Friday, February 8, 2013

Weekly Overseas Health IT Links - 09th February, 2013.

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.

MD Anderson goes big on analytics

By Bernie Monegain, Editor
Created 02/01/2013
The University of Texas MD Anderson Cancer Center will roll out new technology to enable personalized treatment aimed at improving outcomes.
The center announced Jan. 31 that it would deploy Oracle Health Sciences applications and Oracle technology as the foundation for an organization-wide analytics initiative.
The platform will also support the center’s Moon Shots Program, an initiative whose aim is to dramatically accelerate the pace of converting scientific discoveries into clinical advances that reduce cancer deaths.  

Florida practice catches HHS attention

By Mary Mosquera, Senior Editor
Created 02/01/2013
ChenMed, a family owned prmary care practice, has developed a delivery model focused on care for seniors with complicated healthcare issues, including heart disease, diabetes, dementia, and cancer. More than 70 percent of its patients have five or more chronic conditions, according to Bryan Sivak, chief technology officer of the Department of Health and Human Services.
Sivak visited ChenMed, based in southern Florida and now expanding in the Southeast, because it is an example of an innovative care model that improves patient care and makes its delivery more efficient.
Christopher Chen, MD, CEO, demonstrated how ChenMed's uses of data are guiding clinical staff on decision-making from the moment the patient walks through the door, Sivak wrote in a Jan. 28 blog.

E-mail prompts spur activity in online lifestyle intervention programs

February 1, 2013 | By Ashley Gold
Online lifestyle intervention programs are more useful when users are prompted by frequent e-mails encouraging them to stay on track, a new study published in the Journal of Medical Internet Research finds. 
Researchers from Maastricht University, Netherlands, investigated the influence of content and timing of an e-mail prompt on the returning visits to a computer-tailored lifestyle program. The lifestyle programs were aimed at multiple health behaviors: increasing physical activity, increasing fruit and vegetable intake, smoking cessation and decreasing alcohol consumption. These programs compared a user's current health behavior status to Dutch public health guidelines set for certain health behavior--such as working out at least 30 minutes per day five days a week, eating fruit and vegetables daily, drinking plenty of water and not smoking.

EHR Accuracy Remains Problem, CHIME Says

College of Healthcare Information Management Executives warn technology and workflow burdens make EHR reporting nearly impossible.
Recent comments made by members of the College of Healthcare Information Management Executives (CHIME) make clear the organization doubts hospitals' ability to submit accurate and complete data through electronic health records (EHRs). CHIME members' comments were made in response to a Jan. 3 Request for Information (RFI) issued by the Center for Medicare and Medicaid Services (CMS).
In a statement, CHIME members commended federal efforts made toward "reaching a harmonized approach" for electronic clinical quality measurement and reiterated its support for aligning EHR-based reporting and hospital quality reporting programs. But the "number one thing" the organization wanted to convey to CMS is that quality measurements through EHRs are "extremely time intensive and difficult," said Jeffery Smith, assistant director of public policy at CHIME, in an interview with InformationWeek Healthcare. AdTech Ad

More Using Electronics to Track Their Health

Whether they have chronic ailments like diabetes or just want to watch their weight, Americans are increasingly tracking their health using smartphone applications and other devices that collect personal data automatically, according to health industry researchers.
“The explosion of mobile devices means that more Americans have an opportunity to start tracking health data in an organized way,” said Susannah Fox, an associate director of the Pew Research Center’s Internet and American Life Project, which was to release the national study on Monday. Many of the people surveyed said the experience had changed their overall approach to health.
More than 500 companies were making or developing self-management tools by last fall, up 35 percent from January 2012, said Matthew Holt, co-chairman of Health 2.0, a market intelligence project that keeps a database of health technology companies. Nearly 13,000 health and fitness apps are now available, he said.

CHIME: Complete, accurate data reporting via EHRs 'nearly impossible'

January 31, 2013 | By Marla Durben Hirsch
Electronic health record systems are not yet ready to provide complete and accurate reporting of clinical quality measures to the Centers for Medicare & Medicaid Services, according to the College of Healthcare Information Management Executives.
CHIME, responding to a request for information about the Inpatient Quality Data Reporting program, thanked CMS for working to harmonize quality reporting, but noted that hospitals and vendors are not yet able to provide electronic inpatient quality data reports that CMS is contemplating. According to a letter sent by President and CEO Richard Correll and Board Chair George Hickman this week to acting CMS Administrator Marylin Tavenner, "most hospitals do not capture all the necessary CQM data for all patients through the EHR." What's more, according to Correll and Hickman, the 2014 edition of certified EHRs, which is the technology that will be used for such reporting, is "incapable" of generating complete and separate CQM reports..

