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September 26, 2011
Even though Google Inc. has given up on the business of electronic personal health records, Fort Wayne-based NoMoreClipboard.com is launching a new service it thinks will crack open the market.
The company’s latest service, called cc:Me, gives patients a free and secure web-based account that can receive their electronic medical records from any other system and also can receive new records from any electronic medical record system their doctor or hospital happens to use.
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HDM Breaking News, September 27, 2011
The Office of the National Coordinator for Health Information Technology recently launched Query Health, a new initiative to establish standards and services for distributed population queries of electronic health records.
In a posting on ONC's blog, Doug Fridsma, M.D., director of the office of standards and interoperability, explains Query Health and asks industry participants to join one of three workgroups.
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While electronic health records may lessen physician workloads, save time and improve patient care, adapting to the technology can lead physicians to perform in a more standardized, compartmentalized and routine way, eventually causing them to lose some of their clinical decision making and other skills.
That sobering news is from a new study published in the Oct.-Dec. 2011 issue of Health Care Management Review, which found that EHRs may remove critical aspects of physician discretion in everyday work. Essentially, some providers wind up relying more blindly on information from the technology, such as guidelines, rather than their own knowledge and experience, ultimately leading to a "deskilling" process.
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Electronic health records contain features, such as templates, which can help providers reduce the risk of malpractice litigation. But the misuse of EHRs actually can cause providers to be more vulnerable to such lawsuits, according to a recent article in MDNews.com.
An EHR's audit trail function, which keeps track of the date and time of all activities performed on the EHR, can become a malpractice liability, the article points out. For example, if a physician treats a patient and weeks later realizes he left information off of the patient's chart and signs on to add it, the date and time of the amendment will be logged on the audit trail, which can be used against him. Or, since the EHR tracks access to the records, if a provider failed to review data--such as test results that had been received--it's relatively easy for the patient's attorney to discover that omission.
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September 28, 2011 | Michelle McNickle, Web Content Producer
A new year means a fresh start, and as 2012 creeps closer, it's time to think about new IT approaches. Although the reform may mandate certain IT practices be implemented, other non-required initiatives will help to streamline workflows, save money and improve care in the new year.
Fred Pennic, senior advisor with Aspen Advisors and author of the blog Healthcare IT Consultant, suggested 10 initiatives hospitals should undertake in 2012.
1. Meeting Stages 1 and 2 of meaningful use. According to Pennic, meaningful use compliance should be the top priority in health IT during the years to come. "More providers are currently attesting for Stage 1 meaningful use, although it is still unclear if Stage 2 will be delayed until 2014," he said. According to a study published online by Health Affairs, hospitals should be prepared for a higher standard associated with Stage 2 in order to produce improved patient outcomes; authors of the study believe Stages 2 and 3, which will require providers to use electronic orders for 60 to 80 percent of patients, will have a significant impact on both patient mortality rates and care.
2. Health information exchange (HIE). Meaningful use and HIE go hand in hand, said Pennic. "Interoperability is key as it relates to meaningful use’s objectives of electronically exchanging clinical information and summaries of care, along with submitting lab results to public health agencies, et cetera," he said. Looking for resources or a way to network and learn what others are doing when it comes to HIE? The HIMSS HIE Toolkit and the HIMSS HIE Wiki offer insights and information regarding HIE, including important national and state level initiatives.
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Posted by Anthony Guerra on September 28th, 2011
KLAS Finds Homecare Needs Improvement
Best-of-breed vendors tend to score higher than enterprise players across the board in the homecare market for meeting complex CMS regulations, but have little to offer providers in the way of interoperability, according to a new KLAS report, Homecare 2011: New Expectations, New Market Energy.
But even enterprise vendors, which typically have the integration advantage, are “miles” from effectively sharing data electronically with hospitals, the organization found. Said report author Erik Bermudez, “Usually enterprise vendors have an interoperability advantage, but that is not the case yet in homecare. Only a couple of vendors are sharing data with affiliated hospitals and clinics — and even they don’t do it well.”
