Saturday, February 13, 2016

Weekly Overseas Health IT Links - 13th February, 2016.

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.

App keeps family, friends informed during surgery

Published February 04 2016, 8:10pm EST
Northwest Michigan Surgery Center in Traverse City is a busy place, averaging about 85 cases a day. That’s a lot of family and friends wondering how their patient is doing, whether at the center or elsewhere.
For those waiting at the center, there is a screen outside the cafeteria that tracks patients (first name only) through the various phases of a surgical procedure. In the past, some people would mill around near the screen, but most would stay in the waiting room, which had more comfortable chairs. The physical layout of the large waiting room wasn’t conducive for video display of information, so nurses and staff frequently were asked for updates on patients, says LoAnn Vande Leest, CEO at the center.

John Halamka to hand out health IT report card at HIMSS16, gives average grade to sector

If only the EHRs didn't run on 1990s technology, the health IT expert says ahead of his keynote in Las Vegas later this month.
February 04, 2016 08:33 PM
By John Halamka’s standards, healthcare IT is pretty average. In fact, he’d only give the sector a B-minus.
“At home you live in 2016 with $2.00 apps installed instantly on your mobile devices using federated security credentials from Facebook or Google,” he said. “At the office, you turn on your 1990’s architecture computer running a 1990’s operating system to use your 1990’s era EHR.”
Over the last decade many changes have occurred politically, clinically and economically that have impacted healthcare information technology. So as the healthcare industry looks to "reset" again, Halamka plans to take a hard look at where the industry stands at HIMSS16 later this month.

The OpenNotes movement: What comes next

February 5, 2016 | By Susan D. Hall
After a recent $10 million infusion of cash into the OpenNotes movement, a post on the Robert Wood Johnson Foundation's Culture of Health blog outlines the path forward over the next three years.
More than 5 million patients now have access to their doctors' notes, including patients served by Boston Children's Hospital, Cleveland Clinic, Kaiser Permanente Northwest, Mayo Clinic, MD Anderson Cancer Center, the entire Veterans Administration and many others, according to a graphic.

KLAS Names Interoperability Measurement Advisory Team

February 4, 2016
by David Raths
Last October Utah-based research firm KLAS brought together executives of health IT solutions companies and provider organizations to work toward a viable measurement tool of interoperability. On Feb. 4 KLAS announced the establishment of an Interoperability Measurement Advisory Team to expand on that work.
The advisory team’s mission statement is to effect accelerated advancement in the creation, optimization, and ultimate adoption of impactful interoperability through the measurement of provider experiences. The team will provide insight into and oversight of KLAS’ efforts to measure industry progress, focused especially on provider satisfaction with the utility of exchanged information and vendor support and progress. 

Tracking Progress of 5 Major EHR Interoperability Initiatives

By Sara Heath on February 04, 2016

Through various different initiatives, EHR interoperability is taking off across the healthcare industry.

As the industry pushes toward better EHR interoperability, several different projects have emerged. Between privately-funded projects aimed at increasing data exchange and government initiatives using interoperability to achieve a larger end, interoperability has been thrust into the limelight of health IT innovation. has put together a round-up of some of the most notable health IT interoperability initiatives, providing background on the progress of those initiatives.
Since the start of 2016, Carequality has been busy adding framework members in several major EHR vendors including athenahealth, eClinicalWorks, Epic Systems, NextGen Healthcare, and Surescripts.

New IT system? No better time to adjust workflow

Published February 03 2016, 2:49pm EST
I distinctly remember a hallway comment from a clinical leader years ago that went like this: “Edith, we need to get together next week to talk about a new system; but don’t worry, because we want one just like our current one.”
I challenged him with the thought that, if this is truly the case, then why don’t we avoid the arduous budget approval process and save our money for something else. Why was he looking for a new system if everything was working well and he did not want to use technology to achieve any better patient, staff or financial outcomes?

Health IT mistakes can hurt patient safety

Published February 03 2016, 2:49pm EST
Despite the potential for health information technology to improve patient outcomes, adverse events associated with the use of health IT can cause extensive harm and are encountered across all healthcare settings.
That’s the finding of a new analysis of electronic health record-related harm in cases submitted to a large database of malpractice suits and claims maintained by CRICO, an evidence-based risk management group of companies owned by the Harvard medical community.
Researchers identified 248 malpractice cases showing serious unintended consequences from the use of EHRs, representing less than 1 percent of all cases in the database. Of cases with causes related to EHRs, 80 percent involved moderate or severe harm. EHR errors were found to occur more frequently in ambulatory settings than in inpatient settings. Although ambulatory care accounted for more than half of the cases, deaths were more likely to occur in inpatient settings.

