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, March 12, 2012

Weekly Australian Health IT Links – 12th March, 2012.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a few paragraphs. 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

The early part of this week will definitely the calm before the storm - if, as presently expected - the Senate Community Affairs Committee hands down its PCEHR Report on the 13th of March. I suspect the later part of the week will then be spent figuring out what the report means.
I have to say the best thing I read this will was the commentary from Jenny O’Neill on all matters e-Health - and especially her mention of the PC-LES (the Personally Controlled Largely Empty Shell) -  I suspect this will be the most accurate characterisation of what is actually delivered by July 1, 2012.
Remember the PC-LES - we will hear much more of this I think!
Also. remember it is only about 2 months until the release of the Federal Budget. This will be the news of that month when we see what funding is provided for e-Health in general and the PCEHR in particular.
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MSIA: From eHealth blue sky to eHealth grass roots - will the twain ever meet?

Written by Jenny O'Neill on 08 March 2012.
This article first appeared in the 20 February 2012 edition of Pulse+IT Magazine.
Beyond the Wave sites, the usual measured approach to investment in clinical software seems to be occurring by healthcare providers and software companies without a lot of regard for the national agenda. Which begs the question — how can the grass roots of eHealth become more readily engaged in the blue sky vision to help deliver on the government’s health reform agenda?
Since the Federal Government’s announcement that all Australians will be able to sign up for a Personally Controlled Electronic Health Record (PCEHR) by 1st July 2012, you would think there would be frenetic activity going on at every level of the sector towards that common goal. But with blue-sky-thinking outpacing grass-roots-doing at a ratio of around four hundred and sixty seven million to one, the world of eHealth is in danger of spinning off its axis into the blue beyond.
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Labor oversight on e-health position 'improper'

CONSUMER groups have rejected Labor's plan to install the Health Department secretary as head of the personally controlled e-health record system due for launch on July 1.
In a little-heralded addendum to the PCEHR's concept of operations in January, Health jettisoned previous commitments that the secretary would only act as official operator on an interim basis, until an independent oversight body could be formed.
But key advocacy groups have attacked the appointment as totally inappropriate, the Senate inquiry into the PCEHR Bills has heard.
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PCEHR may be hacked, warns IT security group

8 March, 2012 Gemma Collins
Patients could have their private medical records hacked by online criminals once the PCEHR goes live in July, a leading IT security group has said.
Providing the PCEHR over the internet, presumably via a standard internet connection, means the records could be open to fraudsters, compromising the confidentiality of the records, according to AusCERT in its submission to the Senate enquiry on the PCEHR Bill.
The University of Queensland based IT security group accuses the Department of Health of being “misleading” and “misrepresenting” the level of risks of the shared record system by saying the system will be secure.
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PCEHR open to hacking, says AusCert

  • by: Karen Dearne
  • From: Australian IT
  • March 09, 2012 5:00AM
INDEPENDENT computer emergency response team, AusCERT, has issued a blunt warning that the personally controlled e-health record system will be wide open to hacking.
"The current proposal by the Australian government to provide PCEHR over the internet will allow for the exposure of these records to theft and compromise," AusCERT told the Senate inquiry into the PCEHR Bills in submissions released yesterday.
 "Online criminals have for many years been attacking PCs at work and home to gain access to the systems and data they desire.
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Software Developer Conference Hosted by NEHTA & DoHA

Engage with vendors and implementers prior to the launch of the PCEHR in July 2012
With the final set of PCEHR specifications and the initial release of the National Infrastructure due mid March we are reaching a critical time regarding the further development of relationships with the Software Development community that support the healthcare industry.  The focus of this session is on describing the core components of the concept of operations and what will be in place for July as features of the National Infrastructure.
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Gemma Collins: Are we prepared for the PCEHR to go live?

9 March, 2012 Gemma Collins
July 1 is a big day in the health reform calendar. It’s the day when patients are going to be able to have access to their own e-health records, as the long-awaited PCEHR goes live.
Not surprisingly the PCEHR was the hot topic of the two-day International Primary Health Care Reform Conference this week in Brisbane. And the first session on e-health opened with a pre-recorded video presentation by Professor Trisha Greenhalgh who was behind the evaluation of the UK’s equivalent to the PCEHR - the Summary Care Record.
For 20 minutes we hear about all the disastrous problems GPs and patients have been facing in the UK with the new system. It has created “mutual misunderstanding” and “mutual mistrust” between everyone involved, with NHS staff blaming patients about not being able to get into the system, and the IT companies blaming GPs and managers for the problems. And even three years after it was implemented and billions of pounds were spent, only 400 shared records out of a possible two million are being accessed a week and only 20 in hospitals.
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E-health market set to grow as Australia ages: KPMG

Population living longer which would mean more health requirements, says KPMG partner
IT companies are been urged to look at opportunities in the e-health market as Australia faces an aging population over the next 10 years.
KPMG Australia partner, Bernard Salt, told delegates at Gartner’s Infrastructure, Operations and Data Centre Summit that as the baby boomer generation retires and lives longer, the requirement for e-health will rise.
“As of 2012, the average life expectancy for an Australia woman is 84 while for men it is 82 years,” Salt said. “The first baby boomer, born in 1946, turned 65 last year and this is a generation that expects to live a lifestyle in retirement that preceding generations did not.”
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Glitch in online health records

