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Loch-ing IT into health
While England waits for an information revolution the NHS in Scotland is pushing on with its second e-health strategy. Shanna Crispin reports from Edinburgh
15 September 2011
Scotland’s e-health strategy for 2011-17, released on Monday, describes itself as “ambitious” and to have “the citizen at its centre.”
It commits to joining up health and social care IT, increasing patient access to services, and improving support for people with long term conditions.
But a key concern of those making early responses to the strategy is how another commitment - to give clinicians more access to adequate information, when they need it - is going to be managed.
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AHRQ offers guide for avoiding tech-related medical errors
Posted: September 19, 2011 - 12:45 pm ET
Technology-induced medical errors—a problem that health IT stakeholders once were loathe to admit existed—now are part of mainstream discussions about the implications of health information technology.
So, what to do about them?
The Agency for Healthcare Research and Quality funded a study by the not-for-profit RAND Corp. to come up with some answers, which have been posted to AHRQ's website as a "Guide to Reducing Unintended Consequences of Electronic Health Records."
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AHRQ tests tool to identify, report health IT hazards
September 20, 2011 | Mary Mosquera
BETHESDA, MD – The Agency for Healthcare Research and Quality (AHRQ) is testing a tool among physicians to identify and report patient safety risks and near misses that may arise from the interaction of health IT with other systems or as a result of software design.
The health IT hazard manager will ultimately be scalable for use as a national clearinghouse of health IT-related risks, near misses and safety incidents so they can be compared and analyzed and systems corrected.
The hazard manager enables providers to classify and communicate the unintended consequences of establishing electronic health records (EHRs) and other health IT system so the problems can be fixed or controlled before they reach the patient, said Dr. James Walker, CIO of the Geisinger Health System, which is one of seven providers testing the usefulness and usability of the software. Four health IT vendors also participate in the pilot.
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Tuesday, September 20, 2011
Technology Listens as Doctors Keep Talking
How speech recognition software is changing so doctors don't have to.
Doctors don't like technology to get in their way, especially when they are dictating notes about patients. When the typewriter was invented, doctors found someone else to type their observations. When the tape recorder arrived, they mailed off tapes to transcription services.
With computers, speech recognition software has automated the work of turning a doctor's spoken words into text. The match has been good for doctors and also for Nuance Communications, based in Burlington, Mass., the market leader in medical dictation software, which last year generated about $450 million in sales of its Dragon speech software to the medical profession.
But now both Nuance and doctors are facing a threat to the way they do business: the spread of electronic medical records. Record-keeping software, heavily promoted by the government, is meant to improve patient care by getting doctors to record data in digital forms with computer-readable fields. The problem: doctors can't talk into the forms.
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Vendor Mines Data to Find Fragmented Patient Records
HDM Breaking News, September 20, 2011
Medicare/Medicaid transactions processor ABILITY Network Inc., formerly VisionShare, has introduced software to locate fragmented patient medical records or partial medical records on a real-time basis.
In addition to handling claims submission, eligibility, claim status and other transactions, the vendor offers a master patient index assessment service to identify duplicate records. It also resells records cleanup and verification services from consulting firm Just Associates.
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Telehealth Market To Hit $6.28 Billion By 2020
Disease prevalence, aging, and cost pressures seen as major factors in soaring demand for remote monitoring devices.
By Ken Terry, InformationWeek
September 20, 2011
The global telehealth market is headed for explosive growth over the next decade, according to a new report from InMedica, a division of IMS Research. The main reasons are increasing disease prevalence, an aging population, and governmental pressure to hold down healthcare costs.
"Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital," said Diane Wilkinson, research manager at InMedica, in a press release. "This has led to a growing trend for healthcare to be managed outside the traditional hospital environment, and as a result, there is a growing trend for patients to be monitored in their home environment using telehealth technologies once their treatment is complete."
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Blumenthal: Electronic health records, despite flaws, make doctors better
When Dr. David Blumenthal was appointed in 2009 by the Obama administration to coordinate national efforts to promote electronic health records, his wife thought it was “a huge failure of vetting,” he told an audience at a Schwartz Center for Compassionate Healthcare event last night. She manages their home computers. And he had not grown up as someone naturally interested in information technology.
Blumenthal, who left his federal role earlier this year and is a Harvard Medical School professor of health care policy, said that as he learned to use the electronic systems as a primary care physician at Massachusetts General Hospital in the early 2000s, he became a believer. Quite simply, he said, the electronic records made him a better doctor.
