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Improving the Quality and Cost of Healthcare Delivery
The Potential of Radio Frequency Identification (RFID) Technology
This study investigates whether an upcoming class of health information technology (HIT) can be used to address currently outstanding issues in the quality and cost of healthcare delivery. Expert interviews and a literature review were used to describe the 2009 universe of in- and outpatient healthcare RFID applications and to identify those applications expected to have the largest positive impact on the quality and cost-effectiveness of healthcare delivery over the next five to ten years. Next, case studies of actual RFID implementations across seven hospital sites in the U.S. and Europe were conducted to gain an understanding of how each leading RFID application type creates value, what aspects of care it impacts, and what the critical factors driving the promising RFID’s organizational benefits and costs are. As part of this work, an original set of healthcare RFID cost-benefit evaluation tools was developed and tested. The study’s findings indicate that in contrast to other types of HIT, the majority of benefits associated with successful RFID implementation are directly related to money saved (occurring as direct capital and operational cost savings), and that select RFID applications can substantially impact both the cost (e.g., efficiency) and the quality (e.g., timeliness, capacity for continuous improvement) of care delivery. Critical challenges for RFID adoption are described.
Free, downloadable PDF file(s) are available below.
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Monday, June 28, 2010
Patient Engagement in Health IT Efforts Could Be Crucial
At the Health 2.0 conference earlier this month in Washington, D.C., several patient advocates stressed the need to include patients in federal health IT efforts.
Trisha Torrey, who writes the Every Patient's Advocate Blog, noted that many of the policy terms thrown around by the health IT community, like "HITECH" and "meaningful use," are meaningless to patients.
A day later, a survey -- conducted by Harris Interactive for the Xerox Corporation -- was released, finding that only 16% of U.S. adults with a health care provider or institution said they have been approached by that provider or institution to discuss converting to electronic health records. The survey also found that respondents ranked patients as last among groups to benefit from EHRs, with 26% reporting that patients have the least to gain from EHR adoption.
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Possibility of National Electronic Medical Records System Growing
By Andy Opsahl
In San Francisco, Accenture recently hosted the last of its three town hall meetings gauging citizen views on health-care challenges and solutions in partnership with the Council for Excellence in Government. The other two meetings occurred in Miami and Detroit. As health-care costs and the number of uninsured citizens climb, some form of government-supported universal health coverage is becoming more likely in the United States, according to panelists at the San Francisco meeting.
Universal health coverage could make a national electronic medical record (EMR) infrastructure critical to managing such a massive, complex health-care system. A national move to EMRs would create new business opportunities for the IT industry. These gatherings allowed Accenture to test the waters of citizen receptivity to a national EMR system. Meeting attendees have been surprisingly open to the EMR idea, said Ken Dineen, global managing director of Accenture’s health industry practice. The company’s polling data showed 79 percent support for EMR among Miami citizens, 59 percent in Detroit and 74 percent in San Francisco. Privacy and security concerns about such a system fuel the usual objections.
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More IT outreach needed: eHealth Initiative
Posted: July 2, 2010 - 12:15 pm ET
Electronic healthcare initiatives have made headway over the last several years, but health information technology remains an undervalued tool, a new report concludes.
The National Progress Report on eHealth, 2010, released July 1 by the not-for-profit, Washington-based eHealth Initiative, found that significant progress in health IT has been made over the past three years. The American Recovery and Reinvestment Act of 2009 is cited as a key driver of progress.
However, challenges remain, said Jennifer Covich Bordenick, CEO of the eHealth Initiative, in a written statement. "Coordinating public- and private-sector efforts and communicating the true value of HIT and HIE to consumers will be critical as we move forward," she noted.
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20,000 SCRs viewed via Adastra system
29 Jun 2010
More than 20,000 Summary Care Records have been viewed out-of-hours via the integrated solution provided by software supplier Adastra.
The company said the figures covered viewings at the three early adopter sites in Bolton, Bury and Medway, where SCRs are available for the majority of the population.
Dr Alex Yeates, medical director for Adastra, said the 20,000th viewing was recorded over the weekend by a doctor working at night in one of the three centres.
He told EHI Primary Care: “Although it’s only a number, it is a milestone which shows that in these three areas it is now becoming normal to have that record available and to view it when needed.”
