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Brookings: Full interoperability won't be achieved in current environment
February 3, 2015 | By Marla Durben Hirsch
Health information exchanges (HIEs) won't work well and interoperability will not be sustained unless the business models and incentives are changed, according to a new paper from the Brookings Institution.
The paper, written by Niam Yaraghi, a fellow in governance studies at the Center for Technology Innovation, posits that the interoperability problem is more economic and political than technical. In the current fee-for-service reimbursement format, as data sharing lowers costs, it serves as a disincentive for certain providers, such as physicians, labs and radiology centers.
Moreover, Stage 3 of the Meaningful Use program will likely set the interoperability bar too low, and will have the inadvertent consequence of helping not the providers but the dominant vendors, who will need only provide a minimum amount of interoperability, Yaraghi writes.
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Anthem Hack is Healthcare’s Wake Up Call
FEB 5, 2015 3:35pm ET
When the country’s second-largest health insurance company is hacked leaving the personal information of 80 million people vulnerable to identity theft, it’s a watershed moment that cannot be ignored. There is no doubt that this data breach is a wake-up call for a healthcare industry that is lacking when it comes to information security.
As Lynne Dunbrack, research vice president at IDC Health Insights, observes, healthcare organizations today are “at greater risk of a cyberattack than ever before, in part because electronic health information is more widely available today than in the nearly 20 years since the Health Insurance Portability and Accountability Act was passed.” However, no one should be surprised that cybercriminals view the healthcare industry in general as a soft target.
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Details emerge in Anthem hack
February 6, 2015 | By Katie Dvorak
The healthcare industry, which lags behind others when it comes to cybersecurity, now faces what is shaping up to be the largest breach of healthcare data in history.
Hackers broke into health insurer Anthem's database, obtaining the personal information of about 80 million consumers, including names, birth dates, addresses, email addresses, employment information and Social Security/member identification numbers.
Members' Social Security numbers were not encrypted, according to a Wall Street Journal article that cites an anonymous source familiar with the breach. Encrypting the information would have made it more difficult for hackers to access and sell, according to the article.
The company believes a hacker group used a stolen employee password to access the database, the article said.
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Privacy concerns are the biggest barrier to mHealth market, survey finds
February 05, 2015
Mobile health devices are a growing market, but some healthcare executives are still dubious about their security.
A report from The Economist Intelligence Unit found approximately 64 percent of healthcare executives believe mHealth apps will improve health outcomes, and 63 percent predicted that better access to health data will enable patients to make better health decisions. The report surveyed 144 healthcare executives about the mobile health market and their expectations for its future.
However, 49 percent of respondents answered that consumer fears about privacy will limit expansion, and 51 percent said their own biggest concern was privacy.
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Anthem Data Breach a Potential Game Changer for Healthcare
John Commins, for HealthLeaders Media , February 6, 2015
A data security expert explains how a huge cyber attack on one of the nation's largest health plans could be the catalyst that makes the healthcare industry take significant steps toward improving data security.
Anthem Health's massive data breach announced Thursday sent shockwaves through the healthcare information technology sector. As many as 80 million people may have had personal data compromised, placing them at risk of identity fraud, Anthem reported.
Investigators, including the FBI, are sifting through what happened, attempting to determine how security was breached, who may have done it, and what will happen to the stolen information.
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Security experts on Anthem breach: The biggest threat lurks inside your company
February 6, 2015 | By Katie Dvorak
The impact of the recent cyberattack on health insurance company Anthem is rippling through the industry--but health IT leaders and experts say they're not surprised it happened.
"It was only a matter of time until hackers found out that it's much easier to go after Social Security numbers and personally identifiable information with healthcare providers, which in comparison spend significantly less on security [than in other industries], making them tentatively easier targets," Martin Walter, senior director at network security firm RedSeal, tells CIO.com.
Personal information for roughly 80 million individuals was compromised after hackers broke into an Anthem database. Information including names, birthdays, addresses, email addresses, employment information and Social Security/member identification numbers was compromised.
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EHR Business Environment Must Change to Achieve Interoperability
FEB 4, 2015 10:29am ET
The main challenges for the nation’s health IT interoperability are not technical but business related.
That’s the word from former National Coordinators for Health IT speaking in a panel session on Tuesday at ONC’s Annual Meeting in Washington.
