Again there has been just a heap of stuff arrive this week.
First we have:
March 23, 2009
By Jennifer Anderson
President Barak Obama sees an interoperable electronic system for patient records as the foundation for healthcare reform. On March 20, he tapped David Blumenthal, a Harvard University professor who is director of the Institute for Health Policy at Massachusetts General Hospital, to realize the vision. The president argued shortly before he took office that the system will “cut waste, eliminate red tape, and reduce the need to repeat expensive medical tests … [and] save lives by reducing the deadly but preventable medical errors that pervade our health care system."
Blumenthal faces a formidable challenge. In his role as national coordinator for health information technology, the professor will have nearly $20 billion to meet it. An Associated Press article notes that some experts worry the funding could pay for making paper records electronic, without giving doctors and hospitals much greater ability to connect.
Closing the gap between the vision and its realization will require countless ergonomic solutions to individual challenges. Dr. Blumenthal referred to one of the biggest – coaxing hundreds of thousands of doctors to quit using paper files and join the digital age – in an article he wrote with Jonathan Glaser, Chief Information Officer at Partners HealthCare, for the New England Journal of Medicine in 2007. According to the Wall Street Journal, Blumenthal and Glaser pointed out that for doctors, particularly those in solo or small practices, computerization conjures an image of “a waiting room full to bursting, a crashed computer, and a frantic clinician on hold with IT support in Bangalore.”
Lots more here:
http://www.ergoweb.com/news/detail.cfm?id=2323
Now this good doctor has taken on a pretty large job! Interestingly he has featured in the blog before:
See here:
http://aushealthit.blogspot.com/2009/02/international-news-extras-for-week_19.html
And here:
http://aushealthit.blogspot.com/2008/06/new-england-journal-of-medicine.html
Good luck David! You will need it!
Extra commentary here:
http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090323/REG/303239982/1029
By Joseph Conn / HITS staff writer
Posted: March 23, 2009 - 5:59 am EDT
Another excellent article with comprehensive links is here:
http://www.healthleadersmedia.com/content/230120/topic/WS_HLM2_TEC/Blumenthal-Spearheads-Health-IT-Reform.html
Les Masterson, for HealthLeaders Media, March 23, 2009
Second we have:
Rapid learning network would close some gaps in medical knowledge and cut costs
A group of health policy experts is calling on Congress and the Obama administration to support development of a rapid learning network that would share clinical information on Medicare and Medicaid patients in the hope of learning what medical treatments work best.
The experts have signed an open letter calling for state governments and the private sector to join with the federal government in financing the proposed network. The signers include Kenneth W. Kizer, architect of the often-praised health records system of the Department of Veterans Affairs; Karen Davis, president of the Commonwealth Fund; Janet Corrigan, president and CEO of the National Quality Forum, and Margaret O’Kane, president of the National Committee for Quality Assurance, among others.
Such a network would require greater spending on health information technologies for Medicaid, the state-operated program for low-income people, the letter said.
More here:
http://govhealthit.com/articles/2009/03/18/network-for-data-on-medicaid-medicare-patients.aspx
This is important stuff and these techniques can make a real difference over a reasonably short period of time. Search the blog for “rapid learning” to read more.
Third we have:
March 19, 2009 | Bernie Monegain, Editor
BOSTON – Online diabetes management programs may lead to improved patient knowledge, engagement and accountability, as well as better communication between patient and doctor, according to a new study by the Center for Connected Health, a division of Partners HealthCare.
The study is published in the March issue of the Journal of Diabetes Science and Technology.
About 23.6 million children and adults in the United States, or 7.8 percent of the population, have diabetes, according to the American Diabetes Association.
Based on the results of the pilot study, which examined a program called Diabetes Connected Health, the Center for Connected Health has initiated a randomized clinical trial involving 200 patients from six primary care practices affiliated with either Massachusetts General Hospital or Brigham and Women's Hospital.
