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Reality check: Coordinated care is a daunting task
May 3, 2013 | By Alicia Caramenico
This week, FierceHealthcare reported on healthcare's "dirty little secret" about coordinated care: it's not very well coordinated and no one is responsible for it.
The "secret" was aired in a Kaiser Health News/Washington Post article, in which hospital patient advocates bemoaned confusion about who is managing a patient's care, provider miscommunications, unsafe hospitalist workloads and lack of coordination among caregivers.
And exacerbating that lack of coordination is the fact that most physicians need more help than is currently available to create and sustain team-based care--key to implementing coordinated care plans.
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Cancer researchers look to technology, software to make sense of big data
May 3, 2013 | By Gienna Shaw
Researchers at Washington University in St. Louis have used "powerful algorithms" developed by computer scientists at Brown University to assemble the most complete genetic profile yet of acute myeloid leukemia, Brown announced this week.
The work was part of The Cancer Genome Atlas project, which aims to catalog the genetic mutations that cause cells to become cancerous. Doing that requires sequencing the entire genome of cancer cells and comparing it to the genome of healthy cells.
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The Center for Technology and Aging launches online mHealth toolkit
By Diana Manos, Senior Editor
Created 05/02/2013
The Center for Technology and Aging has launched an online mHealth Toolkit that officials say offers key resources to organizations that want to develop a best-in-class mHealth program for chronic disease management.
"mHealth is an emerging technology that increasingly offers providers new options for improving the care of America's aging population, particularly those with a chronic disease," said David Lindeman, director of the Center for Technology and Aging. "This new toolkit offers organizations hands-on strategies and best practices for using mHealth technologies as effectively and efficiently as possible."
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Survey: Local, state gov CIOs underprepared for attacks
By Anthony Brino, Associate Editor
Only about half of state and local government CIOs polled in a recent survey said they’re prepared for a cyber-attack — even as 28 percent of them reported experiencing a system hacking or attack attempt in the previous year.
While a majority of the 36 state and local government CIOs told the Consero Group’s Government IT survey that they had necessary infrastructure in place, about 42 percent said they found the systems vulnerable to security breaches and cyber threats, and 44 percent said they don’t feel prepared for such attack.
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NIST Updates Commonly Used I.T. Security Guidelines
MAY 1, 2013 12:18pm ET
The federal government’s foundational computer security guide, also applicable to and used in the private sector, has been revised and now is available.
The National Institute of Standards and Technology has published the fourth version of Special Publication 800-53, formally called Security and Privacy Controls for Federal Information Systems and Organizations. The controls are designed to be largely policy and technology neutral to an organization.
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EHR transition may be financially risky for hospitals
April 30, 2013 | By Marla Durben Hirsch
Adoption of expensive electronic health record systems may hurt a hospital's bottom line, despite promises that the new systems will increase efficiencies and lower costs. Yet another hospital is reporting that the high cost of implementing a new EHR is having a negative effect, with Henry Ford Health System reporting its investment in Epic being a major factor in a 15 percent decrease in net income--from $62.9 million in 2011 to $53.1 million in 2012.
While HFHS still experienced financial growth overall, the $356 million EHR investment--coupled with an increase in uncompensated care--impacted revenue.
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5 keys to improve EHR return on investment
April 30, 2013 | By Marla Durben Hirsch
Achieving Meaningful Use is a necessary component for a positive return on an electronic health record system investment for physicians, but it's not sufficient to drive a "real" return on investment, according to speakers participating on a recent webinar conducted by EHR vendor CareCloud.
"Meaningful Use is the ultimate return on investment and sets you up for good fundamentals [to reap a better ROI]," said Michael Pepe, EHR implementation project manager for the company.
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Rely on governance, tools to keep clinical decision support up to date
May 2, 2013 | By Susan D. Hall
Beyond implementing clinical decision support tools, keeping the content current remains a weighty responsibility, one that must be tackled with proper governance and technology, according to an Executive Insight article.
With greater emphasis on evidence-based medicine, tools must provide the most current clinical advice at the point of care.
To effectively manage the clinical knowledge embedded in CDS applications requires leadership and a formal strategy, as well as tools to automate as much as possible, according to the article.
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Hunt pledges to respect patient data
26 April 2013 Lis Evenstad
Health secretary Jeremy Hunt has said he will honour patient opt-outs if they do not want their personal, confidential informaton to be shared.
