Weekly Overseas Health IT Links - 08 January, 2011.

Here are a few I have come across this week. Catch Up!

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 subscription payment.

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http://www.medcitynews.com/2010/12/healthcare-it-how-to-send-electronic-records-securely/

12.28.10 | Dr. John D. Halamka | MedCitizen

Getting a secure electronic medical records system

Over the past few years, I’ve posted many blogs about the importance of transport standards. Once a transport standard is widely adopted, content will seamlessly flow per Metcalfe’s law. We already have good content standards from X12, HL7, ASTM, and NCPDP. We already have good vocabulary standards from NLM, Regenstrief, IHTSDO and others. We have the beginnings of transport standards from CAQH, IHE, and W3C. We have the work of the NHIN Direct Project (now called the Direct Project).

After working with Dixie Baker/the HIT Standards Committee’s Privacy and Security Workgroup on the Direct evaluation and after many email conversations with Arien Malec, I can now offer a strawman plan for transport standards.

Based on the implementation guides currently available, the HIT Standards Committee evaluation found the SMTP/SMIME exchange defined by the Direct Project sufficiently simple, direct, scalable, and secure, but stressed the need to develop implementation guidance that is clear and unambiguous. I’ve received many emails and blog comments aboutSMTP/SMIMEverses other approaches. I believe I can harmonize everything I’ve heard into a single path forward.

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http://www.washingtonpost.com/wp-dyn/content/article/2010/12/20/AR2010122004669.html

Hospitals' focus on patient safety hasn't eliminated preventable deaths

By Manoj Jain
Monday, December 20, 2010; 6:57 PM

Some years ago, I got a call at 3 a.m. from the hospital because a patient of mine had spiked a high fever. Suspecting an infection, I called in some antibiotics. A few hours later, a frantic nurse called to say my patient had turned red and was wheezing, likely from an allergic reaction.

I rushed to the hospital and saw my own note in the patient's chart stating that the patient was allergic to the antibiotic I had ordered. I had made a preventable medical error; so had the nurse who had missed the allergy wristband on the patient and the pharmacist who had neglected to check the patient's allergy drug list.

Last weekend when I was on call and seeing my sixth consult, I inadvertently ordered a penicillin-family drug for a patient with a penicillin allergy. This time the pharmacy's software flagged the potential error.

Despite the best of intentions, errors are common in hospitals even with new safeguards. A decade ago the Institute of Medicine published its landmark report "To Err Is Human: Building a Safer Health System," which estimated that 44,000 to 98,000 deaths occur annually because of preventable medical errors in U.S. hospitals.

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http://www.govhealthit.com/newsitem.aspx?nid=75753

Minimal health IT standards, data control are a start for learning health system

By Kathryn Foxhall
Wednesday, December 22, 2010

A minimum of required health IT standards and centralization of data is what’s needed to foster the best climate in which to develop a learning health system and provide a foundation for its expansion, according to the Institute of Medicine.

These were some of the main conclusions garnered from various workshops held throughout 2010, sponsored by the IOM and Office of the National Coordinator for Health IT, which focused on ways to promote technical advances in health care, generate and use information, and engage patients.

A report on the workshop results--Roundtable on Value and Science-Driven Health Care-- was published Dec. 20, and laid out various strategies for using IT to accelerate progress in improving healthcare.

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http://hitechwatch.com/blog/patients-still-moving-slowly-hit

Patients still moving slowly on HIT

12/22/10

By Jeff Rowe, Editor

A new survey from PricewaterhouseCoopers (PwC) indicates that the healthcare sector is going to spend significant amounts on HIT during 2011, but it also suggests consumers still haven’t decided whether or not to jump onto the IT train.

As this article introduces the survey, "While 2011 promises to be a year of increased health IT spending, a report from PricewaterhouseCoopers (PwC) show that 86% of consumers do not access their medical records electronically . . . "

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http://www.healthleadersmedia.com/content/TEC-260637/EHR-Incentives-Registration-Begins-January-3

EHR Incentives Registration Begins January 3

Andrea Kraynak, CPC, for HealthLeaders Media , December 23, 2010

CMS and the Office of the National Coordinator for Health Information Technology (ONC) announced that registration will begin January 3, 2011, for eligible providers hoping to participate in the Medicare electronic health record (EHR) incentive program, according to a December 22 CMS press release.

Several states will also be starting registration for the Medicaid incentive program on that date, including Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas. Several other states (California, Missouri, and North Dakota) will begin registration in February, according to CMS. Others are likely to begin in the spring or summer of 2011.

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http://www.healthleadersmedia.com/print/TEC-260716/Datas-Impact-on-Diabetes

Data’s Impact on Diabetes

Gienna Shaw, for HealthLeaders Media , December 28, 2010

Technology to help diabetics manage their disease—such as the artificial pancreas or mobile phone apps that help monitor glucose readings—might make a difference on an individual level, but the real key to tackling the disease is by making diabetes care more coordinated and patient-centered. The technology that will make a difference in that area is more familiar and less flashy: electronic health records, telemedicine, and basic information networks for sharing and collecting data.

Smart devices that can send glucose data to an information network will only be effective when there is an established and interconnected network for them to talk to, writes Elyas Bakhtiari in the December issue of HealthLeaders magazine. And although the healthcare industry hasn't yet built that base, hospitals and health systems are increasingly making it a priority.

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http://www.healthleadersmedia.com/content/TEC-260680/HITECH-2-Years-In-Verdict-Still-Out.html

HITECH: 2 Years In, Verdict Still Out

Dom Nicastro, for HealthLeaders Media , December 28, 2010

By the time the New Year arrives, HITECH will have been signed into law for approximately 23 months. Some regulations, such as the breach notification interim final rule, have been in effect, but we wait on others like modifications to the HIPAA privacy, security, and enforcement rules.

