Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, December 15, 2012

Weekly Overseas Health IT Links - 15th December, 2012.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
-----

Most Docs Won't Qualify for EHR 'Meaningful Use'

By David Pittman, Washington Correspondent, MedPage Today
Published: December 07, 2012
Two-thirds of office-based physicians plan to apply or have already applied for meaningful use incentives for using electronic health records (EHRs), a government survey found.
However, only about a quarter have computer systems that support Stage 1 meaningful use objectives -- a prerequisite for receiving the incentives. Physicians must meet all 15 of the Stage 1 core objectives to qualify for meaningful use incentives as of 2012, along with a few other requirements.
-----

Q&A: It's crucial for organizations to value their data, says Larry Ponemon

By Tom Sullivan, Editor, Government Health IT
Created 12/07/2012
Three out of five healthcare organizations are not allocating enough resources to protect patient data – and among the reasons is a simple fact that the industry has no way to place a value on that information.
That’s according to Rick Kam, president and co-founder of ID Experts, which sponsored the Ponemon Institute’s third annual benchmark "Study on Patient Privacy and Data Security," published on Dec.6. 
-----

Comments Sought on Privacy/Security of Stage 3-Certified EHRs

DEC 6, 2012 4:10pm ET
The HIT Standards Committee is seeking public comment on Stage 3 privacy and security criteria that should be required of certified electronic health records in 2016.
The standards committee and its partner HIT Policy Committee advise federal officials on health information technology initiatives. The stakeholder-populated committees have substantial influence over development of meaningful use criteria.
-----

U. of Texas launches unique health info exchange lab

Posted: December 6, 2012 - 1:45 pm ET
University of Texas at Austin officials are touting their first-in-the-country learning laboratory for health information exchange, the newest addition to the school's nine-week health IT certification program.
The health information exchange laboratory, launching this week, gives students hands-on training with information exchange software and allows them to watch real-time transfers of patient records in a simulated environment, Leanne Field, the university's director of public health, medical laboratory science and information technology programs, said in an interview.
-----

4 top trends that will shape digital health

November 29, 2012 11:31 AM ES
This was a big year for digital health transformation, especially for advances in personalized and connected care. Looking back at 2012, these are the four trends that I think will ultimately have the greatest impact on the future.
Proliferation of personalized mobile health technologies.
Many will remember 2012 as the year when mobile health apps and sensors took off. In 2012, the FDA approved the first iPhone-enabled blood glucose meter for sale at retail stores in the United States. Another 2012 FDA approved mobile technology is a sensor that sits atop inhalers for people who have asthma or chronic obstructive pulmonary disease. Every time the inhaler is used, the sensor transmits data to a companion app on the user’s mobile phone that tracks information like the location of each medication discharge. This environmental data can be used to help patients and care providers better understand what triggers a patient’s asthma.
-----
Friday, December 07, 2012

Caregivers Turn to Internet for Health Care Information, Support

by Lisa Zamosky, iHealthBeat Contributing Reporter
The United States is becoming a nation of caregivers. Roughly 42 million people -- 30% of the U.S. adult population -- provide care to a spouse, parent or child.
Caregivers often are placed in the stressful position of having to make major health care decisions on behalf of a loved one or manage an aspect of care that requires knowledge that most people simply don't have.
So it's perhaps little surprise that a recent Pew Internet and American Life Project report found that family caregivers go online in search of health information at rates that far exceed other groups.
-----

Doc use of EHRs up 24 percent

By Diana Manos, Senior Editor
Created 12/06/2012
A new report issued by the National Center on Health Statistics (NCHS) found that in 2012, 72 percent of office-based physicians used electronic health records, up from 48 percent in 2009. That represents an increase of 24 percent.
EHR use ranged from 54 percent in New Jersey to 89 percent in Massachusetts, the NCHS study found.
Compared with the national average (72 percent), the percentage of physicians using any EHR system was lowest in Connecticut, Illinois, Louisiana and New Jersey, according to the report, and higher in Arizona, Delaware, Hawaii, Iowa, Massachusetts, Minnesota, North Carolina, North Dakota, South Dakota, Utah and Wisconsin.
-----

