Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Monday, January 17, 2011

The Post of January 11, 2011 Has Really Caused Some Interesting Discussion.

You can read the blog (and all the comments) here:

http://aushealthit.blogspot.com/2011/01/it-looks-like-nehta-delivery-is.html

There was what I see as a major theme from the comments and that was a deep sense of frustration with the status quo and a real concern about whether it could be fixed, and if so how. The germs of some very good ideas appear at the end. Who wants to add to them?

Gems of examples of this were:

Anonymous said...

I wonder whether the Queensland flood situation will see the whole NEHTA initiative placed on hold. Significant immediate funding will be required for essential infrastructure replacement / repairs. Federal and State funding will need to be redirected from existing initiatives. Existing projects which are only in the planning stages and have been going for many years without delivering anything (i.e. NEHTA) will be obvious targets. If NEHTA was actually half way through implementing something (which they should have been), it would be a different story, but now the whole NEHTA project could easily be put on hold with little if any political ramifications.

Friday, January 14, 2011 4:33:00 PM

Anonymous said...

Hey, stop deluding yourself. A whole lot of little pilots with a disparate conglomeration of multiple players under the 'direction' of DOHA will achieve nothing. That is simply a repeat of DOHAs simplistic mentality which resulted in a whole lot of itty bitty HealthConnect projects set up 5 years ago none of which achieved anything of note.

Saturday, January 15, 2011 10:53:00 AM

Anonymous said...

So what should be done? It seems to me you people want to dismantle NEHTA because you say it hasn't achieved anything worthwhile. You want to can the $50M million earmarked by DOHA for eHealth projects because you say that approach failed last time DOHA went down that path.

How about one of you oh-so-smart commentators come up with something constructively positive and tell us what you all think should be done. If you don't like this and you don't like that and you don't like something else what do you like?

Saturday, January 15, 2011 3:53:00 PM

Anonymous said...

Hey hang about there - it is irrelevant whether or not Deloitte had some 'quick hits' to address the impatience problem if the Government, DOHA and NEHTA don't want to acknowledge that and do something about it.

So how about stopping using that as an excuse - you are beginning to sound just like Government.

Why don't all those experts get together and find a way round the obstacles that everyone seems to be so mesmerized by?

Surely there is another way to overcome the roadblock that is frustrating the progress you keep demanding. Or is it that, as you said, "it is complex and difficult and fraught with risk" to the degree that it is just too scary thereby rendering everyone, including Government, NEHTA and industry impotent?

Isn't it time to face reality and stop avoiding the real issues?

Saturday, January 15, 2011 10:54:00 PM

Anonymous said...

We should take the cheap but realistic road of improving the quality of what we already have by insisting on standards compliance with the existing standards we have had for years.

This will increase the cost of software, but that’s what needs to happen to fund the engineering work that needs to be done. Hacking together something for a trial for a pot of $$ is one of the problems. We need to build the foundations of a connected health system and stop trying to add the 14th story to a structure that has no foundations.

Foundation work is not sexy and there is not a lot of cool stuff to show but we need someone in control who knows that its the only way to build something that stays standing for any period.

The silly part is that it would be cheap to mandate compliance and provide some mechanism to support providers to pay a bit more for software that is solid.

We also need a little support for the proper standards process to proceed without interference from an organisation that wants to lay down the law without having the ability to do it well.

Sunday, January 16, 2011 12:10:00 AM

Anonymous said...

http://aushealthit.blogspot.com/2010/12/it-is-now-clear-pcehr-is-nothing-but-pr.html?showComment=1294261142728#c7950044238187712463

In the context of this current discussion John Johnston’s comment of Thursday, January 06, 2011 7:59:00 AM is very relevant.

In particular:

(a)Government initiatives encourage collaboration between parties with a common focus on a better patient result”.

(b)It is implementation experience that exposes strengths of the standard and identifies the weaknesses.

HOWEVER, all this is undermined by the fact that, as he says, “when the chips are down, the collaborative spirit can be overtaken by self interest.”

Furthermore your commentator of Saturday, January 15, 2011 10:54:00 PM asked:

-- Isn't it time to face reality and stop avoiding the real issues?

And another asked on Sunday, January 16, 2011 7:33:00 AM:

--- What can our local health industry software developers do to lift our game with Standards? Or is it all too hard for them?

Clearly the bottom line in all this is that the real obstacles lie NOT with Government but with the inability of the software industry to collaborate when the chips are down as John Johnston so succinctly expresses it..

Anonymous said...

The "perverse ways the industry is incentivised" is certainly a major obstacle to progress. But this has been pointed out to Government and the Department on numerous occasions however they simply do not want to know. So how do you overcome that problem?

Sunday, January 16, 2011 3:35:00 PM

Anonymous said...

I guess you'd have to start by defining what exactly the "perverse ways" are, as you see them.

Sunday, January 16, 2011 5:50:00 PM

Anonymous said...

So easy to say - so difficult to do.

How about starting from this end.

1. What is an incentive?
2. How will it motivate people?
3. What sort of incentive does a health software vendor need?
4. What conditions should be tied to the incentive?
5. What conditions should not be tied to the incentive?
6. Who should receive incentives?
7. Who should not receive incentives?

That's seems like a good first step. We can expand later once we have some answers to the above. Does that sound reasonable?

Sunday, January 16, 2011 6:39:00 PM

Anonymous said...

