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Telehealth fits new landscape
Posted on Apr 28, 2013
By John Andrews, Contributing writer
Although the telehealth concept has been around for decades, the changing healthcare business model combined with the proliferation of wireless communications may finally give it the spark it needs to really catch fire, market observers say. By giving telehealth a solid platform, accessible tools and the right environment, many believe it can finally fulfill the potential it always promised.
It certainly appears that the burgeoning shift from acute to post-acute care and the public's penchant for wireless personal devices have created the right conditions for telehealth to thrive, says David Dimond, chief strategist of healthcare industry solutions for Hopkinton, Mass.-based EMC.
"Where it used to be about the technology side of it, telehealth now is about presence management," he said. "It has grown from viewing images to working collaboratively on patient care and getting patients engaged."
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Beware: The top 4 hurdles to a successful EHR implementation
Posted on May 31, 2013
By Jeff Rowe, Contributing Writer
If you were a healthcare provider and all you did was read press releases, you'd be tempted to think that transitioning to a new EHR involved little more than opening the package and plugging in the contents.
Naturally, things are a little more complicated than that, but many providers aren't aware of just how much more complicated the truth really is.
As Michael Gleeson, senior vice president of product strategy for Arcadia Solutions, a Boston-based health IT consulting company, put it recently, "We've found that using technology is really new for a lot of practices."
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Big data privacy concerns linger despite potential for healthcare
May 31, 2013 | By Dan Bowman
While big data increasingly is being used as a tool to directly bolster patient care and could help to cut as much as $450 billion in costs from the U.S. healthcare system, some experts have tempered their expectations of its effectiveness in healthcare and beyond, citing privacy concerns.
For instance, earlier this month at the Institute for Health Technology Transformation Health IT Summit in Boston, Massachusetts eHealth Collaborative President and CEO Micky Tripathi talked about the challenges associated with sifting through "massive volumes of patient data," according to HealthITSecurity.
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Study: Twitter Reliable Source for Vaccination Information
May 30, 2013 by Gabriel Perna
According to new research from the University of Texas at Austin, Twitter is not only a popular source for receiving and sharing new information about vaccines, but it can also be a reliable one as well.
The researchers analyzed 9,510 vaccination-related tweets from one week in January, 2012, in an attempt to determine the most popular and influential messages on the micro-blogging website. Of those 9,510 tweets, 2,580 received enagement, in the form of reposting and sharing. They were then coded for frequency of sharing, tone toward vaccinations, links to sources (e.g., news outlets, advocacy groups, or healthcare providers), and whether the claims being made in each tweet were scientifically substantiated.
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Rand: DoD must consider privacy, consent in VLER, HIE
By Anthony Brino, Associate Editor
As the U.S. Department of Defense looks for a new EHR system and aims to improve information sharing for veterans with lifetime digital health records, there are also several key patient privacy questions to consider.
According to a recent Rand Corporation report, the Pentagon will have to work through a number of patient privacy issues in the coming years — just as it looks to HIE and the virtual lifetime electronic health record (VLER) to help control costs, with the TRICARE health plan accounting for about 7 percent of the DoD’s annual budget, at $54 billion.
Among the healthcare industry, largely under HIPAA’s direction, there’s a general consensus about the principles that should guide HIE — patient consent, provider disclosure and information accuracy. “However, there is less consensus about the specific approaches used to implement these principles,” wrote Rand researchers Susan Hosek and Susan Straus.
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May 31, 2013
Survey: Meaningful Use Incentives Fuels EHR Adoption to All-Time High
Meaningful Use incentives fuels EHR adoption to all-time high according to recent 2013 Physician Practice Technology Survey.
U.S. adoption of electronic health records (EHR) systems among medical practices has reached an all-time high with more than three in four physicians utilizing EHRs. 62 percent of EHR adopters say they have already successfully attested for meaningful use stage 1, according to the 2013 Physicians Practice Technology Survey, sponsored by ZirMed.
24 percent of the 1,291 physicians surveyed from November 2012 to March 2013 said they still had no EHR access, and about 30 of this group expect to adopt one soon. EHR adoption is a critical step in the transformation of the U.S. health care system that focuses on outcomes rather than services. In order to demonstrate quality, providers need access to the data that EHR systems collect.
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HHS Report: Major Medicare Databases are a Mess
MAY 29, 2013 3:51pm ET
Data pulled from two major Medicare databases--the National Plan and Provider Enumeration System and the Provider Enrollment, Chain and Ownership System--are extremely inaccurate, according to the Department of Health and Human Services’ Office of Inspector General.
