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."

Saturday, January 31, 2015

Weekly Overseas Health IT Links - 31st January, 2015.

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.

Patients increasingly open to video doctor visits

January 23, 2015 | By Susan D. Hall
Patient acceptance of telehealth services is growing, with 64 percent of patients recently surveyed by Harris Poll on behalf of telehealth company American Well saying they are willing to consider a video chat with their doctor instead of an in-person visit.
Based on responses from 2,019 consumers, a majority are open to the convenience and reduced wait times involved in an e-visit. The survey characterizes telehealth as a way for health systems to offer a lower-cost, more convenient alternative to in-person case.
Another recent study found that a telehealth visit saves about $100 or more compared to the estimated cost for in-person care. It put the cost of the average telehealth visit at $40 to $50, while in-person care can cost as much as $176.

Strategy and innovation advisors wants predictive analytics included in HIT strategic plan

January 23, 2015 | By Katie Dvorak
The Health IT Policy Committee's strategy and innovation work group, on Thursday, outlined draft recommendations for the Office of the National Coordinator for Health IT's updated Federal Health IT Strategic Plan.
The workgroup's changes and suggestions for the plan include clarification of language to, among other things:
  • Emphasize a focus on improving health and well-being
  • Explain how a health-oriented infrastructure would function
  • Reflect a greater focus on health equity
Workgroup members also said predictive analytics should be included in the plan, and that ONC should articulate a vision for collection, ownership, protection and uses of personal health information.

Two Generations of Geneticists, Two “Precision Medicine” Wish Lists

Alex Lash1/21/15
In late 2012, President Obama awarded Leroy “Lee” Hood the National Medal of Science for a lifetime of achievements, including the invention of machines that made the historic Human Genome Project possible.
So when Obama announced yesterday a “precision medicine initiative”—something that would surely require ever-deeper knowledge about the personal genetic differences that influence health and disease—I asked Hood for his thoughts.
He didn’t mince words. “It’s so vague and fuzzy, I don’t know what it means,” Hood said this morning from Southern California.
More details should follow, but not at this early date. (The National Institutes of Health referred all questions to the White House, which didn’t return inquiries.)

Top mHealth apps as rated by doctors

January 20, 2015 | Eric Wicklund - Editor, mHealthNews
Aiming to get "the professional side of things," HealthTap has released dozens of lists ranking the top apps recommended by physicians.
The Palo Alto, Calif.-based company surveyed more than 65,000 physicians in its network and another 500,000 in its referral network on their recommendations on a wide variety of health and wellness apps. The company then listed the top 100 iOS and Android apps, then broke the recommendations down into roughly 30 lists on more specific categories, like running and diabetes care.
HealthTap founder and CEO Ron Gutman said the company's goal is to give clinicians and consumers a guide to choosing apps that have been approved by doctors, rather than resorting to the user ratings found in app stores (HealthTap's AppRx app, by the way, has a healthy 4.72 star rating in the Apple App Store, he said). The apps are judged on three standards – ease of use, effectiveness and medical accuracy, validity and soundness. They're not given a number rating, but are ranked solely based on how many doctors would recommend them.

For clinicians, Google Glass isn't dead

Posted on Jan 22, 2015
By Mike Miliard, Editor
Google drew its Glass Explorer program to a close this past week, perhaps tacitly conceding that some of the criticisms of their much-hyped wearable computer – off-putting, invasive, "far too dorky-looking for normal people to want to wear" – had some merit.
But while a cursory look at certain media reports might lead some to think Google Glass is being killed off, that's hardly the case.
There's a decent chance a consumer-focused Glass will be resurrected at some point in the future, completely revamped and in a different form factor – redressing some of the clunkier hardware and software drawbacks that had some all too happy to have fun at its expense.
In the meantime, commercial applications of Glass are marching onward, with scores of outside developers and Silicon Valley startups continuing to work on apps for the platform. Healthcare is one industry that stands to reap the most benefit in the months and years ahead.

