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."

Sunday, November 30, 2014

The Government Has A Very Bad Week and The Medicare Co-Payment Is Right In The Middle!

There has been a lot going on in Federal Politics this week - to say the least. We have had the ABC funding cuts, confusion on the fate of the Medicare Co-Payment, issues with canoe construction, barnacle clearing becoming more like a keel hauling and to top it off the Liberals being kicked out of Government, after only one term in Victoria.
It would be hard to argue the Government has not been losing a fair bit of paint over all this.
Here are the two of the more seminal articles on the Co-Pay.
First we have:

GP co-payment plan hangs in the balance as government insists it is not dead

Reports that Coalition may seek to impose $7 payment by regulation to circumvent Senate opposition
Uncertainty surrounds the federal government’s proposed $7 GP co-payment, after reports it was to be abandoned.
Speaking on ABC radio on Thursday morning, the leader of the government in the Senate, Eric Abetz, insisted the policy was not dead.
“The government’s policy on the GP co-payment remains,” Abetz said. “It is good policy.”
The government announced the co-payment in the May budget, but has yet to introduce legislation because of opposition from Labor, the Greens and crossbenchers in the Senate.
A spokesman for health minister Peter Dutton also dismissed the reports as media speculation, but Tony Abbott refused to say if the co-payment had been shelved.
Speaking to reporters on Wednesday night the prime minister would say only that the charge was “an important reform”.
Lots more here:
Second we have this:

Government sends mixed messages over future of $7 GP co-payment

Date November 27, 2014 - 9:17AM

Lisa Cox

Confusion reigns over the future of the unpopular GP co-payment amid suggestions it will be shelved or that the government could seek to bypass a hostile Senate to introduce some version of the policy through regulation.
The Australian Medical Association (AMA) has called on the government to declare its position, noting that Health Minister Peter Dutton had this week ruled out the possibility the government would bypass the Senate because it had legal advice indicating it could not introduce the fee without legislation.
But on Thursday morning, Mr Dutton told reporters in Canberra he would not "rule things in or out" and the government was "determined to make Medicare sustainable".
In an interview with Radio National on Thursday morning, the government's leader in the Senate Eric Abetz also refused to speculate "as to different methodologies that might be employed" to introduce some form of GP fee.
Fairfax Media and other outlets reported on Thursday that Prime Minister Tony Abbott has privately conceded defeat on the unpopular fee proposal and will shelve the policy before the end of the year. 
AMA president Brian Owler said "it would nice to have certainty from this government about what they're doing".
"Clearly there are a number of messages coming from the Prime Minister's office but then we've got Eric Abetz out there this morning defending the policy," Dr Owler said.
"It would be nice to just have a clear announcement from the government and then we could move on and have a more complex and nuanced discussion about health policy."
Dr Owler said he did not believe the government would attempt to bypass the Senate.
More here:
What seems to have happened is that as part of the of the de-barnacling process the Prime Minister’s Office briefed the press that the GP Co-Payment was off the table - but seemingly did not tell most other senior minister. They have become very annoyed and pushed back.
My feeling is that the Government is desperate to get a ‘price signal’ into Medicare and is now trying to work out what the best way to do this is - without causing huge political ructions as they have so far.
What has been missed in all this - excluding the outrage from Labor and the Greens and a few others - is the implementation complexity of this sort of co-payment as far as GP system providers are concerned. This is especially so regarding how you cap the impact to only the first 10 co-pays each year and exclude some from paying at all.
It seems unlikely the present proposal will now pass the Senate - which means the next chance will be in February, 2015. This is simply not long enough to develop, test and implement systems - especially when there is no legislation that provides clarity as to what is needed at the GP front desk!
To me this, at best, needs to be deferred by a year - if it indeed goes ahead at all. My view is that it is just bad policy but I am sure they won’t give a hoot what I think! I just want to see reasonable treatment of the GP System providers - not as we have seen meted out in the past by DoH and NEHTA. 

Equally I also think the Pharmaceutical Benefits Scheme Co-Payment increases are getting a bit out of had with those without a Senior's Health Care Card having to pay over $40 for each prescription. Seems like a pretty big hit for those on regular prescription medicine. The increases have been rather under the radar as compared to the Medicare Co-Payment. 

