Friday, September 7, 2012

Weekly Overseas Health IT Links - 8th September, 2012.

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

Open-source software suite aims to improve breast health management

August 31, 2012 | By Susan D. Hall
An open-source software suite to be rolled out across Nova Scotia early next year could improve breast health management worldwide, its creators say in a UICC research summary.
The Breast Imaging Electronic Medical Record (BIEMR) comes from 20 years of work to fill voids in proprietary software offerings, according to Mohamed Abdolell, an associate professor in the radiology department at Dalhousie University.
The Web-based cancer data management software Caisis, which was developed at the Memorial Sloan-Kettering Cancer Center in New York City, forms the basis of the system, combining electronic medical records, specimen tracking, statistical analysis and reporting, and clinical trial management, Aunt Minnie reports. It adds in the R statistical software programming language and the LaTeX document-preparation system, making the entire suite open source and easily modified to meet different facilities' unique needs.

Cloud, Consumerization Realities Mean More IT Security Concern

AUG 30, 2012 4:37pm ET
People and process still make up the bulk of IT security concerns, but the next few years will be marked by parallel spikes in strategy to fortify enterprise data in the cloud and on personal devices, according to a new Gartner report.
In his “Top Security Trends and Takeaways for 2012 and 2013” assessment outlined Wednesday, Gartner Managing VP Ray Wagner put the cloud and consumerization, along with poor attack prevention, as the lone “tech-based” risks to enterprise IT. Other security threats feature a technical component, but have “more to do with being able to identify practices and procedures” within the enterprise, rather than deployment and tools. And, in the instance of the cloud and BYOD, they are rising to the top of Gartner’s annual review of the security landscape.
Wednesday, August 29, 2012

The Importance of Voluntary Technical Standard

From the article: "Technical standards are the language that computers, phones, software, and network equipment use to talk to each other, seamlessly and regardless of where the devices or software were developed. Standards allow any technology developer, web site creator, or equipment manufacturer anywhere in the world to have their creations instantly available to and interoperable with the rest of the global Internet." Read more

A, DoD to expand health information exchanges

Aug. 29, 2012 - 03:29PM   |  
The Veterans Affairs and Defense departments are ready to expand 16 pilot programs and offer veterans’ health information exchanges nationwide.
The new exchanges will build on the success of the pilots, where VA and DoD physicians in Indianapolis, Richmond, Va., San Diego and other cities share veterans’ health data with each other and the private sector.
The move is a major step toward fulfilling an administration initiative called the Virtual Lifetime Electronic Record (VLER), which requires VA and DoD to provide service members and veterans with seamless health care and online access to their health and other personal data throughout their lifetimes.

Mostashari: ONC will monitor EHR vendor-to-vendor exchange

By Mary Mosquera
Electronic health records will need to be able to perform in 2014 a number of functions using standards that will make actual information exchange possible for transitions of care, upon discharge from a hospital and to be shared with patients.
That is something that is very difficult and expensive to do today, if at all.
The capability to exchange health information that is structured and coded in standard format must also be across vendor products for real interoperability and not just within single vendor EHRs within a large provider system, according to Dr. Farzad Mostashari, the national health IT coordinator.

EHR Adoption Grows As Docs Bid For Incentives

Three-quarters of docs report using EHRs in latest Medscape survey, but loss of productivity remains an issue for many.
Electronic health record adoption by physicians is growing, to judge by the results of a recent survey sponsored by Medscape, a leading website for continuing medical education. The survey of 21,200 physicians across 25 specialties, conducted last spring, found that 74% of them already were using an EHR and that another 8% of them were currently installing or implementing systems.
In 2011, 57% of physicians said they were using an EHR, according to a survey by the Centers for Disease Control and Prevention (CDC). An SK&A telephone poll in January 2012 found that just 46% of doctors had EHRs. AdTech Ad

