The question was:
What Do You Think Of The Gillard Election Campaign E-Health Announcement?
Visionary and A Vote Changer
- 5 (19%)
Pretty Good
- 5 (19%)
Neutral
- 2 (7%)
Slightly Off Target
- 6 (23%)
Really Disappointing
- 8 (30%)
Votes : 26
I think it is fair to say there was a split about all this – similar to the way the vote from yesterday played out!
Again, many thanks to all those who voted!
David.
Here are a few I have come across this week.
Note: Each link is followed by a title and a paragraph or two. 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.
-----
http://www.fortherecordmag.com/archives/080210p10.shtml
August 2, 2010
By Alice Shepherd
For The Record
Vol. 22 No. 14 P. 10
Critics wonder what good it is to invest in EHR technology if it fails to engender itself to users who feel betrayed by its lack of intuitiveness.
EHR systems promise to increase efficiency and productivity, reduce costs, provide 24/7 accessibility to medical records, and improve clinical outcomes. Each day, about 300 vendors vie for market share, adding bells and whistles to already comprehensive product suites. Yet, if EHRs are so great, why isn’t every provider singing their praises? The problem, some say, lies not with functionality but with usability.
Stuck in the Past
While EHRs provide numerous benefits, users are sometimes frustrated with the time and effort it takes to enter information. “At this time, most providers are not realizing a productivity increase if they switch from paper to electronic records because it takes much longer to enter data,” says Jiajie Zhang, PhD, the Dr. Doris L. Ross professor and associate dean of research at the University of Texas Health (UT Health) Science Center at Houston. Zhang is also the principal investigator of UT Health’s National Center for Cognitive Informatics and Decision Making in Healthcare, which received a $15 million stimulus grant to conduct research to advance the adoption and meaningful use of HIT.
“Usability is a huge barrier to EHR adoption,” adds Eric Ford, PhD, the Forsyth Medical Center professor of healthcare management at the University of North Carolina in Greensboro. “In their current format, EHRs are cognitively burdensome and labor intensive to use. While physicians find that receiving lab and radiology reports electronically is a great time-saver, having to type formerly handwritten material is slow, and making selections from drop-down menus takes too many clicks. It’s still easier and quicker to write a note than to codify a diagnosis in an EHR. Science and industry need to improve the products dramatically.”
Ford and Zhang compare the current state of EHRs with personal computing using DOS 20 years ago. “People had to remember commands, like Shift + F4, and had cardboard labels above the keyboard to remind them of the most common commands,” says Ford. “Since then, consumer products have become far more usable, but that hasn’t happened yet in healthcare.”
-----
http://govhealthit.com/newsitem.aspx?nid=74420
By Mary Mosquera
Wednesday, August 11, 2010
Healthcare providers who already use electronic health records urged a federal health IT advisory panel last week to add more goals for improving patient care coordination into the meaningful use financial incentive plan.
These include sharing information about the medications that they prescribe their patients and merging them into their electronic records as patients obtain treatment from multiple physicians.
The resulting medication reconciliation will improve coordination of care and patient safety by avoiding duplication and potential adverse drug effects, according to one of the physicians testifying at August 5 meeting of the Health IT Policy Committee’s meaningful use work group.
-----
Department of Health and Human Services honored Text4baby messaging service, which has more than 64,000 subscribers.
By Elizabeth Montalbano, InformationWeek
Aug. 9, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226600244
The Department of Health and Human Services (HHS) has granted an innovation award to a mobile application that provides health information for expecting mothers.
Text4baby, which sends weekly health information to pregnant women, is one of three recipients of the department's HHSInnovates award, according to a White House blog post by Hillary Chen, a policy analyst in the White House Office of Science and Technology Policy.
A private-public partnership driven by federal CTO Aneesh Chopra developed Text4baby, which went live in February. The application has more than 64,000 subscribers, who receive free text messages providing pregnancy-health advice every week. More than 3.5 million messages have been sent since the service went live.
-----
Lax handling of data, storage of it, and access to databases biggest culprit
By Ericka Chickowski, Special To Dark Reading, DarkReading
Aug. 10, 2010
URL:http://www.darkreading.com/story/showArticle.jhtml?articleID=226600307
Healthcare data breaches have swollen in 2010: Identity Theft Resource Center reports show that compromised data stores from healthcare organizations far outstrip other verticals this year. According to figures updated last week, healthcare organizations have disclosed 119 breaches so far this year, more than three times the 39 breaches suffered by the financial services industry.
