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."

Sunday, July 19, 2015

NEHTA’s Chairman Beats The Drum Of E-Health. Gets A Trifle Carried Away I Would Suggest!

This appeared a few days ago.

Get elderly patients online

Charlotte Mitchell
Monday, 13 July, 2015
GPs should routinely ask their older patients to set up a personally controlled electronic health record to help them share medical information with their families, according to the chair of the National E-Health Transition Authority.
Dr Steve Hambleton, who is also a Queensland GP, said that in his experience only a couple of patients have ever declined the chance to register for a personally controlled electronic health record (PCEHR).
“From a GP point of view, we do want a patient to share information with their family, especially as they get older and develop more illnesses”, Dr Hambleton told MJA InSight.
He was commenting on US research that found elderly patients often shared control of their personal health information and decision making with family and friends, but the sharing involved complex issues, even under the most well meaning circumstances. (1)
The research was based on group discussions with patients aged over 75 years and with individuals who assisted an older family member, finding broad support for sharing personal health information with caregivers if it would benefit the older patient. However, concerns were raised about autonomy and control, respect for preferences, micromanagement and snooping, and unintended information disclosure.
An accompanying commentary said the study highlighted the importance of developing user-centred software that met the information sharing needs and preferences of older patients and their families. (2)
Dr Hambleton told MJA InSight that Australia’s approach to information sharing was “the envy of nearly every other country in the world”.
He said the PCEHR allowed a patient to give a nominated family member, or an authorised representative, access to their medical information.
“The PCEHR is an extraordinary achievement. It’s an easy opt-in, opt-out resource that has standardised information, standardised nomenclature, standardised medical terminology”, he said.
Lots more here:
Before discussing elders and the PCEHR let is consider these three paragraphs - the bold especially.
“Dr Hambleton told MJA InSight that Australia’s approach to information sharing was “the envy of nearly every other country in the world”.
He said the PCEHR allowed a patient to give a nominated family member, or an authorised representative, access to their medical information.
“The PCEHR is an extraordinary achievement. It’s an easy opt-in, opt-out resource that has standardised information, standardised nomenclature, standardised medical terminology”, he said.”
I look forward to the list of countries that have expressed envy of the fiasco that is the PCEHR and as for the PCEHR being an “extraordinary achievement” I am just left wondering if the NEHTA Chair has been spending too much time listening to the NEHTA and DoH propagandists. What rubbish!
Here is a report covering the study mentioned by Dr Hambleton.
Posted July 10, 2015 - 4:33pm

Study shows elderly want to control what health information family sees


By LISA RAPAPORT
REUTERS
Elderly patients may be willing to let family members access their medical records and make decisions on their behalf, but they also want to retain granular control of their health information, a study suggests.
“Respecting and preserving the autonomy of the elder is critical,” said lead author Dr. Bradley Crotty. “Elders and families should have honest discussions about preferences for information sharing and decision-making, and share these conversations with healthcare providers.”
To understand how patients over 75 and the family members who care for them think about sharing medical information, Crotty and colleagues held separate focus groups in 2013 and 2014 with 30 elders and 23 caregivers.
The elderly participants came from different residential settings - including assisted living and skilled nursing facilities - run by Hebrew Senior Life, an academic health care organization affiliated with Harvard Medical School.
Caregivers were adult children, spouses, or other relatives of residents, and they didn’t have to related to the elderly subjects in the study.
The majority of study participants were white. Most residents and caregivers in the study were women and had college or graduate degrees.
Most of the elderly patients were older than 81. A third of them rarely, if ever, used the internet, while 60% went online daily or almost every day.
Many differences of opinion emerged as the two groups talked about sharing access to the elderly patients’ health records, the researchers reported online July 6 in JAMA Internal Medicine.
Caregivers felt that having information would decrease their stress, but patients wished to maintain control of the information to avoid burdening their children or loved ones with their illnesses and problems.
Many family members also thought having access to elderly patients’ records would make it easier for them to help coordinate care, appointments and communications with the rest of the family. But patients worried that this access would cause anxiety in their children.
The more independent elderly patients didn’t like the idea of losing control of their decision-making abilities and having to rely on their children. They were willing to share information, but reluctant to cede control of the information flow or give up the ability to make their own choices about treatment.
If they did have to give up control, elderly patients wanted this to happen gradually, starting perhaps by only sharing information in an emergency rather than as a routine on a day-to-day basis.
More here:
The issue with this from the perspective of the PCEHR is the complexity of granting access of others to your PCEHR (If you have one) and the fact that the access is rather binary - either your representative can see all of the record or basically no record.
The complexity can be read about from these links:
Here is an explanation of the PAC.

