Saturday, May 13, 2017

Weekly Overseas Health IT Links – 13th May, 2017.

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.
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Prescription databases can play a role in reducing opioid abuse

Published May 04 2017, 7:26am EDT
In the war against rampant opioid abuse, physicians have a powerful weapon in their arsenal—state databases that track all prescriptions written for these addictive drugs.
Almost every state has implemented Prescription Drug Monitoring Programs (PDMPs), which record a patient’s opioid prescribing history. By leveraging these databases, doctors can access information to make an informed decision about whether patients are opioid abusers.
PDMPs collect and share data on prescriptions for controlled substances to flag suspicious prescribing and utilization. However, not all states require providers to access these kinds of databases prior to writing or filling a prescription.
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Health IT workforce trends: Employers value data analytics, security credentials

May 5, 2017 11:07am
Analytics and cybersecurity are two emerging skill sets in an increasingly specialized health IT job market.
The rapid evolution of health technology is reshaping the health IT workforce as employers place more emphasis on specialized skill sets while seeking job applicants with advanced degrees.
That’s not to say there isn’t still a market for midlevel positions. Employers are still overwhelmingly seeking candidates to fill in operations and medical record administration, according to a review of more than 450 active job postings on Indeed.com published in the Journal of AHIMA. More than 75% of the job postings reviewed in February into this category and most were for midlevel positions.
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AI seen as great equalizer in bringing services to the masses

Published May 05 2017, 3:54pm EDT
Artificial intelligence is being described as the third great revolution in business, following the Industrial Revolution and the Information Revolution. And if some industry observers are correct, it will have a transformative effect on consumers, business and government markets around the world.
According to the report “Bot.Me: A revolutionary partnership: How AI is pushing man and machine closer together” from PwC, “AI has the potential to become the great equalizer. Access to services that were traditionally reserved for a privileged few can be extended to the masses.”
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Why IT priorities could evolve in an era of reform

Published May 05 2017, 4:22pm EDT
The news this week in healthcare was dominated by the passage of a GOP bill to repeal and replace the Affordable Care Act. It became a spectacle of partisanship and visuals, from representatives admitting they hadn’t read the bill to a garish celebration on the lawn of the White House after the successful vote.
As most know, that celebration was a bit premature. To use a handy marathon analogy, congratulations—you’ve made it past the first mile. Only 25 more to go.
But it’s clear that the winds of change are blowing. As the Senate works on a version of a repeal-reform bill, it’s likely that there eventually will be some form of legislation that replaces Obamacare. If not, I’m not sure things will revert to anything resembling normal, since the GOP is intent on creating a toxic environment in which the ACA cannot survive.
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Patient access to health records: striving for the Swedish ideal

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2069 (Published 02 May 2017) Cite this as: BMJ 2017;357:j2069
  1. Stephen Armstrong, freelance journalist, London, UK
  1. stephen.armstrong@me.com
All patients in Sweden will shortly have access to their full medical records. Stephen Armstrong reports on the the country’s 20 year struggle to achieve this and what the UK can learn
This spring Stockholm, the last of Sweden’s 22 counties to implement patient accessible electronic health records, is rolling out the country’s Journalen patient portal service.1 The portal is part of the national e-health strategy, which states that “all residents from 16 years should by 2020 have access to all information documented in county funded health and dental care.2
Sweden is leading the way in offering all patients universal access to medical records—all its hospitals, primary care centres, and psychiatric facilities already use electronic health records. The figure in Europe is 65% overall and 81% in hospitals.3 By February 2017, 3 773 178 Swedes, or 37.9% of the population, had set up accounts.
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NHS Digital to move out of ‘ivory tower’, says Beverley Bryant