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HHS offers model privacy policy
Posted: September 22, 2011 - 12:30 pm ET
HHS has posted online a model privacy-policy form (PDF) that providers can use with patients whose individually identifiable medical information is posted to a personal health record.
The three-page document is available on the newly launched HealthIT.gov site for healthcare professionals and organizations as well as consumers.
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Accenture Completes Assessment for Texas Health Services Authority
September 07, 2011
Accenture Completes Assessment for Texas Health Services Authority
Project to Support Health Information Exchange and Interoperability
AUSTIN, TX; September 07, 2011 – Accenture (NYSE: ACN) has completed an assessment and plan to support implementation and interoperability standards for a state-wide health information exchange (HIE) for the Texas Health Services Authority (THSA).
Accenture identified the technology standards, architecture, and strategy to ensure consistency with state and federal requirements. The strategy will support interoperable health information management and exchange among unaffiliated organizations. Accenture also developed an enterprise architecture blueprint (EAB) for state-level HIE services and a plan to manage the EAB lifecycle to help ensure compatibility as standards evolve.
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Tracking diseases before they become outbreaks
WASHINGTON – The doctor doesn't think your sore throat is bad enough yet to order a strep test — unaware that a dozen people across town were diagnosed with strep throat just last week.
Doctors rarely know what bugs are brewing in the neighborhood until their own waiting rooms start to fill. Harvard University researchers reported Monday that getting them real-time information on nearby infections could improve patient care — for strep throat alone, potentially helping tens of thousands avoid either a delayed diagnosis or getting antibiotics they didn't need.
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Internet personal health record services slow to catch on
By John Przybys
LAS VEGAS REVIEW-JOURNAL
Posted: Sep. 18, 2011 | 9:39 p.m.
When did you have that appendectomy? What's the dosage of your blood pressure medication? What was your blood glucose level last Wednesday at noon?
Admit it: If the specifics of our own health history formed the basis of questions on "Who Wants to be a Millionaire?" most of us would be lucky to leave with the change in our pockets.
Keeping our health records -- and keeping them current -- always has been a challenge for busy consumers. But, as it has for so many other aspects of 21st century life, the Internet offers help, in the form of personal health record services.
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The day the EMR died
September 23, 2011 | Jeff Rowe, HITECH Watch
We end the week on a note that is semi-whimsical, and thus also at least half-serious.
This doctor writes of his reaction recently when, gasp, his computer froze when he was with a patient, and nothing he did managed to unlock it.
“It's never supposed to happen of course,” he begins. “But it happened today: the computer froze and could not be resurrected - a brief interlude to the daily clinic routine.”
What ensues is a comedy of bumblings as he – and his colleagues, as well, as it appears the entire practice is similarly locked up – tries to remember the steps he used to take pre-EMR.
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5 technologies every hospital should be using
September 20, 2011 | Michelle McNickle, Web Content Producer
With new health IT products springing up left and right, you may find yourself swimming in a sea of apps, updates, frameworks and systems.
Shahid Shah, enterprise software analyst and owner of the blog The Healthcare IT Guy, breaks it down to the five technologies every hospital should be using.
1. Single Sign-On (SSO) and common identity management with CCOW integration. "Start to phase out all applications that cannot meet common identity or SSO requirements," said Shah. The benefits of SSO are many, and include end-to-end user audit sessions to improve security reporting and auditing as well as significant password help desk cost savings. Likewise, Clinical Context Object Workgroup (CCOW) was designed to allow information sharing between clinical and health IT applications, Shah wrote on his blog, adding that "if a hospital can get their labs, EMR, and CPOE vendors to become CCOW compliant, they can share patient context instead of the user having to log in and out of each application separately."
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Electronic tool being piloted to give babies healthy start
September 22, 2011 | Molly Merrill, Associate Editor
WHITE PLAINS, NY – A new computerized family history tool aimed at allowing providers to take a detailed family history during the first prenatal visit, helping screen for inherited conditions and preterm birth, is being piloted by the March of Dimes and its partner organizations.
The March of Dimes, along with the National Coalition for Health Professional Education in Genetics, the Genetic Alliance and Massachusetts General Hospital will begin piloting their new family history electronic tool in several clinical settings, including a federally funded health center, putting family medical history at doctors' fingertips.
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CHIME: Don't tie metadata to meaningful use
Posted: September 21, 2011 - 6:00 pm ET
The College of Healthcare Information Management Executives is counseling federal health information technology policy makers to go slowly and not tie the use of metadata tagging to future meaningful-use criteria for electronic health-record incentive payments.
The Ann Arbor, Mich.-based association for chief information officers and other healthcare IT leaders, presented its opinion in a two-page response (PDF) to a formal advance notice of proposed rulemaking issued by the Office of the National Coordinator for Health Information Technology last month.