Steve Lohr
Computerised patient records are unlikely to cut healthcare costs and may actually encourage doctors to order expensive tests more often, a study published this week concludes.
Industry experts have said that electronic health records could generate huge savings – as much as $US80 billion ($74 billion) a year, according to a Rand Corporation estimate.
The promise of cost savings has been a major justification for billions of dollars in US federal spending to encourage doctors to embrace digital health records.
Note: The article mentioned here has caused a pretty intense debate - links to which will be in the overseas links this week.
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Exploit GPs or patients to pay: PCEHR dilemma

6th Mar 2012
GPs will have to choose between being “exploited” or charging elderly patients more than $200 each to create shared health summaries for the personally controlled electronic health record (PCEHR) unless the government “foots the bill”, experts say.
The comments came as United General Practice Australia leaders unanimously expressed concern over the lack of preparation ahead of the system’s 1 July launch date and called on the government to ensure GPs were “properly funded and supported”.
A schedule of recommended fees for GPs who take on the ‘nominated provider’ role and create the summaries is still in development by the AMA, but Council of General Practice chair Dr Brian Morton said the fees were likely to be time-based and include an intellectual property component.
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Djakic condemns dept's 'protracted', time-wasting approach

7th Mar 2012
AGPN chair Dr Emil Djakic has blasted the department of health, warning its “arduous” and “protracted” oversight of Medicare Locals is wasting time and leaving the reform vulnerable to a “direct threat” from a future coalition government.
Dr Djakic’s comments to MO yesterday were the first visible dispute between his organisation, which has championed the nationwide transfer of 111 Divisions of General Practice to 62 Medicare Locals, and the department, which has been administering it.
But on the sidelines of the International Primary Health Care Reform conference being held in Brisbane this week, Dr Djakic said he was so concerned about the department becoming “another controlling influence” rather than a funding body that he could no longer stay silent.
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Authority is given, not taken

Posted on March 9, 2012 by Grahame Grieve
Real authority is not something that you can take, that you can purchase, that you can steal. It’s something that other people give you freely of their own accord. There’s no other way to get it. It’s important to distinguish power from authority – power is only ever taken, and never given. The two things are closely related – having authority in a sub-group (i.e. the armed forces, or the engineering department) can help you acquire power in a wider sphere. Authority is better than power, because having authority means that people want to do what you tell them.
In New Zealand, where I grew up, this notion is wonderfully captured in the word “mana”, borrowed and adapted from Maori:
“mana”, taken from the Maori, refers to a person or organization of people of great personal prestige and character. Sir Edmund Hillary, is considered to have great mana both because of his accomplishments and of how he gave his life to service. Perceived egotism can diminish mana…
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Feature: Medibank builds portal for consumer health

Written by Kate McDonald on 08 March 2012.
This article first appeared in the 20 February 2012 edition of Pulse+IT Magazine.
Health insurer Medibank is creating an online health record for its customers in which users can store their personal health information. It is aimed at allowing consumers to take control of their health information and will eventually link up with the PCEHR.
Health insurer Medibank is creating an online health record for its customers in which users can store their personal health information. It is aimed at allowing consumers to take control of their health information and will eventually link up with the PCEHR.
The Medibank healthbook is a personally controlled electronic record of an individual’s health information and history. healthbook will be overseen by 100 Medibank Health Solutions nurses who are already registered with their Healthcare Provider Identifier - Individual (HPI-I).
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Warner Chilcott's sales reps fit pieces of data puzzle on the go

WARNER Chilcott's Australian sales team could spend up to 90 per cent of their time churning data and struggling to make best use of it.
The acquisition of Procter & Gamble's global branded pharmaceutical business in 2009 gave Warner Chilcott significant scale and geographic reach.
With only a small sales force in Australia, the pharmaceutical company needed to have a highly targeted approach.
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Hospitals explore social media

Emma Connors
Hospitals have a lot to gain from social media, but it’s a steep learning curve.
Once upon a time people who were happy with their care wrote a thank you card to a hospital or a letter to their newspaper.
Now they put it on Facebook.
“I would like to thank the theatre staff of 21/2/12,” posted one former patient of Geelong Hospital on the Facebook wall of Victoria’s regional health service Barwon Health.
“Sorry for throwing you a curve ball during my procedure,” the patient went on. “And a huge thanks to the wonderful staff of HW4 for their care and help during my stay there. All are a great credit to Barwon Health.”
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Australia: New Bill – Personally Controlled Electronic Health Records

05 March 2012
Article by Wendy Blacker and Jessica Kinny
The Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011 (Cth) (Consequential Bill) has been introduced to ensure that the Personally Controlled Electronic Health Records Bill 2011 (Cth) (PCEHR Bill), once enacted, operates appropriately and effectively.