Farzad Mostashari, M.D., former National Coordinator for HIT and currently CEO of start-up Aledade which partners with independent primary care physicians, warned that business practices among some electronic health records vendors are inhibiting the sharing of health information by restricting information exchange with users of other EHR products.
“My practices—I’m working with small practices—can’t get their own data out and it’s not because of the technical standards. It’s because of the business practices,” said Mostashari. “I think it’s fantastic to create a value-based payment environment where the providers are incentivized to be able to use that clinical data that we’re now collecting and to take it out and have third party applications do analytics and all this great stuff. But, the vendors don’t have the same incentives as the providers do.”
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EHRs help coordinate patient-centered medical home care, but don't support teamwork
February 2, 2015 | By Marla Durben Hirsch
Electronic health records can help clinicians coordinate patient care, but as currently designed don't support teamwork well, according to a new study published in the Journal of the American Medical Informatics Association.
The researchers, supported by a grant from the Commonwealth Fund, interviewed 63 respondents in 27 primary care practices striving to work as patient-centered medical homes from May 2013 through December 2013. They found that EHRs facilitated teamwork by enhancing communication via improved access to patient information, with-in chart notes, task assignments, and the like. Moreover, when combined with revised clinical workflows, the EHRs reduced task duplication and allowed physicians to delegate more to non-physicians.
However, there were "numerous" challenges with the EHRs that hampered the practices' attempts to work as a team, according to the study. The systems typically lacked care management and population health management functionalities. They ended up creating workarounds or using separate systems. There also was no accountability for standardization or consistency of the EHR data.
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Clinican leadership, governance keys to successful health IT implementation
February 5, 2015 | By Susan D. Hall
SwedishAmerican Health System (SAHS) has recognized the importance of clinician leadership and governance in the successful rollout of IT projects, according to an article at Health Data Management.
The Rockford, Illnois-based organization has created its governance framework around two bedrock principles, writes Chief Medical Information Officer Michael Polizzotto. Those principles are: 1.) The needs and opinions of clinical users should inform decisions about clinical IT; 2.) The IT decision processes will be standardized, transparent and responsive.
SAHS has two advisory panels where clinical needs for IT are prioritized--the Physician Advisory Council and the Interdisciplinary Advisory Council. Those councils report to the eHealth Oversight Council, which is co-chaired by the chief medical officer and chief nursing officer.
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EHR Use by Physicians Lagging
Lena J. Weiner, for HealthLeaders Media , February 5, 2015
More than half of physicians regularly get patient information necessary to coordinate patient care from sources other than EHRs, a study finds.
Despite a federal mandate to adopt electronic health records systems, many physicians remain woefully behind in how they receive patient data, researchers say.
Published in the journal Medical Care, the study is the result of a collaboration by the Agency for Healthcare Research and Quality, the Office of the National Coordinator for Health Information Technology, and the National Center for Health Statistics. Researchers examined three sources of patient health information necessary for proper care coordination:
- Patient history and reason for referral to outside provider
- Consultation with an outside provider
- Hospital discharge information
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How Health Care Payment Reform and Interoperability Are Intertwined
Wednesday, February 4, 2015
WASHINGTON -- Former U.S. Senate Majority Leader Tom Daschle (D-S.D.) called last week a "historic week."
There were two big health policy announcements: HHS' initiative to shift to alternative payment models for Medicare reimbursements and the Office of the National Coordinator for Health IT's 10-year nationwide interoperability roadmap.
At ONC's Annual Meeting in Washington, D.C., this week, officials said those two separate announcements are actually closely intertwined and dependent on one another.
Daschle said the country can't achieve health care delivery and payment system reform "without heavy application of technology along with it."
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ONC's 2015 annual meeting roundup
Posted on Feb 04, 2015
By Erin McCann, Managing Editor
Some 1,200 health IT professionals packed into the Washington Hilton this week for the 2015 ONC Annual Meeting. The focus this year? Interoperability, standards and big data.
There was interoperability talk (ONC is calling for interoperability by 2017); there was meaningful use talk (ONC has proposed a rule shortening the MU reporting period to 90 days); there was talk about care coordination software failing in the interoperability arena; where health IT innovation will come from (private vs. public sector); Blue Button; EHRs; standards – the whole nine yards, really.
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NATE Blue Button trust bundle to improve sharing between providers, patients
February 4, 2015 | By Katie Dvorak
A trust bundle created by the National Association for Trusted Exchange (NATE) will help create a more interoperable patient-mediated exchanged, according to an announcement.