What is a PAC

Personal Access Code (PAC) is a code generated by you in the eHealth system and that you will give to your Nominated Representative and/or Full Access Nominated Representative to access your eHealth record.
(I can see many older citizens going through this!)
A moment of thought will see just how potentially complicated, open to abuse and privacy invasive the PCEHR approach to all this might be.
Sharing health information with family can be both very good and potentially very harmful - and requires a great deal of individual thought as well as extremely granular control in the hand of the individual to decide what the family can access or not! It is clear individual control is something many elders want. As for how different providers fit in to all this there is a set of even more complex discussions waiting!
Reading the now obsolete Concept of Operations of the PCEHR from late 2011, I am not at all sure what older citizens are likely to want and need is even possible - let alone in existence at present!
Capacities of this sort need to be designed in from the ground up I believe.
David.

AusHealthIT Poll Number 279 – Results – 19th July, 2015.

Here are the results of the poll.

Are You Expecting The Government Will Make Major Changes For The Better To The PCEHR Following All The Good Ideas From Submissions Made By ACHI, APF, CHF etc.

Yes 3% (4)

Maybe 9% (14)

Neutral 4% (6)

Probably Not 48% (73)

No 36% (54)

I Have No Idea 0% (0)

Total votes: 151

Seems a very large majority think little will change. Pretty sad that. I hope we are proved wrong.

Good to see such a great number of responses!

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

David.

Saturday, July 18, 2015

Weekly Overseas Health IT Links -18th July, 2015.

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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A ‘Star Trek’ Future Might Be Closer Than We Think

By Anna North
July 10, 2015 11:10 am July 10, 2015 11:10 am
Set against some of the biggest sci-fi franchises of the last five years, many of which imagine the future as a wreckage in which the strong prey relentlessly upon the weak, “Star Trek” can seem kind of quaint. After all, the show, especially in its second and strongest incarnation, “The Next Generation,” takes place in a time when, essentially, everything has worked out.
But it is precisely this quality that interests Manu Saadia, the author of “Trekonomics,” a forthcoming book about the economics of the “Star Trek” universe. The book, which grew in part out of conversations between Mr. Saadia and his friend Chris Black, a former writer for “Star Trek: Enterprise,” will be sold through the publishing platform Inkshares. It examines “Star Trek’”s “post-economic” system, in which money no longer exists and anything you want can be made in a replicator, essentially for free.
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Posted July 10, 2015 - 4:33pm

Study shows elderly want to control what health information family sees

By LISA RAPAPORT
REUTERS
Elderly patients may be willing to let family members access their medical records and make decisions on their behalf, but they also want to retain granular control of their health information, a study suggests.
“Respecting and preserving the autonomy of the elder is critical,” said lead author Dr. Bradley Crotty. “Elders and families should have honest discussions about preferences for information sharing and decision-making, and share these conversations with healthcare providers.”
To understand how patients over 75 and the family members who care for them think about sharing medical information, Crotty and colleagues held separate focus groups in 2013 and 2014 with 30 elders and 23 caregivers.
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Clinician-centered design in EHRs improves workflow

July 10, 2015 | By Katie Dvorak
Design for electronic health records that is clinician-centered can help improve workflow in ambulatory healthcare settings, a recent report found.
The report, published at eGEMs (Generating Evidence & Methods to improve patient outcomes), examined lessons learned from implementing recommendations from the National Institute of Standards and Technology into a software prototype for the Veteran's Health Administration's VAi2 innovation project.
The authors of the report, from Ohio State University, NIST and Johns Hopkins University, put into play 12 of the 15 recommendations to improve workflow made by NIST.
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Online 'Symptom Checkers' Often Miss Diagnosis, Study Finds