So as the New Year arrives, it's time to analyze what we've gotten out of HITECH. What is its effect on the healthcare industry right now? Qui bono? Patients, providers, or the government regulators?

The answer? It's probably too early to tell.

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http://www.startribune.com/business/112531299.html

A healthy niche

Program aims to prepare midcareer professionals for jobs in health care information technology.

By CHEN MAY YEE1, Star Tribune

Last update: December 27, 2010 - 9:32 PM

Some lost their jobs in the recession. Others are midcareer professionals looking to diversify their skills.

With an average age of 50, all are hoping for a bright future in one of the few parts of the economy that's adding jobs: health information technology.

Last month, about 70 students started an online course at Normandale Community College in loomington aimed at churning out professionals to work with electronic medical record systems at hospitals and clinics. The nondegree course lasts six months. Students, who must have either a health care or IT background, pay $500 to enroll.

The program is funded by a grant of $800,000 from the U.S. Department of Health and Human Services to train a total of 300 students over 18 months.

For students, it's a bit of a gamble.

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http://www.healthdatamanagement.com/issues/18_5/ocr-shines-a-harsh-light-on-data-breaches-40156-1.html

OCR Shines a Harsh Light on Data Breaches

Health Data Management Magazine, 05/01/2010

Between Sept. 22, 2009, and Feb. 15, 2010, at least 47 instances of breaches of unsecured protected health information occurred in the United States, each affecting at least 500 individuals with one affecting more than 500,000.

We know this because a new federal rule requires the reporting of such breaches to the Office for Civil Rights in the Department of Health and Human Services. The OCR on Feb. 22 launched a Web site listing the initial batch of health care organizations that reported breaches (see list, pages 34 and 36).

The posting, which the OCR will regularly update, is mandated under the HITECH Act. Breach notification rules from HHS and the Federal Trade Commission (covering personal health records vendors) were published in August 2009 and have been in effect since last September.

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http://topnews.us/content/231426-canada-now-focus-e-health-care-system

Canada to Now Focus on e-health Care System

The doctors of Canada are now going to adopt the simple slogan to improve the health systems of the country and that is “You can do it, we can help.” Now it is going to urge people to take care of their health themselves, more than relying on their doctors.

With a recent report from Commonwealth Fund ranking Canada last in the management and prevention of the chronic diseases, Canada is pulling up their socks by doubling their expenditure on the health systems. The expenditure has rapidly increased to $192-billion from $95-billion.

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http://www.modernhealthcare.com/article/20101229/NEWS/312299961/

Surescripts becomes ONC's sixth certifier

By Andis Robeznieks

Posted: December 29, 2010 - 11:15 am ET

Surescripts, the Arlington, Va.-based for-profit electronic prescribing network created by pharmacy associations and several of the largest pharmacy benefits managers, has been named an authorized testing and certification body by the Office of the National Coordinator for Health Information Technology at HHS.

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http://www.eweek.com/c/a/Health-Care-IT/Virtualization-EHRLinked-Devices-mHealth-to-Lead-Health-Care-IT-in-2011-Analysts-640839/

Virtualization, EHR-Linked Devices, m-Health to Lead Health Care IT in 2011: Analysts

By: Brian T. Horowitz

2010-12-28

In 2011, we'll see EHRs reach the adoption phase, data centers get virtualized, stand-alone medical devices connect to EHRs and m-health take off, according to industry experts.

As we move into 2011, the Obama administration's meaningful-use requirements governing health care IT and EHRs (electronic health records) will continue to influence how health care companies adopt technology to improve patient care.

In 2010, companies began to purchase EHR applications, but in the coming year health care companies will enter an adoption phase for EHR or EMR (electronic medical record) applications, predicts IDC in an upcoming report.

"While purchasing and selection will continue for many providers, early adopters will begin to struggle with the challenges of implementation and adoption of EMRs in 2011," wrote IDC analysts Judy Hanover and Lynne A. Dunbrack.

As adoption of EHRs heats up, Shahid Shah, CEO of IT consulting firm Netspective Communications and author of the Healthcare IT Guy blog, shared with eWEEK his top 5 predictions for the health care IT industry in 2011.

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http://well.blogs.nytimes.com/2010/12/23/new-from-google-the-body-browser/

December 23, 2010, 3:52 pm

New From Google: The Body Browser

By SINDYA N. BHANOO

Six years ago, I took a hard fall while playing soccer and tore a ligament in my knee.

As I weighed my treatment options in confusion, I searched on the Internet for images and videos to help me better understand how the knee works.

I wish I’d had access to Google’s Body Browser, a new, free 3-D tool that lets users rotate the body, peel back layers of it, and zoom in and zoom out, all from within an Internet browser window. There’s a search feature, so I typed in “anterior cruciate ligament” and it zoomed into the part of the knee that I’d injured.

It’s like a Gray’s Anatomy coloring book, come to life. I was curious, though, about what medical practitioners think about it. Is it something that medical students might use, or that doctors might use to educate patients?

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http://www.healthdatamanagement.com/news/Best-in-KLAS-41543-1.html

2010 Best in KLAS Vendors Named

HDM Breaking News, December 15, 2010

KLAS Enterprises LLC has issued its 2010 Best in KLAS Awards based on customer satisfaction with health information technology vendors and consultants.

The awards are based on data from more than 17,000 interviews the Orem, Utah-based vendor research firm has conducted during the past year from thousands of hospitals and physician practices.

The complete Best in KLAS Awards report includes analysis of satisfaction scores from more than 900 software products and types of services in more than 100 market segments. In addition to Best in KLAS, the report also names "category leaders" for dozens of niche products and five professional services

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http://www.healthdatamanagement.com/blogs/blog_Ciotti_Epic_technology-40093-1.html

EPIC Signs the Universe!