The NATE Blue Button for Consumers (NBB4C) Trust Bundle was introduced during the Office of the National Coordinator for Health IT's annual meeting Tuesday in the District of Columbia.
The bundle will help in the secure exchange of health information from apps controlled by a provider to apps controlled by patients.
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Aneesh Chopra: Too many bystanders in health IT
February 4, 2015 | By Dan Bowman
Demand and participation eventually will drive use of open public application program interfaces in healthcare for sharing information between entities, former U.S. Chief Technology Officer Aneesh Chopra predicts. However, he said, first providers must be more willing to make the initial jump onto the bandwagon.
At the Office of the National Coordinator for Health IT's annual meeting this week in the District of Columbia, Chopra--who currently serves as executive vice president of data analytics incubator Hunch Analytics, which he founded in October 2013--said many providers today likely are already using similar tools to share sensitive data in their everyday lives, but are hesitant to take the plunge on the healthcare front.
"If any of you watch Netflix on an Apple TV or an Xbox, you facilitate the sharing of your sensitive rental records data with your TV provider," Chopra said.
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HIMSS wants more Congressional action to spur interoperability
February 4, 2015 | By Dan Bowman
Calling the nation's current healthcare infrastructure inadequate for ubiquitous exchange of patient information, the Healthcare Information and Management Systems Society recently published four recommendations for Congress to spur interoperability.The recommendations stemmed from a discussion that took place among HIMSS government relations personnel Jan. 30.
The recommendations come as officials with the U.S. Department of Health and Human Services and the Office of the National Coordinator for Health IT continue to prioritize interoperability, particularly as HHS moves more rapidly toward a reimbursement system based on value.
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Mayo Clinic CIO explains switch from Cerner to Epic
Posted on Feb 02, 2015
By Mike Miliard, Editor
Cris RossIn one of the biggest health IT announcements in recent memory, the Mayo Clinic earlier this month selected Epic to replace its existing electronic health record and revenue cycle technology.
In an interview with Healthcare IT News, Mayo Clinic Chief Information Officer Cris Ross explains why – and discusses his strategy for ensuring this massive, multi-year project stays on time and on budget.
Q: When did Mayo Clinic start thinking a change needed to be made with your EHR and revenue cycle systems?
A: Mayo has been steadily working toward a convergence of its practice for many years. Across all of our locations – the Midwest, Arizona and Florida. But we started to take a very serious next look at this issue in the spring of 2013. We had done this many times before, and that was time for a fresh view.
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The little red (e)book
The ‘red book’ that records a child’s early health progress is one of the oldest personal health records around; and it’s on the verge of going digital. Kim Thomas reports.
3 February 2015
Although I haven’t had cause to consult it for several years, I can still reach out and pick up my daughter’s ‘red book’ from a shelf next to my desk.
Given to me at her birth nearly 16 years ago, this is her personal health record, and contains weight charts, growth charts, details of vaccinations given, and records of developmental milestones.
A PHR on paper
The red book has been around nationally for 25 years. Unlike other health records, it includes information recorded both by health professionals and by parents and guardians.
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Single opt-out "needed" for patient data
2 February 2015 Sam Sachdeva
Health authorities should implement a single Spine-based opt-out for identifiable patient data, covering all care settings, to uphold a promise to respect patients' rights, an NHS privacy watchdog says.
MedConfidential has released its proposal for a single opt-out following the Health and Social Care Information Centre's revelation that it is working to resolve a significant flaw with the wording of a current opt-out.
In a letter to the parliamentary health committee, the HSCIC said that patients who register a 'type two' objection - for those who object to information about them leaving the HSCIC in identifiable form for any reason, including direct care - "will not be approached for direct care services like e-prescribing, bowel screening, e-referrals or e-pathology reporting".
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HHS bolsters HIE, interoperability efforts with $28 million grant program
February 3, 2015 | By Dan Bowman
Interoperability has been a focal point of the Office of the National Coordinator for Health IT's efforts in recent months, as the Meaningful Use incentive program inevitably sunsets.
That trend continued this week at ONC's annual meeting in the District of Columbia. On Tuesday, for instance, U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell announced a two-year grant program for $28 million to advance the adoption and use of interoperable health IT tools and services to support health information exchange.
