Saturday, November 22, 2014

Weekly Overseas Health IT Links - 22nd 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.

eHealth Initiative 2020 Roadmap Seeks to Address ‘Government Gridlock’

NOV 14, 2014 7:38am ET
With interoperability challenges continuing to plague the healthcare industry and impatience growing among consumers and providers, the eHealth Initiative on Thursday announced the first set of priorities for its 2020 Roadmap designed to “enable coordinated efforts by public and private sector organizations to transform care delivery through data exchange and health information technology.”
The roadmap focuses on three priorities: interoperability, business and clinical motivators, and data access and use. Each focus area includes a set of short-term goals for collaborative action. Among the goals are recommendations for development and testing of data standards in the private sector “rather than mandating untested tools” and “developing incentives in the private sector to move the market rather than looking to the government for funding,” as well as “having vendors work together to harmonize tools and applications so that patients can move information from place to place.”
While the government “has been and will always be a critical part of the conversation and an engine to move things forward, the private sector really needs to lead the way in solving many of these problems,” Jennifer Covich Bordenick, CEO of the eHealth Initiative, told a Nov. 13 media briefing.

eHI spells out its own data sharing plan

Posted on Nov 14, 2014
By Neil Versel, Contributing Writer
As the Office of the National Coordinator for Health Information Technology refines its 10-year vision for interoperability, a diverse coalition of private and public interests has put forth its own ideas for transforming U.S. healthcare through IT.
The eHealth Initiative on Thursday released the first in a series of documents making up its "2020 Roadmap," spelling out its priorities, goals and areas of broad agreement for achieving the Triple Aim of safer care, improved population health and lower costs.
While certainly critical of the direction of the federal meaningful use program, this portion of the roadmap, entitled, "Part 1: National Priorities, Goals and Areas for Consensus," doesn't just pile on. It also offers suggestions — albeit broad concepts rather than specific prescriptions — for accelerating momentum toward the true goal, the Triple Aim.

Patients embrace sharing doc notes with family, caregivers

November 14, 2014 | By Katie Dvorak
Patients increasingly are using technology to share their health information with family or friends, and access to information is causing them to pay better attention to their care, according to a recent study.
Published this week in the Journal of Medical Internet Research, the research looked at patient use of OpenNotes, initially a one-year program that gave patients electronic access to medical notes written by their doctors.  
Of the roughly 4,500 study participants, more than 55 percent said they would like the option of giving family or friends access to the notes, and 21 percent said they shared the information with others during the study period.

3 emerging threats to healthcare privacy and security

November 14, 2014 | By Alok Saboo
The following is an excerpt from an article published in the FierceHealthIT's eBook "Privacy & Security Audits: How to Prepare and Ensure Compliance." Download the eBook here to read more.
By Annette M. Boyle and Brenda L. Mooney
New risks have upped the ante for HIPAA security and privacy officers and increased fines have many on edge. Particularly in the aftermath of the Community Health Systems (CHS) breach, which put 4.5 million patient records at risk across 29 states and 206 hospitals, last year's risk assessments look woefully inadequate for many healthcare systems and practices. What's worrying privacy and security officers this year?

ONC outlines 10-year vision for HIT-enabled quality improvement

November 14, 2014 | By Susan D. Hall
Creating a learning healthcare system will require more closely aligning the tools, teams and goals of clinical decision support (CDS) and clinical quality measures (CQM) efforts, according to a blog post at Health IT Buzz.
The two have long taken parallel paths, but both must be brought together as one community focused on quality improvement, write Jacob Reider, Deputy National Coordinator, and Alicia Morton, director of the Health IT Certification Program.
The Office of the National Coordinator has released a paper outlining its 10-year vision for harnessing health IT for quality improvement, which it describes as interdependent with its efforts to achieve interoperability.