Use of 'free' EHRs may violate new HIPAA rule

January 31, 2013 | By Marla Durben Hirsch
I don't like being interrupted by pop up ads when I'm on the internet. And I imagine providers who receive pop up ads from pharmaceutical and medical device manufacturers while they're using their free EHRs also aren't overly fond of the interruptions.
But now those pop up ads may be more than an annoyance. They could get those physicians into legal trouble, thanks to the new HIPAA megarule, which the U.S. Department of Health & Human services released earlier this month.
I'm not kidding. The HIPAA updates impose new limitations on marketing. For the first time, it requires providers to obtain patient authorizations "for all treatment and healthcare operations communications where the covered entity receives financial remuneration for making the communications for a third party whose product or service is being marketed."  The authorization can't be buried in the provider's notice of privacy practices, and it must inform the patient that the physician is receiving a financial benefit for sharing the third party's information with the patient.

Mostashari spotlights ROI in HIE

By Mary Mosquera, Senior Editor
Created 01/31/2013
The business value for providers and patients is what will drive health information exchange forward, even though most discussions typically center on the technology involved. And different uses for exchange will require different technologies.
That was the sentiment of many organizations that are already exchanging information and shared what made their exchanges tick and what barriers stood in their way at a Jan. 29 joint hearing of the federal advisory Health IT Policy and Standards committees.
Farzad Mostashari, MD, the national health IT coordinator, noted that Camden Coalition’s director, Sandy Selzer, described how the Camden, N.J., health information exchange (HIE) has managed a sustainable return on investment because their costs are low, and they have found a way to add value, through simple ADT (admissions/discharge/transfer) transactions messages, with their existing business relationships within that community.

AHRQ to study health IT impact on ambulatory care workflow

January 31, 2013 | By Ashley Gold
To improve workflow between ambulatory care and healthcare IT, the Agency for Healthcare Research and Quality put forth a proposal for a project that will test how providers are using technology.
Their proposed project, "Applying Novel Methods To Better Understand the Relationship Between Health IT and Ambulatory Care Workflow Redesign" was presented for the Office of Management and Budget this week.

KLAS Goes Abroad to Partner with U.K. Health IT Firm

January 30, 2013
EHealth Insider (EHI), a U.K. independent health IT news, research, and events firm, has announced that it has formed a partnership with Orem, Ut.-based research firm KLAS Enterprises.
The new partnership between EHI and KLAS is designed to improve transparency and performance measures for the U.K. health technology market. The objective will be to ensure that healthcare providers and the patients they serve gain the maximum benefit from key investments such as electronic patient records and other clinical software and medical equipment.

Healthcare Experts Confront EHR-Related Medical Errors

AMIA task force calls on vendors, clinicians, academics and policy-makers to rethink poorly designed health IT systems.
Though questions about the efficacy of electronic health records (EHRs) seem to have increased recently, usability and safety of health IT systems have been on the minds of medical informaticists for a while.
The American Medical Informatics Association (AMIA), which convened an EHR usability task force in late 2011, this week released a position paper on EHR usability in which the group called on multiple stakeholders to act in order to lessen the chance of patient harm from poorly designed and implemented technology. AdTech Ad
In a position paper published online in the Journal of the American Medical Informatics Association (JAMIA), Bethesda, Md.-based AMIA spelled out 10 recommendations in four areas: research into health IT-related human factors; health IT policy; vendors; and clinician end users.

Oncology docs struggle with EHR features

By Bernie Monegain, Editor
Created 01/30/2013
As meaningful use and ACOs pick up steam, oncology providers contend with regulatory pressures with or without help from their vendors, according to a new report from research firm KLAS.
Alerts and reporting, two of the most challenging aspects of medical oncology, have physicians wanting something more – something better, concludes the report "Oncology 2012: Pulling the Curtain Back."

