Friday, October 12, 2012

Weekly Overseas Health IT Links - 13th October, 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.

EHR leader, Kaiser CEO to retire December 2013

By Bernie Monegain, Editor
Created 10/04/2012
SAN FRANCISCO – George Halvorson, chairman and CEO, credited with leading the decision to implement an enterprise-wide electronic health record system that’s often touted as a model, will retire in Dec. 2013. He has served as Kaiser’s chairman and CEO since 2002. Halvorson announced his retirement to his employees on Oct. 4.
Under his leadership, Kaiser Permanente has grown to serve more than 9 million members, has introduced its own electronic health record system, Kaiser Permanente HealthConnect, touted as the largest non-governmental system in the world, supporting the transformation of care delivery and connecting caregivers and patients in new and innovative ways.

AHRQ Wants to Rate the Educational Effectiveness of EHRs

OCT 4, 2012 4:16pm ET
The HHS Agency for Healthcare Research and Quality is in the early stages of developing a “health information rating system” to assess how well electronic health records systems support educating patients.
“In order to fulfill the promise of EHRs for all patients, especially for persons with limited health literacy, clinicians should have a method to determine how easy health education material is for patients to understand and act on, have access to a library of easy-to-understand and actionable materials, understand the relevant capabilities and features of EHRs to provide effective patient education, and be made aware of these resources and information,” according to a notice and request for public comment available here and being published Oct. 5 in the Federal Register.

House Leaders to HHS: Halt and Fix the EHR Incentive Program

OCT 5, 2012 12:03pm ET
Four powerful members of the U.S. House and Representatives have sent a letter to HHS Secretary Kathleen Sebelius calling for an immediate halt to the electronic health records meaningful use incentive program, which they consider to be weak.
The letter, first reported on HIStalk, comes from Republican leaders Dave Camp and Wally Herger, chair of the Ways and Means Committee and its health subcommittee, respectively, and Fred Upton and Joe Pitts, chair of the Energy and Commerce Committee and its health subcommittee. These are two of the most powerful committees in Congress.

Commentary: 5 points congressmen missed in call to end MU

By Tom Sullivan, Government Health IT
Created 10/05/2012
WASHINGTON – Timing being everything and all, the four Republican congressmen who on Oct. 4 sent a letter asking HHS Secretary Kathleen Sebelius to stop distributing meaningful use incentives probably should have attended the Oct. 3 Bipartisan Policy Center event instead. 
The day was packed with doctors, politicians, healthcare industry heavyweights, state and local health officials, who were all essentially agreeing that health information exchange and interoperability are gaining purchase in the industry. 

7 best practices for a successful incident response plan

By Mahmood Sher-Jan, CHPC, Vice president, product management at ID Experts and Chris Apgar, CISSP, CEO and president, Apgar and Associates
An MIT professor once said there is zero correlation between intelligence and wisdom. Intelligence abounds throughout any healthcare organization. When faced with a potential data breach or other incident that can potentially harm organizations and their customers, an incident response plan, or IRP, converts that knowledge into usable wisdom that protects an organization’s patients, customers, and reputation.
Required for covered entities and now because of the HITEHC Act, business associates under the HIPAA Security Rule, an IRP provides organizations with a step-by-step guide for responding to security incidents.

GUEST BLOG: Eight Ways to Avoid an EMR Implementation Disaster

October 2, 2012
Why a detached, “big-bang” approach to EMR implementation can be counterproductive
Over the past 35 years, I have overseen and participated in many enterprise EMR/EHR implementations, including the nation’s largest Epic ambulatory big-bang implementation (146 clinics with 1,500 providers). Some of these implementations went according to plan. Others, not so much. Following are a few of the strategies that have proven themselves time and again in turning EMR implementation pain into EMR performance.
1. Adopt a modified big-bang approach
To help mitigate the inevitable go-live operation/workflow issues, I advise clients to bring up hospitals and clinics at different times. For clinics, I recommend bringing up a pilot group first, and then bringing the remaining clinics up in waves of similar types. One client that chose the enterprise-wide big-bang route could not keep up with the call volume even with an 18-person phone bank, greatly impacting overall user satisfaction.