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Electronic Medical Records: A Silicon Valley Gold Rush
As doctors shift to digital data, companies see an opportunity akin to the social media boom
By Carol Eisenberg and Douglas MacMillan
Patients at Dr. Surinder Saini’s Newport Beach (Calif.) office are no longer given a clipboard upon arrival. Instead, they’re handed an iPad, where they tick off symptoms and allergies with the touch of a finger. A nurse uses her own iPad to plug in vital signs. In the exam room, Saini summons the data by tapping on his tablet and is aided by a list of likely diagnoses for, say, abdominal pain. “Most patients are amazed,” says the gastroenterologist. After the visit, Saini dictates his notes about the patient straight into the iPad, where they’re instantly transcribed and stored with other records.
Lured by new technologies and financial incentives from the U.S. government, doctors are throwing out stacks of paper and replacing them with handheld computers. The programs, made by heavyweights such as Allscripts (MDRX) and Cerner (CERN) as well as a raft of scrappy Silicon Valley startups, promise to save physicians time and help them make smarter decisions based on reliable data that are accessible online. An extra nudge comes from the 2009 economic stimulus, which set aside $27.4 billion to jump-start the switch to electronic records. The law offers doctors up to $63,750 over five years to help pay for the change if they can prove they’re making “meaningful use” of the systems by, say, submitting prescriptions electronically.
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DH and Intellect to stimulate market
22 September 2011 Lyn Whitfield
The Department of Health is to work with Intellect to stimulate the market for NHS IT, following this morning’s announcement that the national programme is to be “dismantled.”
A press release issued by the DH this morning says that a new partnership will “explore ways to stimulate a market place that will no longer exclude small and medium sized companies from participating in significant government healthcare IT projects.”
In response, Intellect issued a statement saying that it wanted the DH to focus on helping the market to deliver interoperable systems and to develop a "central focus on clinical information sharing in the NHS Information Strategy."
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80% of Americans worry about EHR privacy
September 22, 2011 — 8:13am ET | By Marla Durben Hirsch - Contributing Editor
A majority of Americans believe that electronic health records don't keep their medical records confidential, according to a new survey released by security firm SailPoint.
The survey, released September 20, found that 80 percent of Americans were concerned about moving their personal medical information to EHRs because of the risks of identity theft, exposure of their information on the Internet and the viewing of their records by those not directly related to their care. There also was concern that patients' private health conditions could be revealed to current or potential employers.
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Life-saving potential of EHRs already a realization
September 22, 2011 — 11:42am ET | By Marla Durben Hirsch - Contributing Editor
With all of the hoopla regarding how electronic heath records enable providers to earn incentive payments, it's heartening to read Health Affairs' new study that indicates meeting the computerized physician order entry (CPOE) standards for meaningful use may reduce the number of inpatient deaths due to heart attack or failure.
It's even better, however, to learn about real examples of EHRs improving the quality of care for patients.
For instance, the Peter Christensen Health Center, a small family practice located on the Lac du Flambeau reservation in Northern Wisconsin, found that implementing an EHR system enabled the clinic to track patient health data and provide more preventive care to its medically underserved community. It also improved patient care to such an extent that the life expectancy of its patients increased overall by 3.5 years, according to Tony Ryzinski, senior vice president of product management and marketing for Sage Healthcare, whose EHR system the clinic uses.
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Health Insurers Pool $1 Trillion in Claims Data to Spot Trends
September 20, 2011, 3:43 PM EDT
By Pat Wechsler
Sept. 20 (Bloomberg) -- Major health insurers are pooling more than $1 trillion in claims data and creating an institute to cull the statistics and identify the drivers of higher health spending.
More than 5 billion medical claims from Aetna Inc., Humana Inc., Kaiser Permanente and UnitedHealth Group Inc. will be collected and combined with government health claims data by the newly formed Health Care Cost Institute. The nonprofit group, which will likely be housed in Washington, will begin publishing semi-annual scorecards beginning next year on spending and consumption of health-care services and products.
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Revenue growth expected for image management systems in Europe
September 19, 2011 | Jamie Thompson, Web Editor
Medical imaging vendors in Europe are developing cardiology information systems (CIS) with advanced functionality and integration capabilities. New analysis from Frost & Sullivan suggests that this trend will spur revenue growth in the image management systems market.
The report, titled Clinical Information Systems in Europe – Cardiology, finds that in 2010 the market earned $54.5 million – a number that's estimated to reach $104.8 million by 2017.