Computer-generated analysis correctly identified problem about one-third of the time
By Alan Mozes
HealthDay Reporter
THURSDAY, July 9, 2015 (HealthDay News) -- Automated online "symptom checkers" that seem to offer patients a quick opportunity for self-diagnosis provide the right diagnosis in only about one-third of cases, a new analysis reveals.
The study team found that online checkers -- which are typically free services offered by medical schools, insurance companies, and even government entities -- are a more reliable and effective means to get a handle on symptoms than using web search engines such as Google.
The investigation also found that online medical checkers are about as accurate as primary care physician phone services that offer patients advice on whether or not a condition requires urgent care.
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Telemedicine at a Crossroads

by Rebecca Vesely, iHealthBeat Contributing Reporter Friday, July 10, 2015
When the U.S. Supreme Court upheld the Affordable Care Act's subsidies for the federal health insurance exchange late last month, one of telemedicine's chief advocates was elated.
Jonathan Linkous, CEO of the American Telemedicine Association, in a phone interview said that the high court's decision will allow more room for Congress to focus on other priorities this session -- including telemedicine.
"Congress would have been totally swept up in the decision for the rest of the year had the subsidies been struck down," Linkous said, adding, "Telemedicine has always enjoyed bipartisan support."
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Healthcare IT: Time to Train the Machines

JUL 9, 2015 7:49am ET
Healthcare executives expect that within the next three years their industry will need to focus as much on training machines as they do on training people, according to a new report from outsourcing and consulting firm Accenture.
The report, Accenture Healthcare Technology Vision 2015, is based on a survey of 601 doctors, 1,000 consumers and 101 healthcare executives and highlights emerging technology trends that will affect the industry in the next three to five years.
A majority of the health executives surveyed (84 percent) agree or strongly agree that their industry will need to focus as much on training machines, such as using algorithms, intelligent software and machine learning, as they do on training people in the next three years. Most agree that provider organizations, driven by a surge in clinical data, will soon need to manage intelligent machines as well as employees.
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AHRQ: Patient engagement tools both help, hurt clinician workflow

July 6, 2015 | By Marla Durben Hirsch
Health IT applications that engage patients can have both a positive and a negative effect on clinicians' workflow, according to a new final contract report funded by the Agency for Healthcare Research and Quality (AHRQ).
The report reviews patient use of secure messaging, electronic forms patients complete on a computer and portals to upload clinical data to their clinicians, and involves six different clinics in medium sized cities.
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Leapfrog out with troubling hospital safety numbers

Posted on Jul 09, 2015
By Bernie Monegain, Editor-at-Large
Patients may expect cleaner than clean conditions in a hospital – sterile even. Think again. In one of four hospitals across the country hand washing – the best-known way to prevent hospital infections – is apparently not a priority. Nearly a quarter of the hospitals – 23 percent – have yet to implement safe practices such as those.
That's according to a survey by hospital watchdog The Leapfrog Group. Overall, the results paint a picture of hospitals across the country struggling to provide safe care.
Health management company Castlight Health analyzed the results of the annual survey that measures a broad array of safety issues. It found that while hospitals overall showed improvement in 2014 for hand hygiene, rural hospitals aren’t performing as well as their urban counterparts.
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2015 'Most Wired' hospitals turn to new priorities

Posted on Jul 09, 2015
By Bernie Monegain, Editor-at-Large
Health data security and patient engagement are top priorities for the nation’s hospitals, according to results of the 17th annual Health Care’s Most Wired survey, released today by the American Hospital Association’s Health Forum and the College of Healthcare Information Management Executives.
The 2015 Most Wired survey and benchmarking study, conducted in partnership with CHIME and sponsored by VMware, is designed to provide a barometer measuring information technology use and adoption among hospitals nationwide. The survey of more than 741 participants, representing more than 2,213 hospitals, examined how organizations are leveraging IT to improve performance for value-based healthcare in the areas of infrastructure, business and administrative management, quality and safety, and clinical integration.
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Wales rolls-out patient portal

8 July 2015   Thomas Meek
Wales is nearing the complete roll-out of its My Health Online portal for online bookings and repeat prescriptions.
In its latest newsletter, the NHS Wales Informatics Service says the service needs to be implemented at one more GP practice in the Aneurin Bevan Health Board area and this will occur within the month.
Once completed, My Health Online will be live at all 458 GP practices in Wales, offering patients the opportunity do a variety of health-related tasks online, including booking appointments and ordering prescriptions. 
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NHS developing PHR adoption strategy