No 'walled gardens' on path to exchange, warns Mostashari

By Mary Mosquera, Contributing Editor
Created 08/30/2012
WASHINGTON – The capability to exchange health information that is structured and coded in standard format must exist across vendor products – and not just within single vendor EHRs within a large provider system – for true interoperability, says Farzad Mostashari, MD.
The national coordinator for health IT put vendors on notice that ONC will be scrutinizing the progress of interoperability in 2014 and looking toward meaningful use stage 3.
“We will pay close attention to whether the requirements in the rule are sufficient to make vendor-to-vendor exchange attainable for providers," he noted in an Aug. 28 blog post. "If there is not sufficient progress or we continue to see barriers that create data silos or ‘walled gardens,’ we will revisit our meaningful use approach and consider other options to achieve our policy intent."

Robot supports high dependency patients

24 August 2012   Rebecca Todd
A telepresence robot that allows clinicians to remotely listen to a patient’s heart and lungs is in use at a Northern Ireland health trust.
A £500,000 high dependency unit at Daisy Hill Hospital in County Down was opened this month and is the first in the UK to use the robot to give patients access to consultant support.
The robot, provided by InTouch Health,enables intensive care specialists from Craigavon Area Hospital in County Armagh to remotely assess patients in real time.

Welsh GP acute unit uses IHR

30 August 2012   Chris Thorne
A new acute GP service developed by Abertawe Bro Morgannwg University Health Board will use Individual Health Records from 29 GP practices in Swansea.
The IHR will be used as part of the new service at the city's Singleton Hospital, which is intended to relieve pressure on hospital admissions by acting as a "gateway" between local GPs and secondary care.
The IHR provides a summary of all of the coded data that is held in a patient's GP record, including medical problems, recorded allergies, and the results of any recent tests or x-rays.

The way of the dragon

The NHS Wales Informatics Service opened its new labs for EHI reporter Chris Thorne, and outlined its progress to date.
30 August 2012
Centrally funded and driven IT projects may be taboo in the NHS in England, but they continue to determine the direction of travel in Wales.
Of course, there are considerable differences between the two countries and their health systems. The mere size of Wales makes a centralised approach manageable, with its population not even half that of London.
Wales has also removed most of the internal market that is being reinvigorated in the NHS in England, so there is, arguably, both more space for central planning and for co-operation on the ground.
Even so, the NHS Wales Informatics Service not only believes that it is heading in the right direction, but one that is supported by the seven health boards in the country.

Scotland extends use of ECS

28 August 2012   Rebecca Todd
Scottish health boards and GPs have agreed that the Emergency Care Summary can be used in scheduled care to support medicines reconciliation, after a pilot showed clear clinical benefits.
The new access arrangements are being rolled out in phases, starting with five boards: Grampian, Highland, Forth Valley, Tayside and Lanarkshire.
The ECS is a summary of patient information extracted from GP patient records and includes demographics, allergies and medication history.

KLAS: Providers turn to consultants to navigate EHR challenges

August 30, 2012 | By Julie Bird
Healthcare providers are turning to consultants as they struggle with meeting Stage 1 requirements for Meaningful Use of electronic health records, according to new research by KLAS.
Measuring and reporting quality is the challenge most frequently cited by providers interviewed by KLAS researchers for the report, "Rapid Growth of Meaningful Use Consulting Why Providers Are Reaching Out." Other significant challenges include adoption by users and software upgrades and updates, according to the findings.

EHR database drastically enhances medical research

August 30, 2012 | By Dan Bowman
A company backed by the Cleveland Clinic recently proved just how valuable electronic health records can be for medical research. Researchers at Explorys, which was created in 2009 with the intent of providing researchers with searchable access to de-identified patient data, used a database of electronic health records to replicate in three months a study by Norwegian researchers that originally took 14 years to create, The Plain Dealer reports. What's more, the replicated study used a sample roughly 40 times the size of its predecessor.

