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."

Monday, November 10, 2014

Weekly Australian Health IT Links – 10th November, 2014.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment


Another fun week with lots happening on the PCEHR / Results front and a huge number of comments on the topic - as well as an interesting poll.

For those interested the ACHI Evidence Review Paper on results access this can now be downloaded from this page (presently the top item):

http://www.achi.org.au/Documents.htm

The debate has provided some useful input. I wonder if anyone from the Government has been reading. I hope so.

Please do respond to this week’s poll. It will provide some useful food for thought I hope.

Note: NEHTA has had a few releases this week - go to www.nehta.gov.au to review.
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College told to ditch self-interest over patients' pathology results

3 November, 2014 Paul Smith
The RACGP has been told to ditch "self-interest" and stop blocking patients from prompt access to their pathology results.
The row is brewing over the decision to automatically upload virtually all pathology and diagnostic imaging results on to the PCEHR after seven days.
The college fears patients will learn they have serious conditions like melanomas or sexual diseases like chlamydia on the system before the GP has been able to contact them.
But the stance has outraged the Consumers Health Forum of Australia (CHF), which says that full potential of the e-health system is "threatened by self-interested doctors who wrongly claim they are putting patients' interests first".
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Doctors accused of sabotaging e-health

4 November, 2014 Chris Brooker
‘Self-interested’ doctors are threatening the success of the personally-controlled e-health record program, Australia’s leading consumer group claims.
The Consumers Health Forum (CHF) has come out to criticise a recent statement from The Royal Australian College of GPs “arguing against patients learning the results of path tests on ‘safety’ grounds”.
The RACGP claimed patients getting bad news before hearing it from their GP could be subject to “unnecessary distress”.
However Adam Stankevicius, CEO of the CHF dismissed this view.
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Consumers and doctors clash over health records

Date November 8, 2014 - 6:17PM

Dan Harrison

Health and Indigenous Affairs Correspondent

A patient advocacy group has accused doctors of being motivated by self-interest in arguing against patients having direct access to test results via electronic health records.
Pathology and diagnostic imaging reports will be able to be added to electronic health records in the next update of the system, due later this year. 
Patients will be able to access these results following a seven-day delay, which is designed to give doctors time to manage communication of results with their patients.
But the Royal Australian College of General Practitioners is fighting the change, arguing that patients should not be able to access test results until they have been reviewed by the doctor who ordered them. 
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The new tech approach to an age-old problem

Monday, 3 November 2014 | By Kye White
As Australians live longer and longer, more sons, daughters and grandchildren are becoming the primary carers for ageing relatives who want to stay at home.
Brothers Tim and Matt were in such a situation and developed Curo, a technology-based elderly care and insights platform in an effort to give families looking after elderly relatives peace of mind.
The Curo platform includes a number of sensors, which can be placed in homes and used to monitor things like movement, sleep, temperature, and whether or not appliances are being used. Those sensors then feed real time data back to a smartphone app which can be monitored by family members.
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South Australia races the clock to iron out ehealth bugs

Open date for high-tech hospital looms.

The South Australian Government will be racing to repair problems with its $422 million EPAS system to ensure it can open the doors to the New Royal Adelaide Hospital on time and avoid the ehealth pitfalls that have delayed its fellow states.
SA’s Enterprise Patient Administration System has been put on hold as the state’s health department works through a number of funding questions and usability complaints.
But the rollout will need to be brought back to life before long if the New Royal Adelaide Hospital – recently described by the state’s auditor-general as “reliant” on the EPAS for its proposed model of operation – is to meet its April 2016 deadline, the Liberal opposition has pointed out.
“As EPAS is the only option on the table for the new Royal Adelaide Hospital it is critical that the Minister finds a solution to its deep seated problems well before the opening of the new Royal Adelaide Hospital,” shadow health minister Stephen Wade said in a statement.
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Death sparks call for GP access to script records

4th Nov 2014
THE death of a Melbourne woman who obtained scripts from seven different GPs has spurred a coroner to call for doctors to have access to patients’ prescription records “as a matter of urgency”.
Victorian coroner Ian Gray said GPs should have access to a real-time prescription monitoring (RTPM) system to stop ongoing damage and deaths from pharmaceutical misuse and inappropriate prescribing.
He also said an effective monitoring system would operate across state borders and should go beyond Schedule 8 drugs.
Judge Gray made the recommendations after conducting an inquest into the death of Anne Christine Brain, who was last seen alive sleeping on a couch at her home in Melbourne’s west on 24 December 2011.
Ms Brain died of intoxication from the combined effects of tramadol, methadone, diazepam, codeine, alprazolam, risperidone, doxepin and metoclopramide, the coroner found.
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Support for crackdown on doctor shopping

6th Nov 2014
AMA Victoria president Dr Tony Bartone has backed a coroner’s call for urgent action on prescription monitoring, saying the state could effectively crack down on “doctor shopping” for less than it spends on road safety campaigns.
The comparison is apt because more Victorians die from overdoses of prescription drugs than in road accidents, the Melbourne GP told Medical Observer.
“We are talking more deaths than the road toll and significantly inferior spending on the problem and the solution,” he said. 
“On that measure alone, this is a very significant project worthy of immediate resourcing and implementation.” 
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How Fast Starter Health.com.au is disrupting Medibank and Bupa