The PCEHR System

In the 2010-11 Budget, the Government committed $466.7 million to a two-year program to build the national infrastructure for the Personally Controlled Electronic Health Record (PCEHR) system.
To date, individuals' health information has been dispersed across a range of locations rather than being attached to the patient, and individuals need to repeat their medical history each time they visit a new clinician. This could result in poor information flows, unnecessary retesting, delays and errors.
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Report slams medical device alerts

Julie Robotham
March 5, 2012
Government advice to patients and doctors on the safety of medical devices - including critical implants such as pacemakers - is inadequate and inconsistent, and does not reflect the seriousness of the damage they may cause, says a Sydney researcher.
''Reporting of incidents involving medical devices has become more frequent but most reports are not investigated or, after investigation, no action is taken,'' said Richard McGee, a researcher at the University of Sydney school of public health.
Dr McGee analysed alerts and statistics published on the website of the Therapeutic Goods Administration between 2000 and 2011, finding the agency had attributed 295 deaths and 2357 serious injuries to medical devices during that time.
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Windows 8: Training required

Windows 8 includes a more drastic interface change than previous versions of Windows. Here are the top questions new users are likely to ask
Every new version of Windows has included interface changes. Most of these have been minor--an icon moved here, a toolbar added there. Windows 8 will be different, using a completely new Metro interface as the primary environment, and removing important elements like the Start menu from the older but still accessible "desktop" interface. Even IT pros may need to do some web searching to figure out some features. What questions will your workers have, and will you have the answers?
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Windows 8 reviews: 'Mission accomplished', 'transcendent', 'unintuitive'

So far the overall vibe is positive
Early reviews of Windows 8 range from describing it as speedy and elegant to unintuitive, but those who have given the operating system a test drive seem to enjoy the experience.
Several point out that Internet Explorer 10 has two versions, one for touchscreen and one for a mouse and keyboard machine, that look and feel very different, which they find disconcerting.
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Enjoy!
David.

AusHealthIT Poll Number 112 – Results – 12th March, 2012.

The question was:
Is The Federal Opposition Making Policy Sense on E-Health?
Crystal Clear Sense
-  0 (0%)
Not Too Bad
-  1 (5%)
A Bit Vague
- 5 (25%)
Making No Sense At All
- 14 (70%)
Votes so far: 20
A pretty clear outcome - the Coalition needs to do some work in the e-health policy area and tell us their plans.
Again, many thanks to those that voted!
David.

Sunday, March 11, 2012

This Submission Really Bells The Cat On the PCEHR Security Design. It Is Very Risky Indeed.

Some reporting on the AusCERT view on the PCEHR appeared late last week.
We had this:

PCEHR may be hacked, warns IT security group

8 March, 2012 Gemma Collins
Patients could have their private medical records hacked by online criminals once the PCEHR goes live in July, a leading IT security group has said.
Providing the PCEHR over the internet, presumably via a standard internet connection, means the records could be open to fraudsters, compromising the confidentiality of the records, according to AusCERT in its submission to the Senate enquiry on the PCEHR Bill.
The University of Queensland based IT security group accuses the Department of Health of being “misleading” and “misrepresenting” the level of risks of the shared record system by saying the system will be secure.
And says it is “astonishing” that the critical matter relating to the security of the system was “summarily dismissed and left to a later stage” in the DOHA’s recent Privacy Impact Report.
More here:
And also this:

PCEHR open to hacking, says AusCert

  • by: Karen Dearne
  • From: Australian IT
  • March 09, 2012 5:00AM
INDEPENDENT computer emergency response team, AusCERT, has issued a blunt warning that the personally controlled e-health record system will be wide open to hacking.
"The current proposal by the Australian government to provide PCEHR over the internet will allow for the exposure of these records to theft and compromise," AusCERT told the Senate inquiry into the PCEHR Bills in submissions released yesterday.
"Online criminals have for many years been attacking PCs at work and home to gain access to the systems and data they desire.
"There is no reason to think criminals won’t actively target these computers specifically for the benefits they may provide once the PCEHR system goes live (on July 1)."
AusCERT saidsaid fraudsters will be only too keen to harvest "valuable" personal details including full names, dates of birth, current address and Medicare numbers.
As well, it warns the PCEHR may "deliver information to criminals which could be used to fraudulently obtain prescription drugs".
"Apparently criminals have realised that the purity of pharmaceutical quality drugs is worth pursuing rather than trying to ‘cook’ these drugs themselves," it said.
"This trend needs to be considered carefully (against) the possibility the PECHR could be a catalyst for wholesale access to these drugs.
"This could have adverse implications for individuals, doctors and pharmacists whose e-health records are manipulated in order to facilitate criminal endeavours, where the audit trail will lead back to legitimate users who had access to these records, but who were in no way responsible for their fraudulent manipulation."
.....
It notes that the federal Health department "is promoting the benefits of PCEHR over the internet on the basis that it will be secure".
"These statements cannot be assured and are misleading," it said. "If any end-user computer is already compromised by malicious software, the confidentiality of the PCEHR may be easily compromised.
"There is also the potential to compromise the integrity of the record, depending on the user’s modification privileges."
AusCERT said the department "appears to be focused on the security of the back-end systems" rather than the endpoint systems and software people will use to connect to the system.
..... 
 "It is AusCERT’s assessment that the vast majority of end users do not have sufficient knowledge or skills to manage the risks," it said.
"This is evident by the Australian Communications and Media Authority's 2010 finding that some 25,000-30,000 computers are compromised in Australia every day; annually that equates to about 4 million PCs.
"Considering that recovering from a compromise is a non-trivial exercise, it is likely that these compromises persist for days or weeks, and some machines may remain compromised.
"Imagine if each of these computers had at least one user who had used it to access their PCEHR. That represents potentially millions of records compromised by online criminals."
Overall, AusCERT finds there is a "broad and extensive" range of threats facing the PCEHR.
Lots more here:
You can find the full submission here (Submission Number 51 - 3 parts):
What is really interesting is that all this ties in quite nicely with some work I reported last year:
Here is a link to the actual paper which is now on-line.
Here is the abstract.

