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Posted on Dec 06, 2013
By Erin McCann, Associate Editor
Part of moving forward and progressing with health IT initiatives involves proactively setting new goals and establishing a roadmap for the future. The Workgroup for Electronic Data Interchange Foundation has taken this to task by releasing its 2013 report that puts forth recommendations for the health IT industry over the next decade.
Report officials outline 10 recommendations in four critical areas of focus including patient engagement, payment models, data exchange and interoperability and innovative encounter models.
"These recommendations should serve as a catalyst and call-to-action to all stakeholders to truly help implement the health IT infrastructure that our nation will need in the future, both short-term and long-term," the report reads. "Much rides on the success of these recommendations."
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Posted on Dec 06, 2013
By Bernie Monegain, Editor
Cerner Corp., one of the top EHR vendors in the country, is teaming up with Claritas Genomics to advance personalized medicine by building tools and connectivity that will better integrate next-generation, sequence-based diagnostic testing into clinical practice.
The relationship with Cerner will enable Claritas to tap into an existing, scalable computing infrastructure that integrates ordering of genomic sequencing tests, laboratory processing, results interpretation, return of results to the clinician and incorporation of the result in the patient's electronic medical record, executives of both companies announced in a Dec. 5 news release.
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Posted: December 5, 2013 - 1:45 pm ET
The report identifies how today's technology creates new opportunities to improve efficiency in the healthcare system and lower the cost of care. The report also looked at the challenges faced by the industry in applying these new technologies.
More than 200 volunteers from the healthcare industry and government worked on the project, according to Reston, Va.-based WEDI. The workgroup was founded in 1991 by then-HHS Secretary Dr. Louis Sullivan and was designated as a health IT adviser to HHS by the Health Insurance Portability and Accountability Act of 1996. Its 1993 recommendations led to inclusion of the “administrative simplification” section of HIPAA, which includes the “transactions and code sets” provisions, an attempt to bring standardization to electronic healthcare transactions.
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Posted on Dec 06, 2013
By Tom Sullivan, Editor, Government Health IT
A joint CMS and ONC blog post today divulges the government's intentions to extend the timeline for meaningful use Stages 2 and 3.
“Under the revised schedule, Stage 2 would be extended through 2016 and Stage 3 would begin in 2017 for those providers that have completed at least two years in Stage 2,” explained acting national coordinator Jacob Reider, MD, and Rod Tagalicod, director of the CMS office of health standards and services.
“The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3," they write.
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12/5/2013 09:45 AM
Doctors must capitalize on patient curiosity about their own medical records.
For generations, doctors have been saying we want our patients to be more involved in their care, since we know the value engaged patients play in improving outcomes for many preventable illnesses, from heart disease to diabetes. But today, most doctors are not adequately using an available tool to help patients take ownership of their care: the electronic medical record (EMR).
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- December 5, 2013, 7:12 PM ET
REDWOOD CITY, CALIF. — Kaiser Permanente’s use of data analytics is helping it lower hospital mortality rates and look for ways to diagnose illnesses earlier. John Mattison, chief medical information officer at Kaiser spoke, Thursday, at VentureBeat’s Data Science Summit in Silicon Valley. Dr. Mattison predicts that by the year 2020, ten times more medical research will be generated by analyzing vast quantities of medical data than by conventional models of clinical research.
Over the past several years, Kaiser Permanente’s hospitals in southern California – the region with the most members — have enjoyed a lower mortality rate than the national average, according to data from the Centers for Medicare and Medicaid Services. “Today you have a 26% lower chance of dying in one of our hospitals than you do in other hospitals,” said Dr. Mattison, adding that Kaiser is starting to lower its mortality rate much faster than the national average. “A lot of this is directly rated to how we use data and integrate data,” he said.
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- December 5, 2013, 10:32 AM ET
University of Pittsburgh Medical Center has slashed readmission rates by 37% since it began using analytics to predict which patients were more likely to be readmitted to the hospital within 30 days.
That represents considerable savings for the hospital in terms of providing urgent care, let alone saving the hospital from potential penalties levied by the Centers for Medicare and Medicaid Services for failing to lower those rates.
The trouble for most hospitals is that they’re geared up for the “average patient,” whereas no one is actually an average patient. The role of analytics at UPMC is to determine most precisely which course of treatment will be most effective for each individual.
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When front line clinicians confront a clinical mishap or unsafe condition in EHR-enabled healthcare settings (such as a medication error or a missed diagnosis) they may not connect the clinical event with how EHR use could have helped prevent it, how misuse or failure to use EHR functionality as intended contributed to the problem, or how weaknesses in EHR configuration, interfaces, or usability contributed.
