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."

Saturday, April 04, 2009

Report Watch – Week of 30 March, 2009

Just an occasional post when I come upon a few interesting reports that are worth a download. This week we have a few.

First we have:

17 March 2009

eHealth Worldwide

:: Bulgaria: Bulgarian Ministry of Health selects Agfa to integrate diagnostic imaging (10 March 2009 - HealthcareITnews)
The University Hospitals of Alexandrowska, Sveta Anna and Stara Zagora and the Hospital of Blagoevgrad cumulatively serve a population of more than 3.25 million and employ more than 4000 staff members. Agfa HealthCare's solutions will support the country in meeting the existing and future demand for diagnostic imaging and supporting the increasing demand for the service.

Much more here:

http://www.who.int/goe/ehir/2009/17_march_2009/en/index.html

Just a reminder the fortnightly issue has been published and is ready to be browsed.

Second we have:

Tuesday, March 24, 2009

IT Incentives for Doctors, Hospitals Vary Under Federal Stimulus Package

Health IT is expected to experience a huge boost with the new economic stimulus package. The health IT provisions of the stimulus bill aim to accelerate the adoption of electronic health record technologies and facilitate nationwide health information exchanges to improve the quality and coordination of care between health care providers, thereby reducing medical errors and duplicative care.

Most of the package's health IT funding -- approximately $17 billion over five years -- will be made available across the next 10 years as Medicare and Medicaid payment incentives to health care providers who adopt certified health IT systems. According to the Congressional Budget Office, the proposed incentive structure is expected to boost health IT adoption rates to about 70% for hospitals and to about 90% for physicians within the next decade -- a significant improvement over the projected adoption rates of 45% and 65% for hospitals and physicians, respectively, by 2019, in the absence of any incentives.

Another approximately $2 billion in funds will be available immediately through competitive grants and loans to support the development of health IT standards, build the infrastructure for health information exchanges, and enhance patient privacy and information security guidelines.

Lots more here:

http://www.ihealthbeat.org/Perspectives/2009/IT-Incentives-for-Doctors-Hospitals-Vary-Under-Federal-Stimulus-Package.aspx

Useful links to some detailed information and analysis is found here:

Third we have:

Diabetes predictor based on QResearch

18 Mar 2009

A simple new score that could help to identify those at most risk of developing type 2 diabetes has been developed using the QResearch database, researchers have announced.

A study published on BMJ.com reveals details of QDScore, the new diabetes risk algorithm. The researchers say this can identify people at high risk of diabetes, enabling proactive intervention before the disease is developed.

They say the score uses information that is available in electronic health records or that patients themselves would be likely to know. It does not require laboratory tests, so it could be used in routine clinical practice, by national screening programmes or by the public themselves.

More here:

http://www.ehiprimarycare.com/news/4668/diabetes_predictor_based_on_qresearch

Excellent work showing the usefulness of EHR records for rapid learning yet again.

The report is found here:

http://www.bmj.com/cgi/content/abstract/338/mar17_2/b880

The calculator for risk is found here:

http://www.qdscore.org/

Fourth we have:

Five very useful and freely available articles from the New England Journal of Medicine. Two Preprints and three papers in the current issue.

Use of Electronic Health Records in U.S. Hospitals
This national survey showed that less than 2% of U.S. hospitals have a comprehensive system of electronic health records across all clinical units. Respondents cited the initial cost of investment and the high cost of maintenance as the primary barriers to adoption of electronic-record systems. Free Full Text

March 25, 2009 (DOI: 10.1056/NEJMsa0900592), in Print April 16, 2009

Stimulating the Adoption of Health Information Technology
Perhaps the most profound effect on doctors and patients of the recently enacted stimulus bill will result from its unprecedented $19 billion program to promote the adoption and use of health information technology and electronic health records. Dr. David Blumenthal discusses the federal effort to modernize the information systems of a troubled health care system. Free Full Text

March 25, 2009 (DOI: 10.1056/NEJMp0901592), in Print April 9, 2009

Current Issue.

Your Doctor's Office or the Internet? Two Paths to Personal Health Records
P. C. Tang and T. H. Lee
Extract | FREE Full Text | PDF

No Small Change for the Health Information Economy
K. D. Mandl and I. S. Kohane
Extract | FREE Full Text | PDF

Perspective Roundtable: Screening for Prostate Cancer
T. H. Lee, P. W. Kantoff, and M. F. McNaughton-Collins
Extract | FREE Full Text | PDF

Enjoy!

Fifth we have:

Remote patient monitoring improves outcomes for chronically ill, study shows

March 24, 2009 | Bernie Monegain, Editor

MENLO PARK, CA – Remote patient monitoring technology enables healthcare providers to treat patients before their conditions becomes more acute, according to a new study from the Spyglass Consulting Group.

Remote patient monitoring solutions have demonstrated success for patients with congestive heart failure, chronic obstructive pulmonary disease and diabetes.