It sounds reasonable but I doubt anyone will be able or prepared to to construct a sound set of answers to your questions 1 to 7 leaving this discussion thread in a state of perpetual limbo.

Sunday, January 16, 2011 9:04:00 PM

Anonymous said...

I am happy to have a go at these as they are the alternative plan.

1. What is an incentive?

It is income received after you achieve a goal. In this case its proven standards compliance. That may be compliance with eg an AS4700 standard. It should not be paid to do the work but only when the work is done.

2. How will it motivate people?

There needs to be a demand for compliance and that is best done by legislation that requires it. Its as important as having reliable medication that has been tested. At the moment the eHealth snake oil salesman are doing very well.

3. What sort of incentive does a health software vendor need?

An incentive that covers the costs of doing high quality engineering, with the alternative being going out of business.

4. What conditions should be tied to the incentive?

The condition is proper compliance testing, AHML would do as step one but that is only structural and needs to examine content as step two.

5. What conditions should not be tied to the incentive?

No contracts or commercial in confidence deals, and independent testing by a NATA accredited testing organisation.

6. Who should receive incentives?

The providers or users should be able to access a software subsidy to purchase software that complies with the standards. PIP is not that way as it needs to be money for the software purchase only.

7. Who should not receive incentives?

The incentives should be for proven compliance only, so no compliance, no money. The subsidy could be slowly withdrawn over years if the medicare rebates were increased to allow Providers to pay out of their own pocket, but more likely the full subsidy would require more difficult and complex standards compliance each year with a well defined roadmap. The US incentives are a bit pie in the sky and the danger is that everyone will fudge it to save face. The targets need to be modest, but significant.

eg July 2011-2012: AS4700.6/2 compliance with AHML for outgoing messages will each attract a $2000-3000 per provider software subsidy amortised to $0 over 5 years.

The amout needs to be more than they are currently paying for software and in effect be the cost, so that would need some fine tuning but thats a ballpark figure.

Now someone out there can cost that. Its $4000 per doctor per year for proper message compliance, with a steady increase in complexity over 5 years, sounds cheap to me!

After about 5-10 years it could be gradually withdrawn and the price of medical software would have found a level that allowed good engineering practices and the legislation would ensure those practices had to be maintained. New entrants to the market would have assured income for a specified level of function.

No need for NEHTA, Would result in a few AHML clones and the ability to progress a standard knowing that everyone supported the current functionality, rather than still having to dish out PIT to a significant % of applications. Should also apply to Government hospitals!!! Especially them when I think of it.

Monday, January 17, 2011 12:00:00 AM

Anonymous said...

Monday, January 17, 2011 12:00:00 AM said "I am happy to have a go at these as they are the alternative plan."

I agree - it looks like an excellent alternative plan - albeit in its infancy.

After reviewing the responses above I think it an excellent first pass effort and the contributor of Monday, January 17, 2011 12:00:00 AM is to be congratulated.

I plan to take each Question & the above Responses and build on those responses as best I can and hopefully we will not be alone in doing so.

If we remain alone I think it would be fair to conclude that there is not much interest among industry proponents of ehealth to develop an alternate plan for approaching the problem of how to move forward avoiding the obstacles.

Monday, January 17, 2011 11:49:00 AM

OK kind readers, over to you to take this further. We have a forum for discussion that seems to work pretty well - so let’s use it - and hope the ‘powers that be take time to read’!

David.

AusHealthIT Poll Number 53 – Results – 17 January, 2011.

The question was:

Should Optimisation of Clinician E-Health Support (Systems, Secure Messaging, Decision Support etc.) take Priority over the Development of the PCEHR?

The answers were as follows:

Absolutely

- 22 (70%)

Possibly

- 6 (19%)

Neutral

- 0 (0%)

Probably Not

- 2 (6%)

No - Clinician Systems are Already Fine

- 1 (3%)

Votes : 31

Well that is pretty clear cut! The readers here think the Government is heading in the wrong direction! Not often 70% of readers agree!

Again, many thanks to those that voted!

David.

Sunday, January 16, 2011

Weekly Australian Health IT Links – 16 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.

General Comment:

There is virtually no e-Health news that I have come across and of course all eyes and thoughts have focussed on the floods that seem to have engulfed virtually the whole of Eastern Australia.

Such events - still ongoing - certainly assist in preserving perspective on what is important and what it not.

My best wishes and hopes for rapid resolution of all this go to all involved.

Below are a few slightly relevant tit bits I have spotted.

-----

http://news.smh.com.au/breaking-news-national/floods-will-swamp-health-system-ama-20110110-19k3o.html

Floods will swamp health system: AMA

January 10, 2011 - 8:44AM

AAP

Queensland's flood crisis will severely strain the state's health system for months, the Australian Medical Association has warned.

AMA Queensland President Dr Gino Pecoraro says health workers are already dealing with an increase in injuries and illness from the floods.

But he says the peak in health pressures is still weeks away, with the crisis still unfolding.

The most common injuries so far include cuts, sprains, dislocations, concussions and neck and back injuries resulting from people caught in flood waters, slipping or trying to clean up the mess the dirty tide has left behind.

-----

http://www.computerworld.com.au/article/373305/online_registry_launched_help_queensland_flood_victims/

Online registry launched to help Queensland flood victims

Disaster Relief Australia continues legacy of Victorian bushfire appeal

The legacy of the tragic 2008 Victorian bushfires has come to the aid of Queensland flood victims with the launch of online community registry, Disaster Relief Australia.

