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.
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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.
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.
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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.
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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.
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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.
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Greg Slabodkin
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.
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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.
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- September 19, 2014 1:00 PM
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.
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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.
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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.
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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.
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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.
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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.
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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.
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Greg Slabodkin
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.
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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.
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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.
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Greg Goth
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.”
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Greg Slabodkin
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.
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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.
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September 15, 2014 | Eric 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."
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
- Tennessee — 4.5 million individuals
- California — 338,700
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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.
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Group Says Current System Detracts From Patient Care
By
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."
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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.
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Greg Goth
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.
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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.
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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.
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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."
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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.
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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.
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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.”
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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.
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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.
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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.
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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.”
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Enjoy!
David.