Published 05 November 2014 12:21, Updated 05 November 2014 12:25
Health.com.au co-founder Andy Sheats says disgruntled Medibank Private members represent about a third of the customers the start-up is luring to its low-cost online-only offering.
The government-owned Medibank, which is cruising towards its $4 billion-plus initial public offering in November, controls about 29.1 per cent of the market with 1.6 million policyholders across its brands, Medibank and ahm.
After establishing three years ago, Health.com.au doubled its number of policyholders to 90,000 in the 2014 financial year. Health.com.au was second on the BRW Fast Starters list this year and also ranked in BRW’s 50 Most Innovative Companies in 2014.
Health.com.au co-founder and chief executive Andy Sheats said half of the venture’s new members were customers taking up insurance for the first time. However of customers that switched to Health.com.au from another insurer, about a third come from Medibank and about another third come from the second-largest player, Bupa.
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NEHTA hooks up 267 public hospitals to national e-health system

More than 1.7 million individuals and 7,234 health organisations now registered with the system
Byron Connolly (CIO) on 06 November, 2014 12:22
The National E-Health Transition Authority (NEHTA) said on Thursday that it had worked with CIOs to connect 267 public hospitals and health centres to national e-health infrastructure.
This is just over one-third of about 750 public hospitals across the country.
Most of these providers are in Queensland with 219 of the total connected to the national system. Around half of the 41,632 discharge summaries uploaded to the system have been sent by Queensland Health organisations, NEHTA said in its 2013-14 annual report.
Meanwhile, more than 1.73 million Australians are now registered for an e-health record, an increase of 826,948 over the same period last year, according to NEHTA’s 2013-14 annual report.
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Blind spot in Google Glass

5th Nov 2014
GOOGLE Glass may cause blind spots in the peripheral vision of its wearers and impact driving and pedestrian safety, according to research published in JAMA.
Significant scotomas, or blind spots, were found in all of the participants while they were wearing the head-mounted display systems, but not when wearing control frames of a similar colour and temple width. 
The University of California researchers called peripheral vision “essential for daily activities such as driving, pedestrian safety and sports” but noted that more than 10% of the visual field on the horizontal axis was lost by wearers of Google Glass. 
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Telstra to shake up medical care with eHealth kick

James Riley
November 3, 2014
In launching Telstra’s vast ambition to become a major commercial player in the delivery of health services in Australia, David Thodey sounded more like a health minister than the chief executive of a telecommunication company.
When Thodey made his speech last month, it so comprehensively covered the ideals of the Australian eHealth agenda that it could easily have been mistaken for a speech Peter Dutton should have been making.
There was lots of talk about a health system that is “more connected, more effective and more accessible to everyone.” He spoke of improving services to the bush, reducing hospital and GP visits, cutting back-office cost out of the system and of course saving lives.
These are bread and butter eHealth issues, and as the dominant telecommunications services provider in this country, you would certainly expect Telstra to have a deep interest.
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Getting behind Australia’s med-tech sector

Four hot new technologies have been identified as the future of Australian medical technology by being commended as finalists in the first Janssen Health and Technology Challenge (HaTCH).
Sponsored by pharmaceutical company Janssen, the Challenge’s five judges, were given the job of winnowing through around forty entries, all of whom were eligible for the finalist’s $10,000 prizes. The winner, which is slated for announcement on December 3, will receive an additional $100,000 to take their products to market.
The judging panel was made up from experts including World Medical Association chair, Dr Mukesh Haikerwal, Amit Vohra, the former CEO of General Practice Registrar Australia, Cyrus Allen, a partner at Strativity Australia, Chris Hourigan, chief executive of Janssen Australia, and serial entrepreneur Mike Liubinskas.
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Barriers to open source in the NHS

There is a discussion going on on the NHS Technology Community site on what the barriers to open source are in the NHS, and how to address them. The posts are interesting, but one thing is lacking: a statement of what it is people are trying to achieve, other than solving local problems. I made a post that may interest others more widely, as follows (slightly adjusted here).
I would suggest that if people want to understand barriers to open source in the NHS, they need to understand the supposed need for open source. Is it:
  • to enable in-house developers to add to an existing product?
    • They need access to something like plug-in interfaces to do this. Probably not the main product source (e.g. Intersystems Ensemble, Cerner, ….) though.
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Telemedicine celebrates 10 years of sending images of skin rashes and lesions to dermatologists

Mon 3 Nov 2014, 11:31am
Telemedicine is celebrating 10 years of sending images from a remote location for specialist diagnosis.
The Tele-derm service was been developed by the Australian College of Rural and Remote Medicine and is funded by the Australian Government Department of Health under the Rural Health Outreach Fund (RHOF).
It means dermatologists based in major hospitals can tell the patient quickly if they have just a rash, eczema or even skin cancer, melanoma.
The Dean of Medicine at James Cook University in Townsville, Professor Richard Murray, says you can send a digital image of your skin lesion rather than having to book and attend a specialist.
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Orion Health sets IPO price at top end

  • Business Spectator
  • November 07, 2014 11:05AM
NEW Zealand’s Orion Health has set the final price of its IPO at $NZ5.70 ($5.10) a share, the top end of its indicative range, after a two-day book build.
The software provider raised $NZ125 million in the float, comprised of $NZ120m in new capital and $NZ5m in existing shares sold by an entity associated with founder and chief executive Ian McCrae.
Mr McCrae, who founded the company in 1993, will remain the biggest shareholder and retain around 50 per cent of the company. No other shareholders are selling into the IPO.
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Microsoft Band hands-on: The ultimate multi-platform, multi-function wearable

