At Least A Partial Deal Has Been Done At the COAG Meeting on Health Reform. A Long Way From The Initial Vision or What Is Needed I Believe.

The following report appeared a little while ago on the ABC.

Deal done at COAG health meeting

Prime Minister Julia Gillard has emerged from a tough day of negotiations with state and territory leaders with a national agreement in place on health reform.

After more than seven hours of talks at the Council of Australian Governments (COAG) meeting at Parliament House in Canberra, the leaders finally put pen to paper on a heads of agreement for a health reform plan that Ms Gillard described as a "huge step forward".

Ms Gillard said with the heads of agreement in place, the technical details would now be worked through.

It is understood the deal, which was put forward last week, was held up as the leaders argued over Ms Gillard's proposed national health funding pool, which the Prime Minister said would boost transparency.

Ms Gillard said leaders have agreed to have one body distribute the money instead of having separate bodies for each State and Territory, and stressed the federal, state and territory governments would now be 'equal partners in growth'.

"It [multiple distributing bodies] would have risked over time that information was not truly comparable nationally," she said.

"As a result of today's agreement we are sweeping away those eight separate bureaucracies for one national funding body.

"While this has been a very long day, it has been a very successful outcome.

More here:

http://www.abc.net.au/news/stories/2011/02/13/3137595.htm

At least we have got some of the reforms now hopefully in place - but it is a long way from the objective of fixing the ‘blame game’ as far as I can tell. You have to say this was pretty predictable despite the huffing and puffing from the Premiers etc.

It is worth noting that the SMH is reporting that the 'final deal' will be finalised by COAG at a mid-year meeting so this may not be exactly as final as initial reporting suggests.

That the details of actually how funding will flow is still to be sorted leaves a fair bit of room for later problems before the final agreement as Colin Barnett has already said.

Prof John Dwyer put it will on ABC redio pointing out that this was actually a hospital fundinding reform deal and not actually a health system reform deal that shifted the emphasis and model of care to the proper emphasis on prevention, integration and primary care.

No mention of e-Health in the ABC report.

David.

NEHTA Releases A Set of Documents Describing Integration of the Health Identifier Service With the HealthSMART Program in Victoria. Not There Yet!

The most interesting to me is this document of the release is this one:

Vic IHI Integration Clinical Risk Assessment Report v1.1

The document is one of a series of specifications and so on produced as part of a IHI Pre-Implementation Project between NEHTA and HealthSMART.

An overview is found here:

Vic IHI Integration Project Deliverable Release Note 1.0

Overall the project is to deliver the following we are told:

“Project deliverables include:

• Business Requirements

• IHI Integration Functional Design

• IHI Clinical Risk Assessment

• IHI Best Practice Guide

• IHI Integration Technical Design

• IHI Integration Solution Architecture.”

Interestingly the IHI Solution Architecture itself was held back for a later release as it was not ready yet (as of 11-02-2011).

As mentioned, I was especially interested to read this document. Interestingly the risks around the use of the CDMS as the source data for the HI Service seem to not get much discussion or review as far as I can tell.

2.2 Clinical Risk Assessment

This document provided an important input to the Vic IHI Integration Design, and much of the design exists to address the risk areas identified. This document was prepared by the project team with input from health service and other staff well versed in evaluating and mitigating clinical risks.

This document is user and clinician focussed, but may also be of interest to designers and architects of health IT systems.

This is the Table of Contents:

Table of Contents

1. Document Overview

1.1 PURPOSE

1.2 INTENDED AUDIENCE

1.3 REFERENCES

2. Introduction

3. Scope

4. Risk Assessment Report Summary

4.1 APPROACH

4.2 IMPLEMENTATION ASSUMPTIONS

4.3 RESULTS OVERVIEW

4.4 DISCUSSION OF THE HAZARDS ASSESSED AS MEDIUM

4.5 DISCUSSION OF THE HAZARDS ASSESSED AS LOW

5. Detailed Hazards Assessment and Recommended Controls

5.1 HAZARD 001: MISIDENTIFICATION OF THE PATIENT ASSOCIATED WITH AN IHI

5.2 HAZARD 002: INABILITY TO IDENTIFY PATIENT BY IHI IN CLINICAL CARE SETTING

5.3 HAZARD 003: PRIVACY OF PATIENT INFORMATION IS BREACHED

5.4 HAZARD 004:WHOLE OF PART OF THE SYSTEM IS UNAVAILABLE OR ACCESS IS INAPPROPRIATELY DENIED

6. Appendix: NEHTA Sentry Clinical Safety Risk Assessment Criteria

6.1 CLINICAL RISK SEVERITY CATEGORIES

6.2 LIKELIHOOD CATEGORIES

6.3 CLINICAL RISK CLASSIFICATION MATRIX

7. Glossary.

Just a few comments:

First just why is this the first time we have heard of this document?

