Again there has been just a heap of stuff arrive this week.
First we have:
20 Jul 2009
Healthcare IT system supplier EMIS is encouraging its GPs practices to sign up to its primary care tracking database QSurveillance to help provide national and local information on swine flu.
EMIS said the QSurveillance database is already providing information on 23m patients from 3500 GP practices and that the level of detail provided in reports to governments and health authorities had been increased following the rapid rise in the spread of swine flu.
The system, a not-for-profit partnership between EMIS and Nottingham University, provides daily and weekly reports to the Health Protection Agency, The Department of Health and health authorities across the UK.
Dr David Stables, medical director of EMIS and a director of QSurveillance, said the tool enabled NHS planners to quickly identify flu hot spots to ensure resources are focused where they are most needed.
Much more here:
Pity good old OZ is not quite as well organised! This is the sort of problem where you see the real power of second and third generation e-Health.
Second we have:
Cynthia Johnson, July 20, 2009
Medical informatics is playing a significant role in a unique, newly-launched partnership between Durham-based Duke University and the Durham, NC, community. The goal of the partnership, known as Durham Health Innovations (DHI), is to improve the health of everyone living in Durham County by using medical informatics to identify interventions for community members whose needs aren't being met successfully by conventional methods.
"The informatics side of this project is deeply embedded," says Lloyd Michener, MD, chair of the department of community and family medicine at Duke. "The entire project requires a very robust backbone and system. This is an example of what you can do with really good information systems and analytic tools. You're basically doing real-time epidemiologic studies."
The data the partnership uses comes from Duke University's electronic medical records (EMR) system, which is a variation of the system developed by San Francisco-based McKesson. Duke has implemented the system in all of their office practices.
The university collects the data from the EMR and runs customized software on it that assigns geographic locations to the data, also known as geocoding. This process, which is HIPAA-compliant, allows them to look at areas of disease clustering in order to treat specific diseases or disorders prevalent in areas within the community.
"What we're doing that's unique is that, rather than looking at one disease or one subpopulation, we're doing this as a system experiment of how we can look at the health needs of our entire quarter-million people in Durham County and redesign how the system works to improve health," says Michener.
The plan includes 10 individual projects aimed at reducing death or disability from specific diseases or disorders prevalent in the community. The focus of the teams on particular health problems was determined by the community, not by Duke University.
The projects include: adolescent health, asthma, cancer, heart disease, diabetes, HIV and sexually transmitted diseases, maternal health, pain management, substance abuse, and seniors' health.
Lots more here:
This seems like a very important initiative to widen the scope of what Health Informatics can contribute to.
Third we have:
Tuesday, July 21, 2009
by George Lauer, iHealthBeat Features Editor
While big-picture health reform efforts on Capitol Hill are getting most of the mainstream media attention this month, another more focused kind of reform also is under way a few blocks down the road.
Last week, a subcommittee of the newly formed Health IT Policy Committee recommended an end to a five-year monopoly on certifying electronic health record systems.
Since 2004, the Certification Commission for Healthcare IT has been the only government-recognized organization to put its stamp of approval on EHRs. If the Policy Committee follows the recommendation of its certification and adoption work group, that exclusive role will end.
The Policy Committee meets next month in Washington, D.C., and plans to accept public comment on certification, as well as issues related to privacy, security, interoperability, open-source programs and other flexible software sources.
If CCHIT's exclusive role ends as expected, the door will open wider to smaller, simpler, less expensive EHR systems, according to some industry experts.
At its most basic level, the change could be construed as a move from an industry-driven system to a consumer-driven system. In that scenario, the consumer could be defined as the hospital or physician group purchasing an EHR system.
Reporting continues here (with links):
I think this is a decision that needs to be taken carefully as the CCHIT has developed a pretty useful program of progressive system improvement.
Fourth we have:
E-mail can be as useful as a stethoscope in diagnosing, and electronic medical records are for the better.
By Rahul Parikh
July 20, 2009
Wow. I've just taken care of three patients in 12 minutes, and I didn't do it by "churning" them through my office as if it's some sort of factory assembly line. Rather, those patients (their parents, more specifically -- I'm a pediatrician), e-mailed me over a secure network with questions and descriptions of signs and symptoms.
