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, December 21, 2013

Weekly Overseas Health IT Links - 21st December, 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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Healthcare turns to big data analytics for improved patient outcomes

Summary: Analytics platforms and new healthcare-specific solutions together are offering far greater insight and intelligence into how healthcare providers are managing patient care, cost, and outcomes.
By Dana Gardner for BriefingsDirect | December 12, 2013 -- 23:53 GMT (10:53 AEST)
Listen to the podcast. Find it on iTunes. Read a full transcript or download a copy. Sponsor: HP.
Analytics platforms and new healthcare-specific solutions together are offering far greater insight and intelligence into how healthcare providers are managing patient care, cost, and outcomes.
Based on a number of offerings announced this week at the HP Discover Conference in Barcelona, an ecosystem of solutions are emerging to give hospitals and care providers new data-driven advantages as they seek to transform their organizations.
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Sleeker Sepsis Plan Shortens Time to Rx

Published: Dec 13, 2013
By Sarah Wickline , Contributing Writer, MedPage Today
ORLANDO -- Reductions in time to treatment followed the development of more efficient treatment protocols for sepsis, but not after Computer Physician Order Entry (CPOE) systems were put in place, researchers reported here.
A combination of procedural updates, including Code Sepsis and nursing staff alerts, shortened the time between diagnosis and administration of antibiotics by 64% in non-ICU sepsis patients, Tram Cat, PharmD, BCPS, of Cedars-Sinai Medical Center in Los Angeles, Calif., and colleagues reported at the midyear meeting of the American Society of Health-System Pharmacists.
Previous research has shown that time to treatment is crucial for successful management of sepsis. A delay of more than 1 hour from the time a patient develops hypotension to the administration of antibiotics can lower the rate of survival by 8% each hour of delay for the 6 hours following onset of symptoms.
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ONC Meeting to Cover Matching Patients to Their Data

DEC 12, 2013 3:14pm ET
The Office of the National Coordinator for Health Information Technology invites stakeholders to an open meeting in Washington on Dec. 16 to unveil findings of an initiative to improve patient matching efforts.
Space on the premises is limited and participation also will available via the Web. Those who wish to come in person must register as soon as possible.
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Healthcare about to turn on its head

Posted on Dec 13, 2013
By Bernie Monegain, Editor
Most people are optimistic about technology innovations advancing healthcare, are willing to participate in virtual healthcare visits with their doctor, and would use health sensors in their bodies and even their toilets, according to a new study commissioned by Intel Corporation.
The "Intel Healthcare Innovation Barometer," conducted across eight countries by Penn Schoen Berland, found the majority of people also believe that technology innovation holds the best promise for curing fatal diseases – more than increasing the number of physicians or additional funding for research. The survey was conducted online in Brazil, China, France, India, Indonesia, Italy, Japan and the United States from July 28 to Aug. 15, 2013, among a representative sample of 12,000 adults, 18 and older.
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CommonWell EHR Interoperability Pilot Announced

Scott Mace, for HealthLeaders Media , December 12, 2013

The electronic health record vendors in the first series of CommonWell Alliance pilots include Allscripts, Athenahealth, Cerner, CPSI, Greenway, McKesson, RelayHealth and Sunquest. Testing will begin January 1.

CommonWell Alliance announced Wednesday three regions in Illinois, North Carolina, and South Carolina where pilot testing of its cross-vendor EHR interoperability services will commence January 1.
Participating providers include Lake Shore Obstetrics & Gynecology in Chicago; Hugh Chatham Memorial Hospital in Elkin, N.C.; Maria Parham Medical Center in Henderson, N.C., and Midlands Orthopaedics and Palmetto Health, both of Columbia, S.C.
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Mobile Apps Can Save Billions in Health Costs

Published: Dec 12, 2013
By David Pittman, Washington Correspondent, MedPage Today
NATIONAL HARBOR, Md. -- If Omri Bob Shor's father doesn't take his diabetes medication or accidentally takes too much insulin, Shor gets an alert to his phone telling him so.
MediSafe, the system Shor uses and the company he helped found, is like most other medication management applications that have sprung up in recent years with the proliferation of smartphones in that it sends alerts reminding patients to take their medication.
Shor said medication adherence with his app is 86%. He called it a media platform linking various devices with family members and communication lines such as phone calls, emails, and text messages. "MediSafe is the first app to [notify] family members in real time," he told MedPage Today.
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E-Prescribing: Inpatient Results Disappointing

