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Is meaningful use destined for delay?
Posted on Oct 01, 2015
By Tom Sullivan, Editor-in-Chief, Healthcare IT News
There's something about October 1. It's the historic compliance deadline for ICD-10 – pushed back multiple times – and the last possible day for eligible providers to start a 2015 90-day meaningful use reporting period.
One perhaps telling problem: The federal government still has not delivered requisite guidance on exactly what criteria healthcare organizations must meet to qualify for EHR incentives.
There may be little choice at this point other than to tweak 2015 timelines. Indeed, on Sept. 30 U.S. Senators John Thune (R-SD) and Lamar Alexander (R-TN) urged CMS to adopt the Stage 2 modifications immediately and Lamar followed that up on Oct 1. by publicly circulating five reasons to postpone making the final Stage 3 rule.
"There is no reason not to take time to do it right," Alexander said in a prepared statement, "and there are plenty of reasons to do this."
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ONC to develop patient-generated health data policy framework
October 2, 2015 | By Dan Bowman
The Office of the National Coordinator for Health IT will develop a policy framework for identifying best practices, gaps and opportunities for the use of patient-generated health data (PGHD) in research and care delivery through 2024, National Coordinator Karen DeSalvo announced Thursday.
At ONC's annual consumer health IT summit in the District of Columbia, DeSalvo--who called PGHD efforts "near and dear to her heart"--said that the framework will be developed over the next two years.
"It's a framework that's going to look at how we're going to protect that data, how we're going to maximize the doctor-patient relationship using that data, build confidence in providers' and researchers' ... uses of that data and encourage consumers and caregivers to participate" in harnessing the data, she said.
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UPMC's big data approach slashes readmissions
Posted on Oct 01, 2015
By Erin McCann, Managing Editor
Looking to slash your readmission rates using big data but not sure where to start? It's best to hear the stories from the folks who have done it successfully. UPMC's analytics team is one of groups ahead of the curve.
Pamela Peele, the chief analytics officer for UPMC's insurance division, together with her team of 25, have done what many hospitals and payers are just beginning to do: They developed a conditional readmission model on the payer side that delivers a readmission risk prediction score before the patient even walks through the door, and then blending it with a provider-side model.
"So we're predicting your readmission rate, and you haven't even been admitted yet," Peele told Healthcare IT News. "And we're pushing that information over to our provider side, so when somebody presents and they're being admitted, the provider can see the a priori readmission risk that we've already calculated and can act upon that risk starting at the point of admission."
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Open source EHR live at Taunton
28 September 2015
An open source electronic patient record system has gone live across an NHS acute trust for the first time today.
Taunton and Somerset NHS Foundation Trust has become the first to roll-out the open source EPR openMAXIMS. It is live with IMS Maxims’ open source patient administration system as well as A&E, theatres and reporting modules.
Sheffield Teaching Hospitals NHS Foundation Trust has also gone live today with CSC’s Lorenzo electronic patient record.
Digital Health News reported in March 2014 that Taunton had picked IMS Maxims as preferred bidder to supply an EPR to replace its Cerner Millennium system.
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GP2GP allows large file transfer
1 October 2015
Large patient record files can be sent electronically between GP practices with the launch of the latest version of GP2GP.
Emis Health has been awarded full rollout approval for GP2GP version 2.2a for users of its Emis Web clinical system. More than 400 practices already have the new functionality.
GP2GP is a national system used to securely transfer more than 100,000 electronic patient records a month between GP practices in England.
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No EHR? Paper records create dangerous voids in care coordination
Posted on Sep 30, 2015
By Jack McCarthy, Contributing Writer
Many patients are growing increasingly impatient with the progress their doctors are making in adopting digital tools and they're exasperated by the demands placed on them to be responsible for mounds of paperwork.
There's more at stake than just agitating your patients with paperwork, of course.
