Saturday, March 21, 2015

Weekly Overseas Health IT Links - 21st March, 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.

Congressman Takes Aim at EHR Interoperability with Draft Bill

MAR 13, 2015 7:43am ET
Rep. Michael Burgess (R-Tex.), a physician and member of the House Energy and Commerce Subcommittee on Health, has drafted legislation that would establish a congressionally-appointed advisory committee to develop an EHR interoperability standard required for certification that would go into effect by 2018.
The draft bill calls for the termination of both the Health IT Policy and HIT Standards Committees, which are to be replaced with a 12-member advisory committee composed of providers, qualified EHR developers, insurers, group health plans, and other stakeholders. Six of the committee members would be appointed by the House Speaker and minority leader, while the other six would be appointed by the Senate majority leader and minority leader.

Docs are unhappy, and mHealth isn't helping

Posted on Mar 13, 2015
By Eric Wicklund, Editor, mHealthNews
Docs nationwide are unhappy and exhausted in their current roles, and rather than helping, mHealth tools are only adding to the problem. At least that's the finding of a recent survey that took pulse of physician misery levels. 
In the long run, physicians expect mobile health tools to serve to their advantage, but right now, it's just too much on their plates, according to the Geneia's Physician Misery Index survey. 
"Physicians see mobile health as a long-term solution and a short-term nuisance," said Heather Lavoie, chief operating officer of Geneia, the Harrisburg, Pa.-based cealth IT company that conducted the survey. "It's actually adding to their problems right now."

Clinical decision support: It's about more than technology

Posted on Mar 12, 2015
By Mike Miliard, Editor
It's natural to frame thinking and discussion about clinical practice in terms of technology.
But when it comes to clinical decision support, that's the wrong approach, says Jerome Osheroff, MD, a former chief clinical informatics officer and editor-in-chief of HIMSS' CDS guidebook series and the principal and founder of TMIT Consulting, which aims to help providers, agencies and vendors improve processes and outcomes.
To do so, he says, "presumes that clinical decision support is a tool, or an EHR-based intervention." That's not accurate.
Osheroff has been making the case for years that a more inclusive vision of CDS was necessary to ensure it's deployed properly, and that the improved outcomes it promises are realized.

EHR market expected to reach $24B by 2020

Written by Elizabeth Earl | March 12, 2015
The global EHR market has expanded at a prodigious rate in the last five years and is expected to continue to grow rapidly between 2014 and 2020, reaching $23.98 billion by 2020.
The current market is valued at $15.56 billion The market is expected to grow at an annual rate of 6.4 percent for the next six years. Large- and medium-sized hospitals have widely adopted EHR systems, but smaller hospitals are expected to drive the market in the future, according to a report from Transparency Market Research.

Nurses say lack of medical device connectivity, interoperability creates medical errors

By: Jonah Comstock | Mar 12, 2015
Lack of medical device connectivity and interoperability are big contributors to preventable medical errors, according to a recent survey of nurses. According to the 526 registered nurses who participated in the survey, which was commissioned by the Gary and Mary West Health Institute and conducted by Harris Poll, nurses end up shouldering a lot of the burden of medical devices and electronic health records that don’t integrate well together.
Half of the nurses surveyed said they had personally witnessed a medical error that occurred because of a lack of device coordination.
The problem, West Health contends in its report, is that the many different medical monitoring devices in the hospital don’t communicate with each other. Some can communicate indirectly through the EHR, but others need to have their readings manually transcribed onto paper charts by nurses, which opens up a lot of room for error. Forty-six percent of nurses said an error is extremely likely to occur if data is manually transcribed from one device and then entered into an EHR or another device.

Lessons from Ebola: EHR design can impact medical malpractice litigation

March 10, 2015 | By Marla Durben Hirsch
The use and design of a provider's electronic health record can have an impact on medical malpractice litigation, as shown by the recent misdiagnosis of the first Ebola patient in the United States, according to Sharon McQuown, R.N., MSN, LNCC, with the Law Office of Frank L Branson in Dallas, Texas.
McQuown, speaking at the American Bar Association Health Law Section's 16th Annual Conference on Emerging Issues in Health Care Law in Orlando March 6, pointed out that the focus of the problem was the misdiagnosis of the patient in Texas Health Resource's emergency department (ED), which caused the patient to be discharged the same day. He returned and was admitted three days later, confirmed to have Ebola, and died shortly thereafter. The malpractice suit was filed Nov. 12 and settled that day.