AusHealthIT Poll Number 246 – Results – 30th November, 2014.

Here are the results of the poll.

Is NEHTA Offering A Total Funding Pool of $500,000 To Have Private Hospitals Integrate Their Systems With The PCEHR Appropriate When The Fate Of The PCEHR Is Not Yet Announced?

Yes - It Shows They Are Going Ahead. 9% (10)

Neutral 27% (29)

No - NEHTA Is Acting In A Rogue Manner 61% (66)

I Have No Idea 4% (4)

Total votes: 109

A pretty clear response with a majority seeing evidence that NEHTA is off on a bit of a frolic.

Good to see a clear outcome and lots of votes.

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


Saturday, November 29, 2014

Weekly Overseas Health IT Links - 29th November, 2014.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

CommonWell broadens data sharing efforts

Posted on Nov 21, 2014
By Mike Miliard, Editor
CommonWell Health Alliance is marching toward "a new phase" of its vendor-driven interoperability efforts, extending its availability to providers, signing on new corporate members and eyeing new opportunities for nationwide expansion.
Earlier this year, CommonWell's services were launched at more than 10 provider sites representing four different geographies. Since then, more than 20,000 people have opted to connect their records via CommonWell through their participating providers.
Now, CommonWell members have the option to enter into service agreements that offer a broader range of providers and their patients. Additionally, the alliance has locked in its relationship with founding member RelayHealth, whose health information exchange technology underpins CommonWell's efforts.

Digital health records: Toss them out and start over?

November 21, 2014 | By Susan D. Hall
Despite the millions they've spent on digitizing medical records, many hospitals would be better off just scrapping their systems, according to an article at Hospitals & Health Networks.
"Poorly designed and poorly implemented information systems are worse than useless, worse than a waste of those millions and billions of dollars," writes Joe Flower, a healthcare futurist and CEO of The Change Project Inc., and its healthcare education arm, Imagine What If.
"As we go through rapid, serious changes in health care, poor information systems will strangle your every strategy, hobble your clinicians, kill patients and actually threaten the viability of your organization," Flower says.

2015 healthcare predictions: Growth in analytics, mobile, security risks

November 21, 2014 | By Susan D. Hall
Big data continues to dominate the 2015 predictions for health IT from IDC Health Insights, though security plays a major role as well.
Among the predictions in the IDC FutureScape for Health Insights report:
  • By 2015, half of healthcare organizations will have experienced one to five cyber attacks in the previous 12 months, with a third of those attacks successful.

3 reasons for provider moderation in health IT use

November 21, 2014 | By Dan Bowman
While digital tools enhancing communication between physicians and patients has been proven an effective method for boosting medication adherence for some patients, their use should be approached with caution, according to Esther Choo, an assistant professor at Warren Alpert Medical School in Providence, Rhode Island.
Choo, in a commentary for Quartz, warns that while email and text messaging can be helpful for engaging patients, there are a number of challenges associated with using such tools. Here are three:
  1. Impersonal relationships: Particularly when it comes to discussing serious or terminal conditions with patients, plans and reassurances primarily should be delivered in person, as opposed to via text message, for example. "[H]ave we arrived at an age when everything--even professional sympathy and support--can be conveyed electronically?" Choo asks.

Glow adds postpartum-focused tracking to its pregnancy app

By: Aditi Pai | Nov 19, 2014
Fertility tracking app maker Glow has added a new feature to its app for pregnant women, called Glow Nurture. The app will now offer postpartum support.
The postpartum period refers to the time immediately after the birth of a child and lasts for about six weeks. According to Glow, the emphasis during this time is generally on the baby, but the mother is also recovering. Postpartum depression affects 10 to 20 percent of women, the company said, but resources for women during postpartum are lacking.

Study: Health IT Use Could Affect Physicians' Capacity To See Patients

Thursday, November 20, 2014
The increased use of health IT among providers could reduce the number of patients physicians are able to see, according to a study published in the American Journal of Managed Care, FierceHealthIT reports.

Study Details

The study was based on survey responses from primary care physicians in Michigan (Hall, FierceHealthIT, 11/19). The survey -- by the Center for Healthcare Research & Transformation and the University of Michigan Child Health Evaluation and Research Unit -- was conducted between October 2012 and December 2012 and included a total of 739 respondents.
Responses from physicians who were not practicing at the time were not included.