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September 29, 2011 | Molly Merrill, Associate Editor
OTTAWA – Future doctors in Canada expect to produce efficiencies in healthcare delivery by expanding the use of electronic medical records in their practice, according to a new survey.
The 2010 National Physician Survey (NPS) included responses from 5,600 medical students and residents.
The survey is Canada’s largest census survey of physicians and physicians‐in‐training and is conducted jointly by the College of Family Physicians of Canada, the Canadian Medical Association and the Royal College of Physicians and Surgeons of Canada.
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27 September 2011 Shanna Crispin
Birmingham Women’s NHS Foundation Trust is refusing to sign off on its deployment of Lorenzo because it is not satisfied with the level of functionality delivered.
The trust was the third ‘early adopter’ of the iSoft software, which CSC is trying to deploy to the North, Midlands and East of England as part of the National Programme for IT in the NHS.
It went live with the latest version of the software, Lorenzo Care Management Release 1.9 in November last year, and said at the time that it was “pleased” to have taken such an “important step” although there was “much work to do” as new modules were added.
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September 26, 2011 | Molly Merrill, Associate Editor
BOSTON – Contrary to popular belief, a new study has found that older physicians who are clinically busier and see more complex patients are more likely to use new EHR functionality than younger clinicians.
The findings were determined by researchers at Brigham and Women's Hospital (BWH), who analyzed the intervention arm of a randomized trial of new EHR-based tobacco treatment functionality. The trial included 207 clinicians and the functionality was used by 50 percent, or 103 clinicians.
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Posted: September 29, 2011 - 12:00 pm ET
Data mining of electrocardiogram histories is a key component of a new tool developed by a group of university and hospital researchers to better predict the risk of death in patients who have had a heart attack.
Results of the researchers' study and details of their tool to analyze patients' risk of death after a heart attack are published in the Sept. 28 edition of Science Translational Medicine.
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26 September 2011 Shanna Crispin
A sixth Welsh health board is due to go live with the national patient administration system, Myrddin, following significant delays.
The NHS Wales Informatics Service has told eHealth Insider that Aneurin Bevan Health Board will go live with the NHS Wales-developed PAS in the autumn, after initially intending to launch it over June and July.
The health board, which covers Gwent, is opening the Ysbyty Ystrad Fawr Hospital in the next two months, and will start to move patients to the hospital on November.
An Aneurin Bevan Health Board paper states the PAS needed to be live ahead of that date. However, delays to rolling out the system in other health boards have held up implementation and put the latest possible go-live date in jeopardy.
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A tool enabling doctors to electronically take a detailed family history during a woman's first prenatal visit currently is being tested by several hospitals in partnership with the March of Dimes, the organization recently announced. The tool is geared toward helping providers to screen for inherited conditions and preterm birth, as recommended by clinical guidelines.
Patients at participating facilities will fill out a standardized family history questionnaire in their doctor's office using a computerized tablet. The information then will be analyzed electronically, and the tool will provide red flags and recommendations for providers based on current professional guidelines. On the basis of this information, doctors may be prompted to ask the patient more questions, or refer her to a genetic specialist.
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Thursday, September 29, 2011
by George Lauer, iHealthBeat Contributing Editor
SAN FRANCISCO -- If the Health 2.0 movement is perceived as an ongoing conversation, the first four years could be seen as determining who was going to be talking and what the means of communication was going to be. Now, in year five, the focus is turning to what, exactly, everybody's going to be talking about.
"Data is everything," said Health 2.0 cofounder Mathew Holt at the Fifth Annual Health 2.0 Conference this week.
Raw information -- the gathering of it, collating, crunching and ultimately putting it to work -- was a major theme of this year's event.
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September 27, 2011 | Patty Enrado, Special Projects Editor
SAN FRANCISCO – “Health 2.0 has the promise to change the healthcare industry,” the conference’s opening keynote speaker Mark Smith, president of the California HealthCare Foundation, told the audience on Monday.