Data breaches cost healthcare entities $7 billion annually

December 6, 2012 | By Dan Bowman
A pair of reports published this week by the Ponemon Institute and the Health Information Trust Alliance reveal that the healthcare industry continues to play catch up in when it comes to curbing data breaches.
Ponemon's third annual study on patient privacy and data security determined that a whopping 94 percent of the 80 participating healthcare organizations experienced at least one data breach that they were aware of in the past two years; 45 percent of those organizations said they experienced more than five incidents during that time. According to the report, such breaches cost organizations a total of $6.78 billion annually.
-----

Patient Data Breaches: Future Looks Grim

Inadequate security funding, tools and expertise could cost healthcare industry billions of dollars annually, finds Ponemon/ID Expert's third annual study.
A majority of organizations polled for Ponemon and ID Expert's third annual benchmark study on privacy and security don't have the technologies, resources and trained personnel in place to take on modern-day privacy and data security risks.
Since beginning the benchmarking in 2010, Ponemon and ID Experts have found that threats to healthcare organizations have increased. The organizational costs for dealing with breaches are climbing as well, with the average price tag increasing from $2.1 million in 2010 to $2.4 million in 2012. The report projects that eventually the annual cost of continuous breaches for the industry "could potentially be as high as $7 billion." AdTech Ad
-----

IHE, ICSA labs team for interoperability

By Bernie Monegain, Editor
Created 12/05/2012
IHE USA, a nonprofit organization that drives adoption of standards-based interoperability to improve patient care, and ICSA Labs, an independent division of Verizon, today unveiled a new certification program aimed at assuring the security and interoperability of health information technology.
The program will provide industry-accepted certification to complement existing conformance testing to IHE integration profiles to ensure that different software and systems can securely connect. 
-----

Report: Healthcare Analytics Market to See Double-Digit Growth

December 4, 2012
A new report from the Rockville, Md.-based research and consulting firm, MarketsandMarkets indicates that the healthcare analytics market is set for double-digit growth over the coming years thanks to the emergence of big data and the advance of analytical technologies. The report, "Healthcare Analytics/Medical Analytics Market - Trends & Global Forecasts to 2017, says that by 2017 the healthcare analytics industry will be worth $10.8 billion.
-----

Big Data, EHR Driving Healthcare IT Innovation

– Brian Eastwood, CIO
December 05, 2012 
Healthcare IT adoption in the United States today is largely defined by requirements to demonstrate the meaningful use of electronic heath record software by 2014.
Gartner says that EHR adoption is a "trigger" for data analytics, improved care management and other innovations. However, these initiatives will take time, the analyst firm notes in a recent report, "Hype Cycle for Healthcare Provider Applications and Systems."

Big Data Benefits Depend on EHR Systems Evolution

This type of innovation is not necessarily unique to the healthcare industry, says Vi Shaffer, a Gartner analyst and the hype cycle report's primary author. Retailers, for example, are also placing an increased emphasis on customer engagement and data processing technology. The difference, she says, is both the complexity of the data—think of an intensive care unit (ICU), where information about patient vital signs, drug dosages and even room temperature is constantly updated and sent to the computer at the nurses' station—and the fact that, until recently, all this information was only on paper.
-----

CMS, ONC propose tweaks to EHR regs

Posted: December 5, 2012 - 2:45 pm ET
A proposed federal rule nips and tucks previously issued regulations governing the testing, certification and use of electronic health-record systems.
The proposed rule, issued jointly by the CMS and the Office of the National Coordinator for Health Information Technology, tweaks several of the meaningful-use criteria that healthcare providers must meet to qualify for payment under the federal EHR incentive program.
For example, it adds an alternative meaningful-use criterion for the electronic transmission of structured lab results from hospitals to ambulatory-care providers who ordered the lab test.
-----

Next ten Lorenzo adopters each get £1m

3 December 2012   Jon Hoeksma
The next ten NHS trusts that commit to take Lorenzo from CSC under the firm’s new National Programme for IT in the NHS deal will each get a signing-on bonus of £1m for implementation expenses.
The £1m would be in addition to up to £4m that eHealth Insider understands each trust that takes Lorenzo can call on for deployment and training costs under the new interim agreement between the Department of Health and CSC. This would mean that ten trusts could claim up to £5m each.
CSC believes the new incentive programme, open to trusts in the North Midlands and East of England, will be fully subscribed and result in some trusts axing current procurements to take advantage of the offer.
-----
  • December 3, 2012, 10:14 PM ET

