Here are a few I have come across this week.
Note: Each link is followed by a title and a paragraph or two. 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 payment.
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By Martha C. White
Sunday, April 11, 2010; G03
Steve Jobs got a new liver, the rest of us got an easier way to watch Hulu in bed, and the health-care industry just may have gotten the big break it needed to launch into the 21st century. Following his hush-hush surgery last spring, it's easy to imagine the colossus of Cupertino, Calif., staring at the ceiling tiles in his hospital room and wishing for a way to hop online without having to bother with a laptop.
It's also no stretch to picture him watching doctors, nurses and orderlies peck away at a bevy of poorly designed, intermittently integrated and just plain ugly devices and thinking there had to be a better way.
So while the rest of the world texts, tweets and generally fawns over the thing, that's muted compared with the reception the iPad is getting in the health-care universe.
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Issue Brief No. 131
April 2010
Ann S. O'Malley, Genna R. Cohen, Joy M. Grossman
Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication—real-time, face-to-face or phone conversations—with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-workflow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.
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Dr. David Blumenthal, the national coordinator for health information technology, has a lot of confidence in the future of his field. But he also acknowledges that since health IT workers will be in high demand as medical professionals adopt new systems, it will take time to for the workforce to match the pace of IT development. Observers have been predicting a shortage of qualified health IT professionals, and the government is subsidizing college training programs. -----
Posted: April 16, 2010 - 8:54 am ET
When Karen Bell comes aboard April 26 as the new chairwoman of the Certification Commission for Health Information Technology, she might still feel the chill in the room from the recent cold shoulder HHS gave the organization it conceived in 2004, helped fund most of the years since, but distanced itself from in recent months.
It will be up to Bell to steer a new course for CCHIT going forward, operating with a wider separation from HHS and still serving the needs of its former federal patron.
Bell was named Monday to replace fellow physician Mark Leavitt, the founding chairman of the not-for-profit, Chicago-based organization. Leavitt announced last fall his intention to retire by March 2010. -----
April 14, 2010 | Bernie Monegain, Editor
HAMPSHIRE, ENGLAND – Revenues from remote patient monitoring using mobile networks will rise to almost $1.9 billion globally by 2014, according to Juniper Research.
Heart-related monitoring applications in the United States will drive the uptake initially, researchers forecast.
The
mHealth report found that mobile healthcare monitoring would demonstrate substantial growth in the United States and other developed markets. However, while mobile monitoring will contribute to healthcare cost savings in developed markets, national wealth and the structure of the healthcare market in a given geographical region will have an important bearing on the extent to which it is rolled out.
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April 15, 2010 | Kyle Hardy, Community Editor
LINCOLN, NE – MacPractice, the major Apple developer of practice management and clinical software on Macs and iPhones for medical and dental offices, has launched new iPad integration solutions that are expect to allow doctors and dentists to use all MacPractice software on an iPad. MacPractice officials said the motivation behind the launch was the due to objectives to improve efficiency and quality at the point of care.
MacPractice officials said the new iPad interface solutions are designed to leverage collaborative technologies to make the total functionality of MacPractice available on an iPad, including EMR, prescriptions and e-Prescribe, scheduling and more.
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By Mary Mosquera
Wednesday, April 14, 2010
A Health and Human Services Department advisory panel is finalizing elements of what it calls a “trust fabric” for health information exchange in order to spur confidence in using a the nationwide health information network (NHIN).
The panel developed broad recommendations for what constitutes trusted health information exchange via “NHIN Direct,” a streamlined version of NHIN standards and services for sharing health information securely through the Internet.
The Health IT Policy Committee’s NHIN work group will deliver its final trust recommendations to the committee at its meeting April 21, said David Lansky, chairman of the panel and CEO of the Pacific Business Group on Health.
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14 Apr 2010
The Conservative election manifesto has reiterated the Tories' pledge to give patients online control of their own health records.
No details are given of how this will be achieved; leaving open the possibility that a Conservative government might look beyond the NHS’s own HealthSpace to more eye-catching deals with Google or Microsoft.
The manifesto also reaffirms the pledge that a Conservative government would publish much more detailed NHS performance data online. Patients are also promised that they will be able to rate hospitals and doctors.
In the UK’s looming ‘age of austerity’, the Tories are prescribing information as the cure to what ails public services. Far more performance data is promised to be published online for all of the public sector.