Highlighting generic drugs in EHRs boosts generic prescribing, cuts care costs

November 18, 2014 | By Marla Durben Hirsch
The simple act of listing generic drugs first in a physician's electronic health record can substantially increase generic prescribing and lower the cost of healthcare, according to a new study in the Annals of Internal Medicine.
The researchers, from the University of Pennsylvania and the Philadelphia VA Medical Center, evaluated two family medicine ambulatory clinics and two internal medicine ambulatory clinics between June 2011 and September 2012, reviewing 8,934 prescriptions pre-intervention and 12,443 during the intervention period for beta blockers, statins and proton-pump inhibiters. 

Research based on EHR data needs to account for, remove bias

November 19, 2014 | By Marla Durben Hirsch
Screening analyses using electronic health record data need to be refined to reduce the risk of bias and prevent "spurious" findings, according to a new report in eGEMs (Generating Evidence and Methods to Improve Patient Outcomes).  
The researchers, from the Group Health Research Institute in Washington state, noted that EHRs increasingly are being used to facilitate research and quality of care, such as in the review of cancer screening rates. However, the EHR data for cancer screening, such as colon cancer, is inaccurate because there is no separate code for screening; to that end, the data would include diagnostic colonoscopies, as well as screening colonoscopies. This bias can range in overestimation of colon cancer screening by 11.6 percent, according to the study's authors.

DeSalvo keeps focus on EHRs, usability

Posted on Nov 20, 2014
By Neil Versel, Contributing Writer
In case anyone was still wondering about a leadership vacuum at the Office of the National Coordinator for Health Information Technology, Karen DeSalvo, MD, is still national coordinator – a fact that was in evidence Wednesday at the close of the American Medical Informatics Association's annual conference.
DeSalvo – who was named acting assistant secretary of health at the Department of Health and Human Services this past month, to lend her public health expertise to the response to the Ebola outbreak – spent her entire keynote address talking not about Ebola or epidemiology, but about ONC and health IT.

Alert overload could prompt physician turnover

November 20, 2014 | By Susan D. Hall
Primary care physicians who are dissatisfied with electronic health record-based alert notification systems may throw up their hands and quit if those systems are too intrusive, according to a study published at the American Journal of Managed Care.
Previous research had determined that providers using these systems receive 56 to 63 alert notifications a day, and most doctors do little to customize their alert interface to help them be more effective. As a result, many providers become overloaded with alerts they see as unnecessary and feel create more work.

Surgery outcomes data published on MyNHS

19 November 2014   Sam Sachdeva
NHS England has published the latest surgery outcomes data for ten specialties and will release information on three more soon as part of a push for greater transparency around clinical performance.
The surgeon-level data has been published on the MyNHS website this morning, as well as on individual websites for each specialty.
The publication has been driven by Sir Bruce Keogh, NHS England’s medical director, who has been a long-term advocate of making outcomes data public.

Are seniors ready for digital health?

Posted on Nov 18, 2014
By Eric Wicklund, Editor, mHealthNews
The general consensus that older Americans aren't comfortable with new technology means that many are not accessing the Internet for health information or using electronic health records. This low health literacy rate, according to a study from the University of Michigan, might also demonstrate that seniors aren't ready to reap the benefits of digital health.
At the mHealth Summit 2014, in fact, there will be no shortage of solutions or sessions focused on the senior market. But if they're not looking up health issues on the Internet or accessing their records, just what are they doing?

Democratizing Medicine: Eric Topol Pushes a Patient-Centered Healthcare

November 17, 2014
Topol notes that digital health tools can help the patient "come alive"
As the healthcare industry moves into an era of accountable care, new digital tools can help democratize medicine, Eric Topol, M.D., director at the La Jolla, Calif.-based Scripps Translational Science Institute, said in a keynote at the New York eHealth Collaborative's (NYeC) 2014 Digital Health Conference.
In a crowded room full of conference attendees, who at times seemed mesmerized by the examples of how far digital health tools have come, Topol said that these new technologies will allow providers to move to individualized medicine. "You can have multilayers of information about someone,"  he said. "It's almost like a Google Maps for each patient."