UMass Memorial Tests Software to Curb Hospital Readmissions

Clint Boulton - Reporter
Stung by a multimillion-dollar penalty for failing to meet new patient readmissions standards set by Medicare, UMass Memorial Health Care is using transaction analytics software to reduce frequent and costly readmissions for patients with heart attacks, heart failure and pneumonia. UMass Memorial CIO George Brenckle, who declined to say how much the hospital was penalized, said the software will help stave off future non-compliance penalties. The software tracks people who are admitted to UMass Memorial’s five community hospitals and prompts care givers to follow-up with those patients, decreasing the chances that they will be readmitted.
-----

Electronic Health Records Breed Digital Discontent For Some Docs

By Eric Whitney, Colorado Public Radio
Dec 04, 2012
This story is part of a reporting partnership that includes Colorado Public Radio,  and Kaiser Health News.
Two years and $8.4 billion into the government's effort to get doctors to take their practices digital, some unintended consequences are starting to emerge. One is a lot of unhappy doctors. In a big survey by Medscape this summer 38 percent of the doctors polled said they were unhappy with their electronic medical records system.
Dr. Mary Wilkerson is one of those doctors. Her small family practice in Denver made the leap to an electronic health record five years ago, with some pretty high expectations.
"We were told by sales people that we would make more money, because we'd be more efficient, and you'd be able to see more patients," says Wilkerson. "We'd be able to bill faster, get the money in the bank at the push of a button. And none of that panned out."
-----

mHealth industry 'in learning mode' for privacy and security

By Mike Miliard, Contributing Editor
It's no wonder that physicians and clinicians have taken to mobile devices in a big way. The convenience of having near-limitless knowledge, from medical journals to patient records, at one's fingertips is unprecedented. Docs love their smartphones.
But for CIOs and chief privacy officers, the relationship is more complicated. As mobile devices become ever more ubiquitous in hospitals and other clinical settings, the threat they pose to sensitive patient information grows.
Privacy and security is hard enough when dealing with stationary client-server EHRs. Try keeping tabs on dozens, or hundreds, of Droids and iPads, each one just waiting to be left in the back seat of a taxi or get hacked.
-----

Mobile apps changing healthcare

By Jeff Rowe, Editor, EHRWatch
Created 12/04/2012
New mHealth technology is continuing to spread across the healthcare sector, and it’s going to change dramatically the way healthcare services are delivered in the future.
That was the core takeaway from a session at the 2012 mHealth Summit Monday that unpacked the findings of the HIMSS 2012 Mobile Technology Survey. Co-sponsored by HIMSS and Qualcomm Life, the survey collected responses from 180 C-Suite level healthcare executives through October and November.
According to Jennifer Horowitz, senior director of research for HIMSS Analytics, and Anthony Shimkin, senior director of marketing for Qualcomm Life, the survey’s primary goals were to gauge how mHealth technology use has changed since a similar study was conducted in 2011, as well as how federal regulations have impacted the development of mobile health policies at healthcare organizations.
-----

Brain wellness technology market set to top $1B by end of 2012

By Mike Miliard, Managing Editor
Created 12/04/2012
The market for brain health technology will surpass $1 billion by the end of 2012, and is set to grow at a brisk thereafter, to between $4 and $10 billion by 2020, according to SharpBrains, a San Francisco-based market research firm.
The industry report, "The State of the Digital Brain Health Market 2012-2020 – Transforming Health with Digital Tools to Assess, Monitor and Enhance Cognition across the Lifespan," offers insights into the digital revolution transforming brain health and heath overall, officials say.
Such software includes computerized Web-based and mobile cognitive assessments, cognitive training and cognitive behavioral therapies, as well as biometrics-based monitoring and brain training tools that measure physiological responses such as heart rate variability and electroencephalography.  
-----