Survey: One third of physicians use telemedicine, one fifth are reimbursed

By: Jonah Comstock | Nov 13, 2014
Most healthcare practitioners are either using telemedicine or planning to use it soon, but less than a fifth of them are being paid for those services.
That’s according to a survey recently conducted at the Academy of Integrative Health & Medicine (AIHM) annual conference in San Diego. AIHM surveyed 754 practitioners, 78 percent of whom were physicians. Neither the academy nor the conference is specifically focused on telemedicine or technology, but rather on acute care, a spokesperson told MobiHealthNews, so there is no obvious sampling bias toward telemedicine.
Overall, 33 percent of physicians surveyed said they were using some form of telemedicine and another 29 percent said they were planning to, making a total of 62 either using or considering telemedicine, defined as “care via telephone, video visits, web cam visits – or other consultations not in person”.

Report: EHRs should include data on certain social/behavioral determinants of health

November 13, 2014
The Office of the National Coordinator for Health Information Technology and Centers for Medicare & Medicaid Services should include 12 standard measures of social and behavioral determinants of health in its certification and meaningful use regulations for electronic health records, an Institute of Medicine committee recommended today.

Meaningful use: Born 2009 -- died 2014?

Posted on Nov 13, 2014
By Robert Wachter, MD
The policy known as meaningful use was designed to ensure that clinicians and hospitals actually used the computers they bought with the help of government subsidies. In the last few months, though, it has become clear that the policy is failing. Moreover, the federal office that administers it is losing leaders faster than American Idol is losing viewers.
Because I believe that meaningful use is now doing more harm than good, I see these events as positive developments. To understand why, we need to review the history of federal health IT policy, including the historical accident that gave birth to meaningful use.
I date the start of the modern era of health IT to January 20, 2004 when, in his State of the Union address, President George W. Bush made it a national goal to wire the U.S. healthcare system. A few months later, he created the Office of the National Coordinator for Health Information Technology (ONC), and gave it a budget of $42 million to get the ball rolling.

Docs say how they really feel about EHRs

Posted on Nov 13, 2014
By Frank Irving, Editor, Medical Practice Insider
We've seen the numbers: About 8 in 10 office-based physicians have adopted some type of electronic health record, and about half have an EHR with advanced functionality. But if we dig deeper, how do doctors really feel about these systems?
We posed that question to a handful of physicians from very different backgrounds. As shown in their comments below, docs see a lot of room for improvement in the ways in which they interact with EHRs in the patient care setting.
"EHRs are a necessary evil. We can't run from technology, but the reality is there is essentially no effective interoperability platform for practices to share this information. Even more distressing, the value of our time as practicing physicians is clearly minimized in the eyes of vendors and in terms of return on investment. We spend more time with EHRs than we ever did with the patient with a simple paper chart. The EHR does not improve care but over the long run will improve data and accountability. The government's requisites for meaningful use are not relevant to practicing physicians and only serve to create more burdens in the seemingly ever decreasing pool of time left in a day to really practice and speak to patients."
Steven Hacker, MD
Palm Beach, Fla.

Clinical informatics specialists: We need to bring reality into Meaningful Use

November 10, 2014 | By Marla Durben Hirsch
Many providers simply aren't on the same playing field when it comes to Meaningful Use, which has played a big part in attestation, according to Dawn Ross, clinical informatics director for Indianapolis-based Indiana University Health.
"There are different levels of interoperability and we're not on the same set of measures," Ross said. "An example is [transmitting] transition of care summaries. What if there's not another Stage 2 provider around? In Indiana we have an amazing health information exchange [that enables us to meet that measure], but others don't have that benefit."
In an exclusive interview with FierceEMR, Ross and Raymon Nance, director of information services at Washington Regional Medical System in Fayetteville, Arkansas, discuss EHR implementation and government mandates from their vantage points as clinical informatics specialists. They talk about their successes and frustrations, as well as their wish lists for future federal efforts. 

NIB aligns NHS IT with NHS policy

13 November 2014   Lyn Whitfield
The NIB framework supports NHS England policy, issued from its headquarters in Leeds.
The National Information Board has issued its much delayed IT strategy - ‘Personalised Health and Care 2020’ – which ties NHS IT more closely into health service policy, financial and regulatory frameworks.
As flagged by speakers at EHI Live 2014 in Birmingham last week, the strategy emphasises that it is “not a strategy in the conventional sense” and “not a national plan.”
Instead, the document put out by the NIB, which represents 20 health and local government organisations interested in IT, says it is a “framework for action that will support staff, patients and citizens to take advantage of the digital opportunity.”

