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Congress Continues to Block Nationwide Unique Patient Identifier
APR 10, 2015 7:41am ET
Though patient data mismatches remain a significant and growing problem in healthcare, ongoing congressional language in the Department of Health and Human Services appropriations prohibits HHS from using federal agency dollars to create a national unique patient identifier.
“If Congress changes their position on that and gives us authority to do that, we will move forward on it,” said Jodi Daniel, the Office of the National Coordinator’s Director of the Office of Policy Planning, at an April 7 Health IT Policy Committee. “In the meantime, we are acting within our authority.”
The HIPAA law enacted in 1996 mandated a unique individual identifier for healthcare purposes. Because of privacy concerns, Congress later inserted language into the 1999 Omnibus Appropriations Act prohibiting funds made available under HIPAA from being used to adopt a national patient identifier. That language has remained in appropriations bills since, despite concerns that lack of an identifier hampers patient safety and health data exchange.
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Why DoD EHR modernization will fail
April 10, 2015 | By Susan D. Hall
As the U.S. Department of Defense zeroes in on determining which bidding group will be awarded the coveted contract to modernize its electronic health record system, Loren Thompson, COO at the nonprofit Lexington Institute, says the effort is doomed to fail.
As evidence, he uses the words that Christopher A. Miller, the program executive overseeing the project, used in testimony before the Senate's defense appropriations subcommittee.
In prepared remarks, Miller said the Defense Department proposes to buy an "off-the-shelf" commercial product already in use by the healthcare profession and adapt it to military needs. This will be "state-of-the-market" commercial technology, Thompson writes.
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Accenture, Surescripts Join HL7's Argonaut Project
April 9, 2015 by Gabriel Perna
Two more health IT companies have joined nonprofit standards development organization Health Level Seven International's (HL7) Argonaut project.
Accenture, a New York-based company that integrates electronic health record (EHR) systems, and Surescripts, an Arlington, Va.-based company that operates an electronic prescribing (ePrescribing) network, are the latest to collaborate with HL7 on the development of the Fast Healthcare Interoperability Resources (FHIR) standards framework. The Argonaut Project was launched in December of 2014. In a few short months, HL7 has recruited many of the biggest healthcare organizations to develop FHIR, which is a RESTful application programming interface (API). HL7 representatives say this is modern, flexible approach.
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Accenture, Surescripts Join HL7's Argonaut Project
April 9, 2015 by Gabriel Perna
Two more health IT companies have joined nonprofit standards development organization Health Level Seven International's (HL7) Argonaut project.
Accenture, a New York-based company that integrates electronic health record (EHR) systems, and Surescripts, an Arlington, Va.-based company that operates an electronic prescribing (ePrescribing) network, are the latest to collaborate with HL7 on the development of the Fast Healthcare Interoperability Resources (FHIR) standards framework. The Argonaut Project was launched in December of 2014. In a few short months, HL7 has recruited many of the biggest healthcare organizations to develop FHIR, which is a RESTful application programming interface (API). HL7 representatives say this is modern, flexible approach.
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Health IT: 'We Were Bound To Be Disappointed'
Shara Yurkiewicz MD, Staff Writer, MedPage Today , April 10, 2015
In an interview with MedPage Today, Robert Wachter, MD, associate chairman of the Department of Medicine at the University of California San Francisco, reflects on the nimbleness of companies in Silicon Valley and the sense of disappointment with the state of technology in healthcare.
Robert Wachter, MD, works an hour north of Silicon Valley. Being surrounded by an "incredibly dynamic, vibrant IT ecosystem" contributed to a sense of disconnect for the associate chairman of medicine at the University of California San Francisco.
Wachter couldn't help but compare the nimbleness of companies to the sense of disappointment with the state of technology in healthcare, he told MedPage Today.
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Obama Administration Report Slams Digital Health Records
Report criticizes vendors for making it costly to share patient information
By
Melinda Beck
April 10, 2015 12:08 a.m. ET
The Obama administration took vendors of electronic health records to task for making it costly and cumbersome to share patient information and frustrating a $30 billion push to use digital records to improve quality and cut costs.