Vince Ciotti
Health Data Management Blogs, April 12, 2010

Dateline: Verona, Wisconsin; April 12, 2010

EPIC systems today announced the signing of their largest contact to date: the entire Universe, which has agreed to implement EpicCare throughout the galaxy. Details:

• Specific terms of the deal were not announced, but it is estimated that it will cost even more than the $5 billion invested by Kaiser before a gag order was placed on any further financial disclosures there.

• The rulers of the Galaxy are being required to attend special 2-day classes at Epic HQ in Verona, where they may get to meet Judy Faulkner in person, if her busy schedule permits.

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http://www.healthleadersmedia.com/print/TEC-260743/EHR-Effectiveness-for-Hospital-Care-Questioned

EHR Effectiveness for Hospital Care Questioned

Cheryl Clark, for HealthLeaders Media , December 29, 2010

A large RAND study of nearly half the acute care hospitals in the U.S. calls into question the value of electronic medical records, saying that except for basic systems used to treat congestive heart failure patients, EHRs are not improving process of care measures for many large hospitals that have them.

"The lurking question has been whether we are examining the right measures to truly test the effectiveness of health information technology," says Spencer S. Jones, a RAND scientist and lead author for the report. "Our existing tools are probably not the ones we need going forward to adequately track the nation's investment in health information technology."

Jones and authors write that their "results should temper expectations for the pace and magnitude of the effects of the Health Information Technology for Economic and Clinical Health (HITECH) legislation. The challenges and unintended consequences of EHR adoption are well documented."

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http://www.e-health-insider.com/news/6533/2011_

2011 "much tougher" for NHS IT

30 Dec 2010

Analysts expect the NHS to stop spending money on IT in 2011; unless it can show that technology will provide a return on investment or efficiency gains in a matter of months.

Tola Sargeant, research director at TechMarketView, forecast “a much tougher year for NHS IT overall" and said that she expected the market to contract by around 7% in 2011 and 4% in 2012 before returning to growth.

Last year, the market for software and IT services was £1.48 billion. This declined to £1.38 billion in 2010 and will drop to £1.33 billion in 2011.

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http://www.e-health-insider.com/comment_and_analysis/670

Here comes 2011

30 Dec 2010

Over the course of 2010, a new coalition government came into power, another round of reform was unleashed on the NHS and the end of the National Programme for IT in the NHS was announced; although its local service provider contracts live on.

At the end of a sometimes difficult 12 months, EHI reporter Sarah Bruce asks analysts and policy experts to look ahead to 201. What would they like to happen to the NHS and its IT? And what do they think will happen?

Christine Connelly, director general informatics, Department of Health

Innovation will grow at a local level as the wider NHS reforms progress during 2011.There are two key ambitions I hope to see begin to be realised during the year. We will encourage transparency by publishing data before it has been ‘polished’. We will also encourage data collection at the point of care, so we can improve its quality and accuracy, instead of relying on “after the event” memories. Finally, there is a great opportunity to help the efficiency and productivity drive by offering parts of the service online. Being able to communicate via secure email with a clinician, rather than waiting for an appointment, gives patients an accessible service, responsive to their needs.

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http://www.sun-sentinel.com/health/fl-hk-joint-replacement-database-20101219,0,2593955.story

New website helps consumers shop for hip, knee surgery

Floridians can find high-volume doctors, hospitals

By Bob LaMendola

Sun Sentinel

December 20, 2010

About 65,000 Floridians get their hips or knees replaced every year, and now they have a new way to figure out who might be best to do the job.

State health officials last week set up a new online service that lets consumers look up which doctors and hospitals performed many joint surgeries, as well as how much hospitals charge for them.

Studies have shown medical personnel who have the most experience performing a treatment or service tend to have the best results.

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http://www.healthdatamanagement.com/news/onc-meaningful-use-ehr-certification-41614-1.html

ONC Adds to FAQ Page

HDM Breaking News, December 21, 2010

The Office of the National Coordinator for Health Information Technology has posted new entries on its Frequently Asked Questions page covering electronic health records certification and meaningful use criteria.

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http://www.metrowestdailynews.com/top_stories/x1295283307/New-drug-law-will-track-more-prescriptions

New drug law will track more prescriptions

By Sarah Favot and Caroline Hailey/ Daily News correspondents

MetroWest Daily News

Posted Dec 26, 2010 @ 11:14 PM

BOSTON —

Massachusetts residents face a new routine when they pick up certain prescription drugs at the pharmacy on Jan. 1.

Under a law passed last summer, they will have to show a driver's license or another approved ID before the druggist can give them prescriptions ranging from addictive opiates to certain medicines for diarrhea. Their purchases will be recorded in a massive database that will include their names, addresses and the kinds and amount of pills they take.

The goal of the law is to combat the growing problem of prescription drug abuse, particularly among teens and young adults. According to one federal survey, Massachusetts ranked 8th among those 18-to-25 who have used drugs not prescribed to them.

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http://www.modernhealthcare.com/article/20101227/NEWS/312279995/

CMS to modernize IT systems

By Andis Robeznieks

Posted: December 27, 2010 - 11:30 am ET

The CMS is preparing to modernize its information technology systems under a plan that envisions how the agency will transform "from a passive payer of claims to an active purchaser of quality healthcare" by improving communications and information-sharing, acquiring new quality-of-care assessment data and enhancing payment and delivery systems.

In the report "Modernizing CMS Computer and Data Systems to Support Improvements in Care Delivery" (PDF), it's noted that this upgrade was called for in the Patient Protection and Affordable Care Act, which directs the HHS secretary to make data available to help healthcare providers and suppliers better manage and coordinate care for Medicare beneficiaries and to "support consistent evaluations of payment and the delivery system reforms under CMS programs."