The registry, based on the same model used to assist hundreds of families in Victoria, acts as a noticeboard for victims seeking goods and services.

Established by the Fitzroy Oxfam Group, chair Brian Moran said the site is a voluntary project and aimed at easing the load on logistics during the crisis.

“There’s an outpouring of support from Australians wishing to help, but often the emergency organisations don’t have sufficient resources to cope with either the communications or the organisation and logistics of accepting them,” he said in a statement.

-----

http://www.computerworld.com.au/article/373157/brisbane_flood_shuts_down_aapt_data_centre/?eid=-255&uid=25465

Brisbane flood shuts down AAPT data centre

Other data centres and telcos prepare for worst

AAPT has confirmed it is the latest telco to close its Queensland data centre following floods.

A notice distributed to customers on Wednesday states that due to the flooding of the Brisbane region, AAPT will power down the equipment at the 167 Eagle St, Brisbane site as a safety requirement.

“We are currently investigating the issue and will provide further information once it becomes available,” said the statement.

The action follows electricity supplier Energex’s decision to cut power to the Brisbane CBD. It could affect up to 100,000 homes and businesses, but the utility stated the scale of the operation prevented it from notifying individual businesses before they lose power.

-----

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr11-nr-nr004.htm

Momentum Building around E-Health

Personally controlled electronic health records are a step closer with the closing of applications for the second round of lead implementation sites.

7 January 2011

Personally controlled electronic health records (PCEHR) are a step closer today following the closing of applications for the second round of lead implementation sites.

The Minister for Health and Ageing, Nicola Roxon, said the strong response demonstrated a keen interest to get PCEHR up and running.

“The high number and quality of applications has sent a clear message that people want to be a part of the Gillard Government’s investment in revolutionising our health system”, Ms Roxon said.

“After the outstanding success of the e-health conference in Melbourne earlier this month, there is strong momentum behind delivering the Government’s $466.7 million PCEHR system by July 2012.”

-----

http://nehta.gov.au/media-centre/nehta-news/792-alert-for-nehta-brisbane-staff

Alert for NEHTA Brisbane staff

All Brisbane based NEHTA staff please be advised that due to expected flood peaks predicted for Wednesday 12 January 2011, please do not attempt to travel into the NEHTA Office in West End unless safe to do so.

We encourage you to check road closures via national media links and emergency services before travelling.

-----

http://www.techworld.com.au/article/373410/legal_risks_hosting_data_offshore_highlighted/

Legal risks of hosting data offshore highlighted

Compliance and cost the major risk factors with offshore Cloud providers

Australian Cloud providers have been given a boost following warnings from a legal expert on the risks associated with hosting data offshore.

Connie Carnabuci, a partner of law firm Freshfields Bruckhaus Deringer said data stored offshore remained subject to the laws of the country in which it is stored, requiring local customers to submit to a US court, for example, in the event of litigation.

“Hosting data in the US can also make domestic legal and regulatory compliance difficult because it has no national privacy regime that is similar to the Australian National Privacy Principles,” Carnabuci said.

-----

http://www.smartcompany.com.au/economy/20110113-2011-the-sector-by-sector-outlook-2.html

2011: The sector-by-sector outlook

Thursday, 13 January 2011 00:00

James Thomson & Patrick Stafford

Patchy. That was the word that defined the Australian economy in 2010, and could well be the best description again in 2011.

While most economists are predicting Australia's economy will grow at a rate of about 3.75% in 2011 – that's just above the longer-term trend – much of this growth will be driven by the second coming of the resources boom.

…..

Information technology

Technology research firm Gartner predicts IT spending in Australia will increase by just 2% in 2011, to just over $50 billion.

While that looks like something of a slowdown given last year's spending growth of 2011, Australia can take comfort from the fact it is in the fastest-growing IT region in the world – Asia Pacific, where total spending is tipped to rise 7.6% in 2011 to $312 billion.

Gartner says software is likely to be the best performing part of the IT sector, with spending in this category tipped to increase 10%.

Against this slow-growth backdrop, it's not surprising that Australia's listed IT companies have quite different outlooks.

Brisbane's Technology One, which posted a 15% increase in profit in 2009-10, is expecting sales to grow during the current financial year, but has described the operating environment as "challenging and uncertain".

However, Perth-based IT service provider ASG is particularly bullish about the year ahead, having made a number of acquisitions in 2010. Those takeovers are expected to list revenue by 40% during the 2010-11 period, with the company saying it will be looking to chase aggressive growth in the 2012 and 2013 financial years.

On the other hand, health software company iSoft remains locked in a battle to restructure its operations as it battles against a large debt load caused by expansion into the patchy British market.

-----

http://news.theage.com.au/breaking-news-world/two-hours-of-tvwatching-boosts-heart-risk-20110111-19lvm.html

Two hours of TV-watching boosts heart risk

January 11, 2011 - 12:24PM

People who spend more than two hours per day of leisure time watching television or sitting in front of a screen face double the risk of heart disease and higher risk of dying, a new study said.

Researchers said the effect was seen regardless of how much people exercised, indicating that how we choose to spend our free time away from work has a huge impact on our overall health.

"It is all a matter of habit. Many of us have learned to go back home, turn the TV set on and sit down for several hours -- it's convenient and easy to do," said Emmanuel Stamatakis, expert in epidemiology and public health at University College London.

