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, September 20, 2014

Weekly Overseas Health IT Links - 20th September, 2014.

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.
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HIMSS to Congress: 3 actions to improve health IT

September 12, 2014 | By Susan D. Hall
HIMSS has presented three "Congressional Asks"--formal requests to Congress to accomplish specific goals to advance health IT.
These proposals will be presented to Congress during the annual HIMSS Public Policy Summit Day, Sept. 18, as part of National Health Information Technology Week, according to an announcement.
The three requests include:
1. Minimizing disruption in our nation's health system emanating from federally-mandated health IT program changes. This request notes that various federal agencies are involved in regulating aspects of health IT development and adoption, often leading to confusing and conflicting regulatory guidance.
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Ebola Outbreak Drives Home Need for ICD-10

SEP 12, 2014 7:14am ET
The ongoing outbreak of the Ebola virus is an example of the way transitioning to ICD-10 can benefit the ability of public health officials to respond to global pandemics, according to an executive at 3M Health Information Systems.
In a recent blog post, Ann Chenoweth, the company's director of industry relations, said the lack of specificity in classifying Ebola in ICD-9 can hamper quick coordination of action.
"When looking at ICD-9 today, Ebola is often classified to 078.89, Other specified diseases due to viruses," Chenoweth wrote, "but I have also seen Ebola classified to 065.8, Other specified arthropod-borne hemorrhagic fever. This lack of specificity in the ICD-9 code description makes it extremely difficult, if not impossible, to clearly identify Ebola patients in the data. In turn, the ability for our public health organizations to quickly and proactively identify emerging epidemics can be severely compromised."
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Sticking to the Plan: Apps Improve Medication Adherence

SEP 11, 2014 1:49pm ET
It is simple in theory: Patients take their drugs on time and in the dosages prescribed by their physicians. However, in practice, medication non-adherence continues to be a serious problem in the United States, with a patient dying every 90 minutes due to an accidental overdose or missed dose of a prescription drug, according the Express Scripts 2013 Drug Trend Report. It's also costly for the U.S. health system: the United States wastes $317.4 billion annually on unnecessary medical costs that could be avoided by eliminating medication non-adherence, according the same report.
A 2013 poll of U.S. adults showed that nearly two-thirds of Americans who take prescription medications do not take their medication as prescribed. The poll was conducted by Greenberg Quinlan Rosner Research and Public Opinion Strategies for the Council for Affordable Health Coverage.
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Engaging patients: 5 things providers can learn from payers

Posted on Sep 08, 2014
By Andrew Underhill, Systems Made Simple
Payers have long embraced the idea that patients who are engaged in their care are ultimately healthier than those who are not. In recent years, insurers have worked to boost patient engagement by creating incentive programs, social media campaigns and targeted education that encourages healthier lifestyles, regular wellness visits and chronic disease management. The underlying goal is to educate beneficiaries on the critical role they play in preserving their health.
While these efforts are laudable, it is ironic that payers are taking the lead in patient engagement when healthcare providers have more direct contact with patients. Providers are in the middle of a cultural evolution from delivering care to patients to partnering with patients. Moreover, current payment models do not reward engagement strategies because reimbursement is tied to care episodes rather than long-term health management.
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ONC not going at interoperabilty alone

By DAVID PITTMAN | 9/12/14 6:40 AM EDT
You could go blind reading all the reports and recommendations on the vexing issue of interoperability of health information systems.
But despite all the advisory committees, task forces and expert panels dealing with the subject, the country’s health IT czar isn’t seeing stars. The federal government needs help from companies and expert groups of all kinds to move interoperability forward, she says.
 “Interoperability is the perfect example of where we’re not going to only do this federally, and we have got to partner with the private sector,” National Coordinator Karen DeSalvo said at the eHealth Initiative’s 2020 Roadmap Executive Summit.
Her comments came after a day-long meeting Thursday where eHealth Initiative [eHI] members, dozens of providers, payers, employers, EHR vendors and other health IT thought leaders gathered to stamp out details of the initiative’s forthcoming 2020 Roadmap, a vision to advance health IT use in a post-meaningful use era.
The initial report is set to be released in November, with a more fleshed-out version in the spring.
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PwC-led team to offer 'open source' EHR to DoD

September 8, 2014 | By Marla Durben Hirsch
PwC has joined forces with Medsphere, DSS, Inc. and General Dynamics Information Technology to vie for the coveted U.S. Department of Defense Healthcare Management Systems Modernization (DHMSM) electronic health record contract, and plans to merge "open source" software with commercial applications in its proposal, PwC has announced.
Perhaps in acknowledgement of the increased pressure on DoD to ensure that its new system has the capability to share data with the U.S. Department of Veteran Affairs (VA), the PwC partnership intends to propose "open architecture,"  which "promotes greater ease of integration with existing DoD legacy systems, as well as unlimited access to ongoing EHR innovations," according to PwC's Sept. 5 announcement.
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ONC: EHRs are improving patient safety

September 9, 2014 | By Marla Durben Hirsch
Electronic health records are making major strides in improving patient safety, according to the Office of the National Coordinator's latest data brief. The brief, based on the 2013 National Ambulatory Medical Care Physician Workflow Survey of 11,000 physicians, found that three times as many physicians reported that their EHR prevented a potential medication error than caused one; 47 percent were reminded to provide preventive care by their EHRs.
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Why final rule comes as last straw