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Enjoy!

David.

Weekly Overseas Health IT Links - 07 January, 2011.

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 subscription payment.

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http://www.govhealthit.com/newsitem.aspx?nid=75721

Blumenthal to set aggressive pace for health data exchange

By Mary Mosquera

Monday, December 20, 2010

Dr. David Blumenthal, the national health IT coordinator, expects to aggressively pick up the pace on health information exchange following the recent call from the White House for a common language and format for exchanging data between electronic health records systems.

To that end, the Office of the National Coordinator for Health IT will create an advisory panel to see how to implement some of the ideas laid out in the White House report. The work group, comprised of members of ONC’s Health IT Policy and Standards Committees and other privacy and security experts, will make recommendations to both committees by April.

The report, published Dec. 8 by the President’s Council of Advisors on Science and Technology (PCAST), directed ONC and the Centers for Medicare and Medicaid Services to develop the technical definitions and descriptions for the standard language and include them in requirements for meaningful use of electronic health records in 2013 and 2015.

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http://www.ihealthbeat.org/data-points/2010/what-data-can-consumers-with-electronic-access-to-their-medical-records-view.aspx

Wednesday, December 22, 2010

What Data Can Consumers With Electronic Access to Their Medical Records View?

Fourteen percent of surveyed U.S. adults said they have access to their health care information electronically, according to a new survey by the Health Research Institute at PricewaterhouseCoopers. Among respondents who have this access, 58% can check lab reports, 56% can read prescription medication orders and history, 53% can see their immunization records and 52% can view upcoming health care appointments.

The survey also found that 48% of such individuals can obtain physician visit notes and that 33% can view suggested preventive health screening.

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http://www.ihealthbeat.org/perspectives/2010/2011-health-it-forecast-balancing-technooptimism-with-local-realities.aspx

Wednesday, December 22, 2010

2011 Health IT Forecast: Balancing Techno-Optimism With Local Realities

by Jane Sarasohn-Kahn

Health politics, a hyper-market for health IT, health-engaged consumers and privacy ambiguities … 'tis the season when Jane Sarasohn-Kahn provides iHealthBeat readers with her annual health IT forecast for the new year.

Read on for Sarasohn-Kahn's look into the health IT tea leaves for 2011.

Bipartisan support for health IT. It's a long, long way between December 2010 and January 2014, when most provisions in the Patient Protection and Affordable Care Act (ACA) are scheduled to be implemented. While it's rational to expect that the Republican-led House will try to strip out various provisions in the law, there's long been one area of bipartisan support: health care IT. The HITECH Act, which was included in the American Recovery and Reinvestment Act of 2009 (ARRA), will withstand the Republican health reform hazing in Congress. While health reform may be in limbo -- individual mandate, state lawsuits, etc. -- health IT is bipartisan. So from a legislative standpoint, expect the health IT stimulus for electronic health records to still be a "go" in 2011.

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http://www.healthleadersmedia.com/print/LED-260474/Meaningful-Use-Tops-Healthcare-Industry-Challenges-for-2011

Meaningful Use Tops Healthcare Industry Challenges for 2011

Cheryl Clark, for HealthLeaders Media , December 20, 2010

Record spending on health information technology is greatly increasing the demand for experts in the field and tops a list of hot issues on the minds of healthcare leaders.

That's according to a survey and report by PricewaterhouseCoopers Health Research Institute, which ranks the top 6 issues facing healthcare leaders in the coming year.

1.Electronic health records. PwC says federal requirements that hospitals and doctors meet at least one stage-one meaningful use requirement for an electronic health record system in 2011 in order to receive federal stimulus funds has providers scurrying to order the right software and equipment. Additionally, FDA rules will require online reporting of adverse events related to medical devices, resulting in deployment of tracking technology throughout the supply chain.

Electronic health record conversion also means upgraded coding, and the use of the new Health Insurance Portability and Accountability Act formats require more than, 1,300 system modifications by Jan. 1, 2012.

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http://www.fierceemr.com/story/2011-will-be-makeover-year-health-industry-ehrs/2010-12-22

2011 will be makeover year for health industry, EHRs

December 22, 2010 — 10:21pm ET | By Janice Simmons - Contributing Editor

In 2011, healthcare executives, especially CIOs, will be on the frontline for what is expected to be a record year for health information technology (HIT) spending.

In particular, new requirements that hospitals and physicians achieve at least Stage 1 of the government's new "meaningful use" criteria for electronic health records will present new challenges in providing patients with electronic copies of their health records upon request, according to a new report from PricewaterhouseCoopers (PwC) on the top health industry issues of 2011.

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http://www.fiercehealthcare.com/story/expect-see-more-ipads-used-point-care/2010-12-22

Expect to see more iPads used at point-of-care

December 22, 2010 — 12:31pm ET | By Sandra Yin

The use of iPads in healthcare settings is likely to surge in the coming year, according to a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members. Nearly 70 percent of those surveyed said they plan to deploy the iPad and other iOS devices next year. And more than one in four said they plan to deploy the devices immediately.

Point-of-care apps are driving the rapid deployment of iPads in hospitals and other healthcare organizations. One-third of those polled said point-of-care applications--such as lab order visualization and results, clinical decision support and medical image viewing application--were top priorities.

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Guerra On Healthcare: EHR Certification Boosts Competition

Electronic health record vendors are applying for -- and receiving -- a government-backed stamp of approval, expanding options for vendors and buyers.

By Anthony Guerra, InformationWeek

Dec. 21, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228800916

No one is a bigger critic of the government's Health Information Technology for Economic and Clinical Health (HITECH) program than I, but I have to give credit where it's due.