Article posted on: May 5, 2017
“We’re gonna deliver information technology and data (…), partner locally, move out of our ivory tower, make NHS Digital much more responsive and relevant to the services, helping local organisations to transform models of care and use information and technology, “ said Beverley Bryant, NHS Digital Director of Digital Experience
NHS Digital director emphasises need for collaboration between local and national levels to push the health IT agenda further
[London, UK] Giving a keynote speech on the second day of UK e-Health Week, Beverley Bryant, Director of Digital Experience and NHS Digital, emphasised NHS Digital has to move out of its ‘ivory tower’.
Bryant, who moved to NHS Digital after three years and a half at NHS England, said their vision is to simply ‘make health and care better’, placing emphasis on the importance of collaboration between national and local levels, adding they need to know what ‘professionals need on the ground’.
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Carolinas HealthCare IT chief: Interoperability will be solved in 5 to 6 years

Craig Richardville said the holy grail of widespread health information exchange will begin maturing quickly in a shorter period of time than many people expect.
May 03, 2017 04:21 PM
CHARLOTTE, NC – Carolinas HealthCare Systems Craig Richardville said the healthcare industry will achieve information interoperability faster than the financial services sector did.
“You’ll see that happening in our industry, quicker than the decades it took them,” Richardville, who is Carolinas Chief Information and Analytics Officer, said during an interview at his offices here. “Ours will be in probably half a dozen years, you’ll start seeing that really mature.”
As healthcare has been striving to make exchanging data more common interoperability is widely viewed as chief among the biggest technological, cultural and business challenges. 
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How to fix healthcare's greatest cybersecurity weakness: People

Governance, training and, yes, monitoring can go a long way to reducing a system’s risk, expert says.
May 03, 2017 12:17 PM
A healthcare organization’s workforce is its greatest cybersecurity threat, but there are reliable steps organizations can take to lessen the risks, said Kurt Long, founder and CEO of FairWarning, a cybersecurity firm that protects patient information in more than 8,000 healthcare facilities worldwide.
“People are the greatest vulnerability statistically, whether it’s the Verizon breach report, the IBM breach report, or any other survey being conducted, statistically it is obvious the workforce is untrained and vulnerable,” Long said. “Most of these breaches start by an inside user making a mistake. But 45 percent of all the breaches in the IBM breach report were malicious insiders. The solution is much more holistic than the industry currently thinks, and until we wrap our hands around the people problem, there is no amount of technology that is going to make a dent in breaches.”
Luckily, there are a variety of approaches that healthcare organizations can take to tackle the people problem.
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Patients Knows Best lets Surrey view single care record

Laura Stevens

2 May 2017
NHS organisations across Surrey have begun using patient-controlled personal health record technology to allow clinicians to view a single digital care record across four NHS trusts, GPs and four clinical commissioning group areas.
Within six months, clinicians working in Surrey will be able to see a shared integrated record from all the different health organisations using shared record technology supplied by Patients Know Best.
Once health professionals have begun using the shared PKB record the next step will be to extend it to patients as well.  The initiative is expected to eventually cover one million people across the county.
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Massachusetts doctor: End the 'shameful' practice of information blocking

May 4, 2017 3:14pm
Information blocking is "completely unacceptable and a huge distraction," writes one independent physician.
Independent physicians face plenty of challenges in an increasingly complex regulatory environment, but one Massachusetts pediatrician is becoming increasingly frustrated with an issue that prevents him from sharing patient information.
Information blocking—when healthcare vendors or organizations knowingly interfere with the exchange of electronic patient information—has become “completely unacceptable and a huge distraction,” wrote Peter Masucci, a pediatrician in Everett, Massachusetts, in an op-ed for STAT.
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Dignity Health fights sepsis with natural language processing, targeted alerts

May 4, 2017 10:23am
Dignity Health's Joseph Colorafi, M.D. discusses the system's analytics-driven approach to sepsis at the SAS Health Analytics Executive Forum.
At a Dignity Health hospital in Northern California, a woman who had just given birth was showing early signs of septic shock.
Although clinicians noted her elevated heart rate, many of the other indications remained undetectable. Instead, an algorithm picked up on those abnormalities and alerted the nurse on duty. After conferring with a physician, the patient was transferred to the ICU for treatment.
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Building the Healthcare System of the Future