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Posted: April 14, 2010 - 5:59 am ET
Reliable health IT systems and high levels of provider adoption will be critical to the success of future quality improvement initiatives, HHS' Agency for Healthcare Research and Quality, or AHRQ, said in a newly released report.
In its
2009 National Healthcare Quality Report, AHRQ stressed the need for major performance improvements in all areas including patient safety, preventive care and chronic disease-management. The agency also outlined a multipronged action strategy for accelerating improvements that includes revising quality measures, removing barriers to care, and using health IT and training to empower providers.
“Realistically, HIT infrastructure is needed to ensure that relevant data are collected regularly, systematically, and unobtrusively while protecting patient privacy and confidentiality,” AHRQ said in the report.
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13 Apr 2010
Two GP practices in Scotland are to run a trial of an online patient portal enabling patients to access their records over the internet, the Scottish Government has announced.
The Patient Portal will run at two practices in NHS Ayrshire and Arran over the next six months to enable patients to view test results and update their records from anywhere with an internet connection.
The project could pave the way for the patient portal to be rolled out across Scotland, according to health secretary Nicola Sturgeon.
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APRIL 13, 2010
When health-care providers exchange electronic medical records, costs go down and patient care goes up
To understand the potential of shared health records, consider the Bottone family.
Almost everyone agrees that health information technology could create more effective and more efficient systems in the medical world but we still face a number of hurdles in terms of widespread adoption. Journal News Editor Laura Landro
discusses some of the challenges facing the medical industry as they look to digitize health records.
Born prematurely with nonfunctioning kidneys, 4-year-old Jacob Bottone has been through dialysis, angioplasty and a kidney transplant, and seen more specialists than most people will see in a lifetime. His doctors and hospitals had electronic medical-records systems, but no way to access each other's, so his parents had to collect his growing paper medical records in a large accordion folder, haul it from doctor to doctor, explain his medical history over and over again, and often wait for hours while referrals and test results were retrieved and faxed around to different providers. "It was getting to be a bit of nightmare," says his father, Jason Bottone.
Enter electronic information exchange.
Three leading health-care providers in Colorado's Front Range region recently teamed up in an electronic health-record exchange program that will allow them to share data on more than a million Colorado residents, including Jacob. The three—Children's Hospital in Denver, Kaiser Permanente Colorado's physician group and Exempla Healthcare, which operates Saint Joseph and two other hospitals in Denver—have agreed to share their records on a secure network that will allow clinics, doctors' offices and hospitals to exchange data on common patients instantly, including lab reports, radiology images and medical history.
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APRIL 13, 2010
How hospitals can make sure digital records live up to their promise. Because so far, they haven't.
Digital medical records come with some big promises.
They'll improve patient care, in part by eliminating many errors. They'll stem the soaring growth in costs. They'll make health care more efficient.
Those are the promises, anyway. The question is, how can we make sure the technology actually delivers? How can we make sure the digitization of medical records does everything its advocates believe is possible?
David Levy, global health leader at PricewaterhouseCoopers, talks with WSJ's Laura Landro about a new report indicating increased customization of diagnosis, care and cure in the U.S. health-care system and how the new health bill accommodates these trends.
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Health Data Management Blogs, April 12, 2010
John Muir Health in Walnut Creek, Calif., recently started notifying 5,450 patients after the theft of two laptops containing their health information.
The data wasn't encrypted and John Muir soon will join a growing list of organizations with its data breach displayed on a Department of Health and Human Services' Web site. Most of the breaches listed on the site resulted from thefts and most of those were laptops or other portable media. And they weren't encrypted.
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Wednesday, April 14, 2010
by Kate Ackerman, iHealthBeat Senior Editor
Consumers who use personal health records say they know more about their health, ask more questions, feel more connected to their physicians and take steps to improve their health, according to a new survey that many are calling ground-breaking. The study -- commissioned by the California HealthCare Foundation and conducted by Lake Research Partners -- surveyed a representative sample of 1,849 U.S. adults between Dec. 18, 2009, and Jan. 15, 2010. CHCF is the publisher of iHealthBeat.
Michael Perry, a partner at Lake Research Partners, said the survey provides the first data nationwide on the use and benefits of PHRs. He noted that previous research generally has been speculative, asking "would you use" this kind of tool.