Though many of these breaches aren't necessarily caused directly by unauthorized access or hacking of healthcare databases, some experts believe that the high numbers (PDF) are due to lax handling of how data is stored and accessed within these databases. This atmosphere, along with the extreme portability of healthcare data due to consumer devices and laptops and increasing numbers of malicious insiders seeking to profit from electronic medical records (EMRs) and other patient data, has formed a poisonous combination within the industry.
-----
http://fortherecordmag.com/archives/080210p14.shtml
August 2, 2010
Selling Physicians on the Value of Speech Recognition
By Lisa A. Eramo
For The Record
Vol. 22 No. 14 P. 14
To avoid a lackluster reception, experts recommend several steps healthcare organizations can implement to obtain staff buy-in.
At Rockingham Memorial Hospital (RMH) in Harrisonburg, Va., all the tell-tale signs to justify using speech recognition were present: a failing end-of-life legacy dictation system, increasing dictation demands, escalating costs, and overall physician dissatisfaction with transcription services. The hospital knew it needed to make the switch, but first it needed to figure out how to get physicians on board.
“Physician buy-in is critical to the success of any clinical documentation process,” says Mike Rozmus, chief information officer (CIO) and vice president of information services at RMH. In 2008, he organized a transcription task force to examine alternatives to what he says was a failing transcription model that included a combination of insourced and outsourced services.
-----
http://ehr.healthcareitnews.com/blog/hit-safety-and-security-concerns-persist
By Jeff Rowe, Editor
"'In this world,” Ben Franklin once famously wrote to a French acquaintance, “nothing can be said to be certain, except death and taxes."
After reading two recent sets of comments from healthcare sector stakeholders, we can’t help but wonder if even a cursory exposure to the world of HIT might lead Mr. Franklin to add to his list of certainties.
The first comment comes from The Leapfrog Group, a watchdog organization which, in the wake of the new Meaningful Use rule, praised federal policymakers for a “good first step”, but then voiced disapproval for what it sees as a lack of attention to HIT safety issues.
-----
Four Massachusetts community hospitals are investigating how thousands of patient health records, some containing Social Security numbers and sensitive medical diagnoses, ended up in a pile at a public dump.
The unshredded records included pathology reports with patients’ names, addresses, and results of breast, bone, and skin cancer tests, as well as the results of lab work following miscarriages.
By law, medical records and documents containing personal identifying information must be disposed of in a way that protects privacy, and leaving them at a dump is probably illegal, privacy lawyers and hospital officials said. Violators face steep fines.
A Globe photographer discovered the records July 26 when he was dumping his trash at the Georgetown Transfer Station. When he got out of his car, he said, he saw a huge pile of paper about 20 feet wide by 20 feet long. Upset that the paper wasn’t being recycled, he looked more closely.
-----
http://www.modernhealthcare.com/article/20100812/NEWS/100819978
By Joseph Conn / HITS staff writer
Posted: August 12, 2010 - 11:30 am ET
Part one of a two-part series.
Health information technology in current use is incapable of providing the level of privacy protection that some patients may desire, so it is important for federal policymakers as well as healthcare providers not to oversell the limited protections that are available, according to a federal privacy and security advisory panel.
In fact, providers should consider discussing privacy limitations with patients instead.
"I think the conclusion we can draw is if we really want to maintain the patients' sense of trust, we shouldn't let them conclude that they have more protection," said Wes Rishel, a vice president in the healthcare provider research practice of Gartner, an IT market-research firm.
Rishel is a member of the privacy and security Tiger Team, a special work group of the federally chartered Health IT Policy Committee. The committee was created under the American Recovery and Reinvestment Act of 2009 to advise HHS on healthcare policy matters.
-----
August 12, 2010 — 11:14am ET | By Neil Versel
We've often reported how EMRs represent vast, untapped sources of clinical and business intelligence. A system developed at Massachusetts General Hospital to extract EMR data for radiologists may be able to help far beyond imaging departments, according to new research published in the Journal of the American College of Radiology.
"The potential impact of advanced EMR search tools is by no means limited to radiology and in fact many departments in the hospital and outpatient clinic may benefit from these capabilities," lead author Dr. Michael Zalis, a diagnostic radiologist at Mass General, says in an American College of Radiology press release.