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Medicare Smartcards Aim To Thwart Fraud, Waste
Bipartisan legislation would issue digital ID cards to 48 million Medicare enrollees, save $30 billion a year, say sponsors.
By Neil Versel, InformationWeek
September 20, 2011
A small but notably bipartisan group of lawmakers has introduced antifraud legislation that would create smartcards for Medicare enrollees and providers, a move that sponsors say could save $30 billion a year.
The proposed Medicare Common Access Card Act of 2011, introduced in the Senate (S. 1551) Sept. 13 by Sens. Mark Kirk (R-Ill.), Ron Wyden (D-Ore.), and Marco Rubio (R-Fla.), and in the House (H.R. 2925) Sept. 14 by Reps. Jim Gerlach (R-Pa.), Earl Blumenauer (D-Ore.), and John Shimkus (R-Ill.), would create a series of pilot programs to embed secure chips on Medicare identification cards. If the pilots were to prove successful after a year, the legislation would authorize distribution of smartcards to all beneficiaries of Medicare, currently about 48 million people and counting.
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HHS Text4Health, mHealth initiatives focus on smoking cessation
September 19, 2011 | Molly Merrill, Associate Editor
WASHINGTON – The U.S. Department of Health and Human Services announced new recommendations and initiatives on Monday to support health text messaging and mobile health (mHealth) programs.
In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives, which would deliver health information and resources to individuals via their mobile phones.
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Wednesday, September 21, 2011
With Watson, IBM Seeks to Sell Medical Knowledge
As medicine grows more complex, doctors are about to get an ambitious new assistant: the IBM computing system that defeated humans on Jeopardy!.
On the TV show House, Dr. Gregory House spends most of each hourlong episode wrestling with how to diagnose a patient who presents a bewildering set of symptoms.
IBM research engineer Steve Daniels jokes that he and his colleagues could turn House into a "five-second show." The doctors would simply ask, "Hey, Watson, what does this guy have?"
Watson is the supercomputing engine that beat the top two human competitors on the quiz show Jeopardy! this year, and Daniels is on the IBM team developing the software's first commercial application as what could be a stunningly useful diagnostic assistant for doctors. If it works as envisioned, Watson could help doctors identify what is afflicting any patient and suggest a course of treatment.
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- September 19, 2011, 3:57 PM ET
David Brailer: In Health Care, It’s Not All About the Big Ideas
Health-care venture capitalists are often drawn to the bold promise of recent medical advances, but those hunting for their next fund should emphasize solutions within close reach when pitching David Brailer, America’s first digital-health czar and the chairman of investment firm Health Evolution Partners.
A physician and entrepreneur, Brailer is all for innovation. Before launching Health Evolution in 2007, he practiced medicine, formed a company, CareScience Inc., and in 2004 under President Bush began helping craft a 10-year plan for widespread deployment of health IT.
With Health Evolution he backs funds and companies. In either case, he favors those pursuing technologies or services that solve medical-industry problems in the near term.
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http://www.govhealthit.com/news/building-mammoth-federal-ehr-tech-easy-part-julyaugust-2011?topic=32
Building a mammoth federal EHR: Tech is the easy part
September 18, 2011 | Tom Sullivan, Editor
The joint electronic health record (EHR) that the Department of Defense and VA are creating is not the first open source project a federal health agency has undertaken -- but it is the largest and arguably most important.
Consider the scope. According to VA CIO Roger Baker, "The key phrase is single common electronic health system. It's two large systems, and... the intention is to get to a point where there is a single repository for all the data related to an individual' s medical record whether generated in DoD or VA, and I might add through the nationwide health information network."
That admirably ambitious initiative will be composed of proprietary and open source code, many APIs and ATIs, myriad modules, perhaps hundreds of GUIs, beginning with the Tripler GUI currently being piloted in Hawaii, with North Chicago up next.
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VA-DOD details joint EHR interface for unified view
September 21, 2011 | Mary Mosquera
The Veterans Affairs and Defense Departments have provided details on how they will rely on a graphical user interface to knit together current aging and proprietary systems into their planned integrated electronic health record (iEHR), providing a common look and feel.
The shared interface will unify what the providers, employees and patients see even as functions and systems change on the backend throughout the iEHR’s phases of development.
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DH outlines plans for post-GPSoC world
19 September 2011 Fiona Barr
Less choice of system and mandated interoperability are likely to be the future of general practice IT, according to the Department of Health’s programme director for GP IT.
Kemi Adenubi told last week’s EMIS National User Group conference that no decisions had been made about future funding for GP IT when GP Systems of Choice ends in 2013.