May 1, 2017 1:41pm
Introduction
Healthcare in the United States is changing rapidly. An aging population has increased demand for services and the need to manage healthcare plans and benefits. Technology is becoming a major factor both in the delivery of healthcare and payment for services. Costs continue to soar, and payers are faced with the need to keep premiums low while providing adequate coverage.
Despite all of the attempts to lower healthcare costs with subsidized fees or renegotiated terms, the United States still has one of the highest per capita spends in the western world. Unfortunately, that spending has not produced better outcomes. This trend in healthcare spending and poor outcomes is unsustainable. The current economy cannot continue to spend more than it can sustain without having better quality and outcomes.
Multiple solutions are being put into play to help determine the future of healthcare. These ongoing policies will continue to evolve until there is a winning model that improves healthcare by creating quality and cost-effective outcomes. But one thing is for sure: the future of healthcare will focus on putting consumers back in charge of their health through implementing a requirement from the government to protect the payers’ outcomes, lower costs and increase care. This new approach will focus on the care of the patients rather than the costs of their claims.
Sponsored by Oracle
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Recordkeeping Stress Hurts Patient Care, Say Experts

Burden can be minimized through better use of health IT

WASHINGTON -- The healthcare system works best if patients aren't solely responsible for managing their health records and other data, several speakers said here at the Health Datapalooza meeting sponsored by Academy Health.
"You have a chronic illness or an acute illness, and all of a sudden -- on top of everything you have to do on top of living your life -- you have to track down your medical record, and [then there are] all the things you have to keep in your head to make sure you're getting value from the healthcare delivery system," said Jessica Sweeney-Platt, executive director of physician performance research at Athenahealth, a health information technology company based in Watertown, Mass., said at a panel discussion on Thursday.
"We have to figure out how to minimize the burden on patients to memorize all that, and serve it up to clinicians as it's available, in the right form and at the right time," she added. "That's the burden I feel strongly is within our power to solve. It's just a matter of lining up the right pieces."
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ONC launching Patient Matching Algorithm Challenge

Published May 03 2017, 7:20am EDT
Recognizing that the misidentification of patients remains a difficult problem for healthcare organizations, the Office of the National Coordinator for Health Information Technology is planning to launch its Patient Matching Algorithm Challenge early next month.
“There’s a lot of work going on with patient matching in the industry,” says Steve Posnack, director of the ONC Office of Standards and Technology. “But with all the matching that’s gone on, there are very few benchmarks that are publicly available … about how well the algorithms that people are using to do patient matching should perform.”
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Cerner picking up big business from small hospitals

New KLAS market share report also shows athenahealth hospital clients more than doubled in 2016.
May 02, 2017 02:07 PM
Small hospitals made for the majority of new business for Cerner this past year, according to a new KLAS report, due to the popularity of its easy-to-use CommunityWorks platform.
In fact, the KLAS report found many technology vendors are shifting strategies to the community hospital space, as providers with fewer than 200 beds accounted for nearly 80 percent of EHR buying decisions in 2016.
Epic continued its market growth, too, but mostly with larger hospitals and integrated delivery networks. More than half of IDN contracts went to Epic in 2016, according to KLAS. About one-quarter opted for Cerner, however, and one of those network contracts was for a consortium of 30 "microhospitals" of fewer than 15 beds, according to KLAS.
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David Blumenthal: It's time to treat digital health data like a natural resource

May 3, 2017 11:27am
Nurturing and protecting digital health databases will ensure data is used for common good, writes David Blumenthal.
Physicians may be feeling the burden of EHR data entry, but they are contributing to a broader ecosystem that will serve as the foundation for long-term medical innovation—as long as that ecosystem is protected. 
It may be time to start thinking of the vast collections of digital health data as a natural resource, wrote David Blumnethal, M.D., president of the Commonwealth Fund, in the Annals of Internal Medicine. And like most natural resources, those data sources need to be closely protected and nurtured to ensure they are used to advance medical care.
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HHS’s Price Affirms Commitment to Health Data Innovation

Health information technology and innovative uses of data are priorities for the Trump administration, which is committed to the free flow of electronic health-care data, HHS Secretary Tom Price said April 27.
The administration aims to give physicians incentives to use health IT and make it easier for electronic health systems to securely exchange information, also known as interoperability, Price said at Health Datapalooza, an annual health IT and data conference in Washington.
Price said health IT is crucial to democratizing medicine, and there shouldn’t be any roadblocks to letting patients access their health data. However, there must be more emphasis on reducing the physician burden associated with health IT implementation, he said.
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Why digital disruption is only starting in healthcare