NEHTA Hazard Assessment Report – Health Identifiers Release 1, v 1.0 , Feb, 2010

Second on page 6 we read:

“A constraint upon this review was that specialist training in NEHTA Clinical Safety Management methodology, and NEHTA Clinical Risk Assessment of Release 3 HI Service functionality was not available at the time of this Risk Assessment. Capacity to participate in Jurisdictional Clinical Safety Management was identified during this project as a gap in NEHTA support. The NHCIOF have subsequently sponsored a Gap Analysis and Clinical Safety Management Model to be delivered by NEHTA in January 2011.”

Translation from bureaucratese - The team were not ready and not trained to undertake the review!

Further on we read:

”The introduction of healthcare identifiers, whilst designed to improve quality and safety in clinical communication and electronic identification of patients to support clinical care can also increase risk of harm to patients.

The Australian Commission on Safety and Quality in Health Care, Report ‘Review of Technology Solutions to Patient Misidentification’ (2008) notes that:

Throughout the healthcare sector, the failure to identify patients correctly and to correlate that information to an intended clinical intervention continues to result in wrong person, wrong site procedures, medication errors, transfusion errors and diagnostic testing errors.

In examining the potential for technology to assist in solving this problem, the Commission’s key finding noted:

· Diligent execution of appropriate process/workflow remains the key aspect of patient identification. Technology is an enabler, not a sole solution.

· To be successful in the long term, implementation implies ubiquitous deployment of the technology throughout the patient journey.

· The importance of formally developed corporate implementation strategies, planning, and process scoping should not be underestimated.”

So this implementation all needs to happen pretty carefully - or some big issues can flow!

Third on page 8 we then read:

The preferred architecture for the IHI capture in the Victorian health service is as an alternate identifier. The local URN will not be replaced in the short term by the IHI in Victorian health services.

This Risk Assessment did not consider the obtaining and use of healthcare identifiers beyond the individual healthcare identifier (IHI), i.e. the scope does not include Provider Healthcare Identifiers, HPI-I and HPI-O.

This leads one to ask just when the system will actually be trusted in use. Not soon would seem to be the answer.

It seems to me the real ‘guts’ of the assessment is here. On Page 10.

4.3 Results Overview

“Assessment of the level of Clinical Risk associated with the introduction and use of the IHI was seen to be mitigated internally for health services through its use in conjunction with a local UR number. The effect of not relying solely on the IHI was that it reduced overall risk levels. Therefore it is important to realise that the ratings noted in the following review would have been assessed as higher in a situation where the IHI is used singularly to identify a patient.

Where the IHI is used singularly at the point of exchange between health services, ie the sending or receiving a patient referral with an IHI, increased checking of patient demographics with the HI Service to verify the IHI has been included in the controls.

There were two key Clinical Hazards reviewed where the clinical risk was assessed as Medium, however only where the IHI is used in conjunction with a local UR number. If the IHI is used in isolation then these Clinical Hazards would result in High risks.

The identified Hazards were:

· Misidentification of the patient associated with an IHI.

· Inability to identify the patient by IHI in a clinical care setting.

The rating of Medium defines that the clinical risk is of moderate severity and that it may create a situation that is serious and potentially life threatening, however the clinical risk may also be avoided/prevented by a Clinician. This level risk requires that stakeholders be notified of the risk as soon as practicable and appropriate mitigating actions agreed.

If the IHI is used singularly these Clinical Hazards would be considered High risk. High Risk signifies major or catastrophic severity risks that create a situation that is inherently and immediately threatening to a patient’s life. The clinical Hazard may results in permanent harm and/or death to a patient. Harm is unlikely to be prevented by a Clinician in these circumstances. This category will also apply to a Clinical Hazard that causes many occurrences of Moderate or Major Severity.”

This really seems to be saying that, at present, relying on the IHI alone is not recommended and hence the decision to go with both the URN and IHI.

If ever there was a case for staged careful implementation of this service this assessment seems to make it pretty strongly.

It also seems to me that developing a PCEHR service to rely on the HI Service, with unproven work practices and flows, until we are sure all the wrinkles of the foundation are fully managed would be very silly indeed. The technology really does not matter unless the HI Service is a real improvement on what is happening now - and it is not obvious that is true.

We won’t even mention that the overall situation of the HealthSMART Program also seems to be under review!

David.