9 July 2015   Thomas Meek
NHS England is working on an adoption strategy to support the use of personal health records.
The strategy is intended to enable the NHS to develop an understanding of “what do we need to do at centre to help health economies and patients adopt PHRs,” according to Lenore Ogilvy, a commercial specialist at the commissioning board.
Ogilvy, who was speaking at a Future of Personal Health Records event this week organised by Sitekit, the co-creator of the eRedbook, said the plan is part of the National Information Board’s ‘Personalised Health and Care 2020’ framework to drive improved use of digital technology in healthcare.
The work on PHRs comes under workstream 1.1 of the framework, which is focused on enabling patients and the public to use digital tools to access health and care information and make informed choices.
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Congress gets another chance to advance telemedicine

July 08, 2015Eric Wicklund - Editor, mHealthNews
A new version of a bill designed to phase in telemedicine for Medicare beneficiaries is back on the table in Washington.
Rep. Mike Thompson, D-Calif., introduced the Medicare Health Parity Act of 2015 on July 7. Co-sponsors of the bill are Reps. Gregg Harper, R-Miss., Diane Black, R-Tenn., and Peter Welch, D-Vt.
The four legislators said this bill would put Medicare "on the path toward parity with in-person healthcare visits."
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Unless taxpayers stand up and take notice, politicians will continue to waste public funds with impunity.

eHealth Ontario – the Gift that Keeps on Taking

Once again, Ontario taxpayers will be shelling out tens of millions of dollars for a cancelled contract that sees them getting nothing in return.
This time, it’s a new $26.9 million bill from scandal plagued eHealth for a cancelled contract for the development of an unfinished registry of diabetes patients.
In 2010, the Ontario government signed a contract with CGI Information Systems to create a database to track the needs of diabetes patients. The six year contract was cancelled in September 2012 at the request of eHealth.
Deb Matthews (the Health Minister at the time) and eHealth took the position that the contract could be cancelled without a cost to taxpayers, because they alleged repeated delays had made the CGI database obsolete.
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Is Your Organization Ready for the Era of Cybercrime?

JUL 7, 2015 6:08pm ET
Cybercrime is on the rise, and the healthcare industry is the hot new target for increasingly sophisticated, intelligent hackers.
On the black markets of the Dark Web, stolen patient health records can fetch as much as $363 per record, according to data from the Ponemon Institute, which is more than any other piece of data from any other industry. This is because, unlike credit cards and other data, health records contain information that can’t be easily changed or deleted – social security numbers, birth dates and more.
As we see more high-profile attacks against healthcare organizations, our government is responding with increased regulation as a first defense. Compliance demands continue to grow, especially when it comes to protecting personal information. The pending Data Security and Breach Notification Act of 2015 would be the first federal rule requiring organizations to inform consumers that their personal information may have been compromised, and then take reasonable steps to protect personal information they maintain in electronic form.
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Digital Health Funding in 2015 Slightly Behind 2014

JUL 8, 2015 7:35am ET
Funding for digital health companies reached $2.1 billion in the first half of 2015—just short of the $2.3 billion during the same time period during 2014’s record-breaking year—according to Rock Health, which funds and supports early stage healthcare companies.
Rock Health released its 2015 Midyear Report revealing that there were 139 deals in the first six months of the year with the average deal size pegged at more than $15 million, exceeding $14.6 million in 2014. The firm’s funding data only includes disclosed U.S. deals over $2 million.
According to Rock Health, digital health funding was approximately 5 percent of total venture funding in the first quarter (latest data available), outpacing overall funding, the software sector, and traditional healthcare sectors—including biotech and medical devices.
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The seedy underworld of medical data trafficking

Posted on Jul 08, 2015
By Chris Bowen, ClearDATA
As more healthcare organizations are discovering to their woe, having direct access to patients' personal health information puts a giant target on their backs for cyber thieves that traffic in stolen medical records. Medical data breaches are increasing in frequency and scope, with millions of Americans now victims of medical identity theft. Who are the criminals behind this digital era crime wave?
IBM research shows that the vast majority of cybercrime is highly organized and generating unprecedented profits, noting that the largest bank heist in history was $30 million compared to the annual $445 billion cost of cybercrime. Solo cybercriminals are also out there, however. Trend Micro observes that these different classes of criminals also dwell in different forums, with petty thieves showing up in more easily accessed sites, and organized cyber thieves residing in closed forums of their own.
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Patient portal design should be more fluid, varied, researchers say