One mother attached a digital photo of a rash on her 3-month-old daughter's face; it turned out be nothing more serious than baby acne (it'll go away in a month or so). Another mom had noticed that her son was missing one of his pre-kindergarten immunizations (she had pulled up his shot records online) and requested that I order it. And the father of a 5-month-old boy told me that his son has been constipated off and on for the last month. I e-mailed him a questionnaire so I could determine whether the family should try something at home or bring the child to the office.
In the past, these parents would have left a phone message and we probably would have spent the better part of a day or two playing phone tag. Or they would have had to make an appointment, strap their children into car seats, pack diaper bags and snacks and sit in a waiting room full of sick children -- only to spend 5 to 10 minutes with me while I told them everything was fine. Instead, we fixed the issues by e-mail, allowing parents to stay in their lives at home and at work.
Such interactions are no longer a pipe dream for the future of medicine. This is how I (and several thousand of my colleagues at Kaiser Permanente in Northern California) practice medicine every day. In 2006, we implemented an electronic medical record system and haven't looked back.
Much more here:
This is one clinician’s view of how even the simple aspects of e-Health can help.
Fifth we have:
The National Library of Medicine announces the release of the first version of the CORE (Clinical Observations Recording and Encoding) Subset of SNOMED CT® (Systematized Nomenclature of Medicine--Clinical Terms®). The primary purpose of this Subset is to facilitate the use of SNOMED CT for coding of problem list data in Electronic Health Records (EHRs) and to enable more meaningful use of EHRs to improve patient safety, health care quality, and health information exchange. SNOMED CT is owned and maintained by the International Health Terminology Standards Development Organisation (IHTSDO) and is a designated US standard terminology for diagnosis and problem lists. Use of SNOMED CT is free in IHTSDO Member countries, including the United States, in low income countries, and for approved research projects in any country.
The Subset is available at http://download.nlm.nih.gov/umls/kss/SNOMEDCT_CORE_SUBSET/SNOMEDCT_CORE_SUBSET_200907.zip. A free Unified Medical Language System (UMLS) Metathesaurus license (which includes the IHTSDO Affiliate license) is required. It can be obtained via the same site.
This seems like a very useful piece of work indeed.
Sixth we have:
By Jake Miller
A plan to develop a state database of electronic health records by 2014 could save Wisconsin $6 billion annually -- nearly as much as the state budget deficit, according to state health officials.
The Health Information Exchange project, a proposed consolidation of records still in its infancy, is designed to share records among medical facilities, will reduce administrative costs and redundant care at hospitals and clinics, thus saving billions, said Karen Timberlake, Secretary of the Wisconsin Department of Health at a Wednesday meeting at Marshfield Clinic designed to gather input from health professionals.
But making it work is far from simple, requiring input and information from public and private medical providers operating different systems -- many that aren't electronic.
Financial incentives and a push from the federal government have expedited the desire to integrate the entire state into a single pool of information, Timberlake said.
About 60 percent of Wisconsin hospitals and clinics currently have some form of electronic records, including the Marshfield Clinic, which has established itself as a leader in the field.
"Wisconsin is well ahead of the national average, but 60 percent is not 100 percent," she said.
As part of the American Recovery and Reinvestment Act, monetary incentives are available for medical providers and states that develop and initiate comprehensive electronic health records by 2014.
Nationally, $2 billion is available for HIE development.
With reports like this we can see the momentum of roll out is building all over the place – supported, in part, by the US stimulus package.
Seventh we have:
The Associated Press
Posted: 07/16/2009 08:12:08 AM PDT
SAN DIEGO—Patients at a San Diego medical center have been warned that a hacker breached the center's computers and gained access to patients' personal information.
The University of California, San Diego's Moores Cancer Center sent a letter to 30,000 patients after the records were accessed late last month.
Much more here:
Seems like another day, another breach!
Eighth we have:
HDM Breaking News, July 20, 2009
A new coalition of 20 hospitals plus physician practices, employer groups and insurers is forming a statewide health information exchange in Connecticut.
