Saturday, April 04, 2015

Weekly Overseas Health IT Links - 4th April, 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.

Patient EHR Access Can Increase Provider Workloads

MAR 27, 2015 7:34am ET
Giving hospitalized patients access to their electronic health records during hospitalization increases provider workloads, but not as much as anticipated.
That is the finding of a hospital-based study conducted at the University of Colorado in which 50 patients were provided with tablets during their hospital stays and were able to view their EHRs via a patient portal. The results of the study, published in JAMA Internal Medicine, show that enabling patients to view their EHRs did not create additional work for doctors or nurses.

Health Information Exchanges Show Little Evidence of Benefits

MAR 27, 2015 7:42am ET
Though health information exchanges are supposed to improve the speed, quality, safety and cost of patient care, there is little evidence of these benefits in existing HIE studies.
That is the conclusion of a research paper, published in this month’s issue of the journal Health Affairs, in which researchers reviewed 27 studies looking for evidence that HIEs increased efficiency, reduced healthcare costs or improved outcomes.
While researchers found that 57 percent of published analyses reported some benefit from HIE, they also reported that articles employing study designs having strong internal validity—such as randomized controlled trials or quasi-experiments—were significantly less likely than others to associate HIE with benefits.

Interoperability: Just ahead or still far off?

Posted on Mar 27, 2015
By Bernie Monegain, Editor-at-Large
At no other time in history has there been such a concentrated push for interoperability as there is today.
Perhaps the need has become more obvious since the widespread adoption of electronic health record systems. Maybe the industry has gotten a second wind. Maybe the movers and shakers are finally impatient to make it happen. It could be simply that the stars are aligned.
Whatever the reason, interoperability is center-stage. It doesn't mean that it is done, or that the road to interoperability will be an easy ride. But, suddenly industry insiders seem more abuzz and determined to push forward.

Security for Healthcare ‘Internet of Things’ Must Be Addressed Upfront

MAR 26, 2015 7:39am ET
The explosion of networked medical devices and sensors that connect, communicate or transmit information through the Internet hold tremendous promise if security is built into the infrastructure from the outset, according to a new report.
While networked medical devices linked to the “Internet of Things” pose potential security risks, they are outweighed by the potential benefits to society from these devices that are “wearable, temporarily ingested or even embedded in the human body for medical treatment, medication, and general health and wellness.” That is the conclusion of the report by Intel Security (which owns security software vendor McAfee) and the Atlantic Council, a nonpartisan international affairs policy organization.

Allscripts, Cerner top EHR user satisfaction rankings

March 26, 2015 | By Marla Durben Hirsch
Allscripts, Cerner and CPSI all retain the top spot in their respective markets for user satisfaction, according to the latest report from market research firm Black Book Rankings.
The annual report, released March 18 and based on thousands of ballots from technology and nursing staff at 702 hospitals, found that CPSI retained the No. 1 ranking for hospitals under 100 beds, rural hospitals and critical access hospitals for the fifth year in a row. Cerner retained the top spot for community hospitals of 101-250 beds for the same time period; it also came out the best for hospital systems.
Allscripts was the top dog for the second year in a row in the 250-plus category; it edged out Epic last year, according to an announcement on the report.  

EHR inaccuracies threaten patient safety

March 26, 2015 | By Marla Durben Hirsch
Electronic health records are not doing a good job of creating accurate and clear graphs of patient information, which may adversely impact patient safety, according to a new article in the Journal of the American Medical Informatics Association (JAMIA).
The researchers, from the University of Texas Health Science Center, Baylor College of Medicine and elsewhere, evaluated the graphical displays of lab test results in eight EHRs. They used 11 objective criteria, such as title of graph, legends, and x and y axis scales and labels. Six of the EHRs were certified by the Office of the National Coordinator for Health IT, one was an EHR prototype and one was the U.S. Department of Veterans Affairs' EHR system.   
The results were discouraging. There was little standardization among the graphs, and none of them met all 11 criteria; three of them only met five criteria, according to the authors. One plotted data in reverse chronological order, and one plotted data at unequally spaced points in time. Three didn't display the patients' IDs directly on the graph, and only two allowed users to see, hover over or click on a data point to see values of x and y coordinates. 