Published: Dec 12, 2013
By Sarah Wickline , Contributing Writer, MedPage Today
ORLANDO -- Electronic prescription order entry and medication reconciliation reduced some errors in hospital settings but increased others, and did not meet overall expectations, researchers reported here.
After implementation of a computerized prescriber order entry (CPOE) system, one hospital experienced a 29.2% increase in medication dispensation errors American Society of Health-System Pharmacists.
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Allscripts, Cerner, McKesson & Others Launch Interoperability Service

DEC 11, 2013 3:54pm ET
CommonWell Health Alliance, which seven health information technology companies formed in early 2013 to cooperate on systems interoperability issues, will launch initial services in early 2014 in four regions.
The alliance, which continues to welcome other vendors to join, will start with specific provider organizations in Chicago, the cities of Elkin and Henderson in North Carolina, and Columbia in South Carolina. These regions were selected because of strong market share that alliance members have within them.
Founding members of the alliance are Allscripts, athenahealth, Cerner, CPSI, Greenway, McKesson and Sunquest, with McKesson’s RelayHealth unit providing the health information exchange platform. These members, according to the alliance, represent 42 percent of the acute care electronic health records market and 23 percent of the ambulatory market.
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Patient access to e-notes may become 'standard of care'

December 12, 2013 | By Marla Durben Hirsch
Allowing patients access to physicians' electronic notes is becoming more popular, and is influencing the content of the notes themselves, according to a new op-ed article in the New England Journal of Medicine.
The article, written by several participants in the OpenNotes experimental program, states that while the initiative has been welcomed by both patients and physicians, it has changed their approach and drafting of the notes.
Patients are now more careful about what they share with physicians and desire more control over the information. The clinicians are wary about how they phrase notes, particularly about sensitive medical conditions.
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Survey ranks EHR vendors on technology, functionality and interoperability

December 11, 2013 | By Marla Durben Hirsch
EHR vendors tout the importance of their systems' technology when they market their products, but providers were more concerned about vendors' ability to deliver functionality than the particular technology the system used, according to a new study by KLAS Research.
In a survey of 117 organizations, mainstream technology such as Oracle, .Net or SQL were a strong driver in the selection of EHR vendors AllScripts, Cerner, McKesson and Siemens. AllScripts rated highest for programmability and accessibility of data; Cerner rated highest for interoperability and configuration.
"It is easier to access data and modify EMRs that have mainstream technologies at their cores…lower ratings for Epic and Meditech were influenced by a perception of design complexity, vendor protectiveness and scarcity of skilled staff," the researchers found. Epic and Meditech use Cache and MAT technologies.
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Barts clinicians view GP data in Cerner

12 December 2013   Rebecca Todd
Barts Health NHS Trust is using Cerner’s Health Information Exchange to view a summary of patients’ GP records, embedded within its Millennium electronic patient record system.
Hospital clinicians can see GP data showing the patient’s problems, diagnoses, recent medications and recent diagnostic tests.
Patients must give explicit consent for staff to view their 'community record', though there is an exception in emergency situations.
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IMS Offers M-Heath App Ratings

12/10/2013 02:50 PM
Health tech firm offers prescription infrastructure for healthcare providers, along with consumer health app rankings.
IMS Health, a major healthcare research and technology firm, is offering healthcare providers and payers an "mHealth prescribing solution" that can help create "formularies" for physicians who prescribe mobile-health apps to their patients.
While few doctors are currently doing this, IMS Health is entering a crowded field, which already includes Happtique, HealthTap, Cigna, and Partners Healthcare's Center for Connected Health. But only IMS Health claims to provide a comprehensive ranking of m-health apps, coupled with a full-blown m-health prescribing system.
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CMS Releases Security Risk Analysis Tip Sheet

Written by Akanksha Jayanthi (Twitter | Google+)  | December 11, 2013
Hospitals in stage 1 or stage 2 of The Centers for Medicare and Medicaid Services' electronic health record incentive programs can download a free tipsheet to help conduct a security risk analysis to meet the meaningful use requirements and protect the security and privacy of patients' health information.
The tipsheet offers steps for conducting a security risk analysis, tips on how to create an action plan, an outline of security areas to be aware of and myths and facts regarding security risk analysis.
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Supervising IT security across a large healthcare network