More here:
http://www.healthcareitnews.com/news/online-diabetes-management-may-result-better-care-study-concludes
This is really an excellent study and the result shows again how e-Health can make a positive difference!
Fourth we have:
By Joseph Conn / HITS staff writer
Posted: March 23, 2009 - 5:59 am EDT
Responding to an accelerated timeline for standards development and the estimated tens of billions of dollars in government funding coming for information technology subsidies under the new federal economic stimulus legislation, the Certification Commission for Healthcare Information Technology has announced it will, in turn, speed up development and use of what it is calling “advanced technology certification programs” in its healthcare IT systems testing and certification program.
The new categories of accelerated testing criteria are in advanced clinical decision support and advanced security. They were added to the upcoming 2009-10 criteria development cycle, according to a CCHIT news release. Testing criteria for advanced clinical decision support and security already were on what the commission calls its “road map” for future development, but were not scheduled for completion until 2011, the CCHIT release said. They will join already scheduled advanced criteria for interoperability and quality improvement criteria for development in the current, 2009-10 cycle.
More here:
http://www.modernhealthcare.com/article/20090323/REG/303239981
It is good news they are accelerating the work. One wonders where the NEHTA equivalent is up to. Things seem to have become very quiet on that front.
Fifth we have:
By Andis Robeznieks
Posted: March 23, 2009 - 5:59 am EDT
As the old saying goes—popularly attributed to the late Sen. Everett Dirksen—“A billion dollars here, a billion dollars there, pretty soon you’re talking real money.”
If its campaign to get the healthcare industry to use the same swipe-card or bar-code technology that other industries have been using for decades is successful, the Medical Group Management Association calculates that it will knock about $1 billion off the nation’s healthcare bill each year by saving medical practices $872 million and saving hospitals nearly $176 million.
A majority of the savings would come from practices not having to process and resubmit claims denied by insurers after incorrect patient information was typed into a computer, according to the MGMA. It also includes the costs of not having to repeatedly photocopy the same card from a patient making multiple doctor visits along with eliminating the need to manually enter and update that patient’s billing information over and over.
“This will be a great leap forward into the middle 1970s,” says William Jessee, M.D., the MGMA’s president and chief executive officer. “There’s no good reason not to do this. If organizations are not doing this, we’ll be asking why.”
Vastly more here (Registration required):
http://www.modernhealthcare.com/article/20090323/MODERNPHYSICIAN/303159995
Sometimes some simple changes can actually make a big difference!
Sixth we have:
Doctors putting down the paper
Monday, March 23, 2009
By: Emily Bregel (Contact)
For Dr. Jacqueline Shaw, who admits she still sometimes struggles with her cell phone, relinquishing the prescription pad in favor of electronic prescribing hasn’t been easy.
“I had every excuse anybody could think of,” said the pediatrician at Family Health Services on Wilcox Boulevard.
But with the encouragement of her colleagues and the conviction that she can’t remain a “dinosaur” forever, Dr. Shaw cautiously has embraced an e-prescribing program, using software and laptops purchased last fall with help from a state grant.
Electronic prescribing allows doctors to send a prescription through a secure Internet connection directly to the pharmacy.
“This is going to actually be the future,” she said. “Everybody’s talking about ... centralized medical records, centralized information on patients. Why not embrace it?”
With an eye to cutting costs and decreasing medical errors, state officials are trying to put doctors on the fast-track to electronic prescribing with grants and a series of training sessions. Proponents say e-prescribing decreases medical errors that result from illegible doctor handwriting and adverse drug interactions.
Many e-prescribing systems can link a doctor immediately to a patient’s medical history, helping avoid drug interactions, said Melissa Hargiss, director of the state’s Office of e-Health Initiatives.
Many patients don’t know what drugs they’re on, she said.
“Getting the most information we can to the doctor at the point of care will actually help the doctor in making the proper decisions for that patient,” she said.
Lots more here:
http://timesfreepress.com/news/2009/mar/23/rx-going-digital/?local
This is a good summary of the state of play in e-prescribing on the ground in the US.