Before we started down this road, there was one certification organization -- the Certification Commission for Health Information Technology (CCHIT). And it had all sorts of PR problems in the form of links to the vendor-run Healthcare Information and Management Systems Society (HIMSS). But at that time, without certification tied to the distribution of taxpayer money, no one could too vociferously decry a lack options. HITECH, however, changed all that.

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Healthcare iPad Deployment To Approach 70% In 2011

The rising number of iPad point-of-care applications are accelerating its use by physicians, finds Healthcare Information and Management Systems Society survey.

By Nicole Lewis, InformationWeek

Dec. 20, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228800929

Results from a survey of nearly 950 Healthcare Information and Management Systems Society (HIMSS) members indicates that iPad deployments are accelerating in large part due to the mobile device's compelling point-of-care applications and uses.

Conducted October 26 during an online webinar cosponsored by HIMSS and BoxTone, a mobile service management (MSM) company, the survey's results were released earlier this month.

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Epic Keeps Top Spot In Healthcare Software

KLAS' year-end report also cites Siemens, Cerner, and McKesson for making strong improvements in the health IT industry in 2010.

By Anthony Guerra, InformationWeek

Dec. 22, 2010

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228900076

In its end-of-year report, 2010 Top 20 Best in KLAS Awards: Software & Professional Services, health IT (HIT) analyst firm KLAS finds Epic is the top-ranked overall software vendor, with a performance score of 87.0 out of 100, followed by Picis and Philips. The top-rated overall services firm is Hayes Management (90.5), followed by Vitalize Consulting Solutions and CTG.

KLAS president Adam Gale said people keep asking him if Epic can maintain its position at the top of the HIT heap. After reviewing the vendor's last 13 go-lives this year, and finding they aggregate to an "A" score on the KLAS scale, he said there's no reason to think Epic will falter anytime soon.

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http://www.healthleadersmedia.com/print/TEC-260495/Hospital-Privacy-Security-Officers-Make-Their-Wish-Lists

Hospital Privacy, Security Officers Make Their Wish Lists

Dom Nicastro, for HealthLeaders Media , December 21, 2010

What is on the holiday wish list for privacy and security officers?

A recent Ponemon Institute study on data security, it's more staff, more time, and more resources to protect patient privacy.

Of the 65 hospitals surveyed, most in the 100- to 600-bed range, 71% said they have inadequate resources to prevent and quickly detect patient data loss. We caught up with some privacy and security officers ourselves to see what they're hoping for this holiday season:

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http://www.healthdatamanagement.com/blogs/health-reform-41559-1.html

The Health Reform Juggernaut

Gary Baldwin

Health Data Management Blogs, December 16, 2010

The recent federal court ruling that the Obama health reform bill is unconstitutional—due to its mandate that individuals must purchase health insurance—reminds me of a seminar on personal health records I attended several years ago. The speaker, a physician who was running a PHR software company, was asked if the technology would have any impact on health outcomes. His answer: Americans are in denial about their own health. He cited the rising incidence of obesity (which has since grown even more dramatically), the corresponding spread of expensive chronic diseases, and the overall reluctance of many people to take responsibility for their own health, PHRs or no.

There’s no telling how the courts may ultimately rule on the reform law. But I have no problem with the government telling us we need an ownership stake in health insurance. We have become so disassociated from the economic reality of paying for care that we take health care services for granted. We are fast becoming a nation that wants to eat, drink, smoke, snort and inject itself into oblivion, without regard for the fiscal fall-out—let alone regard for our bodies.

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http://www.modernhealthcare.com/blogs/it-everything/20101221/312219999

Tagging the data

Over the next couple of blog posts, I want to discuss the PCAST report on health information technology a little further.

You recall that the President's Council of Advisors on Science and Technology plopped down its tome on health information technology Dec. 8. It recommended that the feds push harder on health information exchange by adopting an XML-based universal exchange language that enables meta-data tagging for record identification, aggregation and privacy protection.

The presidential advisers want to see their changes rolled into the upcoming meaningful-use requirements. The Stage 2 requirements—along with a "roadmap," if not all of the specifics, for Stage 3—are in development now.

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http://www.modernhealthcare.com/blogs/it-everything/20101222/312229999

Not enough time for PCAST goals?

This month's report on health information technology by the President's Council of Advisors on Science and Technology, or PCAST, has startled some in the health IT community and challenged others—while getting everyone's attention.

Particularly arresting and discouraging for some was its call for applying federal persuasion for the healthcare industry to adopt an Internet-friendly "universal exchange language" for storing, retrieving and swapping healthcare data.

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http://www.modernhealthcare.com/blogs/it-everything

IT Pros ponder PCAST report

Healthcare IT professionals aren't short on opinions when it comes to last week's report from the President's Council of Advisors on Science and Technology, or PCAST. Among its recommendations, the report calls for the use of meta-data tagging as a way to promote patient privacy.

Howard Landa is the chief medical information officer for the Alameda County (Calif.) Medical Center and a pediatric urologist for Kaiser Permanente in Hawaii. He also is vice chairman of the Association of Medical Directors of Information Systems, a professional association for physicians in applied medical informatics.

"I think they underestimate what it's going to take to get to that level of specificity," Landa said. "I think we're moving toward that, but any data standards that exist, whether it's on the level of diagnosis or treatment, (are) still not complex enough to really exchange data at a meaningful level.

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http://www.modernhealthcare.com/article/20101221/NEWS/312219996/

Use of fully functional EHRs rises: NCHS

By Joseph Conn

Posted: December 21, 2010 - 11:00 am ET

Finally, a very thin majority of office-based physicians have some form of electronic health-record system in use, according to preliminary data from federal health agency.