How low health literacy, technology leave elderly behind

November 13, 2014 | By Katie Dvorak
The Internet is quickly becoming the go-to place for health information, but those who are not well-versed in understanding health matters, and especially those who are elderly, are being left behind, according to a recent study.
The study, led by Helen Levy of the University of Michigan, examines elderly people's knowledge of health matters and how they use the Internet, according to an announcement. The findings are published in the Journal of General Internal Medicine.  
The researchers looked at data from the 2009 and 2010 Health and Retirement Study, a national survey of Americans 65 years and older. That study looked at how the 1,400 participants used the Internet and what they search for, especially related to health and medical information.

eHealth Initiative roadmap calls for alignment of HIT regulatory efforts

November 13, 2014 | By Dan Bowman
Interoperability and Meaningful Use efforts need to be aligned with other healthcare regulatory and industry initiatives, according to the eHealth Initiative, which on Thursday unveiled its 2020 roadmap for transforming health IT.
The roadmap, which eHealth Initiative CEO Jennfier Covich Bordenick calls "a framework for discussion about core technology issues," includes priorities for three areas: business and clinical motivators, interoperability and data access and use. In particular, she says, the private sector's role must grow in order for health IT to move forward.
"We are heading into a world where healthcare data needs to be exchanged, shared and analyzed, not simply pushed from place to place," Bordenick says in the document. "Similarly, we are developing a 2020 roadmap that requires sharing, analysis and above all, collaboration."

AMA wants penalties removed from MU

Posted on Nov 12, 2014
By Mike Miliard, Managing Editor
With just 2 percent of physicians having managed to attest to Stage 2 meaningful use, clearly something is holding back the vast majority of docs from succeeding in the program. The American Medical Association says they should not be penalized.
In a policy approved this week at the AMA's Interim Meeting, the physician group continued its call for penalties to be abolished from meaningful use – and said the program should be reframed to focus more on interoperability.
"The AMA has been calling for policymakers to refocus the meaningful use program on interoperability for quite some time," said AMA President-elect Steven J. Stack, MD, in a press statement.

Pediatric emergency telemedicine: 5 barriers to success

November 12, 2014 | By Dan Bowman
Telemedicine is an underused technology in pediatric emergency settings, where it could "in theory, improve the quality of ... care at small hospitals, facilitate effective triage ... and reduce costs by eliminating unnecessary transport," according to researchers from RAND and the University of Pittsburgh School of Medicine, whose work was published this month in Telemedicine and e-Health.
For the study, the researchers surveyed 25 providers at 20 unique hub sites with either current, former or planned pediatric emergency telemedicine programs, who identified five barriers to success, including:
  1. Difficulties in cross-hospital credentialing, the process by which doctors at "hub sites" receive permission to practice at "spoke sites"

5 ways health data breaches are far worse than financial ones

By Tom Garrubba, Senior director, Santa Fe Group and Shared Assessments Program
Remember that song Janis Joplin made famous “Piece of My Heart?” I do, and it reminds me of the fundamental difference between financial and healthcare data breaches.
The breach of personal financial information causes stress — recovering missing funds, paying late fees or interest, worrying about credit worthiness. Ultimately, however, a person’s financial identity can be fully restored.
Not so with medical identity. Healthcare data breaches have a much more personal, longer lasting, and potentially deadly impact.
Victims are at the mercy of those who, through fair means or foul, have control of their protected health information (PHI). And several factors contribute to the costlier, deadlier effects of healthcare data breaches over financial ones.

Smart band options heating up

Much the way that Apple shone a light on the entire smartwatch category by unveiling Watch in September, Microsoft unwrapped a new device aptly christened Band.
On the heels of Microsoft’s Band, Jawbone released two new options, the Up Move and UP3, while Fitbit pre-announced its Surge. Those stalwarts join an increasingly crowded space wherein the likes of household names such as Fitbit, LG, Nike and Sony reside alongside upstarts Amiigo, Misfit and Nabu.