Summary: Microsoft launched the Microsoft Band late at night, but it turns out they may have delivered one of the best values in wearable technology to date. Matthew has spent the last three days running, walking, and sleeping with it.
By Matthew Miller for The Mobile Gadgeteer | November 6, 2014 -- 14:00 GMT (01:00 AEST)

Microsoft Band

Microsoft surprised all of us with the Microsoft Health and Band announcements last week. Due to the promise of a cross-platform fitness and activity tracker with GPS, basic smartwatch functionality, and more, I immediately went online and ordered one.
I visited the local Microsoft Store to try to buy one on Friday while mine was in transit, but they were sold out. Since my Microsoft Band just arrived on Monday, I haven't spent enough time with it to give you a full review so I'll start off with some first impressions. A full review that includes running, strength training, and more will be coming in a week or two.
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$1.8m deal sees Invigor score yet another acquisition

By Tony Yoo on Nov 6, 2014 3:50 AM

Mobile data analytics provider Amethon to join growing family.

Australian big data solutions provider Invigor has acquired mobile data analytics provider Amethon for $1.8 million.
“The acquisition positions Invigor as provider of real-time competitor and real-time consumer analytics through the combination of Invigor Insights and Amethon platforms,” said Gary Cohen, executive chairman of Invigor – named by CRN in August as one of the five ASX-listed companies to watch.
A statement to the ASX described Amethon as an operator in the mobile data analytics field “delivering subscriber data through advanced network analytics and content tracking solutions”. The platform works with both “telcos and wifi networks”.
Amethon’s portfolio boasts an e-health network contract with a “major local telco” customer that will involve more than $1 million in annual licence fees over the next seven years.
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Artificial malevolence: watch out for smart machines

Date November 8, 2014

Nick Bilton

Ebola sounds like the stuff of nightmares. Bird flu and SARS also send shivers down my spine. But I'll tell you what scares me most: artificial intelligence.
The first three, with enough resources, humans can stop. The last, which humans are creating, could soon become unstoppable.
Before we get into what could possibly go wrong, let me first explain what artificial intelligence is. Actually, skip that. I'll let someone else explain it: Grab an iPhone and ask Siri about the weather or stocks. Or tell her "I'm drunk." Her answers are artificially intelligent.
Right now these artificially intelligent machines are pretty cute and innocent, but as they are given more power in society, these machines may not take long to spiral out of control.
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Artificial intelligence and singularity could mean demise of human control

Date November 9, 2014 - 12:15AM

Sam de Brito

Columnist

One of humanity's great conceits is thinking we are evolution's finished product.
It's an easy hubris to indulge in considering anatomically modern humans appeared 200,000 years ago and we've ruled the roost since. I doubt when we puny-skulled, slightly built types turned up with our crude jewellery and cave paintings, Neanderthals were too fussed. And look where that got them.
It makes you wonder whether the complacency we display about the technology that serves us today might be our ultimate undoing; we underestimate the challenger. We giggle at Siri's mistakes, roll our eyes when Pandora suggests a dud song and pause Call of Duty to go pee.
Rarely, however, do we pause to consider the beachhead artificial intelligence (AI) has already won in our lives.  
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Enjoy!
David.

Sunday, November 09, 2014

I Bet This Goes Badly! Has The Feel Of A Government Department Really Out Of Their Depth.

This popped into the ether from the Department of Human Services on Friday 7 November 2014.
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From: CO.ONLINE.TECHNICAL.SUPPORT.LIAISON
Sent: Friday, November 07, 2014 1:59 PM
To: CO.ONLINE.TECHNICAL.SUPPORT.LIAISON
Subject: Department of Human Services Advice: MEDICARE ELECTRONIC CLAIMING - Patient Contribution Update [SEC=UNCLASSIFIED]