Global PACS market will keep growing

By AuntMinnie.com staff writers

November 19, 2014 -- The global PACS market is expected to increase in value this decade, but there are still challenges ahead, according to a new report from medical intelligence company GBI Research.
GBI projects that the worldwide PACS market will increase from $2.9 billion in 2013 to more than $5.3 billion by 2020, achieving a compound annual growth rate (CAGR) of 9%.

Can the U.S. Health Care System Realize the Promise of Digital Health?

by Kate Ackerman, iHealthBeat Editor in Chief Thursday, November 20, 2014
NEW YORK -- Embracing digital health is key to curbing out-of-control health care costs, increasing access to care, improving care quality and encouraging patient engagement. But the current regulatory and policy landscape could get in the way of the U.S. realizing the full potential of health IT.
That was the message from speakers and attendees at the New York eHealth Collaborative's fourth annual Digital Health Conference in New York City

A fall standards update

Source: John Halamka, MD Date: Nov 19, 2014 e-mail to a friend
The November HIT Standards Committee focused on "asynchronous bilateral cutover," the compatibility of different CCDA payloads, healthcare IT that supports long term services and support, an update on the Standards & Interoperability projects, a discussion of data provenance efforts and the HITSC workgroup organization.
We started the meeting by thanking Jacob Reider, Deputy National Coordinator, for his chairmanship of the Standards Committee. He’s leaving ONC at the end of the month. He will be missed.
Charles Parisot provided an analysis of Consolidated-Clinical Document Architecture (C-CDA) Version Migration and Cutover Findings. The good news—many vendors can successfully generate and parse different CCDA versions. We discussed two key takeaways. When new versions of standards are introduced attention needs to be paid to backwards compatibility. A bit of planning now can save significant EHR engineering complexity later. Also, at some point, certification will need to codify what it means to be backward compatible. Are older versions stored as human readable documents instead of structured data? The HITSC members recommended to ONC that they seek the input of the EHR vendors as to the appropriate path for historical CDA variants (CCD, C32, CCDAr1, CCDAr2).

Paradigm shift coming for digital health

Posted on Nov 19, 2014
By Erin McCann, Managing Editor
Digital healthcare is no longer a reality of the future. It's happening now. And, as the industry moves toward full digitization, previously resistant clinicians are slowly, but gradually, getting on board with embracing new digital technologies. 
At least that's according to a new report put out by the folks at PwC, who highlight a telling shift in clinicians' attitudes toward digital technology, especially when it comes to connecting with patients. 
In the report, PwC officials surveyed 1,000 industry clinicians – including physicians, nurse practitioners and physician assistants – to gather a sense of how they perceive digital health nowadays. And the takeaways? In many arenas, most clinicians are on board. 

Parsing the paradox of underused PHRs

Posted on Nov 19, 2014
By Neil Versel, Contributing Writer
Rather than just getting more cheerleading for a technology that has been disappointing for years, attendees at the AMIA annual conference on Tuesday heard a refreshingly frank assessment of the slow uptake of personal health records.
But they also heard about strategies informaticists can use to better employ PHRs to engage patients and clinicians alike. And they got to hear from activist patients and caregivers for an often-overlooked perspective.
Noting that the meaningful use regulations to date have not specified a preference for PHRs or patient portals when it comes to making records available to consumers or engaging patients, Joseph Kannry, MD, lead technical informaticist at Mount Sinai Health System in New York City, said no institution wants to put up multiple portals.

RingMD launches global-focused telemedicine app

By: Jonah Comstock | Nov 18, 2014
Singapore-based RingMD launched its first app this week, an Android app designed to connect patients anywhere in the world to doctors anywhere in the world — although for now the doctors are mostly based in Singapore.
“Basically, when it comes down to healthcare and really just the world in general these days you have to think global from day one,” CEO Justin Fulcher told MobiHealthNews. “And we’re one of the only companies that are really taking that to heart as a core part of our philosophy. From there, being based in Singapore, we have the best opportunity to leverage the huge growth in the Asia region, but still given our management team — a lot of them come from the US — leverage our knowledge of the American market and accomplish that remotely.”

