Again there has been just a heap of stuff arrive this week.
First we have:
Tool to Offer Fast Help for H.I.V. Exposure
By RONI CARYN RABIN
Time is of the essence in treating someone who may have been exposed to the AIDS virus. Starting Wednesday, emergency room doctors throughout New York State will be just a computer click away from concise guidelines for starting prompt drug treatment that can reduce the risk of becoming infected.
The guidelines come in the form of a computer application, or widget, developed by a team of doctors from St. Vincent’s Hospital in Manhattan with financing from the state’s AIDS Institute. They are to be given to more than 200 emergency departments this week and distributed more widely over time.
The doctors who developed the widget call it a “one-stop shopping” approach to PEP, or post-exposure prophylactic treatment. It walks users through a screening process to determine whether they are candidates for treatment, provides specific information about the 28-day course of antiretroviral drugs, and even links to consent forms in 22 languages, including Creole, Laotian and Yoruba.
Much more here:
http://www.nytimes.com/2009/09/08/health/08hiv.html?_r=2
Now here is a really useful e-Health application – a quick guide to what to do if you might have had a dangerous needlestick. Would be reassuring to know where that site was and have it bookmarked!
Second we have:
Measuring the Effectiveness of Imaging Tests Not Clear Cut
Carrie Vaughan, for HealthLeaders Media, September 15, 2009
Even though one-third of healthcare providers are continuing a freeze on purchasing imaging equipment, many are in the market to buy again with MRI equipment topping the list for planned imaging equipment purchases in the next two years, according to a new report from KLAS, an independent research organization that monitors the performance of HIT software and medical equipment vendors in Orem, UT.
At the same time, the federal government is looking for ways to reduce its imaging costs, which more than doubled to $14 billion between 2000 and 2006 for Medicare beneficiaries. One strategy is to reduce reimbursement for providers by lowering the value of equipment factored into the payment equation.
Another strategy is to require preauthorization for imaging tests like CT, MRI, and PET scans much like the radiology benefits managers used by some private insurers. A U.S. Office of Inspector General report, which found evidence that doctors in certain geographic areas may order significantly more unnecessary ultrasounds than physicians in other regions, added more ammunition to the debate that Medicare should adopt an RBM model.
However, measuring the effectiveness of imaging tests and determining when tests are appropriate is not as clear cut as one may think. I spoke to Jeffrey Barth Weilburg, MD, associate medical director of the Massachusetts General Physician Organization, which represents approximately 1,600 employed physicians at MGH, for the HealthLeaders magazine story, "How Many Slices Do You Really Need?" (September 2009).
More here:
This is an interesting discussion and shows just how hard it is to manage burgeoning technology costs in the health sector.
Third we have:
While most CIOs feel secure taking on the challenge of traditional radiology-focused PACS, cardiology PACS is another story
by Mark Hagland
Even before they can think about the integration of radiology and cardiology PACS, simply getting first-generation cardiology PACS implemented is turning out to be a major challenge for CIOs.
Why cardiology PACS development should be difficult is illustrated by the simple fact that there are more devices involved, more diverse types of images and data, and a far more complex and interactive patient care environment in cardiology than in radiology. It's no wonder that cardiology PACS remains a first-generation phenomenon, even in the most “advanced” of hospital organizations.
Indeed, when asked what the leading edge is in cardiology PACS development right now, Scott Grier says, “I don't know that there is yet a leading edge, at the moment.” In fact, says Grier, principal in Sarasota, Fla.-based Preferred Healthcare Consulting, “I think that cardiology today is where radiology was in the mid-1990s, in terms of digitization. We spent years porting certain elements of radiology work from analog to digital. Now, we're at the same level in cardiology.” And while there isn't enough pressure from the American College of Cardiology or other organizations to bring all of the disparate formats into one console, some vendors are exploring that, he says. “In hospitals, we have all these formats, but we can't launch from a single workstation. So it raises the costs to be able to view any particular study,” which is why some organizations are moving ahead despite the challenges.
Reporting continues here:
Given the impact of radiology department PACS I was surprised to read this. More work needed I guess.
Fourth we have:
Friday, September 11, 2009
Will Your Health Care Organization Need To Hire More IT Staff in the Next One to Two Years?
Seventy-nine percent of health IT professionals surveyed said their organization would hire additional staff in the next one to two years to meet its IT needs as the industry transitions to electronic health records, according to a new Healthcare Information and Management Systems Society survey.