Jennifer Covich Bordenick, CEO of the eHealth Initiative, said the "survey shows that patients want to get engaged in their health care," adding, "PHRs are one of many tools that can help accomplish that. It is now just a matter of giving them the tools necessary to become meaningful participants in the health care system."
Despite the benefits of PHRs, adoption remains relatively low with just 7% of adults reporting having used a PHR. Still, that is a 159% increase from two years ago when a separate survey from the Markle Foundation found that 2.7% of consumers had used a PHR.
MORE ON THE WEB
HDM Breaking News, April 13, 2010
One in 14 Americans--seven percent--have used a personal health record, according to national survey of 1,849 people taken during December 2009 and January 2010. That figure compares with a 2.7 percent participation rate found in a Markle Foundation survey in 2008.
The California HealthCare Foundation sponsored the new survey. Washington-based Lake Research Partners conducted the survey from recruited panelists across the nation who have agreed to occasionally participate in surveys.
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The survey, "Consumers and Health Information Technology: A National Survey," is available at chcf.org. --Joseph Goedert
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Posted: April 13, 2010 - 5:59 am ET
A mere 7% of Americans used a personal health record in 2009, but that's up from 2.7% the year prior and there appears to be less reluctance to adopting the technology, according to a new survey.
California is still in the lead in terms of PHR adoption, with 15% of survey respondents saying they have used these records. That is largely because of systemwide rollouts at Kaiser Permanente, the Oakland, Calif.-based managed-care giant, and large medical groups in the state. Only 5% of people in the Midwest and 5% in the South said they have used a PHR, according to the survey by the California HealthCare Foundation, a not-for-profit, nonpartisan research and philanthropy group.
The survey of 1,849 people was conducted by Lake Research Partners for the foundation between Dec. 18, 2009, and Jan. 15, 2010.
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Carrie Vaughan, for HealthLeaders Media, April 13, 2010
When Allison Blazek, MD, left M. D. Anderson Cancer Center to open her private practice in June 2008, she figured EMRs, rather than paper, made the most sense. After talking with vendors and pricing EMRs, however, Blazek began thinking paper records might be the wiser option after all.
"All of them were going to be tens of thousands of dollars, and I would have to close my practice for a week, and for some I would have to pay for the training," she says. "Starting out new, I thought, 'I'm not going to go into debt trying to get an EMR. I'd rather keep my overhead low.'"
Then, Blazek heard about San Francisco—based Practice Fusion, which offers a free Web-based EMR system. The company is funded by advertising so that when a physician uses the EMR, similar to Google's AdSense program, the system recognizes keywords and sends condition-specific ads from insurers, medical equipment suppliers, and pharmaceutical companies to the EMR page.
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Gienna Shaw, for HealthLeaders Media, April 13, 2010
The comment window for a temporary measure that would appoint organizations to test and certify EHR systems has closed, but debate on the final certification program is ongoing.
All of the questions about ONC-authorized testing and certification bodies (ATCB) won't be answered until ONC issues its final rule. But there are hints of what's to come, including who will apply for ATCB status and how much they might charge for the service, as well as some comments that could impact the final rule.
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Posted: April 12, 2010, 10:46 PM by NP Editor
Canada Health Infoway and the provinces have already spent billions on electronic health records By Alan Brookstone
It’s hard to know exactly how many dollars Ottawa and the provinces have spent so far on the grand plan to bring electronic health records (EHR) to Canada’s health-care system. Supported by Canada Health Infoway, the federal-provincial agency promoting EHR, a rough count suggests the total to date runs to at least $2-billion, with much more to come. The last federal budget alone committed another $500-million.
As Terence Corcoran stated in a recent column, “EHR is one of those great blue-sky ideas that seem sound and logical.” The objective is to have built an electronic health record for every Canadian — from prescription history to hospital visits, from family doctor records to major surgeries. As a physician and long time proponent of the use of information technology in health care, I am frustrated by the lack of progress on EHR, despite the billions spent.
A series of recent critical Auditor’s General reports have painted a bleak picture of the challenges and experience so far in implementing a national EHR strategy. The auditors general of British Columbia and Ontario have delivered devastatingly critical reports of their respective provincial efforts. The federal auditor general, Sheila Fraser, recently gave general passing marks to Canada Health Infoway. But Ms. Fraser is slated to deliver an overall summary of the federal and provincial EHR project next week.
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Tuesday, April 13, 2010
Algorithm protects patients' personal information while preserving the data's utility in large-scale medical studies.