Mobile technology use by docs on the rise

December 4, 2012 | By Julie Bird
Clinicians are rapidly adopting mobile health technology into patient care, according to a new survey unveiled this week at the mHealth Summit in Washington, D.C., by the Healthcare Information and Management Systems Society. 
Among findings of the 2nd Annual HIMSS Mobile Technology Survey, clinicians using mobile technology to collect data at the bedside rose to 45 percent, up from 30 percent last year. Additionally, clinicians using mobile technology to monitor medical-device data increased to 34 percent from 27 percent. Those using bar code readers on mobile devices rose to 38 percent from 23 percent.
-----

ONC committees discuss verification of patient identification

December 4, 2012 | By Marla Durben Hirsch
The healthcare industry is beginning to tackle just how patients should access the information in their electronic health records, with the Office of the National Coordinator for Health IT's federal advisory committees holding a hearing last week to garner suggestions from stakeholders in the industry regarding how to verify a patient's identity before allowing that access.
The hearing, "Trusted Identity of Patients in Cyberspace" held jointly by the HIT Policy Committee Privacy and Security Tiger Team and the HIT Standards Committee Privacy and Security Workgroup Nov. 29, sought to address the need for patient authentication, such as misuse and fraud, as well as the usability of patient authentication methods, such as passwords and biometrics.
-----

Patient ID proofing for EHR access must be easy, HIT policy committees say

By Mary Mosquera
Some healthcare organizations are already verifying the identity of patients and other authorized users to access their information, even though privacy and security experts are still wrestling with which methods may be the most effective and easy to use so they will be widely adopted.
For example, the Veterans Affairs Department uses the Defense Department service member enrollment system to conduct identity verification for the MyHealtheVet portal, the VA’s personal health record system. When a veteran logs on to MyHealtheVet, it automatically links to the DOD system, according to Elizabeth Franchi, director of the Veterans Health Administration data quality program.
“Patients have to be able to do that identity proofing remotely and easily. We defer that to the Defense system because veterans have had a prior relationship with DOD and are known by the system that is going to authenticate them and provide that level of credential assurance,” she said at a Nov. 29 hearing hosted by the privacy and security panels of the federal advisory Health IT Policy and Standards Committees.
-----

mHealth Trials Are Happening, Without the Clinic

Scott Mace, for HealthLeaders Media , December 4, 2012

HIMSS' mHealth Summit began yesterday in Washington, D.C., and runs through tomorrow. Because it's in the capital, government policymakers are likely to be dazzled by slick vendor presentations and lofty statements about what mobile health technology can do now and will be doing soon.
Meanwhile, outside the Beltway, healthcare providers ponder all the promise and peril of putting sensitive patient information on an ever-proliferating array of gadgets, the vast majority of which merely have garden-variety security, authorization, and authentication controls. After the petabytes of data breached by lost or stolen laptops is subtracted, the good news is that so far, mHealth doesn't seem to account for very many scary stories of health data exposure. But that could change.
Looking over the mHealth Summit agenda, I was struck by the fact that the elephant in the room—government regulation—has no session devoted to it.
-----

For Second Opinion, Consult a Computer?

By KATIE HAFNER
SAN FRANCISCO — The man on stage had his audience of 600 mesmerized. Over the course of 45 minutes, the tension grew. Finally, the moment of truth arrived, and the room was silent with anticipation.
At last he spoke. “Lymphoma with secondary hemophagocytic syndrome,” he said. The crowd erupted in applause.
Professionals in every field revere their superstars, and in medicine the best diagnosticians are held in particularly high esteem. Dr. Gurpreet Dhaliwal, 39, a self-effacing associate professor of clinical medicine at the University of California, San Francisco, is considered one of the most skillful clinical diagnosticians in practice today.
The case Dr. Dhaliwal was presented, at a medical  conference last year, began with information that could have described hundreds of diseases: the patient had intermittent fevers, joint pain, and weight and appetite loss.
-----

Vision-Restoring Implants that Fit Inside the Eye

A coming generation of devices promise clear, high-quality vision for the blind.