Published May 03 2017, 4:30pm EDT
Disruption often is viewed as a positive noun in the business world. Particularly in healthcare, such disruption can result in increased understanding and enhanced outcomes, among other benefits.
Healthcare has clearly benefited from the digital technology disruption. Modern medicine, at a high level, leverages innovation for better diagnostics using X-rays, MRIs and numerous other scans, more comprehensive research and global collaboration, more agile testing and results processes, and thus, advanced comprehension of biology and disease that leads to improved treatment and prevention.
But as these disruptive forces rise and depend on digital technology, healthcare organizations will need to revamp IT approaches to manage the flow of secure transactional data and improve their ability to integrate information sources for big data initiatives.
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Mayo Clinic uses analytics to optimize laboratory testing

Published May 02 2017, 7:27am EDT
To help its providers know what laboratory tests to order and when, the Mayo Clinic is leveraging analytics to reduce test overutilization and unnecessary healthcare costs.
Inefficient clinical laboratory test utilization can not only increase costs but can negatively impact patient safety and quality of care, according to Daniel Boettcher, senior programmer and analyst at the Mayo Clinic’s laboratory in Rochester, Minnesota.
However, the Mayo Clinic has embraced clinical laboratory test utilization management to track provider ordering patterns to identify areas where performance can be improved and to prevent providers from ordering tests that don’t benefit patient outcomes.
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Machine learning can bring more intelligence to radiology

Published May 02 2017, 7:09am EDT
Machine learning is emerging as one of the key hopes to change the practice of radiology—the opportunity seems ripe, with rising calls for radiologists to demonstrate increased quality and more value, even as technology yields bigger datasets and more complexity.
But exactly how machine learning will impact the radiology profession—and healthcare in general—remains to be seen. It will just take time and experimentation with machine learning, some say.
Keith Dreyer, DO, likens the machine learning revolution to the promulgation of electricity, which originally was used simply for lighting, but eventually ushered in a host of helpful inventions—washing machines, dishwashers, air conditioners, televisions, computers—that were previously unimaginable.
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New clinical decision support software guidelines highlight keys to self-regulation

May 2, 2017 10:06am
New voluntary guidelines aim to keep CDS software firmly in a supportive role.
With the Food and Drug Administration adopting a limited role in regulating software that assists physicians with clinical decisions, a coalition of providers and developers released voluntary guidelines aimed at helping the industry self-regulate.
The 21st Century Cures Act excluded clinical decision support (CDS) software from FDA oversight as long as providers can review the information that is fed to them and make an independent decision. To that end, the Clinical Decision Support Coalition has released (PDF) draft voluntary guidelines to ensure CDS software remains as a support tool. The Coalition, which has previously called on the FDA to released case study guidance, is asking for public comments by July 1.
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Oncologists are skeptical of genomics now but see a promising future

May 2, 2017 11:46am
Oncologists say genetic testing will have an impact on cancer care in the next decade but voiced concern about coverage.
Oncologists have a complicated relationship with genetic testing. Many see the emerging technology as overpromoted and impractical for patients, but they also recognize the impact genetic testing will have over the next decade.
Approximately 7 in 10 oncologists believe genetic testing is very important or extremely important to oncology, but 55% also say genomic testing is overpromoted, according to a survey released by Medscape. Ninety percent of providers reported that less than half of their patients benefit from genetic testing currently.
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Why providers must do a better job protecting patient identities

Published May 02 2017, 4:52pm EDT
Swift technological advancements often force healthcare decision makers to evaluate competing solutions to determine which is the smartest investment with the strongest potential to maximize return on investment. A key criteria for healthcare technology investment evaluation is careful analysis of a technology platform’s ability to not only address current problems, but it’s flexibility to adapt.
Take the issue of patient identification in healthcare, for example. Most people believe this is limited to a hospital or doctor’s office registration desk, with patients providing their demographic information and filling out forms.
However, a quick look across the modern healthcare ecosystem indicates that patient identification along the care continuum has quickly evolved into playing an essential role in safeguarding patient data, providing safe and accurate care delivery, and ensuring high levels of data integrity.
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Rural Telehealth Growth Dramatic but Uneven

John Commins, May 2, 2017

Behavioral health visits account for 87% of Medicare's telemedicine billings. But there is a pronounced uneven distribution of services across states.