Speaking in response to the Caldicott2 review led by Dame Fiona Caldicott, Hunt said he understood that effective sharing of patient information could only be done if patients are given a say over how their personal information is used.
“I firmly believe that technology can transform the quality of healthcare in this country, but we must always respect the fact that this is very personal information about an individual,” he said.
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Thursday, May 02, 2013
Tapping Social, Online Tools To Transform Health Care Delivery
There's a tricky balance for those of us who believe that the Internet can save lives. The challenge is juggling the needs for promotion and demonstration of harnessing the brilliance of social tools while also reflecting the realities and restrictions of current health care delivery systems. I know that social, evolving technology will help us reduce suffering and improve health care delivery. It's my contention that the more we leverage the lessons we learn using social tools to listen and educate patients seeking healthier lives, the more relevant science-based data and physicians will remain in improving care and the choices Americans make when patients.
It's our job to anticipate the future of care, how patients learn about health, and respond to the dynamic landscape of health information and health care delivery amidst current realities. The paternity of health remains (doctors decide how patients can obtain and access care) and patients comply.
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- U.S. NEWS
- May 1, 2013, 7:26 p.m. ET
Poor Prognosis for Privacy
Rules That Give Patients More Control of Their Records Face Technical Problems
By MELINDA BECK
Dominick Reuter for The Wall Street Journal
John Halamka, who co-heads a federal committee on data standards, said technology to make only part of a patient file visible isn't widely available.
The sharing of Americans' health information is set to explode in coming years, with millions of patients' medical records converted to electronic form and analyzed by health-care providers, insurers, regulators and researchers.
That has prompted concerns over privacy—and now, new federal rules that aim to give patients more control over their information are posing technical and administrative problems for the doctors and hospitals that have to implement them.
Information-technology experts say the challenges illustrate how difficult it may be to protect sensitive patient information as digitization of the health-care industry expands.
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The Goal: Better Use of Patient-Reported Information
APR 30, 2013 3:50pm ET
In recent years, patient portals, secure e-mail messaging software and patient kiosks in provider facilities have significantly increased the generating of electronically captured patient self-reported health information.
The information includes basic medical histories, test results, symptoms, medications, and in-home testing of glucose levels, blood pressure and weight, among other factors. Now, the Agency for Healthcare Research and Quality is preparing for a study by contractor Abt Associates on how best to capture and use patient-reported information in health information systems and associated workflows.
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Brookings framework aims to improve care and bend cost curve
By Stephanie Bouchard, Contributing Editor
A new report from the Brookings Institution offers a framework for person-centered care that provides sustainable lowered costs and promotes higher quality care.
The report, “Person-Centered Health Care Reform: A Framework for Improving Care and Slowing Health Care Cost Growth,” is the third in the Brookings Institution’s Engelberg Center for Health Care Reform’s “Bending the Curve” series.
The report was authored by 18 experts in their fields, including former U.S. Senate Majority Leader Tom Daschle; Michael Leavitt, former governor of Utah and former secretary of the Department of Health and Human Services; and Mark McClellan, MD, director of the Engelberg Center, all who presented the report during a press conference Tuesday.
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The Big EPR Debate: the first 100 comments
The Big EPR Debate has triggered a lively discussion on how to make progress on electronic patient records in England. Lyn Whitfield rounds up the themes of the first 100 or so responses.
24 April 2013
The NHS is once again being urged to adopt electronic patient records on an unfeasibly tight timescale.
NHS England is due to issue guidance in June on the plans that trusts are supposed to have in place by April for using electronic records by 2015; ahead of the NHS going ‘paperless’ by 2018.
Against this background, EHI has launched The Big EPR Debate in the belief that there is a very small, but real, window of opportunity to influence that guidance – or, at least, to get a handle on whether it will or will not do the job that needs to be done.
The launch of the debate triggered an amazing response, with more than 100 comments – many of them passionate, a lot of them detailed – posted on site in a week (and another 40 posted in the days after that).
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Utah health data breach: A lesson in the myriad benefits of prevention
May 1, 2013 | By Susan D. Hall
The theft of Social Security numbers provides cyber criminals a gift that keeps on giving, posing the potential for fraud for years. When Eastern European hackers gained access to healthcare information for roughly 780,000 Medicaid participants in Utah in March 2012, the Social Security numbers for 280,000 beneficiaries were compromised.
Al Pascual (pictured), a senior analyst of security, risk and fraud at Javelin Strategy & Research, analyzed that breach, among others, for a Data Breach Fraud Impact Report, due out later this month.