Social Media Analytics Tracking of Infectious Diseases

NOV 17, 2014 9:42am ET
The recent outbreak of the Ebola virus has focused public opinion on the analytical methods used by institutions such as the Centers for Disease Control and Prevention (CDC) to manage infectious diseases. In a recent opinion piece on CNN’s website, Sen. Rob Portman wrote that the CDC should get “proactive” about Ebola by switching from “passive” monitoring to “active” monitoring of the outbreak. The media’s attention on Ebola has highlighted the fact that epidemiologists can be limited not only by the data they capture, but also by the traditional methods of analysis available, especially when trying to function in real time.
Generally speaking there are two forms of data capture (i.e., surveillance) when studying the spread and prevalence of an infectious disease: active and passive tracking. Active tracking is where researchers “capture” observation subjects from the “wild” (in the US this might be from the shopping mall or a phone list) with targeted instruments in a timely fashion. With passive tracking, researchers must wait until someone chooses to report information (e.g., a patient chooses to go to the doctor), and therefore they’re potentially unable to influence what or when information is shared.

New Effort to Strengthen EHR-HIE Sharing of Patient Data

NOV 17, 2014 10:26am ET
In an effort to better connect electronic health records to health information exchanges, the New York eHealth Collaborative’s EHR/HIE Interoperability Workgroup has formed a strategic relationship with HIMSS and Integrating the Healthcare Enterprise (IHE) to streamline the process for achieving connectivity between EHR and HIE systems.
According to the organizations, the effort affects more than half the U.S. population and their healthcare providers, with the goal of secure sharing of patient data across multiple states and health IT systems. Specifically, the new alliance is designed to strengthen the EHR/HIE Interoperability Workgroup’s current program to test and certify EHRs and HIE vendors to enable reliable transfer of data within and across organizational and state boundaries.

Pros and cons of pulling behavioral and social data into EHRs

By Mike Miliard, Contributing Editor
Should more types of health data figure into electronic health records?
On the one hand, the Institute of Medicine put out a call for doing just that on the grounds that behavioral and social data can benefit population health practices to ultimately improve the care of individual patients. For physicians who already complain that EHRs are burdensome and distract from care delivery, on the other hand, the idea of making electronic records more complex, perhaps even cluttered, will inevitably be unwelcome news.
"Patient electronic health records provide crucial information to providers treating individual patients, to health systems addressing the health of populations, and to researchers uncovering valuable details on determinants of health and the effectiveness of treatments," IOM officials wrote in the report. "Over the past few decades, substantial empirical evidence points to the contribution of social and behavioral factors – such as living conditions and physical activity levels – to functional status and the onset and progression of disease."

Does encryption cover all HIPAA bases?

Posted on Nov 18, 2014
By Erin McCann, Associate Editor
What are the responsibilities of covered entities when an encrypted laptop or device is stolen, but the pass codes are handed over in the theft as well? A recent robbery reported by Boston's Brigham and Women's Hospital may shed some light on these tricky situations.
Hospital officials on Monday announced that an encrypted – not unencrypted – cellphone and laptop containing patient medical data were stolen this fall after a BWH physician was robbed at knifepoint and forced to disclose the laptop's pass codes.
The two devices contained the names, medical record numbers, ages, medications, clinical diagnoses and treatment data on 999 patients, officials said. The specific set of patients were those who received treatment at BWH's neurology and neurosurgery programs from October 2011 to September 2014, in addition to a group of individuals who participated in research studies.

Public APIs getting ready for prime time

Posted on Nov 18, 2014
By Neil Versel, Contributing Writer
At the American Medical Informatics Association's annual symposium today, developers and backers of public application programming interfaces talked about how the standard could speed interoperability with add-on apps to enterprise EHRs, and help make those bulky systems more nimble.
In a recent draft of its 10-year roadmap toward interoperability, the Office of the National Coordinator for Health IT adopted a recommendation from its JASON task force that Stage 3 of meaningful use include public APIs. The first such API likely would be Fast Healthcare Interoperability Resources, or FHIR (pronounced "fire"), a standard being developed by Health Level Seven International.
On Tuesday at AMIA's annual conference, fans of FHIR discussed a federally funded test implementation of the standard, and what it might mean for moving the needle on interoperability.