The case for expanding API use in healthcare

March 26, 2015 | By Dan Bowman
While the proposed rule for Stage 3 of Meaningful Use and the accompanying certification rule emphasize the use of application programming interfaces (API) for sharing health information with patients, that outlined proposal doesn't go far enough, according to Ashish Jha, a professor of international health at the Harvard School of Public Health.
Jha, writing for the Health Affairs Blog, says if the federal government is serious about fixing the poor usability of EHRs, the systems must be opened up much more robustly.
"[Office of the National Coordinator for Health IT] should require that any vendor that enjoys federal subsidies for its products make its full suite of APIs widely available for third-party products," Jha says. "If these APIs become widely available, third-party vendors will build the tools that currently limit EHR utility and value."

Govt hopeful on patient access target

26 March 2015   Rebecca McBeth
The government is optimistic about meeting an April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
The government is optimistic about meeting its April deadline for patient access to online records, despite January figures revealing that thousands of practices were yet to offer the service.
Health secretary Jeremy Hunt has pledged that all patients who want it will have online access to their GP record by 31 March 2015. The government scaled back the pledge in October 2013, requiring GP practices to provide access to only the brief information held on their Summary Care Record.

Health Information Exchange: Lessons From Libraries

by Charis Baz Takaro Thursday, March 26, 2015
Health information exchange: Congress has encouraged it, the business case is strong and the public assumes it is happening behind the scenes. But on the ground, medical staff fight this war with fax machines and frantic calls to medical record departments.
But what if a lab test only had to be done once, and then everyone had access to the results? What if real-time referrals included pertinent notes and results, transmitted directly as structured data into the specialist's electronic health record system?
Instead, we're living a nightmare. In many cases the primary care provider's office prints stacks of paper from the EHR to fax to the specialist's office, where it is scanned in heaps as unstructured data into the chart. How much human effort supports this system? And what benefit do we derive from this information given its form and volume?   

Public Opinion Screams 'Share My Data, With No Fees'

MAR 25, 2015 7:57am ET
Nearly 75 percent of American adults surveyed believe it is very important that their critical health information should be easily shared between physicians, hospitals and other healthcare providers, according to a survey released by the Society of Participatory Medicine and conducted by ORC International.
The survey also revealed that 87 percent of respondents are overwhelmingly against any fees being charged to either healthcare providers or patients for the transfer of critical health information. However, nearly 20 percent of those surveyed felt that they, or a family member, experienced a problem receiving medical care because their health records could not be shared between different healthcare providers.
 “What this survey points out is that when critical health information can’t be shared across medical practices and hospitals, patients are put at risk,” said Daniel Z. Sands, M.D., co-founder and co-chair of the Society of Participatory Medicine.

Q&A: Robert Wachter on health IT's 'hope, hype and harm'

Posted on Mar 25, 2015
By Mike Miliard, Editor
"The interviews really brought it to life; it was fun to do," says Robert Wachter, MD, describing the 90 or so people, from across the healthcare industry and beyond, he spoke with for his probing and sometimes provocative new book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age (McGraw-Hill), which looks at the consequences – intended and unintended – of the past five years of electronic health records.
Wachter – associate chair of the department of medicine at the University of California, San Francisco; practicing physician; patient safety guru; hospitalist pioneer and blogger – casts a wide net, exploring the sprawling and multi-faceted evolution taking place across this enormous industry these past few years through a series of well-reported and engagingly written vignettes.
He explores the EHR's effect on the physician note and patient experience at the point of care; the successes – and excesses – of HITECH and the meaningful use program; the battle for marketshare and mindshare of pugnacious vendors such as Epic and athenahealth; the impact of big data and supercomputers on doctors and the care they deliver; the changes in store thanks to increasingly engaged and empowered patients.

The role of artificial intelligence in personalized medicine

March 25, 2015 | By Susan D. Hall
Scientists at Carnegie Mellon University and the University of Pittsburgh are using artificial intelligence in their quest to provide individualized treatments, according to a Computerworld article.
As part of the Pittsburgh Health Data Alliance, the University of Pittsburgh Medical Center has agreed to fund the project for six years at between $10 million and $20 million per year.
It's taking data from electronic health records, diagnostic imaging, prescriptions, genomic profiles, insurance records and even wearable devices to create healthcare plans not only by disease, but also for specific types of people.

The disturbing truth behind the Premera, Anthem attacks

March 24, 2015 | By Dan Bowman
As details continue to emerge following the recent hack attacks on payers Anthem and Premera--in which information for close to 90 million consumers combined may have been put at risk--perhaps the most disturbing revelation of all is that, in both instances, neither entity appears to truly take security seriously.
Premera, for instance, knew three weeks prior to the initial penetration of its systems in May 2014 that network security issues loomed large. A report sent by the U.S. Office of Personnel Management's Office of Inspector General detailed several vulnerabilities, including a lack of timely patch implementations and insecure server configurations.
The findings were so bad, they prompted OPM to warn Premera, "failiure to promptly install important updates increases the risk that vulnerabilities will not be remediated and sensitive data could be breached." In addition, OPM told the Mountlake Terrace, Washington-based insurer that failure to remove outdated software would increase the risk of a successful malicious attack on its information systems.