Seventh we have:
March 20, 2009
The New Mexico Legislature has approved legislation to recognize electronic medical records and signatures as legal medical records. Governor Bill Richardson (D) has indicated he will sign the bill.
The legislation, SB 278, also expands privacy protections for electronic medical records. It limits disclosure of information without patient consent unless the disclosure is permitted by state or federal law, required for emergency treatment, or necessary for the operation of a record locator service and health information exchange.
....
More information is available at nmlegis.gov.
--Joseph Goedert
More here:
http://www.healthdatamanagement.com/news/legislation-27905-1.html?ET=healthdatamanagement:e807:100325a:&st=email&channel=document_management
More incremental progress we see!
Eighth we have:
March 20, 2009 (Winnipeg, MB) - The Provincial Client Registry (CR) project was awarded second place in the Project Management Institute (PMI) 2009 Project of the Year Awards on February 10. The awards are handed out annually and recognize Manitoba projects that demonstrate a high level of project-management principles.
The CR is a joint effort of Manitoba eHealth and Manitoba Health and Healthy Living, supported by a consortium of partners including Canada Health Infoway, Sierra Systems, InfoMagnetics Technologies Corporation, and EDS (Electronic Data Systems). CR stores and links demographic and selected personal information such as a client’s name, address, date of birth and medical record number to identify individuals across health care facilities. This initiative is the first health information system project to involve all 11 Manitoba regional health authorities and CancerCare Manitoba.
“Many benefits have resulted with the implementation of Client Registry in Manitoba, including the adoption of registration best practices, introduction of tools to improve and continuously monitor data quality within and across organizations, facilitating processes for early assignment of newborn Personal Health Identification Numbers (PHINs), improving collaboration and co-operation within health information professionals across the province, and building the foundation for the Electronic Health Record,” says Diane French, Manager of Registry Integrity Unit, Manitoba eHealth.
With the CR in place, there has been a significant reduction of repeated information with approximately 80,000 duplicate charts having been merged. Identification from the CR will support the ability to link health records from various locations and sources without a patient having to provide personal information at each site they are treated at.
....
For more information on Manitoba’s Provincial Client Registry, please visit http://www.manitoba-ehealth.ca/ehr_CR.html
Full release here:
http://www.infoway-inforoute.ca/lang-en/about-infoway/news/news-releases/415-manitoba-client-registry-receives-project-of-the-year-award-
Seems at least one Canadian Province has got their NEHTA IHI equivalent up and running!
Ninth we have:
But some fear loss of privacy with U.S. health information network
By Matthew Hay Brown | matthew.brown@baltsun.com
March 23, 2009
As he looks for ways to pay for universal health coverage, President Barack Obama is placing a multibillion-dollar bet on electronic health records.
The goal is to get all of the nation's doctors to make the move from clipboard to computer by 2014, thus creating a national health information network that proponents from across the political spectrum say will improve care, advance medical knowledge and save the country tens of billions of dollars annually.
That future can be glimpsed in Dundalk, where H. Edward Parker has been a patient at Johns Hopkins Community Physicians for decades. Now the retired high school principal sits down next to his doctor as they use a computer program to review his history, look up the latest research and discuss new courses of treatment.
"We have much more meaningful communication" since his doctor's office adopted electronic health records in early 2007, Parker said. "It has made me much more of a participant in my own wellness."
Much more here:
http://www.baltimoresun.com/news/health/bal-te.md.healthtech23mar23,0,3627732.story
This is a good example of the more mature commentary we are now seeing on the HITECH (Stimulus) initiative.
Tenth we have:
CalPERS launches e-prescription pilot
Sacramento Business Journal - by Kathy Robertson Staff writer
The California Public Employees’ Retirement System will launch a pilot project in April to look at ways that electronic prescribing can improve patient safety and reduce health care costs, pension fund officials announced Monday.
Cosponsored by Anthem Blue Cross, Blue Shield of California and Medco Health Solutions Inc., the pilot program will continue through early 2010.