Posted on Sep 11, 2014
By Bernie Monegain, Editor
CMS and ONC disappointed many CIOs and IT teams around the country on Aug. 29 when it issued a final rule for Stage 2 meaningful use that lacked the flexibility on reporting that so many had counted on – and perhaps expected, because what they had proposed seemed like a reasonable compromise to them.
CHIME, which represents 1,400 CIOs, fired off a statement the same day.
Russell Branzell“CHIME is deeply disappointed in the decision made by CMS and ONC to require 365-days of EHR reporting in 2015,” Russell Branzell wrote in his response to the rule. “This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.”
CHIME and other industry organizations had proposed reporting on Stage 2 requirements for any three-month quarter. In their view, it was a practical approach, one that made it more likely they would succeed and one that showed their continued support for the Meaningful Use Program.
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NIB strategy due ‘later this year’

8 September 2014   Sam Sachdeva
The National Information Board is set to release its long awaited informatics strategy later this year, outlining a ten-year plan for how to make the most of data and technology in healthcare.
An update on the NIB’s informatics strategy in the board’s latest working group papers says the document is due to be released soon.
The National Information Board is comprised of representatives from a number of health organisations including the Department of Health, NHS England and the Health and Social Care Information Centre.
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Telemedicine beneficial in management of chronic diseases, lowering costs

September 11, 2014 | By Katie Dvorak
There are many uses for telemedicine to manage chronic diseases, and no matter the process, the technology offers beneficial results and costs reductions, according to a recent study.
The study, published online in the journal Telemedicine and e-Health, looks at the impact telemedicine has on cost, quality and access to care, focusing three chronic diseases: congestive heart failure, stroke and obstructive pulmonary disease.
The authors, which include former American Telemedicine Association President Rashid Bashshur (pictured)--executive director of eHealth at the University of Michigan Health System--found that for each chronic disease, a different telehealth approach was needed.
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Providers: Apple Watch, HealthKit intriguing for patient care, but challenges persist

September 11, 2014 | By Dan Bowman
As Apple looks to team with provider organizations and other health technology vendors on efforts relating to its forthcoming HealthKit platform and its new wearable device, Apple Watch, it will be interesting to see how much traction it gains among clinicians.
To that end, we queried our FierceHealthIT Editorial Advisory Board for their thoughts on Apple's new offerings. Here's what six of our advisers had to say:
Roger Neal, vice president and CIO, Duncan (Oklahoma) Regional Hospital: Ultimately, as a geek, I really like stuff like that for myself. But, my professional techie persona is trying to figure out how to make it all work in our new healthcare world. Some of these systems are capturing more and more relevant information that would be wonderful to have in a patient's global chart, but trying to get at that data securely, import it somewhere and store all of it on patient after patient scares me. Where is it all going to go and how are we going to make it all work securely and privately together?
I think at some point, a lot of this information will be more relevant for healthcare than today. We'll get there and the sophisticated tracking and monitoring via watch, wristband, clothing or whatever will play a part in that. I think on the population wellness front, these types of tools can be of great use if you can co-manage all the data coming in on hundreds or thousands of patients.
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Global Kinetics's wearable KinetiGraph helps diagnose Parkinson's disease

September 10, 2014 by Arezu Sarvestani

Australia's Global Kinetics Corp. lands FDA clearance for its wrist-worn Personal KinetiGraph to help diagnose symptoms of Parkinson's disease.
FDA medtech regulators put the stamp of approval on Global Kinetic Corp.'s Personal KinetiGraph, a wearable device designed to help physicians diagnose symptoms of Parkinson's disease and other movement-based disorders.
The Personal KinetiGraph is the 1st device of its kind, capturing movement outside of the clinic and creating automated reports that neurologists and other caregivers can use to identify signs of neurological disorders. Most Parkinson's diagnoses today are done with in-clinic evaluations, patient's personal reports of symptoms and reactions to medication, Global Kinetic said.
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L.A. County's New EHR System Could Become Model for Rest of U.S.

by Michelle Stuckey, iHealthBeat Contributing Editor Thursday, September 11, 2014
Los Angeles County's Department of Health Services is installing a new countywide electronic health record system that officials say could end up being a model for other health care organizations across the country.
An L.A. County Civil Grand Jury report examined the initiative this summer, assessing how EHR implementation and integration of EHR systems and data among county departments could set the pace for development of a countywide health information exchange for both private and public providers.

L.A. DHS Faces Unique Challenges

Los Angeles DHS is the second largest public health system in the U.S. and serves nearly 10 million residents, according to the report. Robert Bart, CMIO of the department, said DHS includes four traditional hospital-based facilities -- Harbor-UCLA Medical Center, Los Angeles County-University of Southern California Medical Center, Olive View-UCLA Medical Center and Ranchos Los Amigos National Rehabilitation Center -- as well as several offsite clinics.
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ONC Releases Final EHR Guidelines