To help clinicians and other EHR users address health IT-related safety issues, we have posted a guide and slide deck [PDF - 2.7 MB] [PPTX – 3.0 MB] called How to Identify and Address Unsafe Conditions Associated with Health IT, developed by ECRI Institute under an ONC contract. The guide aims to help healthcare organizations and Patient Safety Organizations (and perhaps health IT technology developers, industry professional associations, and risk management and liability insurance companies) improve reporting of unsafe conditions associated with health IT, EHRs in particular.
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Posted on Dec 04, 2013
By Jeff Rowe, Contributing Writer
Unless you’ve just beamed in from another planet, you know there’s a bit of a debate underway about the current state and future of certain healthcare reform efforts. But when it comes specifically to the health IT transition, some stakeholders are still feeling downright upbeat.
As Greg Chittim, senior director of Arcadia Solutions, sees it, the first real wave of optimism about health IT came with the HITECH Act, "and the realization that the technology was at a level that people had a reason to be optimistic about how IT could change healthcare."
While Chittim says that first wave has passed, and many people have begun to ask, "What’s next?," he thinks that "the next 12 months will determine whether our overall optimism over health IT will continue or not."
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December 5, 2013 | By Dan Bowman
Intensive care unit telehealth technology helped to improve survival rates of ICU patients and speed both ICU and hospital discharges, according to research published Thursday in CHEST Journal.
For the study, Craig Lilly, Director of the eICU Program at Worcester, Mass.-based UMass Memorial Medical Center, and a team of researchers examined the impact of tele-ICU technology across 56 intensive care units, 32 hospitals and 19 health systems over a five-year period. Overall, they found that patients who were cared for by hospitals that used the technology were 26 percent more likely than those that received usual ICU care to survive the ICU; additionally such patients were 16 ercent more likely to survive their hospitalization.
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Scott Mace, for HealthLeaders Media , December 6, 2013
Patient survival of ICUs is 26% more likely when backed by eICU services, and patients are discharged faster from the ICU and the hospital, a new study finds.
New research supports telehealth within intensive care units as improving patient survival rates and speeding discharge.
"A Multi-center Study of ICU Telemedicine Reengineering of Adult Critical Care" examined the impact of remote intensive care units (eICUs) on nearly 120,000 critical care patients who were treated at 56 intensive care units, 32 hospitals, and 19 health systems over a five-year period. The research demonstrated reductions in both mortality and length of stay. The results were statistically significant on both an unadjusted and severity-adjusted basis.
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Posted on Dec 05, 2013
By Anthony Brino, Editor, HIEWatch
As providers ready for meaningful use Stage 2 attestation and policymakers start designing Stage 3, CMS announced that the Medicare and Medicaid EHR incentive programs have paid out just shy of $17 billion to spur adoption thus far.
As of the end of October, more than 430,000 eligible hospitals and professionals have achieved meaningful use, with 93 percent of eligible hospitals and 80 percent of eligible professionals registered for the program.
More than 236,000 Medicare-eligible physicians and 139,000 Medicaid-eligible physicians have attested so far, along with more than 4,600 or 85 percent of all eligible hospitals.
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DEC 3, 2013 3:33pm ET
Three provider organizations recently have reported serious breaches where protected information was purposely accessed by unauthorized personnel, but only one is offering protection to patients:
* University of Washington Medicine is notifying approximately 90,000 patients of UW Medical Center and Harborview Medical Center that malware in an email attachment that an employee opened accessed their data files. The FBI is investigating and may be contacting patients, according to the university.
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Posted on Dec 04, 2013
By Mike Miliard, Managing Editor
Whether it's guarding against "malicious insiders" or ensuring C-suite execs are scared straight about the risks and regs they face, the coming year poses big challenges to healthcare according to Kroll's annual Cyber Security Forecast.
The newest report takes a look at a shifting social and legal environment and spotlights seven trends all industries should pay attention to as they guard against legal, monetary and reputational risk.
Those are outlined below, followed by a Q&A with Kroll's Senior Managing Director Alan Brill, who answered some questions from Healthcare IT News about the industry's preparedness for a new year filled with new security threats.
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December 4, 2013 | By Dan Bowman
Patient-centered care needs to be a bigger priority in the medical imaging field, several prominent radiologists have said this week at the Radiological Society of North America's annual meeting in Chicago. The concept holds potential to not only improve the quality of care delivered, but also patient attitudes about the industry, as a whole, according to Bibb Allen, Jr., who serves as vice-chair of the American College of Radiology Board of Chancellors.
