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."

Saturday, November 02, 2013

Weekly Overseas Health IT Links - 03rd November, 2013.

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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Halamka offers lessons on Healthcare.gov's rough go-live

Posted on Oct 24, 2013
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
CIOs face many pressures: increased scope, reduced timelines, trimmed budgets. After nearly 20 years as a CIO, I've learned a great deal about project success factors.
When faced with go live pressures, I tell my staff the following:
"If you go live months late when you're ready, no one will ever remember.
If you go live on time, when you're not ready, no one will ever forget."
I have hundreds of live clinical applications. Does anyone remember their go live date? Nope.
Were there delays in go live dates? Many.
With even the best people, best planning, and appropriate budgets, large, complex projects encounter issues imposed by external factors (new regulations, competing unplanned events, requirements changes) that cannot be predicted during initial project scheduling.
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mHealth enters consumer Golden Age

Posted on Oct 25, 2013
By Erin McCann, Associate Editor
The mobile health market is making a mark -- and it's a big one, as this year saw a record number of U.S. consumers now using mobile phones for health information, according to new industry research. 
Some 95 million Americans are currently using mHealth technologies, up 27 percent from 75 million just in 2012, according to the Manhattan Research Cybercitizen Health study. And these numbers have big implications for pharma marketers. 
Of the more than 8,600 adults surveyed, some 38 percent of smartphone users deemed them "essential" for finding health and medical information, according to the report, which underscores the opportunities for pharma marketers and found that consumers access health information on mobile phones at home, not just on the go.
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'Smart' cane among the robotic projects landing federal grants

October 25, 2013 | By Susan D. Hall
Development of a "smart" cane that can send navigation information to the user is just one of the projects funded through $38 million in federal grants awarded as part of the National Robotics Initiative.
It's the second round of funding doled out by the National Science Foundation (NSF), the National Institutes of Health (NIH), U.S. Department of Agriculture (USDA) and NASA since the initiative began two years ago, according to an NSF release.
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8 ways to manage change, not just HIT implementation

October 25, 2013 | By Julie Bird
There's a way to manage change associated with health IT, healthcare consultant Frank Speidel, M.D., says--eight ways, to be more precise.
Writing at HITConsultant.net, Speidel, chief medical officer for the Health IT staffing firm Healthcare IT Leaders, identifies what he calls eight "ates" for managing that change (check out the full post for more detail):
·         Contemplate the changes IT implementation brings to the health system and its operations by convening a diverse group representing different elements of the organization.
·         Communicate to understand "the why, where and what of the change" and where the change is taking the organization.
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NIH and CDC launch registry for sudden death in the young

By Diana Manos, Healthcare IT News
The National Institutes of Health and the Centers for Disease Control and Prevention have announced they are collaborating to create the Sudden Death in the Young Registry to help researchers work on preventing these type of deaths in the future.
According to NIH officials, data will be entered into a centralized database managed by a data coordinating center at the Michigan Public Health Institute and will not contain personally identifiable information. 
The resulting registry will become a resource for scientists to learn more about the causes of sudden death in the young and ultimately to develop better diagnostic and prevention approaches.
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Study: EHR input can be improved to better assess quality of care

October 22, 2013 | By Marla Durben Hirsch
The quality of data in an EHR shows promise for assessing the quality of primary care, but clinical reporting first needs to be improved, according to a new study published in the Journal of the American Medical Information Association.  
The researchers, from the Radboud University Nijmegen Medical Centre in the Netherlands, noted that quality indicators for diabetes treatment are often retrieved from chronic disease registries. They evaluated the quality of primary care physicians' recording in their EHRs compared to the quality of recordings in a simple chronic disease registry.
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Health IT takes hold around the world

Posted on Oct 24, 2013
By Zack McCartney, Contributing Writer
Every country, every government, every population is a participant in a global trial and error. Each one faces different circumstances and, therefore, approaches healthcare differently.  But, as world health leaders see it, everyone can learn from others' struggles and successes to improve and simplify their respective strategies. Health information technology is at the core.
Finding the global lessons from local healthcare strategies facilitates progress toward Universal Health Coverage, or UHC, a public health concept championed notably by the World Health Organization and it’s director, Margaret Chan. According to Najeeb Al-Shorbaji, director of knowledge, management, and sharing at the WHO, in a statement released to Healthcare IT News, WHO defines UHC as “all people receiving quality health services that meet their needs without exposing them to financial hardship in paying for them.”  
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SCR opt-out does not apply to care.data