One key goal of the coalition, Transforming Healthcare in Connecticut Communities, is to exchange information from participant’s electronic health records.
Several coalition members are subsidizing a portion of the cost for physicians to implement EHRs from Allscripts, Chicago, under the Stark Act exemption and safe harbors to federal anti-kickback statutes.
Full article here:
Seems like we have these springing up like the hoped for ‘green shoots’!
Ninth we have:
Whether it be bills, insurance forms, medical records or prescriptions, patients are often inundated with vast quantities of paper. Google Health is now trying to help you organize all of this paperwork in its platform. Google Health, which finally launched last May after months of rumors, has ambitions to become a centralized and secure place to store medical records online.
The new feature lets patients upload scanned paper documents into your Google Health account. Google particularly suggests that you upload an “advance directive,” which determines your end-of-life wishes so that your family and doctor can honor them if you get sick and are unable to communicate.
This seems like a logical extension of the work Google has been doing.
Tenth we have:
Carrie Vaughan, for HealthLeaders Media, July 21, 2009
The Health IT Policy Committee approved revised recommendations for defining "meaningful use" of electronic health records this past Thursday. But for many providers—especially rural community hospitals and solo or small group practices—the objectives for meaningful use are still out of reach.
The bar needs to push providers, while ensuring that a reasonable number of leading-edge organizations can achieve it by 2011, says John Haughom, MD, senior vice president of clinical quality and patient safety at PeaceHealth, a Bellevue, WA-based seven-hospital system with a 500-member medical group. Haughom is no stranger to HIT. Roughly 14 years ago, PeaceHealth implemented a community health record that shares patient information with providers throughout the region—including its competitors. The community health record has roughly 2 million patient records in its database and more than 20,000 clinical users—only a portion of whom are PeaceHealth employees.
The HIT Policy committee's recommendations are "pretty close" to where they need to be, says Haughom. But he's concerned that the current recommendations "will discourage organizations that aren't as far along" in the process of implementing EHRs. The three objectives of the ‘meaningful use' recommendations that he says should be scaled back are:
Work is continuing and getting closer. Worth a read to know where things are now up to.
Eleventh for the week we have:
Posted: July 21, 2009 - 11:00 am EDT
Medfusion, a Cary, N.C.-based provider of patient-provider online communication solutions, has purchased the iHealth Personal Health Record and other online communication products from San Francisco-based Medem in what Medfusion founder and CEO Steve Malik described as “primarily a stock for assets deal.”
Malik would not disclose how much Medfusion stock was exchanged, but said, “We have purchased the assets known as iHealth,” and these include the Medem personal health record, iHealth Web site and secure online communication system.
More here (registration required):
I suspect this is part of the inevitable consolidation in the PHR space.
Twelfth we have:
Posted: July 21, 2009 - 11:00 am EDT
If the pager is not yet vanished from the healthcare scene, it will soon take its place beside the PalmPilot, Altair and Apple Lisa on a shelf in the museum of outmoded technology, according to presenters at the 18th annual Physician-Computer Connection Symposium sponsored by the Association of Medical Directors of Information Systems, which was held last week in Ojai, Calif.
Michael Blum, medical director of information technology at the 642-bed University of California at San Francisco Medical Center, said pagers are being squeezed by newer communication technologies while their own utility is being compromised.
Pagers used to be cheap, but now pager service is not as cheap as a cell phone,” Blum said. And while the pagers don't require an instant response—a function well-suited to healthcare—“SMS basically replaces the same functionality” while “the quality of the devices has fallen off the deep end,” he said. “We have many more dead zones, and they're not replacing aging equipment.”
Much more here (registration required):
I suspect this trend is all too true – and probably not a bad thing.
Thirteenth we have:
July 21, 2009 | Kyle Hardy, Community Editor
NEW YORK – The WebMD Health corporation has rolled out a new medical application for physicians that's designed to make healthcare information more accessible for the on-the-go situations.