How CPOE can reduce length of stay

Posted on Mar 12, 2015
By Anthony Vecchione, Contributing Writer
Computerized provider order entry, along with bedside bar coding and electronic health records has had a tremendous impact on patient safety and outcomes.
In their poster presentation at the 2015 HIMSS Annual Conference & Exhibition in Chicago, "CPOE Associated with Shorter Length of Stay in a Community Hospital," Richard Schreiber, MD, intends to help attendees understand that is a strong statistical correlation between the increases in rates of CPOE with a drop in length of stay.
In a July 2014 study published in Applied Clinical Informatics, Schreiber, chief medical informatics officer at Holy Spirit Hospital in Camp Hill, Pa., and co-author Steven Shaha, noted the correlation came out to be in the vicinity of about 63 percent.
"That is, about 63 percent of the reduction in length of stay correlates with the rise in CPOE rates. This was true overall, and was statistically significant for 13 of the 19 disciplines for which we had data," Schreiber told Healthcare IT News.

Are seniors really game for health IT?

Posted on Mar 12, 2015
By Michelle Ronan Noteboom, Contributing writer
Over Christmas, my 79-year-old father visited me for a few days and joined us for Christmas Eve mass. Just before the service started, my father’s phone rang. He quickly pulled the phone out of his pocket and silenced it. As he did, the people behind us started giggling and said, “Hey look! It’s a flip phone!”
It is a little funny to see my dad with his quaint flip phone, similar to the one I had about eight years ago. My father, who refuses to attempt texting and never checks his voicemail, will probably never switch to a smart phone since the flip phone already has more features than he’ll ever use.

Access monitoring key to thwarting insider health security threats

March 12, 2015 | By Susan D. Hall
West Virginia United Health System is taking an aggressive stance against inappropriate access of patient records, according to assistant chief information officer Mark Combs.
Though it had a read-only system with sign-off procedures, its previous policy allowed employees to use their work access to look at their own records, he says in an interview with
That has now changed.

Study: Using CDS Improves Mortality Rate for Pneumonia Patients

March 11, 2015
A new study, led by researchers at Intermountain Medical Center in Salt Lake City, found that using advanced clinical decision support (CDS) tools can reduce mortality for pneumonia patients. 
The researchers studied the impact of an advanced computer program designed at Intermountain, which combs through a patient's medical information and risk factors in real time to alert an emergency department physician if the patient likely has pneumonia. Once the diagnosis is confirmed, it calculates severity assessment and provides management recommendations based on current North American guidelines. They found that use of the tool saved up to 12 lives over the course of a year, compared to routine care standards. 

Fear of data breaches leads 21% of patients to withhold information from physicians

Written by Elizabeth Earl | March 11, 2015
The national attention on the risk of data breaches may be keeping patients from sharing information with physicians.
A survey from Austin, Texas-based software advising firm Software Advice of 243 people found that 45 percent of respondents were moderately or very concerned about security breaches involving personal health information. Nearly a quarter, 21 percent, withholds personal information from their physicians for fear of a data breach.

Doctors on This Site Rate Drugs to Give Patients More Power

Online reviews are every business’s nightmare and every consumer’s obsession. We rely on them as we scour restaurants on Yelp, search for power tools on Amazon, choose movies on Netflix, and shop for artisanal jewelry on Etsy.
But when it comes to prescription medication, too often, we take what our doctors give us, no questions asked. That’s a major problem, considering nearly 70 percent of Americans take prescription drugs, according to the Mayo Clinic. And it’s especially troubling because, as comedian John Oliver brilliantly conveyed in a recent episode of Last Week Tonight, in far too many cases, the doctors prescribing those drugs are on the payrolls of the very companies that sell them.
With a new product called RateRx, Ron Gutman, CEO of the digital health startup HealthTap, aims to take on this lack of transparency. RateRx will let doctors from all over the world rate the effectiveness of certain medications for certain ailments. They’ll also be able to leave comments about those drugs and rate other doctors’ answers. From that data, patients will be able to surface the best answers to make informed choices about the drugs they take.

Talking the talk

The language of systems integration has shifted from interoperability to ‘paperless’ working and ‘integrated’ care. The tacit assumption seems to be that the technical bit has been solved, and these phrases are well understood. But is that the case, Daloni Carlisle asks?
There was a time when “systems integration” had a well understood meaning in NHS IT. It meant linking different systems to get an administrative or clinical job done. By and large, it meant doing that in the acute sector.
Not anymore, it would seem. The language has changed. People now talk about ‘paperless’ working and ‘integrated’ care. The tacit assumption is that the technical aspects of interoperability have been solved, so debate can skip on to what it is meant to achieve.
Also, that what it is meant to achieve is clear to all parties. Yet these assumptions may not, in fact, be justified; given the wide range of approaches that are now being taken, both in hospitals and beyond them.