-----
http://www.govhealthit.com/newsitem.aspx?nid=74427
By Mary Mosquera
Wednesday, August 11, 2010
The Veterans Affairs and the Defense departments have agreed on a single common personal identifier, one of the keys to its efforts to build an electronic record that can be follow military service members throughout their lifetimes.
The agreement is a significant step toward making the complex Virtual Lifetime Electronic Record (VLER) project a reality because it will identify a service member whether they are seeking healthcare services or payment benefits and on active duty or retired, according to a senior VA official.
-----
Thursday, August 12, 2010
by Protima Advani
The much-awaited final rule defining the first stage of "meaningful use" of electronic health records -- a requirement that hospitals and eligible professionals (EPs) must meet in order to qualify for the Medicare and Medicaid incentives -- is finally here. Overall, the final definition relaxed the meaningful use criteria for hospitals and physicians, expanded the eligibility requirements making more entities eligible for incentives and clarified critical details surrounding the incentive program payout schedules. Detailed below are the most salient changes to the meaningful use requirements and their implications for health care providers aiming to collect the meaningful use incentives.
-----
http://healthcareitnews.com/news/it-allows-docs-see-patient-%E2%80%9Cfirst-touch%E2%80%99
August 10, 2010 | Molly Merrill, Associate Editor
CINCINNATI – Today some ambulances come equipped with telecommunciations technology that allows in-transport contact with physicians. But even the minutes between when a patient is loaded into the ambulance, or out and into a care setting, can leave room for miscommunications, according to one expert.
That is why Hamilton Schwartz, MD, led an initiative to find a technology that would allow his team access to the patient from the moment of pick-up until the patient was physically in the same room with the physician. Schwartz is a board certified emergency room pediatric practitioner, who serves as the medical director of Statline, a division of the Cincinnati Children’s Hospital Medical Center’s Emergency Department that serves as the hospital’s interface with emergency medical service providers and ambulance transport teams. After hearing about Scottsdale, Ariz., based GlobalMedia, Schwartz contacted the telemedicine company and they began a two-year collaboration.
-----
http://www.ehealtheurope.net/news/6129/welldoc_diabetesmanager_gets_approved
05 Aug 2010
WellDoc, a specialist in mobile health applications, has received FDA clearance for its WellDoc DiabetesManager System aimed at patients with type 2 diabetes.
The United States Food and Drug Administration (FDA) 510(k) clearance to will enable the firm to market the WellDoc DiabetesManager System to healthcare providers and their adult diabetes patients.
WellDoc’s system offers automated clinical coaching and behavioural algorithms driven by real-time patient data. Patients and their healthcare professionals can configure specific parameters and extend their care beyond traditional office visits by using a mobile phone application and the Internet.
-----
http://www.ehealtheurope.net/news/6142/french_health_record_live_by_december
09 Aug 2010
The delayed French electronic health record, Dossier Medical Personnel (DM-Personnel), will be launched by the end of the year, the agency responsible for the programme has said.
The EHR will allow patients to organise their health records for consultations with their GP and other healthcare providers and give them access to medication histories and a summary of recent appointments.
The second part of the programme, the Dossier Medical Patient (DM-Patient), will be developed over the next few years to allow medical records to be shared among healthcare professionals.
-----
Current e-health record software fails to help clinicians identify patients who need additional services, finds government report.
By Nicole Lewis, InformationWeek
Aug. 11, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226700051
As doctors increasingly extract more data from the health IT they've deployed, a new study finds that software that tracks population health at physician practices is very limited.
The report, "Practice-Based Population Health: Information Technology to Support Transformation to Proactive Primary Care," is based on interviews with 18 physicians and nine clinicians and other office staff to find out if they are using technology that collects data on practice-based population health (PBPH).
Published last month by the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ), the report defines PBPH as an approach to care that uses information on a group of patients within a primary care practice or group of practices to improve the care and clinical outcomes of patients within that practice.
-----
http://www.who.int/goe/ehir/2010/10-august-2010/en/index.html
:: Sustaining innovation in telehealth and telecare (2010 - UK NHS, Dept of Health, The King's Fund)
This paper, the first in a series of WSDAN briefing papers, looks at how telehealth and telecare innovations are being used in health and social care. It considers the range of innovative approaches that have been developed, giving some practical examples. We identify some of the key challenges to the adoption of technology-based approaches to care, and suggest some strategies to overcome these challenges, so that telehealth and telecare innovations may be sustained. The ‘References’ and ‘Resources’ sections at the end of the paper provide useful links to key documentation, innovations and evidence.