Author Name Patrick Ouellette   |   Date December 10,
The shift from a training message that is solely tied to HIPAA regulations to a substantial patient care and safety focus is easier said than done. Despite the challenge involved with this type of undertaking, Jim Noga, Vice President and CIO of Partners Healthcare, and CISO Jennings Aske have seen success in concentrating on why they’re securing patient data, as opposed to only a strict regulatory approach.
Noga said that resonates this type of message resonates with staff members because they can identify with moving from a regulatory discussion toward reminding them that the conversation is about providing better patient care and protecting them as members of our staff, not just arbitrary rules meant to complicate clinical processes.
Dr. Gary Gottlieb [President and CEO of Partners HealthCare] talked during Privacy and Security week at Partners about the importance of patient privacy and security and how it needs to become part of our culture. In addition to all the technology, people need to think about it. No matter how you batten down the hatches in healthcare, the unencrypted laptop makes the press. And a lot of that is based on people’s personal behavior.
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Medical IT: Physician Practices Now Spend Over $19k Per FTE Physician

Written by Laura Miller | December 11, 2013
The MGMA Cost Survey Report: 2013 Report Based on 2012 Data shows that medical practice expense per full-time equivalent physician for information technology has climbed to $19,439.
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PwC survey reveals the top health industry trends of 2014

December 12, 2013 | By Ilene MacDonald
The Affordable Care Act isn't the only major concern facing the healthcare industry in 2014. PwC's Health Research Institute's Top Health Industry Issues for 2014 report reveals the upcoming year will force hospitals and health systems to become more retail-focused as they respond to consumer demand for greater price transparency and cost savings.
"While health insurance exchange implementation is driving headlines today--in reality the next 12 months will be marked by how well the industry addresses a range of core business challenges," said Kelly Barnes, PwC's U.S. health industries leader, in the report announcement. "Businesses must address rapid innovation and competition from non-traditional players, but above all they must respond to empowered consumers as customer-centric transformation sweeps healthcare."
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Blue Button gets more powerful

Posted on Dec 11, 2013
By Frank Irving, Editor, Medical Practice Insider
The Office of the National Coordinator for Health IT has big plans for Blue Button, the mechanism that enables consumers to securely download their health information, as part of an overarching effort to enhance patient engagement.
"Providers who engage patients create an environment in which patients feel a partnership," said Ellen Makar, senior program analyst at ONC. "These providers are assisting patients in accessing their own data, and making them feel that they can own their treatment options and share in decision-making."
The EHR meaningful use program is important in this area, Makar explained Tuesday during an ONC-led town hall session at the mHealth Summit in National Harbor, Md. Stage 2 of MU calls for patients to be able to view, download and transmit their information, and Blue Button — while not the only way to give patients those capabilities — is certainly a very recognizable and increasingly popular means to that end.
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FDA commissioner: mHealth requires scientific evidence

December 11, 2013 | By Ashley Gold
FDA Commissioner Margaret Hamburg began her keynote on the final day of the mHealth summit in Washington, D.C., by joking about her qualifications to speak: She only got an iPhone two weeks ago, she said. 
"I may be a late adopter, but I recognize that the world is transforming," said Hamburg (pictured right). "Certainly, the FDA has understood the value of scientific computation to support our mission and the advancement of health."
The FDA supports the growing complexity of products that come before them for review, Hamburg said. And as a physician, she "certainly appreciates" the promise of mHealth.
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Structured reporting could save lives

3 December 2013   Kim Thomas
Structured reporting in radiology could save lives, a meeting at the Radiological Society of North America annual conference heard on Monday.
The claim was made by Curtis Langlotz, professor of radiology at the University of Pennsylvania, in a debate called ‘Is structured reporting the answer?’
Langlotz argued that the unstructured, free-text reports currently used by radiologists could be ambiguous and unclear. As an analogy, he cited an air traffic accident in Tenerife in 1977, which had been caused by a mismatch in the terminology used by a KLM pilot and the terminology used by the control tower.
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Fraud-Wary Feds to Regulate EHR Copy-and-Paste Function

