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Cerner adds FHIR power
Posted on Apr 17, 2015
By Bernie Monegain, Editor-at-Large
Health IT giant Cerner is working with Geisinger Health System and xG Health Solutions, Geisinger's commercial spinoff, to enable the use of emerging SMART on FHIR industry standards. The idea is to facilitate use of software applications across open platform EHRs, such as Cerner Millennium.
Geisinger and xG Health will be able to use these new draft standards to deploy their apps to run inside Cerner Millennium and other FHIR-compliant EHR systems.
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A dispatch from HIMSS
Posted on Apr 15, 2015
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
Unfortunately, I was unable to attend HIMSS this year because a special request from Andy Grove, the former CEO of Intel. He asked me to serve with Roni Zeiger (Smart Patients, Google Health) and John Mattison (CMIO of Kaiser) as co-presenters for the first annual Marc Shuman Anti-Medical School Lecture in San Francisco, sponsored by the Grove Foundation. When Andy calls, you listen.
My second-in-command at BIDMC, Manu Tandon, attended HIMSS on my behalf and sent the following analysis of the key themes he experienced.
"Interoperability is big at HIMSS in 2015. The challenge of patient identification and finding the location of patient records are important informatics problems to solve.
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Survey: 50 percent of docs use smartphones, but 56 percent use desktops
While most clinicians carry one or more mobile devices for a variety of use cases, it’s still the case that no single screen is as popular as the desktop computer for physicians, according to a new survey released by Microsoft. The online survey of 402 U.S. physicians was conducted by YouGov.
Fifty percent of physicians used smartphones, 49 percent used laptop computers, and 23 percent used tablets, according to the survey, but 56 percent still used a desktop computer. Additionally, 55 percent still use a fax machine and 27 percent still use pagers. Thirty-nine percent still use paper.
The desktop was still the primary choice for physicians for many information-sharing use cases: 46 percent used it to communicate with colleagues or specialists, 40 percent used it to schedule surgeries, 39 percent used it to communicate with pharmacists, and 35 percent used the desktop to contact patients.
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HIMSS15: Federal Health Officials 'Optimistic' About Future of Health IT
Friday, April 17, 2015
CHICAGO -- On the final day of the Healthcare Information and Management Systems Society's annual conference, National Coordinator for Health IT Karen DeSalvo and acting CMS Administrator Andy Slavitt took the stage to detail federal efforts to leverage health IT.
With recent changes to the meaningful use program, the health IT implications of a new law to repeal the sustainable growth rate formula and a new report on health information blocking, the record-breaking 43,129 attendees at HIMSS15 were eager to hear from the top health officials on the administration's health IT plans.
DeSalvo said, "I'm so optimistic about the bright future we have" in leveraging health IT to improve health.
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Switching EHRs Adds Functionality but Not Always Satisfaction
Joyce Frieden, News Editor, MedPage Today , April 17, 2015
Providers who switch from one electronic health record to another do so to add more functionality, but often it doesn't make them more satisfied, according to a recently published survey. From MedPage Today.
CHICAGO -- Providers who switch from one electronic health record (EHR) to another do so to add more functionality, but often it doesn't make them more satisfied, according to a recently published survey.
"I love my EHR, but I work with a lot of physicians who don't," Kenneth Adler, MD, MMM, a family physician in Tucson, Ariz., said here Thursday at the annual meeting of the Healthcare Information and Management Systems Society. "I bought them an EHR and they still blame me for it."
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Inherent Risks of Health IT, EHRs Putting Patients in Peril
APR 2, 2015 7:53am ET
As the adoption of health information technology continues to grow industry-wide, the potential for health IT-related harm to patients and even death will increase unless risk-reducing measures are put into place by healthcare organizations.
That’s the dire warning of a new alert from The Joint Commission that identifies specific types of sentinel and adverse events, describes their common underlying causes, and recommends steps to reduce risk and prevent future occurrences. According to the alert, health IT has inherent risks. Specifically, the document cites “incorrect or miscommunicated information entered into health IT systems” and “interfaces built into the technology” as contributing to adverse events, which “may occur through the use of electronic health records and related technologies.”
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Lack of Funds from Congress Leaves Health IT Safety Center in Limbo
APR 16, 2015 6:47am ET
The Office of the National Coordinator for Health Information Technology’s plan to establish a $5 million Health IT Safety Center remains up in the air due to Congress’ refusal to authorize funds for the center.