-----
- 08/09/10 04:42 PM ET
Preventable medical errors cost the country $19.5 billion in 2008 — or roughly $13,000 for each avoidable case, according to a report published Monday by the Society of Actuaries (SOA).
And that number is likely low, according to consultants at Milliman, who crunched the data.
"We used a conservative methodology and still found 1.5 million measureable medical errors occurred in 2008," says Jonathan Shreve, an actuary for Milliman who co-authored the report. "This number includes only the errors that we could identify through claims data, so the total economic impact of medical errors is in fact greater than what we have reported."
-----
From a tiny eye telescope to microscopic health data on the surface of contact lenses to advances in cancer treatments, medical devices continue to get smaller and smaller. And the smallest of the small fields—nanotechnology—is expected to get bigger (so to speak) over the coming years.
The global market for nanotechnology was worth $11.6 billion in 2007 and could reach $27.0 billion by the end of 2013, according to India-based market research firm Bharatbook in a report released this month. Biomedical applications has the highest projected growth rate (56%) compared to other applications over the next 5 years.
-----
http://www.modernhealthcare.com/article/20100810/NEWS/100819998
By Joseph Conn / HITS staff writer
Posted: August 10, 2010 - 11:30 am ET
In a big week for information technology deals, healthcare businesses across the country sought to capitalize on growing demand for IT that can help companies analyze and control their healthcare costs and meet the changing health needs of an aging population.
GE Healthcare and Intel Corp. last week announced they are forming a joint venture to tap what's expected to be a multibillion-dollar market for systems to support independent living and chronic-disease management programs. Meanwhile, four other healthcare industry firms formed new IT alliances. Patient-satisfaction ratings firm Press Ganey Associates, South Bend, Ind., acquired one of the nation's forerunner systems for clinical performance measures, the Maryland Hospital Association's Quality Indicator Project for undisclosed terms. And Eden Prairie, Minn.-based Ingenix, a division of UnitedHealth Group, revealed plans to acquire Executive Health Resources, Newtown Square, Pa., a company that provides software and services that help hospitals with physician medical management and necessity compliance.
-----
http://www.modernhealthcare.com/article/20100810/NEWS/100819996
By Joe Carlson / HITS staff writer
Posted: August 10, 2010 - 11:45 am ET
IBM Corp. has acquired the privately held information-capture firm Datacap, Tarrytown, N.Y., as the company continues to look for inroads into the healthcare industry.
Datacap sells data-management systems that help clients create digital documents from disparate formats and manage them in centralized systems. Healthcare clients, for example, can use the systems to automate image-capture processes for medical claims, patient correspondence, enrollment forms, encounter forms, medical records, laboratory results and other records, according to a news release.
-----
Senators Whitehouse and Reed introduced a bill proposing to expand e-health record system use by mental health, behavioral health and substance abuse professionals and facilities.
By Marianne Kolbasuk McGee, InformationWeek
Aug. 10, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226600286
A bill proposing to extend Health Information Technology for Economic and Clinical Health Act (HITECH) financial incentives for e-health record use by mental health professionals has been introduced into the U.S. Senate, complementing similar legislation introduced in the U.S. House of Representatives in April.
The Health Information Technology Extension for Behavioral Health Services Act of 2010, introduced last week in the U.S. Senate by Senators Sheldon Whitehouse (D-RI) and Jack Reed (D-RI) aims to expand use of e-health record system by mental health, behavioral health and substance abuse professionals and facilities, including licensed psychologists, clinical social workers and psychiatric hospitals.
-----
http://online.wsj.com/article/SB10001424052748703988304575413703202287926.html?mod=djemHL_t
Health-insurance companies including Humana Inc. and Aetna Inc. are stepping into the race to equip doctors with high-tech patient records.
The lure: the estimated 80% of U.S. physicians and 90% of hospitals whose records are still on paper, and the $27 billion in federal stimulus money available to help these holdouts switch. The Obama administration last month outlined how doctors can qualify for the funds starting next year. Come 2015, doctors will be penalized under Medicare if they haven't computerized their records.