9/10/2014 05:13 PM
Office of the National Coordinator for Health IT abandons voluntary 2015 criteria and instead adds flexibility to 2014 EHR certification criteria.
The Office of the National Coordinator for Health IT (ONC) on Thursday released a new final rule for electronic health records (EHRs), which increases the flexibility of the 2014 edition of certification and adds some criteria initially proposed in the 2015 voluntary EHR certification criteria now abandoned by the ONC.
Although it believes that many of the reasons for creating a voluntary certification edition remain valid, the ONC opted to end its pursuit of this option after "consideration of public comment, further reflection of ONC goals and timelines, and a desire to adhere to the administration's principles," the office said, in a document slated to appear in the Federal Register on September 11.
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Report: eHealth Strategy South Africa (2012)

This 36-page policy document outlines the Department of Health's eHealth strategy, which is set to lead the department in improving patient information systems nationwide.
The document employs the World Health Organisation’s definition of eHealth as “the use of information and communication technologies (ICTs) for health to, for example, treat patients, pursue research, educate students, track diseases and monitor public health.”
It outlines ten strategic national priorities for eHealth leading up until 2017. These include capacitating health workers, standards and developing applications to support health care delivery.
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Drug Cost Comparison Tool Seen as Valuable Resource

SEP 9, 2014 8:34am ET
Doctors have great interest in a web-based resource that shows the current prices of comparable brand name and generic drugs at pharmacies in a chosen zip code, according to a study conducted by Community Catalyst.
In the study, physicians highly concerned about patients' abilities to pay for medications were presented with hypothetical resources showing the retail and out-of-pocket costs for drugs at local pharmacies. Following exposure to each resource, the doctors indicated that it would likely facilitate discussions of affordability, reduce non-adherence, and improve patient engagement. Physicians also reported which comparative features were the most useful, how often they would use such a resource, and how such a resource might save time addressing cost.
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States get telehealth report cards

Posted on Sep 10, 2014
By Erin McCann, Associate Editor
How do individual states stack up when it comes to telemedicine coverage and reimbursement? A new report from the American Telemedicine Association details just that -- assigning letter grades to each state and shedding light on the winners and those who still have a long way to go. 
After examining 13 key indictors relating to telemedicine coverage and reimbursement -- think Medicaid coverage, eligible providers, private insurance, etc. -- ATA researchers found both good news and some not-so-good news.
The good news? Some states did have comprehensive coverage and policies that promoted the adoption of telemedicine. Seven states, according to the research, reached the "A" level: those being Maine, Maryland, Mississippi, New Hampshire, New Mexico, Tennessee and Virginia. 
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Apple Watch Takes Tech Giant into New Territory

SEP 9, 2014 4:24pm ET
Apple on Tuesday unveiled a new product category for the Cupertino-Calif.-based company—a smartwatch designed to provide consumers with a variety of technology services including comprehensive health and fitness apps to help them lead healthier lives.
Called Apple Watch and available in early 2015 starting at $349, the device includes an activity app designed to help motivate users to be more active, and a workout app that provides metrics during workout sessions.  Billed as bringing together the capabilities of “an all-day fitness tracker and a highly advanced sports watch in one device,” Apple Watch uses an accelerometer, a built-in heart rate sensor, GPS and Wi-Fi from an iPhone to provide an overall picture of a person’s daily activity.
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The Apple platform for wellness arrives

Posted on Sep 10, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
On September 9 I was at the Flint Center in Cupertino where Steve Jobs introduced the first MacIntosh 30 years ago. Who can forget the iconic commercial “why 1984 won’t be like 1984”? It was the year I graduated from college and the year I married my wife Kathy.
Now, 30 years later, we’re on the cusp of a different kind of revolution: the consumerization of healthcare middleware that gathers data about your body/activity from multiple sensors and consolidates it into a secure container on your personal smartphone. No cloud storage is used. In fact, Apple has specifically changed its policies so that health data is never replicated to iCloud. Data remains on your device under your control. Apple does not specifically provide a function to transmit data off the device. The intent of Healthkit is that it serves as middleware, consolidating data and providing a container to share data with other apps that you specifically trust.
For example, Beth Israel Deaconess could create a Patientsite application that you trust to access healthcare data on your phone. Your care team could monitor this data for meaningful variations and intervene via a home care visit or telemedicine connection when appropriate.
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Success of Consumer-Based Apple Watch Tied to Healthcare Stakeholders

SEP 9, 2014 7:45am ET
Apple’s expected launch today of its long-awaited iWatch device could revolutionize the mobile healthcare market by capturing the hearts and minds of consumers.
However, two industry analysts say the success of this “smartwatch” with health/activity tracking capabilities hinges on more than just the ability of Apple to attract hordes of consumer users.
“No brand can do better than Apple in attracting consumers. And, no company has better resources and talent to design products that people want to use. The key is whether Apple will not only get the hardware/software piece right but also the right partnerships to help consumers with the motivational factors to positively change their health behaviors,” says Harry Wang, director of health and mobile product research at Parks Associates.
In addition to breakthrough wellness and fitness tracking functions, iWatch must garner partnerships with key healthcare industry stakeholders including providers and health insurers, argues Wang.
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Glasgow works with Emis on child health

8 September 2014  Sam Sachdeva
NHS Greater Glasgow and Clyde has implemented a bespoke version of Emis Web to build a single shared child health record, while it helps Emis to develop its child health functionality.
A total of 22 child and adolescent mental health services teams are using the system to securely share patient information within a single patient record, after the first team went live in March 2013.
Karen McFadden, the health board's programme lead, told EHI it chose Emis Web for its child health services because of the company’s flexibility and willingness to customise the software to meet its requirements.
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How to engage baby boomers in healthcare technology

