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5 keys to IT and the physician-patient relationship
By Michelle McNickle, Web Content Producer
Created 04/12/2012
As the concept of patient-centered care continues to evolve, a key to its success is the relationship between physician and patient. But factor in all the technologies springing up left and right, and finding the perfect balance between patient engagement and new IT initiatives can be tricky.
"Focusing specifically on the physician-patient relationship – it's behind the rest of the world," said Steve Wigginton, CEO of Medley Health, a medical practice marketing and communication services company. "But there are a lot of benefits to be had. More information is readily available to physicians as a result of IT, and therefore, it's easier for them to keep track of what's going on with their patients."
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Patients Make Poor Health-Care Consumers, Says Quest Diagnostics’ CMO
Are patients good consumers of healthcare?
Nope, says Jon Cohen, a vascular surgeon and chief medical officer at Quest Diagnostics. The average American spends twice as much time before buying a TV as they do looking for a doctor, he told participants today at TEDMED in Washington.
“Consumer-driven healthcare doesn’t work because people don’t want health care,” he said.
The three main factors that drive consumers to make a choice: price, quality and desire, said Cohen. When it comes to health care, however, price doesn’t correspond with quality, so going to a more expensive doctor doesn’t guarantee better treatment.
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Do We Need Doctors Or Algorithms?
Vinod Khosla
Tuesday, January 10th, 2012
Editor’s note: This is Part II of a guest series written by legendary Silicon Valley investor Vinod Khosla, the founder of Khosla Ventures. In Part I, he laid the groundwork by describing how artificial intelligence is a combination of human and computer capabilities. In Part III, he will talk about how technology will sweep through education.
I was asked about a year ago at a talk about energy what I was doing about the other large social problems, namely health care and education. Surprised, I flippantly responded that the best solution was to get rid of doctors and teachers and let your computers do the work, 24/7 and with consistent quality.
Later, I got to cogitating about what I had said and why, and how embarrassingly wrong that might be. But the more I think about it the more I feel my gut reaction was probably right. The beginnings of “Doctor Algorithm” or Dr. A for short, most likely (and that does not mean “certainly” or “maybe”) will be much criticized. We’ll see all sorts of press wisdom decrying “they don’t work” or “look at all the silly things they come up with.” But Dr A. will get better and better and will go from providing “bionic assistance” to second opinions to assisting doctors to providing first opinions and as referral computers (with complete and accurate synopses and all possible hypotheses of the hardest cases) to the best 20% of the human breed doctors. And who knows what will happen beyond that?
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5 keys to EHRs supporting next-generation business models
By Michelle McNickle, Web Content Producer
Created 04/11/2012
With the rise of accountable care organizations (ACOs) and patient-centered medical homes (PCMH), the spotlight has been put on IT to help make a smoother transition to those new care models. And although the partnership between patient and EHR plays a critical role in their success, Shahid Shah, software analyst and author of the blog The Healthcare IT Guy, believes EHRs have a long way to go before they can take on the full responsibility of supporting these organizations.
"Today's reality of patient management is 'disjointed care,' and most of the collaborators in a patient's care team don't know what each other is doing for the patient in real time," he said.
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EHRs a major cause of patient info breaches
By mdhirsch
Created Apr 12 2012 - 9:27am
The "aggressive" adoption of electronic health records is one of the biggest reasons for the rise in security breaches of patient records, according to HIMSS' latest analytics report [1] on the security of patient data.
The report, commissioned by Kroll Advisory Solutions, noted that with the move to patient records in electronic form, the data is more vulnerable since it's more accessible and mobile. Of the respondent hospitals that have reported a security breach of patient information, 22 percent reported that the data compromised had been in electronic form--such as a computer or mobile device--double the amount reported in 2010. Most of the breaches involved theft or loss.
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New Patient Safety App Challenge from ONC
APR 11, 2012 4:27pm ET
The Office of the National Coordinator for HIT has launched a new challenge for development of a specific health information technology application.
The Reporting Patient Safety Events Challenge seeks an application to facilitate reporting of safety incidents in hospital and ambulatory settings.
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By Joseph Conn
Breaches, hackers and the wisdom of encryption
The recent breach of patient-identifiable healthcare records in Utah is unusual, but not unique, in that it reportedly involved the work of hackers and the extent of the exposure was not immediately known.