MEDICARE ELECTRONIC CLAIMING – Patient Contribution

The Australian Government Department of Human Services (Human Services) anticipates implementing the Patient Contribution Budget Measure from 1 July 2015.  Implementation is subject to the passing of the necessary legislation. With the proposed introduction of Patient Contributions for general practitioner, pathology and diagnostic imaging services, sites will need to check whether the patient has a concessional status and may choose to charge a patient contribution at the point of service as appropriate. These sites will require changes to their practice management software to transmit claims which include a patient contribution. Vendors who provide software to these sites will be required to develop and implement changes to their Medicare Online software and/or Medicare Easyclaim integrated software to provide the new functionality.
Scope
Subject to legislative changes, from 1 July 2015 the Medicare benefit will be reduced by $5 for all patients for:
  • General Practitioner (GP) consultations in Category 1, Groups A1, A2, A11, A22 and A23;
  • out-of-hospital Diagnostic Imaging (DI) services in Category 5, Groups I1, I2, I3, I4 and I5; and
  • out-of-hospital Pathology episodes containing services in Category 6, Groups P1, P2, P3, P4, P5, P6, P7, P8 and P10.
A patient contribution of $7 will be introduced and this may be charged by the provider.  A maximum of 10 patient contributions per calendar year across in-scope GP consultations, DI services and Pathology episodes will be payable by concessional patients (including children under 16), where the provider charges a patient contribution. If the provider chooses to set their own fee for an in-scope service, the provider has charged a patient contribution if the charge is at least $7 greater than the Medicare benefit. The annual cap of 10 patient contributions is  called the Service Cap.  After 10 patient contributions have been charged the Medicare benefit for concessional patients (including children under 16) for these services will revert to the full amount. All patient contribution amounts charged will be excluded from the Original Medicare Safety Net (OMSN) and the Extended Medicare Safety Net (EMSN).
Changes to legislation will be required to allow providers to charge the patient a $7 patient contribution where patients assign their Medicare benefit directly to a provider.
A Low Gap Incentive (LGI) will also be introduced and paid to providers that accept a concessional patient’s (including children under 16) assignment of Medicare benefit, and charge a patient contribution of $7 only. Once concessional patients reach their annual Service Cap, the provider will continue to receive the LGI where they continue to accept the assignment of benefit (bulk bill), and do not charge a patient contribution.
The bulk bill incentive will also cease for in-scope services for:
  • GP consultations;
  • out of hospital Pathology services; and
  • out of hospital DI services.
The bulk bill incentive will continue to be paid for other GP and Pathology services which are not within scope.
These changes will affect software which supports Bulk Billing and/or Patient Claiming for GP consultations, out of hospital Pathology and out of hospital Diagnostic Imaging services.
The software design will include a verification service that will support medical practices and health professionals in determining when to charge or not charge a patient contribution, including when the service cap has been reached.
Medicare Electronic Claiming Client Adaptor Support Policy (Medicare Online and ECLIPSE)
(This section should be read in conjunction with the Medicare Electronic Claiming Client Adaptor Support Policy released 14 October 2014)
To ensure successful implementation of the Patient Contributions budget measure, the department will be making new logic packs available which will be compatible with the May 2009 Release client adaptor version and above.
A new client adaptor will also be made available in 2015 which will meet the requirements for Patient Contributions and resolve some known issues identified in existing adaptors.
The following client adaptor versions identified in the Medicare Electronic Claiming Client Adaptor Support Policy as N, N-1 and N-2, will be compatible for Patient Contributions:
Adaptor Release                 Version
(back to 2009 - Omitted)
In scope vendors who DO NOT meet the client adaptor minimum supported requirements
Vendors who do not currently have a Notice of Integration (NOI) for a client adaptor version of May 2009 Release or above, will need to upgrade to a supported client adaptor and implement the new logic packs and receive a new NOI.
Vendors in this group have 2 options which are:
1.        Commence an upgrade now to a currently supported Client Adaptor N-1 (June 2014 preferred) and then implement the new logic packs in 2015. This may help spread the development time required and reduce the 2015 NOI process.
2.        Upgrade to the latest release (June 2015) and implement the new logic packs.
In scope vendors who DO meet the client adaptor minimum supported requirements
Vendors who have an existing NOI for a client adaptor version of May 2009 Release or above, will need as a minimum to implement the logic pack changes required for Patient Contributions and receive a new NOI.
You may still choose to upgrade to the latest client adaptor (June 2015), however due to the compressed timeframes, priority will be given to the development, testing and support of vendors who do not currently meet the minimum supported requirements.
Vendors NOT in scope for Patient Contributions
Vendors not in scope for Patient Contributions and who do not meet the minimum supported requirements in the Client Adaptor Support Policy will be given an extension to 1 December 2015 to upgrade their adaptors to a supported, N or N-1, version.
Schedule and Testing
Human Services is currently developing a strategy to streamline NOI testing arrangements for Patient Contributions. Further testing information will be provided as soon as practically possible.
  •  A new NOI will be required for the logic pack changes..
  • Beta CD release is scheduled for January 2015.
  • NOI testing can start utilising the Beta CD as of January.
  • Final CD release is scheduled for release May 2015.
  • Human Services Patient Contribution release is scheduled for June 2015 for a 1 July implementation.
Further Communication

As the Patient Contribution measure is subject to the passage of legislation, Human Services will be working closely with the Department of Health to ensure regular updates are provided to vendors. Human Services will be holding a number of forums to discuss the implementation of this measure. Teleconferences will be arranged in coming weeks so that vendors have the opportunity to raise questions and clarify information.

Human Services is unable to provide any additional information at this time other than what has been provided in this message. Should you have any questions in relation to the implementation of Patient Contributions, please email otsliaison@humanservices.gov.au. Questions will only be accepted by email and individual responses may not be provided. However, your questions are a valuable part of this process and will be used to develop a Q&A that will be distributed to all vendors. We will also endeavour to answer as many questions as possible during the teleconferences.
----- Ends

Note the lack of additional info - bold!
What is going on here is that providers of practice management software are being asked - in the absence of any certainty as to legislation or timing of implementation - to undertake a major development project with little hope of being remunerated for their time and effort. At the very least funding for all to undertake this work needs to appear and quickly.
Worse than that you will note that the e-mail has no sense of just how this will be implemented - most especially the 11th patient visit cancellation of the co-payment. Just how is this to happen in real time, how are refunds to be made and so the questions go on and on.
The whole unlegislated co-payment idea is tricky, with 10 payment cap more tricky and with no funds to develop the software to implement it is a joke. Note that is all meant to be designed, tested, implemented and working in 7 months (with 2 months lost for the silly season!).
If I was involved I would demand either legislation having been passed (and full funding)  or full financial indemnity for all expenses + a considerable uplift for inconvenience before lifting a finger!
Dream on Government. Just plain ridiculous, as is the whole co-payment policy in my view!
David.