Amid surge in malpractice lawsuits, EHRs often targeted in litigation, attorney says

Providers often wind up defending their electronic health records, rather than what got them sued in the first place, Mary Re Knack will explain at HIMSS16
February 04, 2016
02:17 PM
As if healthcare executives don't have enough worries about implementing electronic health records, yet another issue is starting to ramp up.
"What's been happening more frequently in the last few years is that certain plaintiffs' lawyers – a kind of group of them who communicate with each other – have started to see the medical record as an opportunity for litigation," said Mary Re Knack, a Seattle-based attorney for the firm Ogden Murphy Wallace.
Knack will be presenting an exploration of these emerging litigation troubles in the session "Just Press Print: Challenges in Producing EHRs in Litigation" with colleague Elana R. Zana at HIMSS16, beginning in late February.

Ireland consults public on identifier

Lyn Whitfield
3 February 2016
Ireland’s Health Service Executive has launched a public consultation on the privacy implications of creating a unique health identifier, similar to the NHS Number.
A privacy impact assessment has been issued that outlines the purpose of the Individual Health Identifier and discusses some of the potential privacy risks.
Members of the public are being asked for their views on whether the benefits and risks have been correctly identified, and whether proposed safeguards are adequate.

Study: Use of OpenEHR can improve standardization of common data elements

February 2, 2016 | By Marla Durben Hirsch
Advanced modeling may be able to apply the OpenEHR archetype to improve data sharing among disparate common data elements (CDEs), according to an article in the Journal of the American Medical Informatics Association (JAMIA).
Clinical research is moving to electronic data capture and e-clinical trials. However, the CDEs, which are used to standardize individual data entry or data fields in electronic health records, have a "poor" level of standardization among different EHR systems, which makes it difficult to harmonize the data and conduct clinical research across multiple institutions.

How EHRs can improve planning for emergency care 'frequent fliers'

February 4, 2016 | By Susan D. Hall
Medicaid "frequent flier" patients to the emergency department have different characteristics than infrequent ED visitors, which call for different strategies, according to research published by Big Data.
The researchers used EHR records to comb through potential factors related to revisits within 72 hours among Medicaid patients at Albany (N.Y.) Medical Center over two years. From more than 15,000 factors, including primary and secondary ICD-9-CM codes, patient demographics and more, they selected 385 factors for statistical analysis.

Clinicians criticize poor workflow, interoperability of EHRs

February 4, 2016 | By Dan Bowman
Clinician organization leaders aired their grievances about electronic health records and the Meaningful Use program Wednesday at the eHealth Initiative's annual conference in the District of Columbia.
American Medical Association President Steven Stack (pictured), American Nurses Association President Pamela Cipriano and American Academy of Physician Assistants President Jeffery Katz all shared their thoughts on the tools and the program, noting that while they understand federal officials weren't purposely trying to hamstring providers, workflow and morale have suffered.
"None of us … want to be the whiners and the complainers, we really, really don't," Stack said. "But we are very frustrated. … If we don't tell you what it's like, then there continues to be a propagation of this disconnect. I think there are a lot of people who think they are providing tools that are awesome for us. But they're not awesome in their current iteration, the way they're affecting what we do, and it's burning out our professionals."

Fewer than 25% of CIOs part of executive teams: 4 key report takeaways

Written by Max Green | February 03, 2016
The explosion in digital health innovations like cloud, mobile and big data analytics has resulted in nearly half of healthcare life sciences firms hiring CIOs in the past three years, according to a new report from the IMS Institute for Healthcare Informatics. At the same time, the core competencies CIOs are expected to bring to the job are changing.

Lifting telemedicine limits would save Medicare $1.8B over 10 years

Remote patient consultations and monitoring would strengthen the patient-physician relationship

Computerworld | Feb 3, 2016 2:13 PM PT
Reimbursing physicians for consulting with and monitoring Medicare patients at home could yield significant savings, according to a new study spurred by recently proposed legislation.
Medicare fee for service (FFS) already allows reimbursement for telehealth services provided to patients at rural area health clinics, but not from the patient's home.
When writing your resume, make sure you sell yourself, rather than present a long list of job

You’ve been hacked: How to recover from the nightmare

Published February 02 2016, 2:45pm EST
As a healthcare CIO, you’ve been putting out various fires today and trying to make progress on several initiatives. That all changed a minute ago; now, you’re in free fall.
Your top security officer has just shared the worst possible news; despite everyone’s best efforts, a hacker found a backdoor to the network and accessed records. The damage report’s coming soon, but it looks like information from thousands of patients was accessed.
It’s a horrific scenario that, unfortunately, is becoming more common with each passing year. Data from the Department of Health and Human Services and its Office of Civil Rights show 56 large hacks of healthcare organizations last year, in which more than 500 healthcare records were accessed. That’s nearly six times more than the number of large hacks reported to HHS/OCR in 2010.