Providers wishing to enroll in Medicare first must apply to get a national provider identifier through NPPES, and then enroll through PECOS. Accurate, complete and consistent data on both system helps ensure the integrity of health programs, OIG notes in a new report, and the office has previously found ongoing problems with the Centers for Medicare and Medicaid Services’ oversight of provider data.
The new study bases its results on a very small set of data in the databases. OIG randomly selected a sample of 170 providers from 987,266 individual providers with records in both NPPES and PECOS. These providers were asked to verify such individual data as name, Social Security number, date of birth, mailing and practice addresses, and license and credential information.
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Canadian hospitals struggle with EHR data access, workflow
May 29, 2013 | By Marla Durben Hirsch
The U.S. is not alone when it comes to electronic health record system challenges: Canadian hospitals also are experiencing data access and workflow efficiency issues, according to a new report from HIMSS Analytics.
Researchers of the report, "Streamlining Workflows and Access to Patient Data in Canadian Hospitals," conducted one-on-one interviews with 12 IT executives from across Canada who identified several barriers to data access. These barriers included continued use of paper records, lack of integration, privacy and security concerns, and lack of available workstations.
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GPSoC tender worth £1.2 billion
29 May 2013 Rebecca Todd
The Department of Health has tendered for a new GP Systems of Choice framework worth up to £1.2 billion over two years.
GPSoC is a framework contract which funds GP IT systems for more than 80% of practices in England.
The framework expired in March, but an extension has been agreed until a new contract is in place, which is expected to be by end of this year.
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CIOs: Patient data segmentation will be one of HIPAA's biggest challenges
May 30, 2013 | By Dan Bowman
Navigating the revamped HIPAA omnibus rule will be no minor feat for healthcare organizations, according to several hospital CIOs who spoke recently with the Wall Street Journal.
In particular, the CIOs talked about data segmentation as being among the most challenging aspects of the rule. Scott Joslyn, vice president and CIO at Orange County, Calif.-based MemorialCare Health System, discussed the impact of patients choosing to share only certain pieces of information with clinicians, saying that it could hinder a provider's ability to provide complete medical care for those patients.
Adding on to that point, Cleveland Clinic CIO Martin Harris said that it's not clear who would even be in charge of setting up the application to allow data segmentation. "Many people need to be involved in understanding the nuances" associated with segmentation, he told the Wall Street Journal.
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Drop-down menus may be to blame for e-prescribing errors
May 30, 2013 | By Susan D. Hall
Fewer drop down menus in e-prescribing systems could reduce common errors, according to a new study in the Journal of the American Medical Informatics Association.
The researchers tracked 629 inpatient admissions at two hospitals in Sydney and the use of two e-prescribing systems: CSC MedChart and Cerner Millennium e-PS.
They looked at system errors made by selecting items from drop-down menus, constructing orders, editing orders or failing to complete new e-PS tasks. Both systems prevented significantly more errors than they generated, the researchers said.
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Calit2 forms quantified self data sharing initiative
The University of San Diego’s California Institute for Telecommunications and Information Technology (Calit2), with the support of the Robert Wood Johnson Foundation, is teaming up with major quantified self thought leaders to launch Health Data Exploration, an initiative aimed at convincing the companies that make tracking devices, connected health devices, and fitness apps to make the data their devices collect available for research purposes.
In addition, the project aims to “examine the barriers that thwart sharing currently, addressing issues like data quality, privacy and confidentiality, and how to help individuals who may want to donate their own health or medical data to researchers,” according to a RWJF spokesperson.
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Thursday, May 30, 2013
The Slow Crawl Toward Improved EHR Usability and Interoperability
by Steven J. Stack, M.D.
Well-developed electronic health records hold the promise of helping health care professionals improve patient care and deliver it more efficiently, and the American Medical Association recognizes that enhancing EHR usability and interoperability will further ensure our nation's goal of a high-performing health care system. Physicians are generally prolific users of technology: new patient monitoring devices, diagnostic imaging, equipment and advanced surgical tools, to name a few. In each case, physicians have adopted these tools quickly and became proficient users -- and they have done so without the need for a national incentive program. Why is it, then, that so many physicians are still trying to incorporate EHRs into their practices?
While the Medicare/Medicaid EHR incentive program can be credited with sparking a rapid adoption of health IT, it has also created negative consequences. Swift implementation of certified EHRs, needed to obtain incentives under the meaningful use program, has compelled physicians to purchase tools not yet optimized to the individual user's needs. These tools often impede, rather than enable, efficient clinical care. EHRs can also pose challenges as a physician attempts to meet documentation, coding and billing requirements. AMA has been an outspoken advocate for health IT improvements and continues to work with the federal government and other stakeholders to advance usability and interoperability.