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“Slow and steady” may not be so bad
By Jeff Rowe, Editor
Given the variety of kinks that still need to be worked out of emerging systems, is it really such a bad thing that the public is slow in understanding the potential benefits of HIT?
That’s the question that came to mind as we skimmed through the results of the most recent Harris Interactive/HealthDay poll that looked at American’s understanding of their physician’s IT capabilities.
According to the press release announcing the poll, “despite years of hype around the issue, less than one in 10 American adults now utilize electronic medical records or turn to e-mail to contact their doctor.”
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Children’s Cancer Hospital Egypt 57357 Improves Patient Safety with Cerner Health Information Technology Solutions
Published Today - 08:51 GMT
The Children's Cancer Hospital Egypt 57357 (CCHE) has successfully gone live with state-of-the-art healthcare information technology (HIT) solutions from Cerner Corporation. More than 700 clinicians and staff are using Cerner Millennium® solutions to provide superior care and improve patient safety for cancer patients at Egypt's leading pediatric cancer hospital. The Cerner® electronic health record (EHR) is the Single Source of Truth™ for accurate patient information, including allergies, the latest diagnostic results and accurate patient weight at the point of care so that CCHE caregivers can safeguard their pediatric patients. CCHF implemented Cerner technology to help ensure safety and reliability in the delicate process of caring for pediatric cancer patients.
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Health Reform Presents I.T. Challenges Big and Small
By Joseph Goedert
Health Data Management Magazine, 07/01/2010
Health Data Management Magazine, 07/01/2010
You can't say the first 18 months of the Obama administration have been boring for the health I.T. industry.
The administration kicked things off with the HITECH Act and its health records, health information exchange and privacy/security provisions. I.T. executives' plates were pushed to overflowing with implementation of the HIPAA 5010 transaction sets and ICD-10 code sets, and the annual modifications to Medicare and Medicaid policies and payments.
The federal government now has served up the Patient Protection and Affordable Care Act, commonly known as the health care reform law, also frequently referred to by both proponents and critics as ObamaCare.
Health Data Management's June and May issues covered several new reform-related challenges, including new "operating rules" to further standardize HIPAA transactions, electronic enrollment for public health and human services programs, lower Medicare/Medicaid reimbursements, and demonstration programs to better coordinate care and adopt best practices.
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Royal Free builds Cerner checklists
30 Jun 2010
The Royal Free Hampstead NHS Trust has developed a fully auditable set of guidelines and actions for clinicians within its Cerner Millennium electronic patient record system.
The trust has been working with Cerner and the BMJ Evidence Centre to pilot a standardised checklist of actions to help clinicians make the best decisions for patients with gastro-intestinal (GI) bleeding.
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CIOs: We Won't Meet MU in Time
HDM Breaking News, June 29, 2010
A survey of 120 hospital CIOs finds that half believe their organization will meet the first set of electronic health records meaningful use criteria in time to get incentive payments in 2011, and a full 80 percent worry about being able to meet expanded criteria in 2015.
Later stage criteria that is worrisome includes using advanced decision support, providing and populating personal health records, and improving health outcomes through data exchange with outside organizations.
New York-based consultancy PricewaterhouseCoopers LLP surveyed the CIOs, all members of the College of Healthcare Information Management Executives, during the second quarter of 2010. The firm also conducted in-depth interviews with 14 CIOs or leaders of delivery systems, health information exchanges, insurers and regional extension centers.
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Hospital CIOs confused over e-health records rollout standards
Lack of clarity about government rules slowing efforts, survey says
Lucas Mearian
The vast majority of hospital CIOs recently surveyed by PricewaterhouseCoopers LLP (PwC) said they're concerned that they won't be able to demonstrate "meaningful use" of electronic health records (EHR) -- and therefore won't qualify for federal reimbursements for rolling out the technology.
Ninety-four percent of the CIOs responding to the survey whose results were released Tuesday said that they're concerned they can't meet government requirements about how to report meaningful use of EHRs, and 92% said that they're concerned about a lack of clarity in the criteria used by the government.