Robert Lowes
December 10, 2013
The Centers for Medicare & Medicaid Services (CMS) is going to regulate the controversial copy-and-paste capability of electronic health record (EHR) systems in its campaign against billing fraud.
CMS made its intentions known in response to a report released online today by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). In a survey of 864 hospitals, OIG found that only one fourth had policies governing the use of EHR copy-and-paste functions. And only 44% had EHR audit logs that record the method of data entry, whether it is copy-and-paste, voice recognition, or keyboarding.
OIG said that the ability to "clone" chart notes from a previous patient encounter to help document the next one can help physicians work more efficiently, but also invite fraud, especially if no one edits the cloned information to make sure it's accurate and up to date. Government officials are worried that many physicians bill for higher levels of evaluation and management (E/M) services than warranted by cloning dense blocks of old patient information. For example, a physician may bring forward a diagnosis from an earlier visit — an infection, for example — that no longer applies.
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The spectre of flawed IT ought to scare us all

I am worried that most of my companies are not tech-savvy enough. Despite our bias towards sectors such as hospitality, technology needs to be front and centre in our thinking. From mobile meal ordering to digital menus to social media wizardry, the eating experience is being reinvented by technology. In the years ahead, any business that fails in its IT strategy will surely go broke.
A few years ago I backed an ailing retail chain with the hope of turning it round. After I invested, I discovered the core reason it was in decline: its technology strategy was deeply flawed and it suffered from a huge under-investment in systems. It had not built its own ecommerce platform. It totally lacked any form of digital marketing presence. Its electronic point of sale systems were useless; its stock-keeping and logistics software and hardware were redundant; its management accounting was in disarray. Unsurprisingly my investment was a write-off.
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mHealth forecast wows audience

Posted on Dec 10, 2013
By Bernie Monegain, Editor
There it was – the clear-as-a-bell prediction about mobile health. Call it the "wow factor."
"I will predict 85 percent of healthcare will be done in the home in the next five or six years," Andrew Watson, MD, told an audience here at an mHealth Summit breakfast meeting Dec. 9. You could hear the hushed "wow" rippling across the room.
"I don’t know the boundaries of this; I don’t think we’re going to know for four or five years," Watson said.
But, if it turns out that his assertion about the changing venue for healthcare is incorrect, he said: “We’ve got to push harder.”
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GP indicators added to NHS Choices

10 December 2013   Rebecca Todd
Forty indicators about GP practice standards and performance have been added to the NHS Choices Accountability Tool.
The indicators are designed to give people a comprehensive view of practice performance across a range of quality and clinical indicators and cover things such as: early diagnosis of cancer; cervical smears; asthma diagnosis; and flu vaccination levels.
Data about GP, hospital and clinical commissioning croup outcomes as well as local authority health information has been brought together in the new easily-navigable tool on the NHS Choices website.
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mHealth13: Patient-centered care will drive mobile adoption

December 10, 2013 | By Ashley Gold
Mobile technology may be the future of patient-centric care, but better evidence is needed to take it to the next level, according to a panel of experts speaking Tuesday morning at the mHealth Summit in Washington, D.C., at FierceMobileHealthcare's executive breakfast panel "mHealth's Role in Patient Engagement."
Cleveland Clinic Chief Medical Information Officer David Levin (pictured second from right) said that while he's devoted most of his career in bringing technology to healthcare, it's mainly been a failure and there's much more to do. Technology shouldn't put more space between the provider and the patient, but all too often, he said, it does.
The question Levin said he's been asked repeatedly: "Why is it going be different this time?" His response: It's a perfect storm now, and it's become about value-based, patient-centric care. Results, he stressed, are really going to matter.
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Telehealth improves home management of chronic disease

December 10, 2013 | By Julie Bird
A pair of separate studies recently published out of northern Canada and Taiwan indicate that telehealth is an effective tool in self-management of chronic disease, including diabetes.
The study from Taiwan, published in the Journal of Medical Internet Research, focused on diabetes self-management. Results indicated "sophisticated technological design" improved five of seven self-care behaviors, resulting in better blood glucose control and glycemic control. While improved self-care resulted in better outcomes, the "changes in behavior required time to show effects," researchers found.
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Diabetes Data Beamed to Your Phone