22 October 2013   Rebecca Todd
Care.data information leaflets being sent to households in January will tell patients that an opt-out of the Summary Care Record scheme will not carry over to a new montly GP data extract.
Patients can opt out of both schemes if they wish, but must do so separately.
The care.data programme involves taking a large dataset from all GP practices covering patient demographics, events, referrals and prescriptions.
This will be linked with Hospital Episode Statistics and other data-sets to create new Care Episode Statistics, giving a more holistic view of patient journeys in the NHS.
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Obamacare woes prove the need for essential IT health

By Richard Waters
Leaving technology to backroom people is no longer an option
Complex IT projects fail. Websites get overwhelmed with too many visitors and seize up. Integrations involving a number of legacy systems lead to a scramble of incompatible technology.
Stuff happens. If this were the extent of the problems facing President Barack Obama’s new online healthcare exchanges – a centrepiece of his healthcare reform – then it would be just another cautionary tale about a mismanaged IT project.
But the shambles in Washington represents something altogether more ominous. IT has been a submerged risk in the business world for a long time, hard to assess and therefore often ignored by investors and senior managers.
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Privacy guru knocks patient ID as ploy

Posted on Oct 23, 2013
By Neil Versel, Contributing Writer
In calling for a national patient identification system, Bill Spooner, senior vice president and CIO of Sharp HealthCare in San Diego, said at the CHIME Fall CIO Forum earlier this month, "The real opponents [to a unique patient ID] are the privacy advocates." He was right.
Adrian Gropper, MD, Watertown, Mass.-based CTO of the Patient Privacy Rights Foundation in Austin, Texas, called the renewed push for a national patient ID an intentional ploy by healthcare providers, insurance companies and health IT vendors to protect revenue streams and avoid investing in patient-matching technology.
"If you wanted to exchange medical information, let the patient specify how they want to be identified," Gropper said. "You don't need [a unique] ID, you need information transparency."
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5 ways to fail a Meaningful Use audit

October 23, 2013 | By Marla Durben Hirsch
Many hospitals are making mistakes that are tripping them up during Meaningful Use audits, according to Meaningful Use audit expert Jim Tate in a new article on HITECHanswers.net.
"There is a lot of money on the table, not to mention careers, and the audit process should not be taken lightly. There is simply too much at stake and a wrong move during the audit or appeal process would take a hospital's staff to a place where it should never have to go," he writes.
Tate identifies some of the "worst practices" he's seen hospitals engage in. In contrast to last week's FierceHealthIT feature, Five ways to survive a Meaningful Use audit, here are five ways to fail a Meaningful Use audit.
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North American health IT market to hit $31.3B by 2017

October 23, 2013 | By Julie Bird
The health IT market in North America is forecasted to hit $31.3 billion by 2017, up 7.4 percent per year from $21.9 billion in 2012, according to a market report from Dallas-based MarketsandMarkets.
Although U.S. providers represent 72.6 percent of the market, the market is growing more quickly in Canada with a compounded annual growth rate of 7.7 percent, according to an announcement describing the research. The Canadian market is expected to leap from $15.9 billion in 2012 to $22.6 billion in 2012, driven in part by a publicly funded health structure.
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RWJF Launches Tool: Comparing Healthcare Quality-A National Directory

Written by Ellie Rizzo (Twitter | Google+)  | October 22, 2013
The Robert Wood Johnson Foundation has launched a tool, Comparing Healthcare Quality: A National Directory, allowing consumers to peruse reports and information on hospitals through a centralized database.
The RWJF's purpose in creating the tool is to allow the public to have easy access to reliable information on quality of care in their communities, according to the news release.
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10 Myths about HIPAA’s Required Security Risk Analysis

OCT 21, 2013 3:40pm ET
With revamped HIPAA privacy and security rules now in effect that include higher emphasis on conducting a security risk analysis, the federal HealthIT.gov Web site dispels 10 pieces of misinformation about what the rules really require:
1. The security risk analysis is optional for small providers. False. All providers who are “covered entities” under HIPAA are required to perform a risk analysis. In addition, all providers who want to receive EHR incentive payments must conduct a risk analysis.
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PHR progress still hangs in limbo