HHS: Privacy laws don't bar fraud victims from seeing thieves' medical data

February 3, 2016 | By Susan D. Hall
People who have their identities stolen have the right to review and correct their own medical records--including taking a look at medical records of the thieves themselves, the Obama administration has said.
Some victims of medical identity theft have been thwarted in their efforts to make corrections to their own records because the thieves' medical data, which is now folded into theirs, is protected by federal privacy law, according to a story in The Wall Street Journal.
The administration outlined the policy in a letter to the Senate Health, Education, Labor and Pensions Committee (HELP). Republican members of the committee have criticized the president as not doing enough to protect consumers.

Provider Burnout Increasing Due to Meaningful Use Burdens

By Sara Heath on February 02, 2016

Almost 90% of physicians have experienced provider burnout, and regulations like meaningful use might be to blame.

An overwhelming majority of physicians have experienced some sort of provider burnout, in large part due to increasing provider burdens such as meaningful use.
According to a recent study from Studer Group, a heaping 90 percent of physicians have felt provider burnout, and nearly two thirds of them say the burnout sometimes pushes them to consider leaving medicine.
This provider burnout is naturally caused by increasing provider burdens, like over compensating for low staffing levels and keeping up with the fast pace of the hospital. Providers also cite regulatory changes like the shift to ICD-10 and meaningful use requirements as major causes for provider burnout.
Feb 2, 2016 @ 07:59 AM

Health On-Demand Attracts $1B In Investments

The move to make the healthcare system a digital-first industry as Uber and Lyft have done for U.S. transportation will trigger a quadrupling to $1 billion the projected venture capital investment in on-demand health products this year.
A new report from Accenture says on-demand healthcare investment will grow from $250 million today to more than $1 billion by 2017 . Already, two of the top 10 venture-backed on-demand companies are telemedicine firms Teladoc (TDOC) and privately held American Well, which link doctors and patients via video for consultations.
“This is heavily focused on consumers,” Brian Kalis, Accenture’s managing director of digital health said in an interview. On-demand companies and their venture backers see consumers wanting “convenience, simplicity and speed and they are trying to bring this into healthcare,” Kalis added.

Telemedicine Advances Faster Than States Can Keep Up

The explosion of online health-care apps and providers has forced states to face tough questions -- many of which they have yet to find an answer to.

by Mattie Quinn | February 2016
At Doctor on Demand, a popular online health site, patients can videoconference with physicians on a host of maladies, from skin rashes and flu diagnoses to getting a prescription for an eye infection. On Maven, a telemedicine app targeted to women, nurse practitioners chat with patients on issues such as birth control, breast feeding and postpartum depression. Opternative offers online eye exams that it says are just as accurate as in-person tests. It’s a boom time for telehealth. Just as smartphone apps have revolutionized ride-hailing and apartment-sharing, telemedicine technology is upending health care.
States have been playing catch-up. As recently as 2011, only 11 states had telehealth parity laws, which require that insurers reimburse telehealth providers exactly as they would for an in-person visit. Today, 29 states and the District of Columbia have parity laws. In those jurisdictions, if a patient with a sore throat wants to confirm she has a strep infection and receive a prescription for antibiotics, it makes no difference to insurance companies whether the visit occurs over the computer or in an office. Forty-eight state Medicaid programs (every state but Connecticut and Rhode Island) offer some form of coverage for telemedicine. Congress is expected to take up legislation this year that would expand telehealth coverage for Medicare enrollees.

eHealth Ireland progress report - 365 days since launch of new health initiative

365 days since the launch of eHealth Ireland, Chief Clinical Information Officer Yvonne Goff writes an exclusive progress report

By Yvonne Goff, eHealth Ireland Chief Clinical Information Officer | 3 February 2016 | CIO UK