AusHealthIT Poll Number 243 – Results – 9th November, 2014.

Here are the results of the poll.

Should Pathology and Radiology Results Be Uploaded To The PCEHR, And Made Accessible To Patients, Before Review Of The Information By The Patient's Clinician?

For Sure 6% (12)

Probably 4% (8)

Neutral 2% (4)

Probably Not 29% (60)

No Way 58% (121)

I Have No Idea 1% (2)

Total votes: 207

It seems most don’t think that result information should be made accessible to patients before review by the ordering clinician.

Good to see such a clear outcome and lots of votes.

Again, many, many thanks to all those that voted!

David.

Saturday, November 08, 2014

Weekly Overseas Health IT Links - 08th November, 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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CIOs: EHR usability to get worse

Posted on Oct 31, 2014
By Bernie Monegain, Editor
Worries over the usability of electronic health records have escalated recently -- in tandem, it seems, with their broad adoption. Now comes research from Frost & Sullivan that confirms this, and suggests that EHR usability challenges are likely to get worse before they get better.
Top problem: Information retrieval. It's nearly impossible for physicians to get the right information at the right time from their EHRs. They need it at the point of care. When it's not there, it's not merely frustrating. It puts patients at risk.
In Frost & Sullivan's analysis, "EHR Usability – CIOs Weigh in On What’s Needed to Improve Information Retrieval," Principal Analyst Nancy Fabozzi posits that as EHR data expand, the retrieval problem will get worse.
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CHIME sees 'troubling' signals for MU

Posted on Oct 31, 2014
By Neil Versel, Contributing Writer
As we head into Congress' lame-duck session after Tuesday's midterm election, the national policy agenda for healthcare CIOs will revolve around meaningful use, cybersecurity, ICD-10 and patient safety.
Of most pressing concern to the College of Healthcare Information Management Executives is the start of Medicare penalties in 2015 for hospitals failing to meet meaningful use standards.
At the CHIME 2014 Fall CIO Forum, CHIME Vice President for Public Policy Jeff Smith noted that a surprisingly low number of healthcare providers had successfully achieved Stage 2 meaningful use, and called the trend "troubling."
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HIT professionals must have 'customer empathy' when creating software

October 31, 2014 | By Katie Dvorak
To create software that works, health IT professionals need to have "customer empathy," according to Todd Dunn, director of innovation for Intermountain Healthcare's I.S. Organization.
Often, IT professionals proclaim that "users don't know what they want," Dunn writes at InformationWeek Healthcare. But that statement is untrue, he says.
There is a great gap that needs to be filled between healthcare professionals who approach design with customer empathy and professionals who do not, he adds.
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CIO Survey: EHRs are Still Slow, Time-Consuming

October 30, 2014
Despite significant progress in electronic health record (EHR) adoption, the road is still paved with pitfalls for many providers, according to new analysis from research firm Frost & Sullivan.
The survey was in conjunction with the College of Health Information Management Executives (CHIME), and primarily targeted CIOs working in mid-to-large sized community hospitals. Frequently highlighted customer pain points include: slow and inaccurate information retrieval from EHRs as well as difficulty in finding and reviewing data, both of which result in productivity losses for clinician end-users as well as potential risks to patient safety; inability to create targeted queries or easily access unstructured data such as clinician notes; and time-consuming data entry tasks.
Specifically, when it came to searching EHRs, respondents said that EHRs are too slow, and the rudimentary search functionality and poor usability of them are more important causes of search problems than lack of end-user training or clinician dislike of technology.
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ICD-10 Is Ready To Serve

10/30/2014 09:06 AM
Jonathan Elion
Commentary
ICD-10's benefits can be defined in just a few simple phrases. It's time to get on board.
With Halloween just around the corner, physicians may find it comforting to know that ICD-10 does not need to be on our list of scary things.
We've all heard so much about ICD-10, I think we're getting a bit numbed to the subject, and some of us may be having trouble separating fact from fiction. Of course, many doctors are -- and should be -- concerned about running a business (namely, their practice), and they wonder how all this will impact their bottom line. But I want to focus instead on ICD-10 as it impacts the clinical side of our profession.
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IT Vendors Come Together to Battle against Ebola

OCT 29, 2014 11:40am ET
Electronic health record systems are not the only information technologies being leveraged in the fight against the Ebola outbreak. A coalition of IT vendors has been established to distribute free information and timely updates on Ebola through mobile and web-based apps to healthcare professionals and consumers worldwide.
Health eVillages, a program of the not-for-profit Robert F. Kennedy Center for Justice and Human Rights and Physicians Interactive which provides mobile devices that include specialized medical reference content and clinical decision support tools to clinicians in developing countries, has launched the collaborative effort.
Under the partnership, Physicians Interactive will distribute information on Ebola through its free Omnio mobile and MedAlert Pro messaging applications. In addition, the Healthways, MedHelp, WELVU and Univadis platforms will be used by the coalition to reach healthcare providers in the U.S. and globally with breaking news, recommendations and guidelines related to the treatment of Ebola.
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Study: EHR users incur greater administrative burden