The Markle Foundation Is Doing Some Interesting Attitude Research on E-Health.

In a press release they describe a large survey done with US patients and clinicians.

Doctors and Patients Overwhelmingly Agree on Health IT Priorities to Improve Patient Care

Support for Online Access to Information and Privacy Protections

January 31, 2011

NEW YORK—Doctors and patients overwhelmingly agree on key requirements for information technology (IT) to increase the quality, safety, and cost-efficiency of care, as well as core privacy protections, according to a national survey released today by the Markle Foundation.

The Markle Survey of Health in a Networked Life is the first of its kind to compare the core values of physicians and the general public, referred to here also as patients based on their opinions as consumers of health care, on deployment of information technology in health care. It comes at the start of a new federal program to help doctors and hospitals upgrade from paper to electronic health records.

"Doctors and patients agree on the importance of putting accurate information in their hands to improve the quality, safety, and efficiency of health care," Markle President Zoë Baird said.

"A surprising 74 percent of doctors say they want to be able to share patient information with other professionals electronically. As medical professionals shift from paper records to electronic systems, this survey shows that the public and physicians overwhelmingly agree that we need to measure the payoff from investments in information technology in terms of better health and more cost-efficient care," Baird said.

Agreement between doctors and the public was strongest on requirements to ensure that new federal health IT incentives will be well spent. The funding was included in the stimulus bill passed by Congress in 2009.

"Roughly 80 percent majorities of both the public and doctors agreed that it’s important to require participating hospitals and doctors to share information to better coordinate care, cut unnecessary costs, and reduce medical errors," said Carol Diamond, MD, MPH, Managing Director at the New York-based nonprofit foundation.

"By the same overwhelming margin, four in five doctors and patients expressed the importance of privacy protections for online medical records, an expectation we have repeatedly found on the part of the public in our previous surveys," Diamond said. "They also agree on the importance of measuring progress. This survey is a powerful indication that the public and physicians alike want investments in health IT to come with accountability."

Survey Shows Many Doctors and Patients Believe Key Information is Lost in Their Health Care Conversations

Of the doctors surveyed, 94 percent said their patients at least sometimes forget or lose track of potentially important things they are told during doctor visits, and 34 percent of the doctors said they themselves at least sometimes forget or lose track of potentially important things that their patients tell them. Among the patient group, 30 percent perceived that their doctors forget or lose track of potentially important information at least sometimes.

According to the Markle Survey of Health in a Networked Life, we have found that:

· Among the doctors, 74 percent would prefer computer-based means of sharing patient information with each other. (Only 17 percent of doctors predominantly use such means today.)

· Nearly half (47 percent) of the doctors would prefer computer-based means of sharing records with their patients. (Only 5 percent do so today.)

· Yet 74 percent of doctors said patients should be able to share their information electronically with their doctors and other practitioners.

· Among the public, 10 percent reported currently having an electronic personal health record (PHR)—up from 3 percent who reported having one in Markle’s 2008 survey.

· Roughly 2 in 3 of both groups (70 percent of the public and 65 percent of the doctors) agreed that patients should be able to download their personal health information online.

· And 70 percent of the public said patients should get a written or online summary after each doctor visit, but only 36 percent of the doctors agreed. (Only 4 percent of doctors say that they currently provide all their patients a summary after every visit).

"Our past surveys show that most US adults believe personal health records that include copies of their own medical information would help them improve their health and communicate better with health professionals," said Josh Lemieux, Director of Personal Health Technology at Markle. "With this survey, we find an increase in PHR use and learn that roughly two in three doctors agree that patients should have the option of online access to their personal health information. The survey also confirms that having modern information tools comes with expectations for privacy protections."

Other findings from the Markle survey include:

· Majorities of 70 percent to 80 percent of both patients and doctors support privacy-protective practices, such as letting people see who has accessed their records, notifying people affected by information breaches, and giving people mechanisms to exercise choice and correct information.

· Majorities (65 percent of the public and 75 percent of doctors) agreed that it’s important to have a policy against the government collecting personally identifiable health information for health IT or health care quality-improvement programs.

· If there are safeguards to protect identity, however, at least 68 percent of the public and 75 percent of the doctors expressed willingness to allow composite information to be used to detect outbreaks, bioterror attacks, and fraud, and to conduct research and quality and service improvement programs.

· Large majorities of the public (75 percent) and the doctors (73 percent) said it will be important to measure progress on improving health care quality and safety to ensure the public health IT investments will be well spent. Both groups (each at 69 percent) agreed on the importance of specific requirements to improve the nation's health in areas like heart disease, obesity, diabetes, and asthma.