Hospital CIOs share experiences, issues with interoperability

January 22, 2015 | By Susan D. Hall
Although most healthcare chief information officers have implemented certified electronic health record systems and the required standards, many remain frustrated in their quest for interoperability, according to Beth Israel Deaconess Medical Center CIO John Halamka.
In a recent blog post, Halamka, from his conversations with healthcare CIOs around the country, shared several issues, including:
  • HL7 2.x messaging is fine for lab and public health reporting, but there remains a need to specify a single transport mechanism for all public health agencies
  • Consolidated Clinical Document Architecture works well for generating transitions of care documents, but merging that with EHRs remains difficult. Those documents can be more than 50 pages, so there needs to be a way to include only the most relevant data
  • Implementing Direct still provides plenty of challenges, including certificate and trust issues. Medical devices use myriad transmission protocols, so getting that data over Direct isn't easy. And sending datasets larger than 10 megabytes can be a struggle

Survey: 64 percent of patients willing to have video visits with docs

By: Aditi Pai | Jan 21, 2015
Sixty four percent of patients are willing to participate in a video visit with a doctor, according to an online Harris Poll survey of 2,019 adults aged 18 and up conducted in December 2014. Telehealth company American Well commissioned Harris Poll to conduct the survey.
Of those that were willing to visit with their doctor over video, 61 percent said convenience was a factor in this decision.
Seven percent of respondents who had been with their doctor for less than a year said they would switch doctors to get online video visits. And 10 percent of respondents who had been with their doctor for two to four years said they would switch. Younger people were more likely to switch to a physician that offered video visits. Eleven percent of patients between the ages of 18 and 34 said they would switch, while 8 percent of patients aged 35 to 44 said they would switch. 

Docs urge big changes to health records program

By Elise Viebeck - 01/21/15 05:23 PM EST
A coalition of 35 medical societies is urging federal regulators to make major changes to the Meaningful Use electronic health records (EHR) program.
Led by the American Medical Association, the coalition wrote Wednesday to the National Coordinator for Health Information Technology arguing that Meaningful Use could harm patients if allowed to continue in its current state.
"We believe the Meaningful Use certification requirements are contributing to EHR system problems, and we are worried about the downstream effects on patient safety," the groups wrote.

Mayo Clinic moves to Epic

Posted on Jan 20, 2015
By Mike Miliard, Editor
In the latest example of a world-class health system yanking its established electronic health record in favor of a blue chip vendor, Mayo Clinic is migrating to Epic.
 “We’re confident in choosing Epic as our strategic partner as we continue to enhance Mayo Clinic’s excellence in health care and medical innovation,” said John Noseworthy, MD, Mayo Clinic's president and CEO, in a statement announcing the partnership.
Epic will deploy a single, integrated EHR and revenue cycle management system at the renowned campus. This will replace Mayo’s three EHRs currently in use today, and will be the foundation for the next "several decades" of care delivery there, officials say.

Erroneous med errors 'sail through' CPOE systems

January 21, 2015 | By Susan D. Hall
Nearly 80 percent of erroneous medication orders could be entered in computerized physician order entry (CPOE) systems, and more than half "sailed right through," with little or no difficulty or warnings, according to research published at BMJ Quality & Safety.
The researchers found 10,060 CPOE-related errors reported to the U.S. Pharmacopeia MEDMARX reporting system. They developed a taxonomy of those errors, then tried to replicate them on 13 CPOE systems at 16 sites.
Only 26.6 percent of erroneous orders generated specific warnings; of those, 69 percent were passive alerts, such as information displayed or easily overridden or ignored. Another 29 percent required workarounds, such as adjusting the dosage, but nonetheless, still could be entered, according to the research.

Obama touts cybersecurity, personalized medicine efforts in State of the Union address

January 21, 2015 | By Dan Bowman
While health IT wasn't directly mentioned in President Barack Obama's State of the Union Address on Tuesday night, two proposals touted--on cybersecurity and personalized medicine--have the potential to alter the landscape of the industry to varying degrees.
Obama's cybersecurity plan, which already has won an endorsement from the Health Information Trust Alliance (HITRUST), calls for increased sharing of information on cyberthreats from the private sector with protection from liability. Specifically, the White House wants the private sector to share its cyberthreat information with the Department of Homeland Security's National Cybersecurity and Communications Integration Center, which would pass that information along to other federal agencies and private-sector operated Information Sharing and Analysis Organizations (ISAOs).
The plan also calls for a single notification requirement that would standardize the "existing patchwork" of state laws currently in place.

