Tuesday, April 30, 2013

Here Is A Wonderful Picture Of How Your Money Is Being Spent Unwisely!

See here:

https://twitter.com/Eleonor_G/status/329159086144905216/photo/1

And Edwin Kruys (@EdwinKruys) sent me this! Even worse and quite naughty I reckon.

https://twitter.com/EdwinKruys/status/329203658656989185/photo/1

Please send more!

Enjoy

David.

Another Report Saying Health IT Is Wonderful - Is It Relevant To What Our Government Is Doing?

The following appeared a few days ago.

EHR use provides Canadian docs billions in benefits

April 24, 2013 | By Marla Durben Hirsch
Electronic health records have proven very useful to Canadian physicians in community-based care, helping them to reap more than $1.3 billion in benefits since 2006, according to a new report by PwC.
The report, commissioned by Canada Health Infoway, involved review of over 250 research articles, surveys and other information. The researchers found a number of advantages to EHR use, including:
  • $800 million in administrative efficiencies in workflow as staff time is redeployed
  • $584 million in health system level benefits, such as the reduced number of duplicative tests
  • Improved outcomes and safety through preventive care and disease management, such as a 49 percent increase in pneumococcal vaccination rates with EHR reminders
  • Increased interactions and communications among providers and between providers and patients
The report's authors also found that most physicians have had a positive return on investment due to overhead cost savings and increased revenue.
Lots more here:
You can find the press release announcing the study here:
You can find the full report to download here:
If ever there was a report that needs to be read carefully to discover just how hard consultants can try to con you this is it!
Carefully reading the report - what it is about is the benefits that can be derived from moving the level of GP EHR usage from 26 to a little over 56% and then taking the benefits estimated to have been acquired over the whole six years. i.e. all the benefits are seen to be cumulative.
If you read closely the vast quantum of benefits - small as they are - flow from clinicians using computers for prescribing, managing results and so on.  Oddly there is no attempt I can see to quantify the benefits of Health Information Exchange which is what the NEHRS is intended to enable.
In Australia, of course, we have already achieved most of these milestones with GP computing a while ago. Rather a pity we did not keep consolidating and incrementally improving before leaping into the PCEHR unknown.
Call me cynical but when one reads this article it is pretty easy to see why this report has appeared just now.

Future of electronic health records agency in question

April 18, 2013 - 1:18pm
Ottawa says Canada Health Infoway not being shut down, despite lack of funding
OTTAWA — Canada’s main electronic health records body received no new funding this year, but the federal government says there are no plans to shut down the agency.
At the same time Ottawa is eliminating the Health Council of Canada, Canada Health Infoway discovered it will unexpectedly receive no new program money in 2013.
Created in 2001, Infoway works with the provinces to create a consistent system of electronic health records across the country.
As is typical for health organizations, Infoway receives block funding every few years instead of annually. It was given $400 million in 2007 and then $500 million in 2010.
That funding is almost entirely spoken for now.
“The vast majority of our funding has been allocated for approved projects,” said Infoway spokesman Dan Strasbourg.
It is not clear how much new money Infoway had asked for in 2013.
A spokesman for Health Minister Leona Aglukkaq said there is no plan to wind down Infoway’s operations. Steve Outhouse said the lack of funding was an austerity budget measure.
“It was a year, obviously, where there was some fiscal restraint that needed to be there,” said Outhouse. “There’s no plan to end Infoway operations at this point in time.
“We’re always looking at how to spend money as best we can, but there’s no immediate decision or anything like that coming up for Infoway.”
Its job for 2013 will be implementing projects already underway, he said. The department can’t guarantee funding Infoway in 2014 because that decision will be made in the lead-up to next year’s budget, Outhouse said.
Since its inception, the agency has received $2.1 billion in capitalization across 370 e-health projects.
Lots more here:
So they have spent $2.1 billion and seem to be suggesting cumulative benefits of a rather rubbery $1.3. I know all the Infoway funds weren’t spent in the area discussed but a good deal was and the return to the public looks rather skinny - to say the least.
I wonder what we will get from the PCEHR program in the years ahead?
David.

AusHealthIT Poll Number 165 – Results – 30th April, 2013.

The question was:

Has The Process Of E-Health Standards Setting In Australia Gone Off The Rails?

For Sure 67% (28)
Probably 14% (6)
Probably Not 2% (1)
No - It Is Fine 12% (5)
I Have No Idea 5% (2)
Total votes: 42
Looks like a very clear majority think we have a train-wreck here.
Again, many thanks to those that voted!
David.

Monday, April 29, 2013

Weekly Australian Health IT Links – 29th April, 2013.

Here are a few I have come across the last week or so.
Note: Each link is followed by a title and a 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.

General Comment

In a day or so we reach the final stage of ePIP implementation with all the various government plans now finalised and now transitioning to waiting and seeing if there will be any useful outcomes for the $billion or so that has been spent. I am pretty sure that by the end of the year (2013) we will be able to form some clear judgements.
Other than that we have all sorts of interesting links to review with Qld Health and so on still rumbling on.
Lastly we have the news that despite all efforts to disprove his work it still seems that Einstein got it right.
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Feds fall behind on e-health sign-ups

By Charis Palmer on Apr 22, 2013 12:28 PM

Data already delivering insights.