“It is not funded—that’s a reality,” Andrew Gettinger, M.D., acting director of ONC’s Office of Clinical Quality and Safety, told Health Data Management at HIMSS15 in Chicago. “We would like it to be funded. We have put it in our budget. We will continue to put it in our budget.”
The $5 million for the Health IT Safety Center was part of the Department of Health and Human Services’ $92 million budget request for ONC in fiscal year 2016. Had the agency secured the funding, Gettinger said that ONC would have “stood up” the Health IT Safety Center next year, “but Congress chose not to fund it.”
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Clinicians create own customized alerts with new CDS tool
April 14, 2015 | By Marla Durben Hirsch
A new approach to clinical decision support (CDS) will allow physicians and others to craft their own CDS rules based on their personal experiences with patients, according to an April 13 announcement from the Regenstrief Institute and Indiana University.
The approach, called Rule Authoring and Validation Environment, or RAVE, was developed by the Regenstrief Institute and tested at Eskenazi Health; it is being presented at the Healthcare Information and Management Systems Society's annual conference in Chicago this week.
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Usability, interoperability remain barriers to HITECH goals
April 16, 2015 | By Susan D. Hall
The HITECH Act has stimulated adoption of digital infrastructure in healthcare to improve care and reduce costs, but problems with usability, interoperability and the fee-for-service paradigm require further government action, according to research published in the Journal of the American Medical Informatics Association.
The authors conducted 47 interviews with government, health policy and HIT experts, as well as physicians, payers, patient advocates, and vendors from across the United States.
There was widespread acknowledgement that HITECH was directly responsible for catalyzing adoption of EHRs in hospitals and ambulatory settings. Physicians, however, expressed concerns about the usability of EHRs and computerized decision support systems, seeing them as immature technologies written on old code bases originally designed for hospital billing, according to the report.
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ONC touts 'significant' boost in health data exchange by hospitals
April 16, 2015 | By Katie Dvorak
From 2008 to 2014 the healthcare industry saw major growth in the adoption of electronic medical records and the ability to exchange information.
In a nationwide survey of non-federal acute care providers, the American Hospital Association found that last year, three out of four hospitals acquired a basic EHR system, according to a brief from the Office of the National Coordinator for Health IT on the survey.
That number is a huge jump from 2013, when only 27 percent of hospitals had EHRs, and an eight-fold increase since 2008, according to the survey.
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Hospitals Monitor ICU Patients Virtually, From Many Miles Away
Some hospital systems are using a sort of virtual command center to monitor their sickest patients from dozens or even hundreds of miles away. Virtual intensive care units, also called eICUs, are a way to bring the expertise of a major medical center to remote hospitals in rural areas.
In the intensive care unit at a small hospital in Lincolnton, Richard Gilbert thought he had two TVs in his room. The screens both look down at his hospital bed.
"I was sitting here watching television and then all of a sudden the other one comes on, and I thought, well, how’d I turn that on?" he said with a laugh.
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IBM launches new health unit, teams up with Apple, J&J, Medtronic
(Reuters) - International Business Machines Corp, deepening its partnership with Apple Inc to make use of health information gathered by millions of Apple devices, is creating a unit dedicated to providing data analytics to the healthcare sector.
Its new Watson Health unit plans to aggregate health information from a large number of devices and providers in the cloud and offer insights to health companies such as Johnson & Johnson and Medtronic, which can then integrate results into services they sell to healthcare companies.
IBM said it will create headquarters for the unit in Boston with 2,000 employees, including about 75 medical practitioners. IBM also said it bought two health technology firms, Explorys and Phytel, for an undisclosed amount, to add to its skills in health data analytics.
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A genomic CDS takes shape at Intermountain
Posted on Apr 15, 2015
By Gus Venditto, VP, Content
Breakthroughs in genetic research represent an exciting frontier for medicine. But in these early stages, the need for more clinical data is clear. And the obvious place to look for this data is in hospital EHRs.
To explore the potential from merging these disparate collections of data, Intermountain Healthcare and Intel set out to build a clinical decision support (CDS) application based on all of the information available to the hospital.
“Today, we can do alerts with clinical decision support in our EHR. And we collect family health records that show risk factors that show the history of their relatives. When did they die? What did they die from? And we can look at genomic data, to see if a specific genomic variant sets a risk factor by itself,” said Grant Wood, senior IT strategist with Intermountain Healthcare’s Clinical Genetics Institute. “What if we brought all three together to form a combined data set? Could we define new risk algorithms and put them in a decision support application?”