Walt Mossberg Reviews Two New Meters From iHealth and LifeScan

By  Walter S. Mossberg
Updated Dec. 10, 2013 9:04 p.m. ET
Two companies, iHealth Lab and LifeScan, have brought diabetic glucose monitoring to the smartphone age with bluetooth devices and apps. Walt Mossberg reviewed these and gives his us his take. (Photo: iHealth Labs/LifeScan)
Home medical devices, as opposed to fitness products like activity-measuring wrist bands, have too often been stuck in the past, even as smartphones have zoomed ahead on hardware and software.
Katie Boehret reviews a peer-to-peer backup system called Space Monkey is a less-costly alternative to many hard-drive and cloud solutions. Full review
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Sharecare goes mobile with health advice app, AskMD

By: Aditi Pai | Dec 9, 2013
Atlanta-based online health advice website Sharecare has launched a free app, AskMD, that is meant to help users keep track of their symptoms and put them in contact with doctors and hospitals.
Launched by WebMD Founder Jeff Arnold, Sharecare is an online portal that connects healthcare professionals and patients. It offers a question and answer service for patients to connect with experts and health systems, a portal to connect with other patients dealing with health issues and a 16-week program to help users get fit. Sharecare also has a “RealAge Test” for users to find the true age of their body, which the company says has been taken by more than 30 million people since the test was first launched.
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Why must our governments be so incompetent at IT?

Ross Clark
If supermarkets and airlines can do it, so should civil servants
The next time I hear a government minister telling us how important it is to improve our computer literacy I am going to scream. Most of us came to terms with the computer age years ago; it is just the government that has been left behind.
Yesterday we learnt of yet another IT fiasco: the Department for Work and Pensions has written off £40 million spent on a non-functioning IT system to administer Universal Credit. The best that Iain Duncan Smith could say was that it wasn’t as bad as Labour’s IT system for the NHS, which has so far cost taxpayers £9.8 billion — for a system dismantled in 2011 after nine years’ of failed development.
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Direct Protocol May Favor Large Providers and Vendors

Scott Mace, for HealthLeaders Media , December 10, 2013

A medical group's call for allowing licensed physicians, without vendor interference, to designate any recipients or senders of messages using the Direct protocol puts a spotlight on nagging EHR interoperability issues.

If 2013 has taught us anything, it's that eventually, every area of healthcare IT becomes enmeshed in politics sooner or later.
This week, speculation is bubbling that the low-cost interoperability promised by the Direct protocol is the latest vehicle for the continuation of expensive, business-as-usual interfaces between different healthcare IT vendors' systems.
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Gov’t Health IT Report Expected in Early 2014 

By David Pittman, Washington Correspondent, MedPage Today
NATIONAL HARBOR, Md. -- A strategy for promoting innovation in health information technology -- due from three federal agencies -- should come out early next year, a government official said Monday.
The FDA, Office of National Coordinator of Health IT (ONC), and the Federal Communications Commission have been working on a report outlining strategies and recommendations on the issue as mandated by the FDA Safety and Innovation Act, which Congress passed last summer, explained Jodi Daniel, JD, MPH, director of ONC's Office of Policy and Planning. Daniel was speaking at the mHealth Summit here, hosted by the Healthcare Information and Management Systems Society (HIMSS).
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Surgeon gives TED talk on using Google Glass in the OR

December 9, 2013 | By Ashley Gold
Google Glass can help surgeons avoid wrong-side surgery, a surgical "never-event," according to Rafael Grossmann, M.D., from Caracas, Venezuela, a general, trauma, advanced laparoscopic and robotic surgeon who practices in Maine, and who recently delivered a TED talk on the use of Google Glass in the operating room. Care coordination software can make HIE more valuable, giving it more currency to help providers track and manage patients as they move through the delivery system, including: dynamic management of care transitions, care planning, referral management, clinical decision support and medication reconciliation. Here’s how:
  1. It applies clinical relevance and workflow context to the information: Care coordination software condenses and reconciles the data from different sources and formats into customized summaries that each provider sets up, presenting the details most relevant to their role as a care manager, primary care physician, specialist and other team members. Behind the scenes, the platform automatically applies logic to the information and feeds it to the relevant applications and users in support of care coordination. For example, a primary care physician is alerted to hospital discharge and can immediately view/update a care plan, manage referrals, reconcile medication list and initiate additional services or communications with other providers. 
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Patients want technology to provide personalized care