Health, fitness connected device services market to hit $1.8B by 2019

By: Jonah Comstock | Mar 24, 2015        
Juniper Research predicts that connected healthcare and fitness device services will produce $1.8 billion in annual revenues by 2019, according to a new report, a sixfold increase from 2015, which has predicted revenues of $320 million.
The services market is due to explode because in order to succeed, connected fitness devices will have to shift their focus from just hardware, to software and services author James Moar writes.
“Connected fitness and health devices provide a way to collect biometric data, not interaction platforms,” he said in a statement. ‘People want to interact with the devices at the app level – the draw is the information. Because of this, and the omnipresence of sensors, the importance of the hardware will diminish at a much faster rate than other CE market segments.”

Survey: Doctors and Patients See Benefits in Mobile Apps

March 24, 2015
Nearly half (46 percent) healthcare professionals say that they will introduce mobile apps to their practice in the next five year, according to the Plano, Tex.-based Research Now Group.
The survey included 500 healthcare professionals and 1,000 health app users in the U. S. Healthcare professionals were asked whether they currently use smartphone technology in their medical practice; whether they thought it was beneficial and for which types of patients; and under what conditions they thought it had the greatest potential. The health app users were asked which types of apps they use and how they feel about using smartphone technology in relation to their health.
The research found that 86 percent of healthcare professionals believe that health apps will increase their knowledge of patients' conditions. What’s more, 96 percent of users think that health apps help to improve their quality of life, and 72 percent of healthcare professionals believe that health apps will encourage patients to take more responsibility for their health.

Growing up fast

Companies wanting to play in the community and child health space have been investing in their IT systems, so they are ready to step out into the big world of integrated care, mobile working, and – even – patient-led record keeping. Daloni Carlisle reports.
Community and child health IT have always been the poor cousins of acute sector IT, with fewer systems to choose from, less investment from suppliers and less investment from the NHS.
But the last couple of years have seen a change with a number of suppliers investing substantially to improve their offering. The reason is twofold.
The end of the National Programme for IT means contracts are up for renewal – some 30 in the South and London and 180 more in the rest of England. Community providers are also looking for mobile solutions that are able to share data with other systems.

Ready for the next generation of EHRs?

Posted on Mar 24, 2015
By Bernie Monegain, Editor-at-Large
The time is now for a "3rd Platform EHR," according to IDC -- systems that operate primarily in the cloud and provide more flexibility than today's "2nd Platform" client/server technology.
"The 3rd Platform, with cloud as its foundation, is widespread and growing across the country today," but mostly for discreet elements of healthcare, such as population health, IT operations and patient engagement, IDC analyst Judy Hanover writes in a new IDC Health Insights report, "Business Strategy: Crossing the Innovation Gap from 2nd Platform to 3rd Platform Acute Care Systems — the athenahealth and BIDMC Collaboration."
IDC sees 3rd Platform systems as "characterized by ease of access, and ubiquitously available applications that can be securely accessed from multiple endpoint devices, coupled with the use of commodity infrastructure available from service providers through software-as-a-service, platform-as-a-service, and analytics-as-a-service offerings, among other constructs," according to the report.

The biggest IT barriers to push for Precision Medicine

March 24, 2015 | By Katie Dvorak
President Barack Obama's Precision Medicine initiative hinges on gathering data from millions of individuals, but there are challenges the healthcare industry will face when it comes to collecting that information, says Niam Yaraghi, a fellow in the Brookings Institution's Center for Technology Innovation. 
Interoperability and security are two issues plaguing the industry, which also will play a role in Obama's initiative, the aim of which is to increase the use of personalized information in healthcare
The first problem is the inability for electronic health record systems to share information seamlessly, Yaraghi writes at Brookings' TechTank. With the current lack of interoperability of EHRs, it seems highly unlikely the industry will be able to obtain a complete medical history of one million Americans, he writes.

FirstLine’s app will send a doctor in person if call, text, video isn’t enough

By: Aditi Pai | Mar 23, 2015        
San Francisco-based FirstLine Medical has launched its doctor consultation service, called FirstLine, available via iPhone app. The offering allows patients to call, text, or video chat with a doctor, similar to other doctor consultation offerings, but FirstLine goes one step further — if users choose, they can also request a doctor to make an in-person visit to their home or office.
FirstLine is backed by and Great Oaks Venture Capital.
The app launched a beta in late 2014. FirstLine CEO Bryan O’Connell told MobiHealthNews that already the app has more than 20,000 users.