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EHR plug-and-play capabilities emerging from SMART on FHIR apps
Posted on Apr 14, 2015
By Frank Irving, Editor, Medical Practice Insider
Have a great idea for a new way to interact with EHR data? An emerging platform enables you to build your own app or use another from an open community.
The name says it all when it comes to an open, standards-based app platform called SMART — Substitutable Medical Applications & Reusable Technologies.
The SMART project was started in 2010 with a four-year, $15 million grant from the Office of the National Coordinator for Health IT, in broad terms to build an app platform for healthcare.
"The idea is that we wanted to support apps that could be chosen by clinicians. The app could plug into their existing EHR system, and then if a better app came along, you could get rid of the old one and swap the new one in," explained Josh Mandel of Boston Children's Hospital, the architect for the collaborative SMART platform team.
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6 in 10 Health Data Breaches Due to 'Criminal Activity'
Cheryl Clark, for HealthLeaders Media , April 15, 2015
Researchers discover that in the majority of incidents, the security and privacy of patient health data is compromised by the theft of paper or electronic medical records rather than computer system hacking.
Theft, illegal hacking, and other breaches of protected health information have compromised 29 million medical records in 949 incidents between 2010 and 2013, spelling out a crying need for better data security, according to a report published in JAMATuesday.
"Most data breaches resulted from overt criminal activity," says the report, written by Vincent Liu, MD, of Kaiser Permanente Division of Research, Mark Musen, MD, of Stanford Center for Biomedical Informatics Research, and Timothy Chou of Stanford's Department of Computer Science.
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Unauthorized Breaches of Medical Records on the Rise
Researchers call for enhanced security as more patient information is stored online
TUESDAY, April 14, 2015 (HealthDay News) -- Breaches in data security exposed more than 29 million health records to potential criminal misuse between 2010 and 2013, a new study found.
Most of the breaches occurred due to simple theft of a computer, with some criminal grabbing a tablet or laptop that contained sensitive and unencrypted medical records, researchers at Kaiser Permanente in California and Stanford University found.
But electronic health records also are increasingly vulnerable to exposure through hacking, the researchers reported.
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e-Referral Service 'live on 15 June'
14 April 2015 Rebecca McBeth
The new NHS e-Referral Service will go-live on 15 June as part of plans to replace all paper-based referrals.
The Health and Social Care Information Centre has confirmed the new date after a planned November 2014 go-live for the electronic booking service was pushed back to spring 2015.
At the time, the HSICIC said the delay was down to the need for “significant test, assurance and defect resolution activity” to be completed.
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EMRs can be costly in malpractice suits
Posted on Apr 13, 2015
By Mike Miliard, Editor
The numbers drew audible gasps from the audience: $1.7 million here, $7.5 million there.
These were damages hospitals had to pay plaintiffs as a result of malpractice cases whose verdicts hinged directly on the documentation – or lack thereof – in electronic medical records.
At HIMSS15 on Monday, Keith Klein, MD, clinical professor of medicine at UCLA, presented four real-world cases where providers were penalized big bucks thanks to deficient use of their EMRs.
His talk, "Medical-Legal Cases That Went South, Costing Over $30 Million," was a stark reminder that while EMRs can improve care, they can also, when used improperly, leave health organizations vulnerable to huge penalties.
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Technology calls for strategic master design plan for clinical setting
April 14, 2015 | By Susan D. Hall
Technology can pose a challenge healthcare when accommodating new tools in the clinical space, where providers must prioritize patient safety and workflow, according to an article at Hospitals & Health Networks.
Health systems must create a strategic technology master plan that aligns with their vision and mission, Debbie Gregory, R.N., a senior clinical consultant with engineering firm Smith Seckman Reid Inc., says in the article.
She urges organizations to create a technology governance committee to guide the process, to review technology investments and service contracts, and evaluate effectiveness and look for potential duplication. Providers should develop a manageable clinical communication strategy that encompasses nurse call, mobile devices and alarm management and focus on consolidating and streamlining devices.
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IBM, Apple partner to anaylze medical data
April 14, 2015 | By Sean West
As part of its partnership with Apple, IBM is taking advantage of health information gathered by the tech giant's devices to create its new Watson Health unit, designed to provide data analytics, Reuters reported.
Watson Health will aggregate health information from devices and providers in the cloud and give insights to health companies such as Johnson & Johnson and Medtronic. IBM will open a unit headquarters in Boston with 2,000 employees, including 75 medical practitioners.
