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Brailer on who owns medical records
Posted on May 01, 2015
By Bernie Monegain, Editor-at-Large
The country's first National Coordinator for Health Information Technology, David Brailer, MD, argues in an opinion piece published in the Wall Street Journal April 30 that it's time for Americans to take charge of their medical records.
But getting access to one's growing mound of digital medical data is not as easy as it seems, he points out.
"You can’t force a covered entity to give your data to someone you choose, and you can’t stop them from giving it to someone they choose, " Brailer writes.
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Is Watson Health Healthcare's 'Linux Moment'?
APR 30, 2015 7:56am ET
It's easy for most of us to remember those cataclysmic societal events after which it is universally intoned that "things will never be the same again." It may be a little more rare to remember those events which slide under the radar of most folks, but which have profound consequences nonetheless.
One of those landmarks in the technology industry was IBM's announcement in 2000 that it was throwing its corporate weight behind the open source Linux operating system. Up to that point, open source software had been viewed as the product of a plucky but overall irrelevant cadre of cranks, crackpots, and cheapskates. It may have been fine for a network of gamers who never left their geek caves, but "mission-critical" enterprise platforms? Please.
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Should Electronic Copies of Medical Records be Free?
APR 30, 2015 7:21am ET
Patients should not be paying to have access to their electronic health records, a study from the Brookings Institution contends.
The HIPAA privacy rule requires providers to upon request provide patients with paper or electronic copies of their records at a “reasonable cost.” Brookings authors Niam Yaraghi and Joshua Bleiberg note that fees for paper records—often high—vary substantially from state to state.
States place caps on the cost of printing paper medical records. Some of the highest costs for copying 75 pages are in Georgia, Pennsylvania, Indiana and Mississippi, ranging from $90 to $101. The lowest caps are in Tennessee, Wisconsin and California with a range of $19 to $29.
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ONC: Health IT has 'raised the floor' on patient safety
April 28, 2015 | By Marla Durben Hirsch
The evidence is in: Health IT and Meaningful Use functions have had a "dramatic" effect on improving patient safety, according to an Office of the National Coordinator for Health IT issue brief.
The brief, prepared by Research Triangle Park, North Carolina-based RTI International and initially published in February before being made public this week, reviewed several recent studies and determined that health IT was working to improve the quality and safety of healthcare. Benefits found include:
- Increased delivery of care in adherence to clinical guidelines and protocols
- Enhanced capability for surveillance and monitoring of care delivery and disease conditions
- Decreased medication error rates
- Decreased rates in the utilization of care
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Senate panel to look into EHR usability
Posted on Apr 30, 2015
By Bernie Monegain, Editor-at-Large
Unhappy with the state of electronic health records across the country two U.S. Senators have decided to take the matter into their own hands.
Lamar Alexander, a Republican from Tennessee and chair of the Senate Committee on Health, Education, Labor and Pension, or HELP, and Ranking Member Patty Murray, a Democrat from Washington State, announced Wednesday they would form a bipartisan, full health committee working group to identify ways to improve electronic health records.
"After $28 billion in taxpayer dollars spent subsidizing electronic health records, doctors don't like these electronic medical record systems and say they disrupt workflow, interrupt the doctor-patient relationship and haven't been worth the effort," said Alexander in a news statement. "The goal of this working group is to identify the five or six things we can do to help make the failed promise of electronic health records something that physicians and providers look forward to instead of something they endure."
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Robots live in new super hospital
29 April 2015 Rebecca McBeth
Glasgow’s new £842 million super hospital opened its doors this week with 26 robot porters operating in the basement.
South Glasgow University Hospitals’ adult hospital has 1,109 en-suite patient rooms all equipped with freeview, radio and Wi-Fi. More than 10,000 staff are based at the hospital, which is one of the largest in Europe.
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Medical apps need CE mark - RCP
29 April 2015 Thomas Meek
Doctors should only use medical apps with an official CE mark, new guidance from the Royal College of Physicians says.