E-prescribing uses an automated data entry system such as a desktop computer, handheld device or personal computer tablet to generate prescriptions in a doctor’s office. The doctor then prints and faxes or electronically transmits the prescription to the pharmacy chosen by the patient.
.....
At the state level, health care reform proposals by Gov. Arnold Schwarzenegger would require e-prescribing by all California providers by 2010.
More here:
http://www.bizjournals.com/sacramento/stories/2009/03/23/daily14.html
The last line is the good one here. The Governator is going to compel e-prescribing by 2010. Not mucking about here!
Eleventh for the week we have:
Monday, March 23, 2009
Now that Healthcare IT is part of the stimulus and newsworthy, I receive many questions from reporters about the fundamentals of healthcare IT. Here's a primer with the Top 10 questions and answers:
1. Can you define EHR, EMR, PHR and PM in simple terms?
Electronic Medical Record - An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.
Electronic Health Record - An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff, across more than one health care organization.
Personal Health Record - An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
Practice Management - An application used to manage the physician business operations including scheduling, registration, and billing
2. How large is the unserved market for HIT?
There are 800,000 clinicians in the US. 17% have EHRs today. This leaves 664,000 who need EHRs. Over the next 5 years the early to mid-adopters will work hard to gain the full stimulus incentive amounts available in 2011-2012. Late adopters will gain the reduced stimulus available in 2013-2014. Resistors will begin receiving penalties in 2015.
More here:
http://geekdoctor.blogspot.com/2009/03/healthcare-it-primer.html
Read the answers to the other 8 questions at the URL above. A must read blog this one!
Twelfth we have:
Mike Klein and Peter Strombom
March 24, 2009
Following the announcement that Kaiser Permanente signed a $500M, 7-year data center outsourcing contract with IBM. WTN News sat down with Kaiser Permanente's, Senior Vice President and Chief Information Officer, Phil Fasano to discuss the rationale for this strategic decision. We also discussed his thoughts on Kaiser's vision for "real time health care delivery." Also covered were Fasano's vision on clinical transformation and adoption of Epic's electronic medical record, and accompanying KP HealthConnect, as well as patient to physician e-mail management. This is part one, of a two part series of an exclusive interview with WTN News.
WTN News: Was the decision to outsource Kaiser's Data Center a well researched and strategic decision for Kaiser?
Phil Fasano: We spent an awful lot of time and energy looking at our operations and looking at organizations around the world that had capabilities that could partner with us and help us to really accelerate the high performing IT function that we have at Kaiser. The goals of our data center project and outcomes we are hoping to achieve with IBM are really centered in this space and on ultimately improving a highly performing data center. IBM has expertise in that area we view as absolutely first rate. We also reviewed their capabilities as extraordinary in a lot of ways. IBM's partner capabilities along with our healthcare experience are unique in that it enhances our capabilities in our core operations. This will increase our overall performance that we are looking to achieve that are being defined as world-class.
More here:
http://wistechnology.com/fusioncio/article/5776/
A worthwhile read on how Kaiser is doing their Health IT – given it could be argued they are the best in the world at it!
Thirteenth we have:
A chip developed by European scientists simulates the learning capabilities of the human brain.
By Duncan Graham-Rowe
An international team of scientists in Europe has created a silicon chip designed to function like a human brain. With 200,000 neurons linked up by 50 million synaptic connections, the chip is able to mimic the brain's ability to learn more closely than any other machine.
Although the chip has a fraction of the number of neurons or connections found in a brain, its design allows it to be scaled up, says Karlheinz Meier, a physicist at Heidelberg University, in Germany, who has coordinated the Fast Analog Computing with Emergent Transient States project, or FACETS.
The hope is that recreating the structure of the brain in computer form may help to further our understanding of how to develop massively parallel, powerful new computers, says Meier.