PwC: Provider, consumer views on healthcare tech closely align

November 18, 2014 | By Katie Dvorak
Healthcare providers' and consumers' views closely align when it comes to the promise digital technology holds for care, according to a new report by PricewaterhouseCoopers.
"Digitally-enabled care is no longer nice-to-have, it's fundamental for delivering high quality care," Daniel Garrett, Health Information Technology Practice Leader at PwC, said in an announcement.
PwC's Health Research Institute surveyed 1,000 physicians for the study.

Data breaches 'should lead to jail time'

18 November 2014   Lyn Whitfield
A leading privacy watchdog has called for tougher penalties for breaches of the Data Protection Act, arguing that present legislation is not enough of a deterrent.
Big Brother Watch says courts should be given the option of imposing custodial sentences on those who breach the act, and that the “worst offenders” should be left with a criminal record.
It also argues that staff should be given better training in a report that identifies 7,255 breaches of the DPA in the NHS over three years.

Why Patient Engagement is Key to Improving Health, Reducing Costs

The Engelberg Center for Health Care Reform recently hosted “The State of Accountable Care: Evidence to Date and Next Steps” to discuss the development, challenges, and potential future for accountable care efforts across the country.  Sean Cavanaugh, Deputy Administrator & Director of the Center for Medicare at CMS, kicked off the event, and highlighted progress and challenges of the Medicare ACO program and potential regulatory changes that could be included in the soon to be released Medicare Shared Savings Program (MSSP) proposed rule.
A Key Takeaway: Patient Engagement is Critical to the Success of ACOs
The need for greater patient engagement was a prevailing theme of the day for ACOs at Brookings.  Patient engagement is viewed as a key to improved health outcomes and lower costs; well-designed patient engagement strategies can also improve patient experience by allowing individuals to become more active participants in their care. For example, shared decision making and patient activation are proven strategies for engaging patients at the direct care level. These approaches help providers and patients to recognize that a clinical decision is necessary, understand the evidence on best available interventions, and ensure patient preferences are built into treatment decisions and plans. A recent study by Jennifer Sweeney and colleagues highlights some successful examples.

Brigham and Women's opening access to the medical record

Nov 13, 2014, 4:54pm EST Updated: Nov 17, 2014, 4:03pm EST
Jessica Bartlett
Reporter- Boston Business Journal
Dr. David Bates clicked through the app's many functions – test results, care team, medications, food – each a snapshot into a patient's needs and status.
But the program, unlike most electronic medical records, wasn't designed for the doctor. This platform was created for patients.
"The notion is to change the way care is delivered," said Bates, senior vice president for quality and safety at Brigham and Women's Hospital.

Healthcare's cloud poised for a shakeup

Posted on Nov 17, 2014
By Erin McCann, Associate Editor
Healthcare industry: Get ready for some serious growth of the cloud market. Due in part to evolving regulatory and health IT landscapes, the cloud market is poised for a double digit growth phase, new analysis suggests. Don't be fooled, though. Some big time barriers remain and have ultimately stymied the industry's shift over to the cloud.
The new data, published by Frost and Sullivan, underscores serious growth slated for both the U.S. and European healthcare cloud market, with analysts projecting that average penetration rates over the next decade will increase anywhere from 10 to 30 percent. As the industry further invests in healthcare IT and government regulations are updated to make cloud solutions more cost efficient, the numbers will only increase, analysts say.  

How To Improve Hospital Emergency Department Communications

11/17/2014 01:20 PM
For better patient outcomes, start by improving communications among staff members, departments, and patients.
A growing body of evidence indicates quality medical care in the emergency department may be enhanced or eclipsed by patients' experiences with their medical providers.
For example, the Joint Commission performed a study to find root causes for all reported sentinel events between 1995 and 2005. Its findings indicate poor communications was the most common cause of negative events in the United States (68%). Meanwhile, lack of technical competence was responsible for only 20% of events.

How Simple Data Analytics is Driving Physician Incentives

Scott Mace, for HealthLeaders Media , November 18, 2014

Easy-to-digest reports and data dashboards may be an easier pill for physicians to swallow than trying to get clinical data into their EHR workflows. Especially if their pay depends upon population management performance.

My latest HealthLeaders magazine cover story on big data started on its journey to publication with the notion that big data is only a sideshow in the healthcare analytics space. During the course of my reporting however, it turned out to be the main event of 2014.