Why It Matters

Sophisticated retinal implants point to a future in which more of the human body can be repaired with technology.
A coming generation of retinal implants that fit entirely inside the eye will use nanoscale electronic components to dramatically improve vision quality for the wearer, according to two research teams developing such devices.
Current retinal prostheses, such as Second Sight’s Argus II, restore only limited and fuzzy vision to individuals blinded by degenerative eye disease. Wearers can typically distinguish light from dark and make out shapes and outlines of objects, but not much more.
The Argus II, the first “bionic eye” to reach commercial markets, contains an array of 60 electrodes, akin to 60 pixels, that are implanted behind the retina to stimulate the remaining healthy cells. The implant is connected to a camera, worn on the side of the head, that relays a video feed.
-----

Nurses using smartphones to fill IT gaps

By Mike Miliard, Managing Editor
Created 12/03/2012
More than two-thirds of hospitals surveyed for a new study reported that their nurses use their personal smartphones while on the job for personal and clinical communications. Still, IT support for those devices is lacking.
The report, from Spyglass Consulting Group, showed 69 percent of hospitals indicating that their nurses use their personal mobile devices. They're often used to fill in communication gaps with the technology provided by hospital IT departments – which some nurses find difficult to use and complain has limited functionality, researchers found.
"Hospital IT is concerned that personal devices on the hospital’s network pose a significant security threat to patient health information stored on the device or the network," said Gregg Malkary, managing director of Spyglass Consulting Group. "Supporting nursing ‘Bring Your Own Device’ initiatives would require hospital IT to define comprehensive mobile governance strategies and to deploy enterprise-class tools to centrally monitor, manage and protect mobile devices, apps and data."
-----

Most providers now using patient portals

By Erin McCann, Associate Editor
Created 12/03/2012
More than half of all healthcare providers in the U.S. are now using patient portal technology, according to a new report conducted by KLAS.
After interviewing providers from health systems, hospitals and clinics, authors of "Patient Portals: the Path of Least Resistance" found that 57 percent of providers are currently using a patient portal solution.
Officials say the numbers come in the wake of the anticipation surrounding Stage 2 meaningful use requirements released August 2012.
-----

Docs less enamored with portal diabetes management than patients

December 3, 2012 | By Susan D. Hall
Physicians viewed diabetes management through use of a patient portal less favorably than patients in a Canadian study published last week in the Journal of Medical Internet Research.
The research involved open-ended interviews with 17 diabetes patients and with 64 healthcare providers, including general practitioners, nurses, dietitians, diabetes educators and others. 
Overall, the patients said the portal improved their knowledge of their disease and helped them better manage it. However, patients used the portal primarily to log blood-sugar readings and rarely accessed other features, such as the health library.
-----

Voters want to cut federal investment in health IT

November 30, 2012 | By Julie Bird
More than four out of 10 voters said the government should reduce its investment in health IT to help rein in healthcare costs, according to a post-election survey conducted by PwC's Health Research Institute.
The results suggest government and the health IT industry should join forces to educate the public about the long-term benefits of health IT, PwC says, including the anticipated return on the $28 billion taxpayer investment driving healthcare's technology revolution.
Reducing federal investment in health IT ranked second among priorities for cutting healthcare costs among the 1,202 voters surveyed. While 50 percent say reducing payments to hospital and doctors should be one of two top priorities, 42 percent cite reducing health IT investment as one of their top priorities.
-----

Recruiting HIT Workers is Tough

Chelsea Rice, for HealthLeaders Media , December 3, 2012

With healthcare information technology deadlines looming, providers are eager to quickly find and hire qualified workers. But numerous forces present challenges to rapid IT staffing. Among them: Healthcare is competing not only within its own industry, but across the economy, for IT workers that are already in short supply.
According to the 2012 College of Healthcare Information Management Executives survey, chief information officers are seeing an 8% increase in the shortage for health IT staff over the last two years. This year, 67% of respondents reported a shortage versus 59% two years ago.
This is good news for IT workers, who can be choosy about where to sign on, but for healthcare CIOs, recruiting and retaining IT staff presents challenges.
-----
Monday, December 03, 2012