December 9, 2013 | By Susan D. Hall
People believe technology innovation holds the best promise for curing fatal diseases--more so than increasing the number of doctors or funding for research, according to a new survey from Intel.
The survey of 12,000 people found that most are open to virtual doctor visits and to the use of health sensors in their bodies--sometimes, even their toilets. What they want most of all, it found, is personalized care.
"This survey indicates very high willingness of people to become part of the solution to the world's healthcare problems with the aid of all sorts of technologies," Eric Dishman, Intel fellow and general manager of the company's Health and Life Sciences Group, said in an announcement.
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RWJF Releases Tools for Using Data in Local Settings

Written by Ellie Rizzo (Twitter | Google+)  | December 06, 2013
The Robert Wood Johnson Foundation has released resources to help local healthcare practices leverage physician-level data for quality improvement.
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Frost & Sullivan names mHealth as top 2013 trend

By: Jonah Comstock | Dec 6, 2013
Research firm Frost & Sullivan listed mHealth among the top three hot topics in healthcare in 2013, garnered from a global survey of 1,835 executives, about 260 of whom worked in the healthcare industry.
Fifty-one percent of respondents nominated mobility in healthcare, or mHealth, as a top trend for the year. The runners up were cloud computing, at 45 percent, and regulatory environments, at 44 percent. They beat out topics like remote monitoring (38 percent), patient engagement (32 percent), and electronic health records (31 percent).
“mHealth expansion has been fueled by the unprecedented spread of mobile technologies, as well as advancements in their innovative application to address health priorities,” the company wrote in a press release. “It is largely supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs) and other wireless devices.”
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Public Health Departments Use Social Media for Education and Monitoring

by Lisa Zamosky, iHealthBeat Contributing Reporter Monday, December 9, 2013
Social media platforms have garnered growing interest as a tool for public health communications. Increasingly, Twitter, Facebook and YouTube and other platforms are being incorporated into public health campaigns to increase health awareness, encourage behavior change and inform the public about medical outbreaks and natural disasters.
These platforms have become an integral part of societal communication and their utility is widely recognized. Their use in the realm of health care communication has grown steadily over the past few years, and many organizations are using these tools to both study and make an impact on public health.
"The criticisms about Facebook or Twitter being just a place where people describe the mundane, like, what people ate for breakfast, can be turned into something powerful. For example, if many people in a metro area are using social networks to report symptoms of a rare flu, that's important public health data,"  John Novack -- communications director at Inspire, a company that builds and manages online patient support communities -- said.
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Enjoy!
David.

Friday, December 20, 2013

Nurses Using An EMR And Also Being Consulted On EHRs Seems To Be A Good Thing For Everyone.

This appeared a little while ago.

Why nurses must be involved in developing new health IT

November 22, 2013 | By Ashley Gold
Nurses are an essential part of the medical system and patient care--so why shouldn't they be more involved in developing new healthcare IT?
This question is explored in an article in Nursing Times, along with discussion on how attitudes toward nurses differ in the U.K. and the U.S., and how nurses can use technology to improve practice. Five key points made in the article include:
1.       In the U.K. and the U.S., nurse leaders must justify their requests for resources.
2.       The value of technology is determined by how it is used and whether it helps or hinders care.
3.       There is a general belief that nurses are "reluctant to accept change and "resent new technology."
4.       The U.S. and U.K. share similar goals for technology innovation, but differ when it comes to economics and delivery.
5.       Frontline staff often is not involved in the planning and implementation of health IT.
One example of how the perception that nurses are slow to adapt to technology is proved wrong is in nurses' work in neonatal or intensive care units, the article argues. Such a belief keeps technology system suppliers from understanding the practicalities of nursing care and how they can support innovation in everyday practice.
More here with references.
I also spotted this summary a while ago,

Study: EHRs improve hospital nursing care

January 11, 2012 — 4:13pm ET | By Marla Durben Hirsch - Contributing Editor
Electronic health records do more than improve care rendered by physicians. They also improve care provided by nurses.
That's the scoop in a study of more than 16,000 nurses published in the Journal of Nursing Administration. According to the study, which covers 316 hospitals in four states, poor patient safety and other quality outcomes occurred less frequently when nurses used an EHR system.  
The study suggests that the implementation of a basic EHR may result in improved and more efficient nursing care, better care coordination and patient safety. 
"EHRs are rapidly becoming part of the daily practice of the bedside nurse," lead researcher Ann Kutney-Lee, a health outcomes researcher with the University of Pennsylvania School of Nursing, said in a statement. "Nursing administrators should be fully engaged in the process of EHR adoption and implementation to ensure effective use and success in creating seamless transitions for patients throughout the healthcare continuum." 
More here:
Here are the detailed links:
To learn more:
- read the study's
abstract
- check out this 
article from the University of Pennsylvania's Nursing School
- read this UPI
piece
- read the
abstract of the nurse EHR training study
- here's the
abstract of the ICU nurse study
The two studies reported here are useful in showing the possible impacts of Health IT when used by clinicians - and especially when used by the most numerous clinicians - the nurses.
So this is an important reminder of the importance of nurses in most aspects of Health IT.
Pity there were so few involved in the PCEHR over the years.
David.