Enhanced Google Flu Trends could detect epidemic early

October 5, 2012 | By Dan Bowman
Google Flu Trends is not sufficient as an early epidemic detection system but could be if augmented with additional computational intelligence, according to researchers publishing this week in the Journal of Medical Internet Research.
The researchers, based at Lahore University of Management Sciences in Pakistan, acknowledge that Google Flu Trends serves as a good "baseline indicator" of epidemic trends but dismissed the notion that it could, for example, serve as a good warning system for emergency departments. To enhance the system, however, they built upon the system, developing a new system dubbed FluBreaks, which converts Google Flu Trends data into an early epidemic detection system through the use of "sophisticated statistical analysis."

Study: Many EHR drug alerts need not be intrusive

October 3, 2012 | By Marla Durben Hirsch
Using more non-interruptive drug-drug interaction alerts in electronic health records may reduce alert fatigue, according to a new study published in the Journal of the American Medical Informatics Association.
Providers bombarded with clinical decision support alerts often will ignore them. This problem is "particularly profound" with DDI alerts, which often have override rates of 90 percent, according to the study's authors.

New mHealth app set to tackle anxiety disorders

By Erin McCann, Associate Editor
Created 10/04/2012
ROCHESTER, MN – A new mobile health application developed by mental health professionals has set its sights on the estimated 40 million people in the U.S. currently living with anxiety. 
Officials say the Anxiety Coach app was created as a self-help tool to help people reduce a variety of fears and worries, ranging from extreme shyness to obsessions and compulsions.
“The reason we created [the app] is because anxiety disorders are one of the most, if not the most common mental health problem faced by both kids and adults, and only approximately 30 percent of people receive treatment," says Stephen Whiteside, director of the Pediatric Anxiety Disorders Program at Mayo Clinic, psychiatrist and co-developer of the application, to Healthcare IT News. “And even though that’s a small number, even a smaller number receive the most effective treatment, which is exposure-based cognitive behavior therapy.”

AHIMA: Keep personal healthcare data safe, experts warn

By Neil Versel
Created 10/04/2012
CHICAGO – Why should hospitals centralize their policies and procedures for disclosing protected health information?
At the American Health Information Management Association (AHIMA) convention Wednesday, Don E. Hardwick, client relations and compliance, MRO Corp., a document and disclosure management company in King of Prussia, Pa., told the story of one hospital client that left PHI management up to each department.
A few years ago, a man went to the radiology department trying to get imaging films for a patient injured in a car accident. The department started processing the request before realizing that the man responsible for the accident wanted to destroy the films so they couldn't be used in court.

Wales thinks big in tough times

3 October 2012   Lyn Whitfield
The NHS Wales Informatics Service has issued an ambitious information services strategy that focuses on supporting health services in a time of austerity.
The strategy, which was issued for consultation earlier this week, argues that the national approach to developing IT that the country has pursued over the past five years has delivered significant benefits.
But it says it is now necessary to take account of the ‘Together for Health’ five year plan for the NHS in Wales, significantly reduced resources, and the advent of new cloud and consumer technologies.

Interoperability Big Barrier for EHRs, Docs Say

By David Pittman, Washington Correspondent, MedPage Today
Published: October 03, 2012
WASHINGTON -- The vast majority of clinicians believe electronic health records (EHRs) improve the quality of care, but nearly as many -- 71% -- cite a lack of interoperability as a major barrier to further implementation, a survey showed.
A number of changes are needed to help physicians overcome those barriers and fully implement EHRs, the Bipartisan Policy Center concluded in a survey and report released Wednesday.

Interoperability issues keep clinicians from sharing health info electronically

October 3, 2012 | By Julie Bird
Clinicians want to share health care information electronically, but are stymied by electronic health records that can't communicate with one another, a lack of information-exchange infrastructure, and the expense of setting up electronic interfaces and information exchanges, a new survey finds.
The survey, "Clinician Perspectives on Electronic Health Information Sharing for Transitions of Care," released today by the Bipartisan Policy Center in Washington, D.C., found that 80 percent of clinicians surveyed said electronic exchange of health information will improve patient care and care coordination. In addition, 69 percent said electronic information exchange would make their practices more efficient, while 57 percent said it was important to reducing health-care costs.

Patients like reading their doctors' notes: study

Genevra Pittman Reuters
4:24 p.m. CDT, October 1, 2012
NEW YORK (Reuters Health) - Both doctors and patients gave high marks to a program allowing patients to access their primary care physicians' office notes online, in a new study.
Researchers at three U.S. practices found doctors' initial concerns about the extra time it would take to write out notes and answer patients' related questions didn't pan out.
And almost everyone who got access to their notes for the study wanted to keep seeing them, even if some patients were concerned about privacy issues.