ONC Provides Vision for HIT-enabled Quality Improvement

NOV 14, 2014 1:48pm ET
The Office of the National Coordinator for Health Information Technology has released its vision for health IT-enabled quality improvements over the next 10 years.
“Leveraging health IT adoption and improving the exchange of health information through the use of health IT will be integral to supporting the essential building blocks of a quality improvement (QI) ecosystem,” states the ONC document. “This paper will illustrate ONC’s ten-year vision for advancing health IT capabilities in a manner that will combine, at a minimum, both clinical decision support (CDS) and clinical quality measurement (CQM) to enable robust and continuous quality improvement.”
Currently, ONC is in the process of developing a 10-year interoperability roadmap that is due to be released for public comment in January 2015. According to the just-released QI vision document, the nationwide interoperability roadmap will be interdependent with the quality initiative.

5 steps toward a learning health system

Posted on Nov 17, 2014
By Neil Versel, Contributing Writer
Without good data, patient-centeredness is just a buzzword. And without a patient-centric focus and proper organization, data can be rather useless.
That was the message Sunday from Amy Abernethy, MD, a hematologist/oncologist and palliative care physician, who delivered the opening keynote address at the American Medical Informatics Association's annual symposium.
"Patients are the anchor for our work," Abernethy, the CMO of Flatiron Health, a New York City-based oncology analytics company, told this gathering of mostly academic medical informatics specialists. Patients' stories help clinicians work better with data, she said.

ONC sees 10 years of quality improvement

Posted on Nov 17, 2014
By Mike Miliard, Managing Editor
In tandem with its 10-year interoperability roadmap, ONC has developed a decade-long vision for ensuring health information technology is deployed to "enable robust and continuous quality improvement."
"Dramatic advancements have been made in digitizing the care delivery system during the past decade," ONC notes in its report – not least the fact that all 50 states have some form of health information exchange services to enable care coordination.
In addition, more than half of U.S. hospitals can electronically search for patient information outside their own walls, with six out of ten electronically exchanging health information with outside providers.

Why ICD-10 is necessary for big data success in healthcare

November 17, 2014 | By Katie Dvorak
While ICD-10 might have codes that seem excessive--like injury via turkey--without its comprehensive codes, doctors will "never detect the one-in-a-million disease when it matters," according to resident physician in family medicine William Rusnak.
With advanced computing power that can record human behavior in vital healthcare situations, we should be able to capitalize on that, Rusnak writes in a recent post for HIT Consultant.
"If a patient suffers the rarest of occurrences or undergoes an abstract procedure, there should be a code for it," Rusnak says. "Likewise, when a physician performs a specific procedure, a code should represent it in detail, including any variations."

Wikipedia tracking helps with disease prediction

November 17, 2014 | By Dan Bowman
First, Google Flu Trends was touted as a potential epidemic detection tool. Then researchers at Johns Hopkins School of Medicine developed a Twitter screening method for delivering real-time data on flu cases to determine which publicly available tweets were linked to actual infections.
Now, researchers at Los Alamos National Laboratory in New Mexico say that tracking Wikipedia page views can forecast the spread of influenza and dengue fever. In a study published this month in PLOS Computational Biology, researchers show that through use of an algorithm, they can connect relevant Wikipedia searches with information from the Centers for Disease Control and Prevention for real-time disease prediction.
The researchers say their algorithm allows them to overcome challenges such as weak scientific peer review and underdeveloped forecasting capabilities that hamper the reliability of other similar data surveillance methods based on Internet information.

Electronic Data Enables Care Evaluation at Individual Nurse Level

NOV 12, 2014 7:06am ET
Researchers from the University of Michigan, the University and Colorado, and Marquette University have demonstrated differences of individual nurse performance in quality of care, based on individual nurse level data linked to patient-specific outcomes.
"This groundbreaking research, released in a the new issue of Health Services Research featuring the Best of the 2014 Academy Health Annual Research Meeting, lays an empirical foundation for recognizing individual nurses as each being a unique and integral component of care delivery," said University of Michigan officials. "Achieving high-quality patient care and reducing costs will require that high-performing nurses are identified, recognized, and rewarded."
Using electronic data extracted from the 854-bed study, hospital electronic patient records and human resources databases on 1,203 staff nurses were matched with 7,318 adult medical-surgical patients discharged between July 2011 and December 2011. The study employed retrospective observational longitudinal analysis using a covariate-adjustment value-added model with nurse fixed effects.