The annual survey, which the National Center for Health Statistics conducted between April and July 2010, questioned more than 10,000 office-based physicians (excluding anesthesiologists, pathologists and radiologists)—its largest sample size to date.

One question NCHS surveyors asked was: "Does this practice use electronic medical records or electronic health records (not including billing records)?"

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http://www.euractiv.com/en/health/eu-us-sign-agreement-cooperate-e-health-news-500816

EU-US sign agreement to cooperate on e-health

Published: 21 December 2010

The European Union and American health authorities have agreed to work more closely on a common approach for electronic health records and education programmes for medical professionals.

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http://www.govhealthit.com/newsitem.aspx?nid=75666

Health IT extension centers enroll 28,000 physicians

By Mary Mosquera

Wednesday, December 15, 2010

Regional health IT extension centers have already recruited more than 28,000 physicians and have been signing providers up at a rate of 1,000 each week over the past three months, according to the Office of the National Coordinator for Health IT.

Some of the centers are already far along towards meeting their primary care target enrollments. Those in Mississippi and Maine, for example, are at 60 percent of their goals.

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http://healthcareitnews.com/news/gartner-releases-its-2010-healthcare-supply-chain-top-25

Gartner releases its 2010 Healthcare Supply Chain Top 25

December 16, 2010 | Molly Merrill, Associate Editor

STAMFORD, CT – Information technology research and advisory company Gartner, Inc. has released its second annual Healthcare Supply Chain Top 25, which identifies organizations striving for supply chain excellence and better patient care.

The "2010 Healthcare Supply Chain Top 25" ranks healthcare manufacturers, distributors, wholesalers and retail pharmacies based on quantitative assessments of their supply chain costs, productivity and efficiency. The organizations were then evaluated according to the opinions of supply chain leaders from the most senior levels of healthcare organizations, as well as a selection of Gartner analysts.

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http://www.healthdatamanagement.com/blogs/stimulus-meaningful-use-health-information-exchange-ehr-41564-1.html

The Game Just Changed for Meaningful Use

Joseph Goedert

Health Data Management Blogs, December 20, 2010

When the President's Council of Advisors on Science and Technology on December 8 recommended adoption of a "universal exchange language" to facilitate the exchange of health information while protecting privacy, I thought, "This is a game changer for meaningful use."

The belief was strengthened when six days later National HIT Coordinator David Blumenthal told the HIT Policy Committee that the Obama administration strongly supports the recommendation and the committee needs to start seriously looking at the issue as it develops future meaningful use criteria. AND, Blumenthal's office recently asked for public comments on how a quick transition in HIE policies and technologies would affect Stage 2 meaningful use criteria.

Universal exchange languages, known as "extensible markup languages" or XML, are widely used in other industries. Here's how PCAST explained such languages in its 108-page report: "The best way to manage and store data for advanced data-analytical techniques is to break them down into the smallest individual pieces that make sense to exchange or aggregate. These individual pieces are called 'tagged data elements' because each unit of data is accompanied by a mandatory 'metadata tag' that describes the attributes, provenance, and required security and privacy protections of the data."

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http://www.modernhealthcare.com/article/20101220/NEWS/312209978/

HIMSS, RSNA brainchild incorporates

By Maureen McKinney

Posted: December 20, 2010 - 12:00 pm ET

An information-exchange organization created by the Healthcare Information and Management Systems Society and the Radiological Society of North America is now formally incorporated, according to its founding groups. IHE USA, whose name stands for Integrating the Healthcare Enterprise, works to improve standards for electronic health information exchange.

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http://www.fiercehealthit.com/story/blumenthal-health-it-key-health-reform/2010-12-20

Blumenthal: Health IT is key to health reform

December 20, 2010 — 12:41pm ET | By Neil Versel

It's been a busy year in the Office of the National Coordinator for Health Information Technology and for health IT in general.

"It's been a whirlwind of activity. Many of you have spent many sleepless nights...dealing with all the things we have worked at. It's easy to forget how much we've accomplished," Blumenthal said during an ONC update last week, CMIO reports. "The 'meaningful use' framework is unprecedented in the history of electronic health information systems....We've started that process; it will evolve."

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http://www.fiercehealthit.com/story/workflow-software-robots-poised-transform-care/2010-12-20

Workflow software, robots poised to transform care

December 20, 2010 — 2:09pm ET | By Neil Versel

We have separate publications called FierceHealthIT and FierceEMR for a reason: Thanks in no small part to the federal "meaningful use" incentive program, EMRs are front of mind for many health IT professionals, but health IT is so much broader than just EMRs. It is with this in mind that we write about Computer Sciences Corp. highlighting six technologies that show promise for improving patient care and making a better working environment for clinicians, particularly nurses.

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http://www.fiercehealthit.com/story/it-could-compensate-higher-expected-care-fragmentation/2010-12-20

IT could compensate for higher-than-expected care fragmentation

December 20, 2010 — 3:22pm ET | By Neil Versel

Interoperable IT could be just the thing to help healthcare reduce the expensive duplication and potential adverse events associated with fragmented care, according to just-published research from Massachusetts. While this is hardly a new notion, the sheer extent of the fragmentation could add new urgency to the push toward a connected health system.

In a study appearing in the December issue of the Archives of Internal Medicine, researchers from Children's Hospital Boston found that of the 3.6 million adults receiving acute care in Massachusetts over a five-year period, 31 percent of patients visited more than one hospital and accounted for 56.5 percent of hospitalizations in the state. About 1 percent, or nearly 44,000 patients, went to five or more hospitals and were responsible for approximately one in 10 acute care visits during the study period.

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Enjoy!

David.