-----
Work on the Department of Health and Human Services' Nationwide Health Information Network to include issuing digital certificates, updating network directories, and providing help desk support.
By Nicole Lewis, InformationWeek
Aug. 3, 2010
URL: http://www.informationweek.com/story/showArticle.jhtml?articleID=226500189
The Department of Health and Human Services has awarded IT services provider Stanley a two-year, time-and-materials contract valued at $6 million to provide operation and infrastructure support for the Nationwide Health Information Network (NHIN).
The NHIN, which is being developed under the direction of the Office of the National Coordinator for Health Information Technology (ONC), will provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and other stakeholders involved in supporting healthcare.
-----
http://www.healthdatamanagement.com/news/health-information-exchange-axolotl-40822-1.html
HDM Breaking News, August 6, 2010
San Jose, Calif.-based Axolotl Corp. has introduced a streamlined, lower-cost version of its core Elysium health information exchange software.
Elysium Express is designed for hospital-to-physician and physician-to-physician connectivity, according to the San Jose, Calif.-based vendor.
-----
Monday, August 09, 2010
Now that the health care industry has had time to fully digest the final rule on "meaningful use," federal officials are looking to the private sector to help drive health IT adoption and propel the country's health care providers to becoming meaningful users of electronic health records.
At a briefing sponsored by the Health Industry Forum at Brandies University and the journal Health Affairs on Thursday, National Coordinator for Health IT David Blumenthal told a packed room at the National Press Club in Washington, D.C., that "changing the health care system is a team sport." He said that it's now time for the private sector to "pick up the baton and run with it."
Based on the panels following Blumenthal's opening remarks, it appears the private sector is ready to do just that.
-----
August 9, 2010 — 2:05pm ET | By Neil Versel
Two government officials who have been at the forefront of health IT implementation and quality improvement for years call last month's publication of the standards for "meaningful use" of EHRs a "starting point" on a "journey toward ubiquitous and effective use of health information technology," while also putting the rule into historical perspective.
Writing on the blog of policy journal Health Affairs, national health IT coordinator Dr. David Blumenthal and CMS Administrator Dr. Donald M. Berwick remind the healthcare community that the Office of the National Coordinator for Health Information Technology has been around for six years. They also note that it's been more than a decade since the Institute of Medicine dropped its bombshell of a report on medical errors, To Err Is Human (1999) and followed it up two years later with an equally significant tome, Crossing the Quality Chasm.
-----
http://www.eurekalert.org/pub_releases/2010-08/mali-tfm080910.php
New Rochelle, NY, August 9, 2010—Without hands-on access to doctors and hospitals, oil rig workers who become sick or injured increasingly rely on telemedicine "visits" with physicians and specialists on land, a trend explored in detail in an article published in Telemedicine and e-Health, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com). The article is available free online at www.liebertpub.com/tmj
Work on an oil rig can be dangerous, with cuts, sprains, fractures, and other injuries not uncommon. Ailments such as respiratory infections, asthma, and heart attack also pose a serious problem on a rig, where access to medical professionals is limited. To improve healthcare delivery, oil companies increasingly depend on technology to link a nurse or emergency medical technician working on the oil platform to emergency physicians and specialists at major medical centers through Internet or satellite connections.
-----
Enjoy!
David.
This appeared this morning.
August 20, 2010
A COALITION government would revive the controversial Howard-era plan for a national access card to identify every individual receiving government benefits, shadow treasurer Joe Hockey has revealed.
On the eve of what Prime Minister Julia Gillard says will be a ''cliffhanger'' federal election, Mr Hockey has told The Age that giving everyone a single identifier for access to health and welfare benefits could lead to ''massive improvements in productivity in health and welfare''.
But instead of everyone having a card, this time the identifier could be in electronic form.
Lots more here:
http://www.theage.com.au/federal-election/coalition-to-revive-identity-card-20100819-12s1l.html
This really is a very bad announcement as it undermines the guarantees we all thought we had about ‘function creep’ being absolutely ruled out!
The possible impact on trust in e-health records and initiatives can only be guessed at.
All I can say is think very carefully as you cast your vote and as Charlie Aitken always says at the end of his newsletters.
Go Australia!
David.
The following appeared a few days ago.
Kaiser system gives glimpse of future
Posted: 08/07/2010 07:10:48 AM PDT
The quest to put medical records on computers are a national priority set by President Barack Obama before he took office.