October 28, 2014 | By Marla Durben Hirsch
Electronic health records increase physicians' administrative burdens rather than decrease them as expected, according to an article in the International Journal of Health Services.
The researchers, professors of public health at the City University of New York and lecturers at Harvard Medical School, evaluated data from the Center of Studying Health System Change's 2008 Health Tracking Physician Survey of 4,720 physicians of various specialties. They found that the average doctor spent 8.7 hours a week (16.6 percent of working hours) on administrative work. They also found that this burden lowered doctor's morale.
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Marc Probst: It feels like Washington isn't listening to us

October 30, 2014 | By Dan Bowman
Intermountain Healthcare CIO Marc Probst is never one to mince words. As a member of the Office of the National Coordinator for Health IT's policy committee, for instance, Probst has been an outspoken advocate for the implementation of standards to drive interoperability in health IT.
"We're still not dealing with the root foundational issues [for interoperability]--the standards," Probst said at the College of Healthcare Information Management Executives' annual fall forum in San Antonio, Texas, this week. "We talked about it in the last policy committee meeting and at the joint meeting, and I think, again, people are starting to get the concept that we need to do it, but we're taking way too much time and going about. It needs to be directed and it needs really strong leadership, but right now that's a little hard to see--based on what's happened at ONC over the past few weeks--that that leadership exists."
In part 1 of an exclusive interview with FierceHealthIT, Probst talks about the ONC's ongoing leadership trials and tribulations, as well as the Meaningful Use program.
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Epic goes live at Cambridge

28 October 2014 Sam Sachdeva
Cambridge University Hospitals NHS Foundation Trust has gone live with its Epic electronic patient record system as part of a £200m IT overhaul.
The go-live marks the first implementation of the American supplier’s EPR in the UK. When Cambridge chose Epic ahead of Allscripts and Cerner, the decision was seen by many as one of the most important NHS IT procurements in recent years.
Dr Keith McNeil, the trust’s chief executive, said the planned go-live date of 25 October was postponed due to “some system issues”, which were resolved in time for a go-live at 2am the next day.
"We look forward to what will be the most exciting endeavour we have ever been involved in,” he added in a statement on the trust website. "We are forging the way for patient safety, not only for Cambridge University Hospitals but for the NHS as a whole."
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The Promise of Health IT Is Suffering Under the Reality of Washington

by David LeDuc Thursday, October 30, 2014
Health care systems around the world are being challenged by aging populations, chronic illness and revolutionary -- but expensive -- treatments. Addressing these issues is increasingly dependent on information, as health care is a data-rich, knowledge-driven industry. And yet, the regulations governing health data were developed at a time when the telephone and typewriter were among the most advanced technologies being used in most doctor's offices.
First, let's consider what's at stake. Applying health care data analytics, delivered in a digestible manner when and where it is needed, can lead to faster treatments coming to market, enhanced patient engagement and increased adherence to care plans, as well as reduced fraud -- all of which not only promise to improve the health of our nation's population, but also lower costs for patients and providers by eliminating needless procedures.  
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AMA tool shows areas in need of care

Posted on Oct 29, 2014
By Bernie Monegain, Editor
The American Medical Association launched what its leaders call a first-of-its-kind tool aimed at helping physicians and other healthcare providers improve patient access to care.
The AMA’s Health Workforce Mapper is an interactive tool that illustrates the geographic locations of the healthcare workforce in each state, including health professional shortage areas, hospital locations, as well as other related trends. It highlights areas where the number of healthcare professionals could be expanded to boost patient access to care close to home.
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Cleveland Clinic releases list of top medical innovations for 2015

October 29, 2014 | By Katie Dvorak
January is only a few months away but Cleveland Clinic is already looking to the New Year with today's release of its list of top medical innovations for 2015.
Among the technologies and developments Cleveland Clinic sees taking off are a mobile stroke ambulance, painless blood testing and an intra-operative radiation approach for breast cancer, according to an announcement from the clinic.
A panel of physicians and scientists at Cleveland Clinic compile the list each year.  
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Karen DeSalvo to 'maintain leadership' at ONC, agency says

October 29, 2014 | By Dan Bowman
Just call Karen DeSalvo the once and future National Coordinator for Health IT.
ONC, in a Health IT Buzz blog post published Tuesday afternoon, said that DeSalvo, in fact, will not step down as National Coordinator--as the agency announced Oct. 23-- but instead will "maintain her leadership of ONC" while also serving as acting assistant secretary of health with the U.S. Department of Health and Human Services.
To that end, according to the post, DeSalvo will continue to serve as chair of the Health IT Policy Committee. Additionally, she will continue to lead efforts to finalize the interoperability road map.
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Google's New Fit App Plays Well With Strava, Runkeeper and Others

Google's Fit app tracks physical activity and weaves in data from other apps.
IDG News Service | Oct 28, 2014 12:10 PM PT
Google is aiming to keep its users healthy—and away from Apple—with a new app that takes a broader view of fitness tracking.
Google Fit, released Tuesday, will use the sensors in Android phones to track and organize people’s walking, biking and running activity. Users can set goals and check their progress from within the app on their smartphone, as well as on the web, tablets, and Android Wear smartwatches.
Mobile fitness apps are a dime a dozen these days, but Google is trying to add value by letting Fit act as a hub for third-party apps like those from Strava, Withings and Runkeeper. Fit users can access data gathered by those apps within the Fit app, instead of having to switch between them. That functionality makes Google Fit the prime competitor to Apple’s HealthKit, a software platform for iOS 8 that lets third-party apps share their data with Apple’s Health app.
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Survey: Patient Portal Usage Growing Despite Reservations