Indeed, some 30 percent of patients need to physically bring test results, X-rays, or health records from one doctor's office to another. What's more, 54 percent indicated that they frequently or always sign paper forms while 28 percent continue to write details of their medical history on paper forms.
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Providers mull adoption of speech recognition tools
September 30, 2015 | By Katie Dvorak
The use of speech recognition in healthcare is growing, with about 30 percent of providers considering adopting the tech.
However, many remain resistant against it, with 25 percent saying they are unlikely to ever adopt it, according to a peeer60 survey of 376 providers from U.S.-based hospitals.
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Thousands of critical medical devices open to attack
September 30, 2015 | By Katie Dvorak
Medical devices used by healthcare organizations are vulnerable to attack and left exposed online--thousands of them, according to security researchers.
Scott Erven and Mark Collao used a search engine, Shodan, which finds specific types of computers connected to the public Internet, to seek out critical medical systems online, and found that many of them could be accessed by malicious actors, according to a report by The Register.
At one large U.S. healthcare organization, which was unnamed, Erven and Collao said they found 68,000 medical systems exposed, including anesthesia devices, infusion systems, pacemakers and more.
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The challenges of rural medicine
Brock Malcolm
Sep 30, 2015
Rural medicine poses special problems for physicians and health centers. It’s tough enough getting people to go to the doctor for preventive care when they live 10 minutes down the road, but rural patients often live an hour or more away on mountain roads that turn treacherous in the winter – and they may face difficulties getting time off work to make an appointment.
Without preventive care, problems snowball: All too often, rural patients endure chronic diseases, and are diagnosed only once they face more serious problems. In fact, according to the Department of Health and Human Services, the 60 million Americans who live in rural areas have higher rates of chronic disease, disability and mortality than their urban and suburban counterparts.
For us, and I suspect many rural health care providers similar to CCWV, our challenges boil down to patient access, patient communication, and patient education.
These are our patients at Community Care of West Virginia. A large majority of our patient population in West Virginia – one of the country’s poorest states – is both rural and working poor. They work hard every day, but generally don’t have employer-sponsored health insurance and many have spent years in the ranks of the uninsured.
These are our patients at Community Care of West Virginia. A large majority of our patient population in West Virginia – one of the country’s poorest states – is both rural and working poor. They work hard every day, but generally don’t have employer-sponsored health insurance and many have spent years in the ranks of the uninsured.
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Successful patient portals require thorough planning
Jeff Rowe
Sep 29, 2015
One of the key opportunities for providers looking to improve their patient engagement efforts is the patient portal. A growing number of patients are already online, so it makes sense to get a patient portal up and running to give them a convenient way of connecting with their doctors.
But despite the public’s growing familiarity with all things on-line, providers need to recognize that there is much more to launching a good portal then assuming, “If we build it, they will come.”
Writing for AAP News, the magazine of the American Academy of Pediatrics, Sogol Pahlavan, M.D., makes clear that “Successful patient portal implementation requires support, education and accountability.”
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Automation and Anesthesia
Tinker Ready, for HealthLeaders Media , September 30, 2015
After years of research, debate, and Food and Drug Administration review, the federal agency will allow nonanesthesia professionals to use a device that administers sedation during colonoscopy and esophagogastroduodenoscopy procedures, provided that certain requirements are met.
Increasingly, a colonoscopy team includes not just a gastroenterologist, but also an anesthesiologist. Not content with conscious sedation achieved through a combination of intravenous drugs, more patients and gastroenterologists are opting for deep sedation that only an anesthesia professional can deliver.
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GAO report: Meaningful Use requirements burdensome to interoperability
September 29, 2015 | By Dan Bowman
Despite the importance of electronic health record interoperability to improving the state of overall care delivered in the U.S., several hurdles remain to get to seamless patient data exchange between providers, according to a new Government Accountability Office report.
Two issues hindering interoperability, according to those interviewed for the report, are the lack of incentives for providers to share data currently and the requirements for the Meaningful Use incentive program.