Eleven percent of respondents said their organizations would not hire additional staff in the next one to two years, while 4% said they did not know and 7% said the question was not applicable to their organization.
More here :
Definitely good news for those in the field! See the Graph on the link.
Fifth we have:
Digital tools let doctors see patients via Internet
'Telehealth' gains amid prospect of shortage, insurers' acceptance
When Robyn Broomell was pregnant a few years ago, she needed advice from a specialist at the University of Maryland Medical Center because she is a diabetic.
But Broomell, 35, of Rising Sun, never set foot in the specialist's Baltimore office. Instead, she met him several times by videoconference while she was at an Elkton hospital, saving her the trip down Interstate 95.
"At first, I was kind of leery" of long-distance medical advice, she said. "I thought it was kind of an odd thing. But it was very convenient, and I could get used to convenience. It takes me 45 minutes to an hour to drive to Baltimore, and I didn't have to do that."
Broomell was an early beneficiary of "telehealth," in which medical professionals using digital tools and the Web can cut the waiting time for care from days or weeks to minutes.
Thanks to factors including a looming physician shortage, the health care reform debate and the increasing willingness of insurance companies to pay for the practice, telehealth is on the verge of becoming routine.
In the near future you could be connected by video to a specialist dozens or hundreds of miles away. Consider something as mundane as a skin rash. If your primary care doctor thinks she needs outside expertise, she can use digital diagnostic tools to generate high-resolution images of the rash and beam them to a dermatologist in another office for rapid diagnosis.
Lots more here:
http://www.baltimoresun.com/business/bal-bz.mobile14sep14,0,136812.story
Acceptance of payment for such services seems to be on the rise in the US.
Sixth we have:
Promise of stimulus money drives up health IT stock prices
The $18 billion being pumped into health care has many investors hoping it will result in big business for vendors.
By Pamela Lewis Dolan, AMNews staff. Posted Sept. 14, 2009.
Even if physicians haven't figured out yet whether they will buy new information technology, Wall Street assumes they will.
According to a July report by Healthcare Growth Partners, which advises small- to medium-sized health companies on financing, health information technology stocks outperformed broader markets during the first half of 2009 with a growth of 30%, compared with a 2% gain by Standard and Poor's 500 index and 16% for the tech-heavy Nasdaq Stock Market. For the most part, health care technology stocks have held those gains into early September.
Meanwhile, Emdeon, a claims-processing company, on Aug. 12 had a rousing initial public offering of stock. It issued 2 million more shares than expected to meet demand, and share prices reached $16.52 at the end of the first day, ahead of the company's $15 target. Emdeon, which raised $365.7 million, formerly was affiliated with Healtheon, which in 1996 was online health's first hugely popular IPO.
Days after Emdeon's IPO, Alpharetta, Ga.-based HealthPort, filed plans for a $100 million initial offering. The health IT company sells services to hospital and physician clinics that allow information from patient records to be requested by and provided to authorized parties such as insurance companies and government agencies. HealthPort did not disclose the timetable of its offering.
Christopher McCord, principal of Healthcare Growth Partners, said that because of the $18 billion made available through the federal stimulus package for the advancement of electronic health record adoption, a lot of activity is expected in the health IT market in the future.
More here:
http://www.ama-assn.org/amednews/2009/09/14/bisc0914.htm
That would have to be what they say as ‘stating the blooming obvious’!
Seventh we have:
Ethiopians offered free AIDS tests by text message
Tue Sep 8, 2009 1:23pm EDT
ADDIS ABABA (Reuters) - Ethiopia is sending text messages to mobile phone users offering free HIV/AIDS tests ahead of New Year celebrations, in a drive to have more people checked in sub-Saharan Africa's second most populous nation.
"New Year! New Life! Test for HIV, test with your partner, get your children tested and brighten the future of your family! Free testing. Happy New Year!" says an SMS message which is being sent in batches ahead of this week's celebrations.
Ethiopia follows a calendar long abandoned by the West that squeezes 13 months into every year and entered the 21st century in 2007. It will become 2002 in Ethiopia on September 11.
The text messages are being sent to all of Ethiopia's 2.5 million mobile users and have been hitting handsets for the last week in the capital Addis Ababa and most of the country's major towns. There is also a billboard campaign offering free checks.