July 7, 2015 | By Marla Durben Hirsch
Patient portals can be a helpful way to share older adults' health information with their caregivers, but privacy and autonomy issues indicate that full access by proxy may not be the best approach, according to a new study in JAMA Internal Medicine.
The researchers, from Beth Israel Deaconess Medical Center and elsewhere, conducted 10 professionally moderated focus groups from October 2013 to February 2014 as part of a broader inquiry regarding the information needs of the elderly and their caregivers. They found there to be "broad support" in general for information sharing if it benefited the older adult, but the elders and caregivers had different perspectives.
For instance, while caregivers wanted access to information to reduce their own stress levels and be helpful, elders resisted sharing because they didn't want to burden their caregiver family member with the information.
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White House announces Precision Medicine Initiative commitments

July 8, 2015 | By Katie Dvorak
The Precision Medicine Initiative was announced by President Barack Obama six months ago, and this week the administration detailed new commitments to the program.
The administration released a rough draft for guiding principles in regard to privacy and trust when it comes to precision medicine projects. It offers guidance on governance; transparency; data sharing, access and use; data security and more.
Some of the guidelines include:
  • Unauthorized re-identification and re-contacting of participants will be expressly prohibited
  • Mechanisms should be created to ensure data integrity is preserved at all stages: collection, maintenance, use, and dissemination
  • A Data Security Framework should be developed with help from experts in data science, security and health IT
The White House is seeking comment from the public on the principles through Aug. 7.
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Program helps to address inconsistencies in use of clinical decision support tools

July 8, 2015 | By Susan D. Hall
A conference series known as TEACH (Teaching Evidence Assimilation for Collaborative Health Care) shows promise for promoting evidence-based practice.
Despite advances in research, clinical guidelines continue to be ignored and clinical decision support (CDS) tools used inconsistently or not at all, according to an article at eGEMS (Generating Evidence & Methods to improve patient outcomes).
The program was developed at the New York Academy of Medicine to look beyond technology to address problems of habit, policy and organizational culture to better align practice with clinical evidence.
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Vital intelligence

The technology funds encouraged trusts to bid for systems that can be used to record vital signs and calculate early warning scores. While they get to grips with their implementations, Fiona Barr discovers that early adopters are starting to extend the use of their devices; and to gain some unexpected benefits.

In the fourth biggest hospital in England, every doctor and nurse has a mobile device in their pocket and uses it throughout their working day.
The IT used by staff at Nottingham University Hospitals NHS Trust is not part of an electronic patient record deployment, but a vital signs project that has made iPods and iPhones as ubiquitous on the ward as they are at home.
The Nottingham project was one of many vital signs projects partly paid for by the government’s health technology funds, which helped to kick-start substantial growth in the vital signs’ market a year ago.
Twelve months on, the second round of the Nursing Tech Fund has supported 24 more projects and the momentum is continuing as trusts start to self-fund the schemes and add more functionality.
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Physicians Increasingly Open to Video Consultations

JUL 7, 2015 7:30am ET
A nationwide survey of more than 2,000 primary care doctors found that 57 percent of physicians are willing to conduct video visits with their patients.
Just 12 percent of respondents are unwilling to see a patient over video and 31 percent remain uncertain. In the online survey conducted by telehealth vendor American Well, physicians cited work-life balance as the most popular reason for seeing patients over video, followed by increased earning opportunity, and improved patient outcomes.
When it comes to technology platforms, 69 percent of doctors indicated that video is superior to phone or email communication for making accurate diagnoses for new patient consults. Only 5 percent of those surveyed said email was best for diagnosis and just 1 percent said text was best.
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July Feature: EHRs Going Against the Flow

JUL 7, 2015 7:24am ET
Implementing clinical information systems at healthcare organizations can be a jarring experience. And when those systems conflict with long-used work processes for accomplishing clinical tasks, it's more than annoying. It can make an IT project a long, uphill slog.
For a health IT project to succeed, the flow of information must be synchronized with clinical workflow-that's how an organization can best ensure it will achieve significant gains in efficiency and quality of care. Conversely, when those flows don't match up, providers become less efficient, forced to take additional steps or create workarounds for incongruities.
Such synchronicity is hard to come by for providers. In fact, studies suggest that the rapid adoption of electronic health record (EHR) systems, spurred by federal incentive programs, have led to usability, workflow and cognitive support issues that hinder patient care.
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Online CME learning has hidden benefits