September 9, 2014 | By Katie Dvorak
As baby boomers age, their increasing need for care will place a high demand on the healthcare industry. Advances in technology may help ease that burden, but only if developers use the right tools and platforms, according to a recent study.
The study, published in the Journal of Medical Internet Research, looks at the degree to which the baby boomer generation is prepared to embrace, or is currently embracing, consumer health tech.
Respondents of all ages, from 18-64 years, were surveyed for the study. The findings show that boomers are more likely than those age 64 and up to embrace five technologies: websites (84.5 percent), email (81 percent), call centers (52 percent), video conferencing (49.6 percent) and texting (49.6 percent).
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Nations should learn from each other on health IT strategies

September 9, 2014 | By Susan D. Hall
The use of health information and communications technologies (ICTs) to improve chronic care "is still in its early days," according to research at Health Affairs comparing approaches used in Australia, Canada, Denmark and the U.S.
The study looked at four types of solutions: electronic health records (EHRs), health information exchange (HIE), telehealth, and patient self-management tools.
The next five years will be critical in addressing common issues, the authors say, adding that common challenges present the opportunity for nations to learn from each other.
Australia has comparatively high EHR adoption (92 percent) and moderate health information exchange adoption (27 percent). The U.S. and Canada have comparatively moderate EHR adoption (around 50 percent) and low levels of HIE.
Denmark, meanwhile, has high EHR adoption (more than 80 percent among primary care providers) as well as high HIE adoption (90 percent).
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Study: Majority of patients ready for telehealth

Laura Pedulli
Sep 08, 2014
The majority of patients indicate a readiness for telehealth, according to a study published in Telemedicine and e-Health .
Researchers at the Mayo Clinic conducted a phone survey of a random sample of 263 patients who had been seen in the outpatient setting at a single institution. The sample was stratified by proximity to the local institution with oversampling for patients living outside a 120-mile radius.
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Mayo, Ralph, Stella and Sloane-Kettering: Will Fashion Meet Function in Wearables?

by Jane Sarasohn-Kahn Tuesday, September 9, 2014
Stella McCartney has been working with adidas for several years, integrating her fashion sense along with sensors in the miCoach sports bra. Women's fashion designer Tory Burch announced her collaboration with Fitbit at the 2014 Consumer Electronics Show. Barneys, the tony Manhattan fashion store, has been working with Intel (which acquired Basis Science, a maker of a wearable health-tracking device, for an estimated $100 million to $150 million this year) on chic smartwatch styling. And this month, Ralph Lauren announced that its iconic polo shirt will morph into a Tech Shirt, galloping into the fitness wearables space.
Will the Polo pony ride a growth curve for consumers and health wearables? And will fashion-meets-health-function move demand beyond early-adopting fitness folks?
Credit Suisse says wearables will be worth $30 billion to $50 billion in the next five years. Currently, Deloitte gauges the wearables market at $3 billion in 2014 (including smart glasses, fitness bands and watches), and VisionGain projects the market to be just over $5 billion by year's end.
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Doctors Say Electronic Records Waste Time

A new study shows that technology has slowed doctors' work.

By Kimberly Leonard Sept. 8, 2014 | 4:00 p.m. EDT + More
Doctors complain that they waste an average of 48 minutes a day, or four hours a week, when they record their patients’ health information into digital records, a new study shows.
The results were collected in a small survey, whose findings were put into a letter that was published Monday in the online edition of JAMA Internal Medicine. A draft of the letter was released Monday to a group of health care reporters at the National Library of Medicine. Dr. Clement McDonald, lead author of the study and director of the NLM Lister Hill National Center for Biomedical Communications, presented the letter, “The Use of Internist's Free Time by Ambulatory Care Electronic Medical Record Systems.”
The findings came from a 19-question survey that the American College of Physicians sent in December 2012 to 900 ACP members and 102 non-members. They received a 53.6 percent response rate; respondents had used 61 different EMR systems.
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Success of Consumer-Based Apple Watch Tied to Healthcare Stakeholders

SEP 9, 2014 7:45am ET
Apple’s expected launch today of its long-awaited iWatch device could revolutionize the mobile healthcare market by capturing the hearts and minds of consumers.
However, two industry analysts say the success of this “smartwatch” with health/activity tracking capabilities hinges on more than just the ability of Apple to attract hordes of consumer users.
“No brand can do better than Apple in attracting consumers. And, no company has better resources and talent to design products that people want to use. The key is whether Apple will not only get the hardware/software piece right but also the right partnerships to help consumers with the motivational factors to positively change their health behaviors,” says Harry Wang, director of health and mobile product research at Parks Associates.
In addition to breakthrough wellness and fitness tracking functions, iWatch must garner partnerships with key healthcare industry stakeholders including providers and health insurers, argues Wang.
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Almost 30% of Broadband Households Own, Use Connected Health Device

SEP 5, 2014 8:44am ET
New survey data from research firm Parks Associates shows that 27 percent of U.S. broadband households currently own and use at least one connected health device.
The survey of more than 5,000 U.S. broadband households also reveals that 13 percent of U.S. broadband households are very likely to purchase a connected health device within the next 12 months.
"The most popular connected health devices are treadmills, exercise bikes, and ellipticals," said Harry Wang, director of health and mobile product research at Parks Associates, in a written statement. "These devices come with built-in support for mobile health apps, which effectively merges the demands of mobile and healthcare consumers.”
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The promises and pitfalls of mHealth