Posted on Oct 22, 2013
By Erin McCann, Associate Editor
Mobile personal health records may be on the uptick in the near future. But before consumers are able to access PHRs at their fingertips from virtually any location, there are some big barriers standing in the way, according to new research by Frost and Sullivan.
One of the biggest challenges, as researchers point out, is interoperability -- or, more accurately put, lack thereof. Traditionally, data collectors, such as providers, hospitals, physician specialty groups, labs, payers, government entities and imaging centers, have operated independently of each other, deploying unique IT infrastructures and fragmented patient record systems. 
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Five realities of healthcare's digital transformation

October 22, 2013 | By Susan D. Hall
The digital transformation in healthcare involves an array of stakeholders as well as regulatory and cultural change. Five "realities" emerge for discussion in a post from David Lee Scher, MD, at Healthcare Talent Transformation.
Among them:
"Build it and they will come" doesn't necessarily work.   Process and workflow changes must accompany the adoption of new technology, as physicians are painfully finding out with the adoption of EHRs, Scher writes. Technology also requires cultural change, with providers and patients both buying into disease-management plans.
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Parents: Email communication with docs should be free

October 22, 2013 | By Ashley Gold
Emailing doctors like you'd email a co-worker or a friend about a concern seems to be the modern way of communicating--but would you be willing to pay for it?
Parents polled by the University of Michigan C.S. Mott Children's Hospital said no. While they said they'd love to get an email response from their child's healthcare provider about a minor visit rather than making a visit, roughly half of all respondents said such a process should come at no cost.
"Most parents know it can be inconvenient to schedule and get to an office visit for a sick child," Sarah Clark, associate director of the National Poll on Children's Health and an associate research scientist in the University of Michigan Department of Pediatrics, said in an announcement. "An email consultation would prevent the hassles of scheduling and allow sick children to remain at home. Email also could be available after hours when their caregiver's office is closed."
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Why Doctors Hate EHR Software

Have meaningful use incentives merely propelled sales for a lot of lousy software?

Maybe this will be a "no duh" observation for those who work in healthcare or health IT, but a lot of doctors really hate the electronic health records (EHR) software they're compelled to use.
As an InformationWeek staffer recently assigned to this beat after only occasionally covering health IT in the past, I was surprised how unanimously and passionately dissatisfied most doctors are with the usability of this software, which they see as draining rather than enhancing their productivity. I'm sure there are exceptions where doctors are more enthusiastic about technology, the software they are using is higher quality, or a little of both. But if you open the door to a conversation about how horrible medical records software is, you'll get an earful.
Here's what I'm basing this on. Having spent the past few months writing about massive open online courses (MOOCs) for the education beat, I was happy to discover a Coursera course on Health Informatics in the Cloud starting at just about the time that I needed to come up to speed on my new beat. I'm happy to say the instructor, Georgia Tech's Mark L. Braunstein, MD, will be contributing to InformationWeek as a columnist, so watch for that. Braunstein has spent most of his career in healthcare IT, so I think it's fair to say he's a true believer in the potential and the necessity of digitizing medical information. However, when I turned to the course discussion forums I found a message thread titled "Health IT Doesn't Fix Problems -- Good Health IT Does."
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How Telemedicine Drives Volume, Revenue

Scott Mace, for HealthLeaders Media , October 22, 2013

Not only is health information technology helping to control costs, it's also creating new opportunities for revenue.

This article appears in the October issue of HealthLeaders magazine.
Healthcare systems find that telemedicine can help grow their volume and drive out inefficiencies, but new methods of care delivery require thoughtful planning to avoid hiccups.
The UC Davis Health System now offers access to 30 specialty care services ranging from behavioral health and dermatology to audiology and ophthalmology for both children and adults.
Recently, the system reported it was able to grow its pediatric medicine practice through telemedicine. In a study published in the July 2013 issue of Telemedicine and e-Health, authors from the UC Davis Health System reported 2,029 children transferred to the hospital from 16 surrounding hospitals connected via telemedicine between July 2003 and December 2010.
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Structured Data Leads to Better Analysis, Outcomes

Scott Mace, for HealthLeaders Media , October 22, 2013

Software that can create structured tables of data from clinicians' notes and then incorporate them into any standard electronic medical record, is easing concerns that structured EHRs are killing the clinical narrative.