The guidance, produced in consultation with the Medicines and Healthcare Products Regulatory Agency and the General Medical Council, applies to medical apps that can be classed as medical devices, which are bound by EU law to carry the mark.
The RCP says an app is classed as a medical device if it is used to “diagnose, support diagnosis or clinical decision, make calculations to determine diagnosis or treatment, or are used for any medical purpose”.
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Few healthcare organizations using advanced analytics tools
April 30, 2015 | By Susan D. Hall
Although data analytics are seen as a way to improve care and save money, only 10 percent of organizations use advanced tools to capitalize on information, according to a new survey from KPMG.
KPMG asked more than 270 healthcare professionals: "Where is your organization in the business and data analytics roadmap?"
Twenty-one percent said they are still planning their journey, 16 percent are using data in strategic decision-making, 28 percent are relying on data warehouses to track key performance indicators and 24 percent are using data marts.
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Vocera launches physicians' app for Apple Watch
April 29, 2015
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ONC Data Brief Describes Positive Trends in the Adoption of EHR Systems
Posted on: Wednesday, April 29, 2015
In a recently released Data Brief, the Office of the National Coordinator for Health Information Technology (ONC) described trends in adoption of Basic EHR and certified EHR in non-federal acute care hospitals from 2008 to 2014. “Basic EHR represents a minimum use of core functionality determined to be essential to an EHR system.” “A certified EHR is EHR technology that meets the technological capability, functionality, and security requirements adopted by the Department of Health and Human Services.” Data cited in the brief are from the American Hospital Association (AHA) Information Technology (IT) Supplement to the AHA Annual Survey.
The Data Brief identifies and discusses four trends.
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A Finnish City Cures Health-Care Inflation
Oulu has 70,000 residents using a digital system to manage their care
10:24 AM AEST
May 1, 2015
May 1, 2015
Located just 100 miles below the Arctic Circle, Oulu, Finland, was for years famous for only one thing: the Air Guitar World Championships each August. Now the city of 196,000 has a new distinction: It boasts one of the world’s most advanced e-health programs.
A digital platform introduced in 2008 lets patients make appointments, refill prescriptions, and exchange messages with doctors from their home computers. There’s even a device that diagnoses ear infections by measuring vibration of the tympanic membrane. Some 70,000 residents are already on the system, called Self Care.
Most medical care in the country is provided by local governments, and Oulu introduced its e-health platform to control per capita health spending that ranked among Finland’s highest. A diet rich in salt and fat—all that pan-fried muikku fish—resulted in elevated rates of hypertension and heart disease. “If we had done nothing, our costs would have doubled within a decade,” says Kirsti Ylitalo-Katajisto, Oulu’s health and welfare director. Before Self Care was introduced, Oulu’s health budget was growing more than 7 percent annually. The rate is forecast to fall to zero in 2015.
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EU must confront ethical dilemmas related to eHealth
Written by on 30 April 2015 in Opinion
Data protection, cybercrime and the technological amplification of human potential require serious debate, says Nicola Caputo.
As one of my priorities within parliament's environment, public health and food safety committee, eHealth is the subject of two of my written declarations – 'Ethical dilemmas in relation to technical innovation' and 'eHealth'.
In addition, I have raised eHealth in numerous questions to the European commission as it holds many possibilities for bringing about decisive advances in healthcare systems within the member states of the EU.
ICT technologies, which could also be linked to wearable devices, can bring improve care methods and life expectancy, reduce costs and management fees and help in the decentralisation of health policies. Its incredible range of benefits obliges the European institutions to stimulate eHealth as much as possible.
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Need Go-Live EHR Training? Call a Med Student
APR 29, 2015 7:57am ET
When opportunity knocks, it sometimes takes the guise of free time. In the case of Zachary Fridirici, M.D., recognizing that led to a brainstorm that is offering mutual benefit to health systems as they go live with EHR systems and a growing cadre of medical students and residents who are helping that process while earning some welcome income at the same time.