Posted on Sep 08, 2014
By Eric Wicklund, Editor, mHealthNews
To say Harry Greenspun, MD, is well versed in mobile healthcare and technology is to put it mildly.
Greenspun, senior advisor at Deloitte's Center for Health Solutions, is also chairman of the HIMSS Government Relations Roundtable and a member of the new HIMSS mHealth Community, and has advised the Obama Administration on the importance of healthcare IT investment. 
Prior to joining Deloitte, he served as chief medical officer for Dell and Northrup Grumman. He's a co-author of “Reengineering Health Care: A Manifesto for Radically Rethinking Health Care Delivery,” and serves on the World Economic Forum’s Global Agenda Council on Digital Health, WellPoint External Advisory Council on Health Inequities and the advisory boards for Georgetown University, the Global Medical Microtechnology Association and Wireless-Life Sciences Alliance.
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Karen DeSalvo: Everyone can weigh in on path to interoperability

September 8, 2014 | By Susan D. Hall
The Office of the National Coordinator for Health IT is focused on gaining as much input as possible on how to make true interoperability happen, National Coordinator Karen DeSalvo said in a recent conversation with Sam Ho, M.D., executive director at United Healthcare and chairman of eHealth Initiative's Board of Directors.
The ONC plans to release a refreshed health IT strategic plan for comment later this year, DeSalvo said, and is "looking forward to some strong feedback on the priorities we should place to move forward."
"[T]here are going to be places where it makes more sense for there to be advancement from the private sector or perhaps the solutions can come from other sources. The solutions don't all have to come from the federal government," she said. "We look forward to another chapter of the strategic process that engages and incorporates what everybody can own and how to make sure we all have a piece of this."
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DeSalvo: America 'waiting for us to get interoperability right'

By Tom Sullivan, Editor
Calling it a “changing of the horizon,” national coordinator Karen DeSalvo, MD, said that her office is working to refresh the Federal Health IT Strategic Plan.
“It’s an opportunity to look at HIT beyond the EHR and policy levers beyond meaningful use,” DeSalvo said of the forthcoming plan. 
The Office of the National Coordinator for Health IT, in fact, has been reshaping itself for the future and is currently working on its strategic plan alongside a 10-year roadmap for interoperability — and that is against the backdrop of health IT reports put out by other federal entities, notably JASON and PCAST. 
Documents from JASON, conducted by independent scientists at The MITRE Group advising the Agency for Healthcare Research and Quality, and the President’s Council of Advisors on Science and Technology (PCAST) delve into health infrastructure and information exchange, essentially pointing to what needs to be done.
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ONC Data Brief: Physicians Report EHRs Prevent Medication Errors

September 5, 2014
Three times as many physicians report that electronic health records (EHRs) are preventing a potential medication error than causing one, according to a newly released data brief from the Office of the National Coordinator for Health IT (ONC).
The data brief used the 2013 National Ambulatory Medical Care Physician Workflow Survey to assess the physician-reported impacts of EHR use – both positive and negative – on quality and patient safety related outcomes. More than half of the approximately 11,000 physician respondents reported that the EHR alerted them to a critical laboratory value and 45 percent said it alerted them to a potential medical error. Only 15 percent said it led to a medical error.
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CMS pays out $24.8B in meaningful use incentives through July

Author Name Jennifer Bresnick   |   Date September 5, 2014   |  
The pace of Stage 2 meaningful use attestation among eligible providers and hospitals is picking up steam after a slow start earlier this year, contributing to more than $24.8 billion in incentive payments cashed by the healthcare industry during the lifetime of the EHR Incentive Programs.
The latest figures from CMS indicate that 95% of eligible hospitals (EHs) have registered for the programs, with 92% of facilities successfully receiving payments for either Stage 1 or Stage 2.  Similar success on the provider side shows that more than 90% of eligible professionals (EPs) have signed up, and more than three-quarters of EPs have already made some sort of financial commitment to EHR technology.
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Stage 2 MU Attestation Rate Remains Sluggish

SEP 5, 2014 10:23am ET
 As of Aug. 25, 143 eligible hospitals and 3,152 eligible professionals have attested to Stage 2 meaningful use, according to the Centers for Medicare and Medicaid Services.
CMS reported the latest Stage 2 attestation numbers during a Sept. 3 Health IT Policy Committee meeting. While the numbers are an improvement compared to the 78 hospitals and 1,898 EPs that had attested as of August 1, they are still sluggish.
“The numbers are very low, particularly for Stage 2 attestation. I mean they are like 4 percent of [providers] that should be currently going for Stage 2,” HITPC member and Intermountain Healthcare CIO Marc Probst commented during the meeting.
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Enjoy!
David.

Friday, September 19, 2014

This Sounds Like Very Good News For E-Health. Some Positive Results.

This appeared a little while ago.