Allen and Mary Mahoney, chair of RSNA's Patient-Centered Radiology Steering Committee talked about the importance of patient-centered care at a special interest session Monday.
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Fred Bazzoli Wednesday, December 4, 2013
Progress by our nation's hospitals in adopting electronic health records is yielding new possibilities and advancements, but it also brings new challenges for IT executives in health care organizations.
The federal HITECH program has served as an effective stimulus to get thousands of hospitals into digital recordkeeping. As of Oct. 1, CMS said that 71% of hospitals have attested to achieving Stage 1 meaningful use of EHRs, up by nearly 83% from a year ago.
Providers know expectations for using EHR systems will rise in subsequent stages of the program, with the intent of achieving safer, more effective and less expensive care. To do that, providers will have to be able to take advantage of an abundance of data that will stretch their ability to gain intelligence from the information. In addition, coping with EHRs provides new challenges that seemed unimaginable even a decade ago.
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Scott Mace, for HealthLeaders Media , December 3, 2013
Computerized physician order entry is a key requirement of meaningful use stage 1. Now that CPOE has reached a tipping point, healthcare IT leaders are at the beginning of a journey that takes the accumulated wisdom of a healthcare provider and codes it into decision-support systems.
This article appears in the November 2013 issue of HealthLeaders magazine.
A key requirement in stage 1 of meaningful use was that providers employ computerized physician order entry for at least 30% of medication orders entered by any licensed healthcare professional who can enter orders into the medical record per state, local, and professional guidelines.
Now that more than 80% of eligible hospitals have received reimbursement for adopting electronic medical record technology, CPOE has gone mainstream. It is also in some ways just the beginning of a journey that takes the accumulated wisdom of a healthcare provider and codes it into decision-support systems that, over time, make CPOE smarter.
"We've got much higher CPOE adoption than we had three or four years ago," says Bill Spooner, senior vice president and chief information officer of Sharp HealthCare, a not-for-profit regional healthcare system based in San Diego with 1,735 licensed beds at four acute care hospitals.
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Jan Walker, R.N., M.B.A., Jonathan D. Darer, M.D., M.P.H., Joann G. Elmore, M.D., M.P.H., and Tom Delbanco, M.D.
December 4, 2013DOI: 10.1056/NEJMp1310132
Forty years ago, Shenkin and Warner argued that giving patients their medical records “would lead to more appropriate utilization of physicians and a greater ability of patients to participate in their own care.”1 At that time, patients in most states could obtain their records only through litigation, but the rules gradually changed, and in 1996 the Health Insurance Portability and Accountability Act entitled virtually all patients to obtain their records on request. Today, we're on the verge of eliminating such requests by simply providing patients online access. Thanks in part to federal financial incentives,2 electronic medical records are becoming the rule, accompanied increasingly by password-protected portals that offer patients laboratory, radiology, and pathology results and secure communication with their clinicians by e-mail.
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Neil Paul has been thinking about the future of GP practice. It needs to change, he argues, and IT needs to help it to do that.
27 November 2013
As you are probably aware, we have just seen the much-awaited GP contract. All sides are claiming it as a success. I remain to be convinced one way or the other.
For me, the key themes are the possible loss of practice boundaries - with NHS England managing home visits for those who live outside a visiting area - the increasing push to case management for vulnerable groups and the desire for extended opening. I don’t have a problem with any of that; but the devil is in the detail.
In order to stay the same, things will have to change
While the new contract is being implemented, we need to be aware of the impending retirement crisis fuelled by the NHS GP pension being destroyed, the imminent loss of seniority payments, the massive increases in taxation, and the general fatigue caused by dealing with increasing demand.
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2 December 2013 Lis Evenstad
The extraction of GP data as part of the care.data programme will begin from March next year.
The programme will take a monthly dataset from GP practices, covering patient demographics referrals and prescriptions. This will be linked with data from secondary care to create a new set of Care Episode Statistics.
An update on the care.data programme, due to be presented to the Health and Social Care Information Centre’s board meeting this week, says that the preparations are “well underway.”
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29 November 2013 Lis Evenstad
The 3millionlives’ pathfinder programme, supposed to deliver 100,000 telehealth users by the end of this year, has been scrapped.
The scheme was the first step in the Department of Health’s project to kickstart the market by recruiting 3m people onto telehealth and telecare schemes by 2017.
NHS England took over responsibility for the programme in April and EHI reported last month that the pathfinder programme was under review.