-----

http://www.watoday.com.au/technology/security/vodafone-may-be-liable-on-privacy-breach-20110109-19jup.html

Vodafone may be liable on privacy breach

Peter Martin and Lucy Battersby

January 10, 2011

VODAFONE faces compensation payments to up to 4 million customers after confirming it is investigating a security breach that has put billing and call records on a publicly accessible website protected only by passwords that change monthly.

It also faces the prospect of privacy concerns being added to a lawsuit being prepared on behalf of 12,500 customers over quality of service issues.

The Justice Minister, Brendan O'Connor, yesterday raised the matter with the Office of the Privacy Commissioner, which will speak to Vodafone today. The commissioner, Timothy Pilgrim, has the power to conduct an ''own motion'' investigation on behalf of affected customers and direct that compensation be paid.

Comment: There is a lesson here about the risk of staff behaving badly!

-----

Enjoy!

David.

Saturday, January 15, 2011

Another Couple of Examples Of Approaches To Patient Safety That Seems to Work.

We had some interesting studies appear over the break.

Study: EHR alert system improves doctor performance

December 22, 2010 | Molly Merrill, Associate Editor

CHICAGO – An electronic health system that alerts physicians with a yellow light when problems exist with a patient's care is being used by doctors at Northwestern Medicine. The system goes one step further by tying docs' responses to the alerts to quarterly performance reports.

Forty primary care physicians at Northwestern Medicine were part of a study which showing that, after one year of using the new system, it had significantly improved doctors' performance and the healthcare of patients with chronic conditions such as diabetes and cardiovascular disease. It also boosted preventive care in vaccinations and cancer and osteoporosis screenings.

Among the improvements: the number of heart disease patients receiving cholesterol-lowering medication rose from 87 to 93 percent, pneumonia vaccinations increased from 80 to 90 percent, and colon cancer screenings from 57 to 62 percent.

"The gains are modest, but if you are already at 90 percent and go to 94 percent, that's important," said lead author Stephen Persell, MD, an assistant professor of medicine at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.

"It helps us find needles in the haystack and focus on patients who really have outstanding needs that may have slipped between the cracks," said Persell, who is also a researcher in the division of general internal medicine.

"Quality healthcare is not just about having good doctors and nurses taking care of you," he added. "It's having systems in place that make it easier for them to do their jobs and insure that patients get what they need."

……

The study is published online in the journal Medical Care and in the February print issue.

More here:

http://healthcareitnews.com/news/study-ehr-alert-system-improves-doctor-performance

Study: Clinical decision support reduces unnecessary imaging

January 04, 2011 | Molly Merrill, Associate Editor

SEATTLE – Clinical decision support systems can help reduce inappropriate medical imaging, including unnecessary computed tomography (CT) and magnetic resonance imaging (MRI) scans, according to a recent study.

Conducted by researchers from Virginia Mason Medical Center in Seattle, the study was published in the January issue of the Journal of the American College of Radiology.

"Clinical decision support systems are point-of-order decision aids, usually through computer order entry systems, that provide real-time feedback to providers ordering imaging tests, including information on test appropriateness for specific indications," said C. Craig Blackmore, MD, MPH, lead author of the study. "Such systems may be purely educational, or they may be restrictive in not allowing imaging test ordering to proceed when accepted indications are absent."

A retrospective cohort study was performed of the staged implementation of evidence-based clinical decision support built into ordering systems for selected high-volume imaging procedures: lumbar magnetic resonance imaging (MRI), brain MRI, and sinus computed tomography (CT). Imaging utilization rates and overall imaging utilization before and after the intervention were determined.

…..

Click
here to read the full study.

More here:

http://www.healthcareitnews.com/news/study-clinical-decision-support-reduces-unnecessary-imaging

Just two more bricks in the wall regarding safety and quality improvements flowing from clinician decision support.

Good stuff!

David.

Friday, January 14, 2011

Now Here is Some Real Progress! Amazing Transnational Co-operation!

This came over my desk a few weeks ago

epSOS Projectathon determines next steps

08 Dec 2010

An epSOS Projectathon held in Slovakia to test whether the interoperability of different countries' healthcare systems meet epSOS specifications concluded that 10 pilot sites can begin sharing real patient data from early next year.

epSOS, the large scale European pilot of patient summary and electronic prescription, held the four day Projectathon to test content documents, such as patient summaries and e-prescription exchanges.

It also allowed national developers and testers to share knowledge and experience and addressed issues such as improving security, semantic interoperability, and avoiding other real patient safety issues.

In addition it saw nine countries - Austria, Czech Republic, Denmark, Spain, France, Greece, Italy, Sweden and Slovakia - successfully test cross-border patient data exchange.

More here:

http://www.ehealtheurope.net/news/6490/epsos_projectathon_determines_next_steps

The link to the project is here:

http://www.epsos.eu/

The description on the site is as follows:

About epSOS

Smart Open Services for European Patients - epSOS, (previously known as S.O.S. - "Smart Open Services", an Open eHealth initiative for a large scale European pilot of patient summary and electronic prescription) is a Europe-wide project organized by 27 beneficiaries representing twelve EU-member states, including ministries of health, national competence centres and numerous companies. This makes it the first European eHealth project clustering such a large number of countries in practical cooperation.

The overarching goal of epSOS is to develop a practical eHealth framework and an Information & Communication Technology (ICT) infrastructure that will enable secure access to patient health information, particularly with respect to basic patient summaries and ePrescriptions between different European healthcare systems.