EHRs help California hospitals reduce medical errors

May 6, 2014 | By Marla Durben Hirsch
An electronic health record is one of the primary tools that can decrease the number of medical errors in hospitals, according to a new report published by the office of U.S. Sen. Barbara Boxer (D-California, pictured).
The staff report surveyed 283 California hospitals to determine what they were doing to reduce common medical errors, such as surgical site infections and pressure ulcers, receiving responses from more than half (53 percent). While hospitals are taking many approaches to reduce medical errors--such as minimizing blood transfusion--EHRs figured prominently in the hospitals' efforts to reduce errors.
Some of the identified approaches included:
  • Using computerized physician order entry with the EHR to eliminate adverse drug events
  • Building a tool in the EHR to document performance and prevent central line bloodstream infections
  • Using the EHR to prompt a clinician to order deep vein thrombosis prevention
The hospitals also acknowledged that alarm fatigue was a problem.
…..
To learn more:
- read the report (.pdf)
More here:
This is a very interesting report from the ‘clinical front-line’ where individual organisations are trying interesting Health IT innovations and reporting the differences they can make.
A good source for some evidence based ideas that can be considered.
David.

Thursday, September 18, 2014

Review Of The Ongoing Post - Budget Controversy 18th September 2014. It Just Rolls On!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot.
It is amazing how the discussion on the GP Co-Payment just runs and runs. Some more this week.
Here are some of the more interesting articles I have spotted this 16th week since it was released.
Parliament is now up for a while and apparently does not come back until 22nd September.

General.

'Confected' budget emergency: Chris Bowen to slam Joe Hockey

Date September 11, 2014 - 6:11AM

Mark Kenny

Chief political correspondent

Labor's Treasury spokesman Chris Bowen will launch a major broadside at the Coalition government on Thursday alleging it has confected a budget emergency in a bid to permanently damage Labor's reputation as a financial manager.
And he will propose three initiatives designed to lift the fiscal debate above politics by strengthening the powers and responsibilities of the independent Parliamentary Budget Office by taking some tasks away from Treasury.
Mr Bowen will use a televised National Press Club address to claim that Treasurer Joe Hockey shifted some of the measurement parameters in last year's mid-year economic and fiscal outlook document - the half-yearly budget snapshot traditionally released towards Christmas.
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Just what the doctors ordered

Anne Hyland
Brian Owler has dropped his eldest daughter at school, assisted a colleague in surgery and reviewed paperwork that includes notes for an afternoon speech by the time he arrives – punctually – for lunch.
I had envisaged an older, professorial type, but in fact Owler, a neurosurgeon who is also the president of the Australian Medical Association, is neither. He’s charismatic, refreshingly down to earth and a little nerdy.
The 43-year-old has picked Bistro Mint on Sydney’s Macquarie Street, near the NSW State Parliament, for lunch as it’s convenient to his next appointment.
He became AMA president in May and stepped right into the federal government’s crosshairs as it pushes to introduce a widely unpopular $7 co-payment for doctor visits. Owler, who has three children under the age of six, clearly relishes a challenge.
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Tony Abbott makes anniversary pledge to ‘protect the vulnerable’

Prime minister says he will repair the budget, which has been criticised for hitting the poorest the hardest
Lenore Taylor, political editor
Tony Abbott has pledged to use the remainder of his term to “protect the vulnerable” and also to build roads and repair the budget, as the government marks the first anniversary of its election.
Just back from a trip to India and Malaysia, Abbott attended a Father’s Day event on Sunday with his own dad, Dick, suggesting voters should reserve judgment on his government – which trails Labor in the polls – and conceding he could have done some things better.
“Look, with the wisdom of 20:20 hindsight there are always some things (that could have been done differently) but we’ve faced some difficult challenges and I think we’ve handled them pretty well. In the end, that’s going to be a matter for the people to judge in two years’ time but we have faced some tough challenges. We’ve faced them squarely and honestly and we’ve done the best we can, sometimes under difficult circumstances,” he said.
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Sensible healthcare reforms are necessary

Australian Broadcasting Corporation
Broadcast: 08/09/2014
Reporter: Emma Alberici
Health Minister, Peter Dutton, discusses government health policy including the proposed Medicare co-payment.

Transcript

EMMA ALBERICI, PRESENTER: With the carbon tax and mining tax now repealed, the Government will turn its attention to its next big-ticket Budget measure, the Medicare co-payment. So far, Clive Palmer and his PUP senators are not for turning. The Health Minister Peter Dutton remains hopeful. He joined me from Canberra a short time ago to discuss that and the future of Australian pharmacies.
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First Year Of Abbott Government.

Tony Abbott admits: we could have done some things better

  • AAP
  • September 07, 2014 1:19PM

Simon King

TONY Abbott has acknowledged he and his party could have some things better in their first year in power.
But speaking at a Father’s Day community tea in northern Sydney he was attending with his 90-year-old father Dick, the Prime Minister defended his party’s performance after one year in office and said overall he “looked back at the last 12 months with some satisfaction”.
“With the wisdom of 20-20 hindsight there are always somethings (we could have done differently), but we’ve faced some difficult challenges and I think we’ve handled them pretty well,” Mr Abbott, who had just returned after a three-day trip to India and Malaysia, said.
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Year of surprises and excuses: Shorten