Why Australia’s E-Health System Will Be A Vulnerable National Asset

Patricia A H Williams
secau - Security Research Centre, School of Computer and Security Science,
Edith Cowan University, Perth, Western Australia
trish.williams@ecu.edu.au
Abstract
Connecting Australian health services and the e-health initiative is a major talking point currently. Many issues are presented as key to its success including solving issues with confidentiality and privacy. However the largest problem may not be these issues in sharing information but the fact that the point of origin and storage of such records is still relatively insecure. Australia aims to have a Personally Controlled Electronic Health Record in 2012 and this is underpinned by a national network for e-health. It is this very foundation that becomes the critical infrastructure, with general practice the cornerstone for its success. Yet, research into the security of medical information has shown that many general practices are unable to create an environment with effective information security. This paper puts together the connections of e-health and the complex environment in which it is positioned. A discussion of how this critical infrastructure is assembled is presented, and the key vulnerabilities are identified. Further, it addresses how security may be approached to cater for this diverse and complex environment. From a national security and critical infrastructure perspective, as medical records are part of society’s critical infrastructure, the most effective system attacks are those on the points of highest vulnerability. In our current health system infrastructure those points are the data collection and records retention areas of individual medical providers. Progress towards changing this situation is key to its success.
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There is also a more comprehensive presentation here:
So, what we have here is experts from both sides of the country saying the claims about ’iron-clad’ security on the part of the PCEHR are - to put is nicely - rubbish.
Any personal information you place in the PCEHR you should assume is vulnerable and unless you are happy with the world knowing all your intimate health information you should not sign up for and use this system.
The thing that amuses me is how DoHA and NEHTA say it is all OK - you don’t need two factor security and so on while the banks are - despite the cost - rolling such technology out as fast as they can. Do the banks know something about security risk that has slipped past NEHTA and DoHA?
There is some real silliness going on here. Until we have properly secured practices from an IT perspective and proper electronic credentialing of citizens the risks of ongoing breeches and the associated publicity is just too high.
David.
p.s. I note Grahame Grieve has done a blog on the same topic - pointing out that AusCERT is unsure just how the problem can be fixed. A link is here:
http://www.healthintersections.com.au/?p=828
Can I suggest the only way the individual can address the risk is to ensure information they wish to keep private never finds its way your PCEHR. (STI information, terminations, mental and other stigmatizing  illnesses etc.). It really is as simple as that.
D.

Saturday, March 10, 2012

Weekly Overseas Health IT Links - 10th March, 2012.

Note: Each link is followed by a title and few paragraphs. 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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Wales makes good progress with IHR

24 February 2012   Rebecca Todd
More than 300 GP practices have switched on access to the Individual Health Record in Wales, making about 2m summary patient records available to emergency care providers.
Approximately 3m people live in Wales. But the IHR is now available in every health board area, following the go-live of the Abertawe Bro Morgannwg University Health Board at the start of the year.
The IHR is the Welsh version of the Summary Care Record in England. It allows secure access to a summary GP record for doctors and nurses working in an out-of-hours services or medical assessment units.
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Liverpool shares info 55,000 times

28 February 2012   Rebecca Todd
More than 55,000 primary care records have been accessed by community, secondary and tertiary care providers in North Mersey over the past year as part of a local clinical pathways project.
North Mersey Health Informatics Service is supporting nine clinical pathways as part of a quality innovation, productivity and prevention programme.
These are: heart failure, urgent care, COPD, children’s services, cancer, diabetes, mental health, dementia and clinical support services.
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Proposed new EHR certification rules released

Posted: February 27, 2012 - 12:15 pm ET
While most of the attention in the health information technology industry last week was focused on the newly proposed Stage 2 standards that providers would have to meet to achieve meaningful use of electronic health-record systems, a companion proposed rule affecting EHR vendors and the organizations that test and certify them also was made public.
The 184-page proposed rule, officially titled "Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology," was released Friday by HHS and the Office of the National Coordinator for Health Information Technology.
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Chip Cards Help Monitor Home Patients

While many provider organizations are looking for ways to electronically connect home-bound patients to clinicians, a new effort combines chip technology with a decidedly low-tech feature—a paper card.
The program, designed to regularly monitor the health status of patients, uses a card with buttons that have an embedded chip in them. Patients press a button to start and then press other buttons to answer pre-selected questions about how they feel, medication adherence, pain levels and other appropriate indicators.
Information from the pressed chips is wirelessly transmitted to a cell phone, USB reader on a computer, or a home monitoring station. The information then is transmitted to personal health records vendor NoMoreClipboard and put into a PHR for a patient or family member, and in a Web portal for appropriate clinicians and case managers to access.
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For HIT, Innovation, Not ROI, is the Benchmark