October 28, 2014
A new survey of hospital and healthcare IT executives reveals that adoption of patient portals is growing even if they aren’t sold on the benefits of these engagement efforts.
The survey, conducted by the Chicago-based Healthcare Information Management and Systems Society (HIMSS) Analytics, reveals a positive picture of the patient engagement requirements of Stage 2 meaningful use which require eligible hospitals and eligible providers to have five percent of their patients view, download, and transmit (VDT) their health data. More healthcare provider organizations are adopting patient portals, much of it facilitated by the electronic medical record (EMR) vendor.
Patient engagement is more than just today’s hot topic – it is foundational to the future of healthcare,” HIMSS Analytics research director, Brendan FitzGerald, said in a statement.  
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CCHIT Announces It Will End Operations by November 14

OCT 28, 2014 2:43pm ET
The Certification Commission for Health Information Technology (CCHIT) today announced that it is winding down all operations, effective immediately, with all work slated to end by November 14, 2014. According to CCHIT, customers and business colleagues have been notified and its staff is assisting in the transition.
CCHIT was established in 2004 through a collaboration with three HIT associations—HIMSS, the American Health Information Management Association, and the National Alliance for Health Information Technology (now defunct)—to provide certification services for health IT products and education for healthcare providers and IT developers. In October 2005, the Department of Health and Human Services contracted with CCHIT to develop certification programs for electronic health records and health information exchanges.
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AMA worried about ONC 'gap'

Posted on Oct 28, 2014
By Bernie Monegain, Editor
The American Medical Association released a statement Monday that points to the organization's concern over the recent departure of key leaders from the Office of the National Coordinator for Health Information Technology. The ONC exits most recently include the coordinator herself, Karen DeSalvo, MD.
"The American Medical Association understands that Karen DeSalvo is leaving her post as the National Coordinator for Health Information Technology to do important work in public health," said AMA President Robert Wah, MD, in the statement.
"DeSalvo's departure, in addition to those of several other senior staff including the Deputy Director of the Office of the National Coordinator for Health IT Jacob Reider, which was also announced last week, leaves a significant leadership gap which could jeopardize the growing momentum around interoperability," Wah noted.
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Predictive analytics in healthcare pose unique challenges

October 28, 2014 | By Susan D. Hall
Looking to take a page from Amazon, Netflix and Google, investors have poured $1.9 billion into companies pursing predictive analytics in healthcare, though predicting the best course of treatment is significantly different than recommending a book or movie, according to a new Rock Health report.
"Even if we had the technology to address interoperability issues, solve privacy concerns, and process unstructured data, hundreds of thousands of factors influence health--many of which medical science still can't explain. Additionally, health outcomes aren't instantaneous. Without an effective, closed-feedback loop, algorithms struggle to continue to learn and improve," Rock Health's Teresa Wang writes in a blog post.
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Beacon Community programs face barriers to success, report says

October 28, 2014 | By Susan D. Hall
An evaluation of four Beacon Community projects found some common issues and barriers, according to a paper at eGEMs (Generating Evidence & Methods to improve patient outcomes.
The paper looked at commonalities among the projects, including structure, people, technology, tasks, and sustainability.
The four projects include:
  • txt4health, a service using text messaging used in Detroit, New Orleans, and Cincinnati Beacon Communities to help patients to better manage their health and to control or prevent diabetes.
  • Southern Piedmont Beacon Community in North Carolina's avatar used to educate patients and conduct administrative intake for the Women, Infants, and Children (WIC) Program.
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NHS plan ‘turning point’ for IT - Kelsey

24 October 2014   Sam Sachdeva
NHS England’s Five Year Forward View could provide a “turning point” for the information revolution, Tim Kelsey has said.
The plan, released yesterday by NHS England and other national bodies, identifies “exploiting the information revolution” and “accelerating innovation” as two enablers for its ambition to close the NHS funding gap.
It argues the gap, which could otherwise reach £30 billion by 2020-21, can be closed by reducing demand on the NHS by improving public health and increasing efficiency across the service by implementing new models of care.
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Johns Hopkins Medicine Leads Online Ebola Learning Module Development

OCT 27, 2014 1:01pm ET
Johns Hopkins Medicine has been tasked by the Centers for Disease Control and Prevention to lead a group designing an interactive web-based learning program that will guide healthcare workers, nurses and physicians through government-approved protocols to aid clinicians as they care for patients who may be at risk of contracting the Ebola virus.
The program will train healthcare providers in three critical areas: proper donning of personal protective equipment, the safe removal of gear, and active monitoring skills. All three modules will be available for free on the CDC’s website in the coming weeks and later available to iOS users on iTunes U, the world’s largest online catalog of free educational content.
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Big data becomes tool in Ebola battle

by Rob Lever
Nine days before Ebola was declared an epidemic, a group of researchers and computer scientists in Boston spotted the hemorrhagic fever beginning to spread in Guinea.
By scouring the Internet for clues from social media, local news reports and other available online data, the algorithm developed by HealthMap had an early picture of the deadly disease moving across West Africa.
"Official agencies tend to be more cautious about these announcements, so public communication tends to lag," said Clark Freifeld, who co-founded HealthMap in 2006 at Boston Children's Hospital.
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How the Military's EHR Reboot Will Impact Interoperability

Scott Mace, for HealthLeaders Media , October 28, 2014

A massive government procurement will speak volumes about the market share, and clout, of one lucky electronic health records system technology. The rest of the healthcare IT industry will be living with the ramifications of the Department of Defense's decision for years to come.