The agency will bestow as many as 12 new awards in the form of cooperative agreements to states, territories or state designated entities to continue work under the same intent as the original State Health Information Exchange Program.
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5 responses to proposed MU reporting period flexibility
Last week, CMS announced plans to modify legislation requirements that would reduce the meaningful use reporting period from one year to 90 days, responding to recommendations from numerous professional organizations.
CMS' announcement was met mostly with praise from the overall healthcare industry. Here are five comments and statements on the proposed meaningful use reporting period changes.
Steven J. Stack, MD, president-elect of the American Medical Association: EHRs are intended to help physicians improve care for their patients, but unfortunately, today's EHR certification standards and the stringent requirements of the meaningful use program do not support that goal and decrease efficiency. We hope the new rule will be issued expediently to provide the flexibility needed to allow more physicians to successfully participate in the meaningful use program and better align meaningful use with other quality reporting programs such as the Physician Quality Reporting System and the Value-Based Modifier. Additionally, we hope ONC will address problems with interoperability and support technologies that provide the ability for information to be exchanged, incorporated and presented to a physician in a contextual and meaningful manner.
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MU Pressure Eases; ICD-10 Uncertainty Continues
Scott Mace, for HealthLeaders Media , February 3, 2015
The good news is that CMS intends to relax the Meaningful Use reporting period for 2015 to 90 days. The bad news is that although the ICD-10 implementation deadline is on the horizon, the head of CHIME says he "wouldn't say it's 100% by any means."
Three perennial hot topics in healthcare IT were in play late last week, and for a change, there was some good news for providers.
First, CMS announced in a blog post that it intends to relax the Meaningful Use reporting period for 2015 to 90 days, as had been requested by CHIME for several months. This proposal must be submitted as a notice of proposed rulemaking (NPRM) and go through public comment, but there is every reason to believe it will survive the proposal stage and be rapidly finalized.
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Athenahealth, BIDMC Ink EHR Development Deal
Scott Mace, for HealthLeaders Media , February 3, 2015
The software provider will use Beth Israel Deaconess Medical Center's electronic health records system as the basis of a commercial product.
Athenahealth Tuesday said it has purchased WebOMR, a cloud-based, meaningful use stage 2-certified EHR. It was developed by and has been in use at Beth Israel Deaconess Medical Center across three decades.
Financial terms of the sale were not disclosed, but Boston-based Beth Israel Deaconess will continue to use WebOMR, retains licensing rights to the software for the next 20 years, and will make available five of its EHR developers to Athenahealth for the next year as Athenahealth pursues the development of a commercial product based on WebOMR.
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ONC Proposes 'Critical Action' to Advance Interoperability
FEB 1, 2015 12:41pm ET
The Office of the National Coordinator for Health IT on Friday released for public comment a draft Interoperability Roadmap aimed at promoting, facilitating, and enhancing the safe/secure exchange and use of health information nationwide.
The 166-page draft document proposes “critical actions for both public and private stakeholders that will advance our nation towards an interoperable health IT ecosystem, advance research and ultimately achieve a learning health,” according to ONC. Erica Galvez, ONC’s interoperability portfolio manager, told reporters in a press briefing that the draft roadmap is “built around” the concept of nationwide interoperability.
“There have been a number of successful efforts focused on exchanging health information and in some cases even achieving interoperability in regional settings, integrated delivery networks, and a number of sub-national venues,” said Galvez. “But, the reality is none of those efforts to date have scaled to the level we need them to scale in order for information to follow a person wherever they need it, regardless of geographic and organizational boundaries.”
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Interoperability: for real this time?
Posted on Feb 02, 2015
By Bernie Monegain, Editor-at-Large
When the Office of the National Coordinator released a draft health IT interoperability roadmap for the nation last week, it sparked optimism from some quarters, and also a 'wait-and-see,' approach from others.
The "time has come for us to be more explicit about standards," said ONC Chief Karen DeSalvo, MD, in a Jan. 30 press call detailing the roadmap, a 150-page plus document addressing everything from governance, standards and certification to privacy and security. "Health IT that facilitates the secure, efficient and effective sharing and use of electronic health information when and where it is needed is essential to better care, smarter spending and a healthier nation," DeSalvo said.
Glenn Tobin, of The Advisory Board Company, is among the optimists.
"I thought it was great," he said, when asked for his first reaction.
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A new business model for HIE?