Clinical decision support provides best return among EHR functions

August 30, 2012 | By Dan Bowman
Although the ultimate goal of the electronic health record Meaningful Use incentive program is to reduce care costs improve care for patients, according to National Coordinator for Health IT Farzad Mostashari, debates continue to rage about whether the program can, in fact, achieve both goals.
In seeking to deduce which specific technologies are up to that task, researchers found that clinical decision support in EHRs produced the best return on investment for providers, according to a study published this month in the American Journal of Managed Care.

Imaging decision-support system proves better alternative to prior authorization

August 30, 2012 | By Susan D. Hall
In search of an alternative to prior authorization and prior notification programs to reduce the rate of diagnostic imaging and to increase appropriateness of tests, a Minnesota pilot program reports success in point-of-order decision-support.
The program, facilitated by the Institute for Clinical Systems Improvement, a regional quality improvement collaborative, involved five large medical groups with more than 6,000 physicians. Results of the pilot have been published at The American Journal of Managed Care.

Plenty of healthcare data, but what to do with it?

By Eric Wicklund, Contributing Editor
Created 08/29/2012
SEATTLE – The proliferation of mobile medical devices means providers, payers and even patients are collecting more data than ever before. But do they know what to do with it?
That was the focus of a panel discussion at last week's Institute for Health Technology Transformation summit in Seattle. Titled "Analytics in Healthcare: Leveraging Data for Organization-wide Improvements," the discussion focused on what's considered one of the hot topics in healthcare these days: Business intelligence.

EHI interview: Katie Davis

EHI editor Jon Hoeksma speaks exclusively to Katie Davis as she prepares to give up her job as head of NHS IT at the Department of Health.
23 August 2012
Katie Davis will be the last person to single-handedly lead NHS IT at the Department of Health when she leaves Richmond House at the end of August.
Although it has gone through many name changes, her role can be traced back to Richard Granger, the director general of NHS IT appointed to lead the National Programme for IT in the NHS back in 2002.
But once Davis leaves, responsibility for NHS IT will be split between the DH, the NHS Commissioning Board and the Health and Social Care Information Centre.

Mostashari: ONC will enforce cross-vendor data exchanges

August 29, 2012 | By Julie Bird
The Office of the National Coordinator for Health IT will be tracking whether structured care summaries are being exchanged between providers and "across vendor boundaries" as intended in the new Stage 2 Meaningful Use rules for electronic health records, says National Coordinator for Health IT Farzad Mostashari, M.D.
"As we stated unequivocally in the final rule, we will pay close attention to whether the requirements in the rule are sufficient to make vendor-to-vendor exchange attainable for providers," Mostashari writes this week in ONC's Health IT Buzz blog. "If there is not sufficient progress or we continue to see barriers that create data silos or 'walled gardens,' we will revisit our Meaningful Use approach and consider other options to achieve our policy intent."

Wolters Kluwer, Altos Group target sepsis mortality with mobile IT

By Mike Miliard, Managing Editor
Created 08/28/2012
MINNEAPOLIS – Wolters Kluwer Health has partnered with the Altos Group for a sepsis mortality reduction program. The pilot will put mobile technology, actionable clinical content and change management programs to work in the hopes of early sepsis identification and intervention.
The Reston, Va.-based Altos Group is a consulting firm that works with providers to implement change management programs aimed at improving patient outcomes. Headed by Julie A. Kliger, its methodology and services have proven effective at impacting sepsis rates. In one case, which was profiled recently by the Agency for Healthcare Research and Quality (AHRQ), a 54.5 percent reduction in average mortality rates was achieved within three years across nine California hospitals.

5 Trends Will Reshape Health IT In 2013

Look for growth in mobile health, telemedicine, clinical analytics, and personal health records—and an EHR vendor shakeout.
Ultimately the goal of all healthcare--IT included--is to put itself out of business. That may sound a bit strange but medicine's primary objective is to cure disease, or prevent it from occurring in the first place. And as the profession gets better at these two tasks, the public should become increasingly self-sufficient and have less and less need for its services.
How far down this path will we be in 12 months? Probably not too far. But we are making progress on five fronts: AdTech Ad
Mobile Health. This segment of the industry offers the most promise. It's no exaggeration to describe consumers' and physicians' embrace of mobile health apps, smartphones, and tablets as transformational.