Are you maximizing the value of IT?

Posted on Mar 10, 2015
By Chris Nerney, Contributing Writer
Over the past few years, U.S. healthcare organizations have poured billions of dollars into information technology. But what kind of return are healthcare providers getting on these massive investments? And how can they maximize the value of IT to both improve patient care and streamline operations?
HIMSS15 attendees can explore the answers to these questions at the annual conference’s first Health IT Value Suite, which will feature patient and healthcare provider success stories that illustrate the ROI possible from health information technology during a time of huge change to the U.S. healthcare system.
“There’s a lot of pressure on health IT from the C-suite and boards of directors to deliver better care, improve patient outcomes and save money,” says Patricia Wise, HIMSS vice president of healthcare information systems. “Simultaneously, regulatory forces from the government are pushing organizations toward value, and the payment structure is being influenced by this.”

John Halamka: CIOs should scrutinize cloud services

March 10, 2015 | By Katie Dvorak
While the cloud holds promises for health IT, chief information officers must look at the services offered to them with a discerning eye, Beth Israel Deaconess Medical Center CIO John Halamka says in a post in the Wall Street Journal.
He says CIOs should look at a variation of software as a service (SaaS), which is operated by a third party and thus does not require new hardware or software installation. The variation, which Halamka calls "Outcomes as a Service," is the blending of business processes, people and technology work to achieve goals.
In Outcomes as a Service "economic incentives are aligned perfectly ... because downtime or poor application functionality results in immediate reduction in cloud vendor income," he writes.

Telemedicine dangers must be addressed

March 11, 2015 | By Katie Dvorak
Despite the promise of telemedicine in improving healthcare, there are downsides to such technology that need to be addressed, according to Russ Alan Prince, president of consulting firm R.A. Prince & Associates Inc.
One impediment to using telemedicine effectively is glitches, he says. If malfunctions occur, it could negatively impact a patient's care and health, Prince writes in Forbes. A glitch could cause allergy information not to be stored in a medical record, which in turn could have severe repercussions, he says. In addition, medical device implants could also malfunction and harm a patient.

Telemedicine via PCPs Ups Diabetic Retinopathy Screenings

Marcia Frellick
March 10, 2015
Researchers have found long-term positive results when primary care physicians (PCPs) use telemedicine to screen for diabetic retinopathy.
Steven Mansberger, MD, MPH, from the Devers Eye Institute in Portland, Oregon, and colleagues found that telemedicine increased the percentage of diabetic retinopathy screening examinations. They also found that most participants did not require referral to an eye care professional after the screening and that diabetic retinopathy levels were relatively stable during the study period. Results were published online March 5 in JAMA Ophthalmology.
This finding suggests that PCPs can use telemedicine with nonmydriatic cameras to take retinal images without dilation, send images for remote evaluation, and watch for disease worsening over time.

Why Health Information Must Be Available Where and When Consumers Need It

by Angela Kennedy Wednesday, March 11, 2015
Lydia Washington, MS, RHIA, CPHIMS -- senior director of HIM Practice Excellence at the American Health Information Management Association -- contributed to this Perspective.
One year ago, I found myself putting in relentless effort to compile an accurate medical record for my daughter after she was diagnosed with the genetic disease Cystic Fibrosis at age 11. I experienced many frustrations in my attempt to gather my child's medical records. Due to an incorrect entry in my daughter's medical record, the inheritable condition was overlooked. The records included an inaccurate statement that had been copied and pasted into all subsequent records for nine years.
Gracie is just one example of why a commitment to consumers must be made that we can provide health information where and when they need it. We need a guarantee that information will be available, accessible, accurate and complete. Copy-paste and copy-forward pose risks to patient care. In my daughter's case, perhaps if the information had been reviewed or audited for accuracy, she would have received an earlier diagnosis. This audit is not just the responsibility of the caregiver but also the responsibility of the patient.

HIE Pushes Value Propositions in CA

Christopher Cheney, for HealthLeaders Media , March 11, 2015

Creating a health information exchange that serves as an independent medical record repository for the majority of California's residents has tremendous potential for payers, providers, and patients.

David Watson is seeking to capitalize on a golden opportunity in The Golden State.
The University of Southern California graduate is CEO of Cal INDEX, one of the most ambitious health information exchange initiative's in the country. A pair of major payers formed the non-profit HIE in August 2014, with Blue Cross of California and Anthem Blue Cross committing $80 million in seed money to help launch the not-for-profit organization.
In a recent interview, Watson told me how Cal INDEX is building a wealth of healthcare information on the foundation of 9 million records drawn from Blue Cross's benefactors.