Medscape Mobile provides physicians with information on a mobile platform available through Apple's iPhone or iPod Touch, the BlackBerry and other mobile devices
"Medscape Mobile extends the reach of Medscape's information and applications from the desktop to the mobile devices that physicians are already using in a variety of clinical settings," said Steve Zatz, MD, executive vice president of WebMD. "Our online physician audience will now have access to Medscape's comprehensive medical information in their specialty, wherever and whenever they need it."
The free application provides physicians with pharmaceutical information, clinical reference tools, medical news and information on continuing medical education.
The spread of the mobile technology and its capabilities just keeps improving.
Fourteenth we have:
Ben Cole, for HealthLeaders Media, July 21, 2009
A partnership between a U.S. information technology services company and the Chinese government has the potential to play a big role in China's goal to revamp its national healthcare system, proponents say.
Under an agreement with the Hunan Provincial Government of the People's Republic of China, Plano, TX-based Perot Systems Corporation will provide IT consulting services for healthcare organizations and public health initiatives throughout the Province.
Working with the Provincial Government and in alignment with China's national healthcare reform, Perot Systems will establish the Regional Health Information Platform of Hunan Province, beginning in its capital city of Changsa.
Ben Zhou, MD, director of Perot Systems Healthcare China and Asia Pacific Perot Systems, says improving healthcare IT has the ability to improve healthcare overall in a country.
"We believe technology would transform the workflow and business process in healthcare delivery and care management, where clinicians, healthcare providers, and payers could focus more on people instead of process," Zhou says. "We know from our deep experience in the U.S. healthcare market that health IT can improve the quality of care, lower costs, and enhance safety."
Earlier this year, China announced a plan to provide all citizens with access to healthcare and invest 850 billion yuan ($125 billion) over the next three years to revamp the system. Under the plan, the government would have greater control of medical costs and access to care would improve through expanded insurance and cooperative medical programs. Rural areas are a particular focus of China's reform efforts, and the government promised to build 700,000 facilities to give every village a medical clinic and every county at least one hospital.
And this is only the beginning, as these are the first steps in a 10-year plan to reform the Chinese health system, according to the Chinese government. The ultimate goal is to extend medical services to all its citizens by 2020.
Much more here:
This is probably an overdue move – but at least it is happening!
Fifteenth we have:
By: Roy Mark
An ABI Research report predicts that about 15 million mobile and wireless health devices will be in use by early 2012 for the purpose of remotely monitoring the well-being of elderly or at-risk people, despite patchy insurance coverage for these systems. Using embedded cellular connectivity, so-called telehealth devices can collect vital signs wirelessly from a range of external devices such as weight scales and blood pressure cuffs.
Cellular modules built into end-use medical devices will be one of the primary drivers of wireless "telehealth" over the next 24 months, according to a study released July 22 by ABI Research. "Some 15 million such systems are forecast to be in use—mainly in North America—by early 2012," the company said in a news release.
North America, with its aging population, tech-oriented medical industry and the world's most expensive health care system, is central to the telehealth market and is expected to remain so over the report's forecast period, which extends through 2014.
Examples are found here:
This seems like a huge emerging market!
Sixteenth we have:
Lisa Eramo, for HealthLeaders Media, July 23, 2009
The incentive money is there to implement EHRs, but most HIM professionals and hospital executives know that deploying the technology is not as simple as pressing a button to go live.
Several industry experts have weighed in on this question: What is the single most important tip you could provide to someone regarding an effective EHR implementation? Their answers, summarized below, are quite telling.
Tip #1: Realize that the EHR will not solve your problems.
"EHRs do not necessarily fix poor processes, but rather, they tend to expose them. Create workflows that depict current scenarios and then revise those workflows once you've implemented the EHR. Use a team approach with IT, HIM, physicians, nurses, and other users of the EHR."
–Jean S. Clark, RHIA, CSHA, service line director for HIM at Roper St. Francis Healthcare in Charleston, SC
"One of the most significant mistakes a provider can make is to implement the EHR so it matches the current practices and workflow. This is a new tool, and providers must map how the business/medical practices must change to increase quality and efficiency before selecting a vendor. This will help them take advantage of the tools the technology has to offer and assist them in finding the right EHR that addresses the specific practice/business needs.
