This blog is totally independent and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Saturday, March 31, 2012
Weekly Overseas Health IT Links - 31st March, 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.
Across the U.S., as healthcare providers implement computerized physician order entry (CPOE) systems, they find themselves dealing with the growing issue of clinical alert fatigue. With patient care alerts proliferating within clinical decision support (CDS) systems, physicians have often come to ignore all alerts. Healthcare IT leaders are working to resolve this important issue to everyone’s benefit, increasingly implementing systems that put out only effective alerts or apply asynchronous alerting strategies.
What happens when something designed for patient safety ends up having the exact opposite effect? In what can best be described as a “boy who cried wolf”-type scenario, this is exactly what is happening in some healthcare communities with CPOE systems.
Kalorama expects the pending penalties to continue to drive up sales and predicts the EMR market growth rate to be 20 percent in 2012-2013.
The proposed new, best-of-breed, joint electronic health-record system to be created for the Veterans Affairs and Defense Departments will cost $4 billion just to develop and probably a lot more to license and install, said Roger Baker, the assistant secretary for information and technology at the VA.
NEW YORK – Propelled by government incentives, a desire to improve patient outcomes and the bottom line, sales of electronic medical records reached $17.9 billion in 2011, up 14.2 percent from the previous year, according to market research publisher Kalorama Information.
In its recent report, “EMR 2012: the Market for Electronic Medical Records,” Kalorama found the uptick in sales is being aided by increasing physician and hospital acceptance, robust competition and growth in EMR budgets.
You don’t want your personal health information to spread virally around the Internet. Save that for the talking baby videos on YouTube.
The truth is, the electronic health information of millions of patients can be breached in a matter of seconds. As the industry moves from paper records to electronic health records (EHR), protected health information (PHI) is now more susceptible to exposure than ever.
Healthcare providers who lined up with the masses this weekend to purchase the new iPad will soon discover that the world's first Bluetooth Smart-Ready tablet may improve their clinical workflow. That is because the iPad will enable healthcare providers to directly access data from Bluetooth-enabled medical home monitoring devices that collect patient data.
The latest version of the iPad, which incorporates Bluetooth 4.0, opens up a world of possibilities for healthcare providers as they seek to manage information in a healthcare industry that is becoming increasingly data-driven and patient-centric.
For instance, the Henry County Health Center, based in Mt. Pleasant, Iowa, is getting ready to roll out 30 iPads this year to doctors who work at the 74-bed hospital. "The doctors are strongly requesting iPads, which is an idea whose time has come," Stephen M. Stewart, Henry County Health Center's CIO told InformationWeek Healthcare. "The reality of life today is that consumer-driven items are infiltrating the workplace, and we need to embrace it rather than fight it."
An online tool to provide counseling to cancer survivors experiencing fatigue was shown to be more effective than traditional, in-person sessions, according to a study published this month in the Journal of Clinical Oncology. The study's authors believe the tool could blaze a trail for other programs aimed at easing what is often a costly and time-consuming process.
March 22, 2012 — Electronic health record (EHR) systems from Epic Systems and Cerner are the safest bets for large groups and hospitals that want to please primary care physicians plus the widest range of specialists with a single program, according to a new report by the research firm KLAS.
Designing an EHR program for specialists as well as primary care physicians has challenged software makers, as KLAS found out when it interviewed more than 700 medical professionals. Internists and family physicians are the happiest with their software, posting scores of 7.6 and 7.5 on a 9-point satisfaction scale, respectively. At the low end of the ratings are oncologists and ophthalmologists, at 5.8.
KLAS zeroed in on Epic, Cerner, and 4 other vendors in an analysis of EHRs that can provide broad specialty coverage in a large group or hospital. Epic and Cerner stand out from the rest because their inpatient and ambulatory EHRs are built on the same software platform, and thus do not need special interface software for exchanging data.
Earlier this week, the United States Supreme Court ruled that a diagnostic testing company could not patent and exclusively control the use of a method for determining the right dosage level of a class of drugs; measuring metabolite levels and telling providers to make applicable adjustments, they said, is not a patentable invention.