EHRs to save $78B over 5 years

Posted on Nov 11, 2014
By Bernie Monegain, Editor
EHRs are expected to save the global healthcare industry as much as $78 billion over five years, according to new analysis from Juniper Research.
The Juniper report, Digital Health, Remote Monitoring & EHR Cost Savings 2014-2019, notes that EHRs are crucial as the supporting infrastructure for a wide range of digital healthcare and mHealth projects. Also, new accountable care organization initiatives, where healthcare providers are paid according to the measured wellness of a patient population, are resulting in a re-think in how healthcare needs should be addressed.

NHS Wales presses on with GP IT

5 November 2014   Rebecca Todd
NHS Wales is on time and under budget to complete the roll out of a centrally hosted IT service to its GPs by July 2015.
Andrew MacBean, NHS Wales Informatics Service director for operational services, told the audience at the Information for Commissioning conference at EHI Live 2014 that 65% of practices have now switched to a new system.
All Welsh surgeries are moving to a centrally hosted service after a national framework contract was agreed in mid-2012, with Emis and INPS named as the two successful suppliers.

Why primary care physicians are seeing fewer patients

Productivity falls, despite flood of newly insured patients covered under the ACA

November 06, 2014
Prior to the launch of the Affordable Care Act (ACA), policy experts predicted that a wave of more than eight million newly insured patients would flood an already strained primary care system. However, those predictions have not yet been borne out.
The 2014 Medical Economics Physician Practice Study found that both family physicians and internists saw a significant dropoff in their average number of patient visits per week, despite the number of hours worked remaining steady.
Family physicians and general practitioners reported an average of 89 patient visits per week. That’s down from 99 visits per week in 2013. Internists reported a drop from 93 patient visits per week in 2013 to 85 visits in 2014.

Health-Care Industry Starts to Pay Attention to Cyber Risks

  • By Rachael King
  • November 7, 2014, 5:31 PM ET
The health-care industry is grappling with how to protect personal health information from increasing cyber threats. In addition to meeting security and privacy regulations, companies can do more to prevent breaches by assessing and prioritizing cybersecurity risks, said Jim Routh, chief information security officer at health insurer Aetna Inc.AET +0.57% The message has already caught on at some health-care companies, who are starting to look for technology executives with risk experience.
Since 1996, the industry’s regulations under the Health Insurance Portability and Accountability Act have required the security and privacy of individually identifiable patient health information. While HIPAA sets out clear expectations for protecting personal health information, it doesn’t address the fast-paced world of cybercriminals and their increasing sophistication in targeting health-care companies.

New Guidance on HIPAA Privacy during Emergencies

NOV 10, 2014 1:26pm ET
In light of the treatment of Ebola patients and other events, the HHS Office for Civil Rights has issued new guidance on sharing patient information under the HIPAA Privacy rule during emergency situations.
The guidance also is meant to “serve as a reminder that the protections of the Privacy Rule are not set aside during an emergency,” OCR cautions.
The privacy rule enables covered entities to disclose without patient authorization protected information necessary to treat the patient or a different patient, the agency explains. “Treatment includes the coordination or management of healthcare and related services by one or more healthcare providers and others, consultation between providers, and the referral of patients for treatment.”

Mining Pennsylvania Error Data Suggests Patient Safety Gains From Advanced EHRs

by Bonnie Darves, iHealthBeat Contributing Reporter Tuesday, November 11, 2014
Implementation of advanced electronic health records that incorporate clinical design support systems (CDSS) and physician documentation capability might be delivering a net gain in improving patient safety in hospitals, according to a new study.
Researchers who mined several years of data collected by the Pennsylvania Safety Authority's mandatory safety event reporting system found that participating hospitals that have adopted advanced, rather than basic, EHR functionality saw a 27% overall decline in reported safety events, including a decline of 30% in medication errors and a 25% drop in safety events due to complications of procedures or tests.
Despite certain study limitations, the study's use of PSA's comprehensive data set and a multi-year period contributes to the literature on an area that remains under-studied, according to Bill Marella, director of patient safety reporting programs for the ECRI Institute and program director for the PSA Pennsylvania Safety Reporting System, which collects the error data.

MU Variabilities Spawn Confusion, Risk, and Legislation

Scott Mace, for HealthLeaders Media , November 11, 2014

The meaningful use program, though well-intentioned, is pretty much a morass of rules, exceptions, extensions and details so mind-numbing that it inflicts its own overhead on the program.