A spokeswoman from NHS England said that the pathfinder programme, which has struggled to gain traction since it started, was part of the old DH delivery model.
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December 3, 2013 | By Katie Sullivan
It's not all about location for health information exchange networks--physicians are influenced by other physicians with whom they interact with and have common patients with more than geographical location in HIEs, according to new research published in the Journal of the American Medical Informatics Association.
For the study, network effects among clusters of physicians based on their professional and geographical proximities were examined. A diffusion model was used to capture both indirect and direct network effects among groups, studied over a three-year period, for an HIE in Western New York by researchers from the State University of New York at Buffalo.
Flow of patients among different groups of physicians was found to be a powerful factor in HIE adoption.
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December 2, 2013 | By Marla Durben Hirsch
The American Journal of Managed Care has now weighed in on the impact of electronic health records and health IT with a special issue devoted to research on the subject.
The issue is highlighted by an introduction by guest editor and former National Coordinator for Health IT Farzad Mostashari, M.D., now a visiting fellow at the Brookings Institute. Mostashari notes that this latest round of health and payment reform is different because of the new tools and data that EHRs and other health IT offer.
"This issue of AJMC provides many reasons to be hopeful that the combination of changing incentives and new data tools can indeed deliver better care at lower cost," Mostashari writes, although he also points to "warning signs" regarding who might reap the most financial benefits.
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December 02, 2013
Two studies tracking adult internet preferences have honed in on the type of experience and information chronic-disease patients are seeking online. Nonprofit Pew Research Center's Internet and American Life Project found, for example, that internet users with more than one chronic condition are more likely to use the internet to “read or watch something online about someone else's personal health experience,” and are also more likely to share what they know with online communities than users without chronic conditions.
Decision Resources finds that this sort of soft support—as opposed to a straightforward brand message—is important to note because while 68% of polled Boomers (who make up the majority of patients with chronic diseases, including diabetes, hypertension, osteoporosis and heart disease) said they use the internet, they generally gravitate toward broad-based health websites, like WebMD for disease and drug information.
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12/2/2013 10:00 AM
Study results are mixed on how portals affect the quality and efficiency of patient care, suggesting more research is needed.
The impact of patient portal use on health outcomes is unclear, according to a systematic review of studies. Moreover, the researchers said, the evidence to date shows that portals are unlikely to have substantial effects on efficiency and utilization of services, at least in the short term.
Physicians' use of patient portals is growing rapidly, because Meaningful Use Stage 2 requires providers to share records electronically with patients. It's widely believed that these portals can help increase patient engagement in healthcare, so the evidence about the actual effects of patient portals is important.
After combing the literature, researchers were able to identify only 46 fairly high-quality studies that addressed how portals "tethered" to EHRs related to health outcomes, patient satisfaction, and adherence; efficiency or utilization; patient characteristics; and/or attitudes or barriers to or facilitators of use. These included 14 randomized controlled trials, 21 observational studies, and 11 descriptive studies.
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Scott Mace, for HealthLeaders Media , December 3, 2013
Seven healthcare IT issues that divide IT leaders, users, and patients, including Healthcare.gov, Epic Systems, ICD-10 and SNOWMED CT, and the BYOD trend.
It's time for those stories that look back at 2013. What better place to start but with those healthcare IT issues that divide us and create lots of topics for journalists like me to pick apart and try to put back together.
My top seven topics:
Healthcare.gov. Its problems were predictable, but is it salvageable? Lipstick on a pig? Now that the calendar has turned to December, mass numbers of signups must materialize for the site to be called a success—especially now that insurers have cancelled millions of old healthcare plans. The new site may do a good job (finally) of showing consumers how much each healthcare plan will cost, but as critics have pointed out, it still fails to make it simple to see exactly what you are buying for that money. How about a section showing the minimum coverage of each health insurance policy? Oh, and while we're at it, let's put all of this in plain English.
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Posted on Dec 02, 2013
By Mike Miliard, Managing Editor
The global medical device connectivity market, worth $3.5 billion this past year, is projected to top $33 billion by 2019, according to a new study.
The report, from Transparency Market Research expects a compound annual growth rate of 37.8 percent from 2013 to 2019.
Integration of data from medical devices into electronic medical records helps save time, eliminate transcription errors and improve overall care. But even as meaningful use EMR incentives augur big growth in device integration, the report points out that connectivity and operational issues, cost barriers for small and mid-sized providers and security concerns are all inhibiting the growth of this market.