The company at the heart of the case, Prometheus Laboratories, had patented a diagnostic testing kit which determined the dosage level of the drugs and issued a warning when the metabolite level was above or below a certain number. It sued the Mayo Clinic, which had purchased the kits, for patent infringement when the hospital refined the process and began using the newer one.
The Court said that the company couldn't restrict providers that way. "They tell a treating doctor to measure metabolite levels and to consider the resulting measurements in light of the statistical relationships they describe. In doing so, they tie up the doctor's subsequent treatment decision ... and threaten to inhibit the development of more refined treatment recommendations," Justice Stephen Breyer said, writing for the Court.
Memorial Sloan-Kettering Cancer Center is the latest health care organization to collaborate with IBM Corp. on the data analytics, natural language processing and retrieval technologies of the Watson supercomputer for research and treatment purposes.
The hospital and vendor will develop an oncology clinical decision support system taking advantage of Memorial Sloan-Kettering’s molecular and genomic databases, and its repository of cancer case histories. The first applications, with piloting scheduled for late 2012 and wider distribution by late 2013, will include lung, breast and prostate cancers.
The Department of Health and Human Services (HHS) plans to launch a pilot in September to determine whether patients can “meaningfully consent” to their data being shared with other health care providers using an application on a tablet in the waiting room. The pilot will take place at a hospital and three clinics in western New York that are all a part of the HEALTHeLINK health information exchange. If the pilot works, HHS and ONC plan to make the patient consent education app open source so that other facilities can use it, too.
WESTBOROUGH, MA – Even as more and more healthcare organizations are implementing EHR systems, many of them are not decreasing their reliance on paper-based processes, according to a new survey from Anoto, which develops digital pen and paper technology.
More than half of the respondents say paper is still a primary source for tracking information within their organizations’ daily activities, the study found, with respondents saying that paper is still too embedded in the culture, that technology adoption is too expensive and that switching to an electronic system requires too much training and disrupts care delivery.
The current healthcare landscape is calling for more collaboration, and possibly the most important partnership is that of the CIO and CFO. With new IT becoming a pressing necessity, it's crucial both professionals understand the ins and outs of IT spending.
"In terms of working with hospitals on their IT spend, it's a new thing," said Jeff Muscarella, EVP of IT at spend management consultancy company NPI. "When we started the company 10 years ago, many folks didn't know you could go out and look for a Kelley Blue Book of IT products and service and pricing. Nowadays, it's become more common."
As physician informaticists rise into CMIO titles, the CMIO role itself is gradually being transformed, particularly in more advanced patient care organizations, from its early “tech-head doc” function to a management role focused on implementation, to increasingly, a transformational leadership role. CMIOs and industry experts agree that the skills needed to help lead change on a broad scale are pushing medical informaticists to new levels of professional development.
The evolution of the CMIO role has been a fascinating one. CMIOs have emerged out of the ranks of physicians as “lone-wolf” information technology advocates; over time many have evolved into part-time implementation facilitators, full-time managers, and senior lieutenants over squadrons of clinician informaticists. Now, those in the most advanced patient care organizations nationwide have taken on the role of senior leaders helping to move their organizations forward on the quality journey.
Last month's announced delay in the rollout of the ICD-10 diagnostic and procedural codes has received the written endorsement of five noted medical informaticists in an article published online by the journal Health Affairs.
The CMS appears to have made the prudent call when it announced last month its rollback of the compliance date for the nationwide conversion to the ICD-10 codes, according to the results of a survey by the Workgroup for Electronic Data Interchange.
Significant numbers of healthcare provider organizations, health insurance plans and even vendors of information technology systems all lagged badly in their preparations for the complex code upgrade, WEDI survey data indicated. The Reston, Va.,-based WEDI is a coalition of health information technology users and developers.
Hospitals need to implement strong ethical rules for physicians' online behavior--and now. That's the upshot of a study published recently in Journal of the American Medical Association.
The study found that out of 48 participating state medical boards, nearly all of them had a story to tell, and they weren't pretty. The most common alleged misbehavior: Asking patients out on dates, according to a report in the Sacramento Bee.