The report, by the Office of the National Coordinator for Health Information Technology, listed a litany of complaints it has received about vendors allegedly charging hefty fees to set up connections and share patient records; requiring customers to use proprietary platforms; and making it prohibitively expensive to switch systems.
The report also cited complaints that some hospital systems make it difficult to transfer patient records to rival systems or physicians as a way to control referrals and enhance their market dominance.
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Why Wearables are Loudly Knocking on the Doctor’s Door
APR 9, 2015 7:51am ET
We have entered the era of the connected patient as shown by the Apple Watch and other wearable devices that gather data seamlessly and continuously. Along with mobile health applications, they promise to extend medical care further into people’s lives than ever before.
This is a relatively new development. Clinical data collection and communication used to be relegated to brief patient-doctor interactions during a clinic or hospital visit. But it is impossible to thoroughly support the health of a patient if most of the patient’s life is inaccessible. Early successes with blood glucose and cardiac monitoring showed the nascent value of home-based data collection, but we need much more. The ubiquity and power of data collection and communication heralds a needed transformation in healthcare.
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Care.data stuck in last chance saloon
Several years after the broad outlines of the care.data programme first took shape, critics say it is sitting in the “last chance saloon”. Sam Sachdeva reports on the controversial initiative in the second feature looking at the major healthcare IT initiatives of the coalition government in the run up to the general election.
9 April 2015
Of all the major health IT initiatives to be launched during the coalition government’s term in power, the care.data programme has been notable by its absence from electioneering.
Health secretary Jeremy Hunt has been quick to highlight the government’s work to improve patient access to online records and move towards a “paperless” NHS at recent health IT conferences, but care.data has had nary a mention.
While this reflects the wide variety of problems that have befallen the programme since work started on it in late 2012, it also raises questions about its future after the general election.
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Health IT to help fight negative health impacts of climate change
April 9, 2015 | By Katie Dvorak
The White House is turning to data and the innovative power of both individuals and tech companies to prepare health systems in the U.S. for changes global warming will bring.
President Barack Obama's administration announced the climate change initiatives this week. Members of the administration are starting to meet with medical professionals, academics and healthcare stakeholders to discuss the initiatives, according to a Washington Post article.
As part of its plan, the government will release data sets on climate.data.gov. The information will be culled from the Centers for Disease Control, NOAA and other federal agencies and will be available to the public.
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Examining three decades of health IT change
April 9, 2015 | By Katie Dvorak
After more than 30 years working at the National Institutes of Health National Library of Medicine, outgoing director Donald Lindberg has seen first-hand the changes technology has had on the healthcare industry.
Lindberg retired April 1, and tells Kaiser Health News in an interview that he had a hand in many government-funded sorting initiatives of new and old medical information the library saw.
"When I first arrived at NLM, I didn't come prepared to change anything, but technology was changing all around all of us," he says. "We've had to make major changes or else we would have become obsolete."
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Innovators Look To Bridge the Gap Between Open Data and Consumers
Thursday, April 9, 2015
Efforts to boost health care transparency have unlocked thousands of data sets, but the sheer amount and density of information available has made it difficult for consumers to use in meaningful ways. This gap has created a market for innovators to step in and develop easy-to-use tools that leverage open data.
The federal government in many ways has been leading the effort to make information on health care cost and quality available to the public. In 2009, the Obama administration launched data.gov, an open-source website where the public can access thousands of data sets on various topics. As of April, the site contained 820 health care-related data sets.
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10 ways virtual reality is revolutionizing medicine and healthcare
Virtual reality isn't just about gaming. Here are 10 ways VR is, and has been, seeping into the way medical professionals train, diagnose, and treat.
When people experience virtual reality for the first time, a common reaction is to start imagining all the different uses the technology might hold. Even within one industry, healthcare, the potential is open-ended. The good thing is that scientists and medical professionals have been at the drawing board for years now, developing and implementing virtual reality in ways that can help them train, diagnose, and treat in myriad situations.
Here are just ten of the use cases that are currently in practice and continually developing as the technology itself develops too.