More here:
http://www.technologyreview.com/computing/22339/?nlid=1885&a=f
Seems that the Deep Thought computer of the Hitchhikers Guide to the Galaxy is not as far off as we thought!
Fourteenth we have:
A 'connected' hospital is more efficient and can provide better patient services,
By: Suchit Leesa-ngunansuk
Published: 25/03/2009 at 12:00 AM
What do you look for when you have to go to hospital? The answer from patients will mostly be better and faster services.
Siriraj Hospital is investing 200 million baht in a new enterprise-wide hospital information system.
To improve the quality of life of patients, government hospitals are planning to become paperless - people need only bring patient ID card to access all hospital services - and use advanced technology to help lower medical costs and ameliorate the shortage of doctors and nurses.
With complaints from its patients for its slow services, one of the government's biggest hospitals, Siriraj Hospital, plans to invest 200 million baht for a new enterprise hospital information systems from iSOFT that will help reduce waiting times for picking up medicine by 30 to 40%. The average waiting time per patient is currently three to four hours.
According to the deputy dean of IT at Siriraj Hospital, Dr Viroje Chongkolwatana, the new system comprises five modules, including a patient index for administrative purposes and billing, and implementation of this first part of the system finished last month. The second and third phases cover clinical and maternity records for both in- and out-patients, and a pharmacy system.
Much more here (registration required):
http://www.bangkokpost.com/tech/technews/13961/it-for-better-healthcare
A Thai perspective on moving ahead with Health IT.
Third last we have:
Thursday, March 26, 2009
by George Lauer, iHealthBeat Features Editor
Health record banking, the "power-to-the-people" version of health information exchange, grew last week with the launch of three pilot projects in the state of Washington. With a statewide bank in the formative stages in Oregon and citywide projects under way in Louisville, Kansas City and Ocala, Fla., the idea of community repositories of electronic health records appears to be gaining traction.
Proponents say health record banking is preferable to provider-controlled health information exchanges because it better protects privacy, ensures stakeholder cooperation and is more financially sustainable.
In health record banks, the sponsoring organization -- so far, it's been a government agency -- collects, collates and displays patients' health records on a Web site. Existing records from physicians, hospitals, laboratories, pharmacies and other sources are included and subsequent records are added. Patients -- not health care providers -- control access to their health data.
Much more here:
http://www.ihealthbeat.org/Features/2009/Health-Record-Banks-Gaining-Traction-in-Regional-Projects.aspx
A useful summary of progress in the interesting area.
Second last for the week we have:
Obama says IT is critical to transforming healthcare
March 25, 2009 | Bernie Monegain, Editor
Selected quote.
"The same applies when it comes to information technologies and healthcare," Obama continued. "We know that healthcare is crippling businesses and making us less competitive, as well as breaking the banks of families all across America. And part of the reason is we've got the most inefficient healthcare system imaginable. We're still using paper. We're still filing things in triplicate. Nurses can't read the prescriptions that doctors have written out. Why wouldn't we want to put that on an electronic medical record that will reduce error rates, reduce our long-term cost of healthcare and create jobs right now?"
More here:
http://www.healthcareitnews.com/news/obama-says-it-critical-transforming-healthcare
Excellent presidential commitment despite the GFC etc!
Last for this week we have:
ARLINGTON, VA—Widespread adoption of health information technology is essential for healthcare reform, Robert Kolodner, M.D., national coordinator in the Office of the National Coordinator for Health Information Technology in the Department of Health and Human Services, told an audience at the 2009 Military Health Management Conference in January.
“We are not going to be able to reform healthcare, the ways we deliver healthcare or achieve those high quality efficient ways of delivering care without health IT,” Dr. Kolodner said.
While the Bush administration had pushed for the majority of Americans to have electronic health records by 2014, the Obama administration has the goal of computerizing all health records by that year.
Very much more here:
http://www.usmedicine.com/dailyNews.cfm?dailyID=446
Useful background to the US Strategic Plans for Health IT.
There is an amazing amount happening (lots of stuff left out). Enjoy!
David.