Apple Launches Software Framework, Apps to Aid Medical Research

MAR 10, 2015 7:32am ET
With more than 700 million iPhones sold globally, Apple has built a new open source software framework that it hopes will revolutionize medical research by turning iPhone users into powerful diagnostic tools for gathering health data.
At Apple’s March 9 product launch event, the company announced ResearchKit, a new platform for researchers to host mobile apps designed to dramatically change how the antiquated methods of medical research—and the treatment of diseases—are conducted.
“One of the biggest challenges researchers have is recruiting,” said Jeff Williams, Apple’s senior vice president of operations. “Small sample sizes—sometimes 50 to 100 people—limits our understanding of diseases. Another issue is subjective data.”

Nurses want probe into EMR failure

Posted on Mar 10, 2015
By Erin McCann, Managing Editor
Nurses at a California hospital are asking state officials to investigate the failure of the hospital's electronic medical record system, an incident they said led to the closure of its emergency room and compromised patient safety.
The EMR system at the 420-bed Antelope Valley Hospital in Lancaster, California, reportedly failed last weekend, resulting in clinicians unable to review patient labs, verify physician orders and access patient records, according to the California Nurses Association and the National Nurses United union. 
"Our entire electronic and data system failed," Feb. 27 wrote Antelope Valley's Maria Altamirano, RN, on behalf of California Nurses Association, in a letter to the Los Angeles County Department of Public Health. Due to the failure, the hospital, Altamirano explained, had to close its emergency department because it failed to have adequate backup plans in place. 
----- on hold until election

3 March 2015   Sam Sachdeva
Lingering questions dogging NHS England's controversial programme will hold up data extractions until after the May general election, Tim Kelsey has confirmed for the first time.
However, NHS England's director of patients and information told EHI News that communications about the programme will still be sent to patients in pilot areas as part of the pathfinder phase.
Speaking at the e-Health Week conference in London, Kelsey said the organisation is still working on its response to a significant number of questions about the programme, raised by an independent review, that must be answered before it can move ahead.

Scottish data share plan survives vote

9 March 2015   Thomas Meek
Scottish government plans to share data from a central NHS database with other public bodies have narrowly survived a Holyrood vote.
The proposals put forward by the SNP government were voted through by 65 to 60, helped by MSP Aileen Campbell who took time out from maternity leave especially to vote.
As reported by EHI News in February, the SNP said it wants to share non-medical data from the NHS central register, which holds details of everyone born or registered with a GP in Scotland, with the HMRC and other public bodies.
This is mainly in order to keep track of taxpayers from April 2016, when the country is set to implement its own rate of income tax.

U.S. health IT market to grow at 6%+ over next 4 years — 5 things to know

Written by Anuja Vaidya | March 09, 2015
The use of information technology is seeing major growth in the U.S. healthcare industry, and it is no secret that health IT will form the foundation of value-based healthcare delivery.
Here are five key trends in the health IT market, according to a report released by Market Research Store:
•    The healthcare IT market in the United States is estimated to grow at a compound annual growth rate of 6.01 percent from 2015 to 2019.

Seeing medical records might ease hospital patients’ confusion

By Lisa Rapaport
Mon Mar 9, 2015 11:54am EDT
(Reuters Health) - Letting patients see their medical records while they’re in the hospital might ease worry and confusion without extra work for doctors and nurses, a small study suggests.
"The hope is that increased transparency achieved by sharing electronic medical records with patients while they're in the hospital would make them more engaged in their care, more satisfied, and more likely to ask questions and catch errors," said lead study author Dr. Jonathan Pell, an assistant professor at the University of Colorado in Denver.
Patients didn't think they could catch medical errors, “so that piece didn't come out the way we had hoped it would," Pell said. "But we were also pleasantly surprised that many of the doctors and nurses didn't see their work load increased by patients having access to their records."
These days patients more often have access to electronic medical records from checkups and outpatient treatments, but typically only after care is completed – and not for procedures while they're in the hospital.

HIE Reduces Medical Imaging Redundancies 25%, Study Says

Christopher Cheney, for HealthLeaders Media , March 10, 2015

A health information exchange in New York State is helping several dozen healthcare providers coordinate care and reduce costs, researchers say.