"This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests," then President-elect Obama said in early January 2009.
"...It will save lives by reducing the deadly but preventable medical errors that pervade our health care system," Obama said.
Late last month, the U.S. Department of Health and Human Services issued rules for hospitals and physicians to receive financial incentives to promote their use of electronic medical records.
Starting in 2015, there will be penalties for failure to meet the government's 19 guidelines for "meaningful use" of electronic health records.
Although 2015 may not mark the year emergency room teams in any Maine hospital will have access to the health records of a vacationing Southern Californian, "we will be a lot further along than we are now," said Dylan H. Roby, a research scientist with the UCLA Center for Health Policy Research.
Hospitals and doctors across much of Los Angeles County are beginning to exchange health information records in a pilot health information exchange program that is being echoed with similar ventures in various stages across the country.
While some facilities have had a great deal of information on computers for years, others are preparing to dive into the process.
Most health care providers will choose among more than six vendors for off-the-shelf software which they will then customize.
"We have narrowed it down to two software vendors and will make a decision very soon," said Dr. Rafael Amaro, medical director of Long Beach-based Molina Healthcare Group, which has 20 health care centers nationwide targeting the ethnically diverse low-income population.
Molina's Southern California locations include Ontario, Fontana and San Bernardino, Pomona and Long Beach.
Mark Amey, chief information officer of the University of Southern California's health units, said that from the perspective of "change of work flow and process," the computerization medical records is the largest project ever undertaken in the healthcare realm.
Once medical records go on the computer, the patient can be brought aboard the medical team in a way not possible previously.
Better compliance with medical instructions and a happier, healthier patient are the hoped for results.
Among the government's "meaningful use" criteria are provisions for the establishment of e-mail communication between doctor and patient.
Oakland-based Kaiser Permanente is generally recognized as a global leader in its use of electronic medical records and related technologies, including e-mail.
Although one might think patient to doctor e-mail might expose busy physicians to a barrage of questions, symptom updates and lengthy prattles from hypochondriac patients, that overall has not been the experience.
A Kaiser Permanente study found that 75 percent of all patient-physician e-mail encounters addressed ongoing medical problems or care plans.
Leading reasons patients contact physicians are to discuss changes in a health condition, lab test results, a new condition, drug dosage adjustments and the need for a new condition.
In a research project published in the July issue of "Health Affairs," a leading health policy journal, Kaiser Permanente's Southern California region showed e-mail messaging improves the effectiveness of care for patients with diabetes, high blood pressure or both.
The study, involving 35,423 patients, showed 2 percentage-points to 6.5 percentage-points improvements in glycemic, cholesterol and blood pressure screening and control.
"Putting patients and their data at the center of care, quality, access and cost," George Halvorson, Kaiser Permanente chairman and CEO, said in a statement.
"This data proves that health IT (information technology) can be a fundamental component of accomplishing those three critical goals," Halvorson said.
"I call it a revolution," says Kaiser Permanente patient Dan Bozick.
"I take a blood test in the morning and get results on the computer in the afternoon," the Redlands resident said.
"I like it (My Health Manager) because it gives us numbers," said Grace Wong of Hacienda Heights.
Test results give specifics and show normal ranges for those tests so patients can know their system is out of whack.
In cases where results are outside normal ranges, patients can query their doctor to find out if this change warrants a visit, a change in medications or just watching for the next test.
After a trip to the doctor, a summary of the visit will be in their hand at departure and on My Health Manager, for later view after the paper has long ago disappeared.
Something in the details a little fuzzy?
Just fire off an e-mail, Wong said.
Rusty Spencer, of West Covina, lost the use of his legs following a motorcycle accident and has since been plagued by frequent urinary tract infections.
He and his wife use a home test kit and frequent e-mails to their doctor to nip those infections earlier with antibiotics before it progresses into a life-threatening situation.
"I've reduced my emergency room trips 90 percent," he said.
.....
BENEFITS OF HEALTH CONNECT
Paperless
Increased and speedy access to patient history and information. The network is most efficient by region, but a national network is in progress.
Improves patient compliance and overall health outcomes.
Gives Kaiser Permanente medical professionals faster access to new information, i.e., medication alerts and clinical libraries.
Provides Kaiser Permanente medical professionals a trusted network of information as all content is verified by the network's own physicians.