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Meaningful use penalties could be difficult to avoid in Stage 2, experts say
By Diana Manos, Senior Editor
The difficulty between what it takes to achieve Stage 1 and Stage 2 is so great, it could easily catch some providers off guard, says Laura Kreofsky, principal advisor at Naperville, Ill.-based Impact Advisors, who specializes in meaningful use. There could be a fair amount of hospitals and eligible providers that will fall short of achieving meaningful use Stage 2, she warns.
“Stage 1 is tough but not too tough. Stages 2 and 3 are darn tough,” Kreofsky says. By making Stage 1 so much easier than Stage 2, in some ways, CMS has set a false sense of security for providers.
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ONC unveils Direct HIE implementation guidelines
May 28, 2013 | By Marla Durben Hirsch
The Office of the National Coordinator for Health IT has released new guidelines to provide recommended policies and practices for health information service providers (HISPs), trust communities and accrediting bodies such as DirectTrust to enable providers to securely exchange patient information across geographic, organizational and vendor boundaries.
The guidelines, released May 24, were developed due to ONC's concern that HISPs were not using a "common standard" and were "creating islands of automation." ONC encourages that the guidelines be adopted and believes that voluntary adoption will help providers meet Stage 2 of the Meaningful Use program and provide care coordination.
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Meaningful use penalties could be difficult to avoid in Stage 2, experts say
By Diana Manos, Senior Editor
The difficulty between what it takes to achieve Stage 1 and Stage 2 is so great, it could easily catch some providers off guard, says Laura Kreofsky, principal advisor at Naperville, Ill.-based Impact Advisors, who specializes in meaningful use. There could be a fair amount of hospitals and eligible providers that will fall short of achieving meaningful use Stage 2, she warns.
“Stage 1 is tough but not too tough. Stages 2 and 3 are darn tough,” Kreofsky says. By making Stage 1 so much easier than Stage 2, in some ways, CMS has set a false sense of security for providers.
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Hospital IT leaders: Workflow issues difficult to overcome during EHR implementation
May 29, 2013 | By Ashley Gold
In a recent roundtable discussion focusing on challenges associated with implementing electronic health record systems, several hospital executives pointed to workflow issues as being the most difficult to overcome, Becker's Hospital Review reported.
For instance, Jonathan Bauer, CIO at Somerset (Pa.) Hospital, pointed to physician documentation as being particularly burdensome, especially since such systems often promote the documentation of more information.
"The main request that physicians have is that they want a scribe," Bauer said. "They want to do what they have done for years and have someone else document in the system."
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Todd Park: 'Data-powered revolution' driving health innovation
May 29, 2013 | By Dan Bowman
The U.S. is in the midst of a "data-powered revolution in healthcare" that is improving the industry "from the ground up," according to Obama administration Chief Technology Officer Todd Park.
In a post this week to The White House Blog, Park (right) says that the American Recovery and Reinvestment Act of 2009--under which the Health Information Technology for Economic and Clinical Health Act was enacted--has "catalyzed" the adoption of electronic health records. That, he adds, is leading to "more proactive" care that ultimately will help to shrink health costs.
Park, touting points raised in a commentary published in the New York Times last week by Thomas Friedman, also says that the Affordable Care Act is helping to unleash a "rising tide of innovation" that is putting the latest evidenced-based tools within reach for clinicians.
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How to get 3 steps closer to PCMH
By Jeff Rowe, Contributing Writer
Electronic health records are a big investment, so it’s not surprising that many providers are both wary of taking on the burden of a transition from paper to EHRs and skeptical that it’s really going to help them provide better care.
That’s where the patient-centered medical home comes in. More specifically, it’s where the PCMH Quality designation outlined by the National Committee for Quality Assurance comes in, as that program is specifically designed to give providers a road map, and a seal of approval, toward improving patient care.
While the effective utilization of EHRs is only one piece of PCMH designation, some providers have found that ensuring that they’re taking advantage of their new EHR also puts them pretty much in alignment with NCQA’s PCMH program.
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Backup plans for EHR failures need regular testing
■ Regardless of whether the system is local or cloud-based, physician practices should have a plan that includes off-site storage of data.