Smith also asserted that health reform is necessary for innovation and vital to the success of Health 2.0 entrepreneurs’ business model because the current system is set up to pay for volume.
Launched in 2007, Health 2.0, stages an annual conference focused on innovation and on tools aimed at helping consumers manage their health and connect to care providers.
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Thursday, September 29, 2011
A company set up to handle prescription orders could be the key to the health-care Internet.
By Antonio Regalado
How difficult is it for doctors to share patient information electronically? Apparently pretty difficult: when a clinic in Minnesota managed to transmit some immunization records to the local public-health department this year, the U.S. government trumpeted the feat in a press release.
U.S. doctors and hospitals are on their way toward adopting electronic patient records for all Americans. After that, the next step in electronic medicine will be to create "health information exchanges." Imagine that wherever you go, your electronic health record will follow, preventing doctors from unnecessarily repeating a test or prescribing a drug you are allergic to. That could save a lot of money, considering that as many as 30 percent of laboratory tests are repeated because doctors don't have access to patients' earlier results.
Yet today U.S. doctors and hospitals struggle to exchange even basic patient information electronically. The reasons include laws protecting patient privacy. But most of all, the problem is that exchanging data hasn't been in anyone's economic interest. "The problem with information exchange is not the technology—it's around the business case," says Farzad Mostashari, the federal government's coördinator for health information technology. Hospitals and doctors simply don't see much economic reason to share information with competitors, or even to avoiding repeating tests.
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09/28/2011 | 03:50 am
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27 September 2011 Jon Hoeksma
The Cabinet Office has published its Major Projects Authority’s review of the National Programme for IT in the NHS, but the heavily redacted document contains some highly significant factual errors and omissions.
The report formed the basis of the government’s announcement that the programme was to be “dismantled” last week. It actually presents a more detailed and nuanced assessment than the announcement might have suggested.
But it is riddled with errors, misspells the names of many trusts, and provides only a partial picture of the vendors supplying the NHS IT market.
On the key patient administration system suppliers it states: “There is only a limited number of alternative suppliers to Cerner and iSoft’s existing product ranges, with only McKesson and GE Healthcare ready to use within the NHS trusts.”
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September 27, 2011 | Molly Merrill, Contributing Editor
Arizona joins the ranks of states creating health information exchanges.
HINAz is an Arizona not-for-profit that began through the work of Southern Arizona Health Information Exchange and Arizona Medical Information Exchange. The two entities joined together to build a more comprehensive HIE for Arizona
The Health Information Network of Arizona (HINAz) and OptumInsight have partnered to create a statewide health information exchange network in Arizona. HINAz will implement the Axolotl HIE platform from OptumInsight to build the HIE infrastructure to enable the sharing and exchange of clinical data from all available sources across the state – improving access, quality and safety of health care while reducing and stabilizing costs.
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Issue Date: October 2011
Staying on Your Feet
CIOs Ponder the Right Formula for Disaster Preparation in the New Healthcare IT World
by John Degaspari
EXECUTIVE SUMMARY:
CIOs are hard at work coming up with the most effective and affordable strategies for protecting electronic data as their hospitals move forward on electronic medical records. While the rise of cloud computing and declining network costs are offering new opportunities in dealing with potential disasters, many find there is no substitute for good planning and constant testing.
Ask any hospital CIO what keeps him or her up at night, and chances are that disaster preparedness ranks high on their lists. In fact, as this issue was about to go to press, Hurricane Irene roared up the Eastern Seaboard, causing massive flooding in coastal cities and towns from the Carolinas to Maine. As if to underline the seriousness of the threat, New York City officials took the unprecedented step of shutting down that city's mass transit system and ordering the evacuation of four major hospitals that were located in flood areas.
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The College of Healthcare Information Management Executives (CHIME) has asked HHS not to include metadata standards to support Meaningful Use Stage 2.