EHR Savings Debate Grows

Credible sources are raising serious concerns about the value of health IT. Some, but not all, of their criticism is warranted.
The last two weeks haven't been kind to the vendors and users of electronic health records.
A recent column in The Wall Street Journal challenged the notion that EHRs are reducing healthcare costs, citing data from an exhaustive scientific review of 36,000 studies on the subject. AdTech Ad

An informatics chief's foray into big data and P4 medicine for personal analytics

By David Riley, Chief of informatics, Harris Healthcare Solutions
As a healthcare technologist I spend a lot of time thinking about where healthcare and medicine is headed in order to understand what role technology can play in realizing the envisioned future. For some time now I have been contemplating Dr. Leroy Hood’s P4 vision of medicine, which stands for predictive, preventive, personalized and participatory. In brief, Hood’s P4 vision entails the integration of genetic data with knowledge of how the environment modulates the expression of genes to create the phenotype of health or disease. It is a bold optimistic vision of the future of healthcare that implies data – lots of it.
Intrigued with Hood’s vision – and its ramifications for the future of healthcare IT – I decided to test it on myself. Could P4 help us formulate a go-forward strategy in government healthcare? So I took a nine-month period off work (from July 2011 through March 2012) to educate myself on the constructs of P4 medicine. It was not long before I was introduced to a veritable zoo of new knowledge disciplines most of which ended in “-omics”.  These included genomics, proteomics, transcriptomics, metabolomics/metbanomics, epigenomics, microbiomics, pharmacogenomics, toxicogenomics, nutrigenomics and functional metagenomics in addition to systems biology and functional medicine.  Most of these disciplines seem to have sprung forth since I graduated from medical school in the early 1990s.

AHIMA: CCHIT expects high bar for certification

By Neil Versel
Created 10/02/2012
CHICAGO – As providers look ahead to Stage 2 of the meaningful use electronic health records incentive program, they will see a greater emphasis on quality of care and improved patient outcomes, according Alisa Ray, executive director of the Certification Commission for Health Information Technology (CCHIT).
With this in mind, Ray said, the new 2014 criteria for certifying EHR technology to federal standards have been designed to support delivery of safer care.
"We are getting feedback that [the Office of the National Coordinator for Health Information Technology] has really, really raised the bar this time," Ray said Monday at the American Health Information Management Association (AHIMA) annual convention.

New data linkage service live

26 September 2012   Jon Hoeksma
The NHS Information Centre has switched on its new trusted data linkage service, linking patient identifiable data nationally for the first time.
Chancellor George Osborne made a commitment in his last Autumn Statement that, from September 2012, the NHS IC would provide a secure data linkage service to enable healthcare impacts to be tracked across the entire health service.
The service went live this month and involves patient identifiable primary care data being linked to identifiable secondary care patient data. Further patient identifiable data types will follow, together with social care data.

Open data platform to replace SUS

1 October 2012   Chris Thorne
The NHS Information Centre is to replace the Secondary Uses Service with an open data platform.
SUS was set up as part of the National Programme for IT in the NHS to provide data for planning, commissioning, management, research and audit; and supports Payment by Results.
It is currently provided by BT as part of the national application service provider contract that delivers the NHS data spine. This is due to expire in 2013, but can be extended to 2016.

Hospitals lagging in assessing interoperability needs

October 2, 2012 | By Susan D. Hall
Though healthcare executives understand the importance of timely electronic exchange of information among care providers, nearly half have yet to fully assess their health information exchange and interoperability needs, according to an ECRI Institute survey.
The non-profit institute polled 132 hospital, health system, and integrated delivery network healthcare professionals. Overall, it found a disconnect in respondents' efforts to define their interoperability requirements across their health community.
Eighty-four percent agreed that senior leadership understands the importance of electronic exchange of data among providers to coordinate care. And 93 percent agreed, or partially agreed, that interoperability of health information systems was one of their organization's top strategic priorities.

A Bloomberg Terminal For DNA Sequencing

Last Thursday, Knome, a small, Cambridge, Mass., startup, announced that in the fourth quarter it will begin selling a $125,000, 600-pound supercomputer to hospitals to allow them to analyze the data contained in one human DNA sequence in as little as a day, at a time when the cost of that data is dropping toward $1,000.
The idea reminds me of nothing so much as the Bloomberg terminals that you find in financial institutions. It’s far more expensive, of course, but this new device is essentially a realization that sometimes experts want particular types of data a few steps away, putting the DNA analysis service business Knome is already running in a box.