One EHR vendor has taken to calling this the "post-EHR" era. It's a silly bit of branding, for while it may be that CIOs have their eyes on how to use EHRs effectively, they are also living in a world where their EHRs, purchased with federal incentives, are also a source of constant irritation, and I am not just talking here about their primitive user interfaces.
Instead, I am speaking of the MU program, formerly known as the MU incentive program, but now more properly referred to as the MU compliance and penalty program. In response, CMS and perhaps soon Congress will recast MU as a compliance, penalty and flexibility program.

Ebola and HIPAA: how to comply

Posted on Nov 10, 2014
By Erin McCann, Associate Editor
In emergency situations like the Ebola crisis that reached American soil this fall, do covered entities need to comply with the HIPAA Privacy Rule? New guidance put out by the Department of Health and Human Services sheds light on how exactly organizations are expected to adhere. 
Be sure of one thing: The privacy rule still applies, but HHS has outlined several exceptions related to public health emergencies that allow in some cases a little more flexibility around information sharing.  
The Office for Civil Rights, the HHS division responsible for enforcing HIPAA, offered its guidance Monday for covered entities and business associates who may find themselves in public health emergency situations. 

CHIME, HIMSS to Burwell: Health IT not a part-time job

November 10, 2014 | By Dan Bowman
The College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society want Department of Health and Human Services Secretary Sylvia Mathews Burwell to replace Karen DeSalvo as National Coordinator for Health IT should she continue to split her duties between ONC and the Office of the Assistant Secretary of Health.
In a letter sent to Burwell on Nov. 3 and made public last Friday, leaders from both organizations expressed concern that, with a rapidly growing list of health IT issues, part-time leadership would not be adequate.

mHealth Apps Linked to Well-Being

November 7, 2014
People are increasingly using mobile health technology to improve their well-being, according to new Gallup research.
About half of smartphone users have downloaded at least one app that is meant to support healthy living, and 19 percent of all adults have downloaded and routinely used at least one such app. This means that one out of every five people are regularly using mobile technology to improve their chances of a life well-lived. Among full-time workers, this percentage climbs to 23 percent, according to the researchers.
Out of 11 popular types of apps on the market, usage varies. Across all adults, the most common use is for calorie counting: 18 percent report having downloaded an app for that purpose. Of these, one-third -—or 6 percent—routinely use the app. Health recipes and food/exercise diaries are the next most common type of apps used.

mHealth apps actually do boost outcomes

Posted on Nov 11, 2014
By Government Health IT Staff
Despite widespread skepticism about the efficacy of many health apps, some evidence is emerging that they might actually work. At least some of them.
One in five people uses mobile technology to improve her or his health, while those who routinely use health-related apps are linked to better outcomes, according to a new report from Gallup.
"People are increasingly using mobile technology to improve their well-being," wrote the authors, Dan Witters and Sangeeta Agrawal. "This isn't surprising, given that mobile technology is becoming more integral to people's lives."

You’re more likely to be robbed than hacked: 68% of HIT breaches due to theft

Written by Ellie Rizzo (Twitter | Google+)  | November 05, 2014
When it comes to security breaches, healthcare organizations are more likely to lose patient information to device theft than hacking, according to a new report from Bitglass.
Bitglass analyzed HHS’ data on publicly reported data breaches, also known as the “wall of shame,” and found that 68 percent of HIPAA violations regarding data breaches were due to loss or theft of devices, while only 23 percent were due to hacking. Of all breaches, 48 percent involved a laptop, desktop computer or mobile device.

Strategic corporate investments at record high in digital health

By: Jonah Comstock | Nov 5, 2014
While digital health funding in general has been growing enormously year-to-year, so too have strategic corporate investments, according to a new report by CB Insights. The research firm reports that 2014 has already had a record number of digital health deals by corporations (about 70 deals) despite two months left to go.
According to CB Insights, since 2010 corporate investors have made 210 deals totaling $2.34 billion into digital health startups. This year has already seen 89 percent more deals than 2012 and 183 percent more deals than 2011.
The roster of corporations that are setting this trend won’t be a big surprise to people who follow digital health investments. The list includes tech, pharma, provider, and payor companies. 


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