Three hundred and sixty five days, a big number in any role. When taking up the role of CIO in Ireland Richard Corbridge was reminded by a commentator on CIO UK that the average tenure of a CIO in 2015 was just over three years; now more than a year into the role, in early January 2016 we held a showcase of all that has been delivered in those 12 months in Ireland. What is fascinating though is making that showcase 'real' for ministers and health leaders means that some of the more important back-office items, the really challenging items for a CIO in a new post was barely touched upon.
Corbridge was the first CIO for health in Ireland, the first time the health service had enabled the concepts of technology in health to have a seat at the board of executives, to truly impact upon the direction of a reformed health service.
The republic of Ireland has a population of around 4.9 million people, the health service is around 109,000 and the newly formed office of the CIO has a very lean 288 staff. The Irish health system has learnt the hard way, like many others, the wrong way, how not to implement technology into health. A significant IT project had publicly been seen to fail in the late 90s burning public and political will to invest in public sector health and in particular health IT.

Medicare to allow wider use of data sets for analysis

Published February 02 2016, 5:45am EST
A new Medicare effort to expand the availability of its data sets—and allow organizations to sell analyzes of that data--also should increase the number of organizations authorized to use the information.
In recent years, CMS has made data sets available to “qualified entities” in its Medicare Data Sharing for Performance Measurement Program, covering home health, durable medical equipment and hospital/physician utilization and payment rates, as well as prescription drug prescribing and patient cost patterns, among other information. Thirteen organizations have applied and been approved to be a qualified entity.
Now, CMS is going further, enabling not just use of its data but the selling of analyses based on the data. Data sold may not include protected health information.

Hackers accessed medical records of 1 in 3 Americans in 2015

Published February 01 2016, 2:02pm EST
Healthcare records for one in three Americans were breached last year, with records of nearly 112 million people affected by hackers, compared with only about 1.8 million individuals in 2014.
That’s the finding of cybersecurity vendor Bitglass, which did a data analysis of the breach disclosure database maintained by the Department of Health and Human Services and required by HIPAA.
Overall, 113 million Americans fell victim to all forms of health data breaches in 2015, compared with just 12.5 million in 2014. Large-scale hacks represented 98 percent of data breaches in 2015; most notably last year’s cyber attack on Anthem exposed nearly 79 million records, and Premera Blue Cross records were compromised, affecting 11 million individuals. Both were the result of phishing attacks.

Medical device security research on the upswing

February 2, 2016 | By Susan D. Hall
Healthcare professionals should look for an uptick in cybersecurity research for medical devices during 2016, security researcher Billy Rios says in an interview with HealthcareInfoSecurity.
Rios, founder of the independent security research and services firm Whitescope, says he's been contacted by an array of people wanting to get involved--people who in the past have not been focused on healthcare security research.
He expects the result to be more advisories from the U.S. Food and Drug Administration, especially along the lines of its warnings about infusion pumps, but also advisories from the Department of Homeland Security.

Health IT outsourcing to grow to $68.3B by 2020

February 2, 2016 | By Katie Dvorak
Outsourcing for healthcare technology will grow in the next four years, and is set to reach $68.3 billion by 2020, according a report from Everest Group.
Such growth will be propelled by providers looking to make up "for their historical lag in technology adoption," Abhishek Singh, practice director at Everest Group, said in an announcement.
In addition, providers will need to increase IT investments to meet regulatory requirements, and adapt to changes in the industry such as the convergence of payer-provider groups and the push for a more consumer-centered experience.

How Managing Referrals Saved One Hospital $1.2 Million

Scott Mace, for HealthLeaders Media , February 2, 2016

Lancaster Regional Medical Center's EHR could not produce a usable summary-of-care document—until it brought in software that generates and tracks referral options. In two years, out-of-network leakage is down 20% and savings exceed $1 million.

When you boil down the care coordination problem at the heart of population health, it's all about the referral workflow.
I would be so bold to say that any population health technology offered to providers which does not manage to insert itself into the referral workflow of those providers is probably doomed to failure.

HIT Enters 'Post-EHR Era'

John Commins, for HealthLeaders Media , February 2, 2016

A drop in the percentage of IT budgets that is directed toward electronic health records systems signals a shift in focus. Now it's on broader business problems and on operational efficiencies, research suggests.

Hospital health information technology budgets are still growing, but the focus has shifted from meaningful use benchmarks and big electronic medical records projects toward business analytics, mobile services, and cloud-based technologies, a new survey shows.
Judy Hanover, research director for IDC Health Insights, the Framingham, MA-based research firm that conducted the survey, says hospitals have entered a "post-EHR, post-Meaningful Use era."