Telemedicine bills in state hoppers

By Eric Wicklund, Editor, mHIMSS
Created 01/30/2013
While their colleagues in Washington are starting to take interest in the promises of digital health, lawmakers in several states are forging ahead with their own legislative ideas.
According to the American Telemedicine Association, seven states and the District of Columbia have seen bills introduced in the past four weeks that address coverage and reimbursement for telemedicine services. To date, 16 states have mandated that all private payers in the state reimburse for telemedicine services if such services would be reimbursed through an in-person visit.

Healthcare IT sees $1.2 billion in VC funding in 2012

January 30, 2013 | By Ashley Gold
Last year was a banner year for healthcare technology, with $1.2 billion in venture capital funding reported for the sector and diverse fields in healthcare IT showing substantial growth, according to a new report released this week by Austin, Texas-based Mercom Capital Group. 
The report focused on funding and mergers and acquisition activity for healthcare IT in 2012. The $1.2 billion in 163 deals reported for 2012--compared to the $480 million in 49 deals in 2011 and $211 million in 22 deals in 2010--reflects a huge upward turn for M&A in healthcare IT.

4 Tips to Prevent Common EMR Implementation Complaints

Written by  Kathleen Roney | January 28, 2013
Although many entities in the healthcare industry believe in the benefit of electronic medical records, it does not mean that EMR implementations will have no concerns or complaints. On the contrary, not every hospital or provider has a seamless experience implementing and transitioning to EMRs.
For instance, some physicians may find imperfections with EMRs based on their potential to negatively, albeit temporarily, impact workflow and hospital operations. Other complaints focus on problems accessing patient information if hospitals have not completed implementation, how EMRs can be hard to use and the lack of training that sometimes accompanies implementation.

Use of Health IT for Higher-Value Critical Care

Lena M. Chen, M.D., Edward H. Kennedy, M.S., Anne Sales, Ph.D., R.N., and Timothy P. Hofer, M.D.
January 30, 2013DOI: 10.1056/NEJMp1213273
The patient had not yet coded but was spiraling downward, prompting a request for a bed in the intensive care unit (ICU). But the ICU had no available beds. Hours passed before the decision was made that another patient could safely be “bumped” out of the unit to accommodate our patient. After the transfer, in the empty room strewn with unused bottles, procedure kits, and hospital gowns, there was a moment of peaceful quiet but weariness. The team was exhausted from worrying that the patient would code before being transferred to the ICU, from running a makeshift ICU on a floor not equipped for it, and from knowing that other patients had been neglected in the interim.
This was not the first time that such a sequence of events had occurred — or the last time it would. Might things be done differently?

ONC offers HIE guidance

By Mary Mosquera, Senior Editor
Created 01/29/2013
The Office of the National Coordinator for Health Information Technology (ONC) has published research that aims to help providers and other healthcare professionals better understand several high-impact services that can sustain health information exchange organizations.
The research is meant to help those who are putting in place health information exchange (HIE) with policy, technical and business-related skills related to query-based exchange, push notification and subscription services, provider directories, master data management and consumer engagement.
ONC is ramping up its convening activities around health information exchange. In addition to the research, ONC hosted a listening session on concerns related to rules of the road and policies between exchanging organizations.

Rekindling the patient ID debate

By Erin McCann, Associate Editor
Created 01/29/2013
Imagine an identification number containing every iota of your health data – documenting every disease and ailment you’ve been treated for, every doctor you’ve seen – a number unique only to you. With such holistic data, the implications for improving patient care and reducing inefficiencies appear enormous. 
Now imagine your personal health data peddled to pharmaceutical behemoths, research corporations and third-party miners, a place where you, in fact, are not in control of your own information. All of a sudden, things appear differently. 
The idea of unique patient identifiers (UPIs) is not a concept extracted from the next dystopian novel. It could very well be reality in the not-so-distant future. The question remaining, however, is whether or not the benefits of such technology outweigh constitutional privacy and patient trust concerns. Naturally, depending on whom you ask, the answer varies considerably.

New HL7 Workgroup Focuses on Quality

JAN 29, 2013 12:22pm ET
Standards development organization Health Level Seven International has formed a new clinical quality information workgroup to create standards to support health quality initiatives.
The issue of quality is foremost in much of the standards making work of existing HL7 workgroups, which focus on specific domains such as orders and observations, electronic health records or unstructured documents. But until now, there hasn’t been a workgroup with the sole focus of quality.