Edward Prewitt, for HealthLeaders Media , February 28, 2012

Healthcare IT is expensive. Just for starters, consider that the per-bed cost to implement EHRs and CPOE runs between $14,000 and $65,000 in the US, according to the federal Office of Management and Budget. Even at the low end of the estimate, that's an astonishing amount of money, and it doesn't include higher-order IT systems such as clinical decision support.
The high cost of IT creates a catch-22 for healthcare leaders already strapped for cash and forecasting declining revenues in years to come. IT systems offer a way—perhaps the only way—to lower healthcare system cost in a sustainable manner. But where do you find the money to invest in IT?
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iPhone shows high accuracy for knee MRI

February 28, 2012 -- The iPhone is a fine platform for interpreting knee MRI images, and for most injuries it's equivalent to a workstation, according to a new study by Canadian researchers that was presented earlier this month at the American Academy of Orthopaedic Surgeons (AAOS) meeting in San Francisco.
Compared to arthroscopy, expert interpretation of iPhone images showed high sensitivity and specificity for medial meniscus and cruciate ligament injuries, though accuracy was reduced for lateral meniscus tears and cartilage injuries, said Dr. John Theodoropoulos, an orthopedic surgeon from the University of Toronto.
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NHS pilot may allow drugmakers to analyse patient data

28 February 2012  Hal Hodson

An NHS Trust is trialling a data mining scheme that could allow biomedical firms to query patient records without them leaving the hospital

An NHS Trust in Southampton is trialling a new analytics service that could open the door for pharmaceutical companies to analyse patient data.
The pilot is the first of its kind since prime minister David Cameron announced a plan to encourage data sharing between the NHS and the biomedical industry in December last year. "We're going to consult on actually changing the NHS constitution so that the default setting is for patient's data to be used for research, unless of course, they want to opt out," Cameron said at the time.
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6 keys to successful mobile medical apps

By danb
Created Feb 29 2012 - 1:49pm
For mobile health--specifically mobile medical apps--to be successful in a patient care setting, six principles must be taken into consideration, according to PricewaterhouseCoopers Managing Director Christopher Wasden, who spoke at a HIT X.0 session [1] at last week's Healthcare Information and Management Systems Society's annual conference in Las Vegas.
Wasden said mobile health has matured beyond novelty and eventually will become core to the practice of medicine, he believes that there is still a way to go before it gets there.
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CMS, Meaningful Use Stage 2 steal the show at HIMSS 2012

By gshaw
Created Feb 29 2012 - 11:12am
No doubt that the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) stole the show with their announcement of the proposed requirements for Stage 2 Meaningful Use and 2014 certification of electronic health records at the Healthcare Information and Management Systems Society's annual conference in Las Vegas.
Following a 60-day comment period, the final rule is scheduled for release this summer.
The proposed rules and standards largely reflect the recommendations made last year by the Health IT Policy Committee and the Health IT Standards Committee, National Coordinator for Health IT Farzad Mostashari, M.D., told an overflow crowd.
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Watson computer offers potential for healthcare decisions

February 29, 2012 -- Is it easy to harness the power of a supercomputer to make it useful, practical, and affordable for healthcare applications? Not really, attendees surmised after a presentation at the Healthcare Information and Management Systems Society (HIMSS) annual meeting last week in Las Vegas.
Ever since Watson, IBM's massive artificial intelligence system equipped with natural language processing, became a contestant on the television game show "Jeopardy," healthcare professionals have been interested in its use. This was the talk of the 2011 HIMSS annual meeting, which took place one week after IBM and Nuance Communications announced that they'd entered into a five-year long joint development agreement.
Dr. Nick van Terheyden, chief medical information officer of clinical language understanding at Nuance Communications, discussed the objectives and challenges of the project to date.
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Thursday, March 01, 2012

Social Media Offers New Recruitment Strategy for Clinical Trials

Facebook and clinical research may sound like strange bedfellows, but researchers from academic settings and the pharmaceutical industry have started to jump onto the social media bandwagon. Many researchers say social media can educate patients about the value of clinical research and encourage them to participate in studies.
The success of clinical research hinges, in large part, on the ability to recruit patients. Yet, targeting the right patients and retaining their participation is one of the greatest challenges researchers face. "The percentage of people getting involved in clinical trials is pretty low, and that's a huge problem for us in this country," said Naz Sykes, executive director of the Dr. Susan Love Research Foundation.
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VA, DoD discuss steps toward iEHR, VLER

By Bernie Monegain, Healthcare IT News
Created 2012-02-29 11:04
When Secretary of Defense Leon Panetta and Veterans Affairs Secretary Eric K. Shinseki met at the Pentagon earlier this week, EHRs was one of the topics on the table.
The meeting on Monday was one in a series the two secretaries have held on issues of common interest to both Departments.
"The vision Secretary Panetta and I share is to provide an integrated, seamless experience to our people across their lifetimes – from when they raise their hands to take the oath, to when they leave active service and join the Veteran ranks, to when they are laid to rest with final honors," Secretary Shinseki said. "Over the past three years, VA and DoD have made significant progress, but more work remains."
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February 29, 2012