Exposure therapy
One treatment for patients with phobias is exposure therapy. In one instance, psychiatrists at the University of Louisville are using VR to help patients deal with fears of things like flying and claustrophobia.
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Survey: Portals Not Achieving True Patient Engagement
APR 8, 2015 7:58am ET
Designed to allow patients to view personal health and billing information as well as schedule appointments, patient portals have thus far proven to be disappointing in terms of increasing patient engagement, improving clinical outcomes and reducing costs.
That’s the finding of new HIMSS Analytics online survey of executives from 114 healthcare organizations and a focus group including nine executives. According to the survey, the top drivers for patient engagement are to enhance and improve the health of the community (77 percent), the quest to build brand loyalty for patients (77 percent), and meeting Meaningful Use requirements (60 percent).
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Report: tracking where stolen data travels
Posted on Apr 08, 2015
By Erin McCann, Managing Editor
If you've ever wondered where data goes once it's stolen or how many cybercriminals view and download the information worldwide, there's finally an answer. A hint? The numbers are staggering.
The threat research team at cloud security company Bitglass conducted an experiment where they compiled a spreadsheet of nearly 1,600 fake names, Social Security numbers, credit card numbers and addresses and then subsequently transmitted the spreadsheet through the company's proxy. Each time the file was opened, a spreadsheet watermark "called home" as officials explained, recording the viewer's IP address, geographic location and device type.
The file was also posted anonymously to cybercrime marketplaces on the Dark Web. Company officials billed the experiment as the "world's first" A/B test for stolen credit card numbers in this location. The experiment, as company officials emphasized, provided valuable insight into how stolen data is used, purchased on the black market and shared globally. So what happened to the data?
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Right faster
Digital dictation is evolving. Increasingly, trusts are looking to use voice recognition to speed up the production of letters – and change workflows. Kim Thomas reports on how University Hospitals Bristol NHS Foundation Trust is exemplifying these trends.
University Hospitals Bristol NHS Foundation Trust faced a problem familiar to many trusts: a never-ending backlog of patient discharge letters. On average, it took 15 days from a consultant’s appointment with a patient to their GP receiving the letter – and it could take 40 days.
That wasn’t the only problem. There was an over-reliance on agency staff for typing up correspondence, and no means to identify which correspondence was overdue at any one time. While 80% of the trust was using a form of digital dictation using dictaphones handed to a medical secretary to transcribe, 20% were still using tape machines.
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Privacy of health data sharing worries consumers
April 8, 2015 | By Susan D. Hall
Although most adults are confident in the privacy and security of their medical records, many express concerns about sharing of information between providers, according to research from the Office of the National Coordinator for Health IT.
The work was based on a 2011-2012 nationally representative survey of 3,924 adults conducted by the National Cancer Institute (NCI) and published at the Journal of Medical Internet Research Medical Informatics.
Overall, three-quarters of adults reported they were very or somewhat confident in the security and privacy of their medical records; this was unrelated to whether their providers used an electronic health record system.
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HIEs Fail to Deliver on Their Promise
Lena J. Weiner, for HealthLeaders Media , April 8, 2015
Evidence that health information exchanges are contributing to improved quality of care, healthcare efficiencies, and lower costs remains remote, researchers say.
Health Information Exchanges (HIEs) aren't ready for their close-up—and even many of the attempts to quantify their effectiveness are best left out of the spotlight, researcher findings suggest.
"The data is just not there," says Nir Menachemi, PhD, MPH, professor and chair at the Department of Health Policy and Management at the Richard M. Fairbanks School of Public Health at Indiana University in Indianapolis, and on of three authors of a research paper published in the March issue of Health Affairs.
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Pharmacy 2U investigated for data sale
2 April 2015 Thomas Meek
An online pharmacy part-owned by clinical software supplier Emis has come under fire for selling the data of some customers to a marketing firm.
An investigation by the Daily Mail claims that Pharmacy2U gave personal details to direct marketing agency Alchemy Direct Media, whose clients include health charities and pharmaceutical companies.
According to the Mail, names and addresses of people who requested online consultations through the site, and who used Pharmacy 2U “to place their GP prescriptions and have them delivered to their home address”, were passed on.