Electronic Health Records Linked to Better Diabetes Outcomes

Damian McNamara
October 1, 2012 — The use of an outpatient electronic health record (EHR) system, rolled out across 17 medical centers, was associated with improvements in clinical outcomes and health care utilization in a study population of nearly 170,000 people with diabetes. Mary Reed, DrPH, a researcher at Kaiser Permanente Northern California in Oakland, and her colleagues found improvements in multiple clinical measures after EHR implementation, particularly among patients with less well-controlled glucose and lipid levels.
"[W]e found that EHR use was associated with improved rates of medication treatment intensification, follow-up monitoring, and glycemic and lipid control in patients with diabetes," the authors write in the October 2 issue of Annals of Internal Medicine.

Kaiser study links EHRs with improved diabetes care

October 3, 2012 | By Susan D. Hall
A Kaiser Permanente study using electronic health records to track diabetes patients at 17 medical centers found that such providers were better able to monitor patients and thus order appropriate treatment changes and follow-up testing. In particular they found that EHR use led to greater improvements for patients with poorer control of their diabetes and lipids.
The study involved 169,711 outpatients tracked between 2004 and 2009 in Kaiser Permanente's Northern California treatment system. An EHR system was installed at the facilities between 2005 and 2010, allowing for before-and-after comparisons, as well as trends in diabetes care unrelated to EHRs, according to announcement.

EHRs Improve Patient Outcomes, Kaiser Study Says

EHR use improves diabetes control and helps doctors pinpoint patients requiring more intensive treatment, reports large Kaiser Permanente study.
Physicians who use EHRs are more likely to identify diabetic patients who need more intense drug treatment, according to a study from Kaiser Permanente. Similarly, EHR use was linked to better management of disease risk factors and greater improvements among patients with poor control of their diabetes and lipid levels.
The study, which appears in the current issue of Annals of Internal Medicine, is the first to demonstrate how EHRs aid clinicians in better targeting treatment changes and follow-up testing for diabetic patients. AdTech Ad

Study: CPOE is Still Hospitals' Largest Barrier to Meaningful Use

Written by Kathleen Roney | October 01, 2012
Implementing computerized provider order entry systems continues to be a major barrier for hospitals in meeting federal health information technology incentives, according to a new study published in the Journal of the American Medical Informatics Association.

AHIMA calls for improved health IT governance

By Diana Manos, Senior Editor
Created 10/01/2012
CHICAGO – The American Health Information Management Association (AHIMA) is calling for improved and unified health information governance to standardize electronic health record (EHR) use.
AHIMA officials announced Monday that they are ready to work with healthcare industry providers, health plans, quality organizations and vendors as well as the Department of Health and Human Services (HHS) to establish standards so healthcare providers have clear principles to guide their patient documentation.

HIEs Essential in Fee-for-Value Era

Karen Minich-Pourshadi, for HealthLeaders Media , October 2, 2012

This article appears in the September 2012 issue of HealthLeaders magazine.
The pursuit of population health and value-based care may be reviving the business case for organizations to join health information exchanges. Now more than ever providers need accurate and complete patient data to effectively manage chronic care populations and attain incentive payments; this means healthcare organizations must have the ability to capture their own data as well as that of their affiliates and competitors. Health information exchanges just became an essential for providers looking to succeed in the fee-for-value era. 
An HIE is an organized regional network that enables hospitals, physicians, and other care providers to upload and access patient health information. HIEs connect data for organizations—from affiliates to competitors—to share clinical data that can improve a patient's overall care. The HIE is generally connected through a provider portal, giving easy access to clinical applications that allow caregivers to see all of the patient's clinical information in real time while restricting access to any claims data or other financial information. Early data indicates the HIE can reduce costs for participants.