Any practice using an electronic health records system must assume that the software, or the equipment it operates on, at some point will suffer a glitch or be at risk of damage in a natural disaster. That’s why experts say it’s important that practices take steps to ensure data backup is being done properly, even if the task is handled by outside parties. The practice also should know how it can restore its data in the event of a system failure.
A practice’s backup plan should include not just the ability to retrieve data, but also the time it takes to retrieve it, said Bob Dupuis, director of managed services at Arcadia Solutions, a health care consulting firm in Burlington, Mass. Because machines can malfunction as easily as software, a backup plan and testing should include the hardware on which the data are run or stored.
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New Guidelines for Direct Project Messaging Specs
MAY 28, 2013 3:28pm ET
The Office of the National Coordinator for Health Information Technology has issued guidelines for implementing Direct Project specifications for secure messaging.
The guidelines are “a common set of policies and practices to ensure Direct is being implemented in a way that will support vendor-to-vendor exchange and interoperability across geographic, organizational and vendor-related boundaries,” according to a blog from Claudia Williams, director of ONC’s state health information exchange program.
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EHRs critical in Oklahoma tornado
By Kaiser Health News
By Jenny Gold
Everyone expects a hospital to be ready to jump into action when disaster strikes. But what about when the disaster devastates the hospital itself?
At least that was the case at Moore Medical Center in Oklahoma, a small hospital right in the path of the tornado that ripped through the suburbs of Oklahoma City on Monday. Three-hundred people — staff, patients and community members — hunkered down in the cafeteria, stairwells and chapel as 200-miles-per-hour winds demolished the building around them.
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Quebec to expand $1.6 billion EHR
By Erin McCann, Associate Editor
Quebec province in eastern Canada is poised to roll out a $1.6 billion electronic health record system across all 17 regions of the province after seeing marked success with four regional pilot programs.
Quebec Minister of Health and Social Services Rejean Hebert announced Monday that starting summer 2013, the Quebec Health Record will be gradually extended to all province regions, reaching more than eight million people by 2015's end.
"We turn now to an experimental project in only four regions to a specific national project," said Hebert, in a press statement. The QHR was initially deployed back in 2008, in the Capitale-Nationale region.
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X-ray market grows as it goes digital
By Bernie Monegain, Editor
The global digital X-ray market is estimated to be worth $4.82 billion by 2018, growing at a CAGR of 4.5 percent from 2013 to 2018, according to a new report from research and marketing firm MarketsandMarkets. The market is divided into three segments based on types, major products and applications in imaging.
Based on types, the market is segmented into computed radiography and digital radiography; the latter is the fastest-growing market.
Analog X-ray systems, which had a major share in the market until 2005, is being replaced by advanced technologies such as computed radiography and digital radiography. Advantages such as low dosage, image quality, image storage and immediate image analysis have made CR and DR systems more attractive compared to conventional analog systems.
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Gwyn Thomas to retire from civil service
28 May 2013 Lyn Whitfield
Gwyn Thomas has announced his retirement as chief information officer for Wales and informatics director for health and social services.
Dr Thomas moved back to work in Wales eight years ago, initially to head up the Informing Healthcare Programme, and then to take on wider responsibilities for IT in the public sector.
Before that, he was chief executive of the NHS Information Authority, the organisation set up to deliver NHS infrastructure by the 1998 IT strategy, Information for Health.
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Medication IT doesn't take time away from patient care
May 28, 2013 | By Susan D. Hall
Using an electronic medication management system did not significantly affect the amount of time doctors and nurses in an Australian study spent on direct patient care or medication-related tasks.
The Australian research, published in the Journal American Medical Informatics Association, involved time and motion studies of 129 doctors and nurses for 633.2 hours on four wards in a 400-bed hospital in Sydney. It compared a period before the system was implemented and the period after the hospital installed the Cerner Millennium PowerOrders technology into its CPOE system, also comparing wards using the new technology on both computers on wheels and desk PCs with wards that still used paper charts.
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Providers: Be on the lookout for 'insider' fraud threats
May 28, 2013 | By Ashley Gold
There are plenty of security threats to worry about when it comes to patients' healthcare information, but you may not have thought of the one possible under your nose--insider threats. Security consultant Mac McMillan warns against this danger and how to combat it in a recent interview with HealthcareInfoSecurity.
According to McMillan, CEO of CynergisTek Inc., an Austin, Texas-based consulting firm which specializes in information security and regulatory compliance in healthcare, there are three types of insider threats: viewing/sharing information without authorization, committing medical identity theft or fraud and acts of sabotage. McMillan says that healthcare organizations need to start being much more aggressive about all three.