The project is co-financed by the European Commission within the Competitiveness and Innovation Programme (CIP). epSOS was launched on July 1, 2008 and will be in progress for 36 months.

To achieve this goal, the national entitities cooperating within epSOS test both services in pilot applications, which interconnect national solutions. The approach, which is based on advanced and distinct use cases and associated infrastructural components, aims to deliver both a methodological process and durable implementations: building blocks. These building blocks will form the basis for a longer term, pan-European approach to develop interoperable service solutions.

The project is structured into work packages (WPs) which analyze the current situation in the participating countries, explore the legal questions, develop technical specifications covering all basic components of secure use of personalised health data, and finally set-up the test environment where the findings can be validated in a close to real life situation.

Dissemination and communication activities will accompany the project throughout the entire period, supported by the CALLIOPE Thematic Network.

----- End description.

Now if we could get the various States of Australia to be as advanced and co-operative as this!

Sounds like pretty good stuff to me! It will be good to hear in due course how these ambitious pilots go!

David.

This Is An Utter Disgrace and Shows The Government Doesn’t Give A Hoot About E-Health.

The World Health Organisation Released a Major Global Report on E-Health a week or two ago.

Global Observatory for eHealth series - Volume 1

ISBN 978 92 4 156416 8
22 December 2010

This publication presents data on the 114 WHO Member States that participated in the 2009 global survey on eHealth. Intended as a reference to the state of eHealth development in Member States, the publication highlights selected indicators in the form of country profiles.

The objectives of the country profiles are to:

  • describe the current status of the use of ICT for health in Member States; and
  • provide information concerning the progress of eHealth applications in these countries.

The countries discussed beginning with A are:

A

I think you will note the team at Federal Health are so embarrassed about their lack of progress they did not even bother responding to the request for information.

Just pathetic.

David.

Thursday, January 13, 2011

Weekly Overseas Health IT Links - 14 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.

-----

http://www.fiercehealthit.com/story/vision-hit-evolution-outlined-iom-workshops-report/2011-01-03

Vision for HIT evolution outlined in IOM workshops report

January 3, 2011 — 1:02pm ET | By Janice Simmons - Contributing Editor

To successfully shape the future of healthcare, a vision of how healthcare information technology should evolve--combined with ways to successfully engage patients and the population--should be considered, according to experts participating in a series of three workshops sponsored by the Institute of Medicine and the National Coordinator for Health IT last summer and fall.

A summary of the workshops' findings and suggestions has been compiled in a new IOM report, "Roundtable on Value and Science-Driven Health Care," which was released in late December.

-----

http://www.ihealthbeat.org/features/2011/blumenthal-looks-back-at-2010-offers-peek-into-plans-for-2011.aspx

Monday, January 03, 2011

Blumenthal Looks Back at 2010, Offers Peek Into Plans for 2011

From the release of the final rule on meaningful use to the launch of the temporary electronic health record certification program to the establishment of 62 Regional Extension Centers aimed at helping physicians become meaningful users of EHRs, there was a flurry of health IT activity in 2010.

Much of the activity centered on implementing policies and programs related to the meaningful use incentive program included in the 2009 economic stimulus package's HITECH Act. Under the program, health care providers who demonstrate meaningful use of certified electronic health records beginning in 2011 can qualify for incentive payments through Medicaid and Medicare. Beginning in January 2015, health care providers who are not meaningfully using EHRs will face penalties equal to a 1% reduction in annual Medicare payments per year up to 5%.

In an interview with iHealthBeat, National Coordinator for Health IT David Blumenthal discussed the biggest challenges the Office of the National Coordinator for Health IT faced over the last year, his office's game plan for 2011 and concerns about current EHR adoption rates. Blumenthal also discussed the importance of health IT to the implementation of the federal health reform law, the role of the government in overseeing EHR safety and why other countries have expressed interest in the U.S.' meaningful use program.

-----

http://www.modernhealthcare.com/article/20101230/NEWS/312309982

CMS launches new doc directory site

By Jessica Zigmond

Posted: December 30, 2010 - 1:15 pm ET

The CMS has added new information about physicians and other healthcare providers to the agency's physician directory tool. Called Physician Compare, the new site updates the agency's healthcare provider directory that guides beneficiaries looking for Medicare-participating physicians online.

According to the CMS, the new site was required by the Patient Protection and Affordable Care Act and contains information about physicians enrolled in the Medicare program, including doctors of medicine, osteopathy, optometry, podiatric and chiropractic medicine. It also contains information about other health professionals who care for Medicare beneficiaries, such as nurse practitioners, clinical psychologists, registered dieticians, physical therapists, physician assistants and occupational therapists.

-----

http://www.healthleadersmedia.com/print/QUA-260799/3-Million-Prize-Offered-to-Solve-Hospital-Admissions-Puzzle

$3 Million Prize Offered to Solve Hospital Admissions Puzzle

Cheryl Clark, for HealthLeaders Media , December 30, 2010

Attention, wizards, rocket scientists, game theorists and stats nerds: There's a physician in Los Angeles who wants to give you $3 million.

All you have to do is design an elegant math model that accurately identifies which of 100,000 Medicare Advantage patients from an actual 2009 database required an unplanned hospital admission in 2010.