Last year, the American Recovery and Reinvestment Act (ARRA) set aside $36 billion to help hospitals and doctors purchase equipment to computerize patient medical records, but even the most sophisticated hospitals in the country are struggling to qualify for the payments, PwC's study indicated. Clinicians and hospitals that deploy the technology and prove that it meets a set of government "meaningful use" standards showing it's being effectively used can receive up to $44,000 per doctor in reimbursement funds beginning next year.
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R.I. ACLU sues state over rules governing medical records
01:00 AM EDT on Wednesday, June 30, 2010
A suit filed Tuesday alleges that newly adopted regulations fail to adequately protect patient privacy under the state’s developing system for exchanging electronic medical records.
The suit by the Rhode Island affiliate of the American Civil Liberties Union says that regulations developed by the state Department of Health are full of gaps that leave patients vulnerable.
The regulations govern the Health Information Exchange, a system that will enable doctors, hospitals, laboratories and pharmacies to easily access and exchange patient information.
The exchange, using the name Currentcare, is already enrolling patients and providers but is not yet operational. Patients may choose whether to participate in the exchange and may also specify who can have access to their records. But patients can’t exclude from their records any aspects of their care, such as treatment for addiction or mental illness.
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Resistance To EHRs May Widen Healthcare Disparities
Small medical practices serving Medicaid patients have been reluctant to adopt electronic health records because they're already overwhelmed with providing medical services.
By Nicole Lewis, InformationWeek
June 28, 2010
As the push to implement new health information technology (HIT) among healthcare providers continues, many small physician practices offering services to Medicaid patients have shown a reluctance to adopt HIT, such as electronic health records (EHRs).
If these medical practices continue to resist implementing modern HIT systems, the situation threatens to widen healthcare disparities in the coming years, said Dianne Hasselman, director of quality and equality at the Center for Health Care Strategies (CHCS), at a recent public hearing on how technology can improve healthcare delivery among low-income populations.
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ONC now taking EHR certifier applications
Posted: July 1, 2010 - 12:30 pm ET
The application window is now open for organizations seeking government recognition as testing and certification bodies for electronic health-record systems eligible for reimbursement under the American Recovery and Reinvestment Act of 2009.
So far, the Office of the National Coordinator for Health Information Technology at HHS has received about 40 inquiries regarding applications and had 14 requests for applications, Carol Bean, an ONC standards harmonization analyst, reported to a meeting of the federally chart.
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Computerized sign-out holds promise, study finds
Posted: July 1, 2010 - 12:08 pm ET
A system for "computerized rounding" and handover of patient responsibility—also called "sign-out"—developed at the University of Washington may help ease the challenges of complying with medical resident 80-hour work limits.
The Web-based system the university developed, called UW Cores, was found to reduce the time residents at two Seattle hospitals spent managing patient information and generating sign-out materials by 30 to 45 minutes a day "without weakening systematic defenses against error or jeopardizing patient safety," according to a report published in Academic Medicine.
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EHR, Operating Cost Hikes Challenge Practice Managers
John Commins, for HealthLeaders Media, June 29, 2010
Rising operating costs, managing finances amid Medicare reimbursement shifts, and installing electronic health records are the top three challenges for medical practice managers, according to Medical Practice Today: What Members Have to Say, an annual survey from the Medical Group Management Association.
"It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued congressional irresponsibility in not permanently addressing the flawed sustainable growth rate formula," said William F. Jessee, MD, president/CEO of Englewood, CO-based MGMA.
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ONC Advisors Tackle Data Exchange
HDM Breaking News, June 28, 2010
The HIT Policy Committee, an advisory group to the Office of the National Coordinator for Health Information Technology, has recommended that ONC encourage the use of models for exchanging personal health information that do not expose any unencrypted PHI.
These models include direct exchange from message originator to message recipient, or exchange using an intermediary that only performs routing services and has no access to PHI.
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After $127 million, VA starts over on scheduling
Posted: June 29, 2010 - 12:00 pm ET
Weaknesses in management and effective oversight have hindered efforts by the Veterans Affairs Department to replace its outpatient scheduling system, the Government Accountability Office has concluded.
In a report released on its website Monday, the GAO chronicles the VA's unsuccessful first attempt to modernize its outpatient scheduling project, otherwise known as the Scheduling Replacement Project.