Depending upon which baseline you start at, and which state you're looking at, telemedicine use expanded significantly between 2004 and 2014, or not much at all.
While the overall use of telemedicine for mental health diagnosis and treatment in rural America remains very low (1.5%), a new study from Harvard Medical School and the RAND Corp. in the May issue of Health Affairs shows an average 45% jump per year in telemedicine visits among rural patients over the decade, with striking variation across states.
Four states had no such visits in 2014. In nine states, however, there were more than 25 telemedicine visits per 100 patients with serious mental illness. 
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Electronic OR Scheduling Linked to 33% Reduction in 'Weekend Effect'

Alexandra Wilson Pecci, May 2, 2017

The outcomes of patients who undergo non-elective surgery on weekends improve when hospitals use electronic operating room scheduling systems and bed-management systems.

Electronic medical record systems significantly improve outcomes for patients who undergo surgeries on weekends, asserts a Loyola Medicine research letter published in JAMA Surgery.
The so-called "weekend effect" of longer hospital stays, higher mortality rates, and ramped-up readmissions has been documented by this Loyola research team in the past.
It noted in a 2015 study that EHR/EMR adoption was the biggest single factor in reducing the weekend effect.
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myUHN gives patients real-time access to health records

  • May 01, 2017
By Jerry Zeidenberg
TORONTO – The University Health Network is steadily rolling out its myUHN Patient Portal to all patients at the organization’s four hospitals – Toronto General, Toronto Western, Princess Margaret Cancer Centre and the Toronto Rehab Institute. Unlike many other portals, test results and other information are posted as soon as they are available, giving patients their results in real-time.
“My patients are seeing their results even before I do,” said Dr. Richard Tsang, a radiation oncologist at UHN. But he said that’s a good development, because patients want their results as soon as possible.
As well, it can save them a lot of time and trouble. “We don’t want them coming in just for test results,” he said.
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Why EHR training can make or break an implementation

Published April 28 2017, 3:51pm EDT
Technical training for an EHR go-live is often hectic, arduous and occurs at the very end of implementation—when end-user nerves are most frazzled, IT expenses are highest and, often, the build is not complete.
Yet much of an organization’s success with their EHR hinges upon the effectiveness of system training. A decade of EHR implementations have taught me one thing—training never stops, it just changes form.
Initial technical training for an EHR must shift to ongoing, long-term education. Having a steady training team in place ensures coverage for day-to-day questions, new-hire training, remedial education and EHR updates. However, for long-term EHR training teams to be effective, executive management must keep three important points in mind:
  • Technical training is very different than long-term education: a different skill set is needed
  • Training is not complete after initial EHR training: like the build team, the training team requires a long-term investment
  • Training occurs in a variety of forms: no single approach works for all learners
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VA leveraging health IT to address its 5 top priorities

Published May 01 2017, 7:13am EDT
Healthcare information technology is crucial to the Department of Veterans Affairs achieving its five strategic priorities, according to Poonam Alaigh, MD, the VA’s acting under secretary for health.
Alaigh told an audience on Friday at the 2017 Health Datapalooza conference in Washington that VA Secretary David Shulkin, MD, has laid out five priorities for the agency: greater choice, modernizing the healthcare delivery system, efficiency, timeliness of care and suicide prevention.
 “Each of those five priorities has a key health information technology piece,” said Alaigh. “There is no better time than right now to be at the VA. We are embarking on such an amazing journey around using data analytics, health services research, bench research and clinical trials in order to help ensure that our veterans are getting the best possible care, the highest quality of care, and the timeliness of care.”
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Readers pan all aspects of Trump's first 100 days dealing with healthcare