Fridirici, currently a resident in otolaryngology at Loyola University Health System in Chicago, is also the founder of MedDocLive, which uses medical students and resident physicians to help nurse practitioners, physician assistants, and physicians, learn some of the intricacies of EHR systems at the time of deployment. Fridirici says he originally got the idea in 2009 while he was a project manager for Epic Systems, when he noticed medical students at a customer site were incredibly quick to pick up the system.
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Coexistence of FHIR, C-CDA Seen Easing Interoperability Problems
APR 29, 2015 7:46am ET
Despite the potential of Health Level Seven’s Fast Healthcare Interoperability Resources (FHIR) to help solve some of the challenges of interoperability, for the foreseeable future government and industry experts predict that FHIR—an application programming interface (API) that leverages the latest web standards—will coexist side-by-side with the Consolidated-Clinical Document Architecture (C-CDA).
“FHIR is particularly useful where you’re looking to query and retrieve specific data elements, not just an entire clinical document,” says Erica Galvez, interoperability and exchange portfolio manager for the Office of the National Coordinator for Health IT, who is leading the agency’s efforts to achieve nationwide interoperability. But, Galvez hastens to add that C-CDA and FHIR serve different purposes.
“It’s really unfortunate to try and line-up C-CDA against FHIR and to do a comparison or a ‘better than,’” she argues. “Frankly, they will probably coexist for some time—maybe forever—if FHIR does continue down a successful trajectory.” However, Galvez cautions that “how rapidly FHIR matures depends on the folks who are creating it.”
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Interoperability's long journey to reality
Posted on Apr 29, 2015
By Bernie Monegain, Editor-at-Large
Interoperability has been part of the healthcare lexicon for at least a couple of decades. At some level, data liquidity has been achieved – as demonstrated annually at the IHE Connecthathon and the Interoperability Showcase at the annual HIMSS Conference & Exhibition, popular venues that always garner enthusiastic participants and audience.
But it’s still not happening at the scale we need.
Karen DeSalvo, MDThankfully, 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.
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Medical providers should make health data free to patients
April 28, 2015 | By Katie Dvorak
Technology makes patient access to medical records easier than ever, but the cost of such data prevents many from doing so, according to Niam Yaraghi and Joshua Bleiberg, fellows at the Brookings Institution.
Access to health information is beneficial for patients, allowing them to take a bigger role in their care and enabling them to share the information with other providers, Yaraghi and Bleiberg write at Brookings' TechTank. The latter is especially important because of the lack of interoperability of electronic medical records, they add.
But while there are virtually no costs of reproducing digital records, "many states still use the same regulatory model--which is based on the number of copied pages--for paper and digital records," they write.
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To err is human; EHRs must account for that, panelists say
April 29, 2015 | By Katie Dvorak
To err is human, so when it comes to electronic health records, better technology is what's needed to make the programs safer, panelists said Wednesday during Politico's Outside In kick-off event in the District of Columbia.
Currently, usability of the systems is "horrific," Ross Koppel, Ph.D., of the University of Pennsylvania's School of Medicine, said. Health technology has made healthcare better and safer, but Koppel wondered if it's as good as it should be due to the cost and effort.
"Are we keeping track of the mistakes it enhances?" he said. "Are we making progress in making it better? And I think the answer to that is resoundingly 'no.'"
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University of Washington has developed an app that detects sleep apnea
The University of Washington (UW) has developed an app that helps detect sleep apnea, called ApneaApp. App development was funded by the National Science Foundation and the University of Washington.
UW said that usually, to diagnose sleep apnea, providers need to use sensors attached to the user’s body and special equipment, but ApneaApp can detect sleep apnea using inaudible sound waves emanating from the phone’s speakers to track breathing patterns. The app also screens out audible background noise from, for example, people talking, cars honking, or a bedroom fan.