A Single Version of the Truth Takes a Whole Toolbox

Scott Mace, for HealthLeaders Media , October 2, 2012

In his 2008 book The Big Switch, Nicholas Carr draws lots of comparisons between electricity and information technology. When the United States began generating electricity, it came from a thousand sources and there was no electricity-sharing grid. Worse, different power sources were generating different kinds of power, with varying voltages, amperages, and protocols (think direct current versus alternating current).
Eventually, through the rough-and-tumble of capitalism and some heavy-handed government meddling, the country converged on a single power system for the public electricity grid, and a variety of other industry standards governing electrical use in everything from cars to lithium batteries. That process took a few decades. To this day, as lightning strikes prove, electric devices are at risk from variations in that system. A whole network of uninterruptible power supplies—more ubiquitous than you might realize—now has to supplement the system.
Tuesday, October 02, 2012

What the Presidential Election Could Mean for Health IT

Given the bipartisanship surrounding health IT for years, it's no surprise that both presidential candidates back the use of IT to improve health care.
The Obama administration is a strong supporter of the meaningful use incentive program and has worked to significantly increase the transparency of federal health data. In a Presidential Message issued during National Health IT Week in September, President Obama wrote, "Modernization of America's health care system is essential to the well-being of our people in the 21st century," adding, "Continued technological advances in how medical information is shared will be key to helping health care providers and patients make more informed decisions."

More docs joining HIEs, attesting to Stage 1

By Erin McCann, Associate Editor
Created 10/01/2012
BURLINGTON, VT – Nearly half of U.S. physician groups plan to join a health information exchange (HIE), according to the findings of a new CapSite report released Friday.
The 4th Annual U.S. Ambulatory Electronic Health Record & Practice Management (PM) Study showed 43 percent of the 509,280 surveyed physicians indicated they plan to join an HIE.
Respondents represent more than 950 physician groups nationwide, offering insight on market adoption, market share, market opportunity and vendor share across the U.S. physician market.

Keep tablets safe - MPS

24 September 2012   Rebecca Todd
The Medical Protection Society is concerned that doctors are accessing patient information on tablet computers in public places and with insufficient security.
The society says that while using tablet devices might give GPs greater flexibility with accessing information on the go, patient confidentiality must be carefully guarded.
MPS head of medical services, Dr Nick Clements, said: “We welcome anything that makes it easier for busy GPs to support patient care, such as accessing medical records remotely, provided convenience doesn’t compromise confidentiality.

Southampton launches My Health Record

20 September 2012   Lyn Whitfield
University Hospital Southampton NHS Foundation Trust has become the first acute trust to launch a personal health record built on Microsoft’s HealthVault platform.
The trust booked a local cinema to launch My Health Record, which it has developed with Microsoft and US developers Get Real Consulting.
Dr Nick Marsden, one of the trust’s non-executive directors, presented it as a first step towards giving patients the kind of online and smartphone interaction with the NHS that they already have with retailers.

UPMC to spend $100 million on data warehouse

October 1, 2012 | By Dan Bowman
As the trend of personalized medicine grows in popularity, larger organizations are becoming more eager to jump on the bandwagon. Case in point, UPMC announced today that it will invest $100 million to develop a robust data warehouse geared toward using analytics for predictive modeling that will impact both clinical and financial decision-making.
For the effort, which will be spread over five years, UPMC is teaming with dbMotion, IBM, Informatica and Oracle. In particular, IBM--which recently extended an agreement with UPMC to provide technology support for the hospital--will provide business analytics software for the project, according to an announcement.

As more consumers connect, mHealth market soars

By Erin McCann, Associate Editor
Created 09/28/2012
NEW YORK – The number of adults using mobile phones and tablets for health information has risen exponentially from last year, according to the findings of a new study conducted by Cybercitizen Health and Manhattan Research.
The healthcare market research study shows that while online health activities are still primarily desktop or laptop-based, mobile and tablet health activity adoption continues to accelerate, with the number of adults using mobile phones for health information pegged at 75 million in 2012, up from 61 million in 2011, and tablet health activity adoption doubling from 15 million to 29 million in the same time period.
September 27, 2012

Congress Considering Special Role for FDA to Approve mHealth Apps

The Food and Drug Administration (FDA) ensures the safety of all food and drugs in this country and also regulates all medical devices and advises on other healthcare-related issues.
However, the organization has not yet taken a strong stance on which mobile health (mHealth) apps it should approve. While there are already tens of thousands of mHealth applications available for download on smartphones and tablets, the FDA acknowledges that it can be hard to know “which ones actually deliver on their health claims and provide accurate information,” according to a story by Jenny Gold.
mHealth apps are so popular because they nix the need to go sit in a doctor’s office for who knows how many hours, wait for a prescription, and then take it to the drugstore to fill it.