Healthcare IT News readers largely booed Trump's choice of appointees, communication by HHS and his attempt at replacing Obamacare.
April 28, 2017
03:01 PM
We asked our audience of healthcare insiders about President Trump’s work on healthcare since he took office in January. Representing many political views from around the country, the majority of responses (coincidentally, we received 100 replies to this survey) were in agreement that the first 100 days of Trump’s presidency lacked clarity on healthcare’s future.
A president is typically judged on his early days in the White House, yet GOP leadership reports now that the first 100 days were too ambitious for major healthcare reform.
In rating Trump’s healthcare appointees on a scale of 1 to 5, 60 percent of respondents gave Trump the lowest score.
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ONC releases interoperability measurement framework

May 1, 2017 11:28am
A new framework released by ONC aims to measure interoperability across the country.
Building on its interoperability roadmap, the Office of the National Coordinator for Health IT (ONC) has released a framework for measuring nationwide progress.
The proposed framework focuses on two key issues: implementation of interoperability standards within health IT products, and how end users such as health systems and providers customize those standards to meet interoperability needs.
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71% of Healthcare Providers Use Telehealth, Telemedicine Tools

More than 70 percent of healthcare providers are using telehealth or telemedicine tools to connect with patients in the inpatient and ambulatory settings.

Thomas Beaton

April 28, 2017 - Provider telemedicine use has risen to an adoption rate of 71 percent, according to new research from HIMSS Analytics.
The research, presented in two separate studies that analyzed inpatient and outpatient telemedicine, highlighted a jump in growth of usage over a three-year period.
“Adoption of telemedicine solutions or services has surged since this study was first conducted in 2014 from roughly 54 percent in 2014 to 71 percent in 2017,” said the reports. “After consistently growing 3.5 percent annually, based on study results adoption has increased roughly 9 percent since 2016.”
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Some practices still don't run analytics on EHR data

MGMA survey finds mixed approach to interpreting, aggregating or organizing their records.
April 28, 2017 01:54 PM
A new survey from MGMA has found that medical practices have mixed approaches to analyzing their electronic health record data.
The survey found 31 percent said they use their EHR analytics capabilities to the fullest extent; another 31 percent said they deploy a combination of EHR analytics along with help from an external vendor partner; 22 percent said they use some of their EHR's analytic capabilities; and 5 percent said they rely on an external vendor.
But a not-insubstantial 11 percent of survey-takers said they don’t perform analytics at all on their EHR data, according to the poll.
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Data center market suffers as more organizations opt for the cloud

Published May 01 2017, 3:27pm EDT
Cloud computing continues to take a bite out of the data center market, as new projections from Gartner Inc. show barely any spending growth for the year.
Worldwide IT spending on the data center system segment is expected to grow by only 0.3 percent this year, Gartner says. Despite that low number, it is better news that last year, which actually saw negative growth.
 “We are seeing a shift in who is buying servers and who they are buying them from,” explained John-David Lovelock, research vice president at Gartner. “Enterprises are moving away from buying servers from the traditional vendors and instead renting server power in the cloud from companies such as Amazon, Google and Microsoft. This has created a reduction in spending on servers which is impacting the overall data center system segment.”
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Why effective healthcare IT can reduce hospital costs

Published May 01 2017, 3:11pm EDT
The focus of federal efforts to incentivize healthcare IT adoption has primarily been on electronic health records (EHRs), which are oriented around hospitals and physician offices. Moving forward, EHRs will remain the anchor technology as data from other devices and applications flows in and becomes both available and comparable.
It’s become readily apparent that healthcare IT is much broader than EHRs alone. Increasingly, healthcare IT is a web of interconnected devices and applications that can feed data to the EHR. So, instead of focusing intently on how healthcare IT can alter inpatient safety and quality, we’re better off looking at technology as all the tools patients and doctors can use to maintain and improve health.
Why might this shift in focus be important? One obvious reason is that hospital and emergency care are expensive. The average cost for a single inpatient day in the United States is more than $2,200. The average cost of an ER visit is about the same—$2,168—without being admitted.
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Enjoy!
David.

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