Difficult birth

Maternity units have been slow to take up IT, and while that’s changing, it’s only changing slowly. Meanwhile, community midwifes and patients are even further behind. Kim Thomas reports and talks to two trusts that have implemented new systems with real benefits; Royal United Hospital Bath NHS Foundation Trust and Bradford Teaching Hospitals NHS Foundation Trust.
When EHI published its first report on maternity IT in 2013, it noted that the adoption of digital technology had been particularly slow at maternity units, despite the complexity of the maternity pathway.
Two years on, that is beginning to change, but there is plenty of room for improvement – and some of the particular challenges of maternity IT, such as the need for community midwives to be able to record data in the field, are only slowly being met.
While for many NHS practitioners, IT is integrated into everyday working practice, the same is not true of midwives. As Louise Caney, maternity and nursing product manager at System C, which supplies Medway Maternity, says: “They are a group of health professionals that are forgotten.”

New privacy concerns over health care website

Ricardo Alonso-Zaldivar, Associated Press 10:39 p.m. EST January 20, 2015
Washington — The government’s health insurance website is quietly sending consumers’ personal data to private companies that specialize in advertising and analyzing Internet data for performance and marketing, the Associated Press has learned.
The scope of what is disclosed or how it might be used was not immediately clear, but it can include age, income, ZIP code, whether a person smokes, and if a person is pregnant. It can include a computer’s Internet address, which can identify a person’s name or address when combined with other information collected by sophisticated online marketing or advertising firms.
The Obama administration says HealthCare.gov’s connections to data firms were intended to help improve the consumer experience. Officials said outside firms are barred from using the data to further their own business interests.

ECRI's top 10 technologies to watch

By Government Health IT Staff
Telehealth, Google Glass, and post discharge clinics are among the top 10 technology trends hospital executives should watch in 2015, according to a nonprofit organization that researches the best approaches to improving patient care.
ECRI Institute’s "2015 Top 10 Hospital C-Suite Watch List" covers what it says are "a blend of novel, new, and emerging technologies that will demand attention and planning over the next 12 to 18 months, plus important issues and programs affecting care processes and delivery in 2015 and beyond."
The institute's list:
1. Disinfection robots
2. Three-dimensional (3-D) printing
3. Alarm management middleware
5. Google Glass
6. New anti-obesity devices
7. Caring for millennials with cancer
8. Fecal microbiota therapy
9. Artificial pancreas device systems
10. Telehealth

Physicians have urgent message for ONC

Posted on Jan 20, 2015
By Bernie Monegain, Editor-at-Large
Responding to the Office of the National Coordinator for Health IT's call for comments on its draft plan, the American Association of Family Physicians  did not mince words.
"Ease the administrative burden physicians face and build on goals set a decade ago," the AAFP wrote in a letter to ONC.
The ONC's 28-page "Federal Health IT Strategic Plan 2015-2020," released this past December, outlines the federal health IT working plan for the next five years.

EHR Use Does Not Result in Coordinated Care

JAN 19, 2015 7:58am ET
Although more than 70 percent of U.S. doctors use electronic health records, up to half don't routinely receive the data necessary to coordinate patient care effectively.
That is the conclusion of a study published in Medical Care. “The study findings highlight the continuing challenges to using health information technology to coordinate care among providers," said lead author Chun-Ju Hsiao, of the U.S. Agency for Healthcare Research and Quality.
The researchers analyzed data from about 4,500 office-based physicians responding to a nationally representative 2012 survey on the use of EHRs and electronic sharing of information. The doctors were also asked how regularly they received specific types of patient health data for effective coordination of care.