September 07, 2014 4:49PM
AAP
AUSTRALIANS have a right to be disappointed about what the Abbott government has served up in its first year, the opposition believes.
OPPOSITION Leader Bill Shorten says there is a sense of anxiety in the community about what the Abbott government has done in the year since it won office.
"When Tony Abbott was elected it was on the basis that things would get better," he told reporters in Melbourne on Sunday, the anniversary of the election.
"Ever since then we've seen nasty surprises and pathetic excuses."
Labor would focus on standing up for ordinary Australians, Mr Shorten said.
Opposition frontbenchers issued a flurry of statements on Sunday morning pointing to promises across all portfolios they said had been broken.
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Aussies feel tasered by Abbott's year: Xenophon

Date September 7, 2014 - 12:19PM
Australians feel more tasered than surprised by the Abbott government's first year in power.
That's the opinion of independent senator Nick Xenophon, who's accused the government of "sneaking up on people with quite radical changes" over the past 12 months.
"The government promised no surprises," Senator Xenophon told ABC on the one-year anniversary of Tony Abbott's election as prime minister.
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Tony Abbott’s one-year report card: ‘needs to improve’

Phillip Hudson

TONY Abbott says he looks back at his first 12 months as Prime Minister with “some satisfaction”. But today’s Newspoll shows satisfied is not the word voters might use.
Of the past five prime ministers, only Julia Gillard suffered a bigger loss of support in the first year of power.
The raw numbers in Abbott’s report card are far worse than those for John Howard and Kevin Rudd who, like him, took power at general elections. The next trip to the ballot box is not due for two years so there is still plenty of time for Abbott, if he’s good enough. The government’s support has ­already risen from the alarming low of 35 per cent reached in June and July after the worst received budget in 20 years.
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GP Co-Payment.

Alternative health cost-saving measures – new book

Jennifer Doggett | Sep 07, 2014 9:56PM |
Whether or not the Abbott Government gets its way on GP co-payments, the sustainability of our health system is likely to remain very much on the political agenda, Dr Agnes Walker, from the Australian Centre for Economic Research on Health, reviews a new book which aims to identify the most cost-effective health system interventions. In line with the recent Senate Committee report on out-of-pocket costs, the book argues for an increased focus on chronic disease prevention and management rather than higher costs for primary health care. Dr Walker writes:
Reducing cardiovascular risks across the Australian population would be much more cost-effective than increasing co-payments, according to a new health economics book.  The book  Health Policy in Ageing Populations: Economic Modeling of Chronic Disease Policy Options in Australia discusses ‘best value for money’ health reforms and is available as an open access ebook.  
Link:
The book is available at  www.eurekaselect.com/118691/volume/1
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Govt holds course on $7 co-payment

9th Sep 2014
THE Coalition is standing firm on plans to introduce its $7 Medicare co-payment despite no current prospect of it actually being legislated.
Health minister Peter Dutton told the ABC last night he was optimistic about introducing the reform before 1 July, 2015, and said discussions with key senators were ongoing.
"I think we can negotiate in good faith, and in private, I'm encouraged by some of the discussions we're having with the independent senators, but as you point out, people publicly have made comments and I'll leave that to them," Mr Dutton said.
Asked if that was a hint Mr Palmer was being disingenuous in ruling out support for the co-payment, Mr Dutton said he couldn't comment on private discussions.
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Time to put some more health funding options on the table

Jennifer Doggett | Sep 12, 2014 9:59AM |
One of the more puzzling aspects of the current debate over health funding is the lack of new or innovative policy options being proposed by the Government and others from the conservative side of politics.  Given the level of panic being invoked about our alleged health funding crisis (disputed by many economists) it would seem logical that policy makers should be searching for viable options to combat the so-called health spending tsunami.   
Yet apart from the GP co-payment, there are few, if any, realistic policy options being put on the table for discussion.  The co-payment proposal has clearly not been accepted by either consumers or health care providers (for good reasons, as discussed at length here and here).  But since the failure of the Government to convince stakeholders that increased primary care co-payments are the way forward, there has been no ‘Plan B’ on offer to reform health funding arrangements to meet the changing needs of the community. 
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Dozens air co-payment concerns: Video

By ADAM HOLMES
Sept. 12, 2014, 3:04 p.m
A SLIGHTLY different shade of green was added to the vibrant greenery of Eaglehawk's Canterbury Park on Friday.
About 30 people held up "Save Medicare" posters in the park as part of an action day to oppose the federal government's Medicare co-payment proposal.
Shadow Health Minister Catherine King spoke to the gathering, and said it should not be government policy to discourage visits to the GP.
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Sigma Pharmaceuticals lifts first-half profit, sees healthy future

Jared Lynch
Australia’s biggest listed pharmacy brand Sigma Pharmaceuticals is welcoming the prospect of a GP co-payment, saying it will be a shot in the arm for chemists.
Sigma chief executive Mark Hooper said cuts to the federal government’s $9 billion Pharmaceutical Benefits Scheme were hurting pharmacists, upending their business models.
But he said the Abbott government’s controversial plan to charge a $7 co-payment for GP visits, could offset some of that pain as pharmacies start introducing more professional health services.
“If there is any hesitation from people wanting to go see a doctor, the next place they will go to is a pharmacy,” Mr Hooper said.
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Pharmacy Related Articles.