Diagnostic Errors Found in 1 of 4 ICU Patient Deaths

Cheryl Clark, for HealthLeaders Media , August 28, 2012

As many as 40,500 American adults may die in hospital intensive care units each year because their critical care teams didn't accurately diagnose their illnesses, according to a Johns Hopkins University School of Medicine review of 30 international papers that examined autopsy results.
That's more people than die each year of breast cancer in the U.S. or from bloodstream infections acquired in the ICU, the researchers say. And many more patients suffer harm from care provided for the wrong condition.
"The bottom line is that these were misdiagnoses made by the ICU staff," says Bradford Winters, MD, associate professor of anesthesiology and critical care medicine at Johns Hopkins University School of Medicine and lead author of the paper.

7 ways HIEs can enhance profitability

By Steff Deschenes, New Media Producer
Created 08/23/2012
Health information exchange, enabling a free flow of clinical information between IT systems, can enhance patient care. For CFOs and CIOs, it can also lead to big revenue returns.
"These are silos that nobody thought about 10 or 15 years ago – this shared info in such a structured format," explained Dave Caldwell, executive vice president of Certify Data Systems, an enterprise HIE provider. "IT departments of hospitals and health organizations are driven by financially-minded individuals with medical and clinical input. They're buying HIE for revenue enhancement."
Caldwell explained seven ways bringing on an HIE across a healthcare system can enhance profitability.

Report: Infection Control Systems Bring Positives, Negatives

August 27, 2012
According to a research report from the Orem, Utah-based KLAS, approximately 30 percent of healthcare providers with an infection control system say even though they couldn't live without it, there are tradeoffs. The findings were released in a KLAS report, Infection Control 2012: Breaking the Barriers and Getting Value, also found that70 percent of those without a solution haven't been able to justify the expense.
The report’s authors found that most infection control practitioners, IT directors, and clinical directors use their systems for the burden of increasingly complex, mandatory government reporting. Only a few use it to actively monitor hospital acquired infection rates.

Hospitals use infection-control software primarily for reporting

August 29, 2012 | By Susan D. Hall
Most healthcare providers who use infection-control software do so to ease the burden of increasingly complex, mandatory government reporting rather than to monitor their hospital's acquired infection rates, according to a newly released KLAS report.
"Infection Control 2012: Breaking the Barriers and Getting Value," finds that justifying the expense has been a barrier to 70 percent of those without such a system, according to a KLAS announcement.
"In an age of analytics, most infection preventionists are still mired in mandatory reporting," report author Coray Tate said in a statement. "But so many requirements are coming down the pike that infection-control solutions might go from being nice to have to being a must-have."

Final MU 2 Rules Will Significantly Ratchet Up Vendor Costs

Scott Mace, for HealthLeaders Media , August 28, 2012

Five weeks ago I wrote that the then-imminent release of the Meaningful Use Stage 2 final rules did not mean vendors could turn a crank and produce software code that healthcare providers, would be able to seamlessly implement in order to meet deadlines looming in 2013 and 2014.
On Friday, during an online briefing about the just-released 2014 final rules, the squeeze on vendors seemed to tighten during an exchange with ONC federal policy division director Steve Posnack.

EHRs: Which Ones Doctors Like and How Their Lives Changed

Shelly Reese
Posted: 08/23/2012


When it comes to electronic health records (EHRs), physicians are sharply divided. But they know which EHRs and vendors they favor, and they know whether their practice has improved or incurred more problems.
In a recent survey, Medscape asked more than 21,000 physicians from 25 specialties what they liked and disliked about their EHR systems and how the systems had affected their practices.
Some doctors raved. Some railed. Many expressed billowing frustration. (For full survey results, see the Medscape slideshow EHR Report -- Physicians' Choice: Best-Ranked EHRs)
August 24, 2012

Palomar Health and Cisco Join to Make Hospital Experience Better

Hospitals have been making great strides toward personalizing and improving the experience patients have while they’re there. Streamlining check-ins, patient education videos, Robots that lift patients from beds, bring clean laundry and even deliver meds to your bedside. 
But Palomar Health recently took it one step further, deploying next-generation body-worn physiological monitoring technology from Sotera Wireless and Palomar vGO robots, powered by Cisco wireless networks, allowing patients, families and staff to collaborate via video from anywhere across the globe, according to Orlando Portale, chief innovation officer at Palomar Health.