At CHIME earlier this month, I heard many CIOs complain that electronic health record systems do a poor job of summarizing clinicians' notes and integrating them with the structured data which forms the backbone for much of the population health analytics which can bend the cost curve of care.
I've been writing for a long time about concerns that structured EHRs are abandoning the clinical narrative. I've even written about the potential for natural language processing (NLP) technology to extract actionable information from that narrative.
Now there is evidence that NLP is starting to make a difference, and more importantly, may not require providers to be locked into a new set of such technologies. Instead, providers might be able to shop around for best-of-breed tools to get the job done.
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Why Copying and Pasting Must Stop Now

OCT 17, 2013 11:21am ET
Copying and pasting documentation within the electronic health record is a practice whose time to stop has come as industry forces demand better documentation. “I think everyone in the industry recognizes it is an issue,” says Michelle Mitcheff, physician services auditor at Indiana University Health’s Southern Indiana Physicians practice in Bloomington, IN.
But awareness isn’t yet significantly translating into action and that action soon may be forced. While putting together its 2013 work plan, the HHS Office of Inspector General took the stand that EHRs being used to copy and paste are making fraudulent activity easier, although it is yet unknown what action the office will take.
During a session at the AHIMA Conference in Atlanta, Mitcheff will walk through why copy and paste has to become history. “I recently sat in on training by a big-name vendor teaching providers how to copy and paste,” Mitcheff says. “But they weren’t telling providers they can be penalized for that.”
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Google Glass delivers patient data

17 October 2013   Kim Thomas
A proof-of-concept that uses Google Glass to deliver patient data to doctors has been announced by Philips and Accenture.
The Google Glass head-mounted display, which is connected to Philips IntelliVue Solutions, is designed to improve the effectiveness of surgical procedures by providing doctors with hands-free access to critical clinical information.
A demonstration of the technology shows how a doctor wearing the display could simultaneously monitor a patient’s vital signs and react to surgical procedural developments without having to turn away from the patient. The display also enables the doctor to monitor a patient’s vital signs remotely or enlist assistance from doctors in other locations.
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HITRUST issues draft privacy controls

October 21, 2013 | By Susan D. Hall
The Health Information Trust Alliance (HITRUST) has issued proposed changes to its Common Security Framework (CSF) to better protect patient data.
Developed by a group of larger healthcare companies, HITRUST aims to create a unified security standard specifically tailored for the healthcare industry. Its draft privacy controls, an effort to keep the framework up to date, include 125 specific changes affecting 35 controls in the CSF. The controls are based on the HIPAA Privacy Rule and recommendations from the National Institute of Standards and Technology (NIST) and some other standards bodies.
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Tech ‘surge’ to repair Obamacare websites

By JASON MILLMAN | 10/20/13 1:38 PM EDT Updated: 10/21/13 11:21 AM EDT
The Obama administration Sunday said it’s called on “the best and brightest” tech experts from both government and the private sector to help fix the troubled website at the root of the Obamacare enrollment problems.
The unusual Sunday 600-word blog post from the Department of Health and Human Services was the first update in more than a week on the many failings of an expensive website that HHS itself described as “frustrating for many Americans.” But it didn’t specify whom the administration had called in, or when the American people would see clear-cut results on HealthCare.gov.
 “We’re kind of thinking of it as a tech ‘surge,’” an HHS official told POLITICO.
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Q3 2013 Federal Health IT Activity

by Helen R. Pfister, Susan R. Ingargiola, and Erica L. Cali, Manatt Health Solutions Monday, October 21, 2013
The federal government continued to implement the Health Information Technology for Economic and Clinical Health Act, enacted as part of the American Recovery and Reinvestment Act, during the third quarter of 2013. Below is a summary of key developments and milestones achieved between July 1 and September 30.

Highlights

The third quarter of 2013 saw a number of important developments:
  • National Coordinator Submits Resignation. On Aug. 6, Farzad Mostashari announced his resignation as National Coordinator for Health IT, effective Oct. 4. Principal Deputy National Coordinator David Muntz also announced his resignation in September. Jacob Reider is serving as acting national coordinator, and Lisa Lewis is serving as acting principal deputy national coordinator until permanent replacements are announced. 
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A New Map of How We Think: Top Brain/Bottom Brain

Forget dated ideas about the left and right hemispheres. New research provides a more nuanced view of the brain