Dutton rules out changes ahead of Pharmacy Guild talks

Joanna Heath
Health Minister Peter Dutton has ­conceded that pharmacies get special protections but says the ­government has no plans to change the rules that limit the number of pharmacies in ­locations and require them to be owned by pharmacists.
Mr Dutton begins negotiations soon with the Pharmacy Guild, a union that represents pharmacy owners, to ­determine the sixth community ­pharmacy agreement.
The five-year agreement sets out ­government remuneration for dispensing prescription medicines at regulated prices. It was last worth $15 billion.
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No supermarket ownership of pharmacy: Dutton

9 September, 2014 Chris Brooker
The Federal Government remains unconvinced of the need for supermarket giants Coles and Woolworths to run pharmacies, according to Health Minister Peter Dutton. 
Speaking on ABC’s Lateline program, Mr Dutton reinforced his previous commitment to existing pharmacy ownership regulations.  
“The Coalition's long held the belief that we shouldn't have that corporate ownership model… we believe very strongly in a pharmacy that is owned at a community level. And I think that is an important policy for us to adopt ongoing.”
Mr Dutton said existing regulations provided the operating basis upon which Sixth Community Pharmacy Agreement negotiations are to be conducted.
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The long arm of the Pharmacy Guild

Joanna Heath
Andrew Laming knows what it’s like to mess with Australia’s $15 billion pharmacy industry. In 2005, the Liberal MP was bold enough to write an op-ed arguing that taxpayer savings could be found in the price of medicines through more generics.
Two years later, in the lead-up to the 2007 federal election, petitions and leaflets designed to weaken his chances of re-election were handed out to people when they walked into a chemist. The campaign was led by the powerful pharmacy owners’ union, the Pharmacy Guild of Australia.
“It made absolutely no difference at all, except every pharmacist knew me by my first name,” says Laming, shrugging off the experience. He’s a rare politician to be so relaxed about the guild.
Pharmacies exist in a parallel world, immune from the ordinary forces of competition. They are cocooned in laws and regulations that prevent big companies like supermarkets from muscling in and “location rules” that create mini-fiefdoms.
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Pharmacy rules ‘archaic’, says Chemist Warehouse’s Gance

Joanna Heath and Jared Lynch

Key points

  • Damien Gance says regulations raise costs and prevent innovation.
  • Pharmacy Guild argues the rules benefit the public.
The reclusive group manager of Chemist Warehouse has broken his silence ahead of the government’s competition review, describing regulations which prevent large companies such as supermarkets owning chemists as bizarre and archaic.
Damien Gance oversees 260 stores nationwide. He argues current arrangements protecting the industry should be abolished.
“The impact of regulation has been to raise costs for consumers, to prevent innovation in the industry and to undermine the value of investments,” he said in a submission to the review. He estimated his businesses’ large-scale and heavy discount model had saved $15 million in pharmaceutical benefit scheme costs in 2010-11.
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Supermarket pharmacy worth considering: AMA

11 September, 2014 Chris Brooker
The AMA appears to have no opposition to pharmacy services being provided in supermarkets, but is concerned with pharmacists checking patients’ blood pressure and cholesterol levels.  
Speaking yesterday at a briefing at Parliament House, AMA national president Dr Brian Owler questioned the Community Pharmacy Agreement and expanding pharmacy services, while appearing to support opening up prescription medicine sales.
When asked if Coles and Woolworths should be allowed to sell prescription medicines, Dr Owler said: “If the best thing is for the patient being able to access medicines at a cheaper rate, but still have access to a pharmacist that has the sort of training and expertise to provide the information to the person that's collecting their script…. then that's something that I think needs to be considered”.
His comments have drawn a strong response from George Tambassis, national president of the Pharmacy Guild of Australia.
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Guild hits back at AMA over supermarket support

12 September, 2014 Christie Moffat
The Pharmacy Guild of Australia says recent claims from the Australian Medical Association (AMA) that supermarket pharmacies are worth “consideration” are contradictory to previous statements made by the organisation.
Earlier this week, AMA national president Dr Brian Owler was questioned on whether supermarkets should be permitted to sell prescription medicines.
Dr Owler said the case “should be looked at in terms of what the best thing is for the patient”.
However, a spokesperson for the Guild quoted an AMA media release from 1 July 2014, where Dr Owler stated, “Good health is not something you can pick off a supermarket shelf”.
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Medicare Locals.

ACT’s future Primary Health Network – opportunities galore

5 September, 2014
Ms Leanne Wells
Dr Paresh Dawda
The Budget brings Medicare Locals short life to an end in June 2015.  Their function as a primary health care organisation will be replaced by Primary Health Networks (PHNs).  Successful PHNs will be announced next year, following an open contestable process; the details of which are expected in Spring.  The ACT Medicare Local  (ACTML) will tender to be the ACT’s PHN.  For the ACTML this is a natural progression in a unique jurisdiction and the reforms offer a springboard to the next level.
The ‘Horvarth’ Report has been endorsed by the Federal Government and provides a window on the specification for PHNs.  The expectations include a paramount role for general practice as well as other primary care providers.  A key function will be to integrate care across the whole health system leading to improved patient outcomes.  Where services gaps exist, they will commission those services rather than provide them (unless there are exceptional circumstances).
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Comment:
I also have to say reading all the articles I still have no idea what is actually going to happen with the Budget at the end of the day!
To remind readers there is also a great deal of useful health discussion here from The Conversation.
Also a huge section on the overall budget found here:
Enjoy.
David.