According to the publicly available segment of the 410 major breach reports collected by HHS' Office for Civil Rights, 24 (not quite 6%) were the result of hacking, primarily of computer servers. Those 24 breaches exposed 550,083 patients' records, or just 3% of the nearly 19.2 million records involved in all 410 reported incidents involving more than 500 patient records.
So far, the Utah breach, at the latest report could involve as many as 780,000 beneficiaries of the state's Medicaid and Children's Health Insurance Program participants. That would make it the single-largest breach involving hacking since the civil rights office began collecting breach reports in September 2009 under a congressional mandate.
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Fierce Q&A: Data governance plan crucial for winning providers' trust
By danb
Created Apr 12 2012 - 12:55pm
A clear data governance plan that includes how data will be collected, maintained and protected is a must for any hospital planning on pushing a big-data initiative, Computer Sciences Corporation senior research analyst Jared Rhoads writes in the company's latest whitepaper, "Transforming Healthcare Through Better Use of Data [1]."
According to Rhoads, such a plan is crucial to winning providers' trust.
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New electronic medical record system to further enhance exchange of vital patient information at Group Health Centre in Sault Ste. Marie
April 12, 2012 (Sault Ste. Marie, ON) - Canada Health Infoway Inc. (Infoway) and the Group Health Centre (GHC) today launched a new $3.3-million initiative, the Group Health Centre Ambulatory EMR and Hospital Information System Connect Project. This project will revitalize GHC's I.T. infrastructure and integrate it with local hospital and provincial electronic health record (EHR) systems to enhance quality of care and share information between healthcare settings. Alignment with provincial and national EMR and EHR initiatives are critical elements of the project.
GHC's existing EMR has been used by local clinicians to store and share information amongst authorized healthcare providers for more than 15 years. While this system has helped position GHC as an EMR leader, the time has come to replace the existing EMR solution with the next generation of EMR.
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Thursday, April 12, 2012
New Leader, New Plan, New EHR Initiative for Cal eConnect
Laura Landry has worked at Cal eConnect since it was formed by the state two years ago, but she looks at the organization a little differently now. After spending the last six months as interim CEO, Landry was officially named CEO on March 19.
Her new position gives her a different perspective -- the overview.
"I think we're on the verge of a breakthrough," Landry said. "People talk about making changes at the speed of trust, and we're at the point where we've engaged stakeholders ... and now we're giving them the things that they need to get things done. We're right on the cusp of making health information easier, making it easier to do health information."
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Blog Explains Direct Project Secure Messaging
APR 10, 2012 11:56am ET
Greg Meyer, a director and principal architect at Cerner Corp., has written the first of three blogs that are a plain English tutorial of the government-funded Direct Project secure messaging service.
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Utah Breach Shows Vulnerability of Health Records
By NICOLE PERLROTH April 10, 2012, 10:29 am
Eastern European hackers have stolen personal records for 780,000 people in the breach of a computer server in Utah.
The list of victims include recipients of Medicaid and a health care program for low-income children in Utah, officials at Utah’s Department of Health said in a statement. Hackers were able to breach the servers by exploiting a technician’s weak password. On March 30, they downloaded 24,000 files to computers in Eastern Europe. Each file contained records for hundreds of recipients.
Utah’s Department of Health has updated the number of victims three times. It initially said 24,000 people were affected but by Monday evening, the list had expanded to include 780,000. Of those, the department said 280,000 had their Social Security numbers stolen, according to the revised statement.
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Epic “ready for NHS”
Two of the senior executives at Epic talk to EHI editor Jon Hoeksma about why “the Epic way” may be the way forward for some trusts in the NHS.
4 April 2012
Author: Jon Hoeksma
The chief operating officer of US electronic patient record vendor Epic says the firm is ready for the NHS, is optimistic about its chances and sincerely hopes it will win the high-profile Cambridge procurement.
In an exclusive interview with eHealth Insider at HIMSS12, Las Vegas, Carl Dvorak, executive vice president, Epic, and Leslie Karls, who is leading on the NHS, said the company had first started engaging with the NHS in England in the mid 2000s, at the request of NHS Connecting for Health.
“Six or seven years ago we decided the NHS market wasn’t right for us, but we’ve been keeping watch of developments and been getting more enquiries from the UK.”