Survey: Physicians trust mobile content more than nurses do

By: Brian Dolan | Aug 23, 2012     105   29   11
A recent survey conducted by digital health communications firm Enspektos found that physicians are more likely than nurses to find medical information in mobile apps credible. Of the more than 100 physicians surveyed, about 70 percent said that mobile apps were a very credible or highly credible, while only about 46 percent of the 100 nurses surveyed were as trusting. Interestingly, while a greater percentage (76 percent) of physicians said the same for medical websites, the gap was smaller for this channel, which 69 percent of nurses said was very credible or highly credible.
Pharmacists fell in the middle. Of the 100 pharmacists surveyed, 61 percent said mobile apps were very or highly credible sources of medical information, while 71 percent said the same for medical websites.

New HHS rule targets HIPAA, standardization the goal

By Erin McCann, Associate Editor
Created 08/24/2012
WASHINGTON – HHS Secretary Kathleen Sebelius announced Friday a final rule establishing a health plan identifier (HPID), that officials say will boost standardization within HIPAA transactions and increase the efficiency of health billing processes.
The final rule, established by the Office of E-Health Standards and Services (OESS), also includes a data element that functions as an “other identity” identifier (OEID), which is designated for non-health related entities or individuals that still need to be identified for standard transactions. 

Asthma app could save money, improve health

Mon, 27 Aug 2012 7:00a.m.

The free asthma iPhone app can help people monitor their health (Asthma NZ)

By Imogen Crispe
A new smartphone application to help people control their asthma is just one of the ways New Zealanders are using mobile phones to monitor their health.
Asthma New Zealand recently launched an iPhone app called “Breathe Easy”, which allows people to monitor their peak flow, set reminders to use inhalers, and keep a symptoms diary.
Asthma New Zealand marketing manager Linda Thompson says the app could help reduce doctors’ visits and hospital admissions for asthma patients, increase their attendance at school and work, and save millions in care costs.

Physician survey: More use EHR, few are satisfied

Author Name Kyle Murphy, PhD   |   Date August 24, 2012   |  
A new survey shows that electronic health record (EHR) among physicians has grown significantly over the past three years and will continue increase over the next couple of years. The Medscape survey of more than 21,000 physicians across 25 specialties, “EHR Report 2012: Physicians Rank Top EHRs,” provides deeper insight into the systems physicians are using and for what purpose as well as confirms suspicions about the purported and actual benefits of using an EHR.
The first takeaway from the survey is the growth in EHRs. Since 2009 when only 38% of physicians indicated that they were using an EHR, nearly 75% are current users with another 20% planning to implement a system within the next two years. Do the math — that’s a 200% uptick in physician use of EHRs. Three-quarters of physicians have already achieved (44%) meaningful or will attest within the next year achieve (31%). Fourteen percent won’t bother. Of those working with an electronic system, three groups are using them more than all others: internists (28%), family practitioners (25%), and pediatricians (22%). The least likely users belong to rheumatology, critical care (not to be confused with emergency medicine), and plastic surgery.

How video observation can improve health IT efforts

August 27, 2012 | By Susan D. Hall
Danish research reviewing nine case studies using video observation argue that the method can be an effective tool for understanding clinical practice. And understanding clinical workflow, the study's authors say, can be integral to improving health information technology development.
While traditional study methods ask what clinicians say they do during their daily work, they don't always include all of their actual activity because some aspects of a job become second nature. Video, in this regard, can capture their actual practice--even those tacit aspects of the job--according to the research article published at BMC Medical Informatics & Decision Making.