The prize is offered by Richard Merkin, MD, Heritage Provider Network CEO and President. Heritage is an accountable care organization-like physician network that absorbs risk for 700,000 lives in Southern and Central California and New York and which contracts with more than 100 hospitals.

The idea is to design a suitable predictive model, so programs and resources can be focused to prevent those admissions – and readmissions – and potentially realize savings of up to $30 billion, the estimated cost of unnecessary hospitalizations throughout the U.S.

-----

http://blogs.wsj.com/digits/2011/01/03/why-are-health-data-leaking-online-bad-software-study-says/

Why Are Health Data Leaking Online? Bad Software, Study Says

Hard-to-use software is behind the leakage of sensitive health data online, according to a study by Dartmouth researchers published in December.

Health documents with sensitive patient information can be found in “peer-to-peer” networks, which people typically use to share music files and the like. The programs used to navigate these networks often locate files on a user’s computer and share them — whether they’re music and videos or things like spreadsheets with health data. The issue can arise when health workers transfer data from firms’ proprietary software to their home computers. If they or someone in their family uses file-sharing software, files can be picked up.

Over a two-week period in 2009, the researchers were able to find more than 200 files that contained identifying information such as name, address, date of birth, social security numbers, insurance numbers and health-related information. It’s not much compared with the vast number of files in these networks, but it presents a big risk — for health companies as well as patients.

-----

Social Security Approves EHR Interoperability Technology

Health IT firm EHR Doctors gets clearance for its C32 Continuity of Care Document, which enables hospitals and doctors to achieve meaningful use in the electronic exchange of medical data.

By Nicole Lewis, InformationWeek

Jan. 3, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=228901631

As the quest to advance the electronic exchange of medical records continues, the Social Security Administration (SSA) has approved the C32 Continuity of Care Document (CCD) technology developed by health IT firm EHR Doctors. The technology enables an interoperable health record to be shared among organizations for purposes ranging from transitions in care to adjudication of insurance claims.

Executives from EHR Doctors said Sunday the capability to generate CCDs is a critical piece of technology that will help hospitals and eligible physicians meet meaningful use requirements, which is a prerequisite to apply for payments under the Medicare and Medicaid EHR incentive programs. EHR Doctors' CCD technology is certified for meaningful use under the Office of the National Coordinator -- Authorized Testing and Certification Body (ONC-ATB) program.

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http://www.ama-assn.org/amednews/2011/01/03/bica0103.htm

EMRs may increase liability claims in short term

Technically Speaking. By Pamela Lewis Dolan, amednews staff. Posted Jan. 3, 2011.

Medical liability insurers once said electronic medical records would let physicians earn discounts on their premiums, because the potential benefits of the technology included improving patient safety.

But those discounts haven't materialized. The reason, a study says, is that liability insurers are betting that claims will rise during a so-called adjustment period, when practices new to the technology are working out the kinks in their systems.

Conning Research and Consulting published a study looking at medical liability and factors that could influence the industry, including the adoption of electronic medical records. It found that EMRs have the potential to reduce the number of liability claims in the long term.

Comment: Useful Summary of New England Journal Article which is here:

"Medical Malpractice Liability in the Age of Electronic Health Records," The New England Journal of Medicine, Nov. 18, 2010 - Free Article

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http://www.healthdatamanagement.com/news/report-medical-mobile-applications-market-share-kalorama-41664-1.html

Report Tracks Medical Mobile Apps Market

HDM Breaking News, January 3, 2011

A new report from market research firm Kalorama Information estimates the worldwide market for medical mobile applications hit $84.1 million in 2010, more than double the $41 million market of 2009.

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http://www.healthcareitnews.com/news/experts-name-top-7-trends-health-information-privacy-2011

Experts name top 7 trends in health information privacy for 2011

January 04, 2011 | Molly Merrill, Associate Editor

A panel of healthcare experts representing privacy, trends, technology, regulatory, data breach and governance have identified the top seven trends in healthcare information privacy for 2011.

The experts suggest that as health information exchanges take form, millions of patient records – soon to be available as digital files – will lead to potential unauthorized access, violation of new data breach laws and exposure to the threat of medical and financial identity theft.

"Endemic failure to keep pace with best practices and advancing technology has resulted in antiquated data security, governance, policy plaguing in the healthcare industry," said Larry Ponemon, chairman and founder, Ponemon Institute.

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http://www.reuters.com/article/idUSTRE7031JL20110104

Online health info popular but often unchecked

Tue, Jan 4 2011

LONDON (Reuters) - The number of people looking for health information online is set to soar as workers return from holiday breaks, but few will check where the information comes from, according to an international survey on Tuesday.

A report by researchers at the London School of Economics (LSE) commissioned by the private healthcare firm Bupa said that with smartphones and tablet computers set to outsell personal computers by 2012, more health information is available online and there are more ways to access it than ever before.

The Bupa Health Pulse survey questioned more than 12,000 people in Australia, Brazil, Britain, China, France, Germany, India, Italy, Mexico, Russia, Spain and the United States and found that 81 percent of those with internet access use it to search for advice about health, medicines or medical conditions.

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http://news.yahoo.com/s/livescience/20110102/sc_livescience/doctorwillskypeyounowmoremdsusewebforhousecalls

Doctor Will Skype You Now: More MDs Use Web for House Calls

Amanda Chan

MyHealthNewsDaily Staff Writer

livescience.com – Sun Jan 2, 9:10 am ET

In the winter, a mountainous region of California that the locals call the Grapevine is plagued by severe weather. The highway that winds through it is coated with snow and ice, making travel between central and southern parts of the state difficult and, sometimes, nearly impossible.