· Many are unaware of the health IT incentives: 85 percent of the public and 36 percent of doctors describe themselves as not very or not at all familiar with the health IT incentives program, which makes subsidies available for doctors and hospitals to increase use of information technology.

"We all have a stake in making sure that information is protected and trusted so that it can be put to best use to improve our health," Diamond said. "This survey shows that doctors and their patients share many of the same hopes and expectations for advancing health in a connected world."

Knowledge Networks (KN) conducted the surveys between August 10 and 26, 2010. The general population survey of 1,582 adults age 18 and older used KN’s KnowledgePanel®, a probability-based panel of 50,000 individuals designed to be representative of the US population. The survey of 779 physicians was conducted using KN’s Physicians Consulting Network (PCN), an invitation-only list of more than 45,000 practicing physicians.

Results are available at www.markle.org.

The release is found here and all the links found there point to aspects of the results. This is really pretty useful material on a range of topics

http://www.markle.org/news-events/media-releases/doctors-and-patients-overwhelmingly-agree-health-it-priorities-improve-pa

Interestingly Markle is also involved in an earlier study that has just been published.

Docs differ widely in PHR attitudes: study

By Maureen McKinney

Posted: February 3, 2011 - 11:45 am ET

Despite the potential benefits of personal health records for patients, physicians differ widely in their past experience with PHRs and in their willingness to use them in their practices, according to a study published in the journal Health Affairs.

The study's authors—the director of the Institute for Ethics at the American Medical Association, a doctoral student in public policy at the University of Chicago and the director of personal health technology at the New York-based Markle Foundation—surveyed 700 physicians in 2008 and 2009 about their use of PHRs. A majority, 64%, had never used one in their practices. About 42% of respondents said they would be willing to use PHRs; 24% expressed unwillingness to use the tool.

But belief in the usefulness of personal health records also varied significantly. "Even among those willing to use them," the study's authors wrote, "fewer than half of physicians believed that these tools would save time, improve their relations with patients or improve accuracy."

More here:

http://www.modernhealthcare.com/article/20110203/NEWS/302039989

The apparent differences in attitudes is very interesting and begs the question of just how current such research has to be to remain relevant for decision making. It looks here that there has been an evolution of views over quite a short period.

Again we have evidence in some areas for high levels of currency!

David.

Weekly Overseas Health IT Links - 11 February, 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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Lessons Learned From The Largest Civilian EHR System

Implementation can costs hundreds of thousands of dollars, so it's critical to make wise decisions.

By Phil Fasano, InformationWeek
Jan. 29, 2011
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229200032

Implementation of electronic health records continues across the nation as healthcare providers position themselves to take advantage of the federal government's incentive payment program, which begins this year and can yield tens of thousands of dollars to those that demonstrate "meaningful use." But implementation itself, from the acquisition of equipment, software, and services to training and utilization, can cost providers hundreds of thousands of dollars, so it's nonetheless critical to make wise choices.

In choosing and deploying an EHR system, continually remind yourself of what it is you're supposed to bring to your practice: connectivity and better coordination among care teams; improved quality and patient safety; efficiency and reduced care costs. As you make system choices, ask how these goals can be advanced--or hampered--through specific EHR capabilities.

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http://www.fierceemr.com/story/ehrs-and-enabling-personalized-medicine/2011-02-03

EHRs and enabling personalized medicine

February 3, 2011 — 1:31pm ET | By Janice Simmons - Contributing Editor

In the healthcare arena, one of the promising areas of innovation is genomics--and how that can be adapted to providing personalized medicine. But while progress is being made in understanding the human genome and how to tailor treatments based on individual's genetic structures, a barrier remains: how to successfully weave together disparate sources of information.

Darrell West, founding director of the Center for Technology Innovation at the Brookings Institution in Washington, brought this issue to the forefront Jan. 28 in a paper and symposium at Brookings. He argues that now is the time to move forward to connect genomic and other personalized information to EHRs.

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http://bits.blogs.nytimes.com/2011/02/02/u-s-tries-open-source-model-for-health-data-systems/?src=busln

February 2, 2011, 1:24 pm

U.S. Tries Open-Source Model for Health Data Systems

By STEVE LOHR

The government’s lofty vision of bringing health care into the computer age to improve care and curb costs will come to nothing, unless some mundane technical problems can be solved.

A basic challenge is for doctors, hospitals, patients and public health authorities to be able to easily and securely share information — things like a person’s vital signs, diagnosis, lab tests and drugs prescribed. A fancy electronic patient record, unconnected, is just an expensive way to capture data.