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HIMSS: Hospitals must be more 'proactive' about data breach prevention
By danb
Created Apr 11 2012 - 1:48pm
Hospitals and health organizations need to be more proactive about preventing health data breaches, concluded the authors of the recently released "2012 HIMSS Analytics Report: Security of Patient Data." The report [1] said most facilities are too wrapped up in compliance issues to focus on keeping patient data protected.
"While increased regulation and better-articulated guidance have led to increases in privacy and security measures within hospitals, they also have contributed to a false sense of security within organizations that comply with these mandates," the report's authors wrote. "Despite the increase in the number of breach incidents reported, most hospitals continue to believe that if they are more prepared, they are more secure."
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Breaches epidemic despite efforts at compliance, says Kroll
By Mike Miliard, Managing Editor
Created 04/10/2012
NEW YORK – A new study from HIMSS Analytics and Kroll Advisory Solutions shows that, a diligent focus on security compliance notwithstanding, healthcare providers are still badly lacking when it comes to privacy protections. In fact, data breaches have only increased in recent years.
According to the 2012 "HIMSS Analytics Report: Security of Patient Data," increasingly stringent regulatory activity with regard to reporting and auditing procedures – and increased compliance from providers – haven't done anything to prevent an uptick in breaches over the past six years.
The report is the third iteration of Kroll’s biannual survey of healthcare providers nationwide.
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Civil liberties group criticizes health information exchanges over privacy
A lack of standards on sharing data could put patient records at risk, according to a report.
A report by the New York Civil Liberties Union examining health information exchanges in the state questioned the legalities of the patient privacy policies in place and criticized the exchanges for not doing enough to protect patients.
The findings are applicable to health information exchanges across the country, the report’s author says, because there are no established best practices for the sharing of data through HIE organizations. New York is often viewed as a leader in such exchanges, as it had some of the first ones in the nation.
Corrine Carey, assistant legislative director of the NYCLU and author of the report, said because information can be uploaded to an HIE without patient consent, the NYCLU and other patient privacy groups have argued that these policies are not consistent with state law, which requires physicians to get consent from a patient before transferring records to a third party. Patients do, however, have to give consent before those files can be accessed by another physician, which makes the policies consistent with the law, according to the New York State Dept. of Health.
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April 10, 2012
EHR Study Update: Top reasons for implementing EHR
By Michael McBride
When asked what their top reasons were for implementing an electronic health record (EHR) system, 95% of the EHR Study's participating physicians listed "to achieve meaningful use" as the primary motivation. For 53% of the doctors polled, "to improve patient quality of care" came in at a distant second-place motivation.
Clearly, complying with the government's mandate motivates more primary care physicians to adopt EHRs in their practices than other, more fundamental healthcare motivations.
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Oregon Health Network's 12 HIT best practices, part 4: Implementation
By Greg Fraser, CMIO, WVP Health Authority
Created 2012-04-09 09:49
Implementation – answering the question of “how” – is #4 on the list of Health Information Technology Best Practice Areas. Having been involved with electronic health record implementation in the ambulatory environment for six years, I can validate some universal truths about implementation and what it takes for a health care organization to successfully navigate its way from a paper to electronic environment. Why do some organizations succeed while others fail? Why do some successful organizations struggle much more than others?
The Buddhist aphorism applies: “Pain is inevitable; suffering is optional.”
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Telemedicine becoming the new house call
The Atlanta Journal-Constitution
6:57 p.m. Monday, April 9, 2012
Travis Proctor logged onto his computer, turned on his new webcam and clicked his mouse.
Within seconds, the 42-year-old father of three was face to face with Dr. Kelvin Burton, his primary care physician.
Just months ago, Proctor would have had to drive for nearly an hour round-trip from his home in Powder Springs to Burton’s Douglasville family care practice just for a checkup.
Not anymore.
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ICD-10 Would be Delayed One Year Under HHS Proposal
Andrea Kraynak, for HealthLeaders Media , April 9, 2012
HHS released a proposed rule Monday announcing a one-year delay of the implementation of ICD-10-CM/PCS. If finalized, ICD-10 would become effective October 1, 2014.
"Many provider groups have expressed serious concerns about their ability to meet the Oct. 1, 2013, compliance date. The proposed change in the compliance date for ICD-10 would give providers and other covered entities more time to prepare and fully test their systems to ensure a smooth and coordinated transition to these new code sets," according to an April 9 press release.