The Government will likely struggle to meet its target of 500,000 registrants for the personally controlled electronic health record (PCEHR) by June, after it was revealed only 109,000 Australians had registered in the last nine months. 
The system, launched last July, has been plagued with issues, including with its online registration system and availability for general practitioners.
Speaking today at a conference on big data in health, Department of Health & Ageing chief information and knowledge officer Paul Madden encouraged attendees to sign up to the program.
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Study reveals most digital assets are not fully secure

MOST local organisations are ill-equipped to secure their digital assets against hackers and other malicious acts, a study finds.
It reveals securing web traffic has proved the biggest security headache facing companies, despite advancements in network security technologies.
It also shows IT security vendors face reputational issues, with many not delivering what has been promised to customers.
Ponemon Institute asked 485 respondents to rate their organisation's ability to prevent cyber attacks, with 10 being excellent. They gave it a 4.6 rating.
Their organisation's ability to quickly detect cyber attacks was rated at 4.4, and they gave its security standing a 4.5.
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ACMA warns telcos after AAPT data breach

THE media regulator has warned telcos not to become complacent about data security after it let AAPT off with a warning for a major breach last year.
Senior Australian Communications and Media Authority (ACMA) member Chris Cheah put the telco industry on notice that the regulator still took data breaches “very seriously”.
He said that publicly singling out AAPT for investigation and naming sent a strong message to the wider industry that ACMA took a stern approach to consumer data protection issues.
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Flow modelling cuts emergency wait times

QUEENSLAND'S Gold Coast Hospital has turned to flow-modelling technology to help reduce waiting times and ensure there is an adequate number of beds available.
The hospital is one of the biggest emergency care providers in the country, seeing about 120,000 emergency cases each year.
It worked with the Australian e-Health Research Centre, a joint venture between CSIRO and the Queensland government, to help develop patient-flow modelling.
The centre found emergency departments generally were overcrowded and struggled to respond to day-to-day arrivals in a timely manner.
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Bad decision-making biggest threat to health funds: report

Date April 23, 2013

Amy Corderoy, Dan Harrison

Expensive new technologies and treatments are being adopted by the health system, despite a ''big black hole'' in the knowledge about their long-term cost and efficacy, experts say.
A Grattan Institute report released on Monday found increases in health spending, in particular on hospitals, were set to create a decade of budget deficits.
Paying world prices for generic drugs would free up more than a billion dollars per a year. 
Queensland University of Technology's Nicholas Graves said new technologies and treatments were being adopted all the time that led to cost blow-outs and over-treatment.
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Surgery blinded by Google Glass advances

Date April 23, 2013

Ben Dixon

Information overload is a dangerous distraction when it's right before your eyes.
Growing up watching Star Wars, I dreamt that one day I'd fly with a "head-up display" that would help me defeat the Empire.
Now the ability to have information projected in front of our eyes is here with Google Glass, which is an internet-connected device. You may have seen the video showing their potential uses.
A tiny camera, microphone and computer processors answer your spoken questions and project responses on the inside of the lens. You can ask, "How do I get to the post office from here?" or "What gate does my flight leave from?", and directions will appear. If you ask it how to say 'half a kilogram' in Chinese, it will.
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Bligh, other pollies to be cross examined

Date April 22, 2013 - 3:20PM
The inquiry into the health payroll debacle has heard former Queensland premier Anna Bligh and former director of public works Mal Grierson will be cross examined in relation to the vendor contract for the flawed IT system.
Assisting Counsel Jonathan Horton said Mr Grierson had a "number of direct contacts and communications with IBM".
Ms Bligh and Mr Grierson are expected to be called to the inquiry within coming weeks.
Former health minister Paul Lucas and former public works minister Robert Schwarten are also expected to be called, however the inquiry has not yet named them.
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Scrum before Qld Health payroll system rolled out

Date April 24, 2013 - 1:35PM
IBM and Queensland Health staff were involved in a "daily scrum" in the lead up to the launch of the failed health payroll system, an inquiry has heard.
Queensland Health's former payroll director Janette Jones on Wednesday told the Queensland Health Payroll Inquiry there were simmering tensions between the IT giant and health staff during the testing phase.
"It was so adversarial," she said.
"There was a view that IBM could not do it, so we shouldn't really be helping them.
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Drug rings continue to trawl pharmacies for cold medicine to make amphetamines despite police tracking equipment

  • by: Kate McKenna, Josh Robertson
  • From: The Courier-Mail
  • April 15, 2013 12:00AM
DRUG rings continue to trawl pharmacies for cold medicine to make amphetamines despite knowing police can track their purchases in real time.
Hundreds of packets of pseudoephedrine are bought by particular individuals in Queensland, according to the first analysis of suspicious sales shared with police under Project STOP since 2005.
In one case, a single ID card was used to buy almost 500 packets, as many as 50 in one day, from 165 different Brisbane pharmacies between November 2006 and September 2010.
"Pseudo-runners" in Queensland also hit Victorian pharmacies, where purchases might go unrecorded because participation in Project STOP is voluntary.
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Canada Finds $1.3 Billion in Savings Through eHealth