More here:
http://www.reuters.com/article/Continental/idUSTRE5874V720090908
This is about as basic an e-Health initiative as one can think of. Well done!
Eighth we have:
Dell Tries to Make an EHR Splash
HDM Breaking News, September 10, 2009
Seeking to capitalize on the federal electronic health records incentive program, hardware giant Dell Inc. is marketing a package of EHR-related consulting services that hospitals can offer to area physicians.
The Round Rock, Texas-based company is attempting to get a piece of the EHR action by helping hospitals assist affiliated physicians with making the transition to electronic records. Two initial clients are Tufts Medical Center in Boston and Memorial Hermann Healthcare System in Houston, says James Coffin, vice president of Dell Healthcare and Life Sciences.
As part of the effort, Dell has entered formal partnerships with two EHR vendors: Allscripts, Chicago, and eClinicalWorks, Westborough, Mass. It plans to eventually partner with other EHR vendors.
Full article here:
Wonderful what major stimulus funds will flush out of the woodwork!
Ninth we have:
Norwegian hospital digitisation examined
16 Sep 2009
A new report, which examines how Norwegian hospitals have adopted digital technologies, concludes there is no single formulae for successful implementations.
The report titled: “Best practices: Norway's hospital evolution- A tale of two cities, compares the successful implementation of integrated hospital networks in newly built facilities in both Olavs Hospital in Trondheim and Ahus Hospital in Oslo.
The projects, which involved full replacement of old facilities in order to create the digital hospitals, used different methods to implement the digital hospital vision
Jan Duffy, research director, IDC Health Insights, said: “St Olavs used a campus-like facility with six clinical centers built around a central plaza while Ahus a large multi-purpose facility.”
The report compares the technologies used by the St Olavs project, which were very young and unproven when they were selected in 1991 with the more mature technology available when Ahus began implementing them in 2001.
More here:
http://www.ehealtheurope.net/news/5209/norwegian_hospital_digitisation_examined
Link
Best practices: Norway’s hospital evolution-A tale of two cities
An interesting report of some different approaches.
Tenth we have:
Rwanda: MoH to Launch E-Health
Irene V. Nambi
16 September 2009
Kigali — In line with the country's goal of promoting the use of ICT in all institutions, the Ministry of Health (MOH) is set to roll out, state-of-the-art software systems in all hospitals next year.
This was revealed by the Ministry's e- Health Coordinator, Richard Gakuba, in an interview with The New Times. He said the new system will be a solution to most problems that hospitals still face with regard to efficiency in service provision and boosting quality care.
"A new software system called Jeeva has already been introduced in King Faisal Hospital (KFH) and installation will soon be completed.
So far, it has enabled patients to register and consult health workers in the shortest time possible and improved general hospital management."
"Many other hospitals are still losing big sums of money as a result of inaccurate financial management but soon, this will be history. Proper management of patients' flow in hospitals as well as stock management will be guaranteed with new software systems," Gakuba explained.
More here:
http://allafrica.com/stories/200909170080.html
This must be a hopeful sign from the recently ravaged country!
Eleventh for the week we have:
Medicare to Fund 'Medical Home' Model
By JANE ZHANG
WASHINGTON --The Obama administration said Medicare will help fund state pilot projects that use primary-care doctors and teams of coordinators to manage patient care and reduce costs.
Under the "medical home" model, pioneered in Vermont and several other states, physicians are paid more for coordinating care for their patients. The goal is to help patients – especially those with chronic illnesses – stay healthy enough to avoid hospital trips and expensive treatments, saving money in the long run.
"It's better for doctors, better for patients, and better for our national balance sheet, which is why this program has such widespread endorsement," said Health and Human Services Secretary Kathleen Sebelius, who announced the initiative Wednesday at the White House with Vermont Gov. Jim Douglas.
Ms. Sebelius said she made the decision at the prodding of governors, including Mr. Douglas, who already has a pilot program running in his state. Vermont's three major insurers along with Medicaid, the state-federal health care program for the poor, fund a pool of money used to pay the salaries for coordinating teams that might include nutritionists, social workers and nurse practitioners.
More here (subscription required):
http://online.wsj.com/article/SB125313645498617439.html
Of course, to adopt this model of care good Health IT is vital!