By Katharine Gammon
Researchers at Vanderbilt University have created an algorithm designed to protect the privacy of patients while maintaining researchers' ability to analyze vast amounts of genetic and clinical data to find links between diseases and specific genes or to understand why patients can respond so differently to treatments.
Medical records hold all kinds of information about patients, from age and gender to family medical history and current diagnoses. The increasing availability of electronic medical records makes it easier to group patient files into huge databases where they can be accessed by researchers trying to find associations between genes and medical conditions--an important step on the road to personalized medicine. While the patient records in these databases are "anonymized," or stripped of identifiers such as name and address, they still contain the numerical codes, known as diagnosis codes or ICD codes, that represent every condition a doctor has detected. -----
New financial incentives spark doctors, hospitals to ramp up digitization
SAN FRANCISCO (MarketWatch) -- Coming soon to a doctor's office near you: Electronic health records. But it may take longer to find out whether broader use of health information technology lives up to its acronym and becomes a HIT.
While a few patients already are plugged in, many more soon may be able to go online to review certain medical test results, immunization lists and summaries of their office visits. They may turn to their computers instead of their telephones to make appointments and request medication refills.
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Medicare patient claims data to be released to public for the first time
The Health and Human Services Department is unveiling two new performance management dashboards and publishing de-identified Medicare patient claims data for the public for the first time as part of 17 initiatives detailed in its Open Government Plan. The Food and Drug Administration and HHS' Office of the National Coordinator for Health Information Technology (ONCHIT) are each developing performance management online dashboard systems to track their activities and programs, according to the plan published April 7.
The FDA-TRACK (Transparency, Results, Accountability, Credibility and Knowledge-sharing) dashboard was launched in beta mode April 7 to allow visitors to view performance data at the program office level.
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John Commins, for HealthLeaders Media, April 9, 2010
The theft of 57 hard drives from a BlueCross BlueShield of Tennessee training facility last fall has put at risk the private information of nearly one million customers in least 32 states, the insurer said this week in an investigative update.
So far, there has been no documented identity theft or credit fraud affecting BlueCross members as a result of this incident, BCBS of Tennessee said in a media release.
"As of April 2, 2010, a total of 998,422 current and former members have been identified at being at risk," said BCBS of Tennessee spokeswoman Mary Thompson, adding that the total figure includes 447,549 current and former members identified in the lowest-risk Tier 1 category.
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HDM Breaking News, April 12, 2010
The Certification Commission for Health Information Technology has named Karen Bell, M.D., as its new chair, effective immediately. She succeeds the retiring Mark Leavitt, M.D.
Bell most recently served as senior vice president of health information services at Masspro, the quality improvement organization of Massachusetts. She previously served in several positions within the Office of the National Coordinator for Health Information Technology, including director of the office of health information technology adoption and acting deputy of ONC.
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Although three vendors now dominate the ambulatory electronic medical record market, a KLAS report finds that other firms are picking up speed.
April 8, 2010
Though three established vendors continue to dominate mindshare, a larger pool of companies is being considered by hospitals and physician practices looking to purchase ambulatory electronic medical records, according to a new report by Orem, Utah-based KLAS.
Allscripts, NextGen, and eClinicalWorks constitute what report author Mark Wagner, KLAS general manager of ambulatory research, calls "the Big Three" in his report, Ambulatory EMR Buying: A Roller Coaster Ride in 2010. For the study, KLAS interviewed more than 370 healthcare providers who plan to choose an EMR solution in the next two years.
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Posted: April 12, 2010 - 5:59 am ET
Physicians' resistance to Internet-based electronic health-record systems appears to be easing, according to a recent health information technology market research report.
Last week, health IT researcher KLAS Enterprises, Orem, Utah, released a new report based on interviews with 370 ambulatory-care physicians or practice leaders who intend to purchase an EHR for the first time or replace their existing EHR system in the next two years.
“What surprised us, quite frankly, was the number of practices,” interested in EHRs delivered as “software as a service,” or SaaS, said KLAS' Mark Wagner, the lead author of the 236-page report, Ambulatory EHR Buying: A Rollercoaster Ride in 2010.
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April 09, 2010 | Bernie Monegain, Editor
ANN ARBOR, MI – CHIME, an organization that represents 1,400 healthcare CIOs, is calling for a rapid analysis of existing electronic health record certification programs, asserting that "above all else providers need a stable marketplace."