A Canadian study by Price Waterhouse Coopers released this week found that the use of electronic medical records (EMR) in Canadian general practice has saved over $1.3 billion between 2006 and 2012.
Savings included an estimated $800 million through administrative efficiencies and $584 million through such savings as a reduction in adverse drug events and in test duplication.
“We’re all under pressure to show stakeholders that there’s value in the big investments that are made in electronic health systems,” says Richard Alvarez, who is the President and Chief Executive Officer of Canada Health Infoway.
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Script data firm backtracks on sale of GPs' names

22 April, 2013 Antonio Bradley
A company that buys doctors’ names, contact details and prescribing histories from pharmacists to sell to pharmaceutical companies has partially backed down after a fierce backlash.
IMS Health, which recently began writing to doctors to inform them of its plan to sell data to clients including pharmaceutical companies, now says it will only sell doctors’ prescribing histories — not their personal information.
These histories will not be able to be attributed to individual doctors, the company said in a statement on Friday.
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Data collection company denies identifying GPs or patients

23rd Apr 2013
A DATA collection company accused of trying to pay pharmacists for information about GP prescribing patterns has denied identifying any individual GP – or patient – as AMA president Dr Steve Hambleton lodged a formal complaint with the privacy commissioner.
Dr Hambleton wrote to the commissioner, Timothy Pilgrim, saying IMS Health was writing to pharmacists apparently seeking to form agreements “for the release, apparently for reward, of certain information relating to doctors and prescriptions”. He said the information IMS wanted included doctors’ names, practice locations, phone numbers, specialities, and which medicines they prescribed.
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3D mammograms 'find more tumours': study

  • From: AAP
  • April 27, 2013 12:00AM
BREAST screening with 3D mammograms increases the detection rate of tumours by a third, a study led by an Australian researcher has found.
Scientists compared the results of ordinary 2D scans with a combination of 2D and 3D screening.
Two-thirds of the cancers detected, a total of 39, were found by both types of scan. But a third only came to light when 3D screening was added.
3D mammograms work in a similar way to a CT scan, by taking multiple X-rays to build up a three-dimensional picture.
They are said to be more sensitive, but have been criticised for increasing the radiation exposure of patients.
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Health care robot brings experts to bedside

The RP-Vita robot allows patients to been seen by experts from afar
A health care robot developed by iRobot and InTouch Health allows doctors who may be thousands of miles away to interact with patients at their bedsides.
Called RP-VITA, the robot stands 1.7 meters high and rolls around hospitals controlled by an iPad. The robot was designed to bring world class doctors and specialists to patients who wouldn't otherwise have access to them.
See RP-VITA in action in a video on YouTube.
"Imagine you had a stroke," said iRobot CEO Colin Angle speaking at the company's headquarters in Massachusetts. "Would you rather be seen by the world expert in strokes...or by the guy down the hall? RP-VITA is about allowing people to see specialists and have access to more sophisticated treatments, which leads to better outcomes."
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Clever Avatar to help ageing Australians

Anna is the animated face of a new tablet-based artificial intelligence system designed to help Australians manage their lives as they age.
The technology was developed by scientists at Flinders University in Adelaide and is being commercialised by a spin-off company called Clevertar.
“We’re still in the development phase, and we’re doing some small scale testing with older people in a retirement village in Adelaide,” says Clevertar CEO, Tanya Newhouse.
Newhouse, who has a strong background in the aged care sector, is working with scientists to turn some significant research combining artificial intelligence, voice recognition and responding to cues, into a product with huge potential.
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NEHTA proud to be a Privacy Awareness Week (PAW) partner

23 April 2013. Privacy Awareness Week (PAW) is an initiative of the Asia Pacific Privacy Authorities forum (APPA) held every year to promote awareness of privacy issues and the importance of the protection of personal information. Privacy Awareness Week 2013 is from 28 April to 4 May 2013 and the Office of the Australian Information Commissioner (OAIC) will celebrate the week with a series of events and the release of new privacy guidance and products. Their focus for PAW 2013 is privacy law reform.
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Cost facts may reduce test ordering

TELLING medical practitioners what medical tests cost would be a “good start” in ensuring only the most appropriate tests are ordered, according to AMA president Dr Steve Hambleton.
“We are not going to be able to afford everything for everyone, so every person in the health care system … needs to take responsibility every time we order a test”, Dr Hambleton told MJA InSight.
Dr Hambleton was commenting on a US trial published in JAMA Internal Medicine which found that providing fee data at the time of test ordering resulted in a “modest” reduction in tests ordered. (1)
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Tools to find health and a perfect match