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ONC to issue ‘rules of the road’ for NHIN Exchange
By Mary Mosquera
Friday, June 25, 2010
The Office of the National Coordinator for Health IT plans to establish rules of the road for the nationwide health information network (NHIN Exchange) in order to expand the kinds of organizations that can participate in it.
Participation in the NHIN Exchange is currently limited to federal health agencies and healthcare organizations that contract with them or are federal grantees.
As the first step in the rulemaking process, ONC will publish a request for information in August to get public comment on the governance process. It expects to then release a proposed rule in early 2011, and to finalize it next summer, said Mary Jo Deering, senior policy advisor in ONC's Office of Policy and Planning.
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VA building mobile version of personal health record
By Mary Mosquera
Thursday, June 24, 2010
The Veterans Affairs Department is exploring a number of applications of wireless technologies to improve the health outcomes of veterans, especially those in rural areas that may be hundreds of miles from the closest VA clinic or hospital.
Wireless technologies can link veterans with their providers through personal cell phones and enable them to manage their health, said Gail Graham, deputy chief officer in health information management in the Veterans Health Administration.
For many veterans, “geographical distance from VA’s physical healthcare assets often presents a challenge to receiving care,” she said at a hearing of the House Veterans Affairs Committee health subcommittee June 24.
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Mobility To Lead Health IT Innovation
Government stimulus funds will help, but not quickly cure, the lag in health IT adoption caused by years of failure to invest in new technology.
By Nicole Lewis, InformationWeek
June 25, 2010
The federal government's stimulus investment in healthcare IT is not a panacea, primarily because during the last decade the healthcare industry failed to invest in technology innovation. For that reason, it will take two to three years for the healthcare industry to catch up to other industries such as retail and banking, a new report concludes.
The report, published this month by Crosstree Capital Partners, a Tampa, Fla.-based investment banking firm, also predicts that the only place where completely new inventions are expected is in the wireless device space.
"While there are a few, mostly generic, applications used by doctors on their iPhones and Blackberrys, the devices are still pretty much used as cell phones, text messaging devices, and for e-mail," said Rob Tholemeier, author of the report and a principal covering health IT at Crosstree Capital. "In the next two to three years this will change dramatically as wireless communications and devices will proliferate throughout all aspects of healthcare delivery."
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Leapfrog finds high risk of order-entry errors
Posted: June 30, 2010 - 11:45 am ET
The Leapfrog Group, a Washington-based healthcare quality organization formed by large employers, has issued a report urging hospitals and information technology vendors to take a closer look at computerized physician order-entry systems to make sure they are detecting potential errors.
In the study that served as the basis for the report, 214 hospitals evaluated their CPOE systems using a Web-based simulation tool from Leapfrog. The simulations, which involved 10 test patients and 50 medication orders, took place between June 2008 and January 2010. More than half of the total medication orders processed in adult hospitals did not trigger the warnings they should have, according to the report. And among 311 potentially fatal medication orders processed in adult hospitals, only 32.8% prompted a warning.
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PACS adoption has reached 'mature stage,' study says
June 25, 2010 | Mike Miliard, Managing Editor
DES PLAINES, IL – A new report from the research firm IMV has found the market for electronic picture archiving and communication systems (PACS) is largely in "replacement mode."
According to "The PACS/IT Continuum: Present Access and Future Integration Strategies, 2010-2012," released by the IMV Medical Information Division, replacement has become the primary motivation for purchasing new systems in 2010, with 85 percent of the planned purchases of complete systems being replacement systems, compared to 15 percent for first buyers.
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Advice: Start now to appraise fitness of EHRs
June 25, 2010 | Bernie Monegain, Editor
FALLS CHURCH, VA – Hospitals and physicians that plan to meet meaningful use eligibility for government incentives must start now to assess their technology and talk with their vendors about certification, says Erica Drazen, managing partner of consulting firm CSC's Healthcare Group.
The Office of the National Coordinator announced the final rules for the temporary certification process on June 18. Certification entities are expected to be in place by late summer.
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ONC plans governance rule to expand NHIN participants
By Mary Mosquera
Friday, June 25, 2010
The Office of the National Coordinator for Health IT plans to establish rules of the road for the nationwide health information network (NHIN Exchange) in order to expand the kinds of organizations that can participate in it.