Posted on Feb 02, 2015
By Mike Miliard, Editor
Technology challenges have some blame for the sorry state of health data exchange in the U.S., but it's also a matter of simple dollars and cents.
Niam Yaraghi, a fellow in the Brookings Institution's Center for Technology Innovation, has authored a new study in which he posits that economic disincentives – much more so than poor interoperability – are to blame for the fact that health information exchange hasn't yet caught on in the real and sustainable way it needs to.
In his Brookings paper, "A Sustainable Business Model for Health Information Exchange Platforms: The Solution to Interoperability in Healthcare IT," Yaraghi makes the case that better aligning economic incentives will spur the varied stakeholders across the care continuum – patients, providers, payers, medical data and providers – to more actively share health data.
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Lawmakers blast CMS, HHS for Healthcare.gov privacy issues
February 2, 2015 | By Katie Dvorak
In light of a report that Healthcare.gov might violate consumers' privacy rights by giving their personal data to third-party sites, lawmakers wrote a letter to Department of Health and Human Services Secretary Sylvia Mathews Burwell requesting information about the safety and security of the site.
Members of Congress had previously contacted the Centers for Medicare & Medicaid Services in September about numerous security vulnerabilities at Healthcare.gov.; they never received a response.
With the most recent letter, the lawmakers don't mince words, saying that overlooking implementation failures has real consequences for those who use the site. In addition, the letter says that a staff analysis reveals that some of those third-party sites include Google, Yahoo, Twitter and Advertising.com.
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Researchers fail to find savings with home telemonitoring among older adults
February 2, 2015 | By Susan D. Hall
Home telemonitoring failed to significantly save money over usual care among older adults with multiple chronic conditions, according to a study published in Telemedicine and e-Health.
The 12-month research project, from the Mayo Clinic and Purdue University, involved 205 people randomly divided into two groups.
The usual care group had access to office visits, phone services and home healthcare, while members of the intervention group used telemonitoring equipment plus vital-sign-measurement equipment such as weight scale, blood pressure, cuff, glucometer, and pulse oximeter. Vitals were transmitted automatically to the provider and monitored by a nurse and medical assistant.
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Jan 30, 2015
Obama Puts a Price on Precision Medicine
President Barack Obama’s administration will request $215 million for his precision medicine initiative in the budget he will propose next week for the federal fiscal year that starts October 1.
The initiative, disclosed by Obama last week in his State of the Union address, is designed to promote wider use of patient-specific medical care, with the aim of delivering new and more effective treatments for diseases.
Administration officials fleshed out some details of the precision medicine effort, outlining the initiative’s five objectives: More and better cancer treatments, creation of a voluntary national research cohort, public-private partnerships, regulatory modernization, and protecting privacy.
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Interoperability: Failure To Launch
Monday, February 2, 2015
On April 27, 2004, President George W. Bush proclaimed a bold goal for the nation: "Within the next 10 years, electronic health records will ensure that complete health care information is available for most Americans at the time and place of care, no matter where it originates. ... These electronic health records will be designed to share information privately and securely among and between health care providers when authorized by the patient."
More than 10 years later, most observers within the U.S. health care system and the health IT industry would agree that this goal of interoperability has not yet been achieved, and may not even be within clear sight. Although pockets of interoperability exist, the EHR systems used by inpatient, outpatient and ancillary providers generally cannot exchange patient data electronically, sometimes even among systems developed by the same EHR vendors. Although myriad interoperability standards exist on paper, real world connectivity between individual EHR systems still requires extensive custom interface development, attended by large and often prohibitive costs.
Last week, the Office of the National Coordinator for Health IT released a new draft 10-year nationwide interoperability roadmap, in which it aims to achieve basic electronic health data interoperability by 2017 and a full array of interoperable health IT products and services by 2024. Will we reach these objectives?
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ONC Unveils HIT Interoperability Roadmap
John Commins, for HealthLeaders Media , February 2, 2015
The first draft of the document identifies critical actions toward improving the way providers are paid and how information is shared more broadly and securely.
The federal government has issued a non-binding "draft Roadmap" that policymakers will use to identify technological standards for interoperability functions.
Draft 1.0 of the roadmap, released Friday, is the result of months of input from HIT experts and policymakers across the nation, and National Coordinator for HIT Karen DeSalvo, MD, pledged continued cooperation with all players across the healthcare spectrum as the process moved forward.
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Enjoy!
David.