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Number of Buyers Replacing Their EHRs Up by 10%
May 24, 2013
The number of buyers who purchased new electronic health records to replace their current EHRS grew by 10 percent, from 21 percent to 31 percent between 2010 and 2013, according to Software Advice, a resource for medical software buyers.
The company published a three-year study for which it collected and analyzed data on thousands of practices looking to purchase medical software. The research was conducted in part to determine the impact the Health Information Technology for Economic and Clinical Health Act had on EHR demand.
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Healthcare IT Merger and Acquisition Activity: Expect More Deals, More Consolidation
May 25, 2013 by Mark Hagland
A new white paper by the Berkery Noyes investment banking firm sees healthcare IT vendor consolidation accelerating in the near future
In late May, the New York-based Berkery Noyes Investment Bankers released a white paper titled “An Overview of M&A in the Healthcare IT Sector,” which provided an investment banking strategic view of merger and activity in the healthcare IT vendor sphere. Given the pace of healthcare IT vendor consolidation that has already occurred, white paper author Tom O’Connor, a managing director at Berkery Noyes, who leads the firm’s Healthcare Group, wrote, “Most innovation in the HIT sector is occurring at smaller and medium size privately held companies. Many of them,” he noted, “have spent years developing unique offerings, achieving some scale, and building recurring revenue models in attractive niches. They now have the opportunity to capitalize on the attention that strategic and financial buyers are showing to HIT solutions companies.”
Indeed, the report continued, “The majority of transactions in HIT are occurring in the lower middle market (i.e., less than $200 million in enterprise value). The most attractive acquisition targets are companies that are growing very fast (30-40 percent revenue growth rate), have recurring revenue models, and offer solutions that solve a pain point along the healthcare continuum.”
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New Interoperability Training Tools Focus on Stage 2 Criteria
MAY 24, 2013 12:05pm ET
The Office of the National Coordinator for Health Information Technology has launched a suite of electronic health records interoperability training tools, available here.
The five modules cover interoperability basics, transitions of care, laboratory interoperability with providers, the view/download/transmit criteria in Stage 2 of meaningful use, and transmitting information to public health agencies.
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Tuesday, May 28, 2013
'Free Data' Movement Gets Boost From Big Conference
by David Gorn, iHealthBeat Contributing Reporter
Bradley Kreit takes exception to the term "big data." That's one of the relatively newer buzz-phrases of the technology world, referring to the massive amounts of stored data we, as a society, are trying to harness and use.
"Big data implies that it's a problem for you, because you somehow have too much information. You have this sense that people are wondering how we're going to manage all of that," said Kreit, co-director of the Health Horizons Program at the Palo Alto-based Institute for the Future.
"But it's not big data," Kreit said, emphatically. "It's abundant data."
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National critic of health care information technology says Marin General should heed nurses' advice
Posted: 05/27/2013 04:03:00 PM PDT
A nationally known critic of electronic health records has harshly criticized managers at Marin General Hospital for their response to a plea by nurses to hold off on a new computer system to prevent potentially dangerous errors.
"The executives at the hospital should be taking out extra insurance policies because they're setting themselves up for a massive corporate negligence lawsuit," said Dr. Scot Silverstein, an adjunct professor of health care informatics at Drexel University in Philadelphia.
Silverstein, who contacted the Independent Journal after reading about the Marin General situation, doesn't dispute the potential of digital records; but he believes implementation has been rushed. He thinks electronic health records should be regulated by the federal Food and Drug Administration, much like medical hardware or pharmaceuticals.
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What the "E" in E-Patient Really Means
Scott Mace, for HealthLeaders Media , May 28, 2013
Patients today are empowered, engaged, equipped, and enabled. Healthcare providers should respond, and should help patients with another important "e": expectations.
By now, you've probably heard of e-patients. But it means much more than "electronic patients."
"Our culture assumes doctors know everything and patients can't possibly add anything useful," writes Dave deBronkart, better known as "e-Patient Dave," in his new e-book, Let Patients Help!, a quick but enlightening read that will inform you that the "e" also means empowered, engaged, equipped, and enabled. "Today some add educated, expert, and anything else 'e,'" deBronkart writes.
I've made a career out of documenting the empowering effects of technology. In the 1980s, among other things, personal computers were a way to engage students of all ages through the interactivity of educational software. In the 1990s, the Internet equipped us to get the most current data. In the 2000s, Web services enabled us to build "digital nervous systems" that automated the publication of that data, and our ability to subscribe to updates through the power of technologies such as RSS and search technologies such as Google.
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Enjoy!
David.