By
Stephen M. Kosslyn and  G. Wayne Miller
Oct. 20, 2013 8:31 a.m. ET
Who hasn't heard that people are either left-brained or right-brained—either analytical and logical or artistic and intuitive, based on the relative "strengths" of the brain's two hemispheres? How often do we hear someone remark about thinking with one side or the other?
A flourishing industry of books, videos and self-help programs has been built on this dichotomy. You can purportedly "diagnose" your brain, "motivate" one or both sides, indulge in "essence therapy" to "restore balance" and much more. Everyone from babies to elders supposedly can benefit. The left brain/right brain difference seems to be a natural law.
Except that it isn't. The popular left/right story has no solid basis in science. The brain doesn't work one part at a time, but rather as a single interactive system, with all parts contributing in concert, as neuroscientists have long known. The left brain/right brain story may be the mother of all urban legends: It sounds good and seems to make sense—but just isn't true.
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Enjoy!
David.

Friday, November 01, 2013

A Very Interesting Review Of A Number Of Approaches To e-Health From Around The World.

This appeared a little while ago.

Health IT takes hold around the world

Posted on Oct 24, 2013
By Zack McCartney, Contributing Writer
Every country, every government, every population is a participant in a global trial and error. Each one faces different circumstances and, therefore, approaches healthcare differently.  But, as world health leaders see it, everyone can learn from others' struggles and successes to improve and simplify their respective strategies. Health information technology is at the core.
Finding the global lessons from local healthcare strategies facilitates progress toward Universal Health Coverage, or UHC, a public health concept championed notably by the World Health Organization and it’s director, Margaret Chan. According to Najeeb Al-Shorbaji, director of knowledge, management, and sharing at the WHO, in a statement released to Healthcare IT News, WHO defines UHC as “all people receiving quality health services that meet their needs without exposing them to financial hardship in paying for them.”  
A video on the WHO’s website, “The many paths to universal health coverage,” documents the various  efforts in Thailand, Rwanda, Oman, China, Mexico, and Turkey to achieve this lofty goal. As the video notes, “Their experience can provide lessons to countries just beginning the journey” toward UHC. This means, ideally, more time and money spent repeating past successes and avoiding past errors – and also innovating.
In December 2012, the UN passed a resolution on UHC that urges member states to develop health systems capable of providing high-quality care while avoiding direct payments at the point of delivery.
Healthcare IT plays a central role in modern healthcare strategies.
As a relatively new component of healthcare, there is still much to learn about how best to integrate digital health systems. Keeping an eye out for successes and innovations -- learning opportunities around the world -- should be a priority for all countries, world health leaders say.
“Similar to UHC, an eHealth strategy is unique to the situation in the country,” said Al-Shorbaji, “But there are still common elements, methodologies and best practices that can help countries to avoid mistakes, for example, investing large amounts of money without a proper plan, roadmap or a strategy – this leads to fragmentation, wasting resources, disconnection with people and ‘solutions looking for problems,’”
Al-Shorbaji detailed several points on how information and communications technology is important to universal healthcare along with the challenges WHO has encountered when working with member states to integrate newer technologies into their healthcare systems. Simply put, “Data collection for public health surveillance or for personal use is a prerequisite for successful health intervention. Absence of timely and quality health data simply means hasty decision-making, non-evidence based planning, low and delayed care delivery, opinion driven management and so on.”
If UHC means targeting everyone with high-quality, affordable services, healthcare systems need to be able to record data on all of its patients, as in a national electronic health record that can allow physicians and patients to share data. Practitioners need to monitor quality of care. The health needs of the population need to be defined and monitored.  
The five main challenges for developing an IT infrastructure, says Al-Shorbaji, are issues of standardization and interoperability, lack of national planning, lack of solid evidence, sustainability (as insufficient funding has limited the success of many eHealth projects), and lack of human resources. ICT, therefore, is a central component to any UHC strategy, as there needs to be a system in place that can collect and share data in the healthcare system. Finding the best route to a meaningful HIT system, though, is still being worked out around the world.    
Here are glimpses at several healthcare IT projects around the world. Some have already proved successful.  Others are in the works, but are exciting prospects for the use of information technology in healthcare.
The officials we talked with say the projects have the potential to contribute to the world’s growing body of knowledge on how the world can best use health IT to provide more comprehensive, more accessible healthcare.
Lots more here including coverage of Australia and Denmark.
It is very interesting to see an international perspective of what is happening here and what others are doing.
Enjoy the read.
David.