Saturday, August 01, 2015

Weekly Overseas Health IT Links -1st August, 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.

Data analytics platform finds $2B overspend for preventable events

Posted on Jul 24, 2015
By Erin McCann, Managing Editor
The Minnesota Department of Public Health for the first time ever has decided to analyze its troves of hospital admissions and ED data statewide. And what they found was more than a bit concerning when it came to costs and clinical outcomes.
Tapping a 3M data analytics platform and delving into the state’s payer claims database, state health officials identified that over the course of 2012, nearly 1.3 million inpatient visits were "potentially preventable."
And the price tag of all these preventable patient visits? A whopping $2 billion cost, the report found.

Study: CPOE Systems Reduce Medical Errors

JUL 23, 2015 7:25am ET
Computerized physician order entry has been shown to reduce medical errors over a five-year period, with no new type of errors detected, according to a new study.
The prospective analytical study, published in the Journal of Clinical Pharmacy and Therapeutics, evaluated the impact of CPOE on the number of medical errors in prescriptions issued by a hematology department at a Spanish hospital.
The study involved three phases: a pre-implementation phase, an implementation phase, and a post-implementation phase, which was conducted five years after the CPOE system when live.

What clinical decision support can learn from a helicopter cockpit

Posted on Jul 23, 2015
By Mike Miliard, Editor
Before he founded clinical decision support developer medCPU, Eyal Ephrat, MD, was a practicing physician. Before that, he was a helicopter pilot. Want to guess which workplace had the more reliable information system?
This past May, Metairie, La.-based East Jefferson General Hospital partnered with medCPU for a new clinical decision support  system to help its clinicians make the most accurate decisions at the point of care.
As it worked to prevent adverse patient events such as deep venous thromboembolism, sepsis and stroke, EJGH deployed medCPU technology to help alert physicians and nurses better adhere to clinical protocols and its own treatment guidelines.

With #FIXEHR, AMA fine-tunes its Meaningful Use reboot strategy

July 23, 2015 | By Marla Durben Hirsch
The American Medical Association (AMA) has kicked its fight against poorly operating electronic health records and the Meaningful Use program up a notch, in a rather novel way.
Increasingly frustrated by the lack of progress with the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services--even after creating its own usability framework and blueprint to improve the Meaningful Use Program and increasingly more blunt language to the feds--the AMA has launched a new effort to attempt to effect change, this time by providing individual physicians with a national platform to voice their experiences so that members of Congress can hear about them.

Report: Canada's health IT 'lags on many fronts'

July 22, 2015 | By Marla Durben Hirsch
Canada has many of the same problems with electronic health record adoption and data sharing as the United States, according to a Canadian report published this month of the Advisory Panel in Healthcare Innovation.
The report, commissioned by the Canadian government, found that the country was being held back by incomplete interoperability, as well as gaps in uptake of EHRs in primary and ambulatory care settings. It lauds the U.S. Meaningful Use program as a good example of incentivizing EHR implementation, noting that there is no similar pan-Canadian incentive/disincentive structure to spur adoption and data sharing. Moreover, progress in rolling out consumer health technologies to patients has been "slow"; only 4 percent of individuals have access to their health information online.

E-Referrals back up to 40,000 a day

Rebecca McBeth
23 July 2015
The number of referrals being made on the new NHS e-Referral Service has risen to 40,000 a day, the same as were made using the Choose and Book system.
In the days after replacing Choose and Book on Monday 15 June, users of the e-Referral Service reported that it was running slowly, and there were several periods during which it was unavailable.
This meant the number of referrals being processed each day was significantly reduced. But following weeks of stabilisation work, the number of referrals being made using the national electronic system are up to the levels recorded before its introduction, at around 40,000 a day.

Patient access to coded GP info by April

Rebecca McBeth
21 July 2015
GP practices must offer patients online access to detailed coded information from their medical record by April next year.
NHS England is close to defining what will be included in this coded information set after working with professional bodies such as the Royal College of GPs and British Medical Association.
Dr Masood Nazir, NHS England’s national clinical lead for the Patient Online programme, told Digital Health News the organisations are weeks away from announcing an agreement.
Common coded information includes test results, immunisations and vaccinations.