The government’s office of national health information technology announced on Wednesday an important step toward the goal of widespread sharing of health data. Two pilot projects, the government said, have successfully used new government-endorsed Internet-based tools for exchanging health information among institutions.

The two pilot projects are in Minnesota and Rhode Island, and the information includes immunization records sent to a public health authority and patient data sent from general practitioners to specialists. Other pilot projects will soon be started in New York, Connecticut, Tennessee, Oklahoma and California.

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http://www.modernhealthcare.com/article/20110204/NEWS/302049989/

Health IT community reacts to Blumenthal departure

By Joseph Conn

Posted: February 4, 2011 - 11:45 am ET

After Dr. David Blumenthal's announcement that he will step down this spring as national coordinator for health information technology and return to Harvard University, members of the health IT community praised Blumenthal's accomplishments and expressed optimism that his legacy will continue.

Over the past two years, Dr. Paul Tang worked with Blumenthal as closely as anyone not on the ONC's staff. Tang served as vice chairman of the Health IT Policy Committee under Blumenthal's chairmanship. The advisory panel was established under the American Recovery and Reinvestment Act of 2009 to guide the ONC on health IT policy matters. When not serving as a federal adviser, Tang works as vice president and chief medical information officer at the Palo Alto (Calif.) Medical Foundation.

In an e-mail late Thursday, Tang described Blumenthal as "a superb national coordinator who accomplished an enormous amount in his two-year tenure." Blumenthal's "wise, even-handed guidance," he added, was essential in promoting a healthcare IT transformation for the country.

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http://www.healthdatamanagement.com/news/blumenthal-onc-resignation-harvard-sebelius-41880-1.html

Sebelius: Blumenthal Built a Strong Foundation

HDM Breaking News, February 4, 2011

Health and Human Services Secretary Kathleen Sebelius sent the following memo to HHS staff announcing that National HIT Coordinator David Blumenthal, M.D., will soon leave to return to Harvard University:

"David Blumenthal has served nearly two years as the National Coordinator for Health Information Technology, and it is with regret that I report that he will be leaving that position later this spring to return to his academic post at Harvard. While this was his plan when he joined ONC, we will miss his formidable abilities, steady leadership and incredible dedication.

"In the last two years, our Nation has finally turned the corner in our critically important journey to the use of health information technology, particularly the adoption of electronic health records. Under the leadership of David Blumenthal and his entire team at ONC, we have made significant strides in the implementation of EHRs.

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Healthcare Software Venture Funding Jumps 19%

The gain in 2010 was driven by the increased market for digitized medical records and other health IT services, reported Dow Jones VentureSource.

By Nicole Lewis, InformationWeek

Jan. 31, 2011

URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=229200097

Venture capital investment in medical software and information services increased from $387.5 million in 2009 to $460 million in 2010 -- a 19% annual growth rate, according to figures from Dow Jones VentureSource.

The investments were driven by the increased adoption of health IT as healthcare delivery organizations move from paper-based systems to digitized medical records. According to Dow Jones VentureSource analysts in a report published last week, that trend is poised to continue in 2011.

"The information management and software area is really the sweet spot for venture capitalists whether in healthcare or in IT overall," Jessica Canning, global research director, Dow Jones VentureSource, told InformationWeek. "It fits their investment model the best because it's much easier to get up and running. It has a shorter investment lifecycle compared with trying to develop new drugs or new cancer research."

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https://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/684

Core elements of electronic health records in place for almost half of Canadians

Benefits being realized across the country as a result of investments in EHRs

February 3, 2011 (Toronto) - As a result of investments made by Canada Health Infoway (Infoway) and its jurisdictional partners, Infoway President and CEO, Richard Alvarez reports today that the core elements of an electronic health records (EHR) are now in place for nearly half of the Canadian population (49.3%).

"We set an ambitious goal of making the core systems of an electronic health record available to authorized care providers for 50 percent of Canadians by the end of 2010. We've come very close to achieving this important milestone and estimate we'll cross this threshold in mid-2011," said Alvarez. "As a result of these efforts, systems are now in place that are delivering value to patients and clinicians from coast to coast to coast."

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http://govhealthit.com/newsitem.aspx?nid=76173

Blumenthal to step down as health IT coordinator

By Mary Mosquera

Thursday, February 03, 2011

Dr. David Blumenthal, the national health IT coordinator, will step down in the spring from his position leading the federal program to drive adoption of electronic health records by the nation’s physicians and hospital.

Blumenthal told his staff in a memo Feb. 3 that he will return to Harvard University, where he was a researcher before President Obama named him to head the Office of the National Coordinator for Health IT in March 2009.