BIG data has become one of the most talked about concepts in IT. But its impact on Australian business depends very much on how you define it in the first place.
While the term was originally used to describe massive and complex data sets, increasingly its techniques have come to be applied to smaller problems.
Hence the term big data is often used to describe data problems that involved the blending of structured corporate data with unstructured data from external sources such as social media, or that are being solved at vastly accelerated speeds through use of distributed processing tools such as Hadoop and MapReduce, or in-memory tools such as SAP's HANA or Oracle's Exalytics.
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Theory of Einstein's Proved Right—Again

By GAUTAM NAIK

Scientists have subjected Albert Einstein's famous theory of gravity to its toughest real-world test so far—and it has prevailed.
The theory, which was published nearly a century ago, had already passed every test it was subjected to. But scientists have been trying to pin down precisely at what point Einstein's theory breaks down, and where an alternative explanation would have to be devised.
Einstein's framework for his theory of gravity, for example, is incompatible with quantum theory, which explains how nature works at an atomic and subatomic level.
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Hubble spies a nursery in a nebula

Date April 22, 2013

Ben Cubby

Environment Editor

Astonishing new images from the Hubble Space Telescope have pierced through a nebula of gas and dust 1500 light years from Earth, to reveal a nursery of newborn stars.
The Horsehead Nebula, a vast plume that forms part of the constellation Orion, is a favourite of astronomers because of its distinctive dark shape, which is set against a background of glowing hydrogen gas.
Using infrared cameras, which capture more wavelengths of light than the human eye, the telescope was able to peer within the Horsehead.
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Enjoy!
David.

Sunday, April 28, 2013

This Is A Really Interesting Development In Information Sharing. The UK Adds A Duty To Share Information - With Safeguards.

The following appeared a little while ago.

Caldicott recommends 'duty to share'

11 April 2013   Lis Evenstad
The Caldicott2 review of information governance in the NHS recommends a new duty to share information when it is in the interest of the patient.
'Information: to share or not to share' will be launched on 17 April alongside health secretary Jeremy Hunt’s response to the recommendations.
It details how the NHS should share patient information while also protecting patient confidentiality as it moves towards a paperless future.
Speaking at a Westminster Health Forum this week, Dame Fiona Caldicott – who led the review - said that education and information sharing were key to providing safe care for patients.
“We’ve come as far as to suggest a new Caldicott principle, which is that information should be shared when that is in the patient interest,” she said.
“Some professionals have become over occupied with concerns about the security of information to the point where they are not confident about how to share it.
“They have lost the sense of confidence that they are putting the patient first, and are able to make judgements on information being shared, and with whom, and when it cannot be shared.”
More here:
Here is a link to the study.

Information: To share or not to share?

Information Governance Review

Patients and clients give staff in health and social care personal and confidential information about themselves all the time and they trust that we will protect the information they give.  As we move to a more electronic age, where information can be shared more easily, and across many more types of organisations, the Government accepted the Future Forum’s recommendation for a review of the balance between protecting patient information and its sharing, to improve patient care.  The term used to describe how we manage this is ‘Information Governance’.
Dame Fiona Caldicott has been leading this review with an independent panel of experts, on behalf of the secretary of state.  The panel was asked to make recommendations on the balance between sharing personal information and protecting individuals’ confidentiality taking into account; how to ensure that we improve the sharing of personal information to support the care of individuals; enable the further use of information more widely to improve health and social care services; protect individuals’ confidentiality and respect their wishes in relation to how their information is used.
We would like to thank everyone who has taken the time to contact us.  See the news items below for more information or follow us on twitter @caldicott2
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There is now a final report released a few days ago -having been  delayed because of Margaret Thatcher’s funeral for a week or so.
The full report can be downloaded from here:
The concept that there is a duty to share information that is in the interests of the patient - presumably with other care providers seems to me to have some interesting implications. Just how you determine what is in the interests of the patient will be a very interesting discussion in the final report.
The response of the UK Health Secretary is interesting. It is clear opt-out has been adopted with safeguards

Press release: Health Secretary to strengthen patient privacy on confidential data use


The Health Secretary today responded to the Caldicott Review, outlining how technology can have a transformational effect on healthcare.

Saturday, April 27, 2013

Weekly Overseas Health IT Links - 27th April, 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.
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Think tank puts data sharing as priority

By Tom Sullivan, Editor, Government Health IT
Created 04/19/2013
Delivering what founder and president Jason Grumet described as “one of the most challenging projects we’ve undertaken,” the Bipartisan Policy Center on Thursday put forth what it hopes will be “a viable political plan to reign in the spiraling costs” of healthcare while also improving quality. At the center is a recommendation to prioritize electronic sharing of information among providers.
The plan, "A Bipartisan Rx for Patient-Centered Care and System-Wide Cost Containment," is signed by former Senate Majority leader Tom Daschle, former Senate Majority Leader Bill Frist, MD, former Senate Budget Committee Chairman Pete Domenici, and former Congressional Budget Office Director Alice Rivlin.
“There is no fiscal solution that doesn’t involve healthcare,” said Michael Peterson, president and CEO of the Peter G. Peterson Foundation in Thursday’s event introducing the report, adding that healthcare has its own challenges.
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CHIME Comments to HHS on New Initiatives to Accelerate HIE