"Representatives from 10 of the initiatives noted that efforts to meet the programs' requirements divert resources and attention from other efforts to enable interoperability," the report's authors say. Additionally, representatives from 10 of the initiatives called the Office of the National Coordinator for Health IT's certification efforts insufficient to achieve interoperability.
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GAO Report: MU Requirements Impede EHR Interoperability
October 1, 2015
by Rajiv Leventhal
Sen. Lamar Alexander references report in his latest push for a Stage 3 delay
A new report from the Government Accountability Office has outlined five key factors—in addition to meaningful use program requirements—that are slowing down the progress of electronic health record (EHR) interoperability.
For the report, GAO was asked to review the status of efforts by entities other than the federal government to develop infrastructure that could lead to nationwide interoperability of health information. Stakeholders and initiative representatives GAO interviewed described five key challenges to achieving EHR interoperability, which are consistent with challenges described in past GAO work. Specifically, the challenges they described are (1) insufficiencies in health data standards, (2) variation in state privacy rules, (3) accurately matching patients’ health records, (4) costs associated with interoperability, and (5) the need for governance and trust among entities, such as agreements to facilitate the sharing of information among all participants in an initiative.
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Survey: Americans want providers who are more digitally connected
September 29, 2015 | By Katie Dvorak
Americans are clamoring for doctors who are more digitally connected, and are more frustrated with paperwork and customer service in the healthcare industry than banks, auto dealerships, cellphone companies and others, a new survey finds.
Almost half of the more than 1,000 respondents to the survey, conducted on behalf of Surescripts, said they had gone to the doctor's office earlier than scheduled to fill out paperwork. In addition, 55 percent said their medical history was incomplete when visiting their provider.
What's more, 50 percent of respondents said that renewing a driver's license would require less paperwork than seeing a doctor for the first time.
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Denials still a major worry as ICD-10 deadline approaches
Only 30% of respondents said they have improved their denial management processes in preparation for ICD-10 complications.
As the October 1 deadline for implementation of ICD-10 fast approaches, healthcare revenue cycle professionals are jittery that denials of claims filed using the new medical and diagnostic coding system will skyrocket.
An August survey by Navicure/Porter Research shows that an "overwhelming majority (94%) of participants" anticipates an immediate increase in their denial rate, with 56% of respondents citing ICD-10's impact on revenue and cash flow as their top concern.
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Patients want interoperability, and here's how they want it: 6 key findings
While the majority of patients want their providers to share data and are comfortable with platforms like health information exchanges, less than half report their providers are able to directly share records, according to a recent survey from EHR comparison platform Software Advice.
The survey sought to determine not only how providers currently share medical records, but also how patients want their providers to share medical records.
Here are six key findings from the survey.
1. Currently, 39 percent of patients said their provider directly sends medical records to other providers. The second most common method for sharing medical records was having the patient deliver them in person (25 percent).
2. However, more patients want their medical records directly exchanged between providers (46 percent) and fewer prefer in-person delivery (21 percent).
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September 28, 2015 | 5:44 PM | Carey Goldberg
Mass. Doctors Join To Vent Frustrations With Electronic Health Records
“Imagine,” said Dr. Steven J. Stack, president of the American Medical Association. “In a world where a 2-year-old can operate an iPhone, you have graduate-educated physicians brought to their knees by electronic health records.”
Has anyone ever summed up better the monumental frustrations that many doctors encounter when grappling with electronic medical records?
And those frustrations have only been growing as federal requirements for electronic medical records have kicked in and grown teeth — to the point that the AMA has now launched a campaign — called Break the Red Tape — to call for a pause on new medical-record rules.
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AHIMA Chief: 'Hospitals are Ready' for ICD-10
Scott Mace, for HealthLeaders Media , September 29, 2015
Lynne Thomas Gordon, CEO of the American Health Information Management Association, says high turnout at the organization's annual conference is an indication that hospitals feel "pretty confident we're ready to go. If not, I don't think we'd have anybody here."