September 26, 2011
The College of Healthcare Information Management Executives (CHIME) has rejected the idea that metadata standards be included in the next notice of proposed rulemaking to support Meaningful Use Stage 2, saying more work needs to be done to verify these standards before they are implemented and used across the healthcare provider community.
CHIME's comments were delivered in a September 21 letter to Department of Health and Human Services' secretary Kathleen Sebelius, in which the organization chided HHS over plans to include metadata standards in Meaningful Use Stage 2, and expressed doubt that healthcare stakeholders are fully onboard with the decision to use the HL7 CDA R2 header to support metadata standards.
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September 26, 2011 | Tom Sullivan, Editor
Playing the role of sometime-cartographers, healthcare policymakers and stakeholders have been working for several years to draft a new kind of national roadmap.
Known as the Nationwide Health Information Network (NwHIN), this map will someday connect communities – not with roads and bridges, but through technology that enables healthcare providers to span borders and share patient data.
Each state, however, has developed its own regulations for how health information can be stored and shared. And while the goal is to develop an information network that will enable the exchange of patient data throughout the nation, there may be as many paths to achieving that end as there are state-designated HIEs.
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Tuesday, September 27, 2011
by Jane Sarasohn-Kahn
In 2005, President George W. Bush channeled Harry Truman's "chicken in every pot" moment saying that "within 10 years, every American must have a personal electronic medical record." That vision is coming into view under President Obama. HHS has undertaken a major push to get U.S. citizens to understand the concept and value of electronic health records.
As that old "Field of Dreams" effect goes, "If you build it, they will come." But, will patients really want to engage with health IT?
Consumers Want Online Health Data Access
Consumer surveys conducted in the past 12 months show most U.S. adults are interested in various aspects of electronic health information. Three-quarters of people would use a secure online tool to make it easier to communicate with the doctor's office, according to an Intuit poll conducted in January 2011. Furthermore, one-half of those interested in online access to doctors would consider switching doctors to one whose office offered secure online access.
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Carol Eisenberg,Douglas MacMillan, Bloomberg Businessweek
Monday, September 26, 2011
Patients at Dr. Surinder Saini's office are no longer given a clipboard upon arrival. Instead, they're handed an iPad, where they tick off symptoms and allergies with the touch of a finger.
A nurse uses her own iPad to plug in vital signs. In the exam room, Saini summons the data by tapping on his tablet and is aided by a list of likely diagnoses for, say, abdominal pain.
"Most patients are amazed," said the Newport Beach (Orange County) gastroenterologist. After the visit, Saini dictates his notes about the patient straight into the iPad, where they're instantly transcribed and stored with other records.
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Posted: September 25, 2011 - 12:01 am ET
HHS has published a formal notice and opened a 60-day public-comment period on a proposal to create a database of healthcare claims information for comparative-effectiveness research.
According to a
posting in the Federal Register (PDF), the database project represents “a private/public partnership with the goal of consolidating access to longitudinal data on health services financed by both public and private payers to help facilitate” comparative-effectiveness research.
Data will be drawn “from multiple sources” to afford “adequate coverage of priority patient populations, less common medical conditions, healthcare interventions, and geographic areas,” the HHS statement said.
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September 21, 2011 — 3:29pm ET | By
Ken Terry
Epic and Cerner are the health IT vendors that have the best technology solutions for healthcare systems that aim to form accountable care organizations, according to providers surveyed by KLAS, the Orem, Utah-based research firm. But KLAS' press release emphasizes that "there are no one-stop shops for providers' ACO IT needs, especially since each ACO will be different."
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September 23, 2011 — 6:15pm ET | By
Ken Terry
The University of California San Diego Health System (UCSD) recently received a rare honor: HIMSS Analytics gave UCSD a Stage 7 award, which means that it has reached the highest level of advancement in electronic health records.