More GPs in Web

24 January 2013  
More than 1,600 GP practices are live with EMIS Web.
EMIS Group’s trading update for the year ended 31 December 2012 says the Web roll-out accelerated during 2012 to complete 1,676 installations, of which 901 were in the second half of the year.
More than one third of EMIS’ GP customers now have the new system, compared with 8% at the start of last year, and more than 2,500 are in the familiarisation process.

GPs can refuse data extract

24 January 2013   Rebecca Todd
GPs will decide whether a massive new dataset can be regularly extracted from their practices.
They will also be able to check the data quality of the extract before it is sent outside the practice.
The NHS Commissioning Board’s first planning guidance, issued in December, said a new GP dataset will be “requested” from practices for submission to the Health and Social Care Information Centre.
GPs are expected to provide the data on a monthly basis using the General Practice Extraction Service.
“The data will flow securely, via GPES, to the HSCIC, the statutory safe haven, which will store the data and link it only where approved and necessary, ensuring that patient confidentiality is protected,” the guidance explained.

Make sure patient portals go beyond meaningful use

Technically Speaking. By Pamela Lewis Dolan, amednews staff. Posted Jan. 28, 2013.
Many physicians are now in the market for a patient portal as they work toward qualifying for meaningful use incentives. But experts say that for real success, adopting a patient portal should be part of a long-term strategy for increasing patient engagement.
Under stage 2 requirements for meaningful use bonuses from Medicare or Medicaid, physicians not only must provide online access to records and be able to exchange secure messages electronically with patients, but they also must ensure that at least 5% of patients actually use both of those features.
Experts say finding the right system will give patients a reason to visit the portal. And it could give practices the ability to increase efficiencies and improve both quality and patient satisfaction. The right system also will help ensure that the practice gets a return on its investment, which could range from a nominal monthly fee for a cloud-based module to several thousand dollars for a locally hosted system.

Pew: Most US adults track health data but few use digital tools

By: Brian Dolan | Jan 28, 2013
Perhaps surprisingly, a majority of American adults track their own health data, however, most aren’t using digital technologies to do so.
About 69 percent of US adults track at least one health indicator, according to a national survey called Tracking for Health, conducted by Pew Research Center’s Internet & American Life Project. About 60 percent of US adults track weight, diet, or an exercise routine, while 33 percent track another health indicator like blood pressure, sleep patterns or headaches. Some 12 percent of adults track health indicators for a loved one.
Susannah Fox, an associate director of the Pew Internet Project, told MobiHealthNews that this survey was the first broad national survey to look at health data tracking and as such her team didn’t know what to expect. They made the decision to ask all adults about health tracking — not just Internet users — in part because the 65+ population is (as a group) more likely to not be online but also more likely to have (at least one) chronic condition that requires some level of tracking.
Tuesday, January 29, 2013

Teenagers, Social Media and Health Information Privacy

by Kate Ackerman, iHealthBeat Managing Editor
Patients increasingly are turning to social media, online communities and blogs for support and to share information about their diagnoses and treatments.
As long as privacy risks are addressed, social media enthusiasts and patient advocates say that patients can use social media to become more engaged in their own care and to learn from patients with similar diseases.
Internet-savvy teenagers seem like just the group to turn to the Web as they manage their chronic diseases.

M-health, Mobile Apps from the Payer Perspective

Scott Mace, for HealthLeaders Media , January 29, 2013

Are healthcare payers ready to reimburse for m-health and mobile phone apps? This week, the conclusion of my healthcare-focused conversation at the International Consumer Electronics Show with Reed Tuckson, MD, UnitedHealthcare group executive vice president and chief of medical affairs.
HLM: What role do you think technology is going to play in mental health?
Tuckson: I think we are especially excited around the telepsychiatry services that are going on in mental health. We recognize the real issues of availability of supply, of trained mental health workers, and we clearly understand also the logistics of geography.
Telepsychiatry is really becoming an established, recognized field, and it is also encouraging that patients actually are not intimidated by not having a person in the room geographically and spatially with them, and seem to respond well to the technology.