"This is what I expected," says Shannon McCall, RHIA, CCS, CCS-P, CPC, CEMC, CPC-I, CCDS, director of HIM and coding at HCPro, Inc., in Danvers, Mass. "But I am happy to hear that they didn’t seem to consider bypassing ICD-10 and going right to ICD-11. This goes to show that they do see the value in the system."
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Patients Take Back Control with Technology
Scott Mace, for HealthLeaders Media , April 10, 2012
Technology can be a wonderful thing. It can also be a cold and dehumanizing thing.
Unfortunately, in medicine, that often happens with one and the same device.
The very instruments that diagnose and treat us can often make us feel more like test subjects than patients receiving care. Anyone who's ever had an MRI knows the device that can find what's ailing us is also oppressively big and noisy. Woe to you if you're claustrophobic.
But technology is now being applied in the interests of healing the entire patient—mind, body, and soul.
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7 types of security features for your tablet
By Michelle McNickle, Web Content Producer
Created 04/06/2012
With the release of the "new" iPad, an increased focus has been placed on how to protect sensitive information. And although there are a myriad of basic ways to safeguard your device, certain security features have become necessary to take tablet protection one step further.
"Clearly, healthcare is a vertical that is more concerned, or needs to be more concerned, about security, more so than any other vertical because of the personal info they're dealing with," said John Bischof, executive director of sales operations for Lenovo Americas.
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CMS Posts Details on Stage 2 Clinical Quality Measures
APR 9, 2012 11:42am ET
The Centers for Medicare and Medicaid Services has posted on its Web site the complete set of clinical quality measures in the proposed rule for Stage 2 electronic records meaningful use starting in 2014.
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States wrestle with prescription data to curb abuse
By gshaw
Created Apr 9 2012 - 12:58pm
Access to drug prescription databases could curb abuse of pain pills, says a Colorado payer--but the state's pharmacy board is having none of it.
Rocky Mountain Health Plans, along with Colorado Medicaid officials, sought access to the database in order to curb doctor-shopping and pharmacy hopping, according to [1] the Denver Post.
But board members said state law allows access only to those providing direct care or dispensing direct prescriptions, and told both organizations they could not conduct wider reviews, according to the paper.
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Adaptive clinical decision support improves patient risk estimation
By danb
Created Apr 9 2012 - 1:34pm
Clinical decision support could become more personalized, if the results of a study [1] recently published in the Journal of the American Medical Informatics Association are any indication. Researchers determined that a new data-driven and adaptive approach to CDS was found to be more reliable than some existing methods.
The new approach--dubbed ADAPT--does not use training data, and instead relies on confidence intervals (CIs) drawn from individuals. Each model uses different features, parameters and samples, according to the study's authors.
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Health privacy issues can be resolved without obstructing care
By kterry
Created Apr 9 2012 - 7:10am
At times, it seems like concerns about the security and privacy of healthcare data have catapulted into overdrive: For instance, it recently was predicted that healthcare spending on security would hit $70 billion a year [1] by 2015--enough to cover the majority of the uninsured. Sure, there are plenty of security breaches--some of them serious enough to attract public attention. But as a few recent cases show [2], universal encryption of data (some forms of which may soon be required under the latest HIPAA rules [3]) could eliminate the biggest source of security breaches. Also, with the advent of virtual desktop infrastructure, there's no reason to store any personal health information on end-user devices.
As for hacking, the Eastern European thieves who are suspected of hacking into Utah's Medicaid system [4] recently were not after the details of Aunt Tilly's hip operation; they wanted her Social Security number. The only cure for that--regardless of how much is spent on security--is to replace the "social" with a national patient identifier. Unfortunately, that's still the impossible dream [5], ironically because of privacy concerns.
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Time To Rethink EMR Design And User Interface
04/06/2012 By Dale Sanders
Dale Sanders, Senior VP, Healthcare Quality Catalyst
There’s a great new article in the March 2012 issue of The American Journal for Managed Care, “IT-Enabled Systems Engineering Approach to Monitoring and Reducing ADEs.” You can find it here. The point I’m trying to make in this blog, by drawing attention to this article, is this: it’s time for EMR vendors to rethink the fundamental design and user interface of their products.