25-Bed Henry County Health Center Shows Meaningful Use Achievable for Small Facilities

by Fred Bazzoli
Many critical access and small rural hospitals are worried about the carrot-and-stick approach that undergirds the federal program to encourage implementation of electronic health records. The incentive program offers additional payments for providers that demonstrate meaningful use of EHRs, but it eventually penalizes providers that lag behind.
That's a concern because there's growing evidence that most of the nation's smaller facilities are falling behind in installing EHR systems and meeting meaningful use requirements. In late September, officials from the Office of the National Coordinator for Health IT outlined a challenge to get 1,000 critical access and small rural hospitals to meaningfully use certified EHR technology by the end of 2014. ONC promised to work with nearly 1,500 small and critical access hospitals, committing additional funds to Regional Extension Centers to help facilities achieve meaningful use.
-----

A Gadget that Makes You the Doctor

Scanadu hopes its tricorder-like device and a smartphone will help people track their health and diagnose problems.

Why It Matters

A device that can accurately track vital signs would make it easier to detect and treat illnesses and make doctor visits less necessary.
Point and scan: A non-working model of Scanadu’s Scout, expected to go on sale by the end of next year for about $150, can scan for a number of vital signs, including temperature and heart rate.
For most of us, checking our health or diagnosing an illness means a trip to the doctor’s office. For Walter De Brouwer, it involves holding a little square up to his temple or spitting onto the edge of a blue plastic square, snapping a photo with his iPhone, and then reading his diagnosis on the small, glowing screen.
-----

Enjoy!
David.

Friday, December 14, 2012

System Selection Processes Need To Work Well To Reduce The Risk of Health IT Implementation.

The following appeared a little while ago:

Picking the Right Partner for an HIT Adventure

NOV 1, 2012
Health care provider organizations buying an information system go through a long process to select the right vendor, but oftentimes a single incident can make a difference in sealing the deal-or killing it.
For Kerry Noble, CEO at Pemiscot Memorial Health Systems in Hayti, Mo., his confidence in a particular electronic health records vendor went way up when Ramsey Evans, CEO of Prognosis Health Information Systems, wrote in the contract that he'd refund the cost of the software if the hospital did not attest to EHR meaningful use within 120 days of go-live. Noble then went to a local bank and got financing to cover the costs of implementation through attestation-with Prognosis' guarantee as collateral. The first meaningful use incentive payment exceeded the cost of the EHR by about $500,000, Noble says.
At 48-bed Sabine Medical Center in Many, La., the willingness of one vendor to make promises-and put them in writing-helped close the deal when the center purchased its first emergency department information system, says Karen Ford, R.N., chief nursing officer. Cost is-and always will be-a big part in the vendor selection process Ford says. But in this case, veEDIS Clinical Systems of Plantation, Fla., promised specific levels of 24x7 on-site, peer-to-peer support by nurses, physicians, and technicians for the first two weeks after go-live. "That is a big deal when you're trying to transition an emergency room," Ford says.
In many I.T. purchases, the final decision really comes down to cost, and at the end of the process there's typically not huge differences between the final candidates. But there are moments in the vendor selection process when the light goes on for an organization that a vendor isn't the right one. In particular, site visits to existing clients of the vendors provide valuable insight if done right, says Paul Burke, director of revenue cycle technology at IMA Consulting in Chadds Ford, Pa. He specializes in vendor selection for financial and enterprise resource planning applications.
Burke advises I.T. decision-makers to insist on a site visit to a hospital with a similar environment and network infrastructure, the same core information system and as close to the same integration package as their facility, Burke advises. If buying contract management software, you don't want to be steered to a McKesson hospital when you are using Siemens.
Bring super-users on the site visit as they know the troublesome day-to-day issues that users of your current software have. The super-users can find common ground with peers and get assurances on how they rectified similar issues. Also, start negotiations before the site visits to keep the sales cycle from going any longer than necessary, but only giving vendors information you think they need at that point, he suggests.
A great deal more is found here:
Most useful is the last section of the article covering a game plan for system selection in a hospital. Reading this section through it really seemed to cover most of the bases. A must read for those in the market for new or replacement systems.
David.

Thursday, December 13, 2012

It Looks Like Patient Portals Are Not Exactly Proven So Far. Did We Jump The Gun On An Unproven Approach?

The following came up a few days ago.