We Need To Set Some Expectations For the Three Trial Implementation Sites. Transparency and Frequent Progress Reporting Would be a Good Start!

Late last year (August 2010) we had an announcement that 3 sites had been chosen as lead implementation and testing sites for the planned Government PCEHR.

This was followed up by this release.

Applications Now Open For Second Wave e-Health Projects

Hundreds of thousands more Australians will join the e-health revolution as a result of up to $55 million from the Australian Government now available for the next round of innovative e-health projects across the nation.

24 November 2010

Hundreds of thousands more Australians will join the e-health revolution as a result of up to $55 million from the Gillard Government now available for the next round of innovative e-health projects across the nation.

Organisations are invited to apply to be one of the country’s lead sites to help introduce personally controlled e-health records.

“Currently 190,000 hospital admissions a year are caused by medication errors, and eight per cent of these are caused by inadequate patient information,” the Minister for Health and Ageing, Nicola Roxon, explained.

“E-health can improve patient care and save time for patients and doctors by reducing extra or repeat tests that don’t need to be done.”

“Of course, patients will ultimately control what goes into their health record and who can access their information.”

Applications are welcome from a variety of patient settings including from Divisions of General Practice, professional organisations, non government organisations, the private sector and others involved in the care of Australian patients.

The new e-health sites will join the first three selected sites in Brisbane, the Hunter Valley and Melbourne’s eastern suburbs, which are at the cutting edge of enabling Australians to use electronic health records. These sites—covering over seven per cent of the population—will be among the first to send hospital discharge summaries electronically to GPs and referrals using national specifications.

These sites will help lead the way for future planning of a secure, reliable e-health system, improving technology and identifying what works well and what could work better.

Organisations wishing to apply to be one of the next wave leading implementation sites of our nation’s e-health reforms should visit www.health.gov.au/tenders from 4.00 pm today. Applications will close on 23 December 2010 and the new sites will be selected in the new year.

The release is found here:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr10-nr-nr182.htm

The respective organisations put out some information as to what was happening and what they were doing:

First here:

GPpartners selected to lead on e-health records

17 August 2010

Brisbane will be one of the first areas in Australia to implement a plan foreshadowed in this year’s Federal Budget for building a national electronic health record system, following an announcement by Health Minister Nicola Roxon earlier today.

GPpartners is one of three Division participants which have received funding to work with the National E-Health Transition Authority (NEHTA) to plan for the establishment of a series of ehealth ‘lead implementation sites’ across Australia.

In addition to e-health records, these three sites will use health care identifiers for patients, providers and hospitals, and will be the first to electronically send discharge summaries and referrals using national specifications.

These sites will help lead the way in developing and informing future planning of the system, improving technology and identifying what works well and what could work better.

GPpartners Chair, Dr Henry Bryan said the Division was well-positioned to assist the government and NEHTA with the planning phase for the widespread adoption of electronic health records.

“GPpartners represents over 800 General Practitioners (GPs) and 200 GP practices, more than any other Division of General Practice in Australia, and we have many years of experience in developing e-health systems locally,” Dr Bryan said.

“We also cover the largest population of any division, but through our roll-out of the Health Record Exchange (HRX) system we’ve already demonstrated our experience in delivering similar projects of this size and scale,” he said.

The HRX is an electronic health record used by GPs to share patient information with other health professionals and hospitals across the GPpartners divisional area on Brisbane’s north side.

The HRX program has been operational for 4 years and is recognised as an Australian exemplar of community based shared electronic health records. The current license for the HRX software (Recordpoint) is supplied by Extensia Solutions Pty Ltd.

“GPpartners is grateful for this new opportunity to articulate its further vision for a truly advanced and connected, twenty-first century health system,” Dr Bryan said.

“We have formed the view that successful adoption of e-health requires ownership at a local community level with community-based care providers able to share patient information electronically across multiple care settings, including, but not limited to, the public health system,” he said.

“In pursuit of that aim, we have partnered with Health Industry Exchange (HIE) and sister Divisions of General Practice to assist the government in developing the implementation plans for lead sites.”

“This announcement today means GPpartners can continue to build upon its pioneering work in the sharing of electronic health records for the benefit of all Australians,” he said.

Also selected to develop implementation plans were Melbourne East General Practice Network (VIC) and GP Access (NSW), situated in the Hunter Valley.

Release here:

http://www.gppartners.com.au/page/About_Us/News_media/press2010/GPpartners_selected_to_lead_on_e-health_records/

and here:

GP Access to take the lead on ehealth records

17 Aug, 2010

GP Access is pleased to confirm that is has been selected as a lead site by the Commonwealth Government to develop an implementation plan for electronic health records

Health Minister Nicola Roxon has announced GP Access is one of three participants to receive funding to work with the National E-Health Transition Authority (NEHTA) on establishing an ehealth lead implementation site, as identified in the 2010/11 Federal Budget.

In addition to e-health records, GP Access will be using health care identifiers for patients, providers and hospitals, and will be the first to electronically send discharge summaries and referrals using national specifications.The purpose of the lead implementation sites will be to:

• Deploy and test national e-health infrastructure and standards in real world settings
• Demonstrate tangible outcomes and benefits from funded e-health projects
• Build stakeholder support and momentum
• Provide a meaningful foundation for further enhancement and roll-out of a national electronic health record.

GP Access CEO, Dr. Mark Foster said the Division was well-positioned to assist the government and NEHTA with the planning phase for the widespread adoption of shared electronic health records.

“GP Access represents over 450 General Practitioners (GPs) and 151 GP practices; we are one of the largest Divisions of General Practice in Australia. We have many years of experience in developing ehealth systems locally and we have the highest uptake of broadband by GPs in Australia. Our success in getting GPs to embrace technology has been assisted by our employment of dedicated IT professionals who have the specialised expertise in General Practice information management & technology systems as well as experience in the wider health sector.” Dr. Foster said.