"Data breaches are precursors to fraud, and failing to protect [personally identifiable information] exposes everyone to pain, Pascual wrote in a blog post. Pascual spoke to FierceHealthIT about the Utah breach.
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Will Electronic Records Cure Health Care?
APR 29, 2013 12:48pm ET
Until we are totally confident we know how to design and deploy EHRs in a manner that will substantially improve health care, why would we want to proliferate these expensive systems? The thinking is that EHR interoperability will solve health care's crisis. But ask yourself: Whenever you've received inadequate care, what was the root cause? Was it (1) because your doctor couldn't access a medical record that was in some other doctor's office? Was it (2) because your doctor did not have access to the clinical knowledge that would have led to accurate diagnosis and/or effective treatment? Or was it (3) because medical science, itself, just does not know enough?
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New Health I.T. Safety Committee Holds First Meeting
APR 29, 2013 1:28pm ET
A recently formed workgroup of the HIT Policy Committee to identify ways to improve the safety of health information technology held its introductory meeting on April 29. Among its charges, the group will compile a report on strategies and recommendations for a risk-based regulatory framework for health I.T., including medical mobile applications.
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Bioinformatics grows by billions
By Bernie Monegain, Editor
Created 04/30/2013
The global bioinformatics market, valued at nearly $3.2 billion in 2012, is forecast to grow to nearly $7.5 billion by 2017, according to Wellesley, Mass.-based BCC Research.
The market attracts considerable funding from central governments and is driven by applications across a variety of sectors, including biotechnology, pharmaceutical research and development, agriculture, food safety, chemicals, manufacturing, and more recently, clinical genomics, according to the research.
Growth in the market has been driven by the industries' need to adopt more cost-effective and productive methods for commercializing proprietary information, researchers found. Companies are looking for suppliers that can offer total integration of data infrastructure, which includes data sharing, data security, customization, data searching and analysis.
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Caldicott2 report treads fine line
26 April 2013 Lis Evenstad
Information should be shared across health and social care when it is in patients’ best interests, but patients should be able to see an audit trail of everyone who has accessed their personal data.
These are the key recommendations of the Caldicott2 review, which reported this morning. 'Information: to share or not to share', was launched today at the ICO Conference Centre in London, and sets out 26 recommendations for the NHS.
The review, led by Dame Fiona Caldicott, who also led the Caldicott Committee that put in place most of the NHS’ existing information governance structures in the mid-1990s, also says patients should also have better access to their own information, including their records and correspondence about them.
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Transparency on quality, outcomes key to personalized care
April 30, 2013 | By Susan D. Hall
A report by the Brookings Institution says that more integrated care systems and a shift away from fee-for-service payment models could deliver more personalized care and could save $300 billion over a decade, and as much as $1 trillion over two decades.
More than a dozen health and economic experts were involved in writing the report, called "Bending the Curve," which outlines proposed reforms to Medicare, Medicaid and private insurance.
Technology, according to the authors, plays an integral role in such efforts.
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Healthcare organizations leaving themselves open to breaches
April 30, 2013 | By Susan D. Hall
Though most healthcare organization understand the risks of a breach, including violating the Health Insurance Portability and Accountability Act, many aren't taking the proper steps to prevent one, according to a recently published Ponemon Institute report.
According to its survey, 94 percent of healthcare organizations have suffered a breach within the last two years. What's more, in the first quarter of 2013, breaches left 875,000 healthcare records exposed, according to American Medical News.
Meanwhile, many physician practices can't envision themselves being the victim of a breach.
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ONC’s Judy Murphy and the Future of Informatics at the Mid-Atlantic Healthcare Informatics Symposium
April 28, 2013 by David Raths
Informaticists warn cuts in funding put research agenda at risk
Judy Murphy, R.N., deputy national coordinator for programs and policy at the Office of the National Coordinator for Health IT, says criticisms of the EHR incentive program because it hasn’t yet led to widespread interoperability are misguided.
In her keynote address, at last week’s Mid-Atlantic Healthcare Informatics Symposium in Philadelphia, Murphy noted that members of Congress, most recently six Republican senators, have asked whether we are getting our money’s worth from the program, focusing in on health information exchange. “But that’s not what we were trying to accomplish in stage 1. Stage 2 is about patient engagement and interoperability,” she said.