"Trends in Remote Patient Monitoring 2009" is a follow-up to the Spyglass Consulting Group's 2006 report on the same topic. Spyglass is based in Menlo Park, Calif.

.....

Among the key findings are:

• Forty-eight percent of healthcare organizations interviewed have funded home telehealth initiatives themselves. A strong return on investment exists for healthcare delivery networks serving as provider and payer, including such organizations as Kaiser Permanente and the Veterans Administration.

• Convergence with consumer electronics products enables patients to use devices with which they are already comfortable, including smart phones, personal computers and cable boxes. Prices for remote patient monitoring devices and associated peripherals need to drop from several thousand dollars to less than $500 per unit before healthcare organizations will make further investments to support their patients with other chronic diseases.

• Healthcare payers are resistant to providing reimbursement for remote patient monitoring despite evidence of their efficacy by the Veterans Administration, which has deployed more than 35,000 units. Healthcare payer reimbursement is focused on a healthcare delivery model ill-equipped to address the needs of an aging Baby Boomer population with chronic illness. Payers reward healthcare providers for the quantity of the procedures performed rather than the quality of care delivered.

More here:

http://www.healthcareitnews.com/news/remote-patient-monitoring-improves-outcomes-chronically-ill-study-shows

The report can be purchased here:

http://www.spyglass-consulting.com/spyglass_whitepaper.html

More here (report link in text):

Sixth we have:

Who Owns Electronic Medical Data?

As the volume of electronic medical information increases, particularly if federal stimulus efforts to boost health information technology are successful, the issue of who owns the electronic data must be clarified, according to an article published in the Journal of the American Medical Association.

Clarification of property rights is necessary before comprehensive medical information networks can emerge, authors contend. Building a network would be expensive, so the "intermediary" that did this would need clear authority to "exercise the economic rights" of the multiple parties contributing data.

.....

The complete article costs $15 without a subscription and is available here.

More here:

http://www.healthdatamanagement.com/news/stimulus-27924-1.html?ET=healthdatamanagement:e809:100325a:&st=email&channel=policies_regulation

This may turn out to be an important article indeed!

Last from the EU we have:

European Network and Information Security Agency

ENISA Press Release

20 March 2009

www.enisa.europa.eu

ENISA kicks off Emerging and Future Risks identification: remote health monitoring and treatment scenario assessed--'Being Diabetic in 2011'

The EU Agency ENISA [European Network and Information Security Agency] today released its report presenting major potential Emerging and Future Risks [EFR] in a possible remote health monitoring and treatment scenario. The report is the result of an Emerging and Future Risk assessment based on scenario building and analysis. E-health is the first scenario that has been developed and analyzed by an international group of interdisciplinary experts. In the report 14 risks have been identified. It also underlines the importance of a cautionary approach to be followed in regards to the adoption of beneficial e-health solutions: “Caution seems to be the prudent answer at this point: the benefits are clear, but also the risks entailed cannot be ignored”.

In our scenario Ralph is a diabetic, enrolled in a remote health monitoring and treatment programme. He goes about his daily business wearing a special vest with biosensors, keeping track of his vital signs, ensuring rapid response from doctors, while his personal data may be literally flowing around, in order to enable this kind of service. This scenario shows us that remote health schemes undoubtedly offer a great potential. Many benefits can be identified for citizens’ wellbeing and quality of life, but what are the risks entailed? It seems that e-health solutions are very important and beneficial. At the same time, they may generate serious considerations, regarding security, privacy, data protection and legal, as well as in the social, political and ethical area.

In the course of the study, the major assets that are to be protected, e.g. health, life, human rights, etc, have been identified. Based on this, the most important risks generated regarding these assets are subsequently identified and further analysed. This is following a comprehensive risk assessment approach, as developed by ENISA in the context of the Emerging and Future Risks Framework. In a nutshell, the report draws the attention to 14 major risks in total, among them breaches of data protection legislation, mission creep meaning secondary use of data, intrusive data surveillance and profiling by insurance companies, employers, credit-checking companies, etc, data loss or theft, system failures and service disruption.

The Executive Director of ENISA, Mr Andrea Pirotti comments:

“With the development of the EFR capacity, the agency aims at early identification of risks for new application areas and/or technologies. This will help developers and policy makers understand the impacts of new application and manage the resulting risks. At the example of the analyzed e-Health scenario ENISA underlines the risks of an overly optimistic approach to e-health, driven by the industry. While such initiatives and services are undoubtedly beneficial and worth deploying for the general good, we must at least identify and understand the various challenges posed and need to be overcome, in particular in respect to security and privacy.”

More here:

http://www.ibls.com/internet_law_news_portal_view.aspx?s=latestnews&id=2214

For the full report please visit: http://enisa.europa.eu/doc/pdf/delivarables/enisa_being_diabetic_2011.pdf

Again, all these are well worth a download / browse.

There is way too much of all this – have fun!

David.

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