They’ve been basically unchanged for 10 years at least, supporting the same concept of encounter-based care that itself goes back at least 50 years. EMR vendors need to stop thinking of patient care as short-term encounters with a clinician and start thinking of patient care as long-term project management with a team of care providers. EMR user interfaces need to look more like a project management tool that enables social collaboration, task assignment and follow-up, and the collective wisdom of the care team, including the patient’s wisdom, more effectively.
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Monday, April 09, 2012
Moving Federal Health Care Targets Becoming a Way of Life
Moving targets are a challenge in skeet shooting; for health care providers, they are becoming a way of life.
Health care organizations are facing a variety of looming federal deadlines, ranging from implementing electronic health records to adopting new transaction standards. These deadlines -- carefully tracked by health care organizations and professional associations such as the College of Healthcare Information Management Executives -- are intended to put pressure on the industry to stay the course.
But recently some federal deadlines have been pushed back in response to evidence that the industry as a whole is not ready to meet them. For example, the Oct. 1, 2013, deadline for use of ICD-10 codes was postponed in February, and most recently, the deadline for enforcing use of ASC X12 Version 5010 and NCPDP Version D.0 was pushed back for a second time, to June 30, 2012.
These reprieves draw sighs of relief from some industry segments, while evoking frustration from others that have invested time, money and staff to meet the original deadline.
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Gingrich Health IT Think Tank Goes Bankrupt
Center for Health Transformation played major role in promoting health IT to Congress and the healthcare industry.
By Ken Terry, InformationWeek
April 09, 2012
The Gingrich Group, which includes Newt Gingrich's think tank, the Center for Health Transformation (CHT), has filed for Chapter 7 bankruptcy. Gingrich severed ties with CHT when he began seeking the Republican presidential nomination in May 2011, and a Gingrich campaign spokesman told the Wall Street Journal that CHT's bankruptcy is a result of its founder's departure.
CHT was a major promoter of health IT both before and after the passage of the HITECH Act, part of the 2009 stimulus law that established the government incentive program for "meaningful use" of electronic health records. 
Back in 2007, when Allscripts and several other technology companies formed the National e-Prescribing Patient Safety Initiative (NEPSI), which offered free e-prescribing software to physicians, Gingrich appeared at the press conference. "In the 21st century, the legibility of a doctor's handwriting should not determine whether a patient lives or dies," said the former Speaker of the House of Representatives in urging widespread adoption of e-prescribing. Later, Gingrich wrote the introduction to a book on the topic entitled Paper Kills, which was edited by CHT project director David Merritt and published by CHT press.
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Kenya's Startup Boom
Local programmers and homegrown business models are helping to realize the vast promise of using phones to improve health care and save lives.
Erick Njenga, a 21-year-old college senior wrapping up his business IT degree at Nairobi's Strathmore University, has a gap-toothed grin and a scraggly goatee. A mild-mannered son of auditors, he didn't say much as we tucked into a lunch of grilled steak, rice, and fruit juice at an outdoor café amid the din of the city's awful traffic. But his code had done the talking. Last year Njenga and three classmates developed a program that will let thousands of Kenyan health workers use mobile phones to report and track the spread of diseases in real time—and they'd done it for a tiny fraction of what the government had been on the verge of paying for such an application. Their success—and that of others in the nation's fast-growing startup scene—demonstrates the emergence of a tech-savvy generation able to address Kenya's public-health problems in ways that donors, nongovernmental organizations, and multinational companies alone cannot.
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Information Integrity: A High Risk, High Cost Vulnerability
APR 1, 2012
Accuracy and validity of data are persistent concerns for those who use it and are the subject of that data. And the concerns are well founded. Data error is a risk to patient safety.
Distrust of data can stop or delay action on a performance improvement agenda and it's very difficult to overcome that distrust. Tracing and correcting errors is costly and often imperfect. The amount of operational inefficiencies due to data quality issues, such as untangling an error in patient identification, is legend.
In short, problems in data accuracy and validity can impair the value of the information that health care is investing so much to digitize.
The Data Warehousing Institute estimates that poor data quality costs U.S. businesses $600 billion a year. There's no estimate of the cost of data quality problems in health care-but even the most conservative guesses for quality problems in the nation's largest industry would indicate there's real money at stake here.
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Enjoy!
David.