Report: With Advanced EMR Systems, Comes Added Benefits

New research from the research arm of the Chicago-based Healthcare Information Management and Systems Society,  HIMSS Analyticsand the Washington D.C.-based The Advisory Boardshows that hospitals with advanced electronic medical records (EMR) systems report achieving a broad range of benefits from their implementations, including clinical quality, patient safety and operational efficiencies.
The data collected for the report, EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals, indicates that highly advanced EMR environments can produce substantial benefits for individual hospitals and the healthcare system as a whole. The survey is the first to report results from hospitals that have achieved Stages 6 or Stage 7 on the EMR Adoption Model (EMRAM).  It collected information from 33 chief information officers (CIOs) at Stage 6 or Stage 7 EMRAM hospitals from throughout the country. 
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Remote monitoring helps Geisinger cut readmissions

By Chris Anderson, Contributing Editor
Created 02/29/2012
DANVILLE, PA – A remote monitoring program implemented by Geisinger Health Plan using interactive voice response (IVR) and other telemonitoring technology to aid case managers has shown a 44 percent reduction in hospital readmissions.
The Geisinger Monitoring Program (GMP) uses a range of technologies from remote monitoring and telehealth company AMC Health designed to increase the number of interactions patients had with caregivers post-discharge.
“That first week or two post-discharge is when you really see readmissions happening,” said Joann Sciandra, director of case management and strategic planning with Geisinger Health Plan. “Having the ability to have a couple more touches or encounters with that patient makes this a very valuable tool. From a case management standpoint, it gives the case manager a little bit more time they may need with more complex patients.”
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February 29, 2012

Private HIEs on the Upswing

After a period of wait-and-see in the health information exchange (HIE) market when the American Reinvestment and Recovery/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act initially passed in 2009, meaningful use has since been pushing providers to adopt the EHR technology necessary to move forward to launch HIEs. Hospitals and health systems, as well as payers, are fueling HIE growth, building information backbones necessary to support care coordination and accountable care organization (ACO) development.
With the multitude of health IT responsibilities on providers’ plates now, it’s a tough decision as to whether an organization should build their own private HIE or link to a nearby public exchange, says Mark Allphin, senior research director, KLAS Research (Orem, Utah). Allphin reports that in a recent survey his consulting firm conducted, providers were in a 50/50 split on the choice, and the deciding factors were the amount of organizational resources the organization had and the maturity of the region’s public HIE. Carladenise Edwards, Ph.D., president and CEO, The BAE Company (Miami, Fla.), says that some primary considerations for assessing the value of a public HIE are access to greater legal protections for data breaches and access to data points and public health reporting inaccessible otherwise.
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HL7 readies Blue Button conversion tool

Posted: February 29, 2012 - 1:00 pm ET
Health Level Seven, the Ann Arbor, Mich.-based standards development organization, announced that by April it will have a file conversion tool and user's guide to adapt its Continuity of Care Document message transport specification to the Blue Button format developed by the U.S. Veterans Affairs Department.
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Advanced EMRs reap advanced benefits

By Mike Miliard, Managing Editor
Created 03/01/2012
CHICAGO – HIMSS Analytics and The Advisory Board have published new research showing hospitals that have implemented advanced electronic medical record systems enjoy a broad range of benefits when it comes to clinical quality, patient safety and operational efficiencies.
The joint report, titled "EMR Benefits and Benefit Realization Methods of Stage 6 and 7 Hospitals," indicates that highly advanced EMR environments can produce substantial benefits for individual hospitals and the healthcare system as a whole. The survey is the first to report results from hospitals that have achieved Stages 6 or Stage 7 on HIMSS Analytics' EMR Adoption Model (EMRAM), offering insight about the benefits that can accrue for hospitals further along the development track.
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6 hot stories from HIMSS12

By Michelle McNickle, Web Content Producer
Created 02/29/2012
HIMSS12 was a record-breaking event, attracting more than 37,000 attendees and 1,100 exhibitors. Speeches were made, demos were given and our favorite policymakers and social media stars spoke about all things health IT. Presenters shined the spotlight on ACOs, patient engagement, HIEs, ICD-10 and meaningful use, with the main highlight being the ability for industry professionals to connect with one another.
Healthcare IT News was there every step of the way, offering everything from breaking news to Twitter recaps, videos, blogs, slideshows and more. Here is our roundup of the six hottest stories from HIMSS12. 
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Top Considerations For Cloud EHR Buyers

Cloud computing offers a speed ramp into the electronic health record highway. But don't overlook critical questions about security, performance, say legal experts at HIMSS.
By Marisa Torrieri, Physicians Practice,  InformationWeek
February 29, 2012
Cloud computing--that lofty-sounding term that conjures visions of pillow-like, white puffs in a baby-blue sky--is a great option for small practices moving to an electronic health record (EHR). Requiring only an Internet connection, a cloud-based EHR allows practices to access, store, and transmit data without worrying about shelling out big bucks for second servers or other heavy hardware parts.
But before practices take the leap into the skies, there are multiple considerations they need to take into account. AdTech Ad
During a Thursday morning session at the HIMSS12 Conference in Las Vegas, Melissa Markey, a shareholder with law firm Hall, Render, Killian, Heath & Lyman, and Margaret Marchak, the associate VP and deputy general counsel for the University of Michigan, gave attendees an earful of these considerations.
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HIMSS, MGMA offers docs help with data exchange