How telemedicine partnerships can reduce hospital readmissions

July 23, 2015 | By Alok Saboo
By Raymond Hino, president and CEO of Sonoma (California) West Medical Center
Telemedicine systems, including remote presence technology, have evolved over the years from stationary workstations to mobile carts to the latest "robotic" units that self-propel themselves down our hospital corridors without a driver, according to preprogrammed GPS instructions. This technology has been credited with bringing specialists, including critical care intensivists, to the bedside in hospitals where no such practitioners live or work within hundreds of miles.

Researchers: Widespread industry support key to success of health IT safety efforts

July 23, 2015 | By Dan Bowman
While the newly proposed Health IT Safety Center Roadmap for the Office of the National Coordinator for Health IT represents progress in terms of improving the implementation and use of tools within healthcare, strong, multistakeholder support will be necessary to ensure the industry stays on the right path, say researchers Dean Sittig and Hardeep Singh.
In a commentary in the Health Affairs Blog, Sittig--a professor in the School of Biomedical Informatics at the University of Texas, Health Sciences Center at Houston who participated in roadmap discussions--and Singh--chief of the health policy, quality and informatics program at the VA Health Services Research Center for Innovations--say that until the last decade, health IT had yet to emerge as an industry. To that end, they believe that developing methods to improve identification and sharing of health IT-based safety events will be difficult.

Mobile EHR Use Meets Care Coordination Needs, Black Book Says

By Jennifer Bresnick on July 22, 2015
Mobile EHR use is on the rise, says the latest Black Book Research provider poll, as clinicians seek more efficient, immediate ways to access patient information from a variety of settings.  Expanded access to EHR data that is optimized for viewing on smartphones and tablets allows providers to communicate more effectively, coordinate care with greater ease, and ensures that emergency care clinicians, consultants, and specialists have the data they need to make timely and informed decisions.
More than half (52 percent) of all ambulatory practice physicians currently use a mobile device to access patient data or reference materials, the survey found, though that number is predicted to rise to 70 percent by the end of 2015. 
Just under a third of respondents use smartphones as some part of their individualized patient management strategy, with emergency department providers, radiologists, OB/GYNs, and surgeons among the most likely to use smartphones to access and manage EHR data on the go.

Mass General plans to debut telemedicine service for second opinions this fall

July 22, 2015 | By Katie Dvorak
Come fall, Massachusetts General Hospital will allow patients to seek second opinions through an online medicine service.
The announcement was made by Sarah Sossong, director of Mass General TeleHealth, at the mHealth + Telehealth World conference in Boston, according to an article in MedCity News.

Is it RIP for the RIS?

A debate is underway about whether trusts need storage, a picture archiving and communications system and a radiology information system; or whether they can do without at least one of these. Kim Thomas talks to those for and against digital imaging as we know it.
These are interesting times for imaging informatics. Where there was once a clear separation between three technologies – picture archiving and communications systems, radiology information systems and vendor neutral archives – the lines are beginning to blur, complicating the decisions trusts have to make.
Let the EPR do the job?
The RIS refresh occasioned by the end of the National Programme for IT contracts is now nearly complete, although a number of London trusts are still to choose a RIS supplier.
Fifty-nine trusts in England have deployed HSS, the original RIS supplier for all trusts outside London under the NPfIT. Soliton, the new kid on the block, has been deployed in 24 NHS trusts, while a handful of trusts have opted for bigger, non-RIS specialists such as Carestream, GE and Agfa.
But RIS’s central role in the radiology department may be under threat from two directions. One is the increased adoption of trust-wide electronic patient record systems from vendors such as Cerner and Epic.

EHRs more 'revolutionary' than expected

Jeff Rowe
Jul 21, 2015
There was a time when EHRs were viewed primarily as a fancy paper chart – basically just another way of capturing and storing information.  But no more.  In fact, says Michael Lovett, there are three ways EHRs are having a much more transformative effect on healthcare
First, “Decision support: EHRs have grown in their ability to intelligently organize a vast amount of information, then make it readily available to clinicians as they care for patients.”