Monday, November 26, 2012

The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials

From the report: "Modern information technology is changing and provides new challenges to health care. The emergence of the Internet and the electronic health record (EHR) has brought new opportunities for patients to play a more active role in his/her care. Although in many countries patients have the right to access their clinical information, access to clinical records electronically is not common. Patient portals consist of provider-tethered applications that allow patients to electronically access health information that are documented and managed by a health care institution. Although patient portals are already being implemented, it is still unclear in which ways these technologies can influence patient care." Read more
Here is the abstract.

The Impact of Electronic Patient Portals on Patient Care: A Systematic Review of Controlled Trials

Elske Ammenwerth1, PhD; Petra Schnell-Inderst2,3, PhD; Alexander Hoerbst4, PhD
1Institute of Health Informatics, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
2Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
3Oncotyrol Center for Personalized Cancer Medicine, Innsbruck, Austria
4Research Division for eHealth and Telemedicine, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall in Tyrol, Austria
Corresponding Author:
Alexander Hoerbst, PhD

Research Division for eHealth and Telemedicine
UMIT - University for Health Sciences, Medical Informatics and Technology
Eduard-Wallnoefer-Zentrum 1
Hall in Tyrol, 6060
Austria

ABSTRACT

Background: Modern information technology is changing and provides new challenges to health care. The emergence of the Internet and the electronic health record (EHR) has brought new opportunities for patients to play a more active role in his/her care. Although in many countries patients have the right to access their clinical information, access to clinical records electronically is not common. Patient portals consist of provider-tethered applications that allow patients to electronically access health information that are documented and managed by a health care institution. Although patient portals are already being implemented, it is still unclear in which ways these technologies can influence patient care.
Objective: To systematically review the available evidence on the impact of electronic patient portals on patient care.
Methods: A systematic search was conducted using PubMed and other sources to identify controlled experimental or quasi-experimental studies on the impact of patient portals that were published between 1990 and 2011. A total of 1,306 references from all the publication hits were screened, and 13 papers were retrieved for full text analysis.
Results: We identified 5 papers presenting 4 distinct studies. There were no statistically significant changes between intervention and control group in the 2 randomized controlled trials investigating the effect of patient portals on health outcomes. Significant changes in the patient portal group, compared to a control group, could be observed for the following parameters: quicker decrease in office visit rates and slower increase in telephone contacts; increase in number of messages sent; changes of the medication regimen; and better adherence to treatment.
Conclusions: The number of available controlled studies with regard to patient portals is low. Even when patient portals are often discussed as a way to empower patients and improve quality of care, there is insufficient evidence to support this assumption.
(J Med Internet Res 2012;14(6):e162)
doi:10.2196/jmir.2238
---- End Extract.
I think we need to wait for some more evidence but given the restricted functionality of the NEHRS / PCEHR I hardly expect to see useful proof of value soon!
David.

Wednesday, December 12, 2012

Good Heavens - It Seems NEHTA Is Hiring Again - And What Are They Seeking? Policy Advice!

This advertisement appeared a few days ago.

Senior Policy Advisor

NEHTA - Sydney Area, Australia

Job Description

The Policy team at NEHTA are vital in developing and delivering consistent national policy frameworks which support eHealth into the future. The Policy team provide specialist advice on governance issues and key to the role is to engage with jurisdictional representatives, consumers and healthcare providers.
As Senior Policy Advisor you will provide specialist policy advice to key stakeholders internally and externally.  In this busy role you will work closely with other quality assurance teams, as well as product developers and implementation support teams and assist with a variety of ehealth projects and initiatives.
To be successful in the role you will have experience in the health sector, in policy and/or operational roles.  You will have experience in identification of risks and issues and have the ability to develop sound, implementable recommendations for action.   You will possess superior communication skills and must have experience developing policy briefings and recommendations, and research reports for senior audiences. 
If you are a team player, self-motivated, enjoy working in a close team, and have a passion for health reform then this role will be well suited to you.
NEHTA’s goal is to attract high performing, experienced individuals looking to be involved in a unique and exciting venture. We are committed to providing a work environment where people enjoy what they do and are motivated to achieve.
For further information regarding the position and NEHTA please visit our careers page at www.nehta.gov.au and apply online.