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Confidentiality Shortcomings With EHR Use for Parents, Teens
Modifications needed for EHRs and PHRs to meet confidentiality requirements of parents, teens
MONDAY, April 13, 2015 (HealthDay News) -- Electronic health records (EHRs) and personal health records (PHRs) require significant modifications in order to meet the confidentiality requirements of specific populations, including parents and adolescents, according to a perspective piece published online April 13 in Pediatrics.
Noting that confidential information shared by adolescent patients and parents is accessible in EHRs and PHRs, Fabienne C. Bourgeois, M.D., M.P.H., from the Boston Children's Hospital, and colleagues discuss ways to overcome these challenges in protecting confidentiality.
The researchers note that EHRs have not been designed to allow all types of information that require special consideration to be flagged as sensitive. Furthermore, PHRs should be designed with different access tools so that users can have different views of the data. These shortcomings have been ignored in the rapid adoption of PHRs. Many health care centers have chosen to discontinue access for parents of adolescents, suppress health information, or revoke all access to the PHR, thereby limiting the risk of disclosure but impeding access to health information. Some centers have a process whereby the adolescent consents to sharing information in the PHR with their parents and can discontinue information sharing at any point due to a confidential visit.
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HIMSS15: Patient Engagement Tug-of-War
Tuesday, April 14, 2015
CHICAGO -- Patient engagement seems to be the catchphrase of this year's Healthcare Information and Management Systems Society's annual conference. It was a major theme in Monday's keynote speech, dominated conversations in conference hallways and was a key part of pitches in the exhibit hall.
On the one hand, it's been a long time coming. Patient advocates for years have been pushing for the country's largest health IT conference to have a bigger patient focus. On the other hand, the timing is interesting, given that CMS on Friday proposed a rule to significantly scale back the meaningful use requirement for patients to electronically download, view and transmit their medical records. Under the proposal, released in response to provider pushback, only one of an eligible professional's patients must do so, down from 5% of patients.
The competing messages have created somewhat of a tug-of-war over what patient engagement really means.
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Technology and the Patient Experience
Scott Mace, for HealthLeaders Media , April 14, 2015
In addition to cutting-edge tools and devices, some healthcare leaders are finding that even putting consumer feedback on a website can play a role.
All too often, technology manages to get in the way of superior patient experiences in healthcare. Despite the benefits technology brings to healthcare, it also can intrude on doctor-patient communications. Too much gathered information remains locked up, unavailable to the public. But at more and more healthcare organizations, attention is shifting to leveraging technology to make the healthcare experience better and more transparent.
Dignity Health, a San Francisco–based system that employs 56,000, has started using Google Glass, along with technology and services provided by startup Augmedix, in patient encounters. "It was with great delight that I got to bring something to bear that actually had a different experience for our physicians," says Davin Lundquist, MD, CMIO for physician integration at Dignity.
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eHealth Exchange Claims Title of Largest U.S. HIE Network
APR 12, 2015 10:37pm ET
The eHealth Exchange, an initiative of the non-profit Healtheway collaborative focused on advancing the implementation of interoperable nationwide health information exchange, has the distinction of being the largest HIE network in the United States.
Healtheway CEO Mariann Yeager told a HIMSS15 Health Information Exchange Symposium on Sunday that as the “largest data sharing network” the eHealth Exchange connects 30 percent of all U.S. hospitals, supports 10,000 medical groups, 8,200 pharmacies, 900 dialysis centers, four federal agencies, and more than 100 million patients around the country—about a third of America’s population.
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HIMSS Survey: Informatics Nurses Leaving Mark on Health IT
APR 12, 2015 10:48pm ET
Informatics nurses are having a positive impact on the health information technology environments in which they work. That’s the finding of a new survey of 576 respondents released at the HIMSS15 conference in Chicago.
The 2015 HIMSS Impact of the Informatics Nurse Survey, which follows up on research conducted in 2009, addresses several areas such as the impact that informatics nurses bring to the clinical systems process at their healthcare organizations, as well as their impact on quality of care and their role with respect to emerging technologies.
According to the survey’s respondents, informatics nurses bring greatest value to the implementation phase (85 percent) and optimization phase (83 percent) of the clinical systems process. While implementation was also the top item identified in the 2009 study, this year’s respondents were much more likely to indicate that informatics nurses would bring value to the optimization process. In addition, those surveyed also reported that informatics nurses have a high degree of impact on workflow, patient safety and user acceptance.