Ontario PCs would scrap eHealth

  • 10:44 am, January 29th, 2013
TORONTO - A Progressive Conservative government would scrap eHealth Ontario.
Leader Tim Hudak will unveil his party's plan at at a pharmacy in Toronto later in the morning.
Officials said the PCs are still committed to digitizing health records but will do so without the eHealth agency.
Scandal-plagued eHealth has a long and controversial history. The quest for a digital medical records system in Ontario was first launched by the PC government, of which Hudak was a member.

4 ways to make IT clinician-friendly

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 01/25/2013
It is no secret that there is a swarm of health IT in the marketplace, all vying for a larger user base. However, at what point does technology become more of a hindrance than a help? Doctors and nurses who are burdened with clunky or inefficient systems run the risk of becoming less effective instead of more. Joe Condurso, president and CEO of PatientSafe, spoke to Healthcare IT News about a few key factors in designing technology that aligns with the workflows of clinicians.
"In order to get compliance of this technology you need to get those at the point of care, nurses, lab directors," says Condurso, speaking to the aims medical technology needs to adopt to succeed. "They have to really love and embrace the systems and the devices and the workflow." In other words: Make the technology align to the practitioner workflow, not the other way around.

The Role of Ethics in Data Governance

JAN 25, 2013 5:25pm ET
Security and privacy have always been at the core of data governance. Typically, company policies, processes, and procedures have been designed to comply with these regulations to avoid fines and in some cases jail time. Very internally focused.  
However, companies now operate in a more external and connected fashion than ever before.
Let's consider this. Two stories in the news have recently exposed an aspect of data governance that muddies the water on our definition of data ownership and responsibility. After the tragedy at Sandy Hook Elementary School, the Journal News combined gun owner data with a map and released it to the public causing speculation and outcry that it provided criminals information to get the guns and put owners at risk. In a more recent posting of a similar nature, an MIT graduate student created an interactive map that lets you find individuals across the US and Canada to help people feel a part of something bigger. My first reaction was to think this was a better stalker tool than social media.

Docs using clincal decision support tools seen as less capable

January 28, 2013 | By Marla Durben Hirsch
Physicians who use their electronic health record's clinical decision support tools are viewed more negatively by patients, according to a study published this month in the journal Medical Decision Making.
The researchers, from the University of Missouri, conducted three separate experiments regarding patient perceptions of physician clinical decision support tool use. They found that patients viewed physicians who used the tools as less capable than those who made judgments without the computerized tool or who chose to consult a colleague. The patients whose physicians used the tools were more dissatisfied and may be more likely not to comply with treatment recommendations.

HIE hurdles include lack of patient ID standards and technical knowledge

January 28, 2013 | By Dan Bowman
In testimony to be presented at a meeting of the Health IT Policy and HIT Standards Committees tomorrow in Washington, D.C., several providers and other health IT stakeholders discuss opportunities, as well as barriers, to the implementation of health information exchange. While several of the latter are identified, the general tone of the testimony is one of optimism for the future of HIEs.
Talking about technical and business barriers and opportunities for HIE, Bill Spooner, CIO at San Diego-based integrated delivery network Sharp HealthCare, says that as electronic health record adoption continues to spread, HIE will prove to be a "necessary element" for supporting quality and affordable care.
"Information exchange is fundamental to [accountable care organizations], the patient-centered medical home, population health management and such similar care concepts," Spooner says. "The highest quality, most cost-effective patient care requires a complete and accurate health record, based on consistent data definitions and patient identification. The health reform carrot may well be more effective than the regulatory stick in furthering HIE adoption."

ONC tackles big challenges with international standards for data sharing

January 28, 2013 | By Susan D. Hall
As if creating standards for health data sharing in the U.S. wasn't difficult enough, making that happen internationally is an even bigger conundrum.
International standards work focuses on creating a set of "building blocks for interoperability," according to a Health IT Buzz blog post by Doug Fridsma, chief science officer and director of the White House Office of Science & Technology. According to Fridsma, several such efforts already are under way, including:
  • Defining an international vocabulary for health terms and products: The Office of the National Coordinator for Health IT is working with the National Library of Medicine and with the European EHR standards group epSOS to create a consistent vocabulary on medications, treatments, lab tests and more.
  • Increasing patient access to their health information: While it seems a given in the U.S. that patients could access their own information, internationally, some systems limit access to providers.