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ONC calls for interoperability by 2017
Posted on Jan 30, 2015
By Bernie Monegain, Editor-at-Large
The Office of the National Coordinator released this morning a draft roadmap, along with proposed actions to take in order to achieve interoperability and a learning healthcare system in the next two years.
The document, Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Draft Version 1.0 outlines steps "that will enable a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017."
The "time has come for us to be more explicit about standards," said ONC Chief Karen DeSalvo, MD, in a Jan. 30 press call detailing the roadmap, a 150-page plus document addressing everything from governance, standards and certification to privacy and security. "Health IT that facilitates the secure, efficient and effective sharing and use of electronic health information when and where it is needed is essential to better care, smarter spending and a healthier nation," DeSalvo said.
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Industry professionals create framework for measuring HIT value
January 29, 2015 | By Katie Dvorak
Healthcare professionals have created a framework for measuring health information technology with a goal of making "HIT evaluations more relevant to the current needs of the healthcare system," according to a paper published at the American Journal of Managed Care.
In the paper, sponsored by the Office of the National Coordinator for Health IT, the researchers--from RAND Health, Harvard Medical School and Brigham and Women's Hospital--say that HIT should take into account three principles.
Those principles are:
- Value includes costs and benefits: Value cannot be found through cost analysis alone, the report's authors say. While costs are important, they do not reveal what the health benefit to patients may be nor do they assess the potential benefits of the technology or system. Studies must be sure to measure both, they say.
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ONC unveils Interoperability Roadmap for public comment
January 30, 2015 | By Katie Dvorak
The Office of the National Coordinator for Health IT has released for public comment its shared nationwide roadmap for interoperability.
The roadmap's goal is to provide steps to be taken in both the private and public sectors to create an interoperable health IT ecosystem over the next 10 years, according to ONC.
One of the main focuses on the roadmap, which spans more than 140 pages, is to enable "a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017."
"We look forward to doing this in partnership with the private sector ... and we believe that by going forward together and holding each other accountable, that we're really going to get to a place where we have the information necessary to see that we have better care, that we can have smarter spending, and healthier people in the country," National Coordinator Karen DeSalvo said during a call on the roadmap
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New interoperability plan called ambitious, necessary by health IT leaders
Healthcare IT community leaders are reacting favorably to the government's new plan to improve the interoperability of health information technology systems.
“I think the overall tone is very positive,” said Jennifer Covich Brodernick, CEO of the eHealth Initiative, a Washington, D.C.-based promoter of health IT. “We want to make sure this is a public-private effort. The government can't do this alone and that sounds like what we're aiming for.”
Russell Branzell, CEO of the College of Healthcare Information Management Executives, a professional association of hospital CIOs, said, "This is a much-needed playbook for each and every health IT professional. Now, healthcare providers and health IT developers have a single source of truth, with an extensible process to align clinical standards towards improved interoperability, efficiency and patient safety.”
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What has SHARP accomplished for EHRs?
Posted on Jan 29, 2015
By Neil Versel, Contributing Writer
After four years and $60 million, the ONC's Strategic Health IT Advanced Research Projects program is essentially done, and each project has made strides in improving various elements of EHRs. Those involved in SHARP believe their work has advanced the health IT field, but it remains to be seen if any of their innovations find their way into widespread use.
"I would say in general that the SHARP programs were successful, but some were more successful than others," said Douglas Fridsma, MD, former ONC chief scientist who departed in September to become president and CEO of the American Medical Informatics Association. Fridsma was effectively the point person for SHARP while at ONC.
With money appropriated by the 2009 HITECH Act, ONC issued grants in 2010 to four major institutions, to "address well-documented problems that impede the adoption of health IT," according to the program's website.
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Public APIs as open platform
Interoperability is the current health IT buzzword because it’s the essential ingredient in creating a system that benefits patients, doctors and hospitals. Almost everyone in healthcare is pressing for it and is frustrated, though probably not surprised, that meaningful use did not get us there.
The ONC says within three years we’ll have a roadmap for providing interoperability “across vendor platforms,” which should probably elicit a collective groan.
Look, a map is a fine tool but of limited use if I don’t speak the language. Change in this industry requires market drivers instituted now, if not sooner. We must move from MU to a health care payment model driving True Interoperability, not the garden-variety stuff.
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Hospitals to Congress: 21st Century Cures telemedicine provisions don't go far enough
January 28, 2015 | By Katie Dvorak
Provisions on improving Medicare's telehealth policy featured in a recently released discussion document by the House Energy and Commerce Committee are a step in the right direction, but don't go far enough, according to a letter from the American Hospital Association to committee chairman Rep. Fred Upton (R-Mich.).
The policy is part of the House committee's 21st Century Cures initiative, which on Tuesday released a broad, overarching document for comment; the goal is to winnow the document down into a bill that can be sent to President Barack Obama by the end of the year.
The AHA's comments specifically refer to the "Advancing Telehealth Opportunities in Medicare" proposal. The provision calls for the U.S. Department of Health and Human Services to create a methodology that would expand coverage and payment for telehealth services.