Recap of Q4 2014 Federal Health IT Activity

by Helen R. Pfister and Dori Glanz, Manatt Health Solutions Tuesday, January 20, 2015
The federal government continues to implement the HITECH Act, enacted as part of the American Recovery and Reinvestment Act. Below is a summary of key developments and milestones achieved between Oct. 1, 2014, and Dec. 31, 2014.

Key Q4 2014 Developments

  • ONC Releases Federal Health IT Strategic Plan. The Office of the National Coordinator for Health IT's new five-year Strategic Plan for Health IT, released on Dec. 10, 2014, frames the federal health IT strategy and focuses on increasing health IT adoption, expanding interoperability of electronic health records, improving the safety of health IT and expanding access to broadband Internet for rural providers.
  • ONC Releases Draft Details on Nationwide Interoperability Roadmap. The draft roadmap -- unveiled at a joint meeting of the Health IT Policy and Standards committees on Oct. 15, 2014 -- focuses on implementing improved interoperability of EHRs, and aims to create a learning health system focused on patients and improved outcomes through improved clinical, cultural, business and regulatory environments. The full roadmap will be released in March.

Allina Health and Health Catalyst's Unusual Deal

Scott Mace, for HealthLeaders Media , January 20, 2015

Teams building analytics technology for healthcare organizations find themselves jointly holding intellectual property and equity in new arrangements not seen before in healthcare.

Follow the money, they say. It's not always easy. "Terms of the transaction were not disclosed" is the common coin of many a deal. But despite this, some deals are harbingers of bigger things.
To make my point, I will appropriate a word: extrapreneur. It's a word that you won't find in most dictionaries. In 1992, the American Heritage Dictionary defined intrapreneur as "a person within a large corporation who takes direct responsibility for turning an idea into a profitable finished product through assertive risk-taking and innovation."

What a National Breach Notification Law May Look Like

JAN 19, 2015 7:53am ET
President Obama’s proposed legislative language to improve the nation’s cybersecurity does not require companies to harden their information networks.
But the legislation sent to Congress lays out the President’s plans to establish a national breach notification rule, lift legal barriers to enable industries and government to share threat data, and change federal racketeering laws “relating to fraud and related activity in connection with computers” which would include deterring development and sale of computer and cell phone spying devices. The legislative language and plain-English summaries are available here.
The breach notification standard--requiring notification to affected individuals within 30 days of discovery and regardless of the size of a breach--would apply to a “business entity,” which would include “any organization, corporation, trust, partnership, sole proprietorship, unincorporated association or venture whether or not established to make a profit.” The legislation does not exempt any industry by name. Under HIPAA, the healthcare industry presently has a 60-day notification requirement.

Execs Upbeat on Population Health ROI

John Commins, for HealthLeaders Media , January 20, 2015

More than half of healthcare executives surveyed believe they'll see a return on investment for healthcare information technology and data/analytic tools in four years or less.

More than half of healthcare executives believe they will recoup their investment in population health management programs within three to four years, an online survey from KPMG LLP shows.
"It can be realistic within three or four years, but let's not sugarcoat it. It takes a lot of time, effort, commitment, and understanding to make that happen," says Joe Kuehn, a partner with KPMG's Healthcare Advisory Practice.

Execs Expect Population Health Management ROI in 3-4 Years

JAN 19, 2015 7:49am ET
More than half of healthcare managers surveyed expected to recoup their investments in population health management programs within three to four years, according to KPMG, the U.S. audit, tax, and advisory firm.
“Our clients see benefits from population health management programs as a part of the solution to reduce avoidable medical costs and variability in care,” said West Johnson, a KPMG advisory partner who heads provider transformation. “Preventive care is given a big priority in these programs, since they deliver improvements in efficient and effective care with a high degree of patient engagement.”
According to KPMG’s online survey, 20 percent believe that investments in healthcare information technology and data and analytic tools will pay off in one to two years. Another 36 percent indicated that the payback period for these investments could take up to three or four years, showing a majority expect to recoup their costs within this time frame. The survey showed that 29 percent see the investment in population health paying off in five or more years. Only 14 percent see them not recouping their costs at all.

Can population health IT investments pay off?