“Nobody knows what’s going to happen in the new world and whether GPs are going to hold the money for GP systems and where choice is going to sit and that’s actually very empowering," she told conference goers.
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HIMSS urges Congress: Create a national patient identifier
September 16, 2011 — 3:52pm ET | By Ken Terry
HIMSS has asked Congress to support the development of a "nationwide patient identity solution" to promote interoperability and reduce errors related to mismatches between health data and patients. The association of health IT professionals also requested that Congress continue to support the adoption of health IT and not cut off funding for the government's electronic health record incentive program.
While there has been no overt effort to repeal the HITECH Act, which authorized up to $27 billion in incentives for Meaningful Use of EHRs, anything is considered possible as Congress moves to reduce the size of the federal budget deficit. So HIMSS' appeal is more than just pro forma.
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ONC announces metadata initiative
Posted: September 19, 2011 - 12:45 pm ET
The Office of the National Coordinator for Health Information Technology has announced the "soft launch" of an initiative to use metadata tagging to create patient consent-management controls over the movement of sensitive elements of patients' electronic records. The controls, the ONC noted in an e-mailed statement, are in keeping with recommendations of a December 2010 report by the President's Council of Advisors on Science and Technology.
The ONC's Office of the Chief Privacy Officer and the Office of Standards and Interoperability are leading the initiative, which aims to "address standards for the ability to exchange parts of a medical record (often called data segmentation)," according to the statement. The initiative is part of the ONC's Standards & Interoperability Framework. Johnathan Coleman was named as initiative coordinator and Jamie Parker as program manager.
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Skype service expands in south Devon
6 September 2011 Fiona Barr
Clinicians in south Devon are using Skype to hold consultations with patients from their own homes using patient-controlled record system supplier Patients Know Best.
Dr Mohammad Al-Ubaydli, founder of Patients Know Best, told EHI Primary Care that the project had been running for a couple of months in response to demand from clinicians working for South Devon Healthcare NHS Foundation Trust.
He added: “It started with speech and language therapy and now lots of other specialists are asking for it and clinicians are using it for pre-operative assessment and also for follow-up appointments.”
Use of the Skype software application for doctor-patient consultations was the subject of debate recently, after NHS medical director Sir Bruce Keogh said he wanted to give doctors’ incentives to carry out online consultations.
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HIMSS members rally on Capitol Hill, 'one voice, one vision' for HIT
September 16, 2011 | Diana Manos, Healthcare IT News
Against the backdrop of National Health IT Week, HIMSS members stormed Capitol Hill Sept. 15 with the intent to raise federal lawmakers' awareness of the importance of healthcare IT.
HIMSS representatives from all over the country rallied at the tenth annual HIMSS Policy Summit in preparation for meeting with their senators and representatives. The meeting was held at the Hyatt Regency Capitol Hill as part of National Health IT Week.
HIMSS’ mantra is “one voice, one vision.”
“With adequate knowledge and the right resources, we can work together to verbalize one voice with one vision, bettering our healthcare system through the use of health information technology,” said HIMSS leaders.
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Monday, September 19, 2011
Health IT Key to Patient Engagement, Better Care, Experts Say
WASHINGTON -- The Robert Wood Johnson Foundation, the Office of the National Coordinator for Health IT and the Agency for Healthcare Research and Quality have teamed up on a new initiative aimed at boosting patient engagement in an effort to improve the quality of health care in the U.S. Health care experts argue that patient empowerment is key to driving health care improvements.
Risa Lavizzo-Mourey, president and CEO of RWJF, said in a news release, "Patients need to understand that the quality of health care varies widely across the nation -- even within communities -- and there are things they can do to ensure they and their loved ones get the best care possible." She added that "it is critical that we all do our part as patients to take responsibility for our own health and care, like learning more about our illness, taking care of ourselves and following recommendations from our doctors and nurses."
At an event on Thursday marking the midpoint of the monthlong project, called Care About Your Care, health care leaders discussed how patients can play an important role in helping to address health care cost and quality issues.
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Monday, September 19, 2011
Mining Data for Better Medicine
The health battles of millions, recorded digitally, open a world of virtual research.
The antidepressant Paxil was approved for sale in 1992, the cholesterol-lowering drug Pravachol in 1996. Company studies proved that each drug, on its own, works and is safe. But what about when they are taken together?
By mining tens of thousands of electronic patient records, researchers at Stanford University quickly discovered an unexpected answer: people who take both drugs have higher blood glucose levels. The effect was even greater in diabetics, for whom excess blood sugar is a health danger.
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Enjoy!
David.