In a letter filed April 7 with the Office of the National Coordinator, CHIME (The College of Healthcare Information Executives) said it supported the general concept of moving to a two-stage approach for creating a certification process for EHRs, but added "significant questions still surround the creation of the approach."
"We are very concerned that the introduction of a two-stage approach for certification will prolong the current instability in the health IT marketplace, which exists because of the un-finalized status of meaningful use and certification regulations," CHIME wrote. "The introduction of two separate certification schemes – one temporary and one permanent – carries a risk of continuing the uncertainty and promoting needless product replacement in the marketplace."
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Women prefer medical professionals over online chat sites for discussing private health matters, a study shows.
April 9, 2010
In the age of Oprah and the Internet, where women can go online and anonymously discuss their private health issues via the World Wide Web, a majority of women still have a higher comfort level with their doctors than with an online community, a study finds.
The online survey, conducted in February by market research firm Harris Interactive on behalf of iVillage, a Web site for women, received 2,618 responses, of which 1,342 participants were women and 310 are mothers of teenagers or younger children.
The survey noted that, "Overall, online women are more comfortable discussing private health concerns or questions that are potentially embarrassing with a medical professional than they are with an online community, their spouse or partner, a close friend, and a family member."
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Integrating and enhancing quality measures.
By Toby Samo, MD
As many hospitals, health systems and physicians scramble to comply with the initial meaningful-use requirements, some may be so focused on electronic health record (EHR) selection and deployment that they lose sight of the broader and more fundamental changes they need to confront.
A long and winding road
EHR adoption is a milestone that lays the foundation for an outcomes- and data-driven approach to quality and excellence. However, it is just the beginning of a journey that will ultimately transform today's retrospective and reactive quality initiatives into predictive and proactive ongoing performance improvement.
Once an EHR has been deployed, hospitals and physicians will no longer be constrained by the limitations imposed by a "rear-view mirror" approach to quality. Instead, they will benefit from EHR-enabled automated transactions and focused knowledge-based systems that provide near-real-time actionable data to improve patient safety, quality of care and health care provider productivity.
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The more than 600 public-health laboratories in the U.S. gather and report critical data on disease outbreaks and threats to national security, but data collection and IT infrastructure largely have been specific to a single public-health program such as HIV prevention or tuberculosis treatment. With this in mind, the Association of Public Health Laboratories joined with the Centers for Disease Control and Prevention to launch the Public Health Laboratories Interoperability Project (PHLIP) in September 2006.
For more:
- read the Public Health Reports article (.pdf) -----
Healthcare organizations may be lulling themselves into a false sense of security when it comes to data security, according to a biannual report from HIMSS Analytics.
The white paper, commissioned by Nashville, Tenn.-based Kroll Fraud Solutions, says respondents gave their organizations high marks--an average of 6 on a scale of 1 to 7--for compliance with HIPAA, state security laws, CMS regulations and the Federal Trade Commission's "Red Flags" rule for identity theft, and a score of 5.75 for compliance with new security requirements of the HITECH Act portion of the American Recovery and Reinvestment Act. Despite these high ratings, 19 percent of organizations reported having a data breach in the past 12 months, up from 13 percent in 2008.
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12 Apr 2010
An independent review has been launched into how as many as 800,000 people on the UK organ donor register had their preferences incorrectly recorded.
A “technical error” has lead to 21 cases in which the wrong organs may have been taken from deceased donors over the past six years.
It is believed that the error occurred when the Driver and Vehicle Licensing Authority in Swansea, which used to collect details of drivers' preferences about organ donation, transferred its records to NHS Blood and Transplant, which now runs the organ donor register.
In a call with E-Health Insider, a spokesperson for NHS Blood and Transplant said: "The problem comes from a programming error tracked back to 1999 which only came to light because we were extending the system that acknowledges registrations.
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LONDON — Britain's transplant authority said Saturday that it was investigating several hundred thousand errors in its organ donor list stretching back about a decade.
The National Health Service Blood and Transplant organization said a proportion of its 14 million-strong organ donor list has been affected by technical errors since 1999 — and that a small group of people may have had their organs removed without proper authorization as a result.
The programming error meant that, for example, people who wanted to donate organs such as their lungs or their skin were incorrectly identified as people who wanted to donate their corneas or heart.
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Enjoy!
David.