"As an example, one of my clients completed the business process analysis and examined what it needed to improve the practice. In this case, the EMR needed to accommodate sound prescription management, given the client operates a pain clinic. Without the initial assessment, the client would not have necessarily selected an EMR that suited its needs and allowed it to address quality and efficiency.
"The bottom line is it is generally far more important to complete the business analysis rather than jumping right to the implementation phase."
–Chris Apgar, CISSP, president of Apgar & Associates, LLC in Portland, OR
Much more here:
The five other tips are on the site! Interesting stuff and pretty sound.
Fifth last we have:
Health Data Management Magazine, July 1, 2009
Before implementing electronic health records, physician group practice administrators invariably hit a significant fork in the road. One path they can choose is the longstanding "do-it-yourself" approach of licensing and installing the application locally. The other path involves relying on a vendor to remotely host the software and provide related services.
Because both approaches have pros and cons, selecting the right strategy is a big challenge. Users of remotely hosted systems tout ease of use and instant access to software updates. They also point to dramatically lower start-up costs because there's no need to license and install software on a local server. But practices that have chosen to install EHR software locally cite concerns about remotely hosted systems that include the unreliability of Internet connections and the potential for disputes over ownership of data, among other factors. Locally installed software, they argue, offers speedier performance and peace of mind about control of valuable information.
Regardless of which path they choose, some clinics feel a new sense of urgency to implement electronic records. That's because the federal economic stimulus package provides financial incentives for practices that make "meaningful use" of such software. To gain the maximum financial incentives, practices must have qualifying records systems up and running by 2012.
As a result, some practices are taking a closer look at remotely hosted records systems because they can cut the upfront cost involved while awaiting incentive payments. The model often can speed up the timeline for implementation. And it offers predictable costs via monthly subscription fees.
But when they start investigating the hosted options, they face a bewildering array of approaches and terminologies that can leave even the most tech-savvy a bit dazed and confused. What was called an application service provider in the 1990s has morphed into "software-as-a-service" or "software-enabled service." Vendors offer widely varying opinions on the definitions of these three terms. And many refer to the broad realm of remotely hosted applications as "cloud computing," with the cloud referring to the Internet.
Vastly more here
Really good review of the issues.
Fourth last we have:
Thursday, July 23, 2009
by Karen Ignagni
It may be too soon to predict the outcome of the health care reform legislation now being debated in Congress, but the potential for improved system efficiencies associated with moving from a paper to an electronic system is clear. Passing reform will accelerate the trend already under way to move our health care system away from its dependence on costly and error-prone paper-based transactions.
Reform will encourage the adoption of coordinated IT strategies that enhance interoperability while protecting the confidentiality of information transmitted among patients, physicians and other care providers and insurers.
America's Health Insurance Plans recently joined with other key health care stakeholders -- the Advanced Medical Technology Association, the American Hospital Association, the Pharmaceutical Research and Manufacturers of America, and the Service Employees International Union -- in a June letter to President Obama affirming our earlier pledge to help bend the health care cost curve in order to make broad reform sustainable in the long run. Accelerating the deployment of health IT strategies is an essential cornerstone of that commitment.
Our members are working on two fronts: First, we are moving from paying for volume to paying for value and providing incentives to improve safety and shrink health care variation. Second, we have proposed major administrative simplification initiatives comparable in concept and scope to the introduction of ATMs in the banking system.
Our goal is a comprehensive overhaul of common administrative transactions between health care providers and health plans, including claims submissions, eligibility determination, claims status, payment authorization and remittance.
Much more here:
This is a useful summary of the issues Health IT may help addressing as the health system is reformed in the US.
Third last we have:
ByJuly 21, 2009 02:54 pm
VANCOUVER - British Columbians wanting to limit the amount of access health care providers have to their electronic health records can now apply for a disclosure directive from the Ministry of Health Services.
The privacy measure comes in advance of the first of B.C.’s eHealth projects -- a health information bank recording lab results -- which is to be enacted over the next few months.
Since Friday, patients have been able to request a form from the ministry that when completed will allow them to block health care providers from accessing their lab results.