Health insurance exchanges are capable of reducing redundancies in medical imaging, which contributes significantly to care coordination and cost-efficiency gains for healthcare providers, research conducted in New York state indicates.
A study, recently published in the American Journal of Managed Care, focuses on the Rochester Regional Health Information Organization, a nonprofit HIE launched in 2006. The study found that dozens of healthcare providers shared medical imaging data through the Rochester HIE, reducing the odds of redundant medical imaging by 25%.

The Best Interoperability Game in Town

Scott Mace, for HealthLeaders Media , March 10, 2015

The ONC's Interoperability Standards Advisory gives providers some things they can start demanding from their vendors and service providers, and gives those same vendors and service providers some notion of which products and services customers will actually buy.

Are your health IT systems using SNOMED-CT? How about RxNorm? How about the HL7 Consolidated CDA?
Until May 1, you have a chance to weigh in on these and numerous other industry standards which, as likely as not, will eventually find their way into regulation as required technical standards in health IT systems in the U.S.
Overshadowed by the release of the proposed 10-year ONC Interoperability Roadmap on January 30, the lesser-publicized 2015 Interoperability Standards Advisory was not originally envisioned to be released at the same time, or even to exist.

Moscow eHealth a Model for the UK

The approach that Moscow City Council has adopted to create an open platform to support health and social care services in Moscow which uses some of the same technology as the Code4Health platform would seem to have relevance to the UK and in particular is a good fit for the needs of emerging new approaches to the integration of health and social care like that recently announced for Manchester.
Many of you will know about HANDI-HOPD the HANDI Open Platform Demonstrator  that we have been working on for the last few months, this has now morphed into the NHS Code4Health Platform launched by NHS England during eHealth Week in London this week (5th March 2015).  However, what you probably won’t know is that one of the key pieces of technology available on the platform is the same as that which is currently powering the whole of the eHealth system in Slovenia and even more impressively Moscow.

5 health IT billionaires you know

Posted on Mar 09, 2015
By Bernie Monegain, Editor-at-Large
The Forbes 2015 list of the richest people on the planet has become longer this year with the addition of even more billionaires. We found five health IT pioneers on the list you've probably heard of.
There are 1,826 billionaires in the world. This year's Forbes list includes 290 newcomers. The top three on the list are Bill Gates, who made his $70.2 billion via Microsoft; Carlos Slim Helu, who garnered his $77.1 billion in the telecom business; and Warren Buffet, investor extraordinaire, who racked up $72.7 billion.

7 tips for EMR success from Stage 7 hospitals

Posted on Mar 09, 2015
By Amanda Burkey, New media producer
Since 2006, HIMSS Analytics has identified a total of 200 hospitals as Stage 7 facilities on the HIMSS Analytics EMR Adoption Model. As challenging as this goal is, new Stage 7 facilities are added each year.
Thirty more hospitals and 1,021 ambulatory facilities reached paperless status in 2014, and will be congratulated next month at HIMSS15. Each of these provider organizations has overcome challenges inherent in achieving a paperless environment. Take advantage of their experiences and keep these seven lessons in mind during your Stage 7 journey.
1. Include all the key stakeholders.
"Balance the need for speed with the need for inclusiveness. Finding the right balance requires an understanding of the culture of your organization and the ability to think like your stakeholders. On one hand if you include everyone you don’t move fast enough and you lose trust; on the other hand if you don’t include the right people you have a hard time with adoption. Respect for people and organizational mission is usually the common ground."

How colleges are incorporating health IT into nursing education

March 9, 2015 | By Katie Dvorak
Health IT is taking over healthcare education--including for aspiring nurses.
At Mount Aloysius College in Cresson, Pennsylvania, high-tech mannequins are helping nursing students get as close to real-life scenarios as possible.
For the class, Nursing Care of the Family, IT specialists manipulate the mannequin's vital signs--they can mimic breathing and have blood pressure--as the students work to save their "patient," according to an article at the Military Times.

mHealth Advocates Fear Net Neutrality

by Rebecca Vesely, iHealthBeat Contributing Reporter Monday, March 9, 2015
While much of the Internet community expressed elation over the Federal Communications Commission's Feb. 26 vote to protect net neutrality, some mobile health advocates said that the rule could harm patients.
The divide over the rules is expected to continue, with possible congressional action and legal challenges over the rules.
"We think this is a big step backward for innovation and creativity," said Joel White, executive director of Health IT Now, which represents providers, employers, carriers and payers, including Aetna, athenahealth, Boeing, Intel, McKesson, Samsung and Verizon. He added, "FCC is treating the Internet as a utility. That was big in the 1930s. The Internet is far more than a water pipe or an electricity cable. It is an engine of creativity."


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