Posted on Jan 19, 2015
By Mike Miliard, Editor
More and more healthcare organizations are recognizing the value of population health management – and a majority say they expect to recoup their investments in the technology to power those programs in just a few years, according to KMPG.
An online poll from KPMG shows that 20 percent of respondents say investments in healthcare information technology and analytics will pay off in one to two years. A slightly bigger group (36 percent) think ROI could take up to three or four years.
The survey showed that 29 percent see the investment in population health paying off in five or more years. Only 14 percent see them not recouping their costs at all.

Philips, MIT collaborate on ICU data sharing

January 15, 2015 10:20 pm by Dan Verel | 
Royal Philips and MIT announced an initiative that will allow healthcare researchers to access data on more than 100,000 patients, which has been collected by Phillips through its Hospital to Home eICU telehealth program.
For researches, data sets are often limited to insurance claims data, which offers a summary of patient’s stay at a hospitals. The Philips effort, officials said, will add a more comprehensive look at ICU patients and will include clinical information like vital signs, pharmacy medication orders, lab results, diagnoses and severity of illness scores.
The data from Philips accounts for 10 percent of all adult ICU patients in the U.S., according to the Dutch company.

MIT, Royal Philips Provide Researchers with Critical Care Data

JAN 20, 2015 9:09am ET
The Massachusetts Institute of Technology and Royal Philips have teamed to provide healthcare researchers with access to one of the largest critical care data resources.
Under the initiative, Philips will be granting access to data from more than 100,000 patients that have been collected and anonymized through the Philips Hospital to Home eICU telehealth program. The Laboratory of Computational Physiology at MIT’s Institute for Medical Engineering and Science will serve as the academic research hub for the initiative, and will provide and maintain access, as well as help educate researchers on the database and offer a platform for collaboration. 
“Most inpatient multi-center data sets available to researchers today are limited to insurance claims data, which offers just a summary of a patient's stay,” according to an announcement “Through this new initiative, Philips will release a more comprehensive look at the ICU patient's journey by opening up data sets from patient stays in eICU centers representing approximately 10 percent of all adult ICU beds in the United States.


Friday, January 30, 2015

It Would Be Good To Know That The PCEHR Does Not Leak Information The Way A Major US Government Health Site Does.

These two articles appeared last week.
First we have:

New privacy concerns over health care website

Ricardo Alonso-Zaldivar, Associated Press 10:39 p.m. EST January 20, 2015
Washington — The government’s health insurance website is quietly sending consumers’ personal data to private companies that specialize in advertising and analyzing Internet data for performance and marketing, the Associated Press has learned.
The scope of what is disclosed or how it might be used was not immediately clear, but it can include age, income, ZIP code, whether a person smokes, and if a person is pregnant. It can include a computer’s Internet address, which can identify a person’s name or address when combined with other information collected by sophisticated online marketing or advertising firms.
The Obama administration says HealthCare.gov’s connections to data firms were intended to help improve the consumer experience. Officials said outside firms are barred from using the data to further their own business interests.
More here:
Second we have:

Group Confirms Healthcare.gov Shares Personal Health Info with Third Parties

JAN 22, 2015 7:47am ET
The Electronic Frontier Foundation, a technology policy advocacy group, says it has confirmed that the federal government's healthcare.gov insurance exchange site is sharing personal data, including ZIP code, income level, smoking status, pregnancy status, and more, with at least 14 third parties.
"EFF researchers have independently confirmed that healthcare.gov is sending personal health information to at least 14 third party domains, even if the user has enabled Do Not Track," EFF staff technologist Cooper Quintin writes in an EFF blog post after recent Associated Press reports.
According to Quintin, the information is sent via the referrer header, which contains the URL of the page requesting a third party resource. The referrer header, he wrote, lets the requested resource know what URL the request came from. In this case, the referrer URL contains personal health information.
Among the companies EFF technologists say the site is sharing information with are network optimization developer Akamai, Yahoo, Twitter, and Google and numerous Google subsidiaries such as Doubleclick and YouTube.
Lots more here:
While it would seem unlikely I wonder does the PCEHR site use similar approaches to share information with other entities?
Anyone able to say yes or no for certain?