“Right now phones have sensing capabilities that we don’t fully appreciate,” Director of the UW Networks and Mobile Systems lab Shyam Gollakota said in a statement. “If you can recalibrate the sensors that most phones already have, you can use them to achieve really amazing things.”
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Survey: Healthcare IT Leaders Focused and Uncertain on Data Analytics
April 28, 2015 by Gabriel Perna
Data analytics is top of mind for CIOs, IT directors, and other tech stakeholders in healthcare, according to the findings of a recent survey.
The survey was conducted by Stoltenberg Consulting, a Pittsburgh, Pa.-based consulting firm, at the 2015 Health Information and Management Systems Society (HIMSS) annual conference held recently in Chicago. The firm surveyed more than 150 project managers, CIOs, IT directors, and consultants. The majority of respondents (41 percent) said that data analytics and business intelligence as the biggest topic in health IT for 2015. Health information exchange (26 percent) and mobile health (21 percent) were the next two most popular answers.
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Finding Health Value in Daily Observations of Living
APR 28, 2015 7:52am ET
An eight-year study of more optimal use of personal health records finds observations of daily life that individuals enter into their PHR are the most meaningful bits of information.
The Robert Wood Johnson Foundation funded the two-round program, called “Project Health Design: Rethinking the Power and Potential of Personal Health Records,” to expand the vision of PHRs beyond being electronic copies of patient medical records, but a tool that engages individuals and offer actionable information.
Findings from the first round show individuals were not focused on the EHR data being pushed to their PHR, but on describing their own personal daily experiences. These include insights on sleep, diet, exercise, mood, energy levels, responses to medications, and other thoughts and attitudes, according to a report on study results.
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EMR market to grow even without carrot
Posted on Apr 28, 2015
By Bernie Monegain, Editor-at-Large
The $25 billion EMR market will continue to grow even after the government incentives for doctors and hospitals to go digital have vanished, according to an "EMR 2015: The Market for Electronic Medical Records," a new report from research firm Kalorama Information.
"Expect a fair amount of competition and stable growth next few years, without incentives boosting the market," said Bruce Carlson, publisher of Kalorama Information, in a statement. "Eventually, there will be market saturation, but this is a bit of a way off, especially in emerging markets."
Moreover, Kalorama forecasts the market will continue to grow well past the period where there are incentives for healthcare providers. Penalties, system upgrades, international sales and continued efficiency improvements will grow the market 7 percent to 8 percent each year for the next five years, according to the report. The market for EMR systems continues to increase as more physicians and hospitals use EMRs and acquire EMR systems, and as hospitals and physician groups upgrade existing systems.
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Health IT in 15 years? Exciting, but no sure thing
Posted on Apr 28, 2015
By Mike Miliard, Editor
In a Wall Street Journal op-ed, former National Coordinator David Blumenthal, MD, conjures a vision of connected healthcare in 2030. He notes, however, that "this future won’t materialize unless some problems are solved along the way."
Writing on WSJ.com, Blumenthal puts forth three technology-enabled scenarios that could soon become routine, from home-based remote monitoring sensors that could detect deterioration in an elderly relative to a smartphone app that could forecast the risk of a heart attack.
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MDU advises GPs on patient access
23 April 2015 Rebecca McBeth
The Medical Defence Union has produced guidance for GPs to help them to ensure the confidentiality and accuracy of medical records being made available to patients online.
Practices have been contractually required to offer patients in England online access to their Summary Care Record information since the start of the month and some are giving patients access to their whole record.
The MDU said it has been contacted by a number of GPs with queries about giving patients access to their records online, including; whether they need to limit access to sensitive information; how to deal with parents' requests to access children's records; and what to do if a patient challenges the accuracy of a record.
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ONC's Karen DeSalvo outlines 3 steps to interoperability
April 28, 2015 | By Katie Dvorak
National Coordinator for Health IT Karen DeSalvo continues to tout "the bright future" of health IT, outlining in a post at Health Affairs what needs to be done to get to full interoperability.