Fourth last we have:
Standards Committee moves into guidance phase
September 17, 2009 — 12:50pm ET | By Neil Versel
It's getting to be crunch time for the federal Health IT Standards Committee, which is moving from studying previous work in the area of standards to producing implementation guidance for the hundreds of thousands of hospitals, physician practices, laboratories, pharmacies, imaging centers, health plans and the like that will be shifting to EMRs in the next few years. The committee this week approved recommendations from its workgroup on privacy and security, but now the task gets more difficult.
More here:
To learn more about the next steps for the HIT Standards Committee:
- see this Healthcare IT News story
- have a look at this Health Data Management piece
- read the committee's report (.ppt)
The links point to some very interesting material.
Third last we have:
Smoothing the Path
Leading with portals can lay the groundwork for CPOE, making rollouts less risky
by Kara Marx, R.N.
At Methodist Hospital, our strategic vision is to provide the Next Generation of Care for our physicians and staff, as well as the patients we treat. Obviously, technology plays a major role in achieving that goal. We set a clear vision of our ultimate healthcare IT destination as part of our strategic plan: a fully functional EMR system and a three-to-five year plan to achieve computerized physician order entry (CPOE). However, the path to achieving this goal was uncertain.
As a community hospital staffed by volunteer physicians, we had several concerns not shared by our colleagues in academic, research and private settings. Community hospitals have a lower threshold for risk tolerance, and it is very difficult to mandate technological change to a volunteer staff. We categorize Methodist as a “fast follower,” rather than early adopter. Any IT path we take has to exhibit proof points from other hospitals who have utilized our vendor of choice before we contract.
We also understand that most CPOE projects to date have been met with, at best, mixed success. Thankfully, as a result of both failed and successful CPOE projects, there was also an opportunity to utilize these lessons to inform our initiative and give it the best chance for success. This was crucial. As everyone reading these words well understands, the consequences of an IT project failure can be huge, not just from a financial standpoint but also from a loss of momentum and confidence. The ability to recover with your users becomes twice as challenging.
In a nutshell: Methodist simply could not tolerate a failure in this endeavor, neither financially nor culturally.
Much more here:
An interesting approach to a complex transition
Second last we have:
IOM: Feds should add ethnicity and language measures to EHRs
By Kathryn Foxhall
Wednesday, September 09, 2009
The Department of Health & Human Services (HHS) should develop standards for detailing patient ethnicity and level of language proficiency in electronic health records, the Institute of Medicine (IOM) recommended in a recent report.
The collection of more specific ethnicity and language information would strengthen data HHS now gathers to track variations in the delivery of healthcare based on race and ethnicity.
“By inclusion of this standardized information in electronic health record systems, it will be possible to stratify quality performance metrics, combine data from various sources, and make comparisons across settings and payment mechanisms,” the Aug. 31 report said.
More here:
http://www.govhealthit.com/newsitem.aspx?nid=72061
The report is available online.
Interesting stuff.
Last, and very usefully, we have:
Federal panel okays EHR security, privacy standards
By Mary Mosquera
Tuesday, September 15, 2009
The Health IT Standards Committee today endorsed a set of security and privacy standards for electronic health record systems that it said would get progressively tougher without holding back wider health information sharing.
The committee’s security and privacy workgroup clarified requirements that electronic health record systems must meet so both vendors and healthcare providers could use a number of access controls in their electronic health record systems and practices by 2011.
The presentation to the Committee was made by workgroup member David McCallie, vice president for medical informatics at Cerner Corp.
McCallie said the standards were designed to ensure that the security of health IT systems is powerful enough to protect health information in a variety of private and public sector settings while at the same time promoting the sharing of records.
For instance, organizations that want to swap information may have differing security and privacy requirements, making it a challenge to exchange data. “If they want to communicate with each other, do we rise to the most stringent system or lower ourselves to the most common denominator?" he said.
The standards under discussion cover access control, authentication, authorization and transmission of health data. The group tried to make the guidance clear enough to make interoperability between organizations a reality, McCallie said.
“Security is a balance between ease-of-use, cost and bullet-proof protection,” added Dr. John Halamka, vice chairman of the Committee. The workgroup has tried to provide “a rational glide path to increasingly constrained security,” he added.
Much more here:
http://www.govhealthit.com/newsitem.aspx?nid=72099
This is important stuff – especially the phased approach being adopted to improved information sharing standards.
There is an amazing amount happening. Enjoy!
David.