The average organizational cost of a data security breach in the U.S. dropped 24 percent to $5.5 million in 2011 from $7.2 million in 2010, according to the latest report from the Ponemon Institute.
Based on the data breach experiences of 49 companies from 14 industries, including healthcare, the average cost per record also dropped from $214 to $194. This was the first time in the seven years for which the Ponemon Institute has done this survey that this cost declined.
First electronic medical record system to receive national mark for privacy, security and interoperability
March 22, 2012 (Toronto, ON) - Canada Health Infoway (Infoway) announced today that Nightingale on Demand, a software product developed by Nightingale Informatix Corporation (TSX-V: NGH), (Nightingale), is the first product in Canada to successfully achieve electronic medical record (EMR) certification.
Infoway has developed EMR certification in concert with its jurisdictional partners, to ensure that EMR solutions conform to national and international standards for privacy, security and interoperability.
"We salute this achievement by Nightingale because it is fundamental to Infoway's mandate that authorized health care providers, such as physicians and nurse practitioners, have ready access to accurate and comprehensive information about their patients through secure connections to electronic health record systems," says Richard Alvarez, President & CEO, Canada Health Infoway.
The roll out of the Cerner Millenium electronic patient records system has led to a series of clinical incidents at North Bristol NHS trust.
The trust began deploying Cerner in December 2011 as a replacement for two older patient records systems.
Between the launch of the system and 17 January 2012, 16 clinical incidents were reported as a direct result of the Cerner implementation, the trust revealed in a response to a freedom of information (FoI) request made by a BBC journalist.
The iPad has become a mainstay in the industry, but with its increased use comes the increased risk of breaches. And although preventing them seems basic, Christina Thielst, vice president at Tower Strategies and author of the blog Christina's Considerations, believes there are benefits to be had from discussing simple ways to not only protect, but also optimize your iPad.
"This is important because of the rise in data breaches, the rise in the risks, and the rapid increase in malicious attacks," she said. "It's why we have to talk about it rather than not worry."
To be most effective, standards should be used by everyone; but must everyone pay for those standards?
For most U.S. railroads, variability in rail gauge—the distance between the rails—is no longer a barrier it once was to the interoperability of rolling stock. With passage of the Pacific Railway Act in 1863, the federal government adopted 4 feet 8 1/2 inches as the U.S. standard gauge for the transcontinental railroad, thus promoting its widespread adoption and facilitating the movement of goods and passengers from one rail line to another.
Here's yet more proof that electronic clinical decision support can help providers treat patients. Doctors who had electronic access to summaries of clinical information found them very useful, according to a recent study published this month by BMC Pediatrics.
In the study, researchers from Canada and Australia used one-page summaries of up-to-date evidence, which they called "clinical answers" to help 83 pediatricians treating children with respiratory issues keep abreast of the latest research. The study's authors theorized that since physicians increasingly are turning to electronic clinical decision support tools for help in delivering care, the summaries would be important because they enabled the physicians to quickly digest the information without having to read voluminous clinical literature.
IBM introduces new analysis packages for financial fraud, consumer behavior and risk management
By Joab Jackson
Tue, March 20, 2012
IDG News Service (New York Bureau) — IBM has unveiled three packages of services and software to help organizations analyze their data for profit and improved efficiency.
The signature solutions, as IBM calls these offerings, go beyond generic analysis software to address three different specific tasks: detecting financial fraud, predicting consumer behavior and estimating financial risk.
"Having software is important but having industry expertise and domain knowledge is also pretty essential," said Deepak Advani, IBM vice president of predictive analytics. IBM's intent behind these packages is to combine its analytic software with the lessons it has learned installing such software for clients, Advani said.
The public’s huge and growing use of the Internet and other technologies to get health information has the U.S. Food and Drug Administration asking a provocative question:
Should the agency stop requiring prescriptions for certain drugs that are used to treat diseases and conditions that people can diagnose by themselves, or with a bit of help?