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Patient attitudes toward telemedicine: 3 key findings
Though telemedicine care may provide more convenient access to physicians, patients are still wary the level of care provided is not comparable to in-person visits, according to a study in Telemedicine journal and e-Health, the official journal of the American Telemedicine Association.
Researchers conducted a statewide survey in Montana to understand patient attitudes toward telemedicine.
They found that 43 percent of patients are "unequivocally averse" to using telemedicine even though it may be more inconvenient than in-person visits. Twenty-nine percent of patients said telemedicine would be "situationally amenable" but still felt uncomfortable using telemedicine, and 23 percent said they would be comfortable using telemedicine if it were convenient, according to the report.
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Health IT prevalent among ECRI's top 10 safety concerns
Alarm fatigue, incomplete electronic health-record data and poor care-coordination due to over-reliance on healthcare IT are among the top 10 patient-safety concerns for healthcare organizations, according to a new report from the ECRI Institute.
This is the second year the not-for-profit patient-safety organization has issued the list to help U.S. hospitals focus attention on highly reported safety issues. “These are things we think warrant people's attention,” says Bill Marella, executive director of operations and analytics for ECRI. Since 2009 the group's patient-safety organization has collected more than 500,000 adverse-event reports from more than 1,000 hospitals. “It's time to take stock and look at whether good systems are in place to prevent these kinds of problems.”
This is the second year the not-for-profit patient-safety organization has issued the list to help U.S. hospitals focus attention on highly reported safety issues. “These are things we think warrant people's attention,” says Bill Marella, executive director of operations and analytics for ECRI. Since 2009 the group's patient-safety organization has collected more than 500,000 adverse-event reports from more than 1,000 hospitals. “It's time to take stock and look at whether good systems are in place to prevent these kinds of problems.”
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Industry Comments on Interoperability Roadmap Run the Gamut
APR 6, 2015 7:01am ET
Friday was the deadline for public comments on the Office of the National Coordinator for Health IT’s draft nationwide Interoperability Roadmap. Comment from industry groups ran the gamut from outright support to tough criticism.
Overall, the Healthcare Information and Management Systems Society supports the roadmap, saying it “lays out a plan that builds on what HIMSS has already invested in: standards that enable the foundation for interoperability today, and processes to test and certify that health IT systems implement those standards consistently and according to constrained implementation guidance.”
However, HIMSS cautioned against creation of a “top-down” governance process dominated by the federal government. “No single network, organization, or process will be able to provide and manage the interoperability life cycle. We, therefore, do not foresee a unitary and monolithic governance process, rather a set of processes that requires some coordination, but largely can operate independently as long as the overall scope, focus, and direction is well understood and shared.”
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Benchmarks: Stage 7 success stories
Posted on Apr 06, 2015
By Mike Miliard, Editor
When looking for advice and best practices for electronic medical record deployments, it's smart to emulate those at the very top of their game.
There are just over 200 U.S. hospitals (and a handful more across Canada, Europe and Asia) that have ascended to the top of the HIMSS Analytics EMR Adoption Model. Stage 7 winners represent elite cohort – just 3.6 percent of the U.S. market – that has achieved remarkable, comprehensive use of healthcare IT.
What's the secret to their success?
"At a very high level, what they are doing right is that they are pretty much enterprise wide with a core clinical system," says HIMSS Analytics Executive Vice President John Hoyt. "In other words – and this may not sound kind – the best-of-breed organizations are not achieving Stage 7. It's the enterprise EHRs that are successful."
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7 traps to skirt on way to interoperability
Posted on Apr 06, 2015
By John W. Loonsk, MD, CMIO, CGI and Johns Hopkins Center for Population Health IT
Kudos should go to Karen DeSalvo and the Office of the National Coordinator for Health IT for finally giving interoperability a central place in the national health IT conversation. Among other things, they have added an Interoperability Roadmap and a Standards Advisory to Stages I, II and now III (in draft) of Meaningful Use and to the burgeoning list of reports (PCAST, JASON, Rand, etc.) that have extolled the need for interoperability progress. Congress is getting back into the interoperability mix too and, together, the whole national talk soup seems almost ready to boil.