Thursday, December 19, 2013

What A Fantastically Interesting Outcome From A Major Implementation. Real Lessons For NEHTA and DoH.

This appeared a little while ago.
December 11, 2013, 5:18 PM ET

Avon’s Failed SAP Implementation Reflects Rise of Usability

The failure of Avon Products Inc.’s $125 million implementation of SAP AG software is the latest – and perhaps most dramatic – example of how usability has become a critical issue in the workplace. People who are accustomed to using simple, well-designed applications in their personal lives have no patience for disappointing technology at work.
As the WSJ’s Drew Fitzgerald reported earlier today, Avon is pulling the plug on a $125 million software system rollout that has been in the works for four years after a test of the system in Canada drove away representatives the door-to-door beauty product company relies on to drive sales.
Avon began testing the new order management software system in Canada in the second quarter. While the new system based on software supplied by SAP AG worked as planned, it was so burdensome and disruptive to the representatives’ daily routine that they left in meaningful numbers. Avon relies on a direct sales model where its representatives aren’t employees, which makes it difficult to add new tasks associated with the software system.
…..
“Basically, users will accept less crap today, when it comes to software,” says Michael Krigsman, an independent industry analyst. “That is because the world of consumer software has become easy and simple to use and has trained users to expect that business software will follow a similar model. And if it doesn’t, people are much less patient than they were in the past.”
…..
UPDATE–This story has been updated to add comment from SAP.
More here:
This line says it all:
“Basically, users will accept less crap today, when it comes to software,”
Surely this is another reason for the debacle of the PCEHR? Users who use iPads, iPhones, late Windows etc. simply will not put up with hopeless, slow, inconsistent and unstable user interfaces.
Maybe someone should point out the basic truth to the powers that be (and shouldn’t be!).
David.

Wednesday, December 18, 2013

After Developing The PCEHR For Two Years and Having It Live for 18 Months NEHTA Notices It Does Not Work Very Well!

This appeared a little while ago on the NEHTA Web Site:

Usability Feedback

PCEHR Viewing
Software vendors have implemented the ability to draw down a list of documents available from the PCEHR for a given patient. Each vendor has implemented a process for sorting and filtering these documents. Feedback received from primary care clinicians suggests a common method of presenting this information (called a Health Record Overview or HRO) would be valuable.  The PCEHR infrastructure will be modified to support the HRO. Subsequent to that, primary care software vendors will build the HRO into their software products. This work is underway, with the first software able to display the HRO expected to be available in mid-2014.

Positive feedback has been received from clinicians regarding the prescription and dispense “smart” view available in the PCEHR (and some software products). This functionality allows the user to filter and sort medication, prescription and dispense records within a patient’s PCEHR in a variety of ways. Where software does not include this function, clinicians can still see the records in a static list together with all other clinical documents based on the date of submission of the document to the PCEHR.

Shared Health Summary Uploading
Feedback has been received about the process for populating and uploading a Shared Health Summary, and the way in which some information is handled within the document. NEHTA has worked with representatives from the peak health bodies to provide further guidance for software vendors on these issues. Primary care software vendors can now start incorporating this guidance within their respective products and release the enhanced software to their users. NEHTA will publish a list of software vendors that have released products addressing this usability guidance.
Accessing PCEHR Functionality within Software
Feedback has been received about the way primary care software systems access the PCEHR, where the PCEHR functions are located, and whether or not a patient has a PCEHR. This guidance has now been released to software vendors.

