality care to patients have low levels of job satisfaction, and EHRs are the biggest obstacle to providing the best possible services, argues the American Medical Association (AMA) and the RAND Corporation in a new report.  Cumbersome workflows and confusing interfaces are a significant source of stress for providers who want to focus on their patients, contributing to high levels of disgruntlement that may serve as an early warning of deeper problems in the healthcare system.
“Many things affect physician professional satisfaction, but a common theme is that physicians describe feeling stressed and unhappy when they see barriers preventing them from providing quality care,” said Dr. Mark Friedberg, the study’s lead author and a natural scientist at RAND, a nonprofit research organization. “Physicians believe in the benefits of electronic health records, and most do not want to go back to paper charts.  But at the same time, they report that electronic systems are deeply problematic in several ways. Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients.”

How transparent should doctors be with their patients?

By Deborah Kotz

Globe Staff   September 11, 2014
Dr. Leana Wen wants her patients to know she was born in Shanghai, China, that she has no kids but would love to someday, and that she drinks the occasional glass of wine. She believes such transparency -- along with a full disclosure about how she earns her paycheck -- is a must for keeping doctors honest and helping patients get a sense about how their doctor’s personal views and financial interests factor into the care they receive.
On a new website she launched in the spring called Who’s My Doctor, Wen wrote in her profile that she receives 55 percent of her annual income from her clinical practice at the George Washington University Emergency Department in Washington and doesn’t get paid based on how many tests she orders or procedures she performs. She also disclosed the sources of her research funding and which hospitals and patient advocacy groups have paid her to give speeches.

EHR Vendors Put Up Roadblocks to Direct Messaging

by Ken Terry, iHealthBeat Contributing Reporter Monday, September 15, 2014
Note: This is part one of a two-part series on Direct messaging. The next article will focus on electronic health record vendors that have obstructed health information exchange by restricting the types of Direct messaging formats and/or attachments they allow their EHRs to receive.
Half of U.S. health care providers now have access to Direct secure messaging through 36 health information service providers, according to DirectTrust, a not-for-profit trade association that accredits HISPs. Yet the policies of certain vendors are impeding physicians' and hospitals' ability to exchange Direct messages, HISPs and providers say.
eClinicalWorks (eCW), an EHR vendor, has decided to negotiate one-to-one agreements between its HISP and other HISPs to permit the exchange of information. By taking this approach -- rather than joining the DirectTrust framework, which assures HISPs of one another's trustworthiness -- eCW has made it difficult for some providers to exchange Direct messages with its customers.

Is the Health IT Punchbowl Being Taken Away?

By John R. Graham Filed under Science and Other News on July 29, 2014 with 10 comments
This blog has been very critical of the federal government’s blowing $30 billion to bribe doctors and hospitals to install Electronic Medical Records (EMRs) that they do not want, and which do not appear to help patient care.
Well, the punchbowl may be taken away soon. One of the goals of the $30 billion was to install EMRs that would talk to each other. Well, in fact, many EMRs do not share information but actually block it.

Health Data "Interoperability": A $30 Billion Unicorn Hunt

John R. Graham , Contributor
Having cheered as $26 billion of taxpayers’ money has been spent since 2009 inducing hospitals and physicians to install electronic health records (EHRs), many champions of the effort are dismayed that the EHRs are not interoperable. That is, they cannot talk to each other – which was the whole point of subsidizing the exercise.
All this money has achieved a process goal: There has been a significant uptake of EHRs. According to a recent review, the proportion of physicians who have at least a basic EHR has increased from under 22 percent to 48 percent. Doctors were motivated by the bounty offered, plus the threat of having reimbursements being clawed back in 2015 if they have not adopted EHRs. The proportion of hospitals has similarly increased from 12 percent to 44 percent.
But these EHRs do not  talk to each other. According to the same review, “only 10 percent of ambulatory practices and 30 percent of hospitals were found to be participating in operational health information exchange efforts.”