During these stormy outbursts, Dr. Gregory Smith, who specializes in treating chronic pain and prescription drug abuse, can't make it from his office in Los Angeles to his Fresno clinic. Two years ago, his only options were to reschedule appointments or cancel altogether.

But now, Smith uses his computer webcam to "see" his patients. He estimates the video technology enabled him to save 350 to 500 appointments this year.

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http://www.healthleadersmedia.com/print/TEC-261008/Medical-Imaging-Study-Flags-Portable-Media-Problems

Medical Imaging Study Flags Portable Media Problems

HealthLeaders Media Staff , January 6, 2011

Radiologists and referring clinicians frequently use CDs and DVDs to review patient medical images (e.g., MRIs and CT scans) acquired at outside imaging centers, but issues regarding access, importability, and viewing of these portable media could negatively affect patient care, according to a study published in the January issue of the Journal of the American College of Radiology.

The report looks at current practices for portable media use for medical imaging in both academic and nonacademic radiology departments in the United States.

Researchers from Johns Hopkins University in Baltimore reviewed a 22-question survey of members of the Association of Administrators in Academic Radiology, the Association for Medical Imaging Management, and the University HealthSystem Consortium.

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http://www.govhealthit.com/newsitem.aspx?nid=75819

HHS trend scan will signal potential health IT breakthroughs

By Mary Mosquera

Wednesday, January 05, 2011

The Health and Human Services Department plans to develop and maintain a continuous scan of current and emerging health information technology innovations to help HHS agencies understand and be aware of potential breakthroughs in healthcare delivery.

The Office of the National Coordinator for Health IT will collect information about technology trends along with subject-matter experts and health IT innovators and developers, according to a Dec.30 announcement in Federal Business Opportunities. HHS will use a vendor to support the innovation scanning effort.

ONC will update the Centers for Medicare and Medicaid Services and the Agency for Healthcare Research and Quality on the development of the most promising health IT innovations that may support the achievement of meaningful use and the adoption of health IT, as well as other program efforts that will be affected by technological advances.

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http://www.fierceemr.com/story/panel-hies-will-be-major-area-privacy-concern-2011/2011-01-06

Panel: HIEs will be a major privacy concern in 2011

January 6, 2011 — 11:11am ET | By Dan Bowman

As more patient information is funneled into online exchanges, more issues will arise, according to top healthcare IT experts, who were asked to offer insights on the most significant privacy trends for 2011. Novice or overworked employees launching said exchanges will be a big factor in just how many breaches occur, they believe, according to data breach prevention specialists ID Experts.

Other predictions made for this year include an increase in fines and regulatory actions due to the increased breaches and cost increases due to a rise in penalties. Experts also anticipate a major data spill that will garner nationwide attention.

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http://healthcareitnews.com/news/study-ehr-alert-system-improves-doctor-performance

Study: EHR alert system improves doctor performance

December 22, 2010 | Molly Merrill, Associate Editor

CHICAGO – An electronic health system that alerts physicians with a yellow light when problems exist with a patient's care is being used by doctors at Northwestern Medicine. The system goes one step further by tying docs' responses to the alerts to quarterly performance reports.

Forty primary care physicians at Northwestern Medicine were part of a study which showing that, after one year of using the new system, it had significantly improved doctors' performance and the healthcare of patients with chronic conditions such as diabetes and cardiovascular disease. It also boosted preventive care in vaccinations and cancer and osteoporosis screenings.

Among the improvements: the number of heart disease patients receiving cholesterol-lowering medication rose from 87 to 93 percent, pneumonia vaccinations increased from 80 to 90 percent, and colon cancer screenings from 57 to 62 percent.

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http://www.modernhealthcare.com/article/20110104/NEWS/301049944/

ONC issues final rule for permanent certification program

By Jessica Zigmond

Posted: January 4, 2011 - 12:01 am ET

HHS' Office of the National Coordinator for Health Information Technology has issued a final rule establishing a permanent certification program for organizations that seek ONC approval to test and certify health information technology.

The meaningful use of certified electronic health-record technology is a core requirement for healthcare providers looking to qualify for incentive payments under the Medicare and Medicaid EHR incentive programs. According to the ONC, the program provides new features that are intended to enhance certification of health IT by increasing the comprehensiveness, transparency, reliability and efficiency of current processes that are used for EHR technology.

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http://www.healthdatamanagement.com/blogs/Tholemeier_EHR_market_analysis-41660-1.html

How To Succeed At EHRs While Really Trying

Rob Tholemeier

Health Data Management Blogs, December 31, 2010

We mostly write from the perspective of health care providers and users of health care I.T., but this one time let’s take a look at electronic health records from the perspective of vendors.

Without a doubt the American Recovery and Reinvestment Act of 2009 is an enormous boost to the EHR industry. The $20 billion or so promised from the feds is just about equivalent to entire annual health care I.T. spend (depending on whose market-size numbers you believe). But that does not mean all EHR vendors will thrive. There’s still a lot of competition.

At Crosstree Capital Partners, we identify five market strategies that successful EHR vendors will adopt. While no vendor uses only one of these approaches to the EHR market, most select a primary strategy and then mix in other techniques as they grow and adapt. See if you can identify your EHR vendor.