“We have already demonstrated our experience in delivering electronic health records through our after hours service which employs over 250 GPs and sees around 50 000 patients each year. Every patient that is seen in our after hours service has a record of their consultation sent via secure electronic messaging to their GP. The record is sent instantly so when the patient sees their regular GP for a follow up consultation, a complete record of their visit is stored on the patient’s file,”

“GP Access welcomes the opportunity to participate in a program that will demonstrate the potential and benefits for an advanced and connected, twenty-first century health system,” Dr. Foster said.

GP Access will be working with Melbourne East General Practice Network (VIC) and GPpartners (Qld), situated in the Brisbane metropolitan area who have also been selected as trial sites.

Release here:

http://www.gpaccess.com.au/news.php?action=show&news_id=266

and there was a mention of the success of the Melbourne East GP Network which can be found here:

http://www.megpn.com.au/

It has now been confirmed that after a hiatus for the election it is all running smoothly at the three sites:

Suspended e-health plans now on track

By Josh Taylor, ZDNet.com.au on September 13th, 2010

Workshops and the trial sites for e-health roll-out in Australia had to be stopped in the course of the election, but they're now back on track, according to National e-Health Transition Authority (NEHTA) CEO Peter Fleming.

In the 2010 election campaign, it was unclear what the Coalition was intending to do instead of the $466.7 million investment in e-health outlined by Labor in the May budget; the spend was expected by many to be reduced significantly. According to Fleming, this meant any projects that didn't come under the Council of Australian Governments budgets were put on hold while the outcome was determined.

"Anything that came under the $466.7 million the Commonwealth had announced we needed to be fairly quiet on. We were still working but not on that particular component," Fleming told ZDNet Australia.

"Prior to the election being called we had actually started a series of workshops around the concept of operations for an electronic health record and also the architecture [and] when we went into caretaker mode those workshops had to be stopped," Fleming said. "But they've been reconvened, almost immediately as you'd expect, and the intention there is to get a very diverse series of views from all of our key stakeholders, document that and publish it for very wide input."

The work on the three test sites for e-health records also had to be halted.

"Because we've been in caretaker mode and the announcements [on the three e-health record trial sites] were made just before, we haven't been able to enter into extended dialogue on that," Fleming told ZDNet Australia. "We're now in deep dialogue with the three sites but more importantly we're bringing in external parties into that dialogue now."

With the Federal Government's investment in e-health now secured due to the Labor Party's return to power, Fleming said these three sites will serve as the catalyst for kicking off e-health around the country.

"What you can expect to see is a very strong focus on implementations. Firstly around implementation of the [health identifier] services in the foundation program and then around implementation of the next level of our work program, which is things like discharge referrals. And that will ultimately lead to the [personally controlled e-health record]," he said.

More here:

http://www.zdnet.com.au/suspended-e-health-plans-now-on-track-339305955.htm

As far as I am concerned there is only one problem. Since the releases and announcement that all was rolling on the silence has been deafening.

As best I can tell the last material that appeared was this report:

NEHTA calls for GP software proposals

• Karen Dearne
• From: Australian IT
• November 19, 2010 6:00PM

MEDICAL software-makers are being asked to help "test and finetune" currently undefined specifications for the Gillard government's $467 million personally-controlled e-health record program, which is yet to be explained in detail.

The National E-Health Transition Authority has called for proposals from GP clinical desktop suppliers willing to join a panel and work alongside it and the three e-health implementation sites announced by Health Minister Nicola Roxon in August.

During the election campaign, Ms Roxon announced $12.5m in total funding for GP divisions in Brisbane, NSW’s Hunter Valley and Melbourne to act as pilots over the next two years.

NEHTA received an extra $300,000 to co-ordinate the project; earlier the three parties -- GP Partners, Hunter Urban and Melbourne East -- had been invited to develop "lead implementation site" proposals for which they were paid $100,000 each.

Selection of the sites raised industry eyebrows as there was no public consultation or tender process.

Lots more here:

http://www.theaustralian.com.au/australian-it/government/nehta-calls-for-gp-software-proposals/story-fn4htb9o-1225956723414

Now we all know there has been over a decade of trials and pilots of e-Health in Australia starting with HealthConnect and Mediconnect and more recently with some State based programs and various other initiatives e.g. Healthelink.

As a matter of almost absolute uniformity each trial has essentially gone nowhere and has typically resulted in a non-sustainable non-continuing outcome with either no public evaluation or an obfuscatory whitewash appearing a year or so after the project finished. (The only possible exceptions I can think of are some of the work in the NT and the Pen Computing tools developed in SA.)

What is needed with these three trial implementations is a total break from the past.

Where we need to start learning in the new era is with how the 3 lead implementations are being planned and managed.

We need an overarching statement of strategic objectives, impacts and expected outcomes.

Additionally, for each of these 3 there should also be a public project and resourcing plan, defined objectives, evaluation criteria, time-lines and all the usual expected material. Each project should also be producing monthly reporting publicly on progress against the plan and so on.

The best way for this to happen would be for NEHTA, who is being paid as project manager, to establish a section for this on their website and report as I suggest openly and fully as to how things are going, what is being learnt and so on.

If we don't see something like this then I will know we have the same-old, same-old and it will all go nowhere.

Who is betting on the old rather than a new open approach being adopted by NEHTA? We shall see!

David.

Rumor Central - Who Will Deliver NASH for NEHTA?

I wonder if it is true but it seems IBM may have won the tender. I expect we will see an announcement that tells us if I was right or wrong over the next few days!

We await a working NASH!

David.