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Setting data exchange on FHIR
By Viet Nguyen, MD, Chief medical information officer for Systems Made Simple
As health care organizations strive for greater interoperability, the industry is poised to make a quantum leap with the introduction of HL7’s next generation standard, Fast Healthcare Interoperability Resources (FHIR). Pronounced “fire,” this robust health care data sharing standard fits many architectures and aims to broaden the scope of data sharing and help organizations exchange more granular, focused and timely information. Those entities that embrace FHIR will ultimately be able to communicate up-to-the minute data across disparate systems, fostering greater collaboration along the care continuum.
What makes FHIR different?
FHIR builds on existing HL7 interoperability standards, including the Version 2, Clinical Document Architecture (CDA) and Consolidated Clinical Document Architecture (C-CDA) standards. While the new interoperability standard includes both the messaging and document paradigms found in previous versions, it has a much more flexible architecture, allowing organizations to exchange more meaningful and targeted information across a variety of architectures, such as REST or SOA. For example, instead of only sharing messages or finite documents, such as the continuity of care document (CCD), FHIR allows users to interact with clinical data — searching, reading and updating it as well as sharing it with outside entities. Because of this flexibility and scalability, FHIR has the potential to chip away at interoperability barriers more than any other interoperability standard to date.
FHIR builds on existing HL7 interoperability standards, including the Version 2, Clinical Document Architecture (CDA) and Consolidated Clinical Document Architecture (C-CDA) standards. While the new interoperability standard includes both the messaging and document paradigms found in previous versions, it has a much more flexible architecture, allowing organizations to exchange more meaningful and targeted information across a variety of architectures, such as REST or SOA. For example, instead of only sharing messages or finite documents, such as the continuity of care document (CCD), FHIR allows users to interact with clinical data — searching, reading and updating it as well as sharing it with outside entities. Because of this flexibility and scalability, FHIR has the potential to chip away at interoperability barriers more than any other interoperability standard to date.
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Emis has eye on interoperable records
27 January 2015 Sam Sachdeva
Emis Group says it is in a good position to capitalise on a push for fully interoperable electronic health records, as it prepares to release its financial results for 2014.
In a trading update for the year ending 31 December, the company reported its revenues grew by 30% in 2014 “including a double digit percentage organic increase”.
Chris Spencer, CEO of Emis, said NHS England’s Five Year Forward View strategy, which stated a commitment to fully interoperable electronic health records, will play to the company’s strengths.
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Innovation Challenges Hit the Big Time
Scott Mace, for HealthLeaders Media , January 27, 2015
Teams selected to enter the NIH's Neuro Startup Challenge are required to "look like successful startups" and are "rigorously evaluated" on criteria that VCs, foundations, and others would use to provide funding, says the model's designer.
How do you unlock innovation?
I've written previously about various healthcare technology challenges—some inspired by the XPRIZE, some outgrowths of the various hackathons and camps spawned over the past decade in Silicon Valley and elsewhere.
Now there is some evidence that the challenge model can unlock science discovered by the National Institutes of Health.
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Can Argonaut Project Make Exchanging Health Data Easier?
1/26/2015 11:24 AM
Dr. John Halamka talks about the Argonaut Project, which aims to bring open standards to the arcane world of healthcare interoperability.
The Argonaut Project has a big, maybe even audacious ambition: to make health data-sharing easier by using Internet-based open messaging and documents standards instead of complex, healthcare-specific ones.
The project's champion, John Halamka, is one of the best-known figures in health information technology. He's the CIO of Beth Israel Deaconess Medical Center, a full professor at Harvard Medical School, the chairman of the New England Health Electronic Data Interchange Network (NEHEN), co-chair of the HIT Standards Committee, and a practicing emergency physician. Under his leadership, in 2012 Beth Israel Deaconess was the No. 1 company in InformationWeek's innovation ranking. His Life as a Healthcare CIO blog is a "must read" for any serious follower of the health IT landscape. As if that weren't enough, he is also an active farmer who raises various species of animals and grows multiple crops at Unity Farm in rural Sherborn, Mass. (See photo below.)
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EHR audit catches snooping employee
Posted on Jan 26, 2015
By Erin McCann, Managing Editor
Electronic health records not only enable faster access to real-time patient data; they also make it a heck of a lot easier to catch snooping employees who inappropriately view patients' confidential information, as one California hospital has observed this past week.
Officials at the 785-bed California Pacific Medical Center in San Francisco – part of Sutter Health system – notified a total of 844 patients Jan. 23 after discovering a pharmacist employee had been inappropriately snooping on patients' medical data for an entire year.
The incident was discovered after the hospital conducted an EHR audit back in October 2014, when it was first discovered only 14 individuals had had their PHI compromised.
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Hospital to let patients add to own EHRs
Posted on Jan 26, 2015
By Mike Miliard, Editor
Beth Israel Deaconess Medical Center is launching a pilot that gives patients unprecedented input to their electronic health records.