APR 18, 2013 5:25pm ET
As the federal government looks to further enhance the exchange of health information exchange, the College of Healthcare Information Management Executives suggests the feds model new initiatives after some of their existing programs.
The Department of Health and Human Services in March issued a request for information as it considers policy moves to further accelerate interoperability and health information exchange beyond initiatives previously launched under the Office of the National Coordinator for Health Information Technology. Responding to the request for information, CHIME applauds the certification programs that HHS already has in place for the electronic prescribing and meaningful use programs.
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Computational model predicts cancer survival rates

April 19, 2013 | By Ashley Gold
A new computational model highly predictive of breast cancer survival has been developed by Columbia University engineering researchers. Their work is outlined in a study published this week in Science Translational Medicine
Lead researcher Dimitris Anastassiou--a professor of engineering at Columbia's Fu Foundation School of Engineering and Applied Science--and his team identified "attractor metagenes," which are gene signatures present in identical form among many types of cancer, according to an announcement from the school.
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Privacy framework necessary as healthcare social networks grow in popularity

April 19, 2013 | By Dan Bowman
As an increasing number of patients and providers flock to health social networking sites to share information and connect with similar individuals, privacy remains a paramount concern. To that end, a comprehensive privacy framework is vital for such environments, according to research published this week in the Journal of the American Medical Informatics Association.
"Empirical and theoretical research suggest that users often lack enough information to make privacy-sensitive decisions and, even with sufficient information, are likely to trade-off long-term privacy for short-term benefits," says author Jingquan Li, an associate professor of computer information systems with the Texas A&M University-San Antonio's school of business. "Users' online practices are also constrained by their degree of digital literacy and by the technical design of the website, which may impede easy management of settings and consent regarding the use and disclosure of personal data."
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Bryant backs The Big EPR Debate

17 April 2013  
Beverley Bryant, NHS England’s director of strategic systems and technology, has given her support to EHI’s Big EPR Debate.
“It will be helpful because I want to be more consultative – not just to funnel stuff down from the centre - and this will help achieve that,” she said.
EHI has launched The Big EPR Debate now because the NHS is once again being urged to implement electronic patient records on a tight timescale.
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Viewing medical history through HIE reduces readmissions

April 18, 2013 | By Susan D. Hall
Emergency room access to a patient's medical history compiled through health information exchange reduced both readmissions and single-day admissions in a study from Israel.
The study tracked whether ED physicians looked at patient medical histories after an information system was installed linking the state-run HMO's seven hospital and various clinics. Data on patients covered by the HMO would be compiled from these various sources, presumably offering a more complete picture. Other patients' data would be limited to that from the facility where they were being treated.
Only 31.2 percent of ED physicians accessed the medical histories at all, according to the study published in BMC Medical Informatics and Decision Making. The study looked at seven-day readmissions and single-day admissions for frequent diagnoses: chest pain, abdominal pain, gastroenteritis, urinary tract infection (UTI) and pneumonia organism.
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Healthcare execs reliant on IT now more than ever

April 18, 2013 | By Ashley Gold
Healthcare executives are becoming more and more reliant on healthcare technology, according to new research from The Economist and RICOH Europe.
Of 432 healthcare executives who responded to the publication's survey, close to 93 percent percent said that they've become more reliant on technology and they're positive about the impact it's having on the industry. Roughly 70 percent said the increased use of technology has increased employees' creativity, while 65 percent agreed there is even more room for efficiency gains
Still, 35 percent of respondents admitted that a computer-automated decision has cost their organization money recently. An accompanying infographic highlights the numbers.
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Kinsa launches a smartphone-connected thermometer to create a real-time health map

Summary:
New York-based Kinsa is trying to create a real-time picture of the country’s health with a smartphone and a simplified digital thermometer.
If you want a real-time picture of the country’s health, you can check out Google Flu Trends or insights from social media. And if you want a more official perspective, you can turn to the Centers for Disease Control. But getting information that is both real-time and accurate is tricky business.
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Feds say big data rewards 3 years away

By Tom Sullivan, Editor
Despite all the attention, the catchphrase big data is lacking any kind of a clear definition. 
The TechAmerica Foundation last October put together its take and on Monday MeriTalk posted the results of its research into the matter, which involved polling 17 “big data big brains” in the federal government and industry on what exactly big data is, what agencies are doing with it today, and what obstacles remain.
“Most of the respondents shared the view of Big Data as the point at which the traditional data management tools and practices no longer apply,” the Meritalk report explained.
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Thursday, April 18, 2013

mHealth Regulation Under the Spotlight on Capitol Hill

by David Collins and Tom Martin
The March House Energy and Commerce hearings on mobile health regulation provided insight into the attention that the mHealth space is garnering on Capitol Hill.
Major topics included the effect of mHealth on health care costs, interoperability of EHRs, the role of FDA in maintaining patient safety and the applicability of the medical device excise tax on tablets and smartphones. The mHIMSS work groups provided an early review of the draft regulations when they were released more than a year ago.
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Contest seeks new big data strategies