Posted on Jul 07, 2015
By Sherree Geyer, Contributing writer
Hospitals that leverage online learning to reduce the cost of continuing education requirements may experience a bonus: lower lengths of stay, reduced readmissions and improved quality indicators.
So says Teresa Fugate, a case management consultant who credits online learning tools with lower lengths of stay at Knoxville, Tenn.-based Covenant Health, where she served as vice president of case management for five years.

"We saw a reduction in LOS by getting tidbits (of information) on how to handle a chronic case," she says – adding that informed case managers made informed decisions.
"The more expertise, the more confident they are and assertive to have conversations with doctors," says Fugate. "If they knew the criteria and could cite the source, the doctor would have more respect and was more likely to take their suggestion."
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Over-budget GPES has no future - NAO

2 July 2015   Rebecca McBeth
Significant delays to the General Practice Extraction Service have seen costs rise from £14 million to £40 million - and design failures mean it is unlikely to have a long-term future, a National Audit Office report has said.
The NAO has today published the findings from an investigation into the service, which collects data from all GP clinical systems in England.
In a statement, it says mistakes in the original procurement and contract management have increased costs, while the HSCIC may get as little as two more years’ use from the system.
“The total expected cost of the GPES programme increased from £14 million to £40 million during the planning and procurement stage,” the report states.
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Niam Yaraghi: Stage 2 of Meaningful Use has 'failed'

July 6, 2015 | By Marla Durben Hirsch
While there are many benefits of health IT, forcing providers to comply with Stage 2 of the Meaningful Use program has been a failure, according to Niam Yaraghi, a fellow at the Brooking Institution's Center for Technology Innovation.
In a recent blog post, Yaraghi says that Stage 1 of the program created an artificial market for electronic health record systems, and that providers were willing to buy the government-subsidized products without worrying about actually using them.
Now that Stage 2 has gone into effect, however, providers are required to use their EHRs; to that end, forcing physicians to adopt and use a one size fits all program was "destined to fail," he says. Instead, according to Yaraghi, adoption should have been allowed to be "organic and voluntary." Health IT, he adds, is a means to achieve the goal of efficiency and forcing an EHR as the only IT solution ignores the fact that other IT services likely would be better.
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Privileged access controls essential to healthcare security strategy

July 7, 2015 | By Susan D. Hall
Recent healthcare data breaches in which hackers got in through administrator credentials highlight the need for privileged access management, Sudhakar Gummadi, chief information security officer at California-based Molina Healthcare, says in an interview at HealthcareInfoSecurity.
Privileged access, which IT workers use to do their jobs of building and maintaining the infrastructure, essentially gives them the keys to the kingdom. These days, though, it doesn't make sense to offer them 24/7 privileged access, Gummadi says.
While encryption and other tactics are good to have as part of a good defense-in-depth strategy, it's critical to have controls for privileged-access management, he says.
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Stop Complaining About ICD-10 and Start Training

Scott Mace, for HealthLeaders Media , July 7, 2015

Misinformation and misunderstandings surround ICD-10 as the go-live date nears. One result is that too many providers have yet to conduct testing. They should take advantage of CMS's grace period, starting now.

The announcement yesterday that the American Medical Association is now working jointly with CMS to educate its membership about ICD-10 is better late than never.
Consider that, according to a survey conducted by the American Health Information Management Association (AHIMA) between May and June, the majority of providers have not yet conducted ICD-10 testing. This annual survey found that 19% of respondents do not even plan to conduct any end-to-end testing.
That is a fairly astounding finding, nearly as astounding as some of the continuing misinformation being circulated about how coding errors in ICD-10 will affect physician's payments. For some clarification on this, I again turned to AHIMA.
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Time to Lower E-Communication Walls between Patients, Docs