The FDA says the idea represents a possible “new paradigm” in health care, and that it will hold public hearings on the matter Thursday and Friday in Washington, D.C. The testimony will focus on drugs commonly prescribed for high cholesterol, high blood pressure, migraine headaches and asthma. The agency also may explore easier access to diabetes treatments.
An important aspect of any product is how easily someone can use it for its intended purpose, also known as usability. Electronic health records (EHR) that are usable have the potential to improve patient care, which is why the National Institute of Standards and Technology (NIST) has outlined formal procedures for evaluating the usability of EHR systems.
The proposed usability protocol encourages a user-centered approach to the development of EHR systems. It provides methods to measure and address critical errors in user performance before those systems are deployed in a medical setting.
“This guidance can be a useful tool for EHR developers to demonstrate that their systems don’t lead to use errors or user errors,” said NIST researcher Matt Quinn. “It will provide a way for developers and evaluators to objectively assess how easy their EHR systems are to learn and operate, while maximizing efficiency.”
It's time to move beyond the isolated patient experience, but the social outlets we're using aren't made for sharing high-stakes information.
"Has anyone else gone through this before?" That's one of the first things a person asks himself after being anointed a "patient." In illness, as in any other life events, we are social creatures looking for shared experiences and in need of support. But the reality is that our health care system is not designed to serve this purpose. Instead, our system evolved to promote isolation. And, in many ways, this isolation is very much at the heart of the patient experience.
There are two solutions to the isolation experience. The first is to build layers upon the patient-clinician relationship -- to build stronger ties, more connections, and a culture of shared decision-making between patient and physician. There are many advocating for this idea, but it requires cultural shifts across a medical profession that typically evolves at a snail's pace and would require systemic changes in both policy and reimbursement. The second is to build communities of patients with shared experiences, shared fears, and shared data -- and it is this second solution that deserves much more public discourse, lest we get ourselves in an unexpected and unfortunate jam.
As you stroll the exhibit floor at the annual Healthcare Information and Management Systems Society conference, it's hard to miss the Interoperability Showcase, where dozens of information systems and medical devices from different vendors send data hither and yon, simulating a health care environment with (ideally) a seamless, glitch-free flow of information.
Its presenting organization is Integrating the Healthcare Enterprise (IHE), a consortium of professional associations, providers, government agencies, research institutions and vendors whose goal is to turn the plethora of HIT data communication standards into something that's usable in the real world. IHE was founded in 1997 by HIMSS and the Radiological Society of North America.
The California Healthcare Foundation (CHCF) has invested in a startup firm called Pipeline Healthcare Solutions to bring the benefits of telepharmacy to California's rural and safety-net hospitals. Pipeline, which has worked with rural facilities in Washington State and Illinois, is now meeting with administrators of critical access hospitals across California, according to Margaret Laws, director of CHCF's Innovation for the Underserved Program.
Telepharmacy uses Internet and teleconferencing tools to deliver the expertise of pharmacists remotely to hospitals that do not have around-the-clock pharmacist coverage. Rural hospitals might not be able to afford this kind of coverage, or they might not be able to find enough pharmacists to staff their pharmacies on evenings and weekends.
By Timathie Leslie and Megan Doscher and Brynnan Toner, Booz Allen Hamilton
Created 2012-03-19 11:53
Electronic health records (EHRs) have traveled on quite a journey since their inception in the 1960s. Powered by the advancement of modern technology, they no longer exist simply on stand-alone terminals – EHRs are now mobile, enabled by mobile broadband, smart phones, and tablets. In recent years, EHR adoption has increased quickly, spurred in part by the federal Meaningful Use Incentive program, bringing promise of vast improvements in healthcare quality, patient safety, workplace efficiencies, and patient empowerment.
Despite this progress, basic EHR functionality remains largely unchanged since 1982, slowing the evolution and integration of new technologies and capabilities, which remain paramount to transforming the healthcare system.
EMIS has been “throttling” the install rate for EMIS Web, but is now preparing to hit the accelerator pedal, according to chief executive Sean Riddell.
In its preliminary results for 2011, released on Friday, the company said it was speeding up the roll-out rate of its next generation system to hit 200 practices a month in the final quarter of this year.