Only 60 hospitals and health systems in the U.S. have achieved this recognition, and no wonder: to do so, an organization must have a complete EHR system, including computerized physician order entry, physician and nursing documentation, closed loop medication administration, clinical decision support, ancillary systems, a data warehouse, and the ability to exchange information with other healthcare systems.
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Some certifications can be baseline requirements for healthcare organizations
By Lucas Mearian
Timothy Stettheimer, CIO for St. Vincent's Health System in Birmingham, Ala., has more confidence in IT certifications than in referrals and in-person interviews when it comes to hiring.
"How do you know you're hiring a good person? You can get a referral, but so what? Someone can interview well, but so what? How do you really know?" Stettheimer said. "But when you can say, 'I've hit these [IT education] targets,' that shows a commitment to advancement."
He admits that some certifications get a bad rap, and are seen as useless or too granular. "I mean, how many Cisco certifications are there out there? I've lost count now. It's great for a technology-specialist-level profession, but for a leadership profession, it's not so helpful," he said. But Stettheimer believes that if you're not growing professionally, you're not doing your job.
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HDM Breaking News, September 23, 2011
A new report from medical market research firm Kalorama Information pegs the U.S. market value for remote patient monitoring at $7.1 billion, with annual growth averaging about 25 percent and a $22.2 billion market by 2015.
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By Emily Greenhalgh
Created 09/23/2011 - 10:26
September 23, 2011 by Emily Greenhalgh
The health care industry is ill prepared to protect patients' medical records as new uses for data arise, according to a report by PricewaterhouseCoopers LLC.
Most health organizations aren't ready to protect patient data as access to confidential patient records expands, according to a PricewaterhouseCoopers report.
As new uses for digital patient information grow, according to PwC, health organizations need to step up their act to make sure their patient information doesn't fall into the wrong hands.
Old privacy and security controls aren't thorough enough to comply with existing privacy laws and patient consent agreements, according to the report, which recommends that organizations adopt a more integrated approach to protecting patient privacy.
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September 22, 2011 | Molly Merrill, Associate Editor
TORONTO – Breast imaging reports generated using an automatic speech recognition system are nearly six times more likely to contain major errors than those generated with conventional dictation transcription, a new study finds.
The study reviewed 615 reports of complex cases discussed on multidisciplinary team rounds: 308 reports generated with automatic speech recognition (where the radiologist dictates the report and software immediately transcribes the report on a computer screen) and 307 reports generated with conventional dictation transcription (where the radiologist dictates the report and a team transcribes and reviews the report).
"Our study found that at least one major error was found in 23 percent of automatic speech recognition (ASR) reports compared to 4 percent of conventional dictation transcription report," said Anabel Scaranelo, MD, of the University Health Network in Toronto.
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A six-month pilot project that connects the VA with military and private providers may finally turn health data exchange into a national priority--if it works.
September 23, 2011
The VA has joined forces with military and private-sector healthcare providers in a
pilot project that tests the value of using the Nationwide Health Information Network (NHIN) to share data among providers that care for veterans and active military personnel.
The project, if successful, could lead to a national rollout of the platform, which is a key part of the Virtual Lifetime Electronic Record (VLER). But Joseph Paiva, VLER project director in the VA's Office of Information Technology, told InformationWeek Healthcare that even if the rollout gets the green light, the evolution of private health information exchanges will determine how quickly the VLER linkage spreads.
The VLER is designed to facilitate the sharing of medical, benefits, and administrative data between the VA and the Department of Defense healthcare systems. The demonstration will begin on October 1 and will run through March 31, 2012.
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Monday, September 26, 2011
Our list of publicly traded companies that could benefit from the e-medicine revolution includes IBM and WebMD.
By Erik Sherman
Medicine is still largely a cottage industry. Most doctors work in small practices where records are kept on paper. But now technology is starting to reshape this industry. The spread of electronic patient records, heavily promoted by government subsidies, will energize companies in such diverse fields as cloud computing, mobile phones, and even artificial intelligence.
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Enjoy!
David.