Will ICD-10 be the Big Easy?
This week, all eyes are on New Orleans, where the American Health Information Management Association has gathered for its annual convention. The event will conclude mere hours before the cutover from ICD-9 to ICD-10 for hospitals—and the one-year grace period for physician practices to adjust to the new coding system.
On Tuesday I spoke briefly with AHIMA CEO Lynne Thomas Gordon here in New Orleans about the transition to ICD-10. The transcript below has been edited for clarity.
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Diagnostic Errors Fuel Health IT Safety Concerns
SEP 28, 2015 7:38am ET
With last week’s highly publicized Institute of Medicine report shining a light on electronic health records and the widespread problem of diagnostic errors, industry observers are hoping that Congress will reconsider funding a Health IT Safety Center that lawmakers have heretofore opposed.
The IOM report specifically called out EHRs for their contributing role in causing diagnostic errors, and provided health IT-related recommendations to improve the diagnosis process. While HIT has improved healthcare and patient safety, the technology “can also get ahead of our knowledge of how to use it,” argues Paul Epner, executive vice president of the Society to Improve Diagnosis in Medicine. “We still have to learn how to use all these tools,” according to Epner.
“Clinicians spend more time with the computer than talking to patients,” warns Hardeep Singh, M.D., a patient safety researcher at the Michael E. DeBakey VA Medical Center and Baylor College of Medicine. In particular, Singh expresses his concern that providers are “rushing through patient visits and quickly entering data into EHRs, with hardly having time to talk to patients about what their history is and what their physical exam looks like.”
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Epic EHR adds to UK hospital's financial mess
Posted on Sep 28, 2015
By Bernie Monegain, Editor-at-Large
The rollout of a $300M Epic EHR implementation at Cambridge University Hospitals in the UK is making a bad financial situation worse, according to news reports from across the pond.
Both CEO Keith M. McNeil and CFO Paul James of Cambridge have resigned, and the finances are under investigation.
"This is the first Epic EMR implementation in the UK and the resignations come amid increasing scrutiny of Cambridge's deteriorating financial condition," financial services firm Robert W. Baird wrote in a September 21 note to investors. "Several other UK hospitals intend to install Epic, but Papworth Hospital recently concluded Epic did not provide the best value."
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How APIs can improve health data sharing
September 28, 2015 | By Susan D. Hall
Gajen Sunthara, who spent a year as a Presidential Innovation Fellow with the Office of the National Coordinator for Health IT, says that patients must be at the center of the healthcare system and that application programming interfaces (APIs) can help, in a post to the Health IT Buzz Blog.
Sunthara (pictured) worked on applying APIs to improve data access, creating, among other things, a prototype personal health record (PHR) called myHealth API, which enables patients to aggregate their data from various providers across multiple data access points using the Fast Health Interoperability Resources (FHIR) framework. Sunthara previously served as principal software architect at the Innovation Acceleration Program at Boston Children's Hospital and wrote his master's thesis at Harvard on streamlining surgeon workflow using Google Glass, according to MedTech Boston.
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Health Care Is Increasingly Moving to the Cloud, but How Does Security Stack Up?
Monday, September 28, 2015
Like many hospital CIOs, John Halamka is obsessed with patient data security. For the last seven years, Halamka, who is CIO at Beth Israel Deaconess Medical Center, has shied away from embracing cloud service providers offering to host the hospital's mission-critical applications on their cloud computing platforms. To ensure security, Halamka built a private cloud that stores and distributes critical information across multiple data centers -- but that model is about to change.
This year Beth Israel is getting ready to transfer critical data, including the hospital's electronic health records, to the cloud computing platforms of Amazon Web Services.
"This year is a tipping point. We are in a proof of concept to move our EHR test-and-development environment to AWS, and if that works, we'll move the production environment to AWS," Halamka said.
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Enjoy!
David.
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