Desired Skills & Experience

1. Critical analysis of strategic & operational policy;
2. Identification of potential risks & the development of mitigation strategies;
3. systemic approaches to national & jurisdictional projects;
4. Sound understanding of the business drivers of government; and
5. Understanding of the application of strategic policy to operations
6. Understanding of risk management and public sector governance.
7. Effective priority management & problem solving skills
8. Effective communication and working relationships with colleagues and stakeholders.

Company Description

The National E-Health Transition Authority Limited (NEHTA) was established by the Australian, State and Territory governments to develop better ways of electronically collecting and securely exchanging health information.  NEHTA is the lead organisation supporting the national vision for e-health in Australia. 
You can read all about it here:
So we have a paragon of Governance failure wanting to do better. All I can say that any action in isolation on Leadership and Governance from NEHTA merely reflects how clueless they are.
What is needed is a ‘root and branch’ review of Governance of e-Health in Australia and the design of a practical, workable and sensible approaches to moving forward. The faux consultation, government secrecy and lack of industry clinical consultation just has to end.
My suspicion is that it will take a change of Government and DoHA leadership to see the required level of change.
David.

Tuesday, December 11, 2012

CIO Magazine Provides Some Gartner Comment On E-Health Trends. PHRs Not Favoured.

The following appeared a little while ago:

Big Data, EHR Driving Healthcare IT Innovation

– Brian Eastwood, CIO
December 05, 2012 
Healthcare IT adoption in the United States today is largely defined by requirements to demonstrate the meaningful use of electronic heath record software by 2014.
Gartner says that EHR adoption is a "trigger" for data analytics, improved care management and other innovations. However, these initiatives will take time, the analyst firm notes in a recent report, "Hype Cycle for Healthcare Provider Applications and Systems."

Big Data Benefits Depend on EHR Systems Evolution

This type of innovation is not necessarily unique to the healthcare industry, says Vi Shaffer, a Gartner analyst and the hype cycle report's primary author. Retailers, for example, are also placing an increased emphasis on customer engagement and data processing technology. The difference, she says, is both the complexity of the data—think of an intensive care unit (ICU), where information about patient vital signs, drug dosages and even room temperature is constantly updated and sent to the computer at the nurses' station—and the fact that, until recently, all this information was only on paper.
----- Lots omitted including key trends to embrace

4 Healthcare IT Trends to Avoid

The following types of applications, however, may not be worth a healthcare CIO's immediate attention:
  • Patient decision aids and personal health management tools. These appear largely in the form of interactive apps that educate patients or help them make care decisions, such as seeking treatment or undergoing surgery for a particular ailment. However, Gartner says their effectiveness is questionable and adoption remains low.
  • Personal health records. The concept is attractive, as it gives patients ownership of their data, but poor usability and vendor disinterest have hindered adoption. Only with a government mandate, as is the case in Australia, does PHR adoption seem to catch on, Gartner says. Patient portals, which connect patients directly to their caregivers, are more popular.
  • The patient-centered medical home. There's been much discussion of making this a reality, especially in light of the accountable care organization model touted by healthcare reform and examples such as the "granny pod," but information exchange challenges and a reimbursement model unfavorable to insurers hinder adoption.
  • Patient self-serve kiosks. While these can streamline patient registration and payment collection, the ROI isn't there, Gartner says. Most organizations are better off focusing on meaningful use or the conversion to the ICD-10 code set, which must be done by Oct. 1, 2014.
.....
Read the full article here:
I especially found number 2 of the items to avoid interesting. Two points:
1. I am not sure Gartner is up to date on just how much adoption the PCEHR has achieved.
2. Again we have clear suggestions that the PCEHR is not what the patients want.
They are right however to have things like the PCEHR and PHRs as an avoid right now!
Oh well!
David.

AusHealthIT Poll Number 148 – Results – 11th December, 2012.

The question was:

Will 2013 Be A Better Year For e-Health Than 2012 Has Been?

For Sure 16% (9)
Possibly 13% (7)
Neutral 9% (5)
Probably Not 38% (21)
Definitely Not 20% (11)
I Have No Idea 4% (2)
Total votes: 55
Very interesting.  Only a limited amount of optimism seem to be about at present.
Again, many thanks to those that voted!
David.