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December 2, 2013 | By Dan Bowman
The certification process for Meaningful Use is in need of a "radical" overhaul, Beth Israel Deaconess Medical Center CIO John Halamka says in his most recent blog post. Halamka (pictured right), who also serves on FierceHealthIT's Editorial Advisory Board, says that while attestation should be maintained as a demonstration of performance, certification should be limited to rigorous standards adoption and interoperability.
To explain, Halamka likens the current certification process to the government hypothetically mandating the use of USB thumb drives.
"Not only would [the government] specify a USB 3.0 standard, they would require it is black, rectangular and weighs 2 ounces," Halamka says. "Such prescriptive requirements would stifle innovation since today's USB drives might be in the shape of a key or even mimic a sushi roll."
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December 2, 2013 | By Susan D. Hall
Technology leaders must focus on solving real human problems if wearable technology is to become the omnipresent, multi-billion dollar industry many predict, according to Marcus Weller, founder and CEO of Skully Helmets.
It must meet a legitimate need and should attract attention for more than just its novelty, he writes in a piece at VentureBeat.
"What many understand already is that investment in new technology not founded on authentic utility is the stuff bubbles are made of. Wearable technology should at its core, enable us to transcend our problems," he says.
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Researchers from the University of Pittsburgh Graduate School of Public Health have created an online database of weekly surveillance reports for reportable diseases in the United States from the past 125 years, according to a press release.
Project Tycho, a collection of digitized weekly notifiable disease surveillance tables published from 1888 to 2013, were collected from various historical reports, including MMWR. All of the data is free and publicly available on the Project Tycho website.
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Monday, December 2, 2013
Northern California health information organizations are helping lay the groundwork for the next steps in expanding health information exchange throughout the state. Their participation in pilot programs for secure messaging, rural health information exchange and personal health records puts Northern California communities in the forefront of the campaign to increase the use of health information technology.
There are 16 community HIOs in California, half of which are operational. A new map shows health technology has reached 35 counties -- more than half of California's 58 counties.
Three Northern California HIOs -- the venerable Santa Cruz HIE, the one-year-old North Coast Health Information Network and the UC-Davis Health System -- are participating in California Health eQuality's California Trust Framework pilot. The effort started in June and runs for six months.
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By CARL ZIMMER
The days of scrawled doctor’s notes are slowly coming to a close. In the United States, 93 percent of hospitals are now using at least some electronic medical records and 2.2 percent have given up paper records completely, according to the consulting firm HIMSS Analytics.
The federal government has been pushing for electronic medical records for a decade, arguing that they will improve health care and bring down costs. That is still a matter of debate. Critics charge that the system is hobbled by poorly designed software and that some hospitals are using electronic medical records to bill more for the same services.
But a new study suggests that electronic medical records may have another, entirely different use: as a Rosetta Stone for our DNA. Researchers are using them to trace links between genes and disease.
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Posted on Nov 21, 2013
By Eric Wicklund, Editor, mHealthNews
Forget the crowded waiting room with crying babies, years-old magazines and a tiny, tinny radio offering instrumental pop music favorites. Today's consumers want healthcare delivered at a time and place of his or her choosing. And it's up to the clinician to meet those demands.
A panel of four distinguished healthcare providers will tackle this problem in "The World is My Waiting Room," an Executive Breakfast presented by mHealth News and Healthcare IT News at the HIMSS Media mHealth Summit. This discussion, sponsored by Symantec, takes place from 7:30-9 a.m. on Monday, December 9, at the Gaylord National Resort and Convention Center just outside of Washington D.C.
With a wide variety of mHealth tools and services at their disposal, healthcare providers now have the ability to reach out to the patient outside the office. The challenge lies in creating an experience that will be rewarding for both doctor and patient, providing easy and effective healthcare and reducing wasted time and money.
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11/29/2013 09:01 AM
When surgeon Brent Ponce wore Google Glass during a shoulder replacement, the ghostly hand of a remote collaborator coached him along.
Brent Ponce wasn't the first surgeon to bring Google Glass into the operating room, but he may have been the first to use it as a truly collaborative tool.
While performing a complete shoulder replacement at the University of Alabama at Birmingham Highlands Hospital, Ponce wore the Glass display under a moonsuit-style surgical hood, allowing the camera built into the frame to capture video and beam it to a colleague, Phani Dantuluri, M.D., tuning in from his office in Atlanta. At the same time, on the Glass' tiny video screen, Ponce could see a virtual hand pointing things out. It was Dantuluri's hand, captured by video on the other end of the Internet connection and superimposed over the surgical field of view.
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Enjoy!
David.