Blumenthal had planned to stay two years when he accepted the position with ONC, he said in the memo.

Blumenthal has steered the development of criteria for meaningful use of EHRs in collaboration with the Centers for Medicare and Medicaid Services and public and private partnerships to nudge providers away from paper to digital records, and then to use them in a way that will help to improve the quality of health care.

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http://www.modernhealthcare.com/article/20110203/NEWS/302039989

Docs differ widely in PHR attitudes: study

By Maureen McKinney

Posted: February 3, 2011 - 11:45 am ET

Despite the potential benefits of personal health records for patients, physicians differ widely in their past experience with PHRs and in their willingness to use them in their practices, according to a study published in the journal Health Affairs.

The study's authors—the director of the Institute for Ethics at the American Medical Association, a doctoral student in public policy at the University of Chicago and the director of personal health technology at the New York-based Markle Foundation—surveyed 700 physicians in 2008 and 2009 about their use of PHRs. A majority, 64%, had never used one in their practices. About 42% of respondents said they would be willing to use PHRs; 24% expressed unwillingness to use the tool.

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http://www.modernhealthcare.com/article/20110203/NEWS/302039988/

VA, DOD lack EHR updates plan: GAO

By Joseph Conn

Posted: February 3, 2011 - 11:45 am ET

According to a Government Accountability Office report, the Defense and Veterans Affairs departments need to better plan for improved connections between their two healthcare organizations and information technology systems.

The two departments have labored for more than a decade to achieve interoperability between their once-related electronic health-record systems, often producing less-than-satisfactory results, according to multiple previous GAO reports.

Those efforts toward Defense Department and VA connectivity were given an added urgency in 2009 by President Barack Obama, who called for creating a virtual lifetime electronic record by 2012 that can seamlessly track the healthcare needs of active-duty military personnel and veterans.

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http://www.fierceemr.com/story/ehr-use-included-new-ncqa-medical-home-standards/2011-02-03

EHR use included in new NCQA medical home standards

February 3, 2011 — 11:58am ET | By Janice Simmons - Contributing Editor

Meaningful use provisions are embedded throughout the new 2011 evaluation standards for patient-centered medical homes issued this week by the National Committee for Quality Assurance (NCQA) to encourage primary-care practices to quickly adopt healthcare information technology.

"By emphasizing access, health information technology, and partnerships between clinicians and patients to improve health, these new standards raise the bar in defining high-quality care," said NCQA President Margaret O'Kane in a statement.

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http://www.huntonprivacyblog.com/2011/01/articles/hipaa-1/presidents-council-of-advisors-on-science-and-technology-release-health-it-report/#page=1

President's Council of Advisors on Science and Technology Release Health IT Report

Posted on January 19, 2011 by Hunton & Williams LLP

While much of the attention of the privacy policy community in Washington, D.C. has been focused on the two reports issued in December 2010 by the Federal Trade Commission and the Department of Commerce, a third government report has received far less press attention, but may have a greater impact on U.S. business and consumers. The work of the President’s Council of Advisors on Science and Technology (“PCAST”) and its Health Information Technology Working Group, the report, “Realizing the Full Potential of Health Information Technology to Improve Healthcare for Americans: The Path Forward,” was released by the White House on December 8, 2010.

The report focuses on the promise of information technology for health treatment and research, noting the considerable investment in the area by industry and the federal government (the American Recovery and Reinvestment Act of 2009 alone provides nearly $36 billion for health information technology). The real thrust of the report, however, is the lack of uptake – “Despite this great promise, the impact of IT on healthcare over the past decade has so far been modest”– and recommendations for what to do about it.

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http://www.healthleadersmedia.com/print/TEC-261953/Telerehab-Matches-Traditional-Rehab-for-Patient-Outcomes

Telerehab Matches Traditional Rehab for Patient Outcomes

HealthLeaders Media Staff , January 31, 2011

Knee-replacement patients who undergo telerehabilitation–an Internet-based postoperative rehabilitation program that can be conducted from home–experience the same – sometimes better -- results as those who undergo traditional rehabilitation, according to a new study published in the Journal of Bone and Joint Surgery.

The randomized controlled trial found that the outcomes achieved via telerehabilitation at six weeks following total knee arthroplasty were comparable with those after conventional rehabilitation.

The researchers enrolled 65 patients who underwent TKA and randomized them to receive six weeks of either traditional outpatient rehab services or Internet-based outpatient rehab.

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http://www.healthdatamanagement.com/news/pqri-xml-meaningful-use-hospitals-41851-1.html

Want MU Money? Understand PQRI XML

HDM Breaking News, January 31, 2011

Attention hospitals seeking to receive electronic health records meaningful use incentive payments: If you don't know what PQRI XML submissions mean, it's time to read John Halamka's latest blog entry.