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ONC releases updated health IT privacy and security guide
April 13, 2015 | By Katie Dvorak
The Office of the National Coordinator for Health IT this morning issued a new version of its privacy and security guide to help healthcare providers better understand how to integrate the requirements into their practices.
The Guide to Privacy and Security of Electronic Health Information has new information on Medicare and Medicaid electronic health record incentive programs and on HIPAA Privacy, Security and Breach Notification Rules.
The guide is the first step toward fulfilling the commitment made by the ONC in its Interoperability Roadmap to foster better understanding in the industry of how security regulations in place help support interoperability, Lucia Savage (pictured right), ONC's chief privacy officer, writes at the agency's Health IT Buzz Blog.
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A new way to make EHR notes
Posted on Apr 12, 2015
By Mike Miliard, Editor
Generally, he's not a fan of how little they've evolved in recent years: Most systems "pretty much look the way they looked at the turn of the century, in 2000," he says.
More specifically, he has a problem with an original sin of EHR design: the fact that "we have elements in EHRs carried over from days of paper."
That skeuomorphism – tabs, notes – sells short the potential for digitized patient records, says Shorr, chief medical information officer at Apex Data Solutions.
Shorr has more than four decades of EHR development experience; he was on the founding team of the Indian Health Services' customizable health information system, Resource and Patient Management System (RPMA) and is veteran informaticist.
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Even as EHR proficiency rises, enthusiasm dips
Posted on Apr 13, 2015
By Tom Sullivan, Executive Editor, HIMSS Media
Doctors have become better at using electronic health records software in the last two years but, fewer physicians believe EHRs actually improve care.
Whereas 62 percent of doctors in 2012 believed their EHR helped improve patient care, only 46 percent answered the same way in 2015, according to research that Accenture published on Monday.
More specifically, 72 percent of respondents indicated that their EHR reduced medical errors and 58 percent said they improved outcomes in 2012 – while those numbers dipped to 64 and 46 percent, respectively.
The takeaway?
“This is a legitimate recognition that improving patient care is about more than just technology,” said Kaveh Safavi, MD, lead of Accenture’s global health business. “The kind of technologies that are going to be useful are bigger than electronic health records.”
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Survey: Docs Better at Using EHRs, But See Little Benefit
APR 13, 2015 2:41pm ET
While most physicians have become adept at using electronic health records in their practices, they are not sold on the ability of EHRs to aid their treatment decisions, reduce medical errors or improve outcomes.
Those are among the findings of a survey from consultancy Accenture of about 600 doctors in the United States. Though Accenture’s 2015 survey found health IT use among physicians has averaged double-digit growth compared to a similar 2012 survey, fewer physicians believe that EHRs have improved treatment decisions (46 percent in 2015 vs. 62 percent in 2012), reduced medical errors (64 vs. 72 percent) and improved outcomes (46 vs. 58 percent).
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CDC to Launch Ebola Mobile Training App for Clinicians
The Centers for Disease Control and Prevention (CDC) will soon launch an Ebola mobile app that provides intuitive coaching to clinicians on CDC’s guidelines for proper use of personal protective equipment (PPE) to prevent transmission of Ebola.
Powered by 22otters’ innovative, speech-enabled and animated, step-by-step mobile coaching technology, will allow healthcare workers to access easy-to-follow directions for putting on (donning) and removing (doffing) PPE and a powered air purifying respirator (PAPR) to ensure that they are following the latest CDC guidelines to prevent transmission of Ebola (for an example of the app’s coaching visit http://www.22otters.com/video/ppevid.mp4). Following the initial Ebola app release, 22otters will release a variant of the app allowing training progress tracking and content modules customized for providers.
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EHR Data 'Blocking' Hobbles HIT, Says ONC
John Commins, for HealthLeaders Media , April 13, 2015
Technology vendors, hospitals, and health systems restrict data access under the guise of security and confidentiality, but it can be challenging to identify and differentiate information-blocking from more benign impediments, says an ONC report.
The federal government's $28 billion investment in health information technology interoperability is undermined by vendors and providers who don't want to share data with perceived competitors, a new study says.
In a report requested by Congress, the Office of the National Coordinator for Health Information Technology said that "information blocking" is a significant problem that is likely to get worse as expectations and the capabilities for HIT mature and improve.
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Enjoy!
David.