The ONC has spent the past year listening to leaders in the health community and developing strategies to promote interoperability, DeSalvo says in the post, based on her presentation at the Healthcare Information and Management Systems Society's annual conference in Chicago April 16.
"Our nation's success in adoption, and even the success we see in the increasingly widespread availability of exchange of health information, is just the beginning," she writes.
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ONC's Karen DeSalvo outlines 3 steps to interoperability
April 28, 2015 | By Katie Dvorak
National Coordinator for Health IT Karen DeSalvo continues to tout "the bright future" of health IT, outlining in a post at Health Affairs what needs to be done to get to full interoperability.
The ONC has spent the past year listening to leaders in the health community and developing strategies to promote interoperability, DeSalvo says in the post, based on her presentation at the Healthcare Information and Management Systems Society's annual conference in Chicago April 16.
"Our nation's success in adoption, and even the success we see in the increasingly widespread availability of exchange of health information, is just the beginning," she writes.
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Technology Improves Medical Access in Doctor Shortage
Story by Zac Baker
Last updated April 28, 2015
Arizonans are feeling the effects of a doctor shortage that health care experts expect to worsen nationally in the next ten years.
According to a report by the Association of American Medical Colleges, the nation will face a shortage of at least 46,000 physicians by 2025, and Arizona is currently 500 to 750 doctors short, said Dan Derksen, director of the Center for Rural Health at the University of Arizona.
General access to medical care in rural areas and access to specialty care throughout the state are most affected by the shortage said Chic Older, executive vice president of the Arizona Medical Association.
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6:03 am ET
Apr 27, 2015
Apr 27, 2015
Leadership
How Technology Will Change the Doctor/Patient Interaction
BOB WACHTER: In the future, televisits and technology-enabled home care will replace many of today’s hospitalizations and ER visits. The asthma patient will be prompted to answer a few questions (“Good morning. How is your breathing? Did you wheeze overnight?”) on her computer each morning. The heart-failure patient will have his hydration and vital signs monitored through sensors in a watch or stuck to the skin. The diabetic or liver disease patient who needs periodic blood testing will be able to prick a finger at home (assuming that the test still requires a drop of blood; sophisticated skin sensors will replace many of today’s blood tests). The specimen will be instantly processed through a smartphone attachment, and the result will be automatically entered into the patient’s electronic record.
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Unearthing Hidden Treasures in Meaningful Use, Despite EHRs' Troubles
Scott Mace, for HealthLeaders Media , April 28, 2015
Electronic health records and meaningful use took heat at a recent panel that featured two EHR vendors and a CIO user. But the consensus was that EHRs, despite shortcomings, are shuffling in the right direction.
The electronic health record got a grilling at a session I moderated last week at a national healthcare journalists' conference.
At the Association of Health Care Journalists annual conference, held in Silicon Valley, the most intense interest was reserved for a panel in which the e-cigarette industry defended its products. Meanwhile, I presided over the inquisition of EHRs.
Market leader Epic Systems had declined my invitation to join the panel, but two other EHR vendors were game, as well as the CIO of the highest-acuity children's hospital in the U.S.
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Volunteer 'Super Users' Make More Effective EHR Trainers
APR 24, 2015 7:57am ET
Health system executives spend a lot time performing their due diligence before they invest in new information technology, but may end up "winging it" when it comes to considering the human factors associated with implementing that technology.
Yale University researcher Christina Yuan is studying the phenomenon around those factors, particularly the role social influence plays on user attitudes about new technology. In what may be a counterintuitive finding in her latest work, Yuan found that "super users" of new electronic health records who volunteered for their positions – and who therefore felt more engaged in the process – made better trainers than those who were appointed by management, even if those appointed trainers were extremely tech-savvy.
"This is a really important question managers have to decide, whether to let their super users volunteer for the role or to pick people who are very tech savvy and could be a whiz with the technology," Yuan told Health Data Management. "There is really great intuition for both, but this is a teaching role, so you really need people who will be good teachers.