By Mike Miliard, Managing Editor
Created 04/17/2013
The Bipartisan Policy Center, Heritage Provider Network and The Advisory Board Company announced Tuesday the launch the Care Transformation Prize Series, a nationwide contest to find ways to more effectively deploy big data in healthcare.
As U.S. healthcare organizations grapple with big changes to care delivery and payment reform, the contest seeks to uncover more effectively use data to drive improvements in healthcare cost and quality, officials say.
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Cost reminders via CPOE lead to fewer test orders

April 17, 2013 | By Susan D. Hall
Displaying the cost of a test via computerized provider order entry systems prompted a 9 percent reduction in the number of tests ordered, according to a study published in JAMA Internal Medicine.
The study compared the number of tests ordered over six months when the CPOE system at Johns Hopkins Hospital displayed the cost of 61 tests to a six-month baseline when costs were not presented. Meanwhile, 6 percent more tests were ordered when cost information was not presented, according to a MedPage Today article.
"Displaying the Medicare allowable fees of diagnostic tests at the time of ordering can modestly affect provider ordering behavior," the study's authors wrote. "Whether broadening this intervention and coupling it with educational interventions related to cost consciousness and stewardship of resources will increase its effect on clinical practice deserves further study, provided that providers are not inappropriately incentivized to limit needed care."
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Hagel promises plan in 30 days for DOD-VA health records sharing

Stars and Stripes                                                                     
Published: April 16, 2013
WASHINGTON — Faced with tough questions from legislators, Defense Secretary Chuck Hagel on Tuesday said he would decide on a plan within 30 days to work through the tangled process to seamlessly share medical records between the Department of Defense and the VA.
At a hearing with members of the House Appropriations Committee, Hagel admitted the process has bogged down, and promised quick action.
“I’m going to acknowledge that we’re way behind,” said Hagel, who took over as defense secretary in February, and previously served as an official at the VA in the 1980s. “We will do better.”
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Hagel on iEHR: 'I didn't think we knew what the hell we were doing'

April 17, 2013 | By Dan Bowman
Secretary for the U.S. Department of Defense Chuck Hagel said Tuesday that lack of understanding regarding the creation of a joint electronic health record system with the U.S. Department of Veterans Affairs led him to block DoD from issuing a request for proposals last month, Federal News Radio reports.
Hagel, speaking at a House Appropriations Committee hearing, said that while not all of the money that has been poured into the project has been wasted, the DoD must do better. He said that he has ordered a restructuring of the process that will include "direct management oversight" by his office, according to the article.
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GOP Senators: HITECH Program Needs to be Rebooted

April 16, 2013
Six Republican Senators have released a whitepaper that argues Congress and the Obama administration need to reboot the Health Information Technology and Economic and Clinical Health (HITECH) Act and the efforts to deploy health IT, because the current program is deficient.
The whitepaper, “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” is the work of Senators John Thune (R-S.D.), Lamar Alexander (R-Tenn.), Pat Roberts (R-Kan.), Richard Burr (R-N.C.), Tom Coburn (R-Okla.), and Mike Enzi (R-Wyo.). The Senators say the failed implementation of health IT through HITECH can be summed up in five points:
  • Lack of Clear Path Toward Interoperability
  • Increased Costs
  • Lack of Oversight
  • Patient Privacy at Risk
  • Program Sustainability
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4 questions on HIT in America vs. the rest of the world

By Tom Sullivan, Editor
Among America’s dichotomies:  The country is widely-viewed as a leader in IT, yet the healthcare industry is notoriously perceived as lagging others in tech adoption. But is it really?
To find out, Government Health IT Editor Tom Sullivan spoke with David Lareau, who as CEO of health IT vendor Medicomp Systems, travels the globe and meets with healthcare customers in other nations.
Q: What is the health IT landscape in other countries like right now?
A:
We’re involved in Malaysia and it has the closest thing to what I’d call the Balkanized healthcare system where every enterprise is its own country with its own clinical data definitions. What is it about every one of our hospitals that makes them think they are such a unique and exciting experience that they need to define their own clinical data? And when I see that it drives me crazy, but when you go to other countries, like Malaysia where there are more chains of hospitals, each one reinvents this stuff time and time again. Remember a few years ago when the big, big thing in our industry everybody was talking about was interoperability?
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6 ways to avoid breaches

By Diana Manos, Senior Editor
Created 04/16/2013
Healthcare organizations should not assume that compliance with regulations, like HIPAA, automatically makes their organization secure, says Larry Hurtado, CEO of Digital Defense, a risk assessment firm in San Antonio, Texas.
“Organizations need a blended approach,” Hurtado says. “They need to balance out compliance with security.”
More than a decade ago, Digital Defense “cut its teeth” on providing security audits to financial institutions, but these days, the company has clients across all types of industries, including healthcare.
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Social media key in enabling quick provider response to Boston bombings