Private Sector Takes on Patient IDs

by Heather Drost, iHealthBeat Editor Wednesday, July 22, 2015
The problems surrounding interoperability and patient safety have renewed dialogue for a national patient identifier system -- nearly 20 years after it was first mandated under HIPAA.
The tale surrounding patient identifiers is far from new -- HIPAA, which was enacted in 1996, called on HHS to develop a system of unique patient identifiers. But Congress effectively put a stop to such efforts about two years later when it passed appropriations legislation for fiscal year 1999 that prohibited HHS from using federal funds to implement a national identifier system, citing privacy concerns. The prohibition language has been included in appropriation bills each year, including the latest Senate HHS appropriations bill for FY 2016 (S 1695). The bill states:
"None of the funds made available in this act may be used to promulgate or adopt any final standard ... providing for the assignment of, a unique health identifier for an individual ... until legislation is enacted specifically approving the standard."

The biggest mHealth fears from the experts

Posted on Jul 21, 2015
By Erin McCann, Managing Editor
The folks at the University of Virginia Health System have done some impressive work with telemedicine. We caught up with Karen Rheuban, MD, director for UVA's Center for Telehealth, and David Cattell-Gordon, director of the UVA's office of telemedicine, to talk mHealth security, challenges and what it means to take it to the next level.
Healthcare IT News' sister publication mHealth News interviewed mHealth masters Rheuban and Cattell-Gordon to hear a little more about what's going on at UVA and what's top of mind for them in the mHealth arena.

Q. What's your biggest fear about mHealth? Why?

A. Our biggest concerns are twofold. The first concern is security. As more and more folks enter this market, there are massive amounts of PHI moving between locations, stored in the cloud and managed with different levels of control and encryption – and a major security breach will have a deep impact on the industry. The second is to ensure that direct-to-consumer telehealth services do not further fragment care but, rather, are provided in the context of integrated delivery models. Consumers have driven this demand; we need to ensure it is of the highest quality.

Docs air EHR frustrations at AMA town hall

July 21, 2015 | By Marla Durben Hirsch
Physicians are facing numerous challenges with electronic health records and the Meaningful Use program, and are being given a better chance to share them publicly due to a new initiative spearheaded by the American Medical Association, launched at a town hall meeting July 20.
The meeting, conducted in conjunction with the Medical Association of Georgia, was aimed at enabling physicians to "share their stories" about their experiences with EHRs and Meaningful Use in order to send a "clear message" to those in policy making, according to AMA President Steven Stack (pictured).
"EHRs have so much potential ... and yet that's not the current state of reality," Stack said at the event. He urged physicians to share their experiences, good and bad via a new on Twitter using the hashtag #FIXEHR. The AMA particularly is focused on usability and the seamless flow of information, as well as the need to "pause" Stage 3 of Meaningful Use so that it can be aligned with other payment models, Stack said. Currently EHRs are blunting efficiency, diminishing their effectiveness and getting between physicians and their patients.

21st Century Cures Act raises privacy questions

July 21, 2015 | By Susan D. Hall
The 21st Century Cures Act, which aims to streamline development and evaluation of new drugs and devices, also contains some language that raises privacy concerns, Kirk Nahra, partner at law firm Wiley Rein, tells HealthcareInfoSecurity.
In particular, he mentions four provisions, two of which he says probably would be positive but raise few privacy questions. One of those would make it easier for researchers to gain access to information to develop study protocols, making that process available electronically on par with the paper process.
The second would allow patients to authorize use of their data to be used for future research, rather than for just a specific study.

10 key apps for nurses

Written by Mary Rechtoris | July 20, 2015
Here are 10 apps nurses are using:
1. NurseGrid: This app is a personal scheduling and communication tool for nurses. The app uses a custom algorithm that remembers users' most common shift times to speed schedule creation. The app will launch a calendar share feature available at the end of July. This option will let a nurse share their NurseGrid calendar to a third party calendaring app including Google Calendar and Outlook.
2. HipaaChat: This application is a HIPAA-compliant text messaging tool for nurses. The app has a FaceTime-like feature that provides accurate consults and patient assessments. HipaaChat provides secure message solutions that will facilitate easy-to-use communication that complies with regulations.

DIGITizE: Displaying and Integrating Genetic Information Through the EHR

July 20, 2015
HL7 conference panel talks FHIR for genetic data
Although many providers are eager to pull genomic data into their electronic health records, the current generation of EHRs cannot handle genomic information. The Institute of Medicine has convened a group of stakeholders in a collaborative effort dubbed “DIGITizE: Displaying and Integrating Genetic Information Through the EHR” to work on scalability, privacy, security and storage issues.
On July 20, at HL7’s Genomics Policy Conference in Washington, D.C., a few members of the collaborative representing Cerner, Epic and Allscripts talked about their visions for successfully integrating genomic information into the EHR.