By Bernie Monegain, Editor
Created 03/01/2012
CHICAGO – To help physician practices navigate health information exchange, HIMSS and the Medical Group Management Association and its standards-setting body, the American College of Medical Practice Executives, have introduced the Ambulatory Health Information Exchange Toolkit for physician practices.
In delivering the proposed rule for meaningful use Stage 2 this past week, ONC chief Farzad Mostashari said Stage 2 emphasizes interoperability and health information exchange.
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iGovernance

By John Morrissey
Hospitals are replacing the often haphazard approach of choosing IT projects with a much more formal and disciplined process
The requests: endless.
The potential payoffs: countless.
The resources: depleted and finite.
That's the scenario facing nearly every hospital executive team as it considers which information technology projects to pursue. Chief information officers are under siege with requests to upgrade this and modify that; link these systems with those systems, and not forget to buy and install new state-of-the-art devices that would make Star Trek's Leonard "Bones" McCoy, M.D., jealous. And do it yesterday.
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Survey Says: Yes, National HIT Architecture is Shifting, Thank Goodness!

By Vince Kuraitis
Feb 08, 12 04:26PM
Brian Ahier sparked a feud with his Google+ post commenting on a recent JAMIA article entitled Shift in the Architecture of the Nationwide Health Information Network. We’re at 60+ comments and going strong. The discussion has also been picked up on in Modern Healthcare.
The JAMIA article was written by Leslie Lenert and colleagues, and Lenert joins in heartily in the Google+ discussion. From the abstract, here are 3 key points they make:
1) …a significant change in the architecture of the NwHIN is taking place. Prior to 2010, the focus of information exchange in the NwHIN was the Regional Health Information Organization (RHIO). Since 2010, the Office of the National Coordinator (ONC) has been sponsoring policies that promote an internetlike architecture that encourages point to-point information exchange and private health information exchange networks.
2) The net effect of these activities is to undercut the limited business model for RHIOs, decreasing the likelihood of their success…
3) These changes may impact the health of patients and communities. Independent, scientifically focused debate is needed on the wisdom of ONC’s proposed changes in its strategy for the NwHIN.
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The Value of Electronic Health Records Extends Far Beyond Patient Care

Embedding Privacy, by Design, Not by Chance
March 2, 2012 (Toronto, ON) Embedding and implementing Privacy by Design (PbD) into electronic health record (EHR) systems being built across Canada will enable us to benefit from the wealth of health information stored on these systems, while protecting patient privacy, according to a new paper released today at the Toronto Board of Trade.
“By incorporating the principles of Privacy by Design into the EHR environment, you can accommodate both individual privacy and access to health information for purposes that benefit society as a whole, such as research purposes — a win-win scenario,” said Dr. Ann Cavoukian, Information and Privacy Commissioner of Ontario.
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ICD-10 Proponents Cry Foul

Cheryl Clark, for HealthLeaders Media , March 1, 2012

Health and Human Services Secretary Kathleen Sebelius has made it official that her agency will "initiate a process" to "examine the pace" of ICD-10's implementation, with a new compliance date forthcoming. But many quality leaders and providers, not to mention vendors, who attended at HIMSS12 last week are imploring HHS to hang tough.
The pro-ICD-10 crowd insists ICD-10 should not be delayed. But if it must be, they want any postponement to be short-lived, limited in scope or perhaps phased in with a transition period. And they are mustering a fight to make their case.
"Our stance is, we're opposed to any kind of delay," says Sue Bowman, director of Coding Policy and Compliance for the 64,000-member American Health Information Management Association (AHIMA).
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NeHC Stakeholder Survey Results Released

February 27, 2012
The Washington, D.C.-basedNational eHealth Collaborative (NeHC) released the results of the 2012 NeHC Stakeholder Survey, featuring responses related to health information exchange (HIE), consumer engagement, and other NeHC programs.  
Coming on the heels of the release of the proposed rule for meaningful use Stage 2, survey results provide insights into stakeholder perceptions related to barriers to HIE and the importance of consumer engagement in transforming healthcare, which relate to some of the core measures that physicians and hospitals must meet in order to be eligible for Stage 2 meaningful use incentives.
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HIT crowdsourcing picks up, VCs eye winners

By Government Health IT Staff
Created 2012-02-27 11:03
Health IT codathons, developer challenges, and programming contests are taking on increasing importance as small groups of developers are being encouraged to enter the innovation game. The hope is that ultimately winners and runners-up will gain venture funding to create systems that improve healthcare and reduce costs.
Also known as crowdsourcing, these challenges are being pushed by HHS, ONC, even the Surgeon General has held a developer contest, all aiming to spark innovation.
Indeed, such innovation historically has been difficult to reach in the healthcare realm, said Jim Hansen, vice president and executive director of Dossia Consortium, a nonprofit open-source personal health record service developed by a group of Fortune 500 employers.
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VA issues stop-work order on crucial element of e-health record system