6 Fitness Trends for 2015 That Have the Experts Buzzing

Posted: 11/13/2014 8:27 pm EST Updated: 11/13/2014 8:59 pm EST
As 2014 starts to wind down, the fitness industry is hotter than ever. We got together with industry thought leaders in New York City for a Talk Sweat roundtable series, hosted by Sweaty Saturday. The panel was stacked with fitness and wellness leaders from all areas of the industry: Marcus Antebi -- founder of Juice Press, Alexia Brue -- co-founder of Well+Good NYC, Joyce Chang -- editor in chief at Self, Erin Corcoran -- brand lead at Nike, John Foley -- founder & CEO of Peloton Cycle and Mark Grabowski -- partner at Catterton Partners all took the stage to discuss the latest topics and trends. The result was an incredibly thoughtful and well-informed discussion about what healthful living looks like today and what it will look like tomorrow. Here are some key themes to look out for in 2015 according to the experts:
Is this the end of wearables or a 2.0-style rebirth? This is a theme that far too many of us can relate to: You buy a new Fitbit, JawBone, FuelBand, etc. and track your sleep and steps religiously for three weeks only to figure out what you average, get bored with charging it and throw it in a drawer. Many find that wearables simply don't offer enough information to keep them interested long-term, and we're still quite a ways from technology that will intuit calories consumed. Should we expect to see a decline in this space, even with the arrival of the iWatch?

AHIMA: ICD-10 Costs Lower Than Previously Reported

November 14, 2014
New data published online in the Journal of AHIMA suggests that the estimated costs, time and resources required by physician offices to convert to ICD-10 are “dramatically lower” than initially estimated.
The evidence also suggests that physicians and their office staff, vendors and health plans have made considerable progress on ICD-10 implementation with fewer resources than previously estimated.
The article estimates that the ICD-10 conversion costs for a small practice are in the range of $1,900-$5,900. This is in stark contrast to a 2014 update of a widely referenced 2008 report by Nachimson Advisors to the American Medical Association (AMA), which estimated the cost for a small practice to implement ICD-10 was in the range of $22,560-$105,506.

Now or Later? Hospital Electronic Clinical Quality Measure Reporting

By Anantachai (Tony) Panjamapirom, Naomi Levinthal and Ernie Hood Monday, November 17, 2014
Hospitals participating in the Medicare Electronic Health Record Incentive Program must stay nimble to the constant changing nature of the program as CMS uses multiple regulatory channels to modify and update the meaningful use requirements. CMS releases an annual Inpatient Prospective Payment System rule, which stipulates the available meaningful use quality reporting requirements for hospitals.
In the 2015 IPPS final rule, CMS finalized two clinical quality measure reporting options -- similar to those available in federal fiscal year (FFY) 2014 --for hospitals:
  1. Attestation; or
  2. Electronic submission.
Both options are available for all eligible hospitals (EHs) and critical access hospitals (CAHs) regardless of stage and year of participation. However, there are slight operational differences depending upon a hospital's given year of meaningful use attestation. The figure below summarizes the CQM reporting options and associated reporting details by year of meaningful use participation. 

CIOs, CMOs Share EHR, Telehealth Adoption Experiences

Cheryl Clark, for HealthLeaders Media , November 17, 2014

At the first annual HealthLeaders Media Health IT & Quality Exchange, executives discuss the challenges of implementing electronic medical record systems and telehealth technologies.

It hasn't been an easy year for Linda Butler, MD, or her colleagues at Rex Healthcare in Raleigh, NC.
As vice president of medical affairs as well as CMO/CMIO, she and her team have had to help manage the hospital's Magnet status reaccreditation, Ebola preparedness, and its three-year review by The Joint Commission.
They've also had to assist with the delicate implementation of Rex's electronic medical record system, an Epic installation. "You replace an EMR maybe once a decade, you go through Magnet accreditation every four years, and TJC every three years. We did all of that in about six months," she says.