Halamka is CIO of Beth Israel Deaconess Medical Center, HIT Standards Committee co-chair and a practicing physician. His new entry tackles the PQRI XML files needed to submit quality measures to the government. Support for these files is required for Complete EHR certification of hospital systems.

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http://www.healthleadersmedia.com/content/TEC-262031/Technology-a-Key-Driver-to-ACO-Adoption.html

Technology a Key Driver to ACO Adoption

Gienna Shaw, for HealthLeaders Media , February 1, 2011

As healthcare organizations begin to explore accountable care models, one thing is clear—technology will play a huge role. Organizations that are leading the way toward ACOs talked about how they'll use technology to reach their goals in the most recent HealthLeaders Media breakthroughs report, The Bridge to Accountable Care Organizations.

In a roundtable event that is part of the multi-media report, leaders talked about electronic medical records and health information exchanges—the foundation for identifying gaps in care and for housing data that will be used to guide physicians.

"Clearly, health IT is the backbone, the enabler to an ACO," says Warren Skea, PhD, director, health industries advisory practice at PricewaterhouseCoopers, which sponsored the report. "There won't be success unless information is free flowing between all entities. What we've heard is that it is critical to have one system within the organization.

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http://www.washingtonpost.com/wp-dyn/content/article/2011/02/01/AR2011020106916.html

Health information remains high on the list of popular uses for the Internet

By Nancy Szokan

Washington Post Staff Writer

Tuesday, February 1, 2011; 12:01 AM

Seeking health information is the third-most-prevalent activity among American Internet users, according to a report being issued Feb. 1 by the Pew Internet Project. The only things more universal were exchanging e-mail and using search engines. (Of course, if someone uses Google to look up "shingles," there's obviously some overlap.) Eight out of 10 Internet users report going online for health information, even if it's only occasionally. "Health-care information is there when they need it," said Susannah Fox, associate director. People most commonly look up diseases, treatments and doctors, often on behalf of a child or other dependent.

Pew has been tracking Internet use in many fields - commerce, music, civic life - since 2000, and from the beginning, Fox said, "we were really struck by the depth of feeling that people expressed" about how the Internet helped them with health care. "In many ways, the Internet has become the de facto second opinion," she said. "People go online to prepare for a doctor's appointment - or recover from [it]."

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http://www.fiercehealthit.com/story/standardization-data-exchange-remains-holy-grail/2011-01-30

Standardization of data exchange remains a Holy Grail

January 30, 2011 — 11:40pm ET | By Ken Terry - Contributing Editor

Recently, I interviewed the CIO of a large Midwestern healthcare system about its plans to become an accountable care organization. The healthcare system was installing a well-known electronic health record that will allow its providers to access patient data across inpatient, outpatient and post-acute care settings. The biggest obstacle the CIO saw to health information exchange was the lack of national standards that would enable the system's EHR to communicate with the EHRs of private practices and other providers outside of the enterprise.

The Obama Administration is trying to address this problem. In the near term, the government is testing its Direct Project, an open-source exchange standard that can help providers "push" care summaries and other data to one another. At the same time, the state health information exchanges receiving federal funds are required to figure out how to get providers to exchange Continuity of Care Documents (CCDs), which contain the key information on diagnoses, medications, and allergies that providers need to treat a patient.

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http://www.modernhealthcare.com/article/20110131/NEWS/301319987

Epocrates looks for $76 million in IPO

By Joseph Conn

Posted: January 31, 2011 - 11:15 am ET

Epocrates, the San Mateo, Calif.-based developer of the eponymous mobile prescription-information tool, is looking to raise about $76 million in an initial public offering of common stock, according to its most recent filing with the Securities and Exchange Commission

In the company prospectus filed with the SEC today, Epocrates seeks listing on the NASDAQ exchange under the symbol EPOC. The company will begin selling stock "as soon as practicable after the effective date of this registration statement," according to the filing.

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http://www.modernhealthcare.com/article/20110131/NEWS/301319988/

Docs, public have similar views on health IT

By Maureen McKinney

Posted: January 31, 2011 - 10:15 am ET

Physicians and patients are in general agreement about health information technology priorities such as data-sharing and criteria for payment incentives, according to results of a new survey from the New York-based Markle Foundation.

"Doctors and patients agree on the importance of putting accurate information in their hands to improve the quality, safety and efficiency of healthcare," Markle President Zoe Baird said in a written release.