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EHR Vendors Sound Off on Plan for National Interoperability
APR 27, 2015 7:12am ET
Recent comments from the HIMSS Electronic Health Record Association on a proposed national health information technology Interoperability Roadmap urge that parts of the project move swiftly while other initiatives should slow down.
In a letter to National Coordinator for HIT Karen DeSalvo, M.D., the association urges recognizing and leveraging the work of existing operational health information exchange initiatives, particularly eHealth Exchange, CommonWell Health Alliance and the Care Connectivity Consortium. Though the projects have different governance models, they all share the same technical approaches for patient identification and document queries.
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Understanding health IT's role in caring for Boomers
Posted on Apr 22, 2015
By Sheetal Shah, Avanade
Digitization is a powerful driver and enabler of change. As the health care industry continues to move toward a fee-for-value system of care in which providers focus on improving the experience of care, health of populations and reducing per capita costs, health systems nationwide are seeking and implementing digital technologies that will streamline workflows, increase patient engagement and improve clinical outcomes, particularly among critical populations.
It seems obvious that patients’ health needs advance as they age, but the sheer size of the aging baby boomer cohort is not to be underestimated. In 2029, when all of the boomers will be 65 years and over, more than 20 percent of the total U.S. population will be over the age of 65.
From that perspective, we’ll have double the elderly population that we have today. We are seeing today’s progressive health systems pivot to rethink their approach to serving the aging baby boomer population – and rightly so. This demographic is living longer, battling more chronic conditions and being prescribed more medications than any other generation in modern history. And in the aftermath of the Affordable Care Act, more boomers are being covered through health insurance exchanges, meaning their health care spend and consumption will only continue to grow.
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Researchers examine balancing privacy risk, utility of de-identified health data
April 27, 2015 | By Susan D. Hall
Researchers have shown how easy it is to re-identify patients in de-identified data, yet de-identified data can lose its value as more identifying factors are stripped out.
In a study published in the Journal of the American Medical Informatics Association, researchers from Vanderbilt University and elsewhere extended an algorithm to explore policy options that balance risk of violating a patient's privacy vs. the use of data for society.
The Safe Harbor model defined by HIPAA is one policy that specifies 18 rules, including suppression of explicit identifiers such as names, and generalization of "quasi-identifiers," such as date of birth, requiring recording the age of all patients over 90 as 90+. This rigid rule-based policy might not be ideal for sharing every data set, such as studies on dementia patients.
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Cedars-Sinai goes all-in on Apple HealthKit
April 27, 2015 | By Dan Bowman
Cedars-Sinai Medical Center in Los Angeles has become the latest provider organization to link its electronic medical records system to Apple's HealthKit software.
CIO Darren Dworkin, speaking to Bloomberg Business, said that information from HealthKit now will appear in health records for more than 80,000 patients. Several other hospitals, including the Mayo Clinic in Rochester, Minnesota, and New Orleans-based Ochsner Health System, as well as Stanford University Hospital and Duke University, also integrate with HealthKit.
"This is just another set of data that we're confident our physicians will take into account as they make clinical and medical judgments," Dworkin said, who added that use of HealthKit will be a learning experience.
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EHR Interoperability Must Be Addressed
Monday, April 27, 2015
I am tired of waiting. Millions of medical professionals and patients are tired of waiting. We have been waiting for electronic health record interoperability since the dawn of EHRs in the 1960s. Enough is enough! Our goal is to achieve EHR interoperability through a grass-roots coalition of medical professionals and patients who are tired of waiting.
The simple life-saving ability of hospital EHR systems to connect to one another so health care providers can easily and readily access patient data is not being addressed. This type of issue is traditionally solved by industry or government initiatives. But so far, they have not and apparently will not solve it. So I have decided to raise this issue through an outpouring of angry citizens, hospital patients, physicians and others who are affected.
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Enjoy!
David.
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