Thanks to a $450,000 grant from The Commonwealth Fund, BIDMC will be one of the health systems to introduce OurNotes, the latest step in the evolution of the OpenNotes movement, which gives patients easy, online access to their doctors' jottings. This new engagement initiative will enable patients to write directly into their own EHRs.
"We believe that OurNotes, which will enable patients to contribute to their own medical records, has the potential to further enhance communication and engage patients in managing illness more effectively and efficiently, leading to improved patient safety and quality of care and potentially, to lower healthcare costs," said Jan Walker, RN, a member of the research faculty of BIDMC's division of general medicine and a co-director of the OpenNotes project, in a press statement.
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Joint Provider-Patient EHR Notes to Undergo Testing
JAN 26, 2015 7:40am ET
Beth Israel Deaconess Medical Center in Boston will lead a project testing the efficacy of care notes jointly developed by both providers and their patients.
The project, called OurNotes, is being funded by a $457,000 grant from the Commonwealth Fund, which says the project is a "novel approach for letting patients, caregivers, and providers jointly create clinical notes and care plans within the shared electronic health record." If successful, this testing could herald a new way to improve care management for high-need, high-cost patients, according to Commonwealth Fund.
The research team will initially review previous research, interview experts, and convene focus groups to identify key elements of OurNotes and the process for co-generating clinical notes and care plans, including pre-visit histories and agendas and post-visit follow-up plans. The team will then build prototypes and pilot the program in five healthcare organizations.
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How technology can streamline discharge process
January 26, 2015 | By Katie Dvorak
The discharge process for patients from a hospital is not an easy one, and if done wrong could also lead to costly readmissions--but the use of technology could make the transition much smoother, according to David Lee Scher, M.D., director at DLS Healthcare Consulting LLC.
Better success in this area could be achieved by combining administrative and clinical predicative models, Scher writes at his blog "The Digital Health Corner." He also says that "better analytics programs applied real-time in the [electronic health record] will facilitate integration of these perspectives."
Some of the other ways technology can be used to help with the discharge process, according to Scher, include:
- Equipment requirements: Using analytics from the EHR, a care coordinator can create a preliminary checklist of the equipment a patient may need. In addition, a digital ordering program would be beneficial to directly connect with a distributor and ensure the product is available, and to check that it's delivered. In addition, patients are embracing digital health tools, and are even looking for providers who offer them, according to a recent survey.
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3 mistakes hospital CIOs should avoid
January 26, 2015 | By Katie Dvorak
The new year will be a challenging one for chief information officers in healthcare as the role continues to evolve, according to David Miller, CIO of consulting firm Optimum Healthcare IT.
With more than 35 years spent in the healthcare industry and 20-plus in healthcare technology, Miller writes at HealthsystemCIO.com that he has seen many challenges of the role first-hand.
Miller offers up advice about what CIOs are doing wrong and paths they should avoid going down, including:
- Making it all about IT: While technology in healthcare is incredibly important, its is a means to an end, Miller writes. Healthcare is about helping people live better, healthier lives, not about the technology.
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FDA Approves Dexcom Mobile Medical Apps for Continuous Glucose Monitoring
The U.S. Food and Drug Administration (FDA) has recently approved the Dexcom mobile medical apps for continuously monitoring glucose level in patients.
On Friday, Jan. 23, the FDA announced that it has given the green light for the marketing of the first set of mobile medical apps that will enable diabetes patients to securely and accurately share information regarding their glucose levels with their doctors in real time by giving their caregivers remote access to the data.
The patients can automatically share the vital information from a continuous glucose monitor (CGM) with the help of portable Apple devices such as the iPhone.
A CGM is a small device, which includes a very small sensor that is wire-like and inserted under the skin. It provides a very steady stream of data about the glucose levels in blood.
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Sepsis Screening Tool Spots Subtle Signs, Saves Lives
Nancy Melville
January 23, 2015
PHOENIX — A simple screening tool predicts sepsis early in trauma patients and reduces mortality, according to a new study.
"The findings show that the sepsis screening tool is a reliable and valid method for the early identification of sepsis in the trauma population," said Laura Moore, MD, from the University of Texas Health Science Center in Houston.
Dr. Moore presented the results here at the Society of Critical Care Medicine 44th Critical Care Congress.
In previous research, Dr. Moore and her team showed that sepsis screening improves outcomes in surgical patients. This time, they assessed trauma patients.
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HealthCare.gov curtails release of personal information
Privacy advocates called on the Obama administration to make changes after The Associated Press reported that the website was sending consumers' personal data to companies.
The Associated Press
WASHINGTON — Bowing to privacy concerns, the Obama administration reversed itself Friday, scaling back the release of consumers’ personal information from the government’s health insurance website to private companies with a commercial interest in the data.
The administration made the changes to HealthCare.gov after The Associated Press reported this week that the website was quietly sending consumers’ personal data to companies that specialize in advertising and analyzing Internet data for performance and marketing.
The personal details included age, income, ZIP code, tobacco use and whether a woman is pregnant.
That prompted lawmakers to demand an explanation, while privacy advocates called on the administration to make changes.
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Enjoy!
David.
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