Event Summary
Feedback has been received from primary care clinicians that they are unclear about what information to include in an Event Summary, and in which situations they would use one. NEHTA intends to produce guidance material relating to this in early 2014.
This information is found here:
How astonishingly incompetent are these guys? For years, at least, I have warned about how clumsy and inaccessible these PCEHR is and how much worse that will become as you add more records. Anyone who has a PCEHR record and is on any regular medications would have been aware of the issue ages ago. Because this obvious flaw was not addressed ages ago the vendors have tried to patch an obvious gap, done it in different ways and we have wound up with systems which work different ways.
This and the other issues would have been spotted ages ago had there been proper development,  testing and acceptance processes and some well planned initial implementations to ensure the system was useable.
To have taken 18 months to come up with these obvious flaws is a testament to just how out of touch with clinical reality NEHTA and DoH are.
As far as not having defined and been clear as to what should be in Event Summaries is just a horrible joke!
Again we see the issues that flow from poor communication, leadership and governance as well as implementing to a political time-table rather than a properly planned and tested time-table.
If there is any plan to attempt to fix the PCEHR then we must ensure none of all the guilty parties have anything to do with it.
David.

Medicare Local Review Announced - Very Short Response Deadline - Commments Welcome

This popped up very recently.

Medicare Locals review

Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.

Page last updated: 16 December 2013
PDF Printable version of Medicare Locals review (PDF 30 KB)

16 December 2013

Australia’s former Chief Medical Officer Prof John Horvath AO will oversee the Australian Government’s review of Medicare Locals.

Prof Horvath is a distinguished doctor, researcher and health adviser and served as the nation’s CMO from 2003 to 2009.

Health Minister Peter Dutton has announced details of the review which was a Coalition election commitment.

It will begin immediately with Professor Horvath providing his independent advice to the Government by March next year.

The 61 Medicare Locals established by the former Labor Governments were allocated flexible federal funding of more than $1.8 billion over five years as well as additional funding for specific programs.

Health Minister Peter Dutton said the government’s priority from the program was to ensure that Commonwealth health funding was used as productively as possible.

“We are committed to reducing waste and spending on administration and bureaucracy, so that greater investment can be made in services that directly benefit patients and support health professionals who deliver those services to patients,” he said.

Stakeholders have been invited to comment on various aspects of Medicare Locals’ functions including:

  • The role of MLs and their performance against stated objectives
  • The performance of MLs in administering existing programmes, including after-hours GP services
  • Recognising general practice as the cornerstone of primary care in the ML functions and governance structures
  • Ensuring Commonwealth funding supports clinical services, rather than administration
  • Processes for ensuring that existing clinical services are not disrupted or discouraged by ML programs
  • Interaction between MLs and Local Hospital Networks and other health services, including boundaries
  • Tendering and contracting arrangements
  • Other related matters.
Here is the link:

http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2013-dutton025.htm

The deadline for those asked to respond is 23rd December, 2013 I am told.

Anyone who has comments that might be fed back on all these issues and MLs effectiveness feel free. Will pass them on if I can.

Most will know I see them as a rather nebulous set of entities whose purpose and actual performance is pretty unclear - given their cost.

David.


Mr David Gonski To Become ANZ Chairman From Next Year. Will He Leave NEHTA?

To quote the Aust Financial Review from today.

“Following the announcement today by the Australia and New Zealand Banking Group Limited that I will be joining the ANZ Board in February 2014 and succeeding John Morschel as Chairman in May 2014, I confirm I will be relinquishing some of my current commitments,” Mr Gonski said.

“I intend to step down as chairman of the guardians of the Future Fund during January 2014 so as to avoid any possible conflict of interest with my new position and allowing sufficient time for a smooth transition and handover to my successor, who will be appointed by the Federal Government.”

The full article is here.

http://www.afr.com/p/business/companies/gonski_appointed_anz_chairman_rhH86b5ksrMIhqNznWADsK

No mention of NEHTA of which he is also Chair. Might be a good time to leave this as well. I am sure ANZ shareholders would like this outcome as the more focus he has on the ANZ the better!

David.

Disclosure: I have a few ANZ shares.

Recent Comments Widget Replaced With A Much Better One!

Enjoy!

David.

Tuesday, December 17, 2013

You Have To Think The MYEFO Budget Problem Will Stop E-Health Spending Big Time!

Given the mess the Federal Budget seems to be  in - what chance further spending on E-Heath?

Curious to know what others think.

My feeling - this will be the excuse to cancel the PCEHR Program.

What do you think? About this and the apparent budget mess in general if you wish.

David.