This would see the majority of the 1,400 practices on its order book completed in 2012.
Riddell told eHealth Insider the company had adopted a controlled roll-out approach towards the end of 2011, which meant “you have your foot on the brake."
NorthShore University HealthSystem in Chicago implemented its electronic medical record system in 2003. It included lots of bells and whistles, such as computerized physician order entry, and was deployed big-bang style at the system's four hospitals and at physician offices and ambulatory care centers.
Joe Cantlupe, for HealthLeaders Media , March 16, 2012
This article appears in the February 2012 issue of HealthLeaders magazine.
Changes wrought by technology are making an indelible mark in service lines for health systems big and small. This is being reflected in a hospital when a patient is given an iPod with a Pandora app to listen to any music she wants to hear as she waits for an oncological exam (You want Motown, you've got it!) and in the surgical suite where physicians use da Vinci robotic systems for minimally invasive procedures, as well as new cloud-based data systems that allow clinicians instantaneous access to a patient's heart rhythms.
Health systems are moving ahead quickly in pursuing technology improvements, using robotics, apps, telemedicine, clouds, electronic medical records, device journals, or other innovations to provide value and add volume to their service lines. Leaders of healthcare systems say they are working to improve patient experience and patient flow in highly personalized programs while using smartphones and tablets to monitor health conditions and evaluate symptoms. Part of the rush is based on federal incentives under meaningful use requirements.
South Warwickshire NHS Foundation Trust has signed a five-year contract with Kainos to digitise all of its patient records and make them available to staff on iPads.
The trust hopes to give staff mobile access to its systems by the end of the year, using Apple iPad devices. The iPads will give staff the ability to access and update a patient’s record at the point of care during a clinic, or a visit to a patient’s home.
The trust published an ICT strategy for 2011-14 in June last year, which said it wants to create a paper-light environment and improve mobile working, especially among its community staff.
ARLINGTON, VA – The Office of the National Coordinator for Health IT has made available the next version of the Connect gateway software that incorporates the most up-to date technical standards and descriptions for the nationwide health information network (NwHIN) Exchange to support functions like patient discovery and query for and retrieve documents.
Connect gateway and adapter software uses NwHIN standards and services to enable healthcare organizations and federal agencies to share patient information securely through the Internet.
In addition to the specifications, the Connect version 3.3 released March 16 is designed to improve performance, usability and prepare it for higher volumes, said Lauren Thompson, director of ONC’s Federal Health Architecture.
I recently had a conversation with a computer security consultant who has worked in both banking and healthcare. He rated data security as very poor in most healthcare organizations, and said that banks do a far better job of protecting their sensitive information. What he said jibed with the long list of security breaches--major and minor--that have been reported over the past year.
One of the simplest methods to safeguard data is simply to encrypt all information stored on end-user devices. Not only does that make it harder for hackers to steal the data, but it also lessens the chance that the loss or theft of laptops and other mobile devices will compromise personal health information (PHI).
by Rebecca Vesely, iHealthBeat Contributing Reporter
Janel Woods woke up one recent morning, looked at herself in the mirror and saw a bad case of pink eye.
The manager of talent strategy and development at Blue Cross and Blue Shield of Minnesota had to get her kids ready for school and herself ready for work.
"My mindset was, 'How do I solve this in the quickest way possible?'" Woods said.
So she logged onto her work laptop, which she had fortunately brought home the night before, and got onto her employer's telehealth video service, called Online Care Anywhere. She was already registered for the service -- she had used it once before to consult with a doctor when her son was experiencing migraines. Within 15 minutes she had completed a video chat with a nearby physician licensed to practice in Minnesota, who called in a prescription to Woods' local pharmacy.
CSC has announced its ‘Pocket Health’ mobile app, developed in collaboration with the NHS. Pocket Health allows UK residents with an iPhone, iTouch or iPad to access a wide range of healthcare information from the NHS Choices website.
Officials say the app is designed to make it easier for people to make healthcare and lifestyle decisions, as well as to find NHS services they need anywhere in England.