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Hospital Execs Forecast Higher IT Spending
Rene Letourneau, for HealthLeaders Media , April 30, 2013
Admissions will shift significantly from the inpatient to the outpatient setting in 2013 as providers transition to new care delivery models, says a Premier healthcare alliance survey. It also indicates that hospitals will make their biggest capital investments this year in information technology.
In its spring 2013 Economic Outlook, Premier reports that 65% of the 530 survey respondents—mainly hospital C-suite executives and materials and practice area managers—are projecting a decrease in inpatient volume in 2013 compared to 2012.
Accordingly, 69 percent of respondents are projecting an increase in 2013 outpatient volume compared to 2012.
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Q&A: Kaiser Permanente's CIO on Predictive Analytics and Other Challenges
Scott Mace, for HealthLeaders Media , April 30, 2013
Sepsis-free hospitals? Predictive analytics is making them a reality. In the second part of a conversation with Kaiser Permanente CIO and executive vice president Phil Fasano, he discusses ' real-time healthcare', Meaningful Use, ICD-10, the CommonWell Alliance, and the shortage of skilled health IT staff. Fasano has written a book, Transforming Health Care, The Financial Impact of Technology, Electronic Tools, and Data Mining.
HealthLeaders: How does your book treat the topic of analytics? Do you get into it at all?
HealthLeaders: What's the message of your book?
Fasano: I get into it a little bit, and I can tell you, as we're looking at the world of this space of healthcare and data, big data particularly, and the use of medical analytics—population care tools, chronic care management tools—[that] we've used them extensively at Kaiser Permanente.
And the forecast I'd make, and I believe I make in my book, is that the healthcare industry is just in its infancy in both getting and using data, and then analyzing that data sufficiently, so that we can get all the learnings from it. I believe that the largest medical breakthroughs are truly ahead of us, and not behind us.
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New Elsevier Content Covers Evidence-based Medicine
APR 26, 2013 3:59pm ET
Medical information content vendor Elsevier has published the first in a series of issue briefs examining the benefits and challenges of adopting evidence-based medicine.
The first brief tackles building a business case for evidence-based medicine, based in part on a roundtable discussion of chief medical information officers in the fall of 2012, which defined EBM as “the integration of the best research evidence with clinical expertise and patient values.”
The brief lays out core components of EBM: converting information into a focused question, identifying the best evidence for answering the question, reviewing evidence for validity and clinical usefulness, applying results to clinical practice and evaluating how the evidence performs in clinical applications. “More recently, experts have refined the definition of EBM to include evidence-based policy, review, research and guidelines.”
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Policy and implementation challenges to achieving big data outcomes (part 1)
By John W. Loonsk, MD, CMO CGI Federal
Created 04/29/2013
"Big data" must be near the top of its hype cycle by now. As with other technologies, it may eventually deliver on a great deal of this hype, but the outcomes will probably come later than the current frenzy would suggest.
Part of the delay is that "new" technologies, such as big data, are frequently restrained by "old" policies and the "old" approaches of existing technologies. It takes time, and sometimes policy and utilization changes, to fully accommodate a new technology's potential. This two-part series of articles will point to key places in health policy and data use where current approaches may be impeding full big data outcomes.
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Health policy and implementation challenges to achieving big data outcomes
By John Loonsk, MD FACMI
April 29, 2013 | John Loonsk, MD FACMI
Big Data must be near the top of its hype cycle by now. As with other technologies, it may eventually deliver on a great deal of this hype, but the outcomes will probably arrive later than the current frenzy would suggest.
Part of the delay is that “new” technologies, like Big Data, are frequently restrained by “old” policies and the “old” approaches of existing technologies. It takes time, and sometimes policy and utilization changes, to fully accommodate a new technology’s potential. This two-part series of articles will point to key places in health policy and data use where current approaches may be impeding full Big Data outcomes.
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A stark link between breaches and fraud
By Erin McCann, Associate Editor
Created 04/29/2013
A new case study examining the 2012 Utah Department of Health data breach that compromised the protected health information of 780,000 individuals has underscored a stark association between healthcare data breaches and cases of fraud.
The case study, conducted by Pleasanton, Calif.-based Javelin Strategy & Research, found that in 2010, if an individual received a data breach notification, there existed a more than one in 10 chance that the individual would also be victim of fraud. In 2012, the correlation jumped to one in four, officials say.
"Something that's come to our attention over the years is that there's an increasing correlation between being a data breach victim and being a fraud victim," said Alphonse R. Pascual, senior analyst of security, risk and fraud, Javelin Strategy & Research, in an interview with Healthcare IT News.