FDA and UL weigh in on security of medical devices, IoT

News and Features Writer

The security of medical devices is on the FDA's radar as IoT moves into healthcare and wearable health technology data flows to doctors' charts.

As IoT increasingly moves into healthcare, and data from wearable health devices flows more from consumers' wrists to physicians' charts, the Food and Drug Administration (FDA) is trying to keep pace with the fast-evolving technologies.
Meanwhile, a well-known private organization interested in the safety and security of medical devices has stepped up its efforts in these arenas.

Should the Feds Fix Interoperability?

Scott Mace, for HealthLeaders Media , July 21, 2015

Population health leaders are divided over government actions to create interoperability—but agree that lack of data standardization hampers good analytics.

If the angst over meaningful use has taught us anything, it's that federal policy and federal money is a blunt instrument when it comes to directing the future of healthcare IT. That's why it's perilous for Congress to be acting as it is to tackle health IT's current big bugaboo, data interoperability. Leaders of the efforts to drive population health initiatives are divided on the notion.
When I brought up this topic at the recent HealthLeaders Media Population Health Exchange, there was no shortage of opinions. The very stimulus money that is driving health IT's winds of change through healthcare is also magnifying the flaws in meaningful use that allow new information silos to arise and lead to accusations of information blocking.

Providers: Benefits of image sharing outweigh challenges

July 20, 2015 | By Katie Dvorak
Providers feel image sharing is crucial to radiology, despite challenges such as security, processing time and a need for larger amounts of storage.
In a survey of 574 providers, peer60 found that 67 percent of respondents believe image sharing is critical. However, the report's authors add that many haven't yet adopted a solution to make image sharing easier.
The report also found that a majority of respondents, 96 percent, said that radiology had some of the greatest need for image sharing, with 35 percent saying every department had need for image sharing.

Task Force Creates Roadmap for Health IT Safety Center

July 17, 2015
Plan calls for federal seed funding of approximately $20 million for first five years of operations
Despite all the progress and safety improvements from electronic ordering and clinical decision support, researchers continue to find hazards to patient safety associated with the introduction of these systems. Now a task force of experts and health IT safety stakeholders convened by the Office of the National Coordinator for Health Information Technology has crafted a roadmap to guide the development of a proposed national Health IT Safety Center.
In 2014, the Federal Communications Commission (FCC) issued a report that proposed a strategy for a risk-based regulatory framework for health IT. The draft FDASIA report identified the potential creation of a Health IT Safety Center as a key non-regulatory component of an effective risk-based framework for health IT.

Managing Change: The Key to a Successful Digital Health Revolution

by Steven Stack Monday, July 20, 2015
When Charles Darwin developed his theory of natural selection he observed, "It is not the strongest or the most intelligent who will survive, but those who can best manage change."
One of the most prominent changes transforming physician practice today is the advent of digital health, which has opened up a world of possibilities for enhancing patient care. But for every opportunity digital health presents, there are also challenges to contend with. The key to success is effectively "managing change" -- embracing digital health as the means to a healthier future, while vigilantly fine-tuning its application. 
Physicians have long been prolific users of technology and often are among the first to adopt innovations. In fact, a recent survey on mobile technology trends coined physicians "digital omnivores." Today, nearly three-fourths of physicians use tablets, cell phones and computers as part of their workflow, and they are celebrating the benefits this technology can bring to patient care.

Achieving EHR Usability

Scott Mace, for HealthLeaders Media , July 20, 2015

While governments and groups gnash teeth and craft future policy concerning EHR usability, providers are turning to overlay software to recast EHR workflow.

This article appears in the June 2015 issue of HealthLeaders magazine.
Electronic health records are doing more than ever, but providers are challenged like never before to find ways to make them easier to work with and more productive; in short, more usable.
In January, the American Medical Association, joined by 34 other medical professional organizations including the College of Healthcare Information Management Executives, told government regulators there is an urgent need to change the current federal EHR certification program to better align end-to-end testing to focus on EHR usability, interoperability, and safety. CMS has even recommended enhanced user-centered design principles in the 2015 EHR certification criteria proposed in conjunction with meaningful use stage 3.


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