Participation in the NHIN Exchange is currently limited to federal health agencies and healthcare organizations that contract with them or are federal grantees
As the first step in the rulemaking process, ONC will publish a request for information in August to get public comment on the governance process. It expects to then release a proposed rule in early 2011, and to finalize it next summer, said Mary Jo Deering, senior policy advisor in ONC's Office of Policy and Planning.
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HIMSS: RFID still mostly used for equipment tracking
Despite more interest in using radiofrequency identification (RFID) to reduce medical errors and increase patient safety, the technology is mainly deployed for non-patient functions, according to a report from the Healthcare Information and Management Systems Society (HIMSS).
The society administered an online survey to 222 participants in May to discuss RFID technology. Nearly one-third (31 percent) of survey respondents believed that the widespread use of RFID applications will benefit healthcare organizations in the area of patient safety, followed by assets and/or biomedical equipment tracking (24 percent).
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Kirkland: EHR systems are important, but...
Posted: June 28, 2010 - 12:01 am ET
He was for them, now he's against them—even though he still thinks they're a good idea.
On his Dr. Ron Kirkland for Congress Facebook page, Ronald Kirkland, Congressional candidate and former chairman of both the American Medical Group Association and the Jackson (Tenn.) Clinic 120-physician multispecialty group, denounces the stimulus law's subsidies to help physicians buy electronic health-record systems and vows to return any such subsidy should he receive one.
At the opening of the AMGA's March 2009 annual conference in Las Vegas, however, Kirkland sang a different tune, explaining how congressional staffers reached out to the AMGA while drafting the American Recovery and Reinvestment Act of 2009, also known as the stimulus law. This led to the inclusion of an $18,000 subsidy for physicians who adopt information technology, Kirkland said. "If this doesn't excite you," he added, "ask a doctor to check your pulse.”
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White House releases identity-security plan
Posted: June 28, 2010 - 12:01 am ET
Citing the critical need to improve security and curb identity theft and fraud in cyberspace, the White House, in partnership with other public- and private-sector organizations, has released a plan to promote safer data exchange.
The government's proposed plan, called the National Strategy for Trusted Entities in Cyberspace, aims to address issues such as the safety of personal health information and banking data and relies primarily on the creation of an “identity ecosystem.” The identity ecosystem, according to the draft, is an online environment that would reduce the need for multiple passwords and logins by offering people the opportunity to obtain a secure, interoperable credential for multiple-use authentication.
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Are We Rushing the Push for Electronic Health Records?
Advocates of electronic health record (EHR) systems, which will likely soon be a fixture in medical settings, claim that the use of EHR will reduce health care costs and improve medical outcomes. Although benefits of bringing information technology to health records can be substantial, EHR systems also give rise to increased liability risks for health care providers due to possible software or hardware problems or user errors.
Two Case Western Reserve University professors, in a scholarly article published in the Berkeley Technology Law Journal, shed light on liability concerns and EHR systems.
Sharona Hoffman, JD, LLM, professor of law and bioethics and co-director of Case Western Reserve’s Law-Medicine Center, and Andy Podgurski, PhD, professor of computer science at the university’s School of Engineering, recently wrote the article, “E-Health Hazards: Provider Liability and Electronic Health Record Systems,” which offers a comprehensive analysis of the liability risks associated with use of this complex and important technology.
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Legal Study: EHRs under-regulated, propose serious liability risks
Despite their many proposed benefits, electronic health record systems could put healthcare providers at significant risk for lawsuits due to software, hardware and user errors, according to a new study in the Berkeley Technology Law Journal.
The design of the current electronic health record (EHR) systems and the legislation governing them do not adequately protect against — and indeed may increase the risk of — malpractice claims and privacy breach claims, the authors said in a press release announcing their study.
The risks of EHRs have received little attention in the legal literature, despite the fact the U.S. Department of Health and Human Services seeks to implement EHRs nationwide by 2014, according to the release.
· Reference:
Hoffman S, Podgurski A. E-Health Hazards: Provider Liability and Electronic Health Record Systems. Berkeley Technology Law Journal [Internet]. 2010 Jun;Case Legal Studies Research Paper No. 09-25(Forthcoming). Available from: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1463671.
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Enjoy!
David.