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http://www.masshightech.com/stories/2011/01/17/weekly9-Clinical-and-electronic-health-records-experience-in-demand.html

Clinical and electronic health records experience in demand

By Kyle Alspach

Christian Renaux used to work as a registered nurse at Brockton Hospital, the largest hospital in the 100,000-resident Massachusetts city of Brockton.

Now he has a leadership role at the hospital in the area of electronic health records — an advance seen by the government and health-care industry as crucial to lowering the cost and improving the quality of health care.

In the roughly nine years between stints at the hospital, now known as Signature Healthcare Brockton Hospital, Renaux gained expertise in electronic health records technology while working at a Massachusetts vendor for EHR systems, Westwood-based Medical Information Technology Inc. (MediTech).

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http://govhealthit.com/newsitem.aspx?nid=76121

HHS plans to offer non-federal health data for innovators

By Mary Mosquera

Thursday, January 27, 2011

The Health and Human Services Department plans to broaden the categories of data that federal agencies will make available in order to help developers create innovative tools.

It’s asking for public comment about the non-federal data and health indicator data sets that it should promote.

The new data groups will not be specific to an individual’s personal health information, according to a notice in the Jan. 27 Federal Register. They could include, for example, health indicator data representing surveys conducted by state government or private organizations.

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Infoway's 2011-2012 Summary Corporate Plan now available

Want to learn more about Infoway's strategy for accelerating the use of electronic health information systems throughout Canada? Read Infoway's Summary Corporate Plan for 2011-2012. The plan talks about the progress that Infoway and our jurisdictional partners have made so far. And, it outlines the priorities and expectations for the coming fiscal year.

https://www2.infoway-inforoute.ca/Documents/Infoway_Sum.Corp.Plan.2011-2012_EN.pdf

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http://www.healthdatamanagement.com/news/ncqa-quality-standards-medical-homes-41842-1.html

NCQA Sets New Medical Home Standards

HDM Breaking News, January 31, 2011

The National Committee for Quality Assurance on Jan. 31 will issue new standards for its Patient-Centered Medical Home program.

More than 7,700 clinicians at 1,500 sites use existing standards from Washington-based NCQA in their medical home initiatives. The initiatives call for substantially better coordination across the continuum of care, anchored by a primary care physician and augmented with extensive use of information technology. Physician practices meeting the new standards, called PCMH 2011, will be well positioned to qualify for meaningful use incentive payments, according to NCQA.

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http://www.ihealthbeat.org/features/2011/california-telehealth-network-gears-up-for-launch.aspx

Monday, January 31, 2011

California Telehealth Network Gears Up for Launch

by David Gorn, iHealthBeat Contributing Reporter

These are heady days for Eric Brown. He's the executive director for the California Telehealth Network, an organization partially funded by the Federal Communications Commission and run by the University of California-Davis that plans to use video feeds to eventually link medical specialists to more than 800 rural and underserved health care facilities across the state.

CTN recently announced that 25 medical facilities now are hooked up to a broadband network, bringing the futuristic vision of telehealth closer to reality in California.

"It's a very exciting time," Brown said, adding, "It's good to be making progress. About 25 sites now have active circuits, and full functionality will come in the next week or two. We're shooting for the first week of February."

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http://www.cbc.ca/health/story/2011/01/30/e-health-records-sunnybrook.html

Online health records popular with patients

10,500 patients use system at Toronto's Sunnybrook hospital

Last Updated: Sunday, January 30, 2011 | 1:16 PM ET

The Canadian Press

Thousands of patients taking advantage of Canada's first online health records system say it is giving them control over their care, but some experts are warning too much information can cause panic.

"Showing patients the information without interpretation does have risks of confusing patients and increasing anxiety," said Alexander Krist, a professor at Virginia Commonwealth University in Richmond who has studied the value of giving patients access to their health records.

"And showing patients information before their doctors have had a chance to explain it to them can also be problematic."

Sunnybrook Health Sciences Centre in Toronto is the first in Canada to offer its patients virtual access to their health records, using an online network called MyChart, and other hospitals are poised to follow suit.

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http://www.680news.com/news/local/article/176540--sunnybrook-s-e-health-technology-gets-positive-feedback

Sunnybrook's e-Health technology gets positive feedback

680News staff Jan 30, 2011 08:34:42 AM

TORONTO - Thousands of Sunnybrook Hospital patients using Canada's first online health records system said it's giving them greater control over their care.

However, some health-care experts said allowing patients to see their test results without a doctor there to interpret them, can cause panic.

Alexander Krist of Virginia Commonwealth University said electronic health records should present information in everyday language, not medical jargon.

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Enjoy!

David.