Study: Switch from manual to electronic transactions could save healthcare $8B

Written by Kelly Gooch | March 23, 2015
Transitioning from billions of manual to fully electronic business transactions between healthcare providers and health plans can potentially result in significant cost savings and efficiencies.
But how much progress has been made? How much remains? 
That's what nonprofit alliance CAQH examined in its newly-released 2014 CAQH Index research report. The report reflects 2013 data from participating health plans representing 112 million enrollees — almost 45 percent of the privately insured U.S. population — on more than four billion transactions.

Cloud Adoption Gains Traction

Scott Mace, for HealthLeaders Media , March 24, 2015

Physician practices and ambulatory care sites have been gravitating to the cloud for years, but Web-based services are now finding hospital-based and even industrywide applications.

This article appears in the March 2015 issue of HealthLeaders magazine.
While no cloud-based electronic health record software of note for hospitals has yet to emerge on the scene, cloud-based ambulatory EHRs continue to gain traction, storage remains a strong cloud option, and intriguing new analytics options are tapping the versatility of cloud technology.

ONC Expanding HIT Certification Beyond Meaningful Use

MAR 23, 2015 7:30am ET
Seeking to accelerate health information technology interoperability among providers not eligible for the electronic health records meaningful use program is the focus of a newly proposed rule from the Office of the National Coordinator for HIT.
ONC released the rule on March 20, the same day that the Centers for Medicare and Medicaid Services released a proposed rule for Stage 3 of the meaningful use program.
The ONC rule establishes new and voluntary 2015 Edition certification criteria for other health information systems, called Health IT Modules. A proposed Base EHR definition specific to the 2015 Edition would include fewer measures to report and targets care settings beyond the ambulatory and inpatient environments, such as long-term post-acute care, behavioral health and pediatrics.

Reaction to Stage 3? Guarded

Posted on Mar 23, 2015
By Bernie Monegain, Editor-at-Large
The reaction to the long-anticipated Stage 3 meaningful use rules has been slow in coming – not surprising, given that the Centers for Medicare & Medicaid Services released them around 3:30 p.m. Eastern Time on Friday, March 20.
CHIME, the College of Health Information Management Executives, was the first to comment. Other organizations, such as the American Medical Association and the American Hospital Association, both vocal in asking the government for flexibility in the program, have not yet weighed in with statements.
"CHIME is closely evaluating both the CMS meaningful use rule and the ONC certification rule," the organization said in a Friday statement issued soon after the rules were released. "Based on our initial review, we are pleased to see flexibility built into the Stage 3 proposed objectives.

Patient-centered medical homes lack effective tools for care coordination

March 23, 2015 | By Susan D. Hall
To serve patient-centered medical homes (PCMHs), health IT needs to evolve from digitized patient record repositories into interoperable electronic collaboration platforms to further care coordination, according to research published in the Journal of the American Medical Informatics Association.
In interviews with 28 people involved in three PCMHs, the researchers found that the individuals developed workarounds to make up for the functionality that their IT systems lack.
A basic need identified in the study includes monitoring tools that manage panels of patients and allow PCMHs to risk-stratify patients based on multiple types of data--clinical and claims--to identify and track those most in need of care coordination.

Stage 3 Meaningful Use rules ambitious but burdensome, providers say

March 23, 2015 | By Dan Bowman
While the Centers for Medicare & Medicaid Services' proposed rule for Stage 3 of Meaningful Use represents an ambitious attempt to jumpstart interoperability in the healthcare industry, there are concerns that it could be a difficult row to hoe for providers.
For instance, John Halamka, CIO of Beth Israel Deaconess Medical Center in Boston, in a conversation with FierceEMR, said that his concern is that the thresholds proposed are not aligned with what is achievable in the marketplace today.
Specifically, Halamka (pictured right), who also serves on FierceHealthIT's Editorial Advisory Board, called the following "stretch goals:"
  • More than 25 percent of patients seen by an eligible professional (EP) or discharged from a hospital or emergency department (ED) must "actively engage" with their electronic records
  • For more than 35 percent of patients seen by an EP or discharged from a hospital or ED, a secure message must be sent using the EHR's secure messaging function or in response to a secure message sent by the patient
  • Patient-generated data from a nonclinical setting must be incorporated into the EHR for more than 15 percent of patients seen by the EP or discharged from a hospital or ED

Stage 3 meaningful use proposed rule and certification criteria released

Posted on Mar 20, 2015
By Mike Miliard, Editor
The new Stage 3 meaningful use rules proposed by the Centers for Medicare & Medicaid Services seek to give providers more flexibility, simplify the program, drive interoperability among electronic health records and put the focus on improved patient outcomes.
  • The Stage 3 proposed rule can be read here.
  • New 2015 Edition IT certification criteria can be seen here.
CMS says the Stage 3 rules are meant to drive better-quality, more cost-effective and coordinated care by improving the way providers are paid and – crucially – bolstering better information sharing.