A patient-provided keyword will enable temporary access by medical professionals if the patient wants the information made available in certain situations. Health care providers are also able to override the disclosure directive in emergencies.
A similar application process for other directives will be required for each new eHealth information bank that is unveiled over the next few years, including banks for diagnostic imaging and prescription histories.
NEHTA needs to keep a close eye on these sorts of plans and the forces that are driving these policy responses.
Second last for the week we have:
Contracts worth more than $100K must be tendered
Lee Greenberg, Canwest News Service
In the wake of the eHealth spending scandal, the Ontario government has brought in new rules for the hiring of consultants, but the opposition says the changes will not fix a system that allows the government to reward friends with contracts.
Under the new rules, which take effect immediately, government agencies must tender all contracts worth more than $100,000.
This hardly comes as a surprise!
Last, and very usefully, we have:
(PR Web Via Acquire Media NewsEdge) California eHealth Collaborative (CAeHC), announced a successful demonstration of five community-based health information exchange (HIE) projects in California using Nationwide Health Information Network (NHIN)-enabled gateways to securely exchange clinical health information to improve patient care.
San Francisco, CA (PRWEB) July 20, 2009 -- California eHealth Collaborative (CAeHC), announced a successful demonstration of five community-based health information exchange (HIE) projects in California using Nationwide Health Information Network (NHIN)-enabled gateways to securely exchange clinical health information to improve patient care. As part of the "Connecting California to Improve Patient Care" conference, held on Friday July 10 at the Krug Event Center in Healdsburg, California, CAeHC hosted the live demonstration. The 160 attendees at the conference included industry leaders with direct experience in successful deployment and operation of health information technology. Another 126 people logged into a webinar service to view the live demonstration.
Using recently released NHIN-enabled CONNECT and other NHIN-enabled Gateway software, five members of the California eHealth Collaborative demonstrated their production-ready ability to share patient clinical information for treatment purposes among regional health care provider networks in California. The public test demonstrated different scenarios showing how clinicians can provide improved care by obtaining critical clinical information from a patient's medical record even if the health data is located in another community.
Much more here:
This shows just how much progress is being made in bringing the US National HIE slowly into existence.
The key outcome is the following:
“The demonstration proved that any community based HIE or provider network that conforms to the NHIN standards can securely exchange health care information for treatment purposes. Providing physicians, hospitals and safety net providers with low cost access to data exchange technology is a key component of the Obama Administration's goal of achieving "meaningful use" of electronic health records (EHR) by 2014. "We are pleased that the California eHealth Collaborative is developing the ability for its member organizations to exchange data using NHIN protocols and conventions. We believe that secure, interoperable health information exchange is going to improve health care for millions of Americans when it is widely adopted," commented Ginger Price, program director for the Nationwide Health Information Network.”
And finally a warning:
By JONATHAN ZITTRAIN
EARLIER this month Google announced a new operating system called Chrome. It’s meant to transform personal computers and handheld devices into single-purpose windows to the Web. This is part of a larger trend: Chrome moves us further away from running code and storing our information on our own PCs toward doing everything online — also known as in “the cloud” — using whatever device is at hand.
Many people consider this development to be as sensible and inevitable as the move from answering machines to voicemail. With your stuff in the cloud, it’s not a catastrophe to lose your laptop, any more than losing your glasses would permanently destroy your vision. In addition, as more and more of our information is gathered from and shared with others — through Facebook, MySpace or Twitter — having it all online can make a lot of sense.
The cloud, however, comes with real dangers.
Some are in plain view. If you entrust your data to others, they can let you down or outright betray you. For example, if your favorite music is rented or authorized from an online subscription service rather than freely in your custody as a compact disc or an MP3 file on your hard drive, you can lose your music if you fall behind on your payments — or if the vendor goes bankrupt or loses interest in the service. Last week Amazon apparently conveyed a publisher’s change-of-heart to owners of its Kindle e-book reader: some purchasers of Orwell’s “1984” found it removed from their devices, with nothing to show for their purchase other than a refund. (Orwell would be amused.)
Much more here:
A must read! Heavens the blog is hosted in the Cloud!
There is an amazing amount happening. Enjoy!