Monday - 2/27/2012, 9:00am  ET
Emily Kopp, reporter, Federal News Radio
The Department of Veterans Affairs has issued a stop-work order on a key component of the integrated electronic health record system it is developing with the Defense Department.
Virginia-based ASM Research was awarded the contract to build a central hub that would let the agencies incorporate private-sector products more easily into the combined system.
VA assistant secretary for information and technology and chief information officer Roger Baker called it the "heart" of the integrated electronic health record (iEHR) system.
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Docs slow to engage patients with IT

By Bernie Monegain, Editor
Created 02/27/2012
WASHINGTON – A new study by the Deloitte Center for Health Solutions indicates physicians are not using IT broadly to engage patients. No more than 20 percent of doctors are providing online scheduling or test results for their patients and just 6 percent are using social media to communicate with them, according to Deloitte.
The report, “Physician Perspectives on Health Information Technology,” shows that measured against the IT goals and deadlines prescribed by the Patient Protection and Affordable Care Act, only 25 percent of physicians are “on target” to meet the meaningful use incentives.
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Beacon Grants Boost HIT, Patient-Centered Care

Greg Freeman for HealthLeaders Media , February 27, 2012

This article appears in the February 2012 issue of HealthLeaders magazine.
Millions of dollars continue to flow from Washington, DC, to communities across the country in the form of grants to so-called Beacon Communities, intended to serve as pilots and role models for how health information technology can be used to improve quality and care coordination. The federal government announced recently the award of $220 million to another 15 communities, and earlier recipients are reporting that the money can make a difference.
The Beacon grants can provide the necessary capital for improvements that many healthcare providers have on their wish list, the recipients say, but the money doesn't necessarily make the job easy.
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HHS Proposes More Security On Healthcare Mobile Devices

Encryption would have stopped many of the patient data breaches caused by lost smartphones, laptops, and tablets, said Stage 2 Meaningful Use proposal.
By Nicole Lewis,  InformationWeek
February 24, 2012
In an attempt to eliminate the potential for patient data breaches on mobile devices, the Notice of Proposed Rulemaking (NPRM) for Stage 2 Meaningful Use has proposed that mobile devices, such as laptops, smartphones, and tablets, that retain patient data after a clinical encounter should have default encryption enabled.
Published by the Department of Health and Human Services (HHS) Thursday, the proposed rule for Stage 2 Meaningful Use for the Electronic Health Record (EHR) Incentive Programs noted the increasing number of reported breaches which involve lost or stolen devices. AdTech Ad
"We agree that this is an area of security that appears to need specific focus. Recent HHS analysis of reported breaches indicates that almost 40% of large breaches involve lost or stolen devices. Had these devices been encrypted, their data would have been secured," the NPRM for Stage 2 Meaningful Use states.
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HL7 offers domain model for EHRs for free

By Mike Miliard, Contributing Editor
Created 2012-02-24 09:00
LAS VEGAS – At HIMSS12 this week, Health Level Seven International (HL7) announced a pilot program that will offer some of its intellectual property, free of charge, in an effort to spur further EHR implementations.
“HL7 is keeping its promise to lower the barriers to adoption of electronic health records by making portions of our valuable intellectual property freely available to our stakeholders,” said Charles Jaffe, MD, CEO of HL7.
“We believe that caregivers, academic centers and vendors will greatly benefit from this significant enhancement for access to valuable HL7 material,” he added.
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HIMSS conference abounds in 'can-do' optimism

By kterry
Created Feb 25 2012 - 4:36pm
Enthusiasm went viral this year at the annual conference of the Healthcare Information and Management Systems Society (HIMSS). About 37,000 people attended the conference--up from 31,500 last year--and their mood was upbeat in the educational sessions and on the exhibit floor.
One reason for the buoyant atmosphere was new evidence that the federal government's incentive program for the meaningful use of electronic health records is working. The U.S. Department of Health & Human services announced [1] it has distributed more than $3.1 billion in incentives and that hospital use of EHRs has doubled in the past two years, and it seems entirely possible that the Office of the National Coordinator for Health IT will meet its goal of getting 100,000 providers [2] to attest to Meaningful Use by the end of 2012.
Also, new technology continues to amaze. Mobile health apps are proliferating to take advantage of ubiquitous smartphones; workable native EHRs for iPads may be just around the corner; and some EHR vendors at HIMSS were demonstrating the use of natural language processing to improve the usability of their products.
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Monday, February 27, 2012

From Volume to Value: Connectivity, Big Data and Sustainability Shape HIMSS12

Las Vegas was an appropriate metaphor for the Healthcare Information and Management Systems Society's annual conference, as bets are being placed on several health IT issues affecting providers: Will health care providers be able to meet Stage 2 of the meaningful use program? What will the timing be for ICD-10? Can health information exchanges survive? And of critical concern, how will slow-to-adopt physicians and community hospitals fare in this environment?
Ultimately, what shaped the sales pitches, product demos and migration paths at the HIMSS conference was not about technology at all: It was the market driver of health care payments moving from volume to value. Accountable care, whether it takes the form of an ACO writ large or in lower case, will compel health providers to undertake greater financial risk for managing population health. While the pace of this change can be debated, the trajectory is inevitable.
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Enjoy!
David.