In much of tech, market share plays an outsize role in determining which standards get adopted. The dawn of the Internet was never supposed to be based upon TCP/IP, but instead on OSI protocols, which blue-ribbon committees carefully crafted to be the best possible foundation for open networks. But then TCP/IP grabbed all the market share and there was nothing left for the OSI protocols to do but fade into history.
The same thing may be about to play out in electronic health records. While the Office of the National Coordinator reboots its various blue-ribbon committees, and struggles to adapt to losing its deputy, Jacob Reider MD, and the loan of its chief, Karen DeSalvo to the administration's response to Ebola, a massive government procurement will speak volumes about the market share, and clout, of one lucky EHR technology.
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Post-Discharge Procedures Do Not Reduce Readmissions

OCT 27, 2014 7:49am ET
Beefing up post-discharge procedures, including using interactive voice monitoring technology, did not significantly reduce the number of patients with congestive heart failure or chronic obstructive pulmonary disease who were readmitted to the hospital or who visited emergency departments.
That’s the finding of a new study from the American Journal of Managed Care.
"A comprehensive hospital-based intervention failed to reduce 30- or 90-day readmissions as well as ED visits for patients with CHF or COPD, compared with usual care," authors Ariel Linden and Susan W. Butterworth concluded. "It did, however, reduce 90-day mortality among COPD patients. Our results suggest the need to continue to experiment with new interventions targeting readmissions — in particular, those focused on building collaborative relationships between hospitals and community-based providers. In the interim, our results point to a challenging road ahead for hospitals seeking to decrease readmissions for chronically ill patients and avoid financial penalties."
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Google Trends promising for health research, but needs more transparency

October 27, 2014 | By Katie Dvorak
While Google Trends has the potential to help with access to population data on behavior and its link to health and healthcare, it needs to be more transparent to be a useful tool, according to a new study.
Researchers from Yale-New Haven Hospital performed a review of healthcare literature using Google Trends to examine the platform's potential and how others in healthcare are using it, according to the study, published in PLOS ONE. Two independent reviewers identified studies using Google Trends for healthcare research from MEDLINE and PubMed. Those studies then were broken down into four topics: infectious disease; mental health and substance abuse; other non-communicable diseases; and general population behavior.
Twenty-seven percent of the articles used Google Trends for casual inference, 39 percent for description and 34 percent for surveillance, according to the authors.
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Combining HIE, eRx database to EHRs improves med list accuracy

Beth Walsh
Oct 23, 2014
Combining the data of EHRs, a commercial medication database and a community health information exchange increased the accuracy of patients' medication lists, according to a study published in the American Journal of Managed Care.
Researchers analyzed EHR data for 858 patients who were admitted at two New York hospitals in the same healthcare system between September 2010 and April 2011. The patients were prescribed a total of 7,731 medications.
Physicians at the hospitals were able to access the EHRs, HIE and database. When researchers compared data from the three sources with medication lists that were compiled by patients and verified, they found that EHRs captured 80 percent of patients' medications accurately; the commercial medication database accurately captured 45 percent; and the HIE accurately captured 37 percent.
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Hospital Study Offers Solutions to 'Alarm Fatigue'

2.5 million beeps, bleeps sounded in one month at one U.S. medical center
WEDNESDAY, Oct. 22, 2014 (HealthDay News) -- Monitoring devices among intensive care patients set off 2.5 million alarms in one month at a U.S. hospital, a new study of "alarm fatigue" shows.
Alarm fatigue occurs when hospital staff become desensitized to the constant beeps and bleeps of alarms, and either ignore them or turn them off. The problem has been identified as a major issue by The Joint Commission, which accredits U.S. hospitals.
"There have been news stories about patient deaths due to hospital staff silencing cardiac monitor alarms and alerts from federal agencies warning about alarm fatigue," study senior author Barbara Drew, a professor in physiological nursing at the University of California, San Francisco, said in a university news release.
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Recap of Q3 2014 Federal Health IT Activity

by Helen R. Pfister, Susan R. Ingargiola and Dori Glanz, Manatt Health Solutions Monday, October 27, 2014
The federal government continued to implement the HITECH Act, enacted as part of the American Recovery and Reinvestment Act, during the third quarter of 2014. As implementation of HITECH's programs begin to wind down, more than $25 billion in incentive payments have been made to providers to spur electronic health record adoption, and more than 90% of eligible hospitals and 75% eligible professionals have adopted and are using EHRs as a result.
At the same time, interoperability and electronic health information exchange between EHRs remains a major challenge, and privacy issues continue to be a central focus for policymakers and regulators. With the amount of HITECH funding available to drive change diminishing, the federal government will be turning to new levers to continue driving adoption of health IT tools to enable real-time coordination and management of care for patients and consumers. Below is a summary of key developments and milestones achieved between July 1 and Sept. 30.
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Enjoy!
David.