Meaningful Use Stage 3 Proposed Rule Detailed

Scott Mace, for HealthLeaders Media , March 23, 2015

The proposed rule aims "to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health," says HHS Secretary Sylvia M. Burwell.

The Centers for Medicare & Medicaid Services on Friday afternoon released the proposed rule for Stage 3 of Meaningful Use.
The agency, in a media statement announcing the move, said the proposed rules "will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care."

IBM invests in EHR system to advance Watson

Beth Walsh
Mar 22, 2015
IBM has invested in Modernizing Medicine, a provider of cloud-based, specialty-specific EMR systems and other technologies that capture structured data, track outcomes and deliver clinical decision support.
The investment aims to accelerate adoption of Watson cognitive computing in healthcare, according to a release. This is the latest direct investment that IBM has made through its $100 million fund to seed Watson innovations. The investment caps $20 million in Series D funding secured by Modernizing Medicine, raising its overall funding total to $49 million.
Over 5,000 healthcare providers in the U.S., including approximately 30 percent of dermatologists, use Modernizing Medicine’s platform. According to the recent 2015 Black Book Market Research report, the company’s EMA Dermatology solution ranked first overall in the dermatology space for the second consecutive year.

Complexity of DEA Rules Hindering E-Rxing of Controlled Substances

by Bonnie Darves, iHealthBeat Contributing Reporter Monday, March 23, 2015
The big push toward electronic prescribing of controlled substances hit a bump in the road this month when New York Gov. Andrew Cuomo (D) rolled back the deadline for mandatory e-prescribing in the state by one year, to March 2016.
The state e-prescription mandate, which was set to take effect March 27, was adopted as part of New York's Internet System for Tracking Over-Prescribing, or I-STOP, Act. The state law served as a jumpstart nationally for entities affected by the Drug Enforcement Administration's 2010 interim final rule allowing e-prescribing of controlled substances. But doctors and other health care professionals had lobbied lawmakers for the extension, noting that many electronic health record systems lack proper federal certification for e-prescribing of controlled substances.

Records of all government hospital patients to be available on database 

With all patient information to be centralised and made accessible over a large network of hospitals and laboratories, life will soon become much easier for the patients in government hospitals. 
The Union Ministry of Health and Family Welfare is all set to bring in the National e-Health Authority (NeHA), for which the officials have already prepared a concept note. 
It will shortly be given the final contours. 

NeHA's integrated health information system to help the sick

Neetu Chandra Sharma   |   Mail Today  |   New Delhi, March 22, 2015 | UPDATED 09:02 IST
The National e-Health Authority (NeHA) will help cut down on repeated medical tests that patients are subjected to before treatment in India. With all patient information to be centralised and made accessible over a large network of hospitals and laboratories, life will soon become much easier for the patients in government hospitals.
The Union Ministry of Health and Family Welfare is all set to bring in the National e-Health Authority (NeHA), for which the officials have already prepared a concept note. It will shortly be given the final contours.
"One of the major challenges faced by patients in India today is that whenever he visits any healthcare provider he is typically subjected to a certain number of tests before the care provider initiates a treatment plan for his/her condition. If a visit is required to another healthcare provider for either the same or another care setting, the patient is likely to be put through the same process of examination, testing and treatment unless s/he diligently carries around his medical records," said Jitendra Arora, director of the e-governance division in Health Ministry.


1 comment:

Terry Hannan said...

In response to the article "Patient EHR Access Can Increase Provider Workloads BY GREG SLABODKIN" and the others referring to patient involvement and use of their records the positive findings echo the philosophy of Larry Weed from 1989 regarding patients.

• They are highly motivated, and if they are not, nothing works in the long run anyway
• They do not charge. They even pay to help
• There is one for every member of the population

Also the results indicate that we need to further continue to look beyond the information management tools we use in paper records being reproduced on e-devices. Many systems fail because the design thinking is transposing "paper record models" into the "e-environments".