But despite all of this talk, objective measures suggest that health IT interoperability itself is still only barely simmering. In this intensely complicated, jargon and acronym-filled area, learning from the past is critical to making an interoperable future work. So, here are seven aphorisms articulating learned lessons that need to be fully digested now if we are to really get interoperability cooking.
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Turning Health Data into Useful Information
APR 6, 2015 7:14am ET
Following listening sessions held last year in five U.S. cities, the Robert Wood Johnson Foundation has issued recommendations on how health data can be collected, shared, protected, and translated in ways that are useful to consumers, organizations and communities nationwide.
The explosion of health data from electronic health records, wearable sensor technology and other sources has generated “excitement” about the potential of turning the tsunami of data into valuable information to improve health and wellness, according to RWJF. However, this promise will only be fulfilled “when people both can access the data and even more importantly trust they can do that with confidence.” For now, “people-related” barriers and technical challenges are standing in the way of “turning all that data into helpful information that people could use to improve health and wellness.”
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Records Exchange Raises Privacy Worries
Experts Suggest Methods to Bolster Patient Trust
A new survey shows that many consumers are concerned about whether their healthcare information will remain private once electronic records are routinely exchanged among providers. But experts say a good way to address those concerns is for organizations to be transparent with patients about who's accessing their data and why.
Devore Culver, executive director and CEO of HealthInfoNet, Maine's statewide health information exchange organization, says that HIEs and healthcare providers should take key steps to earn patients' trust that their records will remain private.
"Acknowledge their concerns," Culver says. "Be clear and transparent about how data will be used and by whom. Confirm that the organization adheres to current data security practices and standards. ... Provide the option for consumers to access audit reports of who is looking at their data."
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Health IT Underused by Primary Care Practices for Quality Improvement
APR 3, 2015 7:40am ET
The Agency for Healthcare Research and Quality has issued a new white paper on health IT best practices for primary care practices to bolster adoption of the technology and to improve quality of care.
“Revitalizing the primary care system in the United States is critically important to achieving high quality, accessible, and efficient healthcare for all Americans,” states the paper. “The effective use of health information technology by primary care practices to facilitate quality improvement can help practices improve their ability to deliver high quality care and improve patient outcomes.”
Despite potential to improve care through data analysis enabled by electronic health records, registries, and health information exchange, health IT is underused for supporting quality improvement in primary care, AHRQ concludes. Part of the reason is that EHR use is relatively new in primary care and users have not mastered advanced functions.
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Hospitals, CIOs call for increased patient identifier action in interoperability roadmap
April 6, 2015 | By Dan Bowman
Hospitals and health system CIOs both stressed the need for patient identifiers in comments sent late last week to the Office of the National Coordinator for Health IT on its draft roadmap.
The College of Healthcare Information Management Executives and the Association of Medical Directors of Information Systems, for instance, call patient identification "paramount" to the formation of an interoperable Learning Health System.
"Without a standard patient identifier, the creation of a longitudinal care record, composed of data and created through disparate systems, geographies and chronology is simply not feasible," the organizations said in a joint statement. "Without a standard patient identifier, the creation of a longitudinal care record, composed of data created through disparate systems, geographies and chronology is simply not feasible."
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Five Things To Watch at HIMSS15
Monday, April 6, 2015
As I prepare for HIMSS15 in Chicago, from April 12-16 at McCormick Place, I think about the transformation of health care through the power of IT -- through innovation, engagement, leadership and more. And, I know others share in this vision; our nearly 40,000 attendees and more than 1,200 exhibiting companies join us to discover, inspire and create the future of health through IT.
Here are the five things I am watching at HIMSS15.
1. HIMSS Health IT Value Suite, South Building, Hall A, Booth 4891
HIMSS expanded the functionality of the Health IT Value Suite, a robust portfolio of more 10,500 evidence-based, value-focused case studies from 1,200 unique health care organizations around the world. Each case study articulates the value of health IT in at least one of five Value STEPS™:
- Satisfaction;
- Treatment;
- Electronic information;
- Prevention and education; and
- Savings.
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Enjoy!
David.
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