SECURITY MEASURES
Functions are limited to what information/access the user needs to perform their specific job. Different levels of access based on level of employee.
Security level designations approved by manager and reviewed quarterly.
Every action leaves an electronic footprint, so questionable access/action can be traced back.
"Break the glass" function: Puts an automatic alert on certain patient records that asks the person seeking access "Do you really need to know?" (Example use: If someone famous is being treated at a particular hospital, this function prevents staff from attempting to snoop the patient's information on any level.) If the "glass" is broken, and the employee didn't have a legitimate reason for doing so, it is a fireable offense.
Lots more here:
http://www.sbsun.com/news/ci_15704319
Here is a little on what the patients think.
Posted: August 11, 2010
Health insurer Kaiser Permanente says its members are embracing online communication methods in their medical care.
The company, reporting on its second-quarter earnings, said it has invested in developing the world’s largest private electronic health record system, Kaiser Permanente HealthConnect, which is now in use across Kaiser Permanente. The company operates in nine states and Washington, D.C.
Kaiser Permanente care teams routinely document patient care with an electronic chart in both inpatient and outpatient settings, according to the company.
For the first six months of 2010, members have exchanged 5.3 million emails with their Kaiser Permanente doctors and refilled 4 million prescriptions online. In addition, 12.7 million lab results have been delivered online in the first six months of the year.
More here:
http://ifawebnews.com/2010/08/11/kaiser-permanente-notes-gains-in-members-online-care-management/
And for proof it all seems to work (one of many papers)
August 10, 2010 | Molly Merrill, Associate Editor
OAKLAND, CA – E-mail use between patients with diabetes and hypertension and their doctors resulted in improved quality of care scores, according to a study of patients in Kaiser Permanente's Southern California region.
The study, which was published in the July issue of Health Affairs, observed 35,423 patients with diabetes, hypertension, or both. Researchers found that the use of secure patient-physician messaging in any two-month period was associated with statistically significant improvements in HEDIS (Healthcare Effectiveness Data and Information Set) care measurements. Results included 2 to 6.5 percentage point improvements in glycemic, cholesterol and blood pressure screening and control.
"Putting patients and their data at the center of care allows Kaiser Permanente to improve health care quality, access and cost," said George Halvorson, chairman and CEO, Kaiser Permanente. "This data proves that health IT can be a fundamental component of accomplishing those three critical goals."
More here:
http://www.healthcareitnews.com/news/study-doctor-patient-e-mailing-improves-patient-outcomes-0
If you want more here might help:
http://www.healthdatamanagement.com/web_seminars/-40802-1.html
Web Seminar Center, September 2, 2010, 11:00AM ET
As a trailblazer in Health IT, Kaiser Permanente continues to set standards with its personal health record initiative to engage patients online with Kaiser Permanente health teams to manage their health and wellbeing.
Anna-Lisa Silvestre, Kaiser Permanente’s vice president of online services, has developed and overseen the strategy for My Health Manager on kp.org. The patient portal now has more than 3 million patients registered to access their PHRs, e-mail physicians and participate in health behavior programs.
This is really important in my view – as it shows what leadership and preparedness to actually invest can achieve.
You can assess what is on offer from our leaders after reading this. Remember the 8 million members of KP are not waiting a further decade this is fully implemented and operational today!
David.
Another valuable publication on E-Health Benefits.
Fran Lowry
August 9, 2010 — A computerized provider order entry (CPOE) system that uses alerts to warn when the wrong medication has been prescribed can reduce the prescription of potentially inappropriate medications (PIMs) in hospitalized older patients, according to the results of a new prospective study published in the August 9/23 issue of the Archives of Internal Medicine.
"Older people admitted to the hospital are especially vulnerable to adverse drug events (ADEs), which occur in up to 40% of hospital admissions," write Melissa L.P. Mattison, MD, from Beth Israel Deaconess Medical Center, Boston, Massachusetts, and colleagues. "Some medications may predispose vulnerable older patients to ADEs." Based on the consensus of a panel of geriatric medicine experts, a proposed list was made up of drugs were identified as medications that should be avoided in older persons. Despite the publication of this list, known as "Beers medications," "the prescription of [PIMs] to elderly patients remains common," the authors explain.
The aim of this study was to determine whether a computerized provider order entry drug warning system could decrease the number of orders for PIMs in such a population.