April 16, 2013 | By Dan Bowman
In the wake of two explosions that rocked downtown Boston at the finish line of the Boston Marathon on Monday, technology and social media played a critical role in the coordination of care efforts.
John Halamka (right), CIO at Boston-based Beth Israel Deaconess Medical Center and FierceHealthIT Editorial Advisory Board member, told FierceHealthIT that from his perspective, maintaining a high bandwidth was key for employees at his hospital in keeping care efforts as fluent as possible, as was a reliable and secure infrastructure.
"The demand for communication--voice, email, social media and streaming video--was very high," Halamka said. "The scalability built into the design of all our systems--networks, servers, storage and client devices--served us well."
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Boston Marathon tragedy reveals potential EHR, HIE flaws

April 18, 2013 | By Marla Durben Hirsch
The Boston hospitals that have been treating the hundreds of victims of the horrific Boston marathon bombings this week have done a terrific job. They, in turn, have credited technology in helping them communicate to staff, volunteers and the public. I presume that these hospitals also have good electronic health record systems that they can rely on.
But I can't help but wonder: wouldn't their work have been enhanced even further and their jobs made easier if the nation was further along in health IT and interoperability? Would it have helped these hospitals if they had had electronic access to victims as they were rushed in, to know about an allergy to penicillin, a patient's blood type, a heart condition that could affect the outcome of surgery?
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IT key for Boston bombing patients

By Bernie Monegain, Editor
Created 04/17/2013
As a Bostonian and an emergency physician, Jonathan Teich's first instinct when the explosions shook the Boston Marathon on April 15 ordinarily would have been to rush to Brigham & Women’s Hospital to help treat the victims, many of whom had life-threatening injuries.
But this Patriot’s Day, it was different. Teich’s son and brother-in-law were both running the marathon. His brother-in-law crossed the finish line at the time of the second explosion – unhurt. Teich’s son, just a couple of miles back, was among the runners diverted off course. So an anxious Teich waited for that first text message saying he was OK. It would be two hours, though, before father and son were reunited.
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Are eICUs as efficient as some studies portray?

April 16, 2013 | By Susan D. Hall
While remote monitoring of intensive care units promises to stretch the skills of an inadequate pool of specialists, a recent New York Times article questions whether eICUs actually improve care for patients or the bottom line for hospitals.
According to the article, while some studies linked to companies that sell such systems have produced large declines in mortality in addition to huge return on investment, other independent studies have found just the opposite in terms of the latter, with no significant impact on survival rates, complications or length of stay.
What's more, some hospitals adopted the technology, then ditched it, according to the Times, including NewYork-Presbyterian Hospital and Kaleida Health in Buffalo, as well as hospital systems in Michigan, Texas and Kentucky.
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Another view: Neil Paul

EHI Primary Care’s columnist is not sure about giving patients online access to their notes; although he has lots of other ideas for helping them digitally.
16 April 2013
The government is having another push on making sure that patients can get access to their GP-held records. In fact, one of the few, definite, commitments that has made on the NHS IT front is that patients should have online access by 2015.
Yet, I’m not convinced that this is something that people really want; even though there may be some benefits when we get around to implementing the idea that have not been discussed yet.
Why aren’t doctors keen?
Most of the doctors I speak with don’t have an intrinsic problem with patients seeing their notes; they just don’t feel it’s a high priority or that it’s going to help more than it hinders.
Their main fear is that they will have to spend time dealing with the minority that hassle them about trivial inaccuracies: “I said the pain was six hours not five”; “the scar is two centimetres above my left knee not three.”
In the same vein, a number worry that some patients will want every medical term explaining. However, I know of companies that are trying to make front-ends to the patient record that make understanding easier, while providing links to existing sources of further information.
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Caldicott recommends 'duty to share'

11 April 2013   Lis Evenstad
The Caldicott2 review of information governance in the NHS recommends a new duty to share information when it is in the interest of the patient.
'Information: to share or not to share' will be launched on 17 April alongside health secretary Jeremy Hunt’s response to the recommendations.
It details how the NHS should share patient information while also protecting patient confidentiality as it moves towards a paperless future.
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4 Steps to Engage Patients While Meeting Meaningful Use Requirements

Written by Sabrina Rodak | April 12, 2013
The focus on engaging patients in their care and the need to meet meaningful use requirements converge in one online tool: the patient portal. Patient portals on a health system's website can allow patient to easily schedule appointments, contact their provider and access other resources, which engages them in their care. These portals also help hospitals and physicians fulfill meaningful use stage 2 requirements of providing patients the ability to view their health information online and using electronic health records to identify patient-specific education resources.
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Lab Tech Standards, With Benefits

Scott Mace, for HealthLeaders Media , April 16, 2013

Is your laboratory thinking about Meaningful Use yet? In all the hubbub over ONC's mammoth incentive program (and the penalties that follow in a few short years if you don't get on board), technology changes affecting every medical lab will provide their own benefits to healthcare's bottom line.
It's been a long time coming.
As far back as the 1960s, it was already understood that a standardized vocabulary for the multitude of lab tests performed in this country was lacking. Those lab tests now amount to about 30-billion-per-year.
While the industry argues about which version of ICD to agree upon in the diagnostic code area, and just how we would get physicians to agree upon these diagnosis codes, information about lab tests were always more amenable to being digitized. A serum sodium test is a serum sodium test, and once a lab test standard exists, there's no reason not to bake it right into the diagnostic equipment itself.
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4 ways health IT can build trust