JUL 6, 2015 7:33am ET
The results of a recent survey conducted by Johns Hopkins University, Brigham and Women's Hospital, and CVS Health point to a clear conclusion: It is time to give more than lip service to finding a mutually agreeable way for patients and their providers to communicate electronically beyond “official” platforms such as EHRs and patient portals.
The survey, which gauged patient use of, and interest in, using email, provider websites, and social media – specifically Facebook – was published in the Journal of General Internal Medicine.
 “The easy answer is there are takeaways for everyone,” lead author Joy Lee, a post-doctoral research fellow at the Bloomberg School of Public Health at Johns Hopkins, told Health Data Management about her team's findings, “but especially for healthcare organizations like hospitals, and then providers. For hospitals and clinics, an important finding is pointing out the realization that demand is there – yes, there are concerns about data security, but this is right now an unmet need.”
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IT Leaders to Congress: We Need Patient Identifier Now

JUL 6, 2015 7:18am ET
The College of Healthcare Information Management Executives is calling for a renewed push to establish a unique national patient identifier and is unleashing its 1,600 chief information officers and clinical medical informatics officers to press Congress to remove the current prohibition on such an identifier.
In recent months, U.S. House and Senate committees—particularly the House Energy and Commerce and the Senate Health, Education, Labor and Pensions Committees—have  held a series of hearings on issues surrounding health information technology. These include electronic health records interoperability, Medicare reimbursement for telemedicine services, improving health IT safety, and regulation of certain software as medical devices, as policymakers seek ways for health IT to better support population health management and cost control.
Time and time again, the lack of a sufficient national patient identifier has been cited by testifying stakeholders as a major impediment to interoperability and patient safety. And, with the House Energy and Commerce Committee sending the 21st Century Cures Act to the House floor for consideration, now is the time for CHIME and other industry associations to make a concerted effort on the identifier issue, says Leslie Krigstein, interim vice president of public policy at CHIME.
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The 'fatal cost' of poor IT rollouts

Posted on Jul 06, 2015
By Mike Miliard, Editor
Too often, health organizations "make rookie mistakes" in their technology implementations, writes Leapfrog President and CEO Leah Binder. And too often, these rollouts leave hospitals vulnerable to serious patient safety risks.
Writing in the Wall Street Journal on July 1, Binder lays out a familiar list of complaints.
"They assume everything is plug-and-play, then panic when things go wrong. They set unrealistic timelines that demoralize staff. They rely too much on vendors. And they expect technology to somehow electronically solve complex human and managerial issues."
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Report: IoT in healthcare could have economic impact of up to $1.7T

July 6, 2015 | By Katie Dvorak
The Internet of Things, when used to improve healthcare and help those with chronic conditions, could have an economic impact ranging from $170 billion to $1.7 trillion a year, according to a recent report from McKinsey & Company.
By 2025, the report estimates that the IoT will have a "total potential economic impact" of almost $4 trillion up to a possible $11.1 trillion per year.
That healthcare figures are based on "cost savings in treatment and the value of longer lives and improved quality of life that patients with chronic conditions could enjoy if IoT monitoring helps them avoid disease complications," the report adds.
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Efficient health information exchange could mean huge savings for hospitals

Written by Max Green | July 02, 2015
Including a health information exchange query for every patient encounter in a emergency department setting could significantly reduce the number of tests and examinations ordered in hospitals and reduce costs, according to a recent study published in the Journal of the American Medical Informatics Association.
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The Evolution From Analytics to Dynamics

by Jacob Kuriyan Monday, July 6, 2015
As health care begins to accumulate and merge electronic health record, claims and "big" data, new IT tools and methodologies will be needed to digest them into information. The challenges are non-trivial and the consequent disruptions to IT and its professionals can be severe.
Currently an important role of analytics in health care is to spot outliers -- highest-cost patients, highest utilizers -- to minimize fraud and abuse and increase efficiency. Analyses of cost and utilization using statistics and other methods help set premiums, evaluate performances and devise incentives to improve quality and care. An alternative approach to statistical analysis is the method of dynamical systems, which has shown value in the study of physical systems in many fields such as physics, ecology, biology and electrical engineering. 
Epidemiologists, for instance, have modeled an HIV population as a dynamical system. Known as the SIR model -- for "susceptible," "infected" and "recovered," the three segments of the population in the model -- it successfully forecasts the spread of HIV in a population. In cancer research, dynamic modeling is used to study the growth and spread of tumors. Amusingly, advertisers and marketers use dynamical system models to understand the viral propagation of rumors and gossip on social networks.
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Enjoy!
David.