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With CDS, familiarity with the system breeds greater acceptance
April 29, 2013 | By Susan D. Hall
A study from The Netherlands found that cardiologists and nurses have preconceived ideas about using a clinical decision support system (CDS) for treating heart failure patients, but those biases subside as they learn more about the system's capabilities and limitations.
The CDS system is designed to improve adherence to best practices for heart failure patients. The study, published at BMC Medical Informatics and Decision Making, echoes a previous report in the journal that found that applying clinical practice guidelines at the point of care with EHRs will require the use of CDS and effective translation of evidence to practice.
The researchers surveyed cardiologists and heart failure nurses in three areas: their ability to take responsibility for care and trust the system; perceived barriers and threats; and knowledge management.
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Anonymous research patients easily re-identified, Harvard researchers find
April 29, 2013 | By Susan D. Hall
Researchers from the Data Privacy Lab at Harvard University have shown how easy it is to identify and link anonymous participants in a public DNA study with their personal data.
Professor Latanya Sweeney, director of the lab, and her research assistants linked data back to patient names in 42 percent of a sample of records from the Personal Genome Project, according to a Forbes article.
More than 2,500 people have submitted their DNA and personal information to the Personal Genome Project, which aims to sequence and make public the complete genomes and medical records of 100,000 volunteers in an effort toward furthering personalized medicine.
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Interns spend more time with computers than patients: study
Posted: April 26, 2013 - 12:45 pm ET
The time medical interns spend interacting with patients continues to drop, taking up only 12% of their working hours, according to a study at Baltimore's Johns Hopkins Hospital and the University of Maryland Medical Center.
In fact, the time they spend walking during a shift is only 5% lower than the time they spend caring for patients directly, and it's significantly less than the time spent behind a computer, which accounts for 40% of their hours.
In fact, the time they spend walking during a shift is only 5% lower than the time they spend caring for patients directly, and it's significantly less than the time spent behind a computer, which accounts for 40% of their hours.
The study, which followed 29 internal medicine interns for three weeks at Johns Hopkins and the University of Maryland, found that interns spend 12% of their time talking with and examining patients; 64% on indirect patient care—placing orders, researching patient history, filling out electronic paperwork; 15% on educational activities (e.g. medical rounds); and 9% on miscellaneous activities.
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Monday, April 29, 2013
Doctors Are Increasingly Dissatisfied With EHRs
Recent studies point to significant and growing problems with the usability of electronic health record systems and their effect on physician productivity. Some of these issues appear to be related to the addition of extra features to meet the meaningful use requirements, such as quality reporting and patient portals. Many physicians also have trouble documenting patient encounters in EHR drop-down boxes, which is an example of the poor usability of user interfaces. Moreover, current EHRs do not fit clinical workflow well, and practices have had to develop numerous workarounds to get their daily tasks accomplished.
Software design is not to blame for all of these problems. Inadequate training and poor preparation for switching from paper to electronic records are also factors, experts say. The rapid adoption of EHRs in response to the government's EHR incentive program has exacerbated these pain points, as doctors scramble up the steep learning curve to EHR mastery. Nevertheless, even many physicians who are experienced EHR users are dissatisfied with their systems.
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Report quantifies EHR benefits for Canadian docs
By Anthony Brino, Associate Editor
April 23, 2013
As some U.S. lawmakers still remain skeptical about the long-term value of federal health IT investments, a PricewaterhouseCoopers report on EHRs in Canadian physician practices pegs the efficiency and patient benefit value at about $1.3 billion since 2006.
Commissioned by Canada Health Infoway, a federally-funded health information technology nonprofit, the PwC study tried to quantify the benefits from EHRs as adoption in primary practices doubled between 2006 and 2012, to 56 percent of all practices, and grew significantly as well for community-based specialists, to about 40 percent.
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Future of electronic health records agency in question
April 18, 2013 - 1:18pm
Ottawa says Canada Health Infoway not being shut down, despite lack of funding
OTTAWA — Canada’s main electronic health records body received no new funding this year, but the federal government says there are no plans to shut down the agency.
At the same time Ottawa is eliminating the Health Council of Canada, Canada Health Infoway discovered it will unexpectedly receive no new program money in 2013.
Created in 2001, Infoway works with the provinces to create a consistent system of electronic health records across the country.
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Enjoy!
David.