Epic shift: Demand for cloud EHR service is soaring

Published February 01 2016, 5:45am EST
When Epic Systems announced that it was buying a Mayo Clinic data center for $46 million, it put the health IT vendor’s growing data hosting business into the spotlight.
The electronic health record giant offers both on-premise and hosted data solutions for its customers. That type of hybrid business model is an absolute necessity in today’s demanding health data management environment, says Epic President Carl Dvorak.
Epic's strategy is to provide healthcare organizations with the most flexible and cost-effective options, regardless of whether Epic or customers themselves manage their IT infrastructure.
"There is not just one way to do healthcare, and there is not just one way to do an EHR," contends Dvorak. "We provide options for our customers, be it on premise, hosted, backup hosted, or hosting data for an ACO or other consortium."

Hospitals coming under increasing hack attacks

Published February 01 2016, 5:46am EST
Phishing created big news in healthcare last year – the really bad kind.
This approach for gaining nefarious access to network credentials was reported to be the cause of two of the biggest attacks reported in the healthcare industry last year – the hack of 78.8 million identities from Anthem, and an additional 11 million identities hacked in a breach at Premera.
Hacking or IT incidents resulted in the release of protected health information of nearly 112 million individuals, about 65 times the number of such incidents last year.
While the hacks reported at Anthem and Premera accounted for the lion’s share of those numbers last year, hackers are using phishing gambits more widely, raising the need for healthcare organizations to ensure that employees and staff are aware of the risks.

Zika virus outbreak makes disease surveillance a critical healthcare IT tool, expert says

To lessen the damage of Zika or any virus, electronic communication between hospitals and health departments is key.
February 01, 2016 04:35 PM
As the Zika virus spreads from South America to the United States, epidemiologist and public health expert Christine Hockett says disease surveillance technology is key to protecting against it.
Keeping open lines of electronic communication between hospitals and their state and local health agencies is critical as those departments "collect and analyze disease counts and monitor how disease spreads throughout a community or geographic location," said Hockett, who works for Xerox-owned Consilience.
Zika, spread to people through mosquito bites, is currently most prevalent in South America. In response, the U.S. Centers for Disease Control and Prevention issued a travel alert for U.S. citizens traveling to regions where virus transmission is ongoing.

IT budgets growing, but not to support EHRs

February 1, 2016 | By Katie Dvorak
IT budgets continue to grow at hospitals and health systems--but that growth is not because of funds needed for electronic health records, according to an IDC Health Insights report.
The fact that only 25 percent of providers responding to the survey said that their budgets were growing because of EHRs shows the industry is in the "post-EHR era," according to an announcement from IDC Health Insights.
Forty percent of providers said their budgets are still growing, with many using the funds to expand mobile and analytics use in the cloud. In addition, "comfort levels" when it comes to cloud tech are growing, the report finds. About 40 percent of respondents said they were more comfortable with the cloud in 2015 than the year before.

Wearables Can Help People With Heart Conditions - If Only They’d Wear Them

By Eric Wicklund on January 29, 2016

A new survey finds that three-quarters of people with heart disease are finding value in activity trackers, but few are using them in the first place.

A new survey finds that people with heart disease can benefit from activity trackers and other mHealth devices. Few, however, are actually using them.
According to HealthMine, three-quarters of people with known heart disease and/or risk said the activity tracker they’re using is helping them. However, of the 501 people surveyed this month, only 27 percent are using trackers, and only 16 percent are using them to manage their heart health.
 “Being connected to your health data can make a difference,” said Bryce Williams, CEO of the Dallas-based consumer engagement technology company, in remarks accompanying the survey’s results. “Millions of wearable fitness tracking devices will be incorporated into wellness programs over the next few years. But they need to tie into a larger, clinically-based strategy to help consumers know where they stand with their health, what they need to do and stay motivated to do it.”

Flint doctor used Epic Systems records to expose lead crisis

The pediatrician who brought the water crisis in Flint, Michigan, to public attention used a Wisconsin tool to do so: Epic Systems’ electronic medical records.
Dr. Mona Hanna-Attisha, of Hurley Medical Center in Flint, analyzed confidential data from blood tests on children stored in software designed by Verona-based Epic Systems Corp.
She and her colleagues discovered that the percentage of Flint children with unsafe levels of lead in their blood doubled — and nearly tripled in the inner city — after the city, under state management, switched its water supply in April 2014.
“If we did not have Epic, if we did not have (electronic medical records), if we were still on paper, it would have taken forever to get these results,” Hanna-Attisha said.


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