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http://www.healthleadersmedia.com/print/TEC-260908/Tech-Gives-Vaccinations-a-Shot-in-the-Arm

Tech Gives Vaccinations a Shot in the Arm

Gienna Shaw, for HealthLeaders Media , January 4, 2011

In a perfect world, everyone in the world would have access to vaccinations against influenza and administration of flu vaccinations would be safe, simple, and effective. We do not, of course, live in a perfect world. But two new technologies are getting medicine a little closer to those goals.

The traditional vaccination method—using a needle and syringe—can be difficult, time-consuming, and dangerous in some countries where unsterile reuse occurs. So why not eliminate the needles? Needle-free jet injectors (and yes, they look like the hypospray devices from the Star Trek TV series) can administer tens of millions of doses of influenza, smallpox, meningitis, and many other vaccines in rapid fashion. Jet injectors reduce the dangers of needles, including reuse of non-sterile needles, needle-stick injuries to health workers, and unsafe disposal of sharps waste, according to the CDC.

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http://www.beckershospitalreview.com/healthcare-information-technology/researchers-study-health-it-utilization-in-patient-medicare-adherence.html

Researchers Study Health IT Utilization in Patient Medicare Adherence

Written by Jaimie Oh | December 27, 2010

Researchers recently examined the various methods and interventions used to improve patient adherence to cardiovascular medications, according to an article published in the American Journal of Managed Care.

The study examined methods and results from 51 randomized clinical trials published since 1975. Most of the studies included in-person interventions, such as direct and personal message delivery by a trained layperson or medical professional at the site of care or over the phone. Other interventions included mailed, faxed or hand-distributed messages and electronic systems.

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http://news.nurse.com/article/20101228/ED02/312280003

Vanderbilt Team Seeks To Bring Robotic Nurse Assistants To Eds

Computer engineers and emergency medicine specialists at Vanderbilt University in Nashville, Tenn., think the time is approaching when robot assistants will help manage patients in the ED.

Mitch Wilkes, associate professor of electrical and computer engineering, represented the team in presenting a paper, “Heterogeneous Artificial Agents for Triage Nurse Assistance,” about hospital ED robots earlier this month at the Humanoids 2010 Conference in Nashville.

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http://www.modernhealthcare.com/article/20110103/NEWS/301039997/

Aetna completes Medicity deal

By Gregg Blesch

Posted: January 3, 2011 - 12:00 pm ET

Aetna has completed its $500 million acquisition of Medicity, a Salt Lake City-based company that develops health information exchange technology.

Medicity, which claims 760 hospitals and 125,000 physicians as customers, will operate as a separate company within the Hartford, Conn.-based insurer, according to a news release from Aetna. The deal was first announced in December.

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http://www.usatoday.com/yourlife/health/healthcare/doctorsnurses/2011-01-03-online-appointments_N.htm

Medical practices increasingly allow online appointments

By Phil Galewitz, Kaiser Health News

After relocating to Washington, Clint Morrison needed a doctor to follow up a tonsillectomy he had a few weeks earlier in California. When he started calling specialists in his health plan's directory, he struck out: They either weren't taking new patients or had no openings for several weeks.

So in September, Morrison went to www.zocdoc.com. He could see doctors' appointment calendars and identify those that took his insurance and were located near his office. With a couple of clicks, Morrison, 24, scheduled an appointment for the next day with Mark Dettelbach, an ear, nose and throat doctor. "It was painless," Morrison says of the experience.

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http://www.fiercehealthit.com/story/online-appointment-scheduling-growing-popularity/2011-01-03

Online appointment scheduling growing in popularity

January 3, 2011 — 3:44pm ET | By Dan Bowman

For doctors looking to add patients and lower overhead costs, one easy solution, according to a Kaiser Health News/USA Today collaboration, is online scheduling. While the practice hasn't exactly gone mainstream yet, with only 16 percent of family doctors using online scheduling in 2009, it clearly has become less of an anomaly. Just four years earlier, only 6 percent of doctors participated in the trend.

Two mass online services highlighted by KHN--ZocDoc and Health In Reach--are fast becoming go-to sites for those looking for quick appointments, particularly younger patients. ZocDoc, which launched in 2007 and currently costs patients nothing and charges doctors a $250 monthly listing fee, boasts hundreds of listings each in four cities: Washington, D.C., New York, Chicago and Dallas. Cyrus Massoumi, the site's CEO, plans to expand to Boston, Los Angeles, Houston and Philadelphia in the near future, and compares his site to restaurant reservation website opentable.com.

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http://www.theaustralian.com.au/australian-it/britain-urged-to-outsource-health-it-to-india/story-e6frgakx-1225980937411

Britain urged to outsource health IT to India

  • Chris Smyth
  • From: The Times
  • January 03, 2011 11:03AM

BRITAIN'S National Health Service has been told millions of pounds could be saved by outsourcing more NHS administration to India.

The call was made by the head of a government-backed company leading healthcare efficiency reform in Britain.

However public unease means these savings are unlikely to be realised.

Patients may not like calling an operator in Delhi to book an appointment with their GP, or having their medical notes stored on overseas databases. But as pressure on NHS budgets intensifies, John Neilson suggests the alternative is cuts to services.

Call centres and offices in Delhi and Pune already handle invoices and other administration for a significant number of NHS trusts for a fraction of what British-based labour would cost.

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Enjoy!

David.