By Benjamin Harris, New Media Producer, Healthcare IT News
Created 04/04/2013
Medicine is a two-way street; it works best when the patient and the provider trust each other, and can work together for the best outcome. While technology can enable those outcomes, when improperly used -- consider the epidemic of patient data breaches -- it can also raise some eyebrows and scare some people away from embracing it. Scott Zimmerman, president at TeleVox Software, understands these concerns. But he sees technology offering a net gain on the road to improving patien-physician relationships and enhancing trust. He shares four ways health IT can improve the quality of care and enhance trust between the patient and the provider.
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E-prescribing in growth mode

By Bernie Monegain, Editor
Created 04/15/2013
The electronic prescribing systems market is estimated to grow to $794 million, at a compound annual growth rate of 26 percent from 2012 to 2017, according to a new study by MarketsandMarkets, which analyzed the major market drivers, restraints and opportunities around the world.
In the U.S., the HITECH Act designates e-prescribing as an essential requirement for meaningful use under the electronic health record incentive programs, thus driving the adoption of electronic prescribing systems, the report found. According to findings, costs can be reduced with the use of eRx systems as these help to improve quality and efficiency and show promise in reducing costs by actively promoting appropriate drug usage; providing information to providers and dispensers about formulary-based drug coverage, including formulary alternatives and co-pay information; and speeding up the process of renewing medications.
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The Big Data Revolution: Part 2

APR 12, 2013 4:16pm ET
Last week’s blog introduced a new book, “Big Data: A Revolution That Will Transform How Live, Work and Think,” that I like a lot. Starting from the current obsession with datafication – “taking information about all things under the sun…and transforming it into a data format to make it quantified” – Big Data identifies three major developments, incredibly large data sets, acceptance of messy data, and a tolerance for correlation in lieu of causation, as drivers of the revolution. From Big Data’s perspective, the business and social implications of these shifts are substantial.
The value of data is evolving. Historically seen as ancillary, “in the age of big data, all data will be regarded as valuable, in and of itself.” Indeed, “data’s value needs to be considered in terms of all possible ways it can be deployed in the future, not simply how it is used in the present …Ultimately, the value of data is what one can gain from all the possible ways it can be deployed.” The “option value” of data is the sum of those possibilities.
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CDS can make best-practices guidelines more accessible

April 15, 2013 | By Susan D. Hall
Electronic health records offer the opportunity to better integrate clinical practice guidelines (CPGs) at the point of care, but the technology and physician practice must evolve, according to a paper published at BMC Medical Informatics and Decision Making.
Just sending out more reminders to physicians won't do the trick, researchers say. At this point, most information about best practices is "parked" in lengthy documents or graphics, such as decision trees, that are too cumbersome for physicians to parse during a patient encounter.  
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Researchers call for national standards for genomic data use

April 15, 2013 | By Ashley Gold
Better standards are needed for how discoveries in genomic medicine are found and recorded as health information technology develops, according to researchers from Harvard and the Mayo Clinic who published a viewpoint in the Journal of the American Medical Association last week.
Advances in genomic medicine, the researchers said, have lead patients and providers to be able to expect large improvements in healthcare effectiveness by 2020. However, institutions must be ready to incorporate "exponentially" larger volumes of genomic, medical, ethical and legal information into electronic health records, which already are fragmented, they added.
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Healthcare firms struggle with IT staffing: survey

Posted: April 12, 2013 - 11:45 am ET
Many U.S. healthcare companies—about 67%—report that they're struggling to attract experienced information technology workers, according to a survey.
That's compared with 10% that said they have problems attracting all workers, according to the Towers Watson 2013 Healthcare IT Survey (PDF). Meanwhile, 38% of healthcare companies reported problems with retaining experienced IT workers, compared with 8% reporting problems retaining all types of workers.
The problems may stem from misconceptions about what attracts employees to a healthcare workplace.
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Monday, April 15, 2013

Efforts Seek To Improve Drug-Drug Interaction Alert Tools

by Bonnie Darves, iHealthBeat Contributing Reporter
In the realm evolving at the intersection of electronic health records and technology-enabled clinical decision support, few issues have gotten as much attention -- in the negative category that is -- as the pesky problem of electronic alert fatigue resulting from what some view as hyper-vigilant drug-drug interaction (DDI) alert systems.
Although the growing use of computer-accessible knowledge databases that flag potentially dangerous DDIs at or before the point of prescribing have been a boon to medication safety improvement overall, a serious downside has emerged. The alerts are so numerous and, in many cases, also either very low priority or irrelevant that clinicians are increasingly overriding or ignoring them -- which might result in important, pertinent alerts being missed. Recent studies have found override rates as high as 95%.    
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Enjoy!
David.