The authors used a prospective before-and-after design among patients aged 65 years or older admitted to their medical center from June 1, 2004, through November 29, 2004 — before the addition of the warning system — and from March 17, 2005, through August 30, 2008 — after the warning system was added.
The investigators studied the ordering patterns for 3 groups of drugs: a larger group of drugs included those on the original Beers medications list that were flagged as not to be used, a second group of Beers medications that were flagged to be used at reduced doses, and a third group of Beers medications that were not flagged.
After the warning system was deployed, there was an immediate and sustained decrease in the rate of orders for the medications that were flagged not to be used, the authors report. The mean (SE) rate of prescribing not-recommended medications dropped from 11.56 (0.36) to 9.94 (0.12) orders per day (difference, 1.62 [SE, 0.33] orders per day; P < .001). There was no evidence that this effect waned over time, the authors write.
More here (Registration Required):
http://www.medscape.com/viewarticle/726621
Again good news regarding the impact quality systems, in the hands of providers, can make to overall patient care.
As far as I know no such similar evidence exists for the Personally Controlled EHR or similar PHRs. If you know of such evidence let me know!
Well worth chasing down the original reference for the a read and the files.
David.
This just arrived.
FEDERAL Health Minister Nicola Roxon has been driving Labor's e-health agenda as part of the government's wider health reform ambitions.
In December 2006, the Labor member for Gellibrand became opposition health spokeswoman and retained the portfolio when Labor won office in 2007.
She's backing a personally controlled e-health records framework expected to come to fruition by 2012 at a cost of $467 million.
Ms Roxon will take e-health questions from readers of The Australian on August 19 from 3pm (AEST) in a live Q&A session.
-----
Be there or be square!
Follow this link:
David.
The following report was announced a few days ago.
RESTON, Va., Aug 12, 2010 (BUSINESS WIRE) -- According to a new report from Accenture, healthcare organizations planning large investments in e-health solutions face challenges in five interrelated disciplines of information governance -- data privacy, confidentiality, security, quality and integrity.
The report, Information Governance: The Foundation for Effective e-Health, details and explores specific targets for the five disciplines and provides an actionable framework that healthcare organizations, such as care providers, insurers, and public health organizations can use to perform a high-level assessment of their current information management situation, challenges and opportunities. The objective is to ensure investments in e-health are supporting strategic goals of increasing efficiency and reducing costs, reducing errors, and improving patient outcomes. The target areas for evaluation explained in the report are:
Data Privacy
-- Patient consent models and mechanisms
-- Patient-provider relationship-based access controls
-- Patient access controls
-- Effective data security and data handling policies
Data Confidentiality
-- Role-based access control models
-- Patient and provider record sealing
-- Identification and authentication
-- Anonymization and pseudonymization
Data Security
-- Message integrity and communications security
-- Event audit and alerting
-- IT security audit
-- Network integrity
Data Quality
-- Error correction
-- Data validation
-- System and interface certification
-- Standards-driven architecture
Data Integrity
-- Code integrity
-- System hardening
-- Interoperability governance
-- Standards-driven architecture and standards management
The new report draws heavily on Accenture's experience supporting health care organizations' efforts to transform administrative and clinical systems, capture and manage data, develop evidence-based insights, and connect fragmented health care systems.
"Health care organizations are making unprecedented investments in e-health systems, and this new framework speaks to the practical but rather complex implementation challenge, namely to ensure the investments are successful," said Mark Knickrehm, global managing director of Accenture's health care practice. "From working on e-health implementations around the world, we have built and are sharing this framework to help organizations address data privacy concerns, ensure compliance with standards and regulations, maximize the value of electronic health record systems, and support physician adoption."
About Accenture
Accenture is a global management consulting, technology services and outsourcing company, with more than 190,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world's most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US$21.58 billion for the fiscal year ended Aug. 31, 2009. Its home page is www.accenture.com.
SOURCE: Accenture
The release is found here:
The full report is downloadable from here:
This seems to me to be a very useful document that provides a good way of thinking about a range of critically important issues. Within its scope the report provides a very useful framework to consider the matters included.
What is missing in the document – and what I see as equally important for a successful implementation of e-Health – is a clear statement of the importance of parallel organisational governance and leadership. I have to say that as far as Australia is concerned we have serious gaps in both areas and